Johannes Zschocke Matthias Baumgartner Eva Morava Marc Patterson Shamima Rahman Verena Peters Editors JIMD Repor ts Volume 23 JIMD Reports Volume 23 . Johannes Zschocke Editor-in-Chief Matthias Baumgartner Eva Morava (cid:129) (cid:129) Marc Patterson Shamima Rahman (cid:129) Editors Verena Peters Managing Editor JIMD Reports Volume 23 Editor-in-Chief Editor JohannesZschocke MarcPatterson DivisionofHumanGenetics DivisionofChildandAdolescent MedicalUniversityInnsbruck Neurology Innsbruck MayoClinic Austria Rochester Minnesota Editor USA MatthiasBaumgartner DivisionofMetabolismandChildren’sResearchCentre Editor UniversityChildren’sHospitalZurich ShamimaRahman Zurich ClinicalandMolecularGeneticsUnit Switzerland UCLInstituteofChildHealth London Editor UK EvaMorava TulaneUniversityMedicalSchool ManagingEditor NewOrleans VerenaPeters Louisiana CenterforChildandAdolescent USA Medicine HeidelbergUniversityHospital Heidelberg Germany ISSN2192-8304 ISSN2192-8312 (electronic) JIMDReports ISBN978-3-662-47466-2 ISBN978-3-662-47467-9 (eBook) DOI10.1007/978-3-662-47467-9 SpringerHeidelbergNewYorkDordrechtLondon #SSIEMandSpringer-VerlagBerlinHeidelberg2015 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartofthematerialis concerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation,broadcasting,reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation,computersoftware,orbysimilarordissimilarmethodologynowknownorhereafterdeveloped. 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Printedonacid-freepaper Springer-VerlagGmbHBerlinHeidelbergispartofSpringerScience+BusinessMedia(www.springer.com) Contents ArginineFunctionallyImprovesClinicallyRelevantHumanGalactose-1-Phosphate Uridylyltransferase(GALT)VariantsExpressedinaProkaryoticModel......... 1 AnaI.Coelho,MatildeTrabuco,MariaJoa˜oSilva,IsabelTavaresdeAlmeida, PaulaLeandro,IsabelRivera,andJoa˜oB.Vicente EffectandTolerabilityofAgalsidaseAlfainPatientswithFabryDiseaseWhoWere TreatmentNa¨ıveorFormerlyTreatedwithAgalsidaseBetaorAgalsidaseAlfa ... 7 OzlemGoker-Alpan,KhanNedd,SumaP.Shankar,Yeong-HauH.Lien,NealWeinreb, AnnaWijatyk,PeterChang,andRickMartin Niemann-PickTypeC-2Disease:IdentificationbyAnalysisofPlasma Cholestane-3b,5a,6b-TriolandFurtherInsightintotheClinicalPhenotype ..... 17 J.Reunert,A.S.Lotz-Havla,G.Polo,F.Kannenberg,M.Fobker,M.Griese,E.Mengel, A.C.Muntau,P.Schnabel,O.Sommerburg,I.Borggraefe,A.Dardis,A.P.Burlina, M.A.Mall,G.Ciana,B.Bembi,A.B.Burlina,andT.Marquardt TheModulatoryEffectsofthePolymorphismsinGLA50-UntranslatedRegion UponGeneExpressionAreCell-TypeSpecific ............................. 27 SusanaFerreira,CarlosReguenga,andJoa˜oPauloOliveira ® TheKuvan AdultMaternalPaediatricEuropeanRegistry(KAMPER) MultinationalObservationalStudy:Baselineand1-YearDatainPhenylketonuria PatientsResponsivetoSapropterin...................................... 35 FriedrichK.Trefz,AniaC.Muntau,FlorianB.Lagler,FlavieMoreau,JanAlm, AlbertoBurlina,FrankRutsch,AmayaBe´langer-Quintana,andFranc¸oisFeillet PostmortemFindingsandClinicalCorrelatesinIndividualswithInfantile-Onset PompeDisease ...................................................... 45 LorenD.M.Pena,AlanD.Proia,andPriyaS.Kishnani ClinicalSeverityofPGK1DeficiencyDueToaNovelp.E120KSubstitutionIs ExacerbatedbyCo-inheritanceofaSubclinicalTranslocationt(3;14)(q26.33;q12), DisruptingNUBPLGene .............................................. 55 Dezso˝ David,L´ıgiaS.Almeida,MaristellaMaggi,CarlosArau´jo,StefanImreh, GiovannaValentini,Gyo¨rgyFekete,andIre´nHaltrich AbnormalNewbornScreeninginaHealthyInfantofaMotherwith UndiagnosedMedium-ChainAcyl-CoADehydrogenaseDeficiency............. 67 LiseAksglaede,MetteChristensen,JessH.Olesen,MortenDuno,RikkeK.J.Olsen, BrageS.Andresen,DavidM.Hougaard,andAllanM.Lund v vi Contents CobalaminCDiseaseMissedbyNewbornScreeninginaPatientwithLow CarnitineLevel...................................................... 71 RebeccaC.Ahrens-Nicklas,EsraSerdaroglu,ColleenMuraresku,andCanFicicioglu AdverseEffectsofGenisteininaMucopolysaccharidosisTypeIMouseModel ... 77 SandraD.K.Kingma,TomWagemans,LodewijkIJlst,JurgenSeppen, MarionJ.J.Gijbels,FritsA.Wijburg,andNaomivanVlies ExpandingtheClinicalandMagneticResonanceSpectrumofLeukoencephalopathy withThalamusandBrainstemInvolvementandHighLactate(LTBL)inaPatient HarboringaNovelEARS2Mutation..................................... 85 RobertaBiancheri,EleonoraLamantea,MariasavinaSeverino,DariaDiodato,Marina Pedemonte,DeniseCassandrini,AlexandraPloederl,FedericaTrucco,ChiaraFiorillo, CarloMinetti,FilippoM.Santorelli,MassimoZeviani,andClaudioBruno MitochondrialDNADepletionandDeletionsinPaediatricPatientswith NeuromuscularDiseases:NovelPhenotypes ............................... 91 TuomasKomulainen,Milla-RiikkaHautakangas,ReettaHinttala,SallaPakanen, VesaVa¨ha¨sarja,PetriLehenkari,Pa¨iviOlsen,Pa¨iviVieira,OutiSaarenpa¨a¨-Heikkila¨, JohannaPalmio,HannuTuominen,PietariKinnunen,KariMajamaa,HeikkiRantala, andJohannaUusimaa Medium-ChainAcyl-CoADehydrogenaseDeficiency:EvaluationofGenotype- PhenotypeCorrelationinPatientsDetectedbyNewbornScreening ........... 101 GwendolynGramer,GiselaHaege,JunminFang-Hoffmann,GeorgF.Hoffmann, ClausR.Bartram,KatrinHinderhofer,PeterBurgard,andMartinLindner Rhabdomyolysis-AssociatedMutationsinHumanLPIN1LeadtoLossof PhosphatidicAcidPhosphohydrolaseActivity ............................ 113 GeorgeG.Schweitzer,SaraL.Collier,ZhoujiChen,JamesM.Eaton, AnneM.Connolly,RobertC.Bucelli,AlanPestronk,ThurlE.Harris, andBrianN.Finck Dup-24bpintheCHIT1GeneinSixMexicanAmerindianPopulations........ 123 T.D.DaSilva-Jose´,K.J.Jua´rez-Rendo´n,J.A.Jua´rez-Osuna,A.Porras-Dorantes, A.Valladares-Salgado,M.Cruz,M.Gonzalez-Ibarra,A.G.Soto,M.T.Magan˜a-Torres, L.Sandoval-Ram´ırez,and Jose´ El´ıasGarc´ıa-Ortiz JIMDReports DOI10.1007/8904_2015_420 RESEARCH REPORT Arginine Functionally Improves Clinically Relevant Human Galactose-1-Phosphate Uridylyltransferase (GALT) Variants Expressed in a Prokaryotic Model Ana I. Coelho(cid:129)Matilde Trabuco(cid:129)Maria João Silva(cid:129) Isabel Tavares de Almeida(cid:129)Paula Leandro(cid:129) Isabel Rivera(cid:129)João B. Vicente Received:30October2014/Revised:28January2015/Accepted:09February2015/Publishedonline:27March2015 #SSIEMandSpringer-VerlagBerlinHeidelberg2015 Abstract Classic galactosemia is a rare genetic disease of Furthermore, it revealed that arginine presents a mutation- the galactose metabolism, resulting from deficient activity specific beneficial effect, particularly on the prevalent of galactose-1-phosphate uridylyltransferase (GALT). The p.Q188R and p.K285N variants, which led us to hypothe- current standard of care is lifelong dietary restriction of sizethatitmightconstituteapromisingtherapeuticagentin galactose, which however fails to prevent the development classic galactosemia. of long-term complications. Structural-functional studies demonstrated that the most prevalent GALT mutations give Introduction rise to proteins with increased propensity to aggregate in solution. Arginine is a known stabilizer of aggregation- Classic galactosemia (OMIM #230400) is a rare metabolic prone proteins, having already shown a beneficial effect in disease resulting from deficient activity of galactose-1- other inherited metabolic disorders. phosphate uridylyltransferase (GALT, EC 2.7.7.12), the Herein we developed a prokaryotic model of galactose second enzyme of the Leloir pathway (Fridovich-Keil and sensitivity that allows evaluating in a cellular context the Walter 2008). This inherited metabolic disorder is a mutations’ impact on GALT function, as well as the potentially lethal disease that develops in the neonatal potential effect of arginine in functionally rescuing clini- period, upon exposure to galactose in milk (Berry and cally relevant variants. Walter2012; Fridovich-Keil and Walter 2008).The present This study revealed that some hGALT variants, previ- standard of care is a lifelong galactose-restricted diet, ously described to exhibit no detectable activity in vitro, which, notwithstanding its irrefutable life-saving role in actually present residual activity when determined in vivo. the neonatal period, fails to prevent long-term cognitive, motor, and fertility impairments (Bosch 2006; Fridovich- Keil and Walter 2008; Waggoner et al. 1990), and thus Communicatedby:GerardT.Berry,M.D. intenseresearchhasbeendedicatedtothepursuitofamore Competinginterests:Nonedeclared effective therapy. : : : : A.I.Coelho: M.Trabu:co M.J.Silva I.T.deAlmeida ClassicgalactosemiaiscausedbymutationsintheGALT P.Leandro I.Rivera J.B.Vicente(*) gene, and more than 260 variations have already been MetabolismandGeneticsGroup,ResearchInstituteforMedicines described, the majority being missense mutations (>60%) (iMed.ULisboa),FacultyofPharmacy,UniversityofLisbon, (Calderon et al. 2007; Leslie et al. 1992). Structural and 1649-003Lisbon,Portugal e-mail:[email protected] functional studies demonstrated that clinically relevant : : : : GALT mutations result in misfolded protein variants M.J.Silva I.T.deAlmeida P.Leandro I.Rivera J.B.Vicente DepartmentofBiochemistryandHumanBiology,Facultyof (Coelho et al. 2014; McCorvie et al. 2013). A decrease in Pharmacy,UniversityofLisbon,1649-003Lisbon,Portugal thermal and conformational stability has been observed for A.I.Coelho severalGALTvariants(McCorvieetal.2013),althoughthe DepartmentofPediatrics/LaboratoryofGeneticMetabolicDiseases, most frequent GALT mutations actually affect the variants’ MaastrichtUniversityMedicalCenter,6202Maastricht, aggregation propensity, particularly the p.Q188R variant, TheNetherlands 2 JIMDReports responsible for >60% of galactosemic phenotypes (Coelho Table 1 Cell culture conditions to evaluate the ability of GALT variantstoalleviategalactosetoxicityandtheeffectofarginine et al. 2014; Suzuki et al. 2001). Argininehasbeenpreviouslydescribed astherapeutically Supplementationa beneficial for a pyruvate dehydrogenase complex-deficient patient whose biochemical and clinical symptoms signifi- Galactose Arginine cantly improved upon arginine aspartate intake (Silva et al. I (cid:3) (cid:3) 2009). A positive roleof argininehas also been observed in II + (cid:3) the peroxisome function of cultured cells from peroxisome III (cid:3) + biogenesis disorder patients with mutations in PEX1, PEX6, IV + + andPEX12(Berendseetal.2013).Furthermore,arginineisa long-recognized protein stabilizer that has been proposed to aAll cultures were grown in M9 minimal medium containing 1% exert an anti-aggregation effect by increasing the activation glycerolascarbonsource,supplementedwith100mMferroussulfate energy of protein aggregation (Baynes et al. 2005). In line and100mMzincsulfate with this, we sought to evaluate whether arginine exerts a protectivestabilizingeffecttowardsclinicallyrelevantGALT variants.Accordingly,thisstudyaimedtoevaluatetheeffect a starting optical density at 600 nm (OD ) of 0.05. At 600nm of arginine on rescuing variant GALT function and alleviat- OD600nm ¼ 0.3, 250 mM isopropyl-D-thiogalactoside ing galactose-induced toxicity in a prokaryotic model of (IPTG) was added to all cultures to induce protein galactose sensitivity. expression, as well as 25 mM arginine to cultures III and IV (Table 1).After 1 hofproteinexpression induction,1% galactose was added to cultures II and IV (Table 1). Materials and Methods Cultures growth was followed by hourly measurements of OD ,startingatinductiontime(t ¼ 0h)andupto9h. 600nm Cloning and Mutagenesis Growth curves were obtained from plotting OD 600nm from cultures I and II (Table 1) as a function of time The Escherichia (E.) coli K-12DgalT strain (JW0741-1;D (Figs. 1, 2, and 3 show representative graphics from galT730::kan), with a deletion of the endogenous galT multiple independent experiments). To directly evaluate gene, was purchased from the Coli Genetic Stock Center the arginine effect on the rescue from galactose toxicity, (Baba et al. 2006). The human GALT (hGALT) cDNA ratios r and r were calculated according to Eqs. (1) and arg sequence, including an N-terminal hexa-histidyl tag-encod- (2), respectively, and were plotted as a function of time ing sequence, was cut from the pET24b-based construct (Figs. 2 and 3 show representative graphics from multiple reported in (Coelho et al. 2014) with the BamHI and independent experiments). Recombinant production of HindIII restriction enzymes and cloned into the pTrcHisA hGALT and hPAH was confirmed by immunoblotting expression vector (Invitrogen). The mutations originating analysis, using, respectively, the anti-GALT and anti-His the studied variants (p.S135L, p.G175D, p.P185S, primary antibodies (sc-365577, Santa Cruz Biotechnology; p.Q188R, p.R231C, pR231H, p.K285N, and p.N314D) 27-4710-01, GE Healthcare Biosciences). wereintroducedbysite-directedmutagenesis,aspreviously described (Coelho et al. 2014), and confirmed by direct r ¼ OD600nmgalðIIÞ ; ð1Þ sequencing. As a negative control, we employed a OD600nmglyðIÞ pTrcHisA-based vector containing the cDNA encoding the OD galþargðIVÞ human enzyme phenylalanine hydroxylase (hPAH) (Lean- r ¼ 600nm : ð2Þ arg OD glyþargðIIIÞ dro et al. 2000). 600nm Cell Cultures and Growth Media Results and Discussion Non-transformed and wild-type hGALT-transformed E. coli DgalT were first grown in M9 minimal medium (Maniatis We have developed a prokaryotic model of galactose et al. 1982) containing either 1% glucose (with or without sensitivity using the E. coli DgalT strain, with a deletion 1% galactose), 1% glycerol, or 1% galactose as carbon oftheendogenousgalTgene(Babaetal.2006).Expressing sources, to evaluate the ability of wild-type hGALT to hGALT variants in this E. coli strain, and assaying the alleviate galactose toxicity. cultures sensitivity to galactose in the culture medium, Cultures expressing all hGALT variants and hPAH were allows evaluating the mutations severity in a cellular grown at 37(cid:1)C in M9 minimal medium (Maniatis et al. context, as well as testing stabilizing compounds. Previous 1982)containingglycerol(1%)assolecarbonsource,from studies reported a yeast model of galactose sensitivity JIMDReports 3 Fig.1 GalactosetoxicityisalleviatedbyexpressionofhumanGALT. was induced with 250 mM IPTG. After 1 h, vehicle (water, full Growth profiles of Escherichia coli DgalT transformed with vectors squares)or1%galactose(hollowsquares)wasaddedtothecultures, encoding wild-type hGALT (Panel a, positive control) or wild-type andthegrowthwasfollowedbyhourlymeasurementsofOD up 600nm hPAH (Panel b, negative control), in the absence or presence of to 9 h. Growth curves are representative graphics from several galactose.Bacteriaweregrownat37(cid:1)CinM9minimalmediumwith independent experiments (n¼12 for wild-type hGALTand n¼12 1% glycerol as carbon source. At OD =0.3, protein expression forPAH) 600nm Fig. 2 Arginine improves the function of p.Q188R, p.K285N, and (water) wasadded tothecultures. Panelsb,d, andfdepict theratio p.G175DhGALT.GrowthprofilesofEscherichiacoliDgalTexpress- curves for bacteria expressing, respectively, p.Q188R, p.K285N, and ingthep.Q188R,p.K285N,andp.G175DhGALTvariants(Panelsa, p.G175D hGALT, obtained by dividing, at each time point, the c, and e, respectively) in the absence or presence of galactose. OD inthepresenceorabsenceofgalactose(blackcircles,inthe 600nm Bacteria were grown at 37(cid:1)C in M9 minimal medium with 1% presenceof25mMarginine;hollowcircles,absenceofarginine).The glycerol as carbon source. At OD =0.3, protein expression was gray-shadedareasandthewhitearrowsdepicttheeffectofarginine 600nm inducedwith250mMIPTG.After1h,vehicle(water,fullsquares)or inimprovingtheabilityofthesevariantstoalleviategalactosetoxicity, 1% galactose (hollow squares) was added to the cultures, and the highlighted by white arrows. Growth curves are representative growthwasfollowedbyhourlymeasurementsofOD upto9h. graphics from several independent experiments (n¼4 for p.Q188R 600nm Simultaneously with water/galactose, 25 mM arginine or vehicle andn¼3forp.G175Dandp.K285N) (Riehman et al. 2001; Ross et al. 2004), which is however carbon source and galactose represents no toxicity in the technicallymoredemandingandtime-consumingcompara- presence of this hexose. This absent toxicity of galactose tively to E. coli. likely results from carbon catabolite repression exerted by glucose,whichrepressesthegalactoseuptakesystemsGalP Effect of Carbon Sources upon the Growth of Non- and Mgl (G€orke and St€ulke 2008; Misko et al. 1987; transformed and Wild-Type hGALT-Transformed E. coli Shimizu 2013; Steinsiek and Bettenbrock 2012). In the DgalT presence of glycerol, transported into E. coli through facilitated diffusion (Chu et al. 2002), the growth rate was Non-transformed and wild-type hGALT-transformed E. coli approximately half of that observed in the presence of DgalT were initially grown in the presence of different glucose, confirming that this polyol is not as efficient as carbonsources.Fornon-transformedE.coliDgalTcultured glucose as a carbon source, as previously described (Chu under glucose or glucose plus galactose, the growth curves et al. 2002). In the presence of galactose, the growth was were indistinguishable, since glucose is the preferred practically arrested, indicating the inability of this strain to