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Refsum disease is caused by mutations in the phytanoyl–CoA hydroxylase gene

Abstract

Refsum disease is an autosomal-recessively inherited disorder characterized clinically by a tetrad of abnormalities: retinitis pigmentosa, peripheral neuropathy, cerebellar ataxia and elevated protein levels in the cerebrospinal fluid (CSF) without an increase in the number of cells in the CSF. All patients exhibit accumulation of an unusual branched-chain fatty acid, phytanic acid (3,7,11,15-tetramethylhexadecanoic acid), in blood and tissues. Biochemically, the disease is caused by the deficiency of phytanoyl-CoA hydroxylase (PhyH), a peroxisomal protein catalyzing the first step in the α-oxidation of phytanic acid. We have purified PhyH from rat-liver peroxisomes and determined the N-terminal amino-acid sequence, as well as an additional internal amino-acid sequence obtained after Lys-C digestion of the purified protein. A search of the EST database with these partial amino-acid sequences led to the identification of the full-length human cDNA sequence encoding PhyH: the open reading frame encodes a 41.2-kD protein of 338 amino acids, which contains a cleavable peroxisomal targeting signal type 2 (PTS2). Sequence analysis of PHYH fibroblast cDNA from five patients with Refsum disease revealed distinct mutations, including a one-nucleotide deletion, a 111-nucleotide deletion and a point mutation. This analysis confirms our finding that Refsum disease is caused by a deficiency of PhyH.

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References

  1. Refsum, S. Heredopathia atactica polyneuritiformis. Acta Psychiatr. Scand. (Suppl.) 38, 9–303 (1946).

    Google Scholar 

  2. Steinberg, D. Refsum disease, in The Metabolic and Molecular Basis of Inherited Disease, 7th ed. (eds Scriver, C.R., Beaudet, A.L, Sly, W.S. & Valle, D.) 2351–2369 (McGraw-Hill, New York, 1995).

    Google Scholar 

  3. Skjeldal, O.H., Stokke, O., Refsum, S., Norseth, J. & Petit, H. Clinical and biochemical heterogeneity in conditions with phytanic acid accumulation. J. Neurol. Sci. 77, 87–96 (1987).

    Article  CAS  Google Scholar 

  4. Mihalik, S.J., Rainville, A.M. & Watkins, P.A. Phytanic acid α-oxidation in rat liver peroxisomes: production of α-hydroxyphytanoyl-CoA and formate is enhanced by dioxygenase cofactors. Eur. J. Biochem. 232, 545–551 (1995).

    Article  CAS  Google Scholar 

  5. Jansen, G.A. et al. Phytanoyl-CoA hydroxylase is present in human liver, located in peroxisomes and deficient in Zellweger syndrome: direct, unequivocal evidence for the new, revised pathway of phytanic acid a-oxidation in humans. Biochem. Biophys. Res. Commun. 229, 205–210 (1996).

    Article  CAS  Google Scholar 

  6. Croes, K., Casteels, M., De Hoffmann, E., Mannaerts, G.P. & Van Veldhoven, P.P. α-Oxidation of 3-methyl-substituted fatty acids in rat liver: production of formic acid instead of CO2, cofactor requirements, subcellular localization and formation of a 2-hydroxy-3-methylacyl-CoA intermediate. Eur. J. Biochem. 240, 674–683 (1996).

    Article  CAS  Google Scholar 

  7. Jansen, G.A. et al. Phytanoyl-CoA hydroxylase is not only deficient in classical Refsum disease but also in rhizomelic chondrodysplasia punctata. J. Inherited Metab. Dis. 20, 444–446 (1997).

    Article  CAS  Google Scholar 

  8. Jansen, G.A., Wanders, R.J.A., Watkins, P.A. & Mihalik, S.J. Phytanoyl–coenzyme A hydroxylase deficiency—the enzyme defect in Refsum's disease. N. Engl. J. Med. 337, 133–134 (1997).

    Article  CAS  Google Scholar 

  9. Lazarow, P.B. & Moser, H.W. Disorders of peroxisome biogenesis, in The Metabolic and Molecular Basis of Inherited Disease, 7th ed. (eds Scriver, C.R., Beaudet, A.L., Sly, W.S. & Valle, D.) 2287–2324 (McGraw-Hill, New York, 1995).

    Google Scholar 

  10. Motley, A.M. et al. Rhizomelic chondrodysplasia punctata is a peroxisomal protein targeting disease caused by a non-functional PTS2 receptor. Nature Genet. 15, 377–380 (1997).

    Article  CAS  Google Scholar 

  11. Purdue, P.E., Zhang, J.W., Skoneczny, M. & Lazarow, P.B. Rhizomelic chondrodysplasia punctata is caused by deficiency of human PEX7, a homologue of the yeast PTS2 receptor. Nature Genet. 15, 381–384 (1997).

    Article  CAS  Google Scholar 

  12. Braverman, N. et al. Human PEX7 encodes the peroxisomal PTS2 receptor and is responsible for rhizomelic chondrodysplasia punctata. Nature Genet. 15, 369–375 (1997).

    Article  CAS  Google Scholar 

  13. Waterham, H.R. & Cregg, J.M. Peroxisome biogenesis. Bioessays 19, 57–66 (1997).

    Article  CAS  Google Scholar 

  14. Subramani, S. S. PEXgenes on the rise. Nature Genet. 15, 331–333 (1997).

    Article  CAS  Google Scholar 

  15. Purdue, P.E. & Lazarow, P.B. Peroxisomal biogenesis: multiple pathways of protein import. J Biol. Chem. 269, 30065–30068 (1994).

    CAS  PubMed  Google Scholar 

  16. Altschul, S.F., Gish, W., Miller, W., Myers, E.W. & Lipman, D.J. Basic local alignment search tool. J. Mol. Biol. 215, 403–410 (1990).

    Article  CAS  Google Scholar 

  17. Kozak, M. Compilation and analysis of sequences upstream from the translational start site in eukaryotic mRNAs. Nucleic Acids Res. 12, 857–872 (1984).

    Article  CAS  Google Scholar 

  18. Swinkels, B.W., Gould, S.J., Bodnar, A.G., Rachubinski, R.A. & Subramani, S. A novel, cleavable peroxisomal targeting signal at the amino-terminus of the rat 3-ketoacyl-CoAthiolase. EMBO J. 10, 3255–3262 (1991).

    Article  CAS  Google Scholar 

  19. De Vet, E.C.J.M., Zomer, A.W.M., Lahaut, G.J.H.T.J., & van den Bosch, H. Polymerase chain reaction-based cloning of alkyl-dihydroxyacetonephosphate synthase complementary DNA from guinea pig liver. J. Biol. Chem. 272, 798–803 (1997).

    Article  CAS  Google Scholar 

  20. Osumi, T. et al. Amino-terminal presequence of the precursor of peroxisomal 3-ketoacyl-CoA thiolase is a cleavable signal peptide for peroxisomal targeting. Biochem. Biophys. Res. Commun. 181, 947–954 (1991).

    Article  CAS  Google Scholar 

  21. Krawczak, M., Reiss, J. & Cooper, D.N. The mutational spectrum of single base-pair substitutions in mRNA splice junctions of human genes: causes and consequences. Hum. Genet. 90, 41–54 (1992).

    Article  CAS  Google Scholar 

  22. Ljlst, L., Wanders, R.J.A., Ushikubo, S., Kamijo, T., & Hashimoto, T. Molecular basis of long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency: identification of the major disease-causing mutation in the α-subunit of the mitochondria! trifunctional protein. Biochim. Biophys. Acta. 1215, 347–350 (1994).

    Article  Google Scholar 

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Jansen, G., Oftnan, R., Ferdinandusse, S. et al. Refsum disease is caused by mutations in the phytanoyl–CoA hydroxylase gene. Nat Genet 17, 190–193 (1997). https://doi.org/10.1038/ng1097-190

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