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A common X-linked inborn error of carnitine biosynthesis may be a risk factor for nondysmorphic autism.


ABSTRACT: We recently reported a deletion of exon 2 of the trimethyllysine hydroxylase epsilon (TMLHE) gene in a proband with autism. TMLHE maps to the X chromosome and encodes the first enzyme in carnitine biosynthesis, 6-N-trimethyllysine dioxygenase. Deletion of exon 2 of TMLHE causes enzyme deficiency, resulting in increased substrate concentration (6-N-trimethyllysine) and decreased product levels (3-hydroxy-6-N-trimethyllysine and ?-butyrobetaine) in plasma and urine. TMLHE deficiency is common in control males (24 in 8,787 or 1 in 366) and was not significantly increased in frequency in probands from simplex autism families (9 in 2,904 or 1 in 323). However, it was 2.82-fold more frequent in probands from male-male multiplex autism families compared with controls (7 in 909 or 1 in 130; P = 0.023). Additionally, six of seven autistic male siblings of probands in male-male multiplex families had the deletion, suggesting that TMLHE deficiency is a risk factor for autism (metaanalysis Z-score = 2.90 and P = 0.0037), although with low penetrance (2-4%). These data suggest that dysregulation of carnitine metabolism may be important in nondysmorphic autism; that abnormalities of carnitine intake, loss, transport, or synthesis may be important in a larger fraction of nondysmorphic autism cases; and that the carnitine pathway may provide a novel target for therapy or prevention of autism.

SUBMITTER: Celestino-Soper PB 

PROVIDER: S-EPMC3361440 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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A common X-linked inborn error of carnitine biosynthesis may be a risk factor for nondysmorphic autism.

Celestino-Soper Patrícia B S PB   Violante Sara S   Crawford Emily L EL   Luo Rui R   Lionel Anath C AC   Delaby Elsa E   Cai Guiqing G   Sadikovic Bekim B   Lee Kwanghyuk K   Lee Kwanghyuk K   Lo Charlene C   Gao Kun K   Person Richard E RE   Moss Timothy J TJ   German Jennifer R JR   Huang Ni N   Shinawi Marwan M   Treadwell-Deering Diane D   Szatmari Peter P   Roberts Wendy W   Fernandez Bridget B   Schroer Richard J RJ   Stevenson Roger E RE   Buxbaum Joseph D JD   Betancur Catalina C   Scherer Stephen W SW   Sanders Stephan J SJ   Geschwind Daniel H DH   Sutcliffe James S JS   Hurles Matthew E ME   Wanders Ronald J A RJ   Shaw Chad A CA   Leal Suzanne M SM   Cook Edwin H EH   Goin-Kochel Robin P RP   Vaz Frédéric M FM   Beaudet Arthur L AL  

Proceedings of the National Academy of Sciences of the United States of America 20120507 21


We recently reported a deletion of exon 2 of the trimethyllysine hydroxylase epsilon (TMLHE) gene in a proband with autism. TMLHE maps to the X chromosome and encodes the first enzyme in carnitine biosynthesis, 6-N-trimethyllysine dioxygenase. Deletion of exon 2 of TMLHE causes enzyme deficiency, resulting in increased substrate concentration (6-N-trimethyllysine) and decreased product levels (3-hydroxy-6-N-trimethyllysine and γ-butyrobetaine) in plasma and urine. TMLHE deficiency is common in c  ...[more]

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