The response to l-carnitine and glycine therapy in isovaleric acidaemia
| العنوان: | The response to l-carnitine and glycine therapy in isovaleric acidaemia |
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| المؤلفون: | Ronald A. Chalmers, C. de Sousa, C. M. Weaver, T. E. Stacey, B. M. Tracey, D. Bradley |
| المصدر: | European Journal of Pediatrics. 144:451-456 |
| بيانات النشر: | Springer Science and Business Media LLC, 1986. |
| سنة النشر: | 1986 |
| مصطلحات موضوعية: | medicine.medical_specialty, Diet therapy, Urinary system, Carboxylic Acids, Glycine, Excretion, Hemiterpenes, Pharmacotherapy, Carnitine, Internal medicine, Valerates, medicine, Humans, Amino Acids, Pentanoic Acids, Amino Acid Metabolism, Inborn Errors, chemistry.chemical_classification, business.industry, Isovaleric acidaemia, medicine.disease, Combined Modality Therapy, Enzyme, Endocrinology, chemistry, Child, Preschool, Pediatrics, Perinatology and Child Health, Drug Therapy, Combination, Female, business, medicine.drug |
| الوصف: | The profound metabolic disturbances which occur in isovaleric acidaemia are due to the intramitochondrial accumulation of isovaleryl coenzyme A (CoA) with a consequent reduction in the availability of free CoA. Secondary carnitine insufficiency is also a feature of this and other disorders of organic acid metabolism. A patient who presented at 2.5 years of age was diagnosed using capillary GC-MS as having isovaleric acidaemia. She showed the full spectrum of abnormal organic acids previously associated with the 'neonatal' form of the disease despite her late presentation, indicating that it is inappropriate to refer to acute early and late onset forms of isovaleric acidaemia. Instead, a spectrum of disease exists, determined by environmental factors, residual enzyme activities and modifying effects of different phenotypes in different individuals. She also showed evidence of carnitine insufficiency. An oral challenge with L-carnitine resulted in the excretion of large amounts of urinary acylcarnitines which were shown by use of fast atom bombardment mass spectrometry to be primarily isovalerylcarnitine. Regular glycine supplementation caused no significant increase in urinary isovalerylglycine and had to be stopped because of side-effects after 5 days. An oral L-carnitine challenge during glycine supplementation resulted in a marked increase in isovalerylglycine excretion, again associated with the excretion of large amounts of isovalerylcarnitine. Carnitine acts by removing (detoxifying) intramitochondrial isovaleryl groups and, in the presence of glycine, it promotes the formation of isovalerylglycine. We believe L-carnitine supplementation is of value in the treatment of isovaleric acidaemia and that, in the present case, L-carnitine together with a moderate dietary restriction has proved to be the optimum form of therapy. |
| تدمد: | 1432-1076 0340-6199 |
| DOI: | 10.1007/bf00441737 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::399d17edeba789284e7aa78b60d911ca https://doi.org/10.1007/bf00441737 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....399d17edeba789284e7aa78b60d911ca |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321076 03406199 |
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| DOI: | 10.1007/bf00441737 |