Phytanic acid alpha-oxidation in peroxisomal disorders: studies in cultured human fibroblasts.

Biochim Biophys Acta

Department of Clinical Chemistry, Free University Hospital, Amsterdam, The Netherlands.

Published: October 1997

We studied the alpha-oxidation of phytanic acid in human fibroblasts of controls and patients affected with classical Refsum disease, rhizomelic chondrodysplasia punctata, generalized peroxisomal disorders and peroxisomal bifunctional protein deficiency. Cultured fibroblasts were incubated with phytanic acid, after which medium and cells were collected separately. 2-Hydroxyphytanic acid and pristanic acid were measured in the medium and cells by stable isotope dilution gas chromatography mass spectrometry. In controls, 2-hydroxyphytanic acid and pristanic acid could be detected in the medium after incubation with phytanic acid, proving that alpha-oxidation of phytanic acid via 2-hydroxyphytanoyl-CoA to pristanic acid was active and intermediates were excreted into the medium. In cells from patients with a defective alpha-oxidation (Refsum disease, rhizomelic chondrodysplasia punctata and generalized peroxisomal disorders) 2-hydroxyphytanic acid and pristanic acid were low or not detectable, showing that in these disorders the hydroxylation of phytanoyl-CoA to 2-hydroxyphytanoyl-CoA is deficient. In cells with a peroxisomal beta-oxidation defect, 2-hydroxyphytanic acid and pristanic acid were formed in amounts comparable to those in the controls.

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http://dx.doi.org/10.1016/s0925-4439(97)00045-8DOI Listing

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Article Synopsis
  • Refsum disease is a rare genetic disorder affecting lipid metabolism, leading to the buildup of phytanic acid and resulting in symptoms like ataxia, neuropathy, and hearing loss, with potential cardiac issues developing later in life.
  • A case study presented a 38-year-old man who experienced acute heart failure due to dilated cardiomyopathy, confirmed by high levels of phytanic acid, illustrating that cardiac problems are common in advanced Refsum disease.
  • Management options for Refsum disease include dietary restrictions on phytanic acid and lipid apheresis to alleviate symptoms and improve patients' quality of life.
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