ACOX2 deficiency: A disorder of bile acid synthesis with transaminase elevation, liver fibrosis, ataxia, and cognitive impairment

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Vilarinho S., SARI S., Mazzacuva F., Bilguvar K., Esendagli-Yilmaz G., Jain D., ...Daha Fazla

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, cilt.113, sa.40, ss.11289-11293, 2016 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 113 Sayı: 40
  • Basım Tarihi: 2016
  • Doi Numarası: 10.1073/pnas.1613228113
  • Dergi Adı: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.11289-11293
  • Anahtar Kelimeler: branched-chain acyl-CoA oxidase, bile acid metabolism, peroxisomal disorder, whole-exome sequencing, idiopathic liver disease, ACYL-COA OXIDASE, ZELLWEGER-SYNDROME, MUTATIONS, DISEASE, DIAGNOSIS, BIOSYNTHESIS, FAILURE, ONSET
  • Gazi Üniversitesi Adresli: Evet

Özet

Acyl CoA Oxidase 2 (ACOX2) encodes branched-chain acyl-CoA oxidase, a peroxisomal enzyme believed to be involved in the metabolism of branched-chain fatty acids and bile acid intermediates. Deficiency of this enzyme has not been described previously. We report an 8-y-old male with intermittently elevated transaminase levels, liver fibrosis, mild ataxia, and cognitive impairment. Exome sequencing revealed a previously unidentified homozygous premature termination mutation (p.Y69*) in ACOX2. Immunohistochemistry confirmed the absence of ACOX2 expression in the patient's liver, and biochemical analysis showed marked elevation of intermediate bile acids upstream of ACOX2. These findings define a potentially treatable inborn error of bile acid biosynthesis caused by ACOX2 deficiency.