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Sialic acid catabolism by N-acetylneuraminate pyruvate lyase is essential for muscle function.

Abstract
Sialic acids are important components of glycoproteins and glycolipids essential for cellular communication, infection, and metastasis. The importance of sialic acid biosynthesis in human physiology is well illustrated by the severe metabolic disorders in this pathway. However, the biological role of sialic acid catabolism in humans remains unclear. Here, we present evidence that sialic acid catabolism is important for heart and skeletal muscle function and development in humans and zebrafish. In two siblings, presenting with sialuria, exercise intolerance/muscle wasting, and cardiac symptoms in the brother, compound heterozygous mutations [chr1:182775324C>T (c.187C>T; p.Arg63Cys) and chr1:182772897A>G (c.133A>G; p.Asn45Asp)] were found in the N-acetylneuraminate pyruvate lyase gene (NPL). In vitro, NPL activity and sialic acid catabolism were affected, with a cell-type-specific reduction of N-acetyl mannosamine (ManNAc). A knockdown of NPL in zebrafish resulted in severe skeletal myopathy and cardiac edema, mimicking the human phenotype. The phenotype was rescued by expression of wild-type human NPL but not by the p.Arg63Cys or p.Asn45Asp mutants. Importantly, the myopathy phenotype in zebrafish embryos was rescued by treatment with the catabolic products of NPL: N-acetyl glucosamine (GlcNAc) and ManNAc; the latter also rescuing the cardiac phenotype. In conclusion, we provide the first report to our knowledge of a human defect in sialic acid catabolism, which implicates an important role of the sialic acid catabolic pathway in mammalian muscle physiology, and suggests opportunities for monosaccharide replacement therapy in human patients.
AuthorsXiao-Yan Wen, Maja Tarailo-Graovac, Koroboshka Brand-Arzamendi, Anke Willems, Bojana Rakic, Karin Huijben, Afitz Da Silva, Xuefang Pan, Suzan El-Rass, Robin Ng, Katheryn Selby, Anju Mary Philip, Junghwa Yun, X Cynthia Ye, Colin J Ross, Anna M Lehman, Fokje Zijlstra, N Abu Bakar, Britt Drögemöller, Jacqueline Moreland, Wyeth W Wasserman, Hilary Vallance, Monique van Scherpenzeel, Farhad Karbassi, Martin Hoskings, Udo Engelke, Arjan de Brouwer, Ron A Wevers, Alexey V Pshezhetsky, Clara Dm van Karnebeek, Dirk J Lefeber
JournalJCI insight (JCI Insight) Vol. 3 Issue 24 (12 20 2018) ISSN: 2379-3708 [Electronic] United States
PMID30568043 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Hexosamines
  • mannosamine
  • Oxo-Acid-Lyases
  • N-acetylneuraminate lyase
  • N-Acetylneuraminic Acid
Topics
  • Adult
  • Animals
  • Disease Models, Animal
  • Edema, Cardiac (metabolism)
  • Gene Expression Regulation, Developmental
  • Gene Knockdown Techniques
  • Genetic Diseases, Inborn (genetics, metabolism)
  • HEK293 Cells
  • Hexosamines (metabolism)
  • Humans
  • Male
  • Muscle, Skeletal (growth & development, metabolism)
  • Muscular Diseases (genetics, metabolism, physiopathology)
  • Mutation
  • N-Acetylneuraminic Acid (metabolism)
  • Oxo-Acid-Lyases (genetics, metabolism, therapeutic use)
  • Sialic Acid Storage Disease (metabolism)
  • Young Adult
  • Zebrafish (embryology)

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