Levodopa-responsive aromatic L-amino acid decarboxylase deficiency.

TitleLevodopa-responsive aromatic L-amino acid decarboxylase deficiency.
Publication TypeJournal Article
Year of Publication2004
AuthorsChang, YTerng, Sharma, R, J Marsh, L, McPherson, JD, Bedell, JA, Knust, A, Bräutigam, C, Hoffmann, GF, Hyland, K
JournalAnn Neurol
Volume55
Issue3
Pagination435-8
Date Published2004 Mar
ISSN0364-5134
KeywordsAdolescent, Adult, Alanine, Antiparkinson Agents, Aromatic-L-Amino-Acid Decarboxylases, Binding Sites, Carbidopa, Chromatography, High Pressure Liquid, Developmental Disabilities, DNA Mutational Analysis, Drug Combinations, Electrochemistry, Family Health, Female, Glycine, Humans, Levodopa, Male, Models, Structural, Point Mutation, Protein Binding, Protein Conformation
Abstract

We report three siblings, who were treated empirically with levodopa combined with carbidopa. There was an immediate therapeutic response. Biochemical investigation surprisingly showed the clinical phenotype to be caused by aromatic L-amino acid decarboxylase deficiency. Molecular characterization showed a homozygous point mutation (c.387 G-->A) in exon 3. Kinetic studies showed the mutation to decrease the binding affinity for the substrate. This, combined with structural modeling suggesting alteration of active site configuration, provided an explanation for the therapeutic response to levodopa.

DOI10.1002/ana.20055
Alternate JournalAnn. Neurol.
PubMed ID14991824
Grant ListR01 HD 36049 / HD / NICHD NIH HHS / United States
R01 HD 36081 / HD / NICHD NIH HHS / United States