| Title | Intractable secretory diarrhea in a Japanese boy with mitochondrial respiratory chain complex I deficiency. | | Author(s) | Murayama K, Nagasaka H, Tsuruoka T, Omata Y, Horie H, Tregoning S, Thorburn DR, Takayanagi M, Ohtake A | | Institution | Department of Metabolism, Chiba Children’s Hospital, 579-1, Henda-cho, Midori-ku, Chiba, 266-0007, Japan, kmuraya@mri.biglobe.ne.jp. | | Source | Eur J Pediatr 2008 Jun 17. | | Abstract | The etiology of secretory diarrhea in early life is often unclear. We report a Japanese boy who survived until 3 years of age, despite intractable diarrhea commencing soon after birth. The fecal sodium content was strikingly high (109 mmol/L [normal range, 27-35 mmol/L]) and the osmotic gap was decreased (15 mOsm/kg), consistent with the findings of congenital sodium diarrhea. We examined the mitochondrial respiratory chain function by blue native polyacrylamide gel electrophoresis (BN-PAGE) in-gel enzyme staining, BN-PAGE western blotting, respiratory chain enzyme activity assay, and immunohistochemistry. Liver respiratory chain complex (Co) I activity was undetectable, while other respiratory chain complex activities were increased (Co II, 138%; Co III, 153%; Co IV, 126% versus respective control activities). Liver BN-PAGE in-gel enzyme staining and western blotting showed an extremely weak complex I band, while immunohistochemistry showed extremely weak staining for the 30-kDa subunit of complex I, but normal staining for the 70-kDa subunit of complex II. The patient was, therefore, diagnosed with complex I deficiency. The overall complex I activity of the jejunum was substantially decreased (63% of the control activity). The immunohistochemistry displayed apparently decreased staining of the 30-kDa complex I subunit, together with a slightly enhanced staining of the 70-kDa complex II subunit in intestinal epithelial cells. These data imply that intestinal epithelial cells are also complex I-deficient in this patient. Complex I deficiency is a novel cause of secretory diarrhea and may act via disrupting the supply of adenosine triphosphate (ATP) needed for the maintenance of ion gradients across membranes. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18560889 |
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