Abstract
In the present paper two siblings are presented with clinical manifestations very similar to those of patients affected by neonatal adrenoleukodystrophy. In contrast to neonatal adrenoleukodystrophy patients, hepatic peroxisomes in these siblings were enlarged in size and not decreased in number. Accumulation of very-long-chain fatty acids (VLCFA) was associated with an isolated deficiency of the fatty acyl-CoA oxidase, the enzyme that catalyzes the first step of the peroxisomal β-oxidation. Plasma levels of di- and trihydroxy-coprostanoic acid, phytanic acid, and pipecolic acid were normal; furthermore, acyl-CoA:dihydroxyacetone phosphate acyltransferase activity in cultured fibroblasts was also found to be normal. The clinical, biochemical, and cytochemical features found in these two siblings are compared with those seen in two other disorders characterized by the absence of a decreased number of hepatic peroxisomes and the presence of VLCFA: (1) pseudo–Zellweger syndrome (deficiency of peroxisomal thiolase activity) and (2) X-linked childhood adrenoleukodystrophy (deficiency of activation of lignoceric acid). Review of the different biochemical defects possible in very-long-chain fatty-acid oxidation reveals different clinical pictures of varying severity, depending on the level at which the biochemical defect occurs.
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Selected References
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- Aubourg P., Scotto J., Rocchiccioli F., Feldmann-Pautrat D., Robain O. Neonatal adrenoleukodystrophy. J Neurol Neurosurg Psychiatry. 1986 Jan;49(1):77–86. doi: 10.1136/jnnp.49.1.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brown F. R., 3rd, McAdams A. J., Cummins J. W., Konkol R., Singh I., Moser A. B., Moser H. W. Cerebro-hepato-renal (Zellweger) syndrome and neonatal adrenoleukodystrophy: similarities in phenotype and accumulation of very long chain fatty acids. Johns Hopkins Med J. 1982 Dec;151(6):344–351. [PubMed] [Google Scholar]
- Chen W. W., Watkins P. A., Osumi T., Hashimoto T., Moser H. W. Peroxisomal beta-oxidation enzyme proteins in adrenoleukodystrophy: distinction between X-linked adrenoleukodystrophy and neonatal adrenoleukodystrophy. Proc Natl Acad Sci U S A. 1987 Mar;84(5):1425–1428. doi: 10.1073/pnas.84.5.1425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooper A., Hatton C., Sardharwalla I. B. Acid beta-mannosidase of human plasma: influence of age and sex on enzyme activity. J Inherit Metab Dis. 1987;10(3):229–233. doi: 10.1007/BF01800067. [DOI] [PubMed] [Google Scholar]
- Goldfischer S., Collins J., Rapin I., Coltoff-Schiller B., Chang C. H., Nigro M., Black V. H., Javitt N. B., Moser H. W., Lazarow P. B. Peroxisomal defects in neonatal-onset and X-linked adrenoleukodystrophies. Science. 1985 Jan 4;227(4682):67–70. doi: 10.1126/science.3964959. [DOI] [PubMed] [Google Scholar]
- Goldfischer S., Collins J., Rapin I., Neumann P., Neglia W., Spiro A. J., Ishii T., Roels F., Vamecq J., Van Hoof F. Pseudo-Zellweger syndrome: deficiencies in several peroxisomal oxidative activities. J Pediatr. 1986 Jan;108(1):25–32. doi: 10.1016/s0022-3476(86)80764-8. [DOI] [PubMed] [Google Scholar]
- Goldfischer S., Moore C. L., Johnson A. B., Spiro A. J., Valsamis M. P., Wisniewski H. K., Ritch R. H., Norton W. T., Rapin I., Gartner L. M. Peroxisomal and mitochondrial defects in the cerebro-hepato-renal syndrome. Science. 1973 Oct 5;182(4107):62–64. doi: 10.1126/science.182.4107.62. [DOI] [PubMed] [Google Scholar]
- Hashmi M., Stanley W., Singh I. Lignoceroyl-CoASH ligase: enzyme defect in fatty acid beta-oxidation system in X-linked childhood adrenoleukodystrophy. FEBS Lett. 1986 Feb 17;196(2):247–250. doi: 10.1016/0014-5793(86)80256-3. [DOI] [PubMed] [Google Scholar]
- Kelley R. I., Datta N. S., Dobyns W. B., Hajra A. K., Moser A. B., Noetzel M. J., Zackai E. H., Moser H. W. Neonatal adrenoleukodystrophy: new cases, biochemical studies, and differentiation from Zellweger and related peroxisomal polydystrophy syndromes. Am J Med Genet. 1986 Apr;23(4):869–901. doi: 10.1002/ajmg.1320230404. [DOI] [PubMed] [Google Scholar]
- Marler J. R., O'Neill B. P., Forbes G. S., Moser H. W. Adrenoleukodystrophy (ALD): clinical and CT features of a childhood variant. Neurology. 1983 Sep;33(9):1203–1205. doi: 10.1212/wnl.33.9.1203. [DOI] [PubMed] [Google Scholar]
- Moser A. E., Singh I., Brown F. R., 3rd, Solish G. I., Kelley R. I., Benke P. J., Moser H. W. The cerebrohepatorenal (Zellweger) syndrome. Increased levels and impaired degradation of very-long-chain fatty acids and their use in prenatal diagnosis. N Engl J Med. 1984 May 3;310(18):1141–1146. doi: 10.1056/NEJM198405033101802. [DOI] [PubMed] [Google Scholar]
- Moser H. W., Moser A. B., Powers J. M., Nitowsky H. M., Schaumburg H. H., Norum R. A., Migeon B. R. The prenatal diagnosis of adrenoleukodystrophy. Demonstration of increased hexacosanoic acid levels in cultured amniocytes and fetal adrenal gland. Pediatr Res. 1982 Mar;16(3):172–175. doi: 10.1203/00006450-198203000-00002. [DOI] [PubMed] [Google Scholar]
- Osmundsen H., Neat C. E., Borrebaek B. Fatty acid products of peroxisomal beta-oxidation. Int J Biochem. 1980;12(4):625–630. doi: 10.1016/0020-711x(80)90015-4. [DOI] [PubMed] [Google Scholar]
- Poll-The B. T., Saudubray J. M., Ogier H. A., Odièvre M., Scotto J. M., Monnens L., Govaerts L. C., Roels F., Cornelis A., Schutgens R. B. Infantile Refsum disease: an inherited peroxisomal disorder. Comparison with Zellweger syndrome and neonatal adrenoleukodystrophy. Eur J Pediatr. 1987 Sep;146(5):477–483. doi: 10.1007/BF00441598. [DOI] [PubMed] [Google Scholar]
- Poll-The B. T., Saudubray J. M., Ogier H., Schutgens R. B., Wanders R. J., Schrakamp G., van den Bosch H., Trijbels J. M., Poulos A., Moser H. W. Infantile Refsum's disease: biochemical findings suggesting multiple peroxisomal dysfunction. J Inherit Metab Dis. 1986;9(2):169–174. doi: 10.1007/BF01799455. [DOI] [PubMed] [Google Scholar]
- Poulos A., van Crugten C., Sharp P., Carey W. F., Robertson E., Becroft D. M., Saudubray J. M., Poll-The B. T., Christensen E., Brandt N. Prenatal diagnosis of Zellweger syndrome and related disorders: impaired degradation of phytanic acid. Eur J Pediatr. 1986 Dec;145(6):507–510. doi: 10.1007/BF02429053. [DOI] [PubMed] [Google Scholar]
- Roels F., Cornelis A., Poll-The B. T., Aubourg P., Ogier H., Scotto J., Saudubray J. M. Hepatic peroxisomes are deficient in infantile refsum disease: a cytochemical study of 4 cases. Am J Med Genet. 1986 Oct;25(2):257–271. doi: 10.1002/ajmg.1320250210. [DOI] [PubMed] [Google Scholar]
- Roels F., Goldfischer S. Cytochemistry of human catalase. The demonstration of hepatic and renal peroxisomes by a high temperature procedure. J Histochem Cytochem. 1979 Nov;27(11):1471–1477. doi: 10.1177/27.11.92501. [DOI] [PubMed] [Google Scholar]
- Schram A. W., Goldfischer S., van Roermund C. W., Brouwer-Kelder E. M., Collins J., Hashimoto T., Heymans H. S., van den Bosch H., Schutgens R. B., Tager J. M. Human peroxisomal 3-oxoacyl-coenzyme A thiolase deficiency. Proc Natl Acad Sci U S A. 1987 Apr;84(8):2494–2496. doi: 10.1073/pnas.84.8.2494. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schutgens R. B., Heymans H. S., Wanders R. J., van den Bosch H., Tager J. M. Peroxisomal disorders: a newly recognised group of genetic diseases. Eur J Pediatr. 1986 Feb;144(5):430–440. doi: 10.1007/BF00441734. [DOI] [PubMed] [Google Scholar]
- Schutgens R. B., Schrakamp G., Wanders R. J., Heymans H. S., Moser H. W., Moser A. E., Tager J. M., Bosch H. V., Aubourg P. The cerebro-hepato-renal (Zellweger) syndrome: prenatal detection based on impaired biosynthesis of plasmalogens. Prenat Diagn. 1985 Sep-Oct;5(5):337–344. doi: 10.1002/pd.1970050506. [DOI] [PubMed] [Google Scholar]
- Singh I., Moser A. E., Goldfischer S., Moser H. W. Lignoceric acid is oxidized in the peroxisome: implications for the Zellweger cerebro-hepato-renal syndrome and adrenoleukodystrophy. Proc Natl Acad Sci U S A. 1984 Jul;81(13):4203–4207. doi: 10.1073/pnas.81.13.4203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tager J. M., Van der Beek W. A., Wanders R. J., Hashimoto T., Heymans H. S., Van den Bosch H., Schutgens R. B., Schram A. W. Peroxisomal beta-oxidation enzyme proteins in the Zellweger syndrome. Biochem Biophys Res Commun. 1985 Feb 15;126(3):1269–1275. doi: 10.1016/0006-291x(85)90322-5. [DOI] [PubMed] [Google Scholar]
- Vamecq J., Van Hoof F. Implication of a peroxisomal enzyme in the catabolism of glutaryl-CoA. Biochem J. 1984 Jul 1;221(1):203–211. doi: 10.1042/bj2210203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wanders R. J., Saelman D., Heymans H. S., Schutgens R. B., Westerveld A., Poll-Thé B. T., Saudubray J. M., Van den Bosch H., Strijland A., Schram A. W. Genetic relation between the Zellweger syndrome, infantile Refsum's disease, and rhizomelic chondrodysplasia punctata. N Engl J Med. 1986 Mar 20;314(12):787–788. doi: 10.1056/NEJM198603203141216. [DOI] [PubMed] [Google Scholar]
- Wanders R. J., van Roermund C. W., de Vries C. T., van den Bosch H., Schrakamp G., Tager J. M., Schram A. W., Schutgens R. B. Peroxisomal beta-oxidation of palmitoyl-CoA in human liver homogenates and its deficiency in the cerebro-hepato-renal (Zellweger) syndrome. Clin Chim Acta. 1986 Aug 30;159(1):1–10. doi: 10.1016/0009-8981(86)90160-9. [DOI] [PubMed] [Google Scholar]
- Wanders R. J., van Roermund C. W., van Wijland M. J., Heikoop J., Schutgens R. B., Schram A. W., Tager J. M., van den Bosch H., Poll-Thé B. T., Saudubray J. M. Peroxisomal very long-chain fatty acid beta-oxidation in human skin fibroblasts: activity in Zellweger syndrome and other peroxisomal disorders. Clin Chim Acta. 1987 Jul 15;166(2-3):255–263. doi: 10.1016/0009-8981(87)90428-1. [DOI] [PubMed] [Google Scholar]
- Wolff J., Nyhan W. L., Powell H., Takahashi D., Hutzler J., Hajra A. K., Datta N. S., Singh I., Moser H. W. Myopathy in an infant with a fatal peroxisomal disorder. Pediatr Neurol. 1986 May-Jun;2(3):141–146. doi: 10.1016/0887-8994(86)90004-4. [DOI] [PubMed] [Google Scholar]