Summary
Garrod presented his concept of ‘the inborn error of metabolism’ in the 1908 Croonian Lectures to the Royal College of Physicians (London); he used albinism, alkaptonuria, cystinuria and pentosuria to illustrate. His lectures are perceived today as landmarks in the history of biochemistry, genetics and medicine. Garrod gave evidence for the dynamic nature of metabolism by showing involvement of normal metabolites in normal pathways made variant by Mendelian inheritance. His concepts and evidence were salient primarily among biochemists, controversial among geneticists because biometricians were dominant over Mendelists, and least salient among physicians who were not attracted to rare hereditary ‘traits’. In 2008, at the centennial of Garrod’s Croonian Lectures, each charter inborn error of metabolism has acquired its own genomic locus, a cloned gene, a repertoire of annotated phenotype-modifying alleles, a gene product with known structure and function, and altered function in the Mendelian variant.
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References
Alsberg C, Folin O (1905) Protein metabolism in cystinuria. Am J Physiol 14: 54–72.
Antonarakis SE, Beckmann JS (2006) Mendelian disorders deserve more attention. Nat Rev Genet 7: 277–282.
Bateson W, Saunders ER (1901) Report to the Evolution Committee of the Royal Society. Vol. 1, 133–134. London: Royal Society.
Beadle GW (1964) Genes and Chemical Reactions in Neospora. Nobel Lectures: Physiology or Medicine. 1942–1962. Amsterdam: Nobel Lectures: Physiology or Medicine, 587–599.
Beadle GW, Tatum E (1941) Genetic control of biochemical reactions in Neurospora. Proc Natl Acad Sci U S A 27: 499–506.
Bearn AG (1993) Archibald Garrod and the Individuality of Man. Oxford: Clarendon Press.
Beltran-Valero de Bernabe D, Granadino B, Chiarelli I, et al (1998) Mutation and polymorphism analysis of the human homogentisate 1,2-dioxygenase gene in alkaptonuria patients. Am J Hum Genet 62: 776–784.
Beltran-Valero de Bernabe D, Jimenez FJ, Aquarion R, Rodriguez de Cordoba S (1999) Analysis of alkaptonuria (AKU) mutations and polymorphisms reveals that the CCC sequence motif is a mutation hotspot in the homogentisate 1,2 dioxygenase gene (HGO). Am J Hum Genet 64: 1316–1322.
Benfey PN, Mitchell-Olds T (2008) From genotype to phenotype: systems biology meets natural variation. Science 320: 495–497.
Brown BH, Lewis HB (1932) Cystine in normal and cystinuric human blood. Proc Soc Exp Biol Med 36: 488–489.
Calonge MJ, Gasparini P, Chillaron J, et al (1994) Cystinuria caused by mutations in rBAT, a gene involved in the transport of cystine. Nat Genet 6: 420–425.
Camargo SM, Bockenhauer D, Kleta R (2008) Aminoacidurias: clinical and molecular aspects. Kidney Int 73: 918–925.
Childs B (1970) Sir Archibald Garrod's conception of chemical individuality: A modern appreciation. N Engl J Med 282: 71–77
Childs B, Wiener C, Valle D (2005) A science of the individual: implications for a medical school curriculum. Annu Rev Genomics Hum Genet 6: 313–330.
Church WS (1909) The influence of heredity on disease etc. A discussion. 2. London, Longmans, Green and Co. Proc Roy Soc Med.
Crawhall JC, Purkiss P, Watts RW, Young EP (1969) The excretion of amino acids by cystinuric patients. Ann Hum Genet 33: 149–169.
Davenport CB (1916) Heredity of albinism. J Hered 7: 221–223.
Davenport GC, Davenport CB (1910) Heredity of skin pigmentation in man. Am Nat 44: 705–731.
Dello Strologo L, Pras E, Pontesilli C, et al (2002) Comparison between SLC3A1 and SLC7A9 cystinuria patients and carriers: A need for a new classification. J Am Soc Nephrol 13: 2547–2553.
Dent CE, Harris H (1951) Genetics of cystinuria. Ann Eugen 16: 60–87.
Dent CE, Rose GA (1951) Amino acid metabolism in cystinuria. Q J Med 20: 205–219.
Dent CE, Senior B (1955) Studies on the treatment of cystinuria. Br J Urol 27: 317–332.
Dent CE, Senior B, Walshe JM (1954) The pathogenesis of cystinuria. II. Polarographic studies of the metabolism of sulfur-containing amino acids. J Clin Invest 33: 1216–1226.
El-Kabbani O, Ishikura S, Darmanin C, et al (2004) Crystal structure of human l-xylulose reductase holo enzyme: Probing the role of asn107 with site-directed mutagenesis. Proteins 55: 724–732.
Fernandez-Canon JM, Granadino B, Beltran-Valero de Bernabe D, et al (1996) The molecular basis of alkaptonuria. Nat Genet 14: 19–24.
Font-Llitjos M, Jimenez-Vidal M, Bisceglia L, et al (2005) New insights into cystinuria: forty new mutations, genotype–phenotype correlation, and digenic inheritance causing partial phenotype. J Med Genet 42: 58–68.
Font MA, Feliubadalo L, Estivill X, et al (2001) Functional analysis of mutations in SLC7A9 and genotype-phenotype correlation in non-type 1 cystinuria. International Cystinuria Consortium. Hum Mol Genet 10: 305–316.
Fowler D, Harris H, Warren FL (1952) Plasma-cystine levels in cystinuria. Lancet 1: 544–545.
Garrod AE (1899) A contribution to the study of alkaptonuria. Med-Chir Trans 82: 369–394.
Garrod AE (1901) About alkaptonuria. Lancet ii: 1484–1486.
Garrod AE (1902) The incidence of alkaptonuria. A study in chemical individuality. Lancet 160(4137): 1616–1620.
Garrod AE (1908) The Croonian Lectures on Inborn Errors of Metabolism. Delivered before the Royal College of Physicians on June 18th, 23rd, 25th, and 30th, (1908). Lancet 172(4427): 1–7; 172(4428): 73–79; 172(4429): 142–148; 172(4430): 214–230.
Garrod AE (1909a) Anomalies of urinary excretion. In: Osler W, ed. Osler’s Modern Medicine. Philadelphia: Lea and Febiger, 71.
Garrod AE (1909b) Inborn Errors of Metabolism. Oxford: Oxford University Press.
Garrod AE (1923) Inborn Errors of Metabolism. London: Henry Frowde, Hodder and Stoughton.
Garrod AE (1931a) The Inborn Factors in Disease: An Essay. [Republished with annotations: Scriver CR, Childs B Oxford University Press. 1989]. Oxford: Clarendon Press.
Garrod AE (1931b) The Inborn Factors in Disease: An Essay. Oxford: Clarendon Press.
Garrod AE (1996) The incidence of alkaptonuria: a study in chemical individuality (1902) (reprinted). Mol Med 2: 274–282.
Garrod AE (2002) The incidence of alkaptonuria: a study in chemical individuality (1902) [classical article]. Yale J Biol Med 75: 221–231.
Gehrig A, Schmidt SR, Muller CR, Srsen S, Srsnova K, Kress W (1997) Molecular defects in alkaptonuria. Cytogenet Cell Genet 76: 14–16.
Goh K-I, Cusick ME, Valle D, Childs B, Vidal M, Barabasi A-L (2007) The human disease network. Proc Natl Acad Sci U S A 104: 8685–8690.
Goicoechea De Jorge Eeal (2002) Alkaptonuria in the Dominican Republic: identification of the founder AKU mutation and further evidence of mutation hotspots in the HGO gene. J Med Genet 39: E40.
Granadino D, Beltran-Valero de Bernabe D, Fernandez-Canon JM, Penalva MA, Rodriguez de Cordoba S (1997) The human homogentisate 1,2-dioxygenase (HGO) gene. Genomics 43: 115–122.
Greenwald I (1930) The nature of the sugar in four cases of pentosuria, a correction. J Biol Chem 89: 501.
Haffner ME (2006) Adopting orphan drugs – two dozen years of treating rare diseases. N Engl J Med 354: 445–447.
Harnevik L, Fjellstedt E, Molbaek A, Denneberg T, Soderkvist P (2003) Mutation analysis of SLC7A9 in cystinuria patients in Sweden. Genet Test 7: 13–20.
Harris G, Mittwoch U, Robson EB, Warren FL (1955a) Pattern of amino acid excretion in cystinuria. Ann Hum Genet 19: 196–208.
Harris G, Mittwoch U, Robson EB, Warren FL (1955b) Phenotypes and genotypes in cystinuria. Ann Hum Genet 20: 57–91.
Harris H (1963) Garrod’s Inborn Errors of Metabolism. Reprinted with a Supplement. London: Oxford University Press. Oxford Monographs on Medical Genetics.
Harris H (1970) The Principles of Human Biochemical Genetics. London: North Holland Publishing.
Harris H, Warren FL (1953) Quantitative sties on the urinary cystine in patients with cystine-stones and their relatives. Ann Eugen 18: 125–171.
Hartman JL, Garvik B, Hartwell L (2001) Principles for the buffering of genetic variation. Science 291: 1001–1004.
Hiatt HH (2008) Pentosuria. In: Valle D, et al, eds. New Online Metabolic and Molecular Bases of Inherited Disease. New York: McGraw-Hill. http://www.ommbid.com.
Hogben LT (1931) The genetic analysis of familial traits. J Genet 25: 97–112.
Hogben L, Worrall RL, Zieve I (1932) The genetic basis of alkaptonuria. Proc R Soc (Edinburgh) 52: 264–295.
Horecker BL, Hiatt HH (1958) Pathways of carbohydrate metabolism. N Engl J Med 258: 225–232.
Jaeken J, Martens K, François I, et al (2006) Deletion of PREPL, a gene encoding a putative serine oligopeptidase, in patients with hypotonia-cystinuria syndrome. Am J Hum Genet 78: 38–51.
Janocha S, Wolz W, Srsen S, et al (1994) The human gene for alkaptonuria (AKU) maps to chromosome 3q. Genomics 19: 5–8.
Johnson EH, Miller RL (1993) Alkaptonuria in a cynomolgus monkey (Macaca fascicularis). J Med Primatol 22: 428–430.
Kacser H, Burns JA (1973) The control of flux. Symp Soc Exp Biol 27: 65–104.
Kacser H, Burns JA (1981) The molecular basis of dominance. Genetics 97: 639–666.
Kacser H, Porteous JW (1987) Control of metabolism: what do we have to measure? Trends Biochem Sci 12: 5–14.
Kamoun P, Coude M, Forest M, Montagutelli X, Guenet J-L (1992) Ascorbic acid and alkaptonuria. Eur J Pediatr 151: 149.
Kayser MA, Introne W, Gahl WA (2008) Alkaptonuria. In: Valle D, et al, eds. New Online Metabolic and Molecular Bases of Inherited Disease. New York: McGraw Hill. http://www.ommbid.com.
King RS, Hearing VJ, Creel DJ, Oetting WS (2008) Albinism. In: Valle D, et al, eds. New Online Metabolic and Molecular Bases of Inherited Disease. New York: McGraw Hill. http://www.ommbid.com.
Knox WE (1958a) Sir Archibald Garrod’s “Inborn Errors of Metabolism”. III. Albinism. Am J Hum Genet 10: 249–267.
Knox WE (1958b) Sir Archibald Garrod’s “Inborn Errors of Metabolism”. IV. Pentosuria. Am J Hum Genet 10: 385–397.
Knox WE (1958c) Sir Archibald Garrod’s “Inborn Errors of Metabolism”. I. Cystinuria. Am J Hum Genet 10: 3–32.
Knox WE (1958d) Sir Archibald Garrod’s “Inborn Errors of Metabolism”: I. Cystinuria; II. Alkaptonuria; III. Albinism; IV. Pentosuria. Am J Hum Genet 10: 3–32, 95–124, 249–266, 385–397.
Knox WE (1966) Cystinuria. In: Stanbury JB, Wyngaarden JB, Fredrickson DS, eds. The Metabolic Basis of Inherited Disease. New York: McGraw Hill, 1262–1282.
Knox WE, Edwards SW (1955) Homogentisate oxidase of liver. J Biol Chem 216: 479–487.
La Du BN (2001) Alkaptonuria. In: Scriver CR, Beaudet A, Sly SW, Valle D, eds; Childs B, Kinzler KW, Vogelstein B, assoc. eds. The Metabolic and Molecular Bases of Inherited Disease. New York: McGraw Hill, 2109–2123.
La Du BN, Zannoni VC, Laster L, Seegmiller JE (1958) The nature of the defect in tyrosine metabolism in Alcaptonuria. J Biol Chem 230: 251–260.
Lane AB (1985) On the nature of l-xylulose reductase deficiency in essential pentosuria. Biochem Genet 23: 61–72.
Lane AB, Jenkins T (1985) Human l-xylulose reductase variation: family and population studies. Ann Hum Genet 49: 227–235.
Lasker M (1955) Mortality of persons with xyloketosuria. Hum Biol 27: 294–300.
Lasker M, Enklewitz M, Lasker GW (1936) The inheritance of l-xyloketosuria (essential pentosuria). Hum Biol 8: 243–255.
Levene PA, La Forge FB (1914) Note on a case of pentosuria. J Biol Chem 18: 319–327.
Lustberg TJ, Schulman JD, Seegmiller JE (1969) Metabolic fate of homogentisic acid-1-14C (HGA) in Alcaptonuria and effectiveness of ascorbic acid in preventing experimental ochronosis. Arthritis Rheum 12: 678.
Manning K, Fernandez-Canon JM, Montagutelli X, Grompe M (1999) Identification of the mutation in the alkaptonuria mouse model. Hum Mutat (Mutations in Brief #216, online) 13: 171.
Milch RA (1960) Studies of alcaptonuria: inheritance of 47 cases in eight highly inter-related Dominican kindreds. Am J Hum Genet 12: 76–85.
Montagutelli X, Lalouette A, Coude M, Kamoun P, Forest M, Guenet J-L (1994) aku, a mutation of the mouse homologous to human alkaptonuria, maps to chromosome 16. Genomics 19: 9–11.
Nakagawa J, Ishikura S, Asami J, et al (2002) Molecular characterization of mammalian dicarbonyl/l-xylulose reductase and its localization in kidney. J Biol Chem 277: 17883–17891.
Neuberger A, Rimington C, Wilson JMG (1947) Studies on alcaptonuria II. investigations on a case of human alcaptonuria. Biochem J 41: 438–449.
O’Brien WM, La Du BN, Bunim JJ (1963) Biochemical, pathological and clinical aspects of alcaptonuria, ochronosis, and ochronotic arthropathy: review of world literature (1584–1962). Am J Med 34: 813–838.
Olby R (1974) The Path to the Double Helix. Seattle: University of Washington Press.
Oltvai ZN, Barabasi AL (2002) Life’s complexity pyramid. Science 298: 763–764.
Osler W (1904) Ochronosis: The pigmentation of cartilages, sclerotics, and skin in alkaptonuria. Lancet 1: 10.
Palacin M, Estevez R, Bertran J, Zorzano A (1998) Molecular biology of mammalian plasma membrane amino acid transporters. Physiol Rev 78: 969–1054.
Palacin M, Nunes V, Font-Llitjos M, et al (2005) The genetics of heteromeric amino acid transporters. Physiology 20: 112–124.
Palacin M, Goodyer P, Nunes V, Gasparini P (2008) Cystinuria. In: Valle D, et al, eds. Online Metabolic and Molecular Bases of Inherited Disease. New York: McGraw-Hill. http://www.ommbid.com.
Patch FS (1934) Cystinuria and cystine lithiasis. Can Med Assoc J 31: 250–255.
Pearson K, Nettleship E, Usher CH (1911) A Monograph on Albinism in Man. London, Cambridge University Press. VI, VIII, IX. Parts I, II and IV. Draper’s Company Research Memoirs.
Phornphutkul C, Introne WJ, Perry MB, et al (2002) Natural history of alkaptonuria. N Engl J Med 347: 2111–2121.
Pollak MR, Chou Y-HW, Cerda JJ, et al (1993) Homozygosity mapping of the gene for alkaptonuria to chromosome 3q2. Nat Genet 5: 201–204.
Robson EB, Rose GA (1957) The effect of intravenous lysine on the renal clearance of cystine, arginine, and ornithine in normal subjects, in patients with cystinuria and Fanconi syndrome and in their relatives. Clin Sci 16: 75–93.
Rosenberg LE, Durant JL, Holland JM (1965) Intestinal absorption and renal extraction of cystine and cysteine in cystinuria. N Engl J Med 273: 1239–1245.
Schmidt SR, Gehrig A, Koehler MR, Schmid M, Muller CR, Kress W (1997) Cloning of the homogentisate 1,2-dioxygenase gene, the key enzyme of alkaptonuria in mouse. Mamm Genome 8: 168–171.
Scriver CR (1996) Alkaptonuria: such a long journey. Nat Genet 14: 5–6.
Scriver CR (2001) Garrod’s foresight; our hindsight. J Inherit Metab Dis 24: 93–116.
Scriver CR (2002) Does hereditary metabolic disease modulate senescence and ageing? J Inherit Metab Dis 25: 235–251.
Scriver CR (2004) After the genome – the phenome? J Inherit Metab Dis 27: 305–317.
Scriver CR, Tenenhouse HS (1992) Mendelian phenotypes as “probes” of renal transport systems for amino acids and phosphate. In: Windhager EE, ed. Handbook of Physiology. Section 8. Renal Physiology. Oxford: Oxford University Press, 1977–2016.
Scriver CR, Waters PJ (1999) Monogenic traits are not simple. Lessons from phenylketonuria. Trends Genet 15: 267–272.
Scriver CR, Gregory DM, Sovetts D, Tissenbaum G, Scriver CR (1985) Normal plasma free amino acid values in adults: the influence of some common physiological variables. Metabolism 34: 868–873.
Scriver CR, Mahon B, Levy HL, et al (1987) The Hartnup phenotype: Mendelian transport disorder, multifactorial disease. Am J Hum Genet 40: 401–412.
Segal S, Thier SO (1995) Cystinuria. In: Scriver CR, Beaudet A, Sly SW, Valle D, eds; Childs B, Kinzler KW, Vogelstein B, assoc. eds. The Metabolic and Molecular Bases of Inherited Disease. New York: McGraw Hill, 3581–3601.
Simmell O (2001) Lysinuric protein intolerance and other cationic amino acidurias. In: Scriver CR, Beaudet A, Sly SW, Valle D, eds; Childs B, Kinzler KW, Vogelstein B, assoc. eds. The Metabolic and Molecular Bases of Inherited Disease. New York: McGraw-Hill, 4933–4956. Updated chapter available at http://genetics.accessmedicine.com.
Srsen S, Cisarik F, Pasztor L, Harmecko L (1978) Alkaptonuria in the Trencin district of Czechoslovakia. Am J Med Genet 2: 159–166.
Stein WH (1951) Excretion of amino acids in cystinuria. Proc Soc Exp Biol 78: 705–708.
Stenn F, Milgram JW, Lee SL, Weigand RJ, Veis A (1977) Biochemical identification of homogentisic acid pigment in an ochronotic Egyptian mummy. Science 197: 566–568.
Suwannarat P, O'Brien K, Perry M, et al (2005) Use of nitisinone in patients with alkaptonuria. Metabolism 54: 719–728.
Suzuki Y, Oda K, Yoshikawa Y, Maeda T, Suzuki T (1999) A novel therapeutic trial of homogentisic aciduria in a murine model of alkaptonuria. J Hum Genet 44: 79–84.
Titus GP, Mueller HA, Burgner J, Rodriguez de Cordoba S, Penalva MA, Timm DE (2000) Crystal structure of human homogentisate dioxygenase. Nat Struct Biol 7: 542–546.
Trevor-Roper PD (1952) Marriage of two complete albinos with normally pigmented offspring. Br J Ophthalmol 36: 107.
Wamelink MMC, Jakobs C (2008) Ribose-5-phosphate isomerase deficiency and transaldolase deficiency. In: Valle D, et al, eds. New Online Metabolic and Molecular Bases of Inherited Disease. New York: McGraw-Hill. http://www.ommbid.com.
Wang YM, Van Eys J (1970) The enzymatic defect in essential pentosuria. N Engl J Med 282: 892–896.
Wolf CGL, Shaffer PA (1908) Protein metabolism in cystinuria. J Biochem 4: 439–472.
Wollaston WH (1810) On cystic oxide, a new species of urinary calculus. Philos Trans R Soc Lond 100: 223–230.
Yeh HL, Frankl W, Dunn MS, Parker P, Hughes B, Gyorgy P (1947) The urinary excretion of amino acids by a cystinuric subject. Am J Med Sci 214: 507–512.
Zannoni VG, Seegmiller JE, La Du BN (1962) Nature of the defect in alcaptonuria. Nature 193: 952.
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Scriver, C.R. Garrod’s Croonian Lectures (1908) and the charter ‘Inborn Errors of Metabolism’: Albinism, alkaptonuria, cystinuria, and pentosuria at age 100 in 2008. J Inherit Metab Dis 31, 580–598 (2008). https://doi.org/10.1007/s10545-008-0984-9
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DOI: https://doi.org/10.1007/s10545-008-0984-9