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In vivo metabolic flux profiling with stable isotopes discriminates sites and quantifies effects of mitochondrial dysfunction in C. elegans.
[pyruvate dehydrogenase deficiency]
Mitochondrial
respiratory
chain
(
RC
)
disease
diagnosis
is
complicated
both
by
an
absence
of
biomarkers
that
sufficiently
divulge
all
cases
and
limited
capacity
to
quantify
adverse
effects
across
intermediary
metabolism
.
We
applied
high
performance
liquid
chromatography
(
HPLC
)
and
mass
spectrometry
(
MS
)
studies
of
stable-isotope
based
precursor-product
relationships
in
the
nematode
,
C
.
elegans
,
to
interrogate
in
vivo
differences
in
metabolic
flux
among
distinct
genetic
models
of
primary
RC
defects
and
closely
related
metabolic
disorders
.
C
.
elegans
strains
studied
harbor
single
nuclear
gene
defects
in
complex
I
,
II
,
or
III
RC
subunits
(
gas-
1
,
mev-
1
,
isp-
1
)
;
enzymes
involved
in
coenzyme
Q
biosynthesis
(
clk-
1
)
,
the
tricarboxylic
acid
cycle
(
TCA
,
idh-
1
)
,
or
pyruvate
metabolism
(
pdha-
1
)
;
and
central
nodes
of
the
nutrient-sensing
signaling
network
that
involve
insulin
response
(
daf-
2
)
or
the
sirtuin
homologue
(
sir-
2
.
1
)
.
Synchronous
populations
of
2000
early
larval
stage
worms
were
fed
standard
Escherichia
coli
on
nematode
growth
media
plates
containing
1
,
6
-
(
13
)
C
2
-
glucose
throughout
their
developmental
period
,
with
samples
extracted
on
the
first
day
of
adult
life
in
4
%
perchloric
acid
with
an
internal
standard
.
Quantitation
of
whole
animal
free
amino
acid
concentrations
and
isotopic
incorporation
into
amino
and
organic
acids
throughout
development
was
performed
in
all
strains
by
HPLC
and
isotope
ratio
MS
,
respectively
.
GC
/
MS
analysis
was
also
performed
to
quantify
absolute
isotopic
incorporation
in
all
molecular
species
of
key
TCA
cycle
intermediates
in
gas-
1
and
N
2
adult
worms
.
Genetic
mutations
within
different
metabolic
pathways
displayed
distinct
metabolic
profiles
.
RC
complex
I
(
gas-
1
)
and
III
(
isp-
1
)
subunit
mutants
,
together
with
the
coenzyme
Q
biosynthetic
mutant
(
clk-
1
)
,
shared
a
similar
amino
acid
profile
of
elevated
alanine
and
decreased
glutamate
.
The
metabolic
signature
of
the
complex
II
mutant
(
mev-
1
)
was
distinct
from
that
of
the
other
RC
mutants
but
resembled
that
of
the
TCA
cycle
mutant
(
idh-
1
)
and
both
signaling
mutants
(
daf-
2
and
sir-
2
.
1
)
.
All
branched
chain
amino
acid
levels
were
significantly
increased
in
the
complex
I
and
III
mutants
but
decreased
in
the
PDH
mutant
(
pdha-
1
)
.
The
RC
complex
I
,
coenzyme
Q
,
TCA
cycle
,
and
PDH
mutants
shared
significantly
increased
relative
enrichment
of
lactate
+
1
and
absolute
concentration
of
alanine
+
1
,
while
glutamate
+
1
enrichment
was
significantly
decreased
uniquely
in
the
RC
mutants
.
Relative
intermediary
flux
analyses
were
suggestive
of
proximal
TCA
cycle
disruption
in
idh-
1
,
completely
reduced
TCA
cycle
flux
in
sir-
2
.
1
,
and
apparent
distal
TCA
cycle
alteration
in
daf-
2
.
GC
/
MS
analysis
with
universally-labeled
(
13
)
C-
glucose
in
adult
worms
further
showed
significantly
increased
isotopic
enrichment
in
lactate
,
citrate
,
and
malate
species
in
the
complex
I
(
gas-
1
)
mutant
.
S
table
isotopic
/
mass
spectrometric
analysis
can
sensitively
discriminate
primary
RC
dysfunction
from
genetic
deficiencies
affecting
either
the
TCA
cycle
or
pyruvate
metabolism
.
These
data
are
further
suggestive
that
metabolic
flux
analysis
using
stable
isotopes
may
offer
a
robust
means
to
discriminate
and
quantify
the
secondary
effects
of
primary
RC
dysfunction
across
intermediary
metabolism
.
Diseases
Validation
Diseases presenting
"c"
symptom
adrenomyeloneuropathy
alexander disease
cadasil
coats disease
cohen syndrome
dedifferentiated liposarcoma
epidermolysis bullosa simplex
erythropoietic protoporphyria
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kallmann syndrome
oligodontia
papillon-lefèvre syndrome
phenylketonuria
pyruvate dehydrogenase deficiency
von hippel-lindau disease
x-linked adrenoleukodystrophy
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