Abstract
Biotinidase deficiency is an autosomal recessively inherited disorder that results in the inability to recycle the vitamin biotin. The disorder can cause neurologic and cutaneous abnormalities that can be treated effectively with pharmacologic doses of biotin. We identified 21 mutations that cause profound biotinidase deficiency in 37 symptomatic children (30 different probands and 7 siblings), as well as provide relevant biochemical and clinical information for each child. The two most common mutations (G98:d7i3 and R538C) were found in 31 of 60 alleles (52%), whereas the remainder of the alleles are accounted for by the 19 other unique mutations. Serum samples were available from 18 children, of these 11 had no detectable cross-reacting material (CRM) to antibody prepared against normal human serum biotinidase, three had reduced quantities of CRM and four had normal quantities of CRM in serum. All of these mutations result in complete absence of biotinyl-transferase activity in serum. Two polymorphisms were also identified in normal individuals. It is apparent that a child who inherits any of these mutations, either in the homozygous state or in combination, can develop the clinical features of the disorder if untreated. There are, however, no clear genotype/phenotype correlations that would allow for the prediction of the type, severity, or age of onset of symptoms.
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Abbreviations
- CRM:
-
cross-reacting material
- SSCA:
-
single-stranded conformational analysis
References
Bonjour J-P 1977; Biotin in man's nutrition and therapy-a review. Int J 47: 107
Wolf B. 1995; Disorders of biotin metabolism. In: Scriver CR, Beaudet AL. Sly WS. Valle D (eds) The Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill, New York. pp 3151–3180
Pispa J 1965; Animal biotinidase. Ann Med Exp Biol Fenn 43: suppl 5 1–39.
Hymes J. Fleischhauer K. Wolf B . 1995; Biotinylation of histones by human serum biotinidase: assessment of biotinyl-transferase activity in sera from normal individuals and children with biotinidase deficiency. Biochem Mol Med 56: 76–83.
Wolf B, Grier RE, Allen RJ, Goodman SI, Kien CL, 1983; Biotinidase deficiency: The enzymatic defect in late-onset multiple carboxylase deficiency. Clin Chim Acta 131: 273–281
Wolf B. Heard GS Weissbecke KA McVoy Secor Jr Girer RE Leshner RT 1985; Biotinidase deficiency: Initial clinical features and rapid diagnosis. Ann Neurol 18: 614–617.
Wolf B, Grier RE, Allen RJ, Goodman SI, Kien CL, Parker WD, Howell DM, Hurst DL, 1983; Phenotypic variation in biotinidase deficiency. J Pediatr 103: 233–237.
Cole H, Reynolds TR, Buck GB, Lockyer JM, Denson T, Spence JE, Hymes J, Wolf B 1994; Human serum biotinidase: cDNA cloning, sequence and characterization. J Biol Chem 269: 6566–6579.
Cole H, Weremowicz H, Morton CC. Wolf B 1994; Localization of serum biotinidase (BTD) to human chromosome 3 in band p25. Genomics 22: 662–663.
Pomponio RJ, Norrgard KJ, Reynolds TR, Hymes J, Buck GA. Wolf B 1997; Arg538 to Cys mutation in a CpG dinucleotide of the human biotinidase gene is the second most common cause of biotinidase deficiency in symptomatic children with biotinidase deficiency. Hum Genet 99: 506–512.
Pomponio RJ, Reynolds TR, Mandel H, Admont O, Buck GA, Wolf B 1997; Profound biotinidase deficiency caused by a point mutation that creates a downstream cryptic 3′ splice acceptor site within an exon of the human biotinidase gene. Hum Mol Genet 6: 739–745.
Pomponio RJ, Narasimhan V, Reynolds Buck GA, Povirk LF, Wolf B 1996; Deletion/insertion mutation that causes biotinidase deficiency may result from the formation of a quasipalindromic structure. Hum Mol Genet 5: 1657–1661.
Pomponio RJ, Reynolds TR, Cole H, Buck GA, Wolf B 1995; Mutational “hotspot” in the human biotinidase gene as a cause of biotinidase deficiency. Nat Genet 11: 96–98.
Neitzel H 1986; A routine method for the establishment of permanent growing lymphoblastoid cell lines. Hum Genet 73: 320–326.
Hart PS, Hymes J, Wolf B 1992; Biochemical and immunological characterization of serum biotinidase in profound biotinidase deficiency. Am J Hum Genet 50: 126–136.
Orita M, Suzuki Y, Sekiya T, Hayashi K 1989; Rapid and sensitive detection of point mutations and DNA polymorphisms using the polymerase chain reaction. Genomics 5: 874–879.
Orita M, Iwahana H, Kanazawa H, Hayashi K 1989; Detection of polymorphisms of human DNA by gel electrophoresis as single-stranded conformation polymorphisms. Proc Natl Acad Sci USA 86: 2766–2770.
Norrgard KJ, Pomponio RJ, Swango KL, Hymes J, Reynolds TR, Buck GA, Wolf B 1997; Double mutation (A171T and D444H) is a common cause of profound biotinidase deficiency in children ascertained by newborn screening in United States. Hum Mutat (in press)
Hart PS, Hymes J, Wolf B 1991; Isoforms of human serum biotinidase. Clin Chim Acta 197: 257–264.
Wolf B 1991; Worldwide survey of neonatal screening for biotinidase deficiency. J Inherited Metab Dis 14: 923–927.
Bousounis DP, Camfield PR, Wolf B 1993; Reversal brain atrophy with biotin treatment in biotinidase deficiency. Neuropediatrics 24: 213–217.
Diamantopoulos N, Painter MJ, Wolf B, Heard GS, Roe C 1986; Biotinidase deficiency: accumulation of lactate in the brain and response to physiologic doses of biotin. Neurology 36:1107-1109. Neurology 36: 1107–1109.
Burton B, Roach ES, Wolf B, Weissbecker KA 1987; Sudden death associated with biotinidase deficiency. Pediatrics 79: 482–483.
Thoene J, Baker H, Yoshino M, Sweetman L 1981; Biotin responsive carboxylase deficiency associated with subnorml plasma and urinary biotin. N Engl J Med 304: 817–820.
Cowan MJ, Wana DW, Packman S, Ammann AJ, Yoshino M, Sweetman L, Nyhan WL 1979; Multiple biotin-dependent carboxylase deficiencies associated with defects in T-cell and B-cell immunity. Lancet 2: 115–118.
Clauser TA, Bay CA, Hayward JC, Wolf B, Sladsky JT, Kaplan P. Berry GT 1990; Reversible metabolic myopathy and cerebral spinal fluid lactic acidosis in biotinidase deficiency. Pediatr Res 28: 344A
Wolf B, Pomponio RJ, Norrgard KJ, Lott IT, Baumgartner ER, Suormala T. Raemaekers VTh, Coskun T, Tokatli A, Ozalp I, Hymes J 1997; Delayed-onset profound biotinidase deficiency: a different phenotype in older children with the disorder. J Pediatr (in press)
Cole H 1994; Cloning and characterization of the human biotinidase gene, Ph.D. thesis
Acknowledgements
The authors thank the children, their parents, and their physicians, Drs. R. Allen. M. Batshaw, C. Bay, G. T. Berry, C. Black, D. M. Bousounis, G. Breningstal, B. Burton, P. Camfield, M. Cowger, D. Crisp, P. Ferreira, S. Goodman, B. Hainline, G. Hug, Kahler, S., P. Kaplan, R. Kennedy, R. Krause, R. Mardach, C. Mize, S. Packman, M. Painter, V. Proud, G. Seashore, S. Snyderman, J. Thoene, and A. Tsao, for the clinical information and samples. Special thanks go to Pamela Melone, Katie Swango, and Joshua Raemeka for their technical assistance.
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Supported by National Institutes of Health Grant DK48258.
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Pomponio, R., Hymes, J., Reynolds, T. et al. Mutations in the Human Biotinidase Gene That Cause Profound Biotinidase Deficiency in Symptomatic Children: Molecular, Biochemical, and Clinical Analysis. Pediatr Res 42, 840–848 (1997). https://doi.org/10.1203/00006450-199712000-00020
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DOI: https://doi.org/10.1203/00006450-199712000-00020
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