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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Inherit+Metab+Dis
2017 ; 40
(3
): 385-394
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Mutations in SLC25A22: hyperprolinaemia, vacuolated fibroblasts and presentation
with developmental delay
#MMPMID28255779
Reid ES
; Williams H
; Anderson G
; Benatti M
; Chong K
; James C
; Ocaka L
; Hemingway C
; Little D
; Brown R
; Parker A
; Holden S
; Footitt E
; Rahman S
; Gissen P
; Mills PB
; Clayton PT
J Inherit Metab Dis
2017[May]; 40
(3
): 385-394
PMID28255779
show ga
Mutations in SLC25A22 are known to cause neonatal epileptic encephalopathy and
migrating partial seizures in infancy. Using whole exome sequencing we identified
four novel SLC25A22 mutations in six children from three families. Five patients
presented clinical features similar to those in the literature including
hypotonia, refractory neonatal-onset seizures and developmental delay. However,
the sixth patients presented atypically with isolated developmental delay,
developing late-onset (absence) seizures only at 7 years of age. Abnormal
metabolite levels have not been documented in the nine patients described
previously. One patient in our series was referred to the metabolic clinic
because of persistent hyperprolinaemia and another three had raised plasma
proline when tested. Analysis of the post-prandial plasma amino acid response in
one patient showed abnormally high concentrations of several amino acids. This
suggested that, in the fed state, when amino acids are the preferred fuel for the
liver, trans-deamination of amino acids requires transportation of glutamate into
liver mitochondria by SLC25A22 for deamination by glutamate dehydrogenase;
SLC25A22 is an important mitochondrial glutamate transporter in liver as well as
in brain. Electron microscopy of patient fibroblasts demonstrated widespread
vacuolation containing neutral and phospho-lipids as demonstrated by Oil Red O
and Sudan Black tinctorial staining; this might be explained by impaired activity
of the proline/pyrroline-5-carboxylate (P5C) shuttle if SLC25A22 transports
pyrroline-5-carboxylate/glutamate-?-semialdehyde as well as glutamate.