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Safety profile of idursulfase administered at home in patients with mucopolysaccharidosis II enrolled in the Hunter Outcome Survey 参与Hunter结局调查的粘多糖病II型患者在家中使用idursulase的安全性
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-12 DOI: 10.1016/j.ymgme.2026.109734
Barbara K. Burton , Nathalie Guffon , Jane Roberts , Ans T. van der Ploeg , Simon A. Jones , Jennifer Audi , Jaco Botha , David A.H. Whiteman , Roberto Giugliani , Joseph Muenzer
The Hunter Outcome Survey (HOS) collected global, real-world data on the natural history of mucopolysaccharidosis II and its treatment with intravenous idursulfase. For eligible patients, home therapy offers a convenient alternative to in-clinic therapy. Using data in HOS as of January 2023, we provide an updated assessment of the safety/tolerability profile of home therapy with idursulfase. The analysis population comprised 333 patients who had received at least one home infusion and 708 patients who had never received home therapy. Median (10th percentile [P10], 90th percentile [P90]) age at home therapy start was 8.9 (2.9, 21.1) years. Median (P10, P90) ages at latest visit were 15.5 (7.7, 29.3) years in the home therapy group and 13.9 (5.2, 29.0) years in the no home therapy group. Patients received a median (P10, P90) of 6.0 (0.8, 12.0) years of home infusions after 1.8 (0.3, 8.7) years of in-clinic therapy, and these timings varied by geographic region. The infusion-related reaction (IRR) rate was 0.11/patient-year during home therapy, 0.13/patient-year for the in-clinic period for the same patients (first 6 months excluded), and 0.05/patient-year for patients who never received home therapy (first 6 months excluded). More than 60% of IRRs were categorized as mild. The adverse event (AE) rate was lower during home therapy (0.59 AEs/patient-year) than during the in-clinic period for the same patients (0.86 AEs/patient-year). Among patients who never received home therapy, the rate was 0.60 AEs/patient-year. Deaths occurred at a rate of 2.17 deaths/100 patient-years of home therapy and 3.60 deaths/100 patient-years among patients never treated with home therapy. No deaths were deemed related to treatment. The rate of missed infusions was 0.52/year during the home therapy period compared with 1.42/year during the in-clinic period for the same patients and 0.57/year for patients who never received home therapy. Our data indicate a similar safety/tolerability profile for intravenous idursulfase administered at home and in clinic in patients with mucopolysaccharidosis II.
Hunter结局调查(HOS)收集了全球关于II型粘多糖病的自然史和静脉注射伊杜硫酶治疗的真实数据。对于符合条件的患者,家庭治疗提供了一个方便的替代诊所治疗。使用截至2023年1月的HOS数据,我们提供了最新的idursulase家庭治疗的安全性/耐受性评估。分析人群包括333名至少接受过一次家庭输液的患者和708名从未接受过家庭治疗的患者。家庭治疗开始时的中位年龄(第10百分位数[P10],第90百分位数[P90])为8.9岁(2.9岁,21.1岁)。家庭治疗组的中位年龄(P10, P90)为15.5(7.7,29.3)岁,无家庭治疗组的中位年龄为13.9(5.2,29.0)岁。在1.8年(0.3年,8.7年)的临床治疗后,患者接受家庭输液的中位数(P10, P90)为6.0年(0.8年,12.0年),这些时间因地理区域而异。家庭治疗期间输液相关反应(IRR)率为0.11/患者-年,同一组患者(排除前6个月)临床期间为0.13/患者-年,未接受家庭治疗的患者(排除前6个月)为0.05/患者-年。超过60%的内部反应被归类为轻度。不良事件发生率(AE)在家庭治疗期间(0.59 AE /患者-年)低于临床治疗期间(0.86 AE /患者-年)。在从未接受过家庭治疗的患者中,发生率为0.60 ae /患者年。在接受家庭治疗的患者中,死亡率为2.17例/100患者-年,从未接受过家庭治疗的患者中死亡率为3.60例/100患者-年。没有死亡被认为与治疗有关。家庭治疗期间漏注率为0.52/年,而同一组患者在临床期间漏注率为1.42/年,未接受家庭治疗的患者漏注率为0.57/年。我们的数据表明,粘多糖病II型患者在家中和临床静脉注射伊杜硫酶具有相似的安全性/耐受性。
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引用次数: 0
L-fucose supplementation in a patient with global hypofucosylation and a mono-allelic variant in SLC35C1: Clinical improvement and assessment of biomarkers 在SLC35C1整体低聚焦和单等位基因变异的患者中补充L-焦点:临床改善和生物标志物评估
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-08 DOI: 10.1016/j.ymgme.2026.109727
Rodrigo T. Starosta , Miao He , Sara Gracie , Janell Kierstein , Christian Thiel , Nastassja Himmelreich , Yupeng Liu , Wenyue Zhang , Andrew C. Edmondson , Naomi Meeks , Austin Larson , Johan L.K. Van Hove , Aaina Kochhar
Fucosylation disorders are rare types of congenital disorders of glycosylation (CDG), the most common being SLC35C1-CDG, which is classically described as a leukocyte adhesion deficiency (hence the previous name of “leukocyte adhesion deficiency type II”) with dysmorphic features, short stature, and moderate-to-severe developmental and intellectual disabilities. In more recent years, several cases have been described of individuals with bi-allelic SLC35C1 variants and biochemical proof of hypofucosylation who had short stature, dysmorphic features, and intellectual disability, but no hematological abnormalities. In this article, we report a patient with growth faltering, neuroirritability, nystagmus, developmental delays, microcephaly, dysmorphic features, and hypogammaglobulinemia G. Biochemical investigations including serum N-glycan profiling, fucosylation-focused whole serum glycoprotein profiling, and serum lectin blots, all of which showed significant global hypofucosylation. Exome sequencing revealed a single likely pathogenic variant, SLC35C1 (NM_018389.4):c.503_505delTCT, p.(Phe168del), which was inherited from an unaffected mother. Whole genome sequencing with manual review of raw data did not reveal any second pathogenic variants; SLC35C1 mRNA sequencing was negative for changes in the second allele or allelic imbalance. The patient was started on L-fucose supplementation, with subsequent improvements in weight and head circumference, normalization of IgG levels, and remarkable developmental catch-up. Biochemically, there was an increase in abundance of previously decreased fucosylated glycan species in serum, especially Fuc1GlcNAc2Man3 (a glycan that is known to be enriched in neutrophils). In summary, we present here further evidence for the role of L-fucose supplementation in treating hypofucosylation disorders and suggest that IgG and fucosylated glycan species may be useful as biomarkers in this scenario, although further research is needed to validate them as such. It is likely that the early introduction of L-fucose in this patient may have led to the excellent developmental outcomes observed.
聚焦障碍是一种罕见的先天性糖基化障碍(CDG),最常见的是SLC35C1-CDG,经典描述为白细胞粘附缺陷(因此以前称为“白细胞粘附缺陷II型”),具有畸形特征,身材矮小,中重度发育和智力障碍。近年来,有几个案例描述了具有SLC35C1双等位基因变异和低聚焦的生化证据的个体,他们有身材矮小、畸形特征和智力残疾,但没有血液异常。在这篇文章中,我们报告了一位生长迟缓、神经过敏、眼球震颤、发育迟缓、小头畸形、畸形特征和低γ -球蛋白血症g的患者。生化调查包括血清n-聚糖分析、聚焦全血清糖蛋白分析和血清凝集素斑点,所有这些都显示出明显的低聚焦。外显子组测序显示一个可能的致病变异SLC35C1 (NM_018389.4):c。503_505delTCT, p.(Phe168del),遗传自未受影响的母亲。人工审查原始数据的全基因组测序未发现任何第二致病变异;SLC35C1 mRNA测序对第二等位基因的变化或等位基因失衡呈阴性。患者开始补充L-焦点,随后体重和头围改善,IgG水平正常化,发育明显恢复。生化方面,血清中先前减少的浓缩聚糖种类的丰度增加,特别是Fuc1GlcNAc2Man3(一种已知在中性粒细胞中富集的聚糖)。总之,我们在这里提出了L-聚焦补充在治疗低聚焦失调中的作用的进一步证据,并建议IgG和聚焦的聚糖物种可能在这种情况下作为生物标志物有用,尽管需要进一步的研究来验证它们的有效性。很可能在该患者中早期引入L-病灶可能导致了观察到的良好的发育结果。
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引用次数: 0
Navigating the complexity of managing coexisting inborn errors of metabolism and gender incongruence 引导复杂的管理共存的先天代谢错误和性别不一致。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-08 DOI: 10.1016/j.ymgme.2026.109729
Stephanie Newman , Srinitya Gannavarapu , Andrea C. Yu , Suzanne Ratko , Natalya Karp , Melanie Napier , Sue MacLean , Ranjit Singarayer , C.A. Rupar , Chitra Prasad
Clinical care and management of inborn errors of metabolism (IEM) are lifelong, complex, and resource-intensive for the healthcare team, patient, and families. A cohort of individuals with IEM who in addition have gender incongruence (GI) presents a unique challenge of patient care in current practices. Here, we discuss four patients with different IEM (phenylketonuria (PKU), 3-Hydroxy-3-methylglutaryl-CoA lyase deficiency (HMGCLD), ornithine transcarbamylase (OTC) deficiency that presented with GI either in their adolescence or adulthood. We review their IEM management and evolving expression of GI as we highlight the influence of various clinical and psychosocial stressors, including social acceptance and self-esteem. Significant research on the comorbidity between IEM and GI has not yet received attention in the literature. Here we aim to explore this underrepresented topic to encourage expansion of knowledge and how to navigate the complex management and support to individuals with IEM experiencing GI.
对于医疗团队、患者和家庭来说,先天性代谢错误(IEM)的临床护理和管理是终身的、复杂的和资源密集型的。一个队列的个体与IEM谁除了有性别不一致(GI)提出了一个独特的挑战,病人护理在当前的做法。在这里,我们讨论了四例不同的IEM(苯丙酮尿症(PKU), 3-羟基-3-甲基戊二酰辅酶a裂解酶缺乏症(HMGCLD),鸟氨酸转氨基甲酰基酶缺乏症(OTC),在青春期或成年期表现为GI。我们回顾了他们的IEM管理和GI的演变表达,因为我们强调了各种临床和社会心理压力源的影响,包括社会接受和自尊。关于IEM与GI合并症的重要研究尚未在文献中得到重视。在这里,我们的目标是探索这个未被充分代表的主题,以鼓励知识的扩展,以及如何在复杂的管理和支持中为经历GI的IEM患者导航。
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引用次数: 0
Disease or non-disease - about the identification of metabolic conditions that require no treatment 疾病或非疾病-关于不需要治疗的代谢状况的识别
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-07 DOI: 10.1016/j.ymgme.2026.109728
Jörn Oliver Sass , Johannes Häberle
Many inborn errors of metabolism (IEM) fulfil clinically relevant criteria and therefore are considered metabolic diseases. Typically, these conditions are due to impaired biosynthesis or breakdown of substances within specific pathways. However, there is also a growing number of metabolic conditions that are understood to represent merely biochemical phenotypes but are not linked to typical clinical findings and do not require treatment. The distinction between disease and non-disease is often not straightforward, but may have several nuances as well as overlaps, and may even be impossible to definitely classify as in many instances there is a continuum from non-disease to disease rather than categories. This article aims for deeper insights into the characteristics of conditions under discussion in this regard.
许多先天性代谢错误符合临床相关标准,因此被认为是代谢性疾病。通常,这些情况是由于在特定途径中受损的生物合成或物质的分解。然而,也有越来越多的代谢状况被理解为仅仅代表生化表型,但与典型的临床表现无关,也不需要治疗。疾病和非疾病之间的区别往往不是直截了当的,但可能有一些细微差别和重叠,甚至可能不可能明确分类,因为在许多情况下,从非疾病到疾病是连续的,而不是类别。本文旨在更深入地了解这方面所讨论的条件的特征。
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引用次数: 0
Metformin therapy to facilitate weight loss in adults with classic maple syrup urine disease 二甲双胍治疗促进体重减轻成人经典枫糖浆尿病。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-07 DOI: 10.1016/j.ymgme.2026.109730
Ashlin Rodrigues , Erin Sweigert , Donna Robinson , Makenna Kregel , Joelle Williamson , Alanna Koehler , Sean Schreckengast , Cara Forry , KaLynn Loeven , Erik Puffenberger , Alexis McVey , Christine Hendrickson , Andrea Patel , Anne Thomas , Sarah Thomas , Karlla W. Brigatti , Kevin Strauss , Grace Loudon Meier
Surplus calories are used to prevent protein catabolism in patients with maple syrup urine disease (MSUD) but can also lead to obesity and its related complications. At present, there are no evidence-based guidelines to inform weight loss strategies for patients with inborn errors of metabolism. Obese MSUD patients often resist weight loss due to the fear of metabolic decompensation, and their dietary options are limited by dependence on medical foods with fixed nutritional composition. We examined the anthropometric and biochemical effects of metformin in nine adults with severe (classic) MSUD who were instructed to reduce their calorie intake from medical food by 10%. Eight participants (67% female) completed the 52-week study; one withdrew following elective liver transplantation. Baseline median age, body mass index (BMI), and glycosylated hemoglobin (HgbA1C) were 33.8 years (IQR 25.3–41.6), 38.3 kg/m2 (IQR 31.6–42.2), and 5.3% (IQR 5.0–5.6), respectively. We titrated the daily metformin dose to a median of 2000 mg (IQR 1000–2000) by week 25, at which time seven (88%) participants successfully reduced total calories from medical food by 10%. Metformin was generally well tolerated. Diarrhea was the most common treatment-related complication, affecting 56% of participants, and limited dose escalation in two (22%) of them. No participant achieved the primary outcome of a > 10% BMI change. However, metformin therapy allowed for modest and significant reductions in weight (−2.8%, p = 0.023), BMI (−2.8 kg/m2, p = 0.016), and calories from medical food without altering plasma leucine concentrations or the proportion of dietary protein from intact sources. Serum triglycerides, high-density lipoprotein, and HgbA1C did not change over the study period. Based on these clinical observations, we conclude that classic MSUD patients can safely use metformin to aid weight loss without triggering metabolic instability, and may therefore tolerate more aggressive weight loss strategies.
多余的卡路里被用来防止枫糖尿病(MSUD)患者的蛋白质分解代谢,但也可能导致肥胖及其相关并发症。目前,尚无基于证据的指南来指导先天性代谢缺陷患者的减肥策略。肥胖的MSUD患者往往因为担心代谢失代偿而抵制减肥,并且由于依赖固定营养成分的医用食品,他们的饮食选择受到限制。我们检查了二甲双胍对9名患有严重(经典)MSUD的成年人的人体测量学和生化影响,这些人被指示将他们从医疗食品中摄入的卡路里减少10%。8名参与者(67%为女性)完成了为期52周的研究;1例择期肝移植后退出。基线中位年龄、体重指数(BMI)和糖化血红蛋白(HgbA1C)分别为33.8岁(IQR 25.3-41.6)、38.3 kg/m2 (IQR 31.6-42.2)和5.3% (IQR 5.0-5.6)。到第25周,我们将每日二甲双胍剂量滴定到2000毫克(IQR 1000-2000)的中位数,此时7名(88%)参与者成功地将医疗食品的总热量减少了10%。二甲双胍总体耐受良好。腹泻是最常见的治疗相关并发症,影响了56%的参与者,其中两人(22%)的剂量增加有限。没有参与者达到BMI改变100 - 10%的主要结局。然而,二甲双胍治疗可以适度而显著地减少体重(-2.8%,p = 0.023)、BMI (-2.8 kg/m2, p = 0.016)和来自医疗食品的卡路里,而不会改变血浆亮氨酸浓度或来自完整来源的膳食蛋白质的比例。血清甘油三酯、高密度脂蛋白和糖化血红蛋白在研究期间没有变化。基于这些临床观察,我们得出结论,典型MSUD患者可以安全地使用二甲双胍来帮助减肥,而不会引发代谢不稳定,因此可以耐受更积极的减肥策略。
{"title":"Metformin therapy to facilitate weight loss in adults with classic maple syrup urine disease","authors":"Ashlin Rodrigues ,&nbsp;Erin Sweigert ,&nbsp;Donna Robinson ,&nbsp;Makenna Kregel ,&nbsp;Joelle Williamson ,&nbsp;Alanna Koehler ,&nbsp;Sean Schreckengast ,&nbsp;Cara Forry ,&nbsp;KaLynn Loeven ,&nbsp;Erik Puffenberger ,&nbsp;Alexis McVey ,&nbsp;Christine Hendrickson ,&nbsp;Andrea Patel ,&nbsp;Anne Thomas ,&nbsp;Sarah Thomas ,&nbsp;Karlla W. Brigatti ,&nbsp;Kevin Strauss ,&nbsp;Grace Loudon Meier","doi":"10.1016/j.ymgme.2026.109730","DOIUrl":"10.1016/j.ymgme.2026.109730","url":null,"abstract":"<div><div>Surplus calories are used to prevent protein catabolism in patients with maple syrup urine disease (MSUD) but can also lead to obesity and its related complications. At present, there are no evidence-based guidelines to inform weight loss strategies for patients with inborn errors of metabolism. Obese MSUD patients often resist weight loss due to the fear of metabolic decompensation, and their dietary options are limited by dependence on medical foods with fixed nutritional composition. We examined the anthropometric and biochemical effects of metformin in nine adults with severe (classic) MSUD who were instructed to reduce their calorie intake from medical food by 10%. Eight participants (67% female) completed the 52-week study; one withdrew following elective liver transplantation. Baseline median age, body mass index (BMI), and glycosylated hemoglobin (HgbA1C) were 33.8 years (IQR 25.3–41.6), 38.3 kg/m<sup>2</sup> (IQR 31.6–42.2), and 5.3% (IQR 5.0–5.6), respectively. We titrated the daily metformin dose to a median of 2000 mg (IQR 1000–2000) by week 25, at which time seven (88%) participants successfully reduced total calories from medical food by 10%. Metformin was generally well tolerated. Diarrhea was the most common treatment-related complication, affecting 56% of participants, and limited dose escalation in two (22%) of them. No participant achieved the primary outcome of a &gt; 10% BMI change. However, metformin therapy allowed for modest and significant reductions in weight (−2.8%, <em>p</em> = 0.023), BMI (−2.8 kg/m2, <em>p</em> = 0.016), and calories from medical food without altering plasma leucine concentrations or the proportion of dietary protein from intact sources. Serum triglycerides, high-density lipoprotein, and HgbA1C did not change over the study period. Based on these clinical observations, we conclude that classic MSUD patients can safely use metformin to aid weight loss without triggering metabolic instability, and may therefore tolerate more aggressive weight loss strategies.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"147 3","pages":"Article 109730"},"PeriodicalIF":3.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of kidney transplantation in three patients with single large-scale mitochondrial DNA deletion syndromes 3例单大规模线粒体DNA缺失综合征患者肾移植的结果
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-07 DOI: 10.1016/j.ymgme.2026.109731
Steven H. Lang , Naiga Cottingham , Colleen Donnelly , Sarah Risen , Rossana Malatesta Muncher , Eileen D. Brewer , Jeffery M. Saland , Corrine Benchimol , Fernando Scaglia , Jaya Ganesh
Single large-scale mitochondrial DNA deletion syndromes (SLSMDS) are a clinical continuum of three classic discrete clinical syndromes: Pearson marrow-pancreas syndrome, Kearns-Sayre syndrome, and chronic progressive ophthalmoplegia. Kidney manifestations, including chronic kidney disease with progression kidney failure has emerged as significant cause of morbidity and mortality in SLSMDS. Despite this recognition, reports of kidney transplantation in this population are limited. Here, we describe outcomes of kidney transplantation in three patients with SLSMDS and kidney failure over a 1–2.5-year follow-up period. All three patients had multisystem involvement at the time of transplantation. In all three patients, surgery was uncomplicated without evidence of acute metabolic decompensation in the perioperative period and standard immunosuppressive protocols were well tolerated. One patient developed post-transplant lymphoproliferative disease at 9 months status-post transplant which was ultimately fatal. The two surviving patients remain with stable graft function and functional quality of life at 1- and 3.5-years post-transplant.
单大规模线粒体DNA缺失综合征(SLSMDS)是三种典型的离散临床综合征的临床连续体:Pearson骨髓-胰腺综合征、Kearns-Sayre综合征和慢性进行性眼麻痹。肾脏表现,包括进展性肾衰竭的慢性肾脏疾病已成为SLSMDS发病率和死亡率的重要原因。尽管认识到这一点,但在这一人群中进行肾移植的报道有限。在这里,我们描述了3例SLSMDS合并肾衰竭患者在1 - 2.5年随访期间的肾移植结果。所有3例患者在移植时均有多系统受累。在所有3例患者中,手术均不复杂,围手术期无急性代谢失代偿的证据,标准免疫抑制方案耐受性良好。1例患者在移植后9个月出现移植后淋巴增生性疾病,最终死亡。两名存活的患者在移植后1年和3.5年仍然具有稳定的移植物功能和功能生活质量。
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引用次数: 0
SWATH-MS reveals tissue-specific proteomic changes in a Leigh syndrome mouse model SWATH-MS揭示了Leigh综合征小鼠模型中组织特异性蛋白质组学的变化
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-02 DOI: 10.1016/j.ymgme.2025.109715
Sibonelo Glen Khumalo , Previn Naicker , Jeremie Zander Lindeque , Marianne Venter
Mutations in the Ndufs4 gene encoding the accessory subunit of complex I (CI) of the mitochondrial oxidative phosphorylation (OXPHOS) system, are the most common causes of Leigh Syndrome (LS). LS is a severe infantile neurodegenerative disorder characterised by various clinical phenotypes ranging from ataxia, cardiomyopathy, swallowing difficulties, visual problems, psychomotor regression to fatal respiratory failure. The mechanistic processes contributing to the onset and progression of these clinical manifestations remain poorly understood.
This study investigates tissue-specific proteomic changes in a mouse model of LS using quantitative proteomics as a hypothesis-generating technique. Six distinct tissues, namely three brain regions (brainstem, cerebellum, olfactory bulb), heart, kidney, and liver, were collected from the LS mouse model (Ndufs4 KO mice) and compared to wild type (WT) controls using SWATH-MS analysis as a data acquisition method. Functional enrichment analysis revealed distinct tissue-specific cellular responses which include a shift toward amino acid metabolism in the heart, increased mitochondrial translation in the kidney, and alterations in phase II detoxification pathways in the liver. Our results unravel candidate mechanisms for tissue-specific vulnerability and highlight the regulation of PTEN gene transcription as potential driver of neurodegeneration. These findings provide data-driven hypotheses for tissue-specific vulnerability in LS, highlighting potential mechanisms and therapeutic targets.
This study established a foundation for future hypothesis-driven research into the tissue-specific pathophysiology of mitochondrial disease.
编码线粒体氧化磷酸化(OXPHOS)系统复合体I (CI)副亚基的Ndufs4基因突变是Leigh综合征(LS)的最常见原因。LS是一种严重的婴儿神经退行性疾病,以各种临床表型为特征,从共济失调、心肌病、吞咽困难、视觉问题、精神运动退化到致命的呼吸衰竭。导致这些临床表现的发生和发展的机制过程仍然知之甚少。本研究利用定量蛋白质组学作为假设生成技术,研究了LS小鼠模型中组织特异性蛋白质组学的变化。从LS小鼠模型(Ndufs4 KO小鼠)中收集6个不同的组织,即3个脑区(脑干、小脑、嗅球)、心脏、肾脏和肝脏,并使用SWATH-MS分析作为数据采集方法与野生型(WT)对照进行比较。功能富集分析揭示了不同的组织特异性细胞反应,包括心脏向氨基酸代谢的转变,肾脏线粒体翻译的增加,肝脏II期解毒途径的改变。我们的研究结果揭示了组织特异性易感性的候选机制,并强调了PTEN基因转录的调控是神经变性的潜在驱动因素。这些发现为LS的组织特异性易感性提供了数据驱动的假设,突出了潜在的机制和治疗靶点。这项研究为未来线粒体疾病组织特异性病理生理学的假设驱动研究奠定了基础。
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引用次数: 0
Use of untargeted metabolomics for the study of pediatric neurometabolic disorders: A review 非靶向代谢组学在小儿神经代谢疾病研究中的应用综述
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-01 DOI: 10.1016/j.ymgme.2025.109711
Cathrin Lytomt Salvador , Paula Juliana Rodríguez-Soler , Cristian Irela Aranda , Aruna Gowdra , Helge Rootwelt , Alfonso de Oyarzábal Sanz

Background

The use of omics technologies in the field of neurometabolic disorders (NMD) continues to grow each year. Genomics is most widely used, but metabolomics is a powerful, complementary tool emerging in this field. With this review, we aim to assess the usefulness of untargeted metabolomics in the identification of new biomarkers in pediatric NMD for understanding the pathophysiology and for diagnostics and therapeutic strategies.

Methods

We conducted a review of the literature of untargeted metabolomics used for the study of NMD with principal manifestations in pediatric age, analyzing a total of 168 published works. Of those, only 47 fulfilled eligibility criteria and were reviewed as full text. The following variables and outcomes were assessed: type of study, disease, sample material, number of patients involved, choice of controls, methods used for untargeted metabolomics, principal metabolic findings, and pathophysiological/clinical implications.

Results

Small molecule disorders were the predominant group, accounting for 47 % of the NMD studies. Almost all the studies (93 %) were based on MS-technology, confirming its technical versatility and superior performance for metabolomic investigations. The most impactful and frequent findings were the detection of new biomarkers (55 %) and recognition of new pathophysiological mechanisms in known diseases (62 %).

Conclusions

Untargeted metabolomics is an unbiased and powerful tool in the field of NMD. Further technical improvements, larger databases and reduced analytical costs, combined with worldwide collaboration and standardization regarding preanalytical and analytical aspects, is expected to make this a cost-effective supplement to targeted analyses in the field of NMD. Are we finally entering the metabolomics era?
组学技术在神经代谢紊乱(NMD)领域的应用每年都在持续增长。基因组学是最广泛使用的,但代谢组学是一个强大的,互补的工具,在这一领域的新兴。在这篇综述中,我们旨在评估非靶向代谢组学在儿科NMD中鉴定新生物标志物的有用性,以了解病理生理学以及诊断和治疗策略。方法对以儿童年龄为主要表现的NMD的非靶向代谢组学研究文献进行综述,共分析168篇已发表的文献。其中只有47个符合资格标准,并作为全文审查。评估了以下变量和结果:研究类型、疾病、样本材料、涉及的患者数量、对照组的选择、非靶向代谢组学使用的方法、主要代谢发现和病理生理/临床意义。结果以小分子疾病为主,占NMD研究的47%。几乎所有的研究(93%)都基于质谱技术,证实了其技术的通用性和代谢组学研究的优越性能。最具影响力和最常见的发现是检测新的生物标志物(55%)和识别已知疾病的新病理生理机制(62%)。结论靶向代谢组学在NMD领域是一个公正有力的工具。进一步的技术改进、更大的数据库和更低的分析费用,加上分析前和分析方面的全球合作和标准化,预计将使其成为NMD领域有针对性分析的一种具有成本效益的补充。我们是否终于进入了代谢组学时代?
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引用次数: 0
Dietetic guidance for nutritional management of people with phenylketonuria receiving sepiapterin 苯丙酮尿患者接受头孢哌啶的营养管理的饮食指南。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-01 DOI: 10.1016/j.ymgme.2025.109705
Anita MacDonald , Kirsten Ahring , Alexa Bledsoe , Hiroki Fujimoto , Sara Giorda , Christian Kogelmann , Jessica Kopesky , Laura Nagy , Sara O'Neill , Alex Pinto , Soraia Poloni , Paige Roberts , Annemiek M.J. van Wegberg , Suzanne Hollander

Background/Objectives

Phenylketonuria (PKU) is an autosomal recessive inborn error of metabolism. If untreated, elevated blood phenylalanine (Phe) levels lead to neurological and behavioral impairments. Phe levels can be managed through a lifelong Phe-restricted diet; however, this can be challenging to maintain. Sepiapterin is an adjunct therapy for PKU that has shown efficacy in reducing blood Phe levels in both tetrahydrobiopterin (BH4)-responsive and BH4-non-responsive people with PKU in clinical trials. Practical guidance is needed for dietitians and other healthcare professionals supporting the dietary management of people with PKU who are initiating or receiving sepiapterin.

Methods

A group of international dietitians participated in a questionnaire, virtual meeting, and series of online sessions to develop globally applicable consensus recommendations to support individuals with PKU who are initiating or receiving sepiapterin treatment.

Results

The expert consensus group has issued 32 recommendations on using sepiapterin in PKU, covering the following topics: preparation, administration, response evaluation, dietary liberalization, protein substitute adjustment, healthy food choices, illness management, and if necessary, treatment cessation. These statements provide a framework to standardize care, clarify therapeutic effectiveness, guide natural protein escalation, reduce low-Phe protein substitutes, and maintain nutritional adequacy. By integrating pharmacological and dietary approaches, the guidance promotes equitable access, supports informed resource allocation, and reinforces the importance of patient-friendly education and ongoing monitoring.

Conclusions

This guidance is intended to inform clinical practice and foster consistency in the use of sepiapterin for individuals with PKU. The recommendations should evolve as new scientific evidence and growing clinical experience continue to shape best practice.
背景/目的:苯丙酮尿症(PKU)是一种常染色体隐性遗传的先天性代谢错误。如果不治疗,血液中苯丙氨酸(Phe)水平升高会导致神经和行为障碍。Phe水平可以通过终生限制Phe的饮食来控制;然而,这可能很难维护。sepapterin是一种PKU的辅助疗法,在临床试验中显示,在四氢生物蝶呤(BH4)应答和BH4无应答的PKU患者中,sepapterin都能有效降低血液中Phe水平。营养师和其他医疗保健专业人员需要提供实用的指导,以支持正在启动或接受sepapterin的PKU患者的饮食管理。方法:一组国际营养师参与了问卷调查、虚拟会议和一系列在线会议,以制定全球适用的共识建议,以支持正在开始或接受头孢哌啶治疗的PKU患者。结果:专家共识小组发布了32项关于在PKU中使用sepapterin的建议,涵盖以下主题:制备,给药,反应评估,饮食自由化,蛋白质替代品调整,健康食品选择,疾病管理,必要时停止治疗。这些声明为标准化护理、明确治疗效果、指导天然蛋白升级、减少低phe蛋白替代品和保持营养充足提供了框架。通过整合药理学和饮食方法,该指南促进了公平获取,支持知情的资源分配,并强调了对患者友好的教育和持续监测的重要性。结论:本指南旨在为临床实践提供信息,并促进PKU患者使用sepapterin的一致性。这些建议应随着新的科学证据和不断增长的临床经验继续形成最佳实践而不断发展。
{"title":"Dietetic guidance for nutritional management of people with phenylketonuria receiving sepiapterin","authors":"Anita MacDonald ,&nbsp;Kirsten Ahring ,&nbsp;Alexa Bledsoe ,&nbsp;Hiroki Fujimoto ,&nbsp;Sara Giorda ,&nbsp;Christian Kogelmann ,&nbsp;Jessica Kopesky ,&nbsp;Laura Nagy ,&nbsp;Sara O'Neill ,&nbsp;Alex Pinto ,&nbsp;Soraia Poloni ,&nbsp;Paige Roberts ,&nbsp;Annemiek M.J. van Wegberg ,&nbsp;Suzanne Hollander","doi":"10.1016/j.ymgme.2025.109705","DOIUrl":"10.1016/j.ymgme.2025.109705","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Phenylketonuria (PKU) is an autosomal recessive inborn error of metabolism. If untreated, elevated blood phenylalanine (Phe) levels lead to neurological and behavioral impairments. Phe levels can be managed through a lifelong Phe-restricted diet; however, this can be challenging to maintain. Sepiapterin is an adjunct therapy for PKU that has shown efficacy in reducing blood Phe levels in both tetrahydrobiopterin (BH<sub>4</sub>)-responsive and BH<sub>4</sub>-non-responsive people with PKU in clinical trials. Practical guidance is needed for dietitians and other healthcare professionals supporting the dietary management of people with PKU who are initiating or receiving sepiapterin.</div></div><div><h3>Methods</h3><div>A group of international dietitians participated in a questionnaire, virtual meeting, and series of online sessions to develop globally applicable consensus recommendations to support individuals with PKU who are initiating or receiving sepiapterin treatment.</div></div><div><h3>Results</h3><div>The expert consensus group has issued 32 recommendations on using sepiapterin in PKU, covering the following topics: preparation, administration, response evaluation, dietary liberalization, protein substitute adjustment, healthy food choices, illness management, and if necessary, treatment cessation. These statements provide a framework to standardize care, clarify therapeutic effectiveness, guide natural protein escalation, reduce low-Phe protein substitutes, and maintain nutritional adequacy. By integrating pharmacological and dietary approaches, the guidance promotes equitable access, supports informed resource allocation, and reinforces the importance of patient-friendly education and ongoing monitoring.</div></div><div><h3>Conclusions</h3><div>This guidance is intended to inform clinical practice and foster consistency in the use of sepiapterin for individuals with PKU. The recommendations should evolve as new scientific evidence and growing clinical experience continue to shape best practice.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"147 1","pages":"Article 109705"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Cover 2 / Ed. Board 封面2 /编印板
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-01 DOI: 10.1016/S1096-7192(26)00003-X
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期刊
Molecular genetics and metabolism
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