Glutaric aciduria type I and kynurenine pathway metabolites: a modified hypothesis.

Abstract:

:Glutaric aciduria type I is an inborn error of organic acid metabolism that demonstrates a particular temporal vulnerability (acute encephalopathic episodes in infancy) and a spatial vulnerability (acute striatal necrosis, focused on the putamen). Excitotoxic mechanisms involving 3-hydroxyglutaric acid as the major neurotoxin have been suggested. This paper proposes a role for metabolites of the kynurenine pathway in the pathogenic process and modifies the hypothesis of Heyes. Deficiency of glutaryl-CoA dehydrogenase blocking the glutarate pathway and activation of indoleamine 2,3-dioxygenase in macrophages/monocytes by intercurrent inflammation may increase flux down the kynurenine pathway towards the production of quinolinic acid. Quinolinic acid is neurotoxic and is an endogenous agonist at N-methyl-D-aspartate receptors. Synergistic excitation of these receptors by quinolinic acid and 3-hydroxyglutaric acid, which alone does not have sufficient potency, may be involved in the pathogenesis of striatal necrosis.

journal_name

J Inherit Metab Dis

authors

Varadkar S,Surtees R

doi

10.1023/B:BOLI.0000045767.42193.97

keywords:

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

835-42

issue

6

eissn

0141-8955

issn

1573-2665

pii

5383913

journal_volume

27

pub_type

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