A novel small molecule approach for the treatment of propionic and methylmalonic acidemias

Propionic Acidemia (PA) and Methylmalonic Acidemia (MMA) are inborn errors of metabolism affecting the catabolism of valine, isoleucine, methionine, threonine and odd-chain fatty acids. These are multi-organ disorders caused by the enzymatic deficiency of propionyl-CoA carboxylase (PCC) or methylmal...

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Vydáno v:Molecular genetics and metabolism Ročník 133; číslo 1; s. 71 - 82
Hlavní autoři: Armstrong, Allison J., Collado, Maria Sol, Henke, Brad R., Olson, Matthew W., Hoang, Stephen A., Hamilton, Christin A., Pourtaheri, Taylor D., Chapman, Kimberly A., Summar, Marshall M., Johns, Brian A., Wamhoff, Brian R., Reardon, John E., Figler, Robert A.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.05.2021
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ISSN:1096-7192, 1096-7206, 1096-7206
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Shrnutí:Propionic Acidemia (PA) and Methylmalonic Acidemia (MMA) are inborn errors of metabolism affecting the catabolism of valine, isoleucine, methionine, threonine and odd-chain fatty acids. These are multi-organ disorders caused by the enzymatic deficiency of propionyl-CoA carboxylase (PCC) or methylmalonyl-CoA mutase (MUT), resulting in the accumulation of propionyl-coenzyme A (P-CoA) and methylmalonyl-CoA (M-CoA in MMA only). Primary metabolites of these CoA esters include 2-methylcitric acid (MCA), propionyl-carnitine (C3), and 3-hydroxypropionic acid, which are detectable in both PA and MMA, and methylmalonic acid, which is detectable in MMA patients only (Chapman et al., 2012). We deployed liver cell-based models that utilized PA and MMA patient-derived primary hepatocytes to validate a small molecule therapy for PA and MMA patients. The small molecule, HST5040, resulted in a dose-dependent reduction in the levels of P-CoA, M-CoA (in MMA) and the disease-relevant biomarkers C3, MCA, and methylmalonic acid (in MMA). A putative working model of how HST5040 reduces the P-CoA and its derived metabolites involves the conversion of HST5040 to HST5040-CoA driving the redistribution of free and conjugated CoA pools, resulting in the differential reduction of the aberrantly high P-CoA and M-CoA. The reduction of P-CoA and M-CoA, either by slowing production (due to increased demands on the free CoA (CoASH) pool) or enhancing clearance (to replenish the CoASH pool), results in a net decrease in the CoA-derived metabolites (C3, MCA and MMA (MMA only)). A Phase 2 study in PA and MMA patients will be initiated in the United States.
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A.A, S.C., B.H., M.O., B.J, B.W., J.R., R.F. designed research and discussed results. A.A. supervised the project and wrote the paper. B.H. and J.R. conceived the original idea. S.H. analyzed the data. C.H. and T.P. carried out the experiments and contributed to the interpretation of the results. K.C. and M.S. reviewed and advised the project. All authors provided critical feedback and helped shape the research, analysis and manuscript.
Author Contributions
ISSN:1096-7192
1096-7206
1096-7206
DOI:10.1016/j.ymgme.2021.03.001