• Title/Summary/Keyword: Acyl CoA dehydrogenase

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A Case of asymptomatic Short-chain Acyl-CoA Dehydrogenase Deficiency (무증상의 경쇄 acyl-CoA 탈수소효소 결핍증 1례)

  • Lee, Hwapyung;Kim, Jinsup;Huh, Rimm;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.2
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    • pp.98-100
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    • 2015
  • Short-chain acyl-CoA dehydrogenase (SCAD) deficiency is a rare mitochondrial fatty-acid oxidation disorder that is inherited as an autosomal recessive pattern. SCAD deficiency is caused by mutations in the ACADS gene (Acyl-CoA Dehydrogenase, Short-chain, OMIM #606885), which encodes SCAD, the mitochondrial enzyme that catalyzes the first reaction in the beta-oxidation of fatty acids four to six carbons in length. Here, we describe one Korean pediatric case of SCAD deficiency, which was diagnosed during newborn screening through tandem mass spectrometry. An increased concentration of butyrylcarnitine was detected on the newborn screening test, and the urine organic acid analysis showed increased urinary excretion of ethylmalonic acid. The patient has been asymptomatic and has shown normal growth and development by 8 months of age without any intervention during follow-up period.

Short-chain Acyl-CoA Dehydrogenase Deficiency in an Asymptomatic Neonate (무증상 신생아에서 진단된 경쇄 acyl-CoA 탈수소효소 결핍증 1례)

  • Lee, Yeonhee;Kim, Jinsup;Huh, Rimm;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.2
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    • pp.93-97
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    • 2015
  • Short-chain acyl-CoA dehydrogenase (SCAD) deficiency is an autosomal recessive hereditary metabolic disorder of mitochondrial fatty acid beta-oxidation. Mutations in the ACADS gene cause short-chain acyl-CoA dehydrogenase deficiency, which is characterized by developmental delay, hypotonia, seizure, and hypoglycemia. Here, we describe one Korean pediatric case of SCAD deficiency, which was diagnosed during newborn screening by tandem mass spectrometry and confirmed by molecular analysis. The level of C4 was typically elevated 5.23 mg/dL (reference range <1.5 mg/dL). This patient had a homozygous mutation [c.1031A>G, p. E344G] in ACADS. Therefore, we present a case of SCAD deficiency in an otherwise healthy neonate and her subsequent development and growth over four years.

Ethylmalonic Encephalopathy

  • Yun, Hye-Ran;Han, Si-Hun;An, Yeong-Min;Sin, Yun-Jeong
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.1 no.1
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    • pp.5-12
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    • 2001
  • 아시아 및 한국에서 처음 발견된 3명의 소아 Ethylmalonic encephalopathy (EE) 환자들은 riboflavin을 이용한 치료법에 점진적인 호전을 보인 것으로 나타났다. Ethylmalonic aciduria가 3가지 효소-2-methyl-branched-chain acyl CoA dehydrogenase (2MBCAD), iso-valeryl CoA dehydrogenase (IVCAD), 그리고 short-chain acyl CoA dehydrogenase (SCAD) - 들의 부분적인 결함으로 생긴다는 가설하에 dehydrogenase (탈수효소)의 보조 효소인 riboflavin이 부분적으로 나마 치료 과정에서 어떤 역할을 수행하는지의 여부를 살펴보았다. 다음의 세 증례에서 riboflavin 혹은 coenzyme Q10을 병행하여 치료한 결과 인지 행동(cognitive behavior)과 만성 점액성 설사(chronic mucoid diarrhea)가 호전된 것으로 관찰되었다. 또한, 치료 후 운동 기능도 일부 호전되었다. EE의 질병 발생 기전이 현재까지 완전히 밝혀지지는 않았지만, 세 명의 EE 환자들의 치료경과를 관찰하여 위의 가설을 뒷받침 할 수 있었다.

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Compound heterozygous mutations of ACADS gene in newborn with short chain acyl-CoA dehydrogenase deficiency: case report and literatures review

  • An, Se Jin;Kim, Sook Za;Kim, Gu Hwan;Yoo, Han Wook;Lim, Han Hyuk
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.45-48
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    • 2016
  • Short-chain acyl-CoA dehydrogenase deficiency (SCADD) is a rare autosomal recessive mitochondrial disorder of fatty acid ${\beta}$-oxidation, and is associated with mutations in the acyl-CoA dehydrogenase (ACADS) gene. Recent advances in spectrometric screening for inborn errors of metabolism have helped detect several metabolic disorders, including SCADD, without symptoms in the neonate period. This allows immediate initiation of treatment and monitoring, so they remain largely symptomless metabolic disease. Here, we report a 15-month-old asymptomatic male, who was diagnosed with SCADD by newborn screening. Spectrometric screening for inborn errors of metabolism 72 hours after birth revealed an elevated butyrylcarnitine (C4) concentration of $2.25{\mu}mol/L$ (normal, < $0.99{\mu}mol/L$). Urinary excretion of ethylmalonic acid was also elevated, as detected by urine organic acid analysis. To confirm the diagnosis of SCADD, direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Subsequent sequence analysis revealed compound heterozygous missense mutations c.164C>T (p.Pro55Leu) and c.1031A>G (p.Glu344Gly) on exons 2 and 9, respectively. The patient is now growing up, unretarded by symptoms such as seizure and developmental delay.

Medium-chain Acyl-CoA Dehydrogenase Deficiency in an Asymptomatic Neonate (무증상 신생아에서 진단된 중쇄 acyl-CoA 탈수소효소 결핍증 1례)

  • Kyung, Yechan;Huh, Rimm;Kwun, Younghee;Lee, Jieun;Cho, Sung Yoon;Jin, Dong-Kyu;Lee, Jeongho;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.1
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    • pp.35-39
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    • 2015
  • Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the most common mitochondrial fatty acid oxidation disorder which is inherited as an autosomal recessive pattern. MCAD deficiency is caused by mutations in the ACADM gene; medium-chain acyl-CoA dehydrogenase gene (ACADM; OMIM 607008) on chromosome 1p31 which encodes MCAD, the mitochondrial enzyme which catalyzes the first reaction in beta-oxidation of fatty acids with medium-chain length. Here, we describe one Korean pediatric case of MCAD deficiency, which was diagnosed during newborn screening by tandem mass spectrometry and confirmed by molecular analysis. The level of hexanoyl (C6), octanoyl (C8), decenoyl (C10:1) carnitine, and C8/C2 ratio was elevated. Homogenous c.1189T>A (p.Tyr397Asn) mutation of ACADM gene was identified by direct sequencing. He has been asymptomatic and has shown normal growth and development by 25 months of age without any intervention. There was no episode of metabolic acidosis during follow-up period.

Effect of t:inseng Extracts on the Activities of Fatty Acid Metabolism Enzymes. (지방산 대사효소활성에 미치는 인삼 추출물의 영향)

  • 이영옥;정노팔
    • Journal of Ginseng Research
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    • v.9 no.1
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    • pp.112-118
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    • 1985
  • It has been known that the ginseng extracts activate the lipid metabolism in animal body. The experiments were undertaken to elucidate the effects of total, diol, and trial saponin of ginseng on the activities of acyl Co-A synthetase and hydroxyacyl Co-A dehydrogenase involved in fatty acid metabolism in normal albino rat liver. The acyl Co-A synthetase activity, in vitro, was increased by 20% with treatment of 2.5${\times}$10-3% total saponin, by 14% with 2.5${\times}$10-3% diol saponin, arid 30% with 2.5${\times}$10-4% triol saponin, respectively. And the enzyme activity was increased by 27% at 2 hours after intraperitoneal injection of total saponin. Hydroxyacyl Co-A dehydrogenase activity, in vitro, was increased by 77% with 10-4% total saponin, by 64% with 10-2% diol saponin, and by 72% with 10-3% triol saponin, respectively. Also, the enzyme activity, in vivo, was increased by 15.3% and 33% at 2 hours and 4 hours.

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Very Long Chain Acyl-coenzyme A Dehydrogenase Deficiency: A Review of Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment (장쇄 수산화 아세틸코에이 탈수소효소 결핍증에 대한 고찰)

  • Kang, Seokjin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.22 no.1
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    • pp.21-27
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    • 2022
  • Very long-chain acyl-coenzyme A dehydrogenase (VLCAD) deficiency (VLCADD) leads to a defective 𝛽-oxidation, specifically during prolonged fasting, infection, or exercise. Patients with VLCADD usually suffer from cardiomyopathy, hypoketotic hypoglycemia, hepatic dysfunction, exercise intolerance, muscle pain, and rhabdomyolysis, and sometimes succumb to sudden death. VLCADD is generally classified into three phenotypes: severe early-onset cardiac and multiorgan failure, hypoketotic hypoglycemia, and later-onset episodic myopathy. Diagnostic evaluation comprises acylcarnitine analysis, genetic analysis, and VLCAD activity assay. In the acylcarnitine analysis, the key metabolites are C14:1, C14:2, C14, and C12:1. A C14:1 level >1 mmol/L strongly suggests VLCADD. Various treatment recommendations are available for this condition. Dietary management includes decreasing fat content, increasing medium-chain triglyceride levels, and decreasing fasting periods. Supplementation with L-carnitine is controversial. Triheptanoin (a seven-carbon fatty acid triglyceride) treatment demonstrates improvement of cardiac functions. Bezafibrate may improve the quality of life of patients with VLCAD.

Identification of Novel Compound Heterozygous Mutations in the ACADS Gene of an Asymptomatic Korean Newborn with Short Chain Acyl-CoA Dehydrogenase Deficiency by Tandem Mass Spectrometry

  • Cheon, Chong-Kun;Choi, Hyung-Soon;Kim, Su-Yung;Yoo, Han-Wook;Kim, Gu-Hwan
    • Journal of Genetic Medicine
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    • v.9 no.1
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    • pp.42-46
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    • 2012
  • Short-chain acyl-CoA dehydrogenase deficiency (SCADD; OMIM # 201470) is an autosomal recessive inborn error of mitochondrial fatty acid ${\beta}$-oxidation, presenting with a variety of clinical signs and symptoms. Developmental delay, hypertonia or hypotonia, ketotic hypoglycemia, and epilepsy are most frequently reported. In general, patients diagnosed through newborn screening have shown normal growth and development in contrast to those diagnosed as a result of clinically initiated evaluations. Here, the case of an asymptomatic Korean newborn with SCADD identified by tandem mass spectrometry is reported. The patient showed an elevated concentration of butyrylcarnitine detected on newborn screening. Urinary excretion of ethylmalonic acid was elevated by urine organic acid analysis. To confirm the diagnosis of SCADD, a direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Genetic analysis of ACADS showed the following novel compound heterozygous missense mutations: c.277C>A (p.Leu93Ile) on exon3 and c.682G>A (p.Glu288Lys) on exon6. These results will provide further evidence of mutational heterogeneity for SCADD.