Key result
ASPA missense mutations with higher residual enzyme activity are linked to milder Canavan disease.
Why the study?
Does residual aspartoacylase enzyme activity correlate with clinical phenotypes in patients with Canavan disease?
Observational (n=14)
Does residual aspartoacylase enzyme activity correlate with clinical phenotypes in patients with Canavan disease?
Residual aspartoacylase enzyme activity correlates with clinical severity in Canavan disease, allowing for phenotypic prediction of novel variants.
May aid prediction of Canavan severity from novel ASPA variants; hypothesis-generating from Level 5 evidence.
We describe 14 patients with 12 novel missense mutations in ASPA, the gene causing Canavan disease (CD). We developed a method to study the effect of these 12 variants on the function of aspartoacylase-the hydrolysis of N-acetyl-l-aspartic acid (NAA) to aspartate and acetate. The wild-type ASPA open reading frame (ORF) and the ORFs containing each of the variants were transfected into HEK293 cells. Enzyme activity was determined by incubating cell lysates with NAA and measuring the released aspartic acid by LC-MS/MS. Clinical data were obtained for 11 patients by means of questionnaires. Four patients presented with a non-typical clinical picture or with the milder form of CD, whereas seven presented with severe CD. The mutations found in the mild patients corresponded to the variants with the highest residual enzyme activities, suggesting that this assay can help evaluate unknown variants found in patients with atypical presentation. We have detected a correlation between clinical presentation, enzyme activity, and genotype for CD.
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Mendes et al. (2017) conducted an observational in Canavan disease (n=14). ASPA missense mutations vs. Wild-type ASPA was evaluated on Aspartoacylase enzyme activity and clinical phenotype correlation. ASPA missense mutations found in patients with mild Canavan disease corresponded to variants with the highest residual enzyme activities, demonstrating a genotype-phenotype correlation.
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