Amadori rearrangement products as potential biomarkers for inborn errors of amino-acid metabolism

• Published in: Communications biology Vol. 4; no. 1; p. 367
• Main Authors: van Outersterp, Rianne E, Moons, Sam J, Engelke, Udo F H, Bentlage, Herman, Peters, Tessa M A, van Rooij, Arno, Huigen, Marleen C D G, de Boer, Siebolt, van der Heeft, Ed, Kluijtmans, Leo A J, van Karnebeek, Clara D M, Wevers, Ron A, Berden, Giel, Oomens, Jos, Boltje, Thomas J, Coene, Karlien L M, Martens, Jonathan
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 19.03.2021; Nature Publishing Group UK; Nature Portfolio
• Subjects: Advanced glycosylation end products; Aging; Amadori compounds; Amino acids; Biology; Biomarkers; Body fluids; Citrulline; Diabetes mellitus; Glycosylation; Hexose; Inborn errors of metabolism; Intermediates; Lysine; Magnetic resonance spectroscopy; Mass spectroscopy; Metabolic disorders; Metabolism; Metabolites; Methionine; NMR; Nuclear magnetic resonance; Pathophysiology; Phenylalanine; Phenylketonuria; Proline
• ISSN: 2399-3642; 2399-3642
• DOI: 10.1038/s42003-021-01909-5

The identification of disease biomarkers plays a crucial role in developing diagnostic strategies for inborn errors of metabolism and understanding their pathophysiology. A primary metabolite that accumulates in the inborn error phenylketonuria is phenylalanine, however its levels do not always directly correlate with clinical outcomes. Here we combine infrared ion spectroscopy and NMR spectroscopy to identify the Phe-glucose Amadori rearrangement product as a biomarker for phenylketonuria. Additionally, we find analogous amino acid-glucose metabolites formed in the body fluids of patients accumulating methionine, lysine, proline and citrulline. Amadori rearrangement products are well-known intermediates in the formation of advanced glycation end-products and have been associated with the pathophysiology of diabetes mellitus and ageing, but are now shown to also form under conditions of aminoacidemia. They represent a general class of metabolites for inborn errors of amino acid metabolism that show potential as biomarkers and may provide further insight in disease pathophysiology.