The molecular basis of pediatric long chain 3-hydroxyacyl-CoA dehydrogenase deficiency associated with maternal acute fatty liver of pregnancy

Harold F. Sims, Jeffrey C. Brackett, Cynthia K. Powell, William R. Treem, Daniel E. Hale, Michael J. Bennett, Beverly Gibson, Scott Shapiro, Arnold W. Strauss

Research output: Contribution to journalArticle

176 Scopus citations


Mitochondrial long chain fatty acid β-oxidation provides the major source of energy in the heart. Deficiencies of human β-oxidation enzymes produce sudden, unexplained death in childhood, acute hepatic encephalopathy, skeletal myopathy, or cardiomyopathy. Long chain 3-hydroxyacyI-CoA dehydrogenase [LCHAD; long-chain-(S)-3-hydroxyacyl-CoA:NAD+ oxidoreductase, EC] catalyzes the third step in β-oxidation, and this activity is present on the C-terminal portion of the α subunit of mitochondrial trifunctional protein. We used single-stranded conformation variance analysis of the exons of the human LCHAD (α subunit) gene to determine the molecular basis of LCHAD deficiency in three families with children presenting with sudden unexplained death or hypoglycemia and abnormal liver enzymes (Reye- like syndrome). In all families, the mothers had acute fatty liver and associated severe complications during pregnancies with the affected infants. The analysis in two affected children revealed a G to C mutation at position 1528 (G1528C) of the α subunit of the trifunctional protein on both alleles. This is in the LCHAD domain and substitutes glutamine for glutamic acid at position 474 of mature α subunit. The third child had this G1528C mutation on one allele and a different mutation (C1132T) creating a premature termination codon (residue 342) on the second allele. Our results demonstrate that mutations in the LCHAD domain of the trifunctional protein α subunit in affected offspring are associated with maternal acute fatty liver of pregnancy. This is the initial delineation of the molecular basis of isolated LCHAD deficiency.

Original languageEnglish (US)
Pages (from-to)841-845
Number of pages5
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number3
StatePublished - Jan 31 1995
Externally publishedYes



  • fatty acids
  • mitochondrial
  • sudden death
  • β-oxidation

ASJC Scopus subject areas

  • General

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