Abstract

The molecular genetics of well-characterized inherited diseases, such as phenylketonuria (PKU) and hyperphenylalaninemia (HPA) predominantly caused by mutations in the phenylalanine hydroxylase (PAH) gene, is often complicated by the identification of many novel variants, often with no obvious impact on the associated disorder. To date, more than 1100 PAH variants have been identified of which a substantial portion have unknown clinical significance. In this work, we study the functionality of seven yet uncharacterized PAH missense variants p.Asn167Tyr, p.Thr200Asn, p.Asp229Gly, p.Gly239Ala, p.Phe263Ser, p.Ala342Pro, and p.Ile406Met first identified in the Czech PKU/HPA patients. From all tested variants, three of them, namely p.Asn167Tyr, p.Thr200Asn, and p.Ile406Met, exerted residual enzymatic activity in vitro similar to wild type (WT) PAH, however, when expressed in HepG2 cells, their protein level reached a maximum of 72.1% ± 4.9%, 11.2% ± 4.2%, and 36.6% ± 7.3% compared to WT PAH, respectively. Remaining variants were null with no enzyme activity and decreased protein levels in HepG2 cells. The chaperone-like effect of applied BH4 precursor increased protein level significantly for p.Asn167Tyr, p.Asp229Gly, p.Ala342Pro, and p.Ile406Met. Taken together, our results of functional characterization in combination with in silico prediction suggest that while p.Asn167Tyr, p.Thr200Asn, and p.Ile406Met PAH variants have a mild impact on the protein, p.Asp229Gly, p.Gly239Ala, p.Phe263Ser, and p.Ala342Pro severely affect protein structure and function.

Highlights

  • Phenylketonuria (PKU; OMIM #26160), one of the most frequent disorders of amino acid metabolism in the Caucasian population, affects on average one in 10,000 live births [1]

  • Since p.Asn167Tyr, p.Thr200Asn, p.Asp229Gly, p.Phe263Ser, and p.Ile406Met variants were analyzed in silico in our previous study [16], we performed modeling only for p.Gly239Ala and p.Ala342Pro based on experimental X-ray structures

  • We used new experimental tetrameric rat PAH structure ([20]: First structure of full-length mammalian phenylalanine hydroxylase reveals the architecture of an autoinhibited tetramer; PDB ID: 5DEN)

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Summary

Introduction

Phenylketonuria (PKU; OMIM #26160), one of the most frequent disorders of amino acid metabolism in the Caucasian population, affects on average one in 10,000 live births [1]. The impairment of phenylalanine hydroxylase (PAH; OMIM #612349), encoded by the PAH gene, is in 98% of patients as the major cause of PKU. Due to this impairment, the dietary phenylalanine (Phe) cannot be metabolized properly, which results in the bloodstream. Patients present with mild to severe neurological features, including neurodevelopmental delay, intellectual disability, seizures, and microcephaly, or they can develop psychiatric disorders along with behavioral, emotional, and social problems as well [7]. Restrictive diet intervention and its lifelong strict compliance are essential for the prevention of these symptoms [4,5]

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