title: Differential effect of DCA treatment on the pyruvate dehydrogenase complex in patients with severe PDHC deficiency.
abstract: Dichloroacetate (DCA) is a structural analog of pyruvate that has been recommended for the treatment of primary lactic acidemia, particularly in patients with pyruvate dehydrogenase (PDHC) deficiency. Recent reports have demonstrated that the response to DCA may depend on the type of molecular abnormality. In this study, we investigated the response to DCA in various PDHC-deficient cell lines and tried to determine the mechanism involved. The effect of chronic 3-d DCA treatment on PDHC activity was assessed in two PDHC-deficient cell lines, each with a different point mutation in the E1alpha subunit gene (R378C and R88C), and one cell line in which an 8-bp tandem repeat was deleted (W383 del). Only two (R378C and R88C) of the three PDHC-deficient cell lines with very low levels of PDHC activity and unstable polypeptides were sensitive to chronic DCA treatment. In these cell lines, DCA treatment resulted in an increase in PDHC activity by 125 and 70%, respectively, with concomitant increases of 121 and 130% in steady-state levels of immunoreactive E1alpha. DCA treatment reduced the turnover of the E1alpha subunit in R378C and R88C mutant cells with no significant effect on the E1beta subunit. Chronic DCA treatment significantly improved the metabolic function of PDHC in digitonin-permeabilized R378C and R88C fibroblasts. The occurrence of DCA-sensitive mutations suggests that DCA treatment is potentially useful as an adjuvant to ketogenic and vitamin treatment in PDHC-deficient patients.
authors.affiliation: Unité de Recherche Mixte INSERM U530-Université Paris 5, Centre Universitaire des Saints-Pères, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Fouque
authors.forename: Michelle
authors.initials: M
authors.lastname: Brivet
authors.forename: Audrey
authors.initials: A
authors.lastname: Boutron
authors.forename: Christiane
authors.initials: C
authors.lastname: Vequaud
authors.forename: Cécile
authors.initials: C
authors.lastname: Marsac
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Zabot
authors.forename: Chantal
authors.initials: C
authors.lastname: Benelli
mesh_terms: D002478:Cells, Cultured; D003999:Dichloroacetic Acid / Q000494:pharmacology*; D051047:Dihydrolipoyllysine-Residue Acetyltransferase; D004789:Enzyme Activation / Q000187:drug effects; D005260:Female; D005347:Fibroblasts / Q000166:cytology / Q000201:enzymology; D006801:Humans; D066298:In Vitro Techniques; D007223:Infant; D008214:Lymphocytes / Q000166:cytology / Q000201:enzymology; D008297:Male; D030481:Pyruvate Dehydrogenase (Lipoamide) / Q000096:biosynthesis / Q000378:metabolism; D011768:Pyruvate Dehydrogenase Complex / Q000096:biosynthesis / Q000378:metabolism*; D015325:Pyruvate Dehydrogenase Complex Deficiency Disease / Q000188:drug therapy* / Q000378:metabolism*; D012720:Severity of Illness Index
chemical_list: D011768:Pyruvate Dehydrogenase Complex; D003999:Dichloroacetic Acid; D030481:Pyruvate Dehydrogenase (Lipoamide); D051047:Dihydrolipoyllysine-Residue Acetyltransferase