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N-carbamylglutamate augments ureagenesis and reduces ammonia and glutamine in propionic acidemia.


ABSTRACT:

Objectives

The objective of this study was to determine whether N-carbamylglutamate (NCG) reduces plasma levels of ammonia and glutamine and increases the rate of ureagenesis in patients with propionic acidemia (PA).

Methods

Identical 4-hour studies were performed before and immediately after a 3-day trial of oral NCG in 7 patients with PA. An oral bolus of [(13)C]sodium acetate was administered at the start of each study, and sequential blood samples were obtained to measure [(13)C]urea, ammonia, urea, and amino acids.

Results

With longitudinal mixed-effects linear regression, peak [(13)C]urea increased after treatment with NCG (from 2.2 to 3.8 microM; P < .0005). There were concomitant decreases in mean plasma ammonia (59-43 microM; P < .018) and glutamine (552-331 microM; P < .0005).

Conclusions

NCG augments ureagenesis and decreases plasma ammonia and glutamine in patients with PA. The drug may serve as an important therapeutic adjunct in the treatment of acute hyperammonemia in this disorder.

SUBMITTER: Ah Mew N 

PROVIDER: S-EPMC3297024 | biostudies-literature | 2010 Jul

REPOSITORIES: biostudies-literature

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Publications

N-carbamylglutamate augments ureagenesis and reduces ammonia and glutamine in propionic acidemia.

Ah Mew Nicholas N   McCarter Robert R   Daikhin Yevgeny Y   Nissim Itzhak I   Yudkoff Marc M   Tuchman Mendel M  

Pediatrics 20100621 1


<h4>Objectives</h4>The objective of this study was to determine whether N-carbamylglutamate (NCG) reduces plasma levels of ammonia and glutamine and increases the rate of ureagenesis in patients with propionic acidemia (PA).<h4>Methods</h4>Identical 4-hour studies were performed before and immediately after a 3-day trial of oral NCG in 7 patients with PA. An oral bolus of [(13)C]sodium acetate was administered at the start of each study, and sequential blood samples were obtained to measure [(13  ...[more]

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