Pyruvate dehydrogenase (PDH) deficiency is caused by a number of pathogenic variants and the most common are found in the PDHA1 gene. The PDHA1 gene encodes one of the subunits of the PDH enzyme found in a carbohydrate metabolism pathway involved in energy production. Pathogenic variants of PDHA1 gene usually impact the α-subunit of PDH causing energy reduction. It potentially leads to increased mortality in sufferers. Potential treatments for this disease include dichloroacetate and phenylbutyrate, previously used for other diseases such as cancer and maple syrup urine disease. However, not much is known about their efficacy in treating PDH deficiency. Effective treatment for PDH deficiency is crucial as carbohydrate is needed in a healthy diet and rice is the staple food for a large portion of the Asian population. This review analysed the efficacy of dichloroacetate and phenylbutyrate as potential treatments for PDH deficiency caused by PDHA1 pathogenic variants. Based on the findings of this review, dichloroacetate will have an effect on most PDHA1 pathogenic variant and can act as a temporary treatment to reduce the lactic acidosis, a common symptom of PDH deficiency. Phenylbutyrate can only be used on patients with certain pathogenic variants (p.P221L, p.R234G, p.G249R, p.R349C, p.R349H) on the PDH protein. It is hoped that the review would provide an insight into these treatments and improve the quality of lives for patients with PDH deficiency.
Kajian ini dijalankan untuk menilai kemampuan kaedah penentuan jumlah homosisteina dalam plasma dengan menggunakan kromatografi cecair berprestasi tinggi jenis penukar ion (HPLC-IEC) dan membandingkan kaedah ini dengan kit komersil yang menggunakan kromatografi cecair berprestasi tinggi jenis fasa berbalik (HPLC-RPC). Validasi kaedah bagi penentuan jumlah homosisteina menggunakan HPLC-IEC telah dilakukan mengikut panduan yang dikeluarkan oleh Jabatan Standard Malaysia. Sebanyak 57 sampel daripada pesakit yang dihantar untuk penentuan jumlah homosisteina telah diuji secara serentak untuk menentukan korelasi antara kedua kaedah tersebut. Hasil kajian ini mendapati bahawa validasi kaedah ini telah memenuhi keperluan ISO MS 15189 dan kelinearan sehingga 500 µM dengan pekali penentuan, r2 ialah 0.999. Kepersisan yang dikaji pada aras normal (10 µM) dan aras berpenyakit/abnormal (60 µM) bagi kebolehulangan adalah masing-masing 3.2% dan 3.8% manakala bagi kebolehasilan semula masing-masing adalah 8.0% dan 8.3%. Had pengesanan dan had pengiraan yang diperoleh adalah 0.9274 dan 3.0912 µM. Keputusan ketepatan bagi kembalian semula adalah 92% dan bias adalah -8.6%. Perbandingan kaedah yang telah divalidasi dengan kit komersil menunjukkan hubungan korelasi yang kuat antara kedua-dua kaedah ini (y = 0.721x + 4.034; r = 0.978; p<0.05). Oleh yang demikian, kaedah penentuan jumlah homosisteina menggunakan HPLC-IEC menunjukkan kepersisan yang memuaskan dan korelasi yang kuat setara dengan kit komersil yang dianalisis menggunakan HPLC-RPC. Kaedah ini lebih menjimatkan kos reagen dan mampu menganalisis lebih banyak sampel jika dibandingkan dengan kit komersil. Ini sekaligus dapat membantu dalam diagnosis bagi penyakit kepincangan metabolisme terwaris (IEM) terutama dalam metabolisme homosisteina dengan tepat.
Background: Mucopolysaccharidoses type II (MPS II) is an X-linked lysosomal storage disease (LSD). It is due to mutation in IDS gene encoding iduronate-2-sulphatase (IDS) involved in the catabolism of dermatan sulphate and heparan sulphate. Currently, the treatments for MPS II patients are enzyme replacement therapy (ERT) and bone marrow transplantation (BMT). However, ERT is not effectively reducing the central nervous system manifestation and finding the suitable donor maybe quite challenging in BMT. Over the past decades, pharmacological chaperone has been an alternative approach for management of MPS II patient. Here, we described the in vitro profiling of small molecules in group of chondroitin/dermatan (CD) sulphate disaccharide, heparin oligosaccharides, unsaturated heparin disaccharides and 6-O-desulphated heparin oligosaccharide, using recombinant human iduronate-2-sulphatase (rhIDS). Twenty-one small molecule compounds with several concentrations were each screened by inhibition and thermal stability assays. Results: Our study revealed that condroitin dermatan trisulphate (CD3S), heparin tetrasaccharide (H4Sac), heparin octasaccharide (H8Sac) and heparin octadecasaccharide (H18Sac) showed high inhibition constant, Ki and low inhibition concentration, IC50 in comparison to others. In the thermal stability study, only rhIDS incubated with CD3S was found to preserve enzyme activity (20%) after incubated at 67oC. Conclusion: Overall, our experiments discovered that CD3S was able to bind, inhibit and chaperone rhIDS. These features suggest a potential pharmacological chaperone for MPS II.
Background: Serum protein electrophoresis (SPE) is a widely used laboratory technique to diagnose patients with multiple myeloma (MM) and other disorders related to serum protein. In patients with MM, abnormal monoclonal protein can be detected by SPE and further characterized using immunofixation electrophoresis (IFE). There are several semi-automated agarose gel-based systems available commercially for SPE and IFE. In this study, we sought to evaluate the analytical performance of fully automated EasyFix G26 (EFG26) and semi-automated HYDRASYS 2 SCAN (H2SCAN) for both SPE and IFE. Methods: Both instruments were operated according to manufacturer's instructions. Samples used include a commercially available normal control serum (NCS) and patients' specimens. The following were evaluated: precision and comparison studies for SPE, and reproducibility and comparison studies for IFE. Statistical analyses were performed using Microsoft Excel.Results: For SPE repeatability study, our results showed that EFG26 has higher coefficient of variation (%CV) compared with H2SCAN for both samples except for monoclonal component with %CV of 0.97% and 1.18%, respectively. Similar results were obtained for SPE reproducibility study except for alpha-1 (4.16%) and beta (3.13%) fractions for NCS, and beta fractions (5.36%) for monoclonal sample. Subsequently, reproducibility for IFE was 100% for both instruments. Values for correlation coefficients between both instruments ranged from 0.91 to 0.98 for the five classic bands. Conclusion:Both instruments demonstrated good analytical performance characterized by high precision, reproducibility and correlation.
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