Lipid changes in the metabolome of a single case study with maple syrup urine disease (MSUD) after five days of improved diet adherence of controlled branched-chain amino acids (BCAA).

dc.contributor.author

Douglas, Teresa D

dc.contributor.author

Newby, L Kristin

dc.contributor.author

Eckstrand, Julie

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Wixted, Douglas

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Singh, Rani H

dc.date.accessioned

2022-12-07T20:03:21Z

dc.date.available

2022-12-07T20:03:21Z

dc.date.issued

2020-12

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2022-12-07T20:03:18Z

dc.description.abstract

Background

Distinguishing systemic metabolic disruptions in maple syrup urine disease (MSUD) beyond amino acid pathways is under-investigated, yet important to understanding disease pathology and treatment options.

Methods

An adolescent female (15 years) with MSUD without liver transplant, attended 2 study visits, 5 days apart. Medical diet adherence was determined based on her 3-day diet records and plasma branched-chain amino acid (BCAA) concentrations at both study visits. Plasma from a single age- and sex-matched control (MURDOCK Study, Duke University) and the case patient were analyzed with UPLC/MS/MS for intensity (m/z), annotated, and normalized against a median of 1 (Metabolon, Morrisville NC). Differences between case/control and 5-day comparisons were defined as ≥ ǀ 0.5 ǀ.

Results

434 lipid metabolites were identified across samples; 90 (20.7%) were higher and 120 (27.6%) lower in the MSUD case at baseline compared with control. By study visit 2, plasma BCAA had declined, while 48 (53%) of elevated lipids and 14 (11.7%) of lower lipid values had moved to within ǀ 0.5 ǀ of control. Most shifts towards control by day 5 were seen in long-chain fatty acid intermediates (42%) and acylcarnitines (32%). Although androgenic (28%) and bile acid (23%) metabolites increased towards control, neither reached control level by day 5.

Discussion

This comparative metabolomics study in a single MSUD case and healthy control suggests intrinsic differences in MSUD lipid metabolism potentially influenced by therapeutic diet. Findings suggest influences on hormone regulation, fatty acid oxidation, and bile acid synthesis, but further studies are needed to confirm an association between MSUD and lipid dysregulation.

Synopsis

Within 5 days of improved dietary adherence, a single MSUD case experienced substantial changes in lipid markers potentially related to changes in plasma branched-chain amino acids.
dc.identifier

S2214-4269(20)30097-5

dc.identifier.issn

2214-4269

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2214-4269

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https://hdl.handle.net/10161/26351

dc.language

eng

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Elsevier BV

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Molecular genetics and metabolism reports

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10.1016/j.ymgmr.2020.100651

dc.subject

Alloisoleucine

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BCKDH

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Branched-chain amino acids

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Branched-chain ketoacid dehydrogenase deficiency

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Isoleucine

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Leucine

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Lipids

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MSUD

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Maple syrup urine disease

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Metabolomics

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Mitochondria

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Peroxisomes

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Valine

dc.title

Lipid changes in the metabolome of a single case study with maple syrup urine disease (MSUD) after five days of improved diet adherence of controlled branched-chain amino acids (BCAA).

dc.type

Journal article

duke.contributor.orcid

Newby, L Kristin|0000-0002-6394-8187

duke.contributor.orcid

Wixted, Douglas|0000-0002-6128-7813

pubs.begin-page

100651

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Duke

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School of Medicine

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Staff

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Clinical Science Departments

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Institutes and Centers

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Medicine

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Medicine, Cardiology

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Duke Clinical Research Institute

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Duke Clinical & Translational Science Institute

pubs.publication-status

Published

pubs.volume

25

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