Deficiency in SLC25A1, Encoding the Mitochondrial Citrate Carrier, Causes Combined D-2- and L-2-Hydroxyglutaric Aciduria  Benjamin Nota, Eduard A. Struys,

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Deficiency in SLC25A1, Encoding the Mitochondrial Citrate Carrier, Causes Combined D-2- and L-2-Hydroxyglutaric Aciduria  Benjamin Nota, Eduard A. Struys, Ana Pop, Erwin E. Jansen, Matilde R. Fernandez Ojeda, Warsha A. Kanhai, Martijn Kranendijk, Silvy J.M. van Dooren, Marianna R. Bevova, Erik A. Sistermans, Aggie W.M. Nieuwint, Magalie Barth, Tawfeg Ben-Omran, Georg F. Hoffmann, Pascale de Lonlay, Marie T. McDonald, Alf Meberg, Ania C. Muntau, Jean-Marc Nuoffer, Rossella Parini, Marie-Hélène Read, Axel Renneberg, René Santer, Thomas Strahleck, Emile van Schaftingen, Marjo S. van der Knaap, Cornelis Jakobs, Gajja S. Salomons  The American Journal of Human Genetics  Volume 92, Issue 4, Pages 627-631 (April 2013) DOI: 10.1016/j.ajhg.2013.03.009 Copyright © 2013 The American Society of Human Genetics Terms and Conditions

Figure 1 Schematic Overview of Genomic Organization and Protein Domain Structure of SLC25A1 (A) SLC25A1 contains nine exons that encode a 311 amino acid long product. The first 13 amino acids are a transit peptide (red) for mitochondrial targeting, and the mature protein contains six membrane-spanning helices (orange). Locations of the 12 different identified mutations are shown. An alignment of the involved amino acids with different species is shown in Figure S1. (B) Immunoblot analysis of SLC25A1 accumulation in fibroblasts derived from control “C” and affected subjects 1–5, 7, and 9. SLC25A1 is immunodetected in control, subjects 1–3 (homozygous missense mutations), and subject 5 with mutation c.18_24dup (p.Ala9Profs∗82) and c.499G>A (p.Gly167Arg). Low detection in subject 4 (homozygous mutation c.821C>T [p.Ala274Ilefs∗24]) and no detection in subject 7 with mutation c.18_24dup (p.Ala9Profs∗82) and c.768C>G (p.Tyr256∗) and subject 9 (homozygous mutation c.18_24dup [p.Ala9Profs∗82]) is consistent with the presence of truncating mutations. The whole-blot image and a blot with a lower exposure time are shown in Figure S3. The American Journal of Human Genetics 2013 92, 627-631DOI: (10.1016/j.ajhg.2013.03.009) Copyright © 2013 The American Society of Human Genetics Terms and Conditions

Figure 2 Decreased Citrate and Isocitrate Levels in Combined D,L-2-HGA (A and B) Urinary levels of (A) citrate and (B) isocitrate were measured with LC-MS/MS in samples of controls (n = 40) and of individuals with combined D,L-2-HGA (n = 11) with SLC25A1 mutations. Horizontal lines indicate the group sample means. The differences observed between controls and combined D,L-2-HGA-affected individuals were statistically significant by Mann-Whitney’s test for both citrate (p = 0.0011) and isocitrate (p = 0.0015) levels (p < 0.05 was considered significant). Urinary levels of an unrelated metabolite (α-aminoadipic acid) was not significantly different between individuals with combined D,L-2-HGA and controls (Figure S4). (C) Fibroblast cultures derived from affected subjects (n = 7) were given [U-13C6]glucose, which is metabolized by glycolysis predominantly to [13C2]acetyl-CoA. [13C2]acetyl-CoA is converted to [13C2]citrate within mitochondria via the Krebs cycle. Levels of [13C2]citrate were measured after 72 hr incubation in culture medium and are expressed as percentage compared to control fibroblasts (n = 2). Error bars indicate standard error of mean of replicate measurements (n = 3). The American Journal of Human Genetics 2013 92, 627-631DOI: (10.1016/j.ajhg.2013.03.009) Copyright © 2013 The American Society of Human Genetics Terms and Conditions