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Pathway Description
3-Hydroxyisobutyric Aciduria
Homo sapiens
Category:
Metabolite Pathway
Sub-Category:
Disease
Created: 2022-11-18
Last Updated: 2023-10-25
3-Hydroxyisobutyric aciduria, also called HIBA, is an extremely rare inherited inborn error of metabolism (IEM) of valine metabolism. Only 12-13 patients have been identified with this condition. It is an autosomal recessive disorder that may be caused, in some cases, by a defective aldehyde dehydrogenase 6 family member A1 (ALDH6A1) gene which codes for methylmalonate semialdehyde dehydrogenase (MMSDH). MMSDH is a mitochondrial methylmalonate semialdehyde dehydrogenase that plays a role in the valine and pyrimidine catabolism. This protein catalyzes the irreversible oxidative decarboxylation of malonate and methylmalonate semialdehydes to acetyl- and propionyl-CoA. Another possible cause of the disorder is a mutation in 3-hydroxyisobutyrate dehydrogenase, a mitochondrial enzyme which catalyzes the conversion of 3-hydroxyisobutyrate into methylmalonic semialdehyde, or in the conversion of the semialdehyde to propionyl-CoA. Individuals with this disorder have very high levels of 3-hydroxyisobutyric acid secreted in their urine. Other indications of organic acidemia are also present. Signs and symptoms of 3-hydroxyisobutyric aciduria include developmental delay, dysmorphic facial features, and brain abnormalities. The excretion of 3-hydroxyisobutyric acid in the urine can range from 170 to 390 mmol/mol of creatinine. Concentrations of free carnitine are also low, and esterified carnitine can be elevated in patients. Protein-restricted diets and carnitine supplementation have been tried with varying degrees of success.
References
3-Hydroxyisobutyric Aciduria References
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Feigenbaum AS, Robinson BH: The structure of the human dihydrolipoamide dehydrogenase gene (DLD) and its upstream elements. Genomics. 1993 Aug;17(2):376-81. doi: 10.1006/geno.1993.1335.
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Pubmed: 17974005
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