Japanese patients with mitochondrial 3‑hydroxy‑3‑methylglutaryl‑CoA synthase deficiency: In vitro functional analysis of five novel HMGCS2 mutations

Yasuhiko Ago, Hiroki Otsuka, Hideo Sasai, Elsayed Abdelkreem, Mina Nakama, Yuka Aoyama, Hideki Matsumoto, Ryoji Fujiki, Osamu Ohara, Kazumasa Akiyama, Kaori Fukui, Yoriko Watanabe, Yoko Nakajima, Hidenori Ohnishi, Tetsuya Ito, Toshiyuki Fukao

Research output: Contribution to journalArticlepeer-review

Abstract

Mitochondrial 3‑hydroxy‑3‑methylglutaryl‑CoA synthase (HMGCS2) deficiency is a metabolic disorder caused by mutations in the HMGCS2gene. The present study describes the identification of four cases of HMGCS2 deficiency in Japan. Hepatomegaly and severe metabolic acidosis were observed in all cases. Fatty liver was identified in three cases, which suggested the unavailability of fatty acids. All patients presented with a high C2/C0 ratio, suggesting that the fatty acid oxidation pathway was normal during metabolic crisis. Genetic analyses revealed five rare, novel variants (p.G219E, p.M235T, p.V253A, p.S392L and p.R500C) in HMGCS2. To confirm their pathogenicity, a eukaryotic expression system and a bacterial expression system was adopted that was successfully used to obtain affinity‑purified HMGCS2 protein with measurable activity. Purified M235T, S392L and R500C proteins did not retain any residual activity, whilst the V253A variant showed some residual enzymatic activity. Judging from the transient expression experiment in 293T cells, the G219E variant appeared to be unstable. In conclusion, the present study identified five novel variants of HMGCS2 that were indicated to be pathogenic in four patients affected by HMGCS2 deficiency.

Original languageEnglish
Article number39
JournalExperimental and Therapeutic Medicine
Volume20
Issue number5
DOIs
Publication statusPublished - 11-2020

All Science Journal Classification (ASJC) codes

  • Immunology and Microbiology (miscellaneous)
  • Cancer Research

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