Medium-chain acyl-CoA deficiency: outlines from newborn screening, in silico predictions, and molecular studies.
ScientificWorldJournal
; 2013: 625824, 2013.
Article
in En
| MEDLINE
| ID: mdl-24294134
ABSTRACT
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is a disorder of fatty acid oxidation characterized by hypoglycemic crisis under fasting or during stress conditions, leading to lethargy, seizures, brain damage, or even death. Biochemical acylcarnitines data obtained through newborn screening by liquid chromatography-tandem mass spectrometry (LC-MS/MS) were confirmed by molecular analysis of the medium-chain acyl-CoA dehydrogenase (ACADM) gene. Out of 324.000 newborns screened, we identified 14 MCADD patients, in whom, by molecular analysis, we found a new nonsense c.823G>T (p.Gly275∗) and two new missense mutations c.253G>C (p.Gly85Arg) and c.356T>A (p.Val119Asp). Bioinformatics predictions based on both phylogenetic conservation and functional/structural software were used to characterize the new identified variants. Our findings confirm the rising incidence of MCADD whose existence is increasingly recognized due to the efficacy of an expanded newborn screening panel by LC-MS/MS making possible early specific therapies that can prevent possible crises in at-risk infants. We noticed that the "common" p.Lys329Glu mutation only accounted for 32% of the defective alleles, while, in clinically diagnosed patients, this mutation accounted for 90% of defective alleles. Unclassified variants (UVs or VUSs) are especially critical when considering screening programs. The functional and pathogenic characterization of genetic variants presented here is required to predict their medical consequences in newborns.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Proportional Hazards Models
/
Genetic Testing
/
Neonatal Screening
/
Genetic Predisposition to Disease
/
Acyl-CoA Dehydrogenase
/
Lipid Metabolism, Inborn Errors
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Female
/
Humans
/
Male
/
Newborn
Country/Region as subject:
Europa
Language:
En
Journal:
ScientificWorldJournal
Journal subject:
MEDICINA
Year:
2013
Document type:
Article
Affiliation country:
Italy