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Biotinidase deficiency: New directions and practical concerns

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Opinion statement

Biotinidase deficiency is a readily treatable inherited disorder. Discovery of the enzyme deficiency as the cause for late-onset multiple carboxylase deficiency initially seemed to answer almost all of the questions about the disorder. However, as is the case for most inborn errors of metabolism, finding the enzyme that causes the disorder, cloning the gene, and determining the spectrum of clinical features of the disease only opens a Pandora’s box. As researchers have found, there are still many important and interesting questions about this disorder that must be addressed and answered. However, when compared with other inherited metabolic diseases, biotinidase deficiency is still one of the most readily treatable. If a child must have an inborn error of metabolism, let it be biotinidase deficiency and let it be identified by newborn screening.

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References and Recommended Reading

  1. Wolf B: Disorders of biotin metabolism. In The Metabolic and Molecular Bases of Inherited Disease, edn 8. Edited by Scriver CR, Beaudet AL, Sly WS, Valle D. New York: McGraw-Hill; 2001:3935–3962. Comprehensive review of clinical, biochemical, molecular, and cell biologic aspects of biotinidase deficiency.

    Google Scholar 

  2. Moss J, Lane MD: The biotin-dependent enzymes. Adv Enzymol 1971, 35:321–442.

    PubMed  CAS  Google Scholar 

  3. Wolf B, Feldman GL: The biotin-dependent carboxylase deficiencies. Am J Hum Genet 1982, 34:699–716.

    PubMed  CAS  Google Scholar 

  4. Thoma RW, Peterson WH: The enzymatic degradation of soluble bound biotin. J Biol Chem 1954, 210:569–579.

    PubMed  CAS  Google Scholar 

  5. Pispa J: Animal biotinidase. Ann Med Exp Biol Fenn 1965, 43(suppl):1–39.

    Google Scholar 

  6. Heard GS, Wolf B, Reddy JK: Pancreatic biotinidase activity: the potential for intestinal processing of dietary protein-bound biotin. Pediatr Res 1984, 18:198A.

    Article  Google Scholar 

  7. Wolf B, Grier RE, Allen RJ, et al.: Biotinidase deficiency: the enzymatic defect in late-onset multiple carboxylase deficiency. Clin Chim Acta 1983, 131:273–281.

    Article  PubMed  CAS  Google Scholar 

  8. Wolf B, Heard GS, Weissbecker KA, et al.: Biotinidase deficiency: initial clinical features and rapid diagnosis. Ann Neurol 1985, 18:614–617.

    Article  PubMed  CAS  Google Scholar 

  9. Gaudry M, Munnich A, Ogier H, et al.: Deficient liver biotinidase activity in multiple carboxylase deficiency. Lancet 1983, 2:397.

    Article  PubMed  CAS  Google Scholar 

  10. Thibideau D, Wolf B: Biotinidase deficiency: booklet for professionals and families. Connecticut Children’s Medical Center. Available at http://www.ccmckids.org/ Professionals/Biotinidase/index.htm. Updated online booklet about clinical aspects of biotindase deficiency written for health professionals and for families of children with biotinidase deficiency.

  11. Wolf B, Pomponio RJ, Norrgard KJ, et al.: Delayed-onset profound biotinidase deficiency. J Pediatr 1998, 132:362–365.

    Article  PubMed  CAS  Google Scholar 

  12. Schulz PE, Weiner SP, Belmont JW, Fishman MA: Basal ganglia calcifications in a case of biotinidase deficiency. Neurology 1988, 38:1326–1328.

    PubMed  CAS  Google Scholar 

  13. Bousounis DP, Camfield PR, Wolf B: Reversal of brain atrophy with biotin treatment in biotinidase deficiency. Neuropediatrics 1993, 24:214–217.

    Article  PubMed  CAS  Google Scholar 

  14. Wolf B: Disorders of biotin metabolism: treatable neurological syndromes. In The Molecular and Genetic Basis of Neurological Disease. Edited by Rosenberg R, Prusiner SB, Di Mauro S, et al. Stoneham, MA: Butterworth Publishers; 1992:569–581. Detailed review of the neurologic aspects of biotinidase deficiency.

    Google Scholar 

  15. Wolf B, Norrgard K, Pomponio RJ, et al.: Profound biotinidase deficiency in two asymptomatic adults. Am J Med Genet 1997, 73:5–9.

    Article  PubMed  CAS  Google Scholar 

  16. Heard GS, Secor McVoy JR, Wolf B: A screening method for biotinidase deficiency in newborns. Clin Chem 1984, 30:125–127.

    PubMed  CAS  Google Scholar 

  17. Pettit DA, Amador PS, Wolf B: The quantitation of biotinidase activity in dried blood spots using microtiter transfer plates: identification of biotinidase-deficient and heterozygous individuals. Anal Biochem 1989, 179:371–374.

    Article  PubMed  CAS  Google Scholar 

  18. Wolf B: Worldwide survey of neonatal screening for biotinidase deficiency. J Inherited Metab Dis 1991, 14:923–927.

    Article  PubMed  CAS  Google Scholar 

  19. Bonjour JP, Bausch J, Suormala T, Baumgartner ER: Detection of biocytin in urine of children with congenital biotinidase deficiency. Int J Vitam Nutr Res 1984, 54:223–229.

    PubMed  CAS  Google Scholar 

  20. Chauhan J, Dakshinamurti K: The role of human serum biotinidase as biotin-binding protein. Biochem J 1988, 256:265–270.

    PubMed  CAS  Google Scholar 

  21. Mock DM, Lankford G: Studies of the reversible binding of biotin to human plasma. J Nutr 1990, 120:375–381.

    PubMed  CAS  Google Scholar 

  22. Hymes J, Fleischhauer K, Wolf B: Biotinylation of biotinidase following incubation with biocytin. Clin Chim Acta 1995, 233:39–45.

    Article  PubMed  CAS  Google Scholar 

  23. Hayakawa K, Oizumi J: Human serum biotinidase is a thiol-type enzyme. J Biochem 1988, 103:773–777.

    PubMed  CAS  Google Scholar 

  24. Vesely DL, Kemp SF, Elders MJ: Isolation of a biotin receptor from hepatic plasma membranes. Biochem Biophys Res Comm 1987, 143:913–916.

    Article  PubMed  CAS  Google Scholar 

  25. Hymes J, Fleischhauer K, Wolf B: Biotinylation of histones by human serum biotinidase: assessment of biotinyl-transferase activity in sera from normal individuals and children with biotinidase deficiency. Biochem Molecul Med 1995, 56:76–83.

    Article  CAS  Google Scholar 

  26. Cole H, Reynolds TR, Buck GB, et al.: Human serum biotinidase: cDNA cloning, sequence and characterization. J Biol Chem 1994, 269:6566–6570.

    PubMed  CAS  Google Scholar 

  27. Cole H, Weremowicz H, Morton CC, Wolf B: Localization of serum biotinidase (BTD) to human chromosome 3 in band p25. Genomics 1994, 22:662–663.

    Article  PubMed  CAS  Google Scholar 

  28. Knight HC, Reynolds TR, Meyers GA, et al.: Structure of the human biotinidase gene. Mammal Genome 1998, 9:327–330.

    Article  CAS  Google Scholar 

  29. Hymes J, Stanley CM, Wolf B: Mutations in BTD causing biotinidase deficiency. Hum Mutat 2001, 200:375–381. Up-to-date summary of mutations that cause profound and partial biotinidase deficiency.

    Article  Google Scholar 

  30. Wolf B, Jensen K, Hunern G, et al.: Seventeen novel mutations that cause profound biotinidase deficiency. Molecul Genet Metabol 2002, In press.

  31. Pomponio RJ, Hymes J, Reynolds TR, et al.: Mutations in the human biotinidase gene that cause profound biotinidase deficiency in symptomatic children: molecular, biochemical and clinical analysis. Pediatr Res 1997, 42:840–848.

    Article  PubMed  CAS  Google Scholar 

  32. Pomponio RJ, Reynolds TR, Cole H, et al.: Mutational “hotspot” in the human biotinidase gene as a cause of biotinidase deficiency. Nature Genet 1995, 11:96–98.

    Article  PubMed  CAS  Google Scholar 

  33. Pomponio RJ, Norrgard KJ, Reynolds TR, et al.: Arg538 to Cys mutation in a CpG dinucleotide of the human biotinidase gene is the second most common cause of biotinidase deficiency in symptomatic children with biotinidase deficiency. Hum Genet 1997, 99:506–512.

    Article  PubMed  CAS  Google Scholar 

  34. Norrgard KJ, Pomponio RJ, Swango KL, et al.: Mutation (Q456H) is the most common cause of profound biotinidase deficiency in children ascertained by newborn screening in the United States. Biochem Molecul Med 1997, 61:l22–27.

    Article  Google Scholar 

  35. Norrgard KJ, Swango KL, Wolf B: Double mutation (A171T and D444H) is a common cause of profound biotinidase deficiency in children ascertained by newborn screening in the United States (mutations in brief-online). Hum Mutat 1997, 11:410.

    Article  Google Scholar 

  36. Swango KL, Demirkol M, Huner G, et al.: Partial biotinidase deficiency is usually due to the D444H mutation in the biotinidase gene. Hum Genet 1998, 102:571–575.

    Article  PubMed  CAS  Google Scholar 

  37. Wolf B, Grier RE, Allen RJ, et al.: Phenotypic variation in biotinidase deficiency. J Pediatr 1983, 103:233–237.

    Article  PubMed  CAS  Google Scholar 

  38. Wolf B, Grier RE, Heard GS: Hearing loss in biotinidase deficiency. Lancet 1983, 2:1365.

    Article  Google Scholar 

  39. Wolf B, Spencer R, Gleason T: Hearing loss is a common feature of symptomatic children with profound biotinidase deficiency. J Pediatr 2002, 140:242–246. Most comprehensive survey of hearing loss in symptomatic children with biotinidase deficiency. Demonstrates that hearing loss is more common in untreated children than previously thought.

    Article  PubMed  Google Scholar 

  40. Heller AJ, Stanley CM, Shaia WT, et al.: Localization of biotinidase in brain: implications for its role in hearing loss in biotinidase deficiency. Hearing Res 2002, 173:62–68.

    Article  CAS  Google Scholar 

  41. Moslinger D, Stockler-Ipsiroglu S, Scheibenreiter S, et al.: Clinical and neuropsychological outcome in 33 patients with biotinidase deficiency ascertained by newborn screening and family studies in Austria. Eur J Pediatr 2001, 9:277–282.

    Article  Google Scholar 

  42. Suormala TM, Baumgartner ER, Bausch J, et al.: Quantitative determination of biocytin in urine of patients with biotinidase deficiency using high-performance liquid chromatography. Clin Chim Acta 1988, 177:253–269.

    Article  PubMed  CAS  Google Scholar 

  43. Chan PW, Bartlett K: A new solid-phase assay for biotin and biocytin and its application to the study of patients with biotinidase deficiency. Clin Chim Acta 1986, 159:185–196.

    Article  PubMed  CAS  Google Scholar 

  44. Taitz LS, Green A, Strachan I, et al.: Biotinidase deficiency and the eye and ear. Lancet 1983, 2:918.

    Article  PubMed  CAS  Google Scholar 

  45. McVoy JR, Levy HL, Lawler M, et al.: Partial biotinidase deficiency: clinical and biochemical features. J Pediatr1990,116:78–83.

    Article  PubMed  CAS  Google Scholar 

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Wolf, B. Biotinidase deficiency: New directions and practical concerns. Curr Treat Options Neurol 5, 321–328 (2003). https://doi.org/10.1007/s11940-003-0038-4

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