title: Urinary bile acids and peroxisomal bifunctional enzyme deficiency.
abstract: The biosynthesis of normal bile acids involves beta-oxidation of the 8-carbon side-chain of cholesterol, in addition to numerous modifications of the sterol nucleus. Because beta-oxidation of the sterol side-chain has been localized to the peroxisome, bile acid analysis has been suggested to be useful in the diagnostic evaluation of individuals suspected of having peroxisomal disorders. Although data from subjects with generalized peroxisomal disorders support this, few data exist regarding the bile acids in individuals having single peroxisomal beta-oxidation enzyme disorders. In this study, we analyzed the urinary bile acids from 12 patients with peroxisomal bifunctional protein deficiency using continuous flow fast atom bombardment mass spectrometry. All 12 patients had abnormal spectra, although their ion profiles and rank order of intensity of ions varied considerably. Ten of 12 individuals had abnormal spectra with presence of taurine-conjugated tetrahydroxycholestenoates, allowing a definite diagnosis of a peroxisomal beta-oxidation defect and a presumptive diagnosis of bifunctional protein deficiency; the other two cases were nondiagnostically abnormal. The strengths and limitations of urinary bile acid analysis for the diagnosis of peroxisomal beta-oxidation disorders are discussed.
authors.affiliation: Division of Medical Genetics and Biomedical Sciences, Shriver Center for Mental Retardation, Waltham, MA 02254, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Natowicz
authors.forename: J E
authors.initials: JE
authors.lastname: Evans
authors.forename: R I
authors.initials: RI
authors.lastname: Kelley
authors.forename: A B
authors.initials: AB
authors.lastname: Moser
authors.forename: P A
authors.initials: PA
authors.lastname: Watkins
authors.forename: H W
authors.initials: HW
authors.lastname: Moser
mesh_terms: D015094:3-Hydroxyacyl CoA Dehydrogenases / Q000172:deficiency*; D001647:Bile Acids and Salts / Q000652:urine*; D004746:Enoyl-CoA Hydratase / Q000172:deficiency*; D006801:Humans; D007535:Isomerases; D015394:Molecular Structure; D009097:Multienzyme Complexes / Q000172:deficiency*; D063994:Peroxisomal Bifunctional Enzyme; D018901:Peroxisomal Disorders / Q000201:enzymology* / Q000652:urine; D016339:Spectrometry, Mass, Fast Atom Bombardment / Q000379:methods
chemical_list: D001647:Bile Acids and Salts; D009097:Multienzyme Complexes; D015094:3-Hydroxyacyl CoA Dehydrogenases; C576253:EHHADH protein, human; D004746:Enoyl-CoA Hydratase; D063994:Peroxisomal Bifunctional Enzyme; D007535:Isomerases