Abstract
Glutamine synthetase (GS) deficiency is an ultra-rare inborn error of amino acid metabolism that has been described in only three patients so far. The disease is characterized by neonatal onset of severe encephalopathy, low levels of glutamine in blood and cerebrospinal fluid, chronic moderate hyperammonemia, and an overall poor prognosis in the absence of an effective treatment. Recently, enteral glutamine supplementation was shown to be a safe and effective therapy for this disease but there are no data available on the long-term effects of this intervention. The amino acid glutamine, severely lacking in this disorder, is central to many metabolic pathways in the human organism and is involved in the synthesis of nicotinamide adenine dinucleotide (NAD+) starting from tryptophan or niacin as nicotinate, but not nicotinamide. Using fibroblasts, leukocytes, and immortalized peripheral blood stem cells (PBSC) from a patient carrying a GLUL gene point mutation associated with impaired GS activity, we tested whether glutamine deficiency in this patient results in NAD+ depletion and whether it can be rescued by supplementation with glutamine, nicotinamide or nicotinate. The present study shows that congenital GS deficiency is associated with NAD+ depletion in fibroblasts, leukocytes and PBSC, which may contribute to the severe clinical phenotype of the disease. Furthermore, it shows that NAD+ depletion can be rescued by nicotinamide supplementation in fibroblasts and leukocytes, which may open up potential therapeutic options for the treatment of this disorder.
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Abbreviations
- GS:
-
Glutamine synthetase
- NAD+ :
-
Nicotinamide adenine dinucleotide
- PBSC:
-
Peripheral blood stem cells
References
Abramson RD, Barbosa P, Kalumuck K, O’Brien WE (1991) Characterization of the human argininosuccinate lyase gene and analysis of exon skipping. Genomics 10:126–32
Bieganowski P, Pace HC, Brenner C (2003) Eukaryotic NAD+ synthetase Qns1 contains an essential, obligate intramolecular thiol glutamine amidotransferase domain related to nitrilase. J Biol Chem 278:33049–55
Boulland JL, Rafiki A, Levy LM, Storm-Mathisen J, Chaudhry FA (2003) Highly differential expression of SN1, a bidirectional glutamine transporter, in astroglia and endothelium in the developing rat brain. Glia 41:260–75
Bruzzone S, Fruscione F, Morando S, Ferrando T, Poggi A, Garuti A, D’Urso A, Selmo M, Benvenuto F, Cea M, Zoppoli G, Moran E, Soncini D, Ballestrero A, Sordat B, Patrone F, Mostoslavsky R, Uccelli A, Nencioni A (2009) Catastrophic NAD(+) depletion in activated T lymphocytes through Nampt inhibition reduces demyelination and disability in EAE. PLoS One 4
Carlsson M, Carlsson A (1990) Interactions between glutamatergic and monoaminergic systems within the basal ganglia–implications for schizophrenia and Parkinson’s disease. Trends Neurosci 13:272–6
Chaudhry FA, Reimer RJ, Krizaj D, Barber D, Storm-Mathisen J, Copenhagen DR, Edwards RH (1999) Molecular analysis of system N suggests novel physiological roles in nitrogen metabolism and synaptic transmission. Cell 99:769–80
Derouiche A, Ohm TG (1994) Glutamine synthetase immunoreactivity in the human hippocampus is lamina-specific. Neurosci Lett 165:179–82
Dorner M, Zucol F, Berger C, Byland R, Melroe GT, Bernasconi M, Speck RF, Nadal D (2008) Distinct ex vivo susceptibility of B-cell subsets to epstein-barr virus infection according to differentiation status and tissue origin. J Virol 82:4400–12
Eid T, Thomas MJ, Spencer DD, Runden-Pran E, Lai JCK, Malthankar GV, Kim JH, Danbolt NC, Ottersen OP, de Lanerolle NC (2004) Loss of glutamine synthetase in the human epileptogenic hippocampus: possible mechanism for raised extracellular glutamate in mesial temporal lobe epilepsy. Lancet 363:28–37
Eisenberg D, Gill HS, Pfluegl GM, Rotstein SH (2000) Structure-function relationships of glutamine synthetases. Biochim Biophys Acta 1477:122–45
Farrow NA, Kanamori K, Ross BD, Parivar F (1990) A N-15-Nmr study of cerebral, hepatic and renal nitrogen-metabolism in hyperammonaemic rats. Biochem J 270:473–481
Forget PP, van Oosterhout M, Bakker JA, Wermuth B, Vles JS, Spaapen LJ (1999) Partial N-acetyl-glutamate synthetase deficiency masquerading as a valproic acid-induced Reye-like syndrome. Acta Paediatr 88:1409–11
Häberle J, Görg B, Rutsch F, Schmidt E, Toutain A, Benoist JF, Gelot A, Suc AL, Höhne W, Schliess F, Häussinger D, Koch HG (2005) Congenital glutamine deficiency with glutamine synthetase mutations. N Engl J Med 353:1926–33
Häberle J, Görg B, Toutain A, Rutsch F, Benoist JF, Gelot A, Suc AL, Koch HG, Schliess F, Häussinger D (2006a) Inborn error of amino acid synthesis: human glutamine synthetase deficiency. J Inherit Metab Dis 29:352–8
Häberle J, Görg B, Toutain A, Schliess F, Häussinger D (2006b) Glutamine synthetase deficiency in the human. In: Häussinger D, Kircheis G, Schliess F (eds) Hepatic encephalopathy and nitrogen metabolism. Springer, Dordrecht, pp 336–348
Häberle J, Shahbeck N, Ibrahim K, Hoffmann GF, Ben-Omran T (2011) Natural course of glutamine synthetase deficiency in a 3 year old patient. Mol Genet Metab 103:89–91
Häberle J, Shahbeck N, Ibrahim K, Schmitt B, Scheer I, O’Gorman R, Chaudhry FA, Ben-Omran T (2012) Glutamine supplementation in a child with inherited GS deficiency improves the clinical status and partially corrects the peripheral and central amino acid imbalance. Orphanet J Rare Dis 7:48
Hara N, Yamada K, Terashima M, Osago H, Shimoyama M, Tsuchiya M (2003) Molecular identification of human glutamine- and ammonia-dependent NAD synthetases. Carbon-nitrogen hydrolase domain confers glutamine dependency. J Biol Chem 278:10914–21
Hardy J, Cowburn R (1987) Glutamate neurotoxicity and Alzheimer’s disease. Trends Neurosci 10:406
Häussinger D (1990) Nitrogen metabolism in liver: structural and functional organization and physiological relevance. Biochem J 267:281–90
Häussinger D (1998) Hepatic glutamine transport and metabolism. Adv Enzymol Relat Areas Mol Biol 72:43–86
Häussinger D, Sies R (1984) In: Häussinger D, Sies R (eds) Glutamine metabolism in mammalian tissues. Springer, Berlin, pp 3–15
Häussinger D, Laubenberger J, vom Dahl S, Ernst T, Bayer S, Langer M, Gerok W, Hennig J (1994) Proton magnetic resonance spectroscopy studies on human brain myo-inositol in hypo-osmolarity and hepatic encephalopathy. Gastroenterology 107:1475–80
He YJ, Hakvoort TBM, Kohler SE, Vermeulen JLM, de Waart DR, de Theije C, ten Have GAM, van Eijk HMH, Kunne C, Labruyere WT, Houten SM, Sokolovic M, Ruijter JM, Deutz NEP, Lamers WH (2010) Glutamine synthetase in muscle is required for glutamine production during fasting and extrahepatic ammonia detoxification. J Biol Chem 285:9516–9524
Krajewski WW, Collins R, Holmberg-Schiavone L, Jones TA, Karlberg T, Mowbray SL (2008) Crystal structures of mammalian glutamine synthetases illustrate substrate-induced conformational changes and provide opportunities for drug and herbicide design. J Mol Biol 375:217–28
Laemmli UK (1970) Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 227:680–5
Liaw SH, Kuo I, Eisenberg D (1995) Discovery of the ammonium substrate site on glutamine synthetase, a third cation binding site. Protein Sci 4:2358–65
Lowry OH, Rosebrough NJ, Farr AL, Randall RJ (1951) Protein measurement with the Folin phenol reagent. J Biol Chem 193:265–75
Luo J, Nikolaev AY, Imai S, Chen D, Su F, Shiloh A, Guarente L, Gu W (2001) Negative control of p53 by Sir2alpha promotes cell survival under stress. Cell 107:137–48
Nissen-Meyer LS, Chaudhry FA (2013) Protein kinase C phosphorylates the system N glutamine transporter SN1 (Slc38a3) and regulates its membrane trafficking and degradation. Front Endocrinol (Lausanne) 4:138
Spencer RL, Preiss J (1967) Biosynthesis of diphosphopyridine nucleotide. The purification and the properties of diphospyridine nucleotide synthetase from Escherichia coli b. J Biol Chem 242:385–92
Tang K, Sham H, Hui E, Kirkland JB (2008) Niacin deficiency causes oxidative stress in rat bone marrow cells but not through decreased NADPH or glutathione status. J Nutr Biochem 19:746–753
Tullius SG, Biefer HRC, Li SY, Trachtenberg AJ, Edtinger K, Quante M, Krenzien F, Uehara H, Yang XY, Kissick HT, Kuo WP, Ghiran I, de la Fuente MA, Arredouani MS, Camacho V, Tigges JC, Toxavidis V, El Fatimy R, Smith BD, Vasudevan A, ElKhal A (2014) NAD(+) protects against EAE by regulating CD4(+) T-cell differentiation. Nature Communications 5
Tumani H, Shen GQ, Peter JB (1995) Purification and immunocharacterization of human brain glutamine synthetase and its detection in cerebrospinal fluid and serum by a sandwich enzyme immunoassay. J Immunol Methods 188:155–63
Vermeulen T, Görg B, Vogl T, Wolf M, Varga G, Toutain A, Paul R, Schliess F, Häussinger D, Häberle J (2008) Glutamine synthetase is essential for proliferation of fetal skin fibroblasts. Arch Biochem Biophys 478:96–102
Wu C (1977) Glutamine synthetase. IX. Purification and characterization of the enzyme from sheep spleen. Can J Biochem 55:332–9
Yamamoto H, Konno H, Yamamoto T, Ito K, Mizugaki M, Iwasaki Y (1987) Glutamine synthetase of the human brain: purification and characterization. J Neurochem 49:603–9
Young AB, Greenamyre JT, Hollingsworth Z, Albin R, D’Amato C, Shoulson I, Penney JB (1988) NMDA receptor losses in putamen from patients with Huntington’s disease. Science 241:981–3
Acknowledgments
This study was supported by grants from Qatar Foundation and from Hartmann Müller Stiftung (Grant 1492 to JH). Grant sponsors had no influence on study design, interpretation of data or manuscript writing.
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Human and Animal Rights and Informed Consent
This article does not contain any studies with animal subjects. Studies with human material are in accordance with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from the legal guardians of the patient for being included in the study.
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Communicated by: Jerry Vockley
DedicationThe authors want to dedicate this work to the late Hamad Ajool, the then only known patient with inherited GS deficiency, who was able to give so much to his family and to science.
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Hu, L., Ibrahim, K., Stucki, M. et al. Secondary NAD+ deficiency in the inherited defect of glutamine synthetase. J Inherit Metab Dis 38, 1075–1083 (2015). https://doi.org/10.1007/s10545-015-9846-4
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DOI: https://doi.org/10.1007/s10545-015-9846-4