Therapeutic potential of dichloroacetate for pyruvate dehydrogenase complex deficiency.
We reviewed the use of oral dichloroacetate (DCA) in the treatment of children with congenital lactic acidosis caused by mutations in the pyruvate dehydrogenase complex (PDC). The case histories of 46 subjects were analyzed with regard to diagnosis, clinical presentation and response to DCA. DCA decreased blood and cerebrospinal fluid lactate concentrations, and was generally well tolerated. DCA may be particularly effective in children with PDC deficiency by stimulating residual enzyme activity and, consequently, cellular energy metabolism. A controlled trial is needed to determine the definitive role of DCA in the management of this devastating disease.
Berendzen
Kristen
K
Division of Endocrinology and Metabolism, Department of Medicine, University of Florida College of Medicine, P.O. Box 10226, Gainesville, FL 32610, USA. berenkm@medicine.efl.edu
Theriaque
Douglas W
DW
Shuster
Jonathan
J
Stacpoole
Peter W
PW
D000140:Acidosis, Lactic / Q000151:congenital; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003999:Dichloroacetic Acid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008928:Mitochondria / Q000378:metabolism; D008954:Models, Biological; D009154:Mutation; D011768:Pyruvate Dehydrogenase Complex / Q000378:metabolism*; D015325:Pyruvate Dehydrogenase Complex Deficiency Disease / Q000188:drug therapy*
D011768:Pyruvate Dehydrogenase Complex; D003999:Dichloroacetic Acid