Inherited Defects of Cobalamin Metabolism

Vitamin B12 ◽  
2017 ◽  
pp. 94-114 ◽  
Author(s):  
David Watkins ◽  
David S. Rosenblatt
Keyword(s):  
1976 ◽  
Vol 34 (3) ◽  
pp. 277-283 ◽  
Author(s):  
Huntington F. Willard ◽  
Lalit M. Ambani ◽  
Anita C. Hart ◽  
Maurice J. Mahoney ◽  
Leon E. Rosenberg

2020 ◽  
Vol 29 (13) ◽  
pp. 2109-2123 ◽  
Author(s):  
Jennifer L Sloan ◽  
Nathan P Achilly ◽  
Madeline L Arnold ◽  
Jerrel L Catlett ◽  
Trevor Blake ◽  
...  

Abstract Cobalamin C (cblC) deficiency, the most common inborn error of intracellular cobalamin metabolism, is caused by mutations in MMACHC, a gene responsible for the processing and intracellular trafficking of vitamin B12. This recessive disorder is characterized by a failure to metabolize cobalamin into adenosyl- and methylcobalamin, which results in the biochemical perturbations of methylmalonic acidemia, hyperhomocysteinemia and hypomethioninemia caused by the impaired activity of the downstream enzymes, methylmalonyl-CoA mutase and methionine synthase. Cobalamin C deficiency can be accompanied by a wide spectrum of clinical manifestations, including progressive blindness, and, in mice, manifests with very early embryonic lethality. Because zebrafish harbor a full complement of cobalamin metabolic enzymes, we used genome editing to study the loss of mmachc function and to develop the first viable animal model of cblC deficiency. mmachc mutants survived the embryonic period but perished in early juvenile life. The mutants displayed the metabolic and clinical features of cblC deficiency including methylmalonic acidemia, severe growth retardation and lethality. Morphologic and metabolic parameters improved when the mutants were raised in water supplemented with small molecules used to treat patients, including hydroxocobalamin, methylcobalamin, methionine and betaine. Furthermore, mmachc mutants bred to express rod and/or cone fluorescent reporters, manifested a retinopathy and thin optic nerves (ON). Expression analysis using whole eye mRNA revealed the dysregulation of genes involved in phototransduction and cholesterol metabolism. Zebrafish with mmachc deficiency recapitulate the several of the phenotypic and biochemical features of the human disorder, including ocular pathology, and show a response to established treatments.


2020 ◽  
Vol 6 (2) ◽  
pp. 33 ◽  
Author(s):  
Dimitar K. Gavrilov ◽  
Amy L. Piazza ◽  
Gisele Pino ◽  
Coleman Turgeon ◽  
Dietrich Matern ◽  
...  

The expansion of the recommend uniform screening panel to include more than 50 primary and secondary target conditions has resulted in a substantial increase of false positive results. As an alternative to subjective manipulation of cutoff values and overutilization of molecular testing, here we describe the performance outcome of an algorithm for disorders of methionine, cobalamin, and propionate metabolism that includes: (1) first tier screening inclusive of the broadest available spectrum of markers measured by tandem mass spectrometry; (2) integration of all results into a score of likelihood of disease for each target condition calculated by post-analytical interpretive tools created byCollaborative Laboratory Integrated Reports (CLIR), a multivariate pattern recognition software; and (3) further evaluation of abnormal scores by a second tier test measuring homocysteine, methylmalonic acid, and methylcitric acid. This approach can consistently reduce false positive rates to a <0.01% level, which is the threshold of precision newborn screening. We postulate that broader adoption of this algorithm could lead to substantial savings in health care expenditures. More importantly, it could prevent the stress and anxiety experienced by many families when faced with an abnormal newborn screening result that is later resolved as a false positive outcome.


2015 ◽  
Vol 241 (2) ◽  
pp. 173-184 ◽  
Author(s):  
Susana Langa ◽  
Juan L. Arqués ◽  
Pilar Gaya ◽  
Margarita Medina ◽  
Jose Mª Landete
Keyword(s):  

1984 ◽  
Vol 66 (2) ◽  
pp. 113-121 ◽  
Author(s):  
J. C. Linnell ◽  
D. M. Matthews

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