Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Plecko, B; Paul, K; Mills, P; Clayton, P; Paschke, E; Maier, O; Hasselmann, O; Schmiedel, G; Kanz, S; Connolly, M; Wolf, N; Struys, E; Stockler, S; Abela, L; Hofer, D.
Pyridoxine responsiveness in novel mutations of the PNPO gene.
Neurology. 2014; 82(16):1425-1433
Doi: 10.1212/WNL.0000000000000344
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- Führende Autor*innen der Med Uni Graz
- Plecko Barbara
- Co-Autor*innen der Med Uni Graz
- Hofer Doris
- Paschke Eduard
- Paul Karl
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- Abstract:
- To determine whether patients with pyridoxine-responsive seizures but normal biomarkers for antiquitin deficiency and normal sequencing of the ALDH7A1 gene may have PNPO mutations. We sequenced the PNPO gene in 31 patients who fulfilled the above-mentioned criteria. We were able to identify 11 patients carrying 3 novel mutations of the PNPO gene. In 6 families, a homozygous missense mutation p.Arg225His in exon 7 was identified, while 1 family was compound heterozygous for a novel missense mutation p.Arg141Cys in exon 5 and a deletion c.279_290del in exon 3. Pathogenicity of the respective mutations was proven by absence in 100 control alleles and expression studies in CHO-K1 cell lines. The response to pyridoxine was prompt in 4, delayed in 2, on EEG only in 2, and initially absent in another 2 patients. Two unrelated patients homozygous for the p.Arg225His mutation experienced status epilepticus when switched to pyridoxal 5'-phosphate (PLP). This study challenges the paradigm of exclusive PLP responsiveness in patients with pyridoxal 5'-phosphate oxidase deficiency and underlines the importance of consecutive testing of pyridoxine and PLP in neonates with antiepileptic drug-resistant seizures. Patients with pyridoxine response but normal biomarkers for antiquitin deficiency should undergo PNPO mutation analysis.
- Find related publications in this database (using NLM MeSH Indexing)
- Aldehyde Dehydrogenase - genetics
- Alleles -
- Animals -
- Brain Diseases, Metabolic - diagnosis
- Brain Diseases, Metabolic - drug therapy
- Brain Diseases, Metabolic - genetics
- CHO Cells -
- Chromosome Deletion -
- Cricetulus -
- DNA Mutational Analysis -
- Diagnosis, Differential -
- Drug Substitution -
- Electroencephalography - drug effects
- Epilepsy - drug therapy
- Epilepsy - genetics
- Exons - genetics
- Female -
- Gene Expression - genetics
- Genetic Carrier Screening -
- Humans -
- Hypoxia-Ischemia, Brain - diagnosis
- Hypoxia-Ischemia, Brain - drug therapy
- Hypoxia-Ischemia, Brain - genetics
- Infant, Newborn -
- Male -
- Mutation, Missense - genetics
- Pyridoxal Phosphate - therapeutic use
- Pyridoxaminephosphate Oxidase - deficiency
- Pyridoxaminephosphate Oxidase - genetics
- Pyridoxine - therapeutic use
- Seizures - diagnosis
- Seizures - drug therapy
- Seizures - genetics
- Spasms, Infantile - diagnosis
- Spasms, Infantile - drug therapy
- Spasms, Infantile - genetics
- Status Epilepticus - chemically induced