B12 METABOLISM IN HUMANS By NICOLE AURORA LEAL A ...
B12 METABOLISM IN HUMANS By NICOLE AURORA LEAL A ...
B12 METABOLISM IN HUMANS By NICOLE AURORA LEAL A ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
23<br />
The cblB complementation group is characterized by a deficiency in the conversion<br />
of cobalamin to AdoCbl. Cell extracts derived from patients with cblB disorder were<br />
unable to synthesize AdoCbl even when provided with a reducing system, labeled<br />
HOCbl, and ATP (Fenton and Rosenberg 1981). Patients with this disorder are defective<br />
in ATP:cob(I)alamin ATR activity. At the start of this study, the gene encoding the cblB<br />
defect was unknown and the protein had not been isolated.<br />
The clinical presentation of cblA, cblB, and cblH disorders are very similar and<br />
include methylmalonic aciduria, lethargy, failure to thrive, vomiting, dehydration,<br />
respiratory distress, and anemia (Fenton and Rosenberg 2000). These disorders have<br />
been treated by a diet restricted in amino acid precursors of methylmalonate and<br />
cobalamin supplementation (Kapadia 1995).<br />
Homocystinuria without Methylmalonic Aciduria<br />
Inborn errors of cellular cobalamin metabolism resulting in homocystinuria without<br />
methylmalonic aciduria are defined by cblE and cblG complementation groups. There<br />
has been only one patient in the cblE group that had combined homocystinuria and mild<br />
methylmalonic aciduria (Wilson et al. 1999). Cultured fibroblasts from these patients<br />
show a deficiency in CH3Cbl synthesis and decreased methionine synthase activity<br />
(Watkins and Rosenblatt 1989). Complementation analysis has shown that cblE and<br />
cblG defects occur at distinct chromosomal locations (Watkins and Rosenblatt 1988).<br />
Fibroblasts from patients with cblE and cblG disorders showed normal incorporation of<br />
labeled propionate into macromolecules; however, the incorporation of labeled CH3THF<br />
was reduced when compared to controls suggesting an abnormality in the methionine<br />
synthase pathway (Watkins and Rosenblatt 1989). To date there are 12 patients