Evaluation of metabolic changes in acute intermittent porphyria patients by targeted metabolomics

Acute intermittent porphyria (AIP) is an inherited rare hepatic disorder due to mutations within the hydroxymethylbilane gene. AIP patients with active disease overproduce aminolevulinic acid (ALA) and porphobilinogen (PBG) in the liver which are exported inducing severe neurological attacks. Differ...

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Detalles Bibliográficos
Autores: Gómez Gómez, Àlex, Aguilera Peiró, Paula, Langohr, Klaus|||0000-0001-7075-9192, Casals Mercadal, Gregori, Pavón Solís, Cristina, Marcos del Aguila, Jose, To Figueras, Jordi, Pozo Mendoza, Oscar J.
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Politècnica de Catalunya (UPC)
Repositorio:UPCommons. Portal del coneixement obert de la UPC
Idioma:inglés
OAI Identifier:oai:upcommons.upc.edu:2117/371348
Acceso en línea:https://hdl.handle.net/2117/371348
https://dx.doi.org/10.3390/ijms23063219
Access Level:acceso abierto
Palabra clave:Mathematical statistics
acute intermittent porphyria
metabolomics
LC-MS/MS
tricarboxylic acid cycle
tryptophan
kynurenine
Estadística matemàtica--Aplicacions
Classificació AMS::62 Statistics::62P Applications
Àrees temàtiques de la UPC::Matemàtiques i estadística::Estadística matemàtica
Descripción
Sumario:Acute intermittent porphyria (AIP) is an inherited rare hepatic disorder due to mutations within the hydroxymethylbilane gene. AIP patients with active disease overproduce aminolevulinic acid (ALA) and porphobilinogen (PBG) in the liver which are exported inducing severe neurological attacks. Different hepatic metabolic abnormalities have been described to be associated with this condition. The goal of this research was to explore the metabolome of symptomatic AIP patients by state-of-the art liquid chromatography-tandem mass spectrometry (LC-MS/MS). A case versus control study including 18 symptomatic AIP patients and 33 healthy controls was performed. Plasmatic levels of 51 metabolites and 16 ratios belonging to four metabolic pathways were determined. The results showed that the AIP patients presented significant changes in the two main areas of the metabolome under study: (a) the tryptophan/kynurenine pathway with an increase of tryptophan in plasma together with increase of the kynurenine/tryptophan ratio; and (b) changes in the tricarboxylic acid cycle (TCA) including increase of succinic acid and decrease of the fumaric acid/succinic acid ratio. We performed a complementary in vitro study adding ALA to hepatocytes media that showed some of the effects on the TCA cycle were parallel to those observed in vivo. Our study confirms in plasma previous results obtained in urine showing that AIP patients present a moderate increase of the kynurenine/tryptophan ratio possibly associated with inflammation. In addition, it also reports changes in the mitochondrial TCA cycle that, despite requiring further research, could be associated with an energy misbalance due to sustained overproduction of heme-precursors in the liver.