Skin fibroblasts (CC-69) cultured from a patient with a unique syndrome of ketoacidosis associated with coenzyme A transferase (EC 2.8.3.5) deficiency showed an altered pattern of carbohydrate metabolism. These cells used glucose at a rate significantly less than controls (125 against 680 nmol/mg per hr). The oxidation of glucose to 14CO2 by these cells was also significantly di- 175. This change was not due to new enzyme formation because incubation with puromycin had no effect on the increased use of glucose. Mixing experiments demonstrated no transfer of a permeable inhibitor or activating substances. In view of the deficiency of coenzyme A transferase in these cells, the data suggest an indirect regulatory role for this enzyme in peripheral tissue glycolysis.Cultivation of human fibroblast cell strains provides a unique system for in vitro metabolic studies, and the use of explants from human skin biopsies has permitted the precise definition of several inborn errors of metabolism (1-3). Carbohydrate metabolism in cells in culture has been studied under various experimental conditions (4-7), and extensive reviews by Levintow and Eagle (8), Paul (9), and Cristofalo, Howard, and Kritchevsky (10) have documented that the metabolic processes of cells in tissue culture were consistently similar.Investigations in this laboratory have described an alteration in the oxidation of labeled glucose in the tissue culture fibroblasts (CC-69) derived from a skin biopsy from an infant with an unknown form of ketoacidosis (11,12). Subsequent reports have shown that the ketoacidosis in that infant was associated with a deficiency of Succinyl-CoA: 3-ketoacid CoA transferase (CoA transferase) (EC 2.8.3.5) (13,14). The continued study of this cell strain offers a unique opportunity for the understanding of cellular metabolism.It is the purpose of this report to further describe the alterations and irregularities in glucose metabolism in CC-69 cells and to contrast the metabolic processes in those cells with those in tissue culture fibroblast explants from normal controls. These data suggest an interrelationship between glucose metabolism and the oxidation of ketone bodies.
MATERIALS AND METHODSSkin fibroblasts were grown from skin obtained by a punch biopsy from an infant with severe ketoacidosis who was shown to have a deficiency in CoA transferase (14). Control cell lines were derived from the foreskins and diagnostic skin biopsies of children with no evidence of ketoacidosis. All fibroblasts were maintained in culture in 8-oz bottles in Eagle's Minimal Essential Medium (Grand Island Biological Co., Grand Island, N.Y.) with added glutamine (1.8 mM), penicillin (56 ug/ml), streptomycin (90,ug/ml), and fetal-calf serum (10%). Periodic tests for contamination by bacteria and mycoplasma were negative.For metabolic studies, cells were grown directly in 25-ml tissue culture reaction flasks (Kontes Glass Co., Vineland, N.J.), and were used 3-5 days after replating. After the medium was decanted and the adherent cell layer ri...