Research of Inborn Errors of Metabolism

A special issue of Metabolites (ISSN 2218-1989). This special issue belongs to the section "Endocrinology and Clinical Metabolic Research".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 1621

Special Issue Editors


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Guest Editor
Division of Inherited Metabolic Diseases, Department of Diagnostic Services, University Hospital of Padua, 35128 Padua, Italy
Interests: lysosomal storage disease; newborn screening; inborn errors of metabolism; dried blood spot; biomarkers

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Guest Editor
1. Genetics and Molecular Pathology, SA Pathology (at Women's and Children's Hospital), North Adelaide 5006, Australia
2. Adelaide Medical School, University of Adelaide, Adelaide 5005, Australia
Interests: lysosomal storage disorders; diagnosis of inborn errors of metabolism; understanding and treating inherited neurodegenerative disease
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Special Issue Information

Dear Colleagues,

Inborn errors of metabolism (IEMs) are genetic disorders caused by disruptions in metabolic pathways, typically due to mutations in genes encoding enzymes that metabolize proteins, fats, or carbohydrates. These disorders highlight the interplay between genetics and the environment, making them crucial for understanding both monogenic and multifactorial diseases. Enzymatic deficiencies often lead to toxic substance accumulation or shortages of essential products, disrupting normal bodily functions. This issue examines both unique and common pathogenic mechanisms and biochemical pathway disturbances that translate primary metabolic defects into clinical symptoms. IEMs often present in infancy or early childhood with varying severity, depending on the disorder and enzymatic deficiency. The discussion includes novel laboratory techniques that promise improved diagnostic and prognostic testing for these inherited diseases. Diagnosis typically involves newborn screening, genetic testing, and biochemical assays to detect abnormal metabolite levels. Addressing disease thresholds and pathophysiology can complicate therapeutic interventions, as treatments must target pathology across all affected tissues. Early diagnosis and intervention are crucial, as many IEMs can be managed with dietary changes, enzyme replacement therapy, or other treatments. Advances in genetic research enhance our understanding and management of these disorders, offering hope for improved outcomes and quality of life for affected individuals.

Dr. Vincenza Gragnaniello
Dr. Maria Fuller
Guest Editors

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Keywords

  • inborn errors of metabolism
  • pathogenic mechanisms
  • bio-chemical pathway
  • inherited diseases
  • diagnosis

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Published Papers (2 papers)

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Research

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12 pages, 246 KiB  
Article
Riboflavin Transporter Deficiency Type 2: Expanding the Phenotype of the Lebanese Founder Mutation p.Gly306Arg in the SLC52A2 Gene
by Jean-Marc T. Jreissati, Leonard Lawandos, Julien T. Jreissati and Pascale E. Karam
Metabolites 2025, 15(7), 491; https://doi.org/10.3390/metabo15070491 - 21 Jul 2025
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Abstract
Background: Riboflavin transporter deficiency type 2 is an ultra-rare, yet treatable, inborn error of metabolism. This autosomal recessive disorder is caused by pathogenic mutations in the SLC52A2 gene leading to progressive ataxia, polyneuropathy, and hearing and visual impairment. The early initiation of [...] Read more.
Background: Riboflavin transporter deficiency type 2 is an ultra-rare, yet treatable, inborn error of metabolism. This autosomal recessive disorder is caused by pathogenic mutations in the SLC52A2 gene leading to progressive ataxia, polyneuropathy, and hearing and visual impairment. The early initiation of riboflavin therapy can prevent or mitigate the complications. To date, only 200 cases have been reported, mostly in consanguineous populations. The p.Gly306Arg founder mutation, identified in patients of Lebanese descent, is the most frequently reported worldwide. It was described in a homozygous state in a total of 21 patients. Therefore, studies characterizing the phenotypic spectrum of this mutation remain scarce. Methods: A retrospective review of charts of patients diagnosed with riboflavin transporter deficiency type 2 at a tertiary-care reference center in Lebanon was performed. Clinical, biochemical, and molecular profiles were analyzed and compared to reported cases in the literature. Results: A total of six patients from three unrelated families were diagnosed between 2018 and 2023. All patients exhibited the homozygous founder mutation, p.Gly306Arg, with variable phenotypes, even among family members. The median age of onset was 3 years. Diagnosis was achieved by exome sequencing at a median age of 5 years, as clinical and biochemical profiles were inconsistently suggestive. The response to riboflavin was variable. One patient treated with high-dose riboflavin recovered his motor function, while the others were stabilized. Conclusions: This study expands the current knowledge of the phenotypic spectrum associated with the p.Gly306Arg mutation in the SLC52A2 gene. Increased awareness among physicians of the common manifestations of this rare disorder is crucial for early diagnosis and treatment. In the absence of a consistent clinical or biochemical phenotype, the use of next-generation sequencing as a first-tier diagnostic test may be considered. Full article
(This article belongs to the Special Issue Research of Inborn Errors of Metabolism)

Review

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21 pages, 1041 KiB  
Review
The Hidden Burden: Gastrointestinal Involvement in Lysosomal Storage Disorders
by Vincenza Gragnaniello, Chiara Cazzorla, Daniela Gueraldi, Andrea Puma, Christian Loro and Alberto B. Burlina
Metabolites 2025, 15(6), 361; https://doi.org/10.3390/metabo15060361 - 29 May 2025
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Abstract
Background: Lysosomal storage disorders (LSDs) are rare inherited metabolic diseases characterized by defects in lysosomal enzyme function or membrane transport. These defects lead to substrate accumulation and multisystemic manifestations. This review focuses on gastrointestinal (GI) involvement in LSDs, which is a significant but [...] Read more.
Background: Lysosomal storage disorders (LSDs) are rare inherited metabolic diseases characterized by defects in lysosomal enzyme function or membrane transport. These defects lead to substrate accumulation and multisystemic manifestations. This review focuses on gastrointestinal (GI) involvement in LSDs, which is a significant but often overlooked aspect of these disorders. Methods: A comprehensive literature review was conducted to examine the pathophysiology, clinical presentation, diagnosis and management of GI manifestations in several LSDs, including Fabry disease, Gaucher disease, Pompe disease, Niemann–Pick disease type C, mucopolysaccharidoses and Wolman disease. Results: The pathogenesis of GI involvement in LSDs varies and encompasses substrate accumulation in enterocytes, mesenteric lymphadenopathy, mass effects, smooth muscle dysfunction, vasculopathy, neuropathy, inflammation and alterations to the microbiota. Clinical presentations range from non-specific symptoms, such as abdominal pain, diarrhea and malabsorption, to more severe complications, such as protein-losing enteropathy and inflammatory bowel disease. Diagnosis often requires a high level of suspicion, as GI symptoms may precede the diagnosis of the underlying LSD or be misattributed to more common conditions. Management strategies include disease-specific treatments, such as enzyme replacement therapy or substrate reduction therapy, as well as supportive care and targeted interventions for specific GI complications. Conclusions: This review highlights the importance of recognizing and properly managing GI manifestations in LSDs to improve patient outcomes and quality of life. It also emphasizes the need for further research to develop more effective treatments for life-threatening GI complications associated with these rare genetic disorders. Full article
(This article belongs to the Special Issue Research of Inborn Errors of Metabolism)
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