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Histidinemia, also referred to as histidinuria, is a rare autosomal recessive metabolic disorder caused by a deficiency of the enzyme histidase. Histidase is needed for the metabolism of the amino acid histidine.^[1] Although originally thought to be linked to multiple developmental disorders histidinemia is now accepted as a relatively benign disorder,^[2] leading to a reduction in the prevalence of neonatal screening procedures.^[3]

Prevalence

Histidinemia has an autosomal recessive pattern of inheritance.

Histidinemia is a rare autosomal recessive disorder. However, histidinemia is considered the most prevalent inborn error of metabolism^[3]^[4] with a reported incidence of 1:8600 (Quebec); 1:180,000 (New York) and 1:9600 (Japan); and an average of 1:12,000 observed in the neonatal screening of over 20 million newborns.^[3]

Diagnosis and symptoms

Histidenemia is characterized by increased levels of histidine, histamine and imidazole in blood, urine and cerebrospinal fluid. This also results in decreased levels of the metabolite urocanic acid in blood, urine, and skin cells.^[1] In Japan, neonatal screening was previously performed on infants within 1 month of birth; infants demonstrating a blood histidine level of 6 mg/dl or more underwent careful testing as suspected histidinemia cases.^[5] A typical characteristic of histidinemia is an increase in the blood histidine levels from normal levels (70-120 μM) to an elevated level (290-1420 μM).^[3] Further testing includes: observing histidine as well as imidazolepyruvic acid metabolites in the urine. However, neonatal urine testing has been discontinued in most places, with the exception of Quebec.^[3]

Histidinemia is considered benign as most patients remain asymptomatic, early correlational evidence from the first decade of histidinemia research lead to the theory that histidinemia was associated with multiple developmental symptoms including hyperactivity, speech impediment, developmental delay, learning difficulties, and sometimes mental retardation.^[3] However, these claims were later deemed coincidental as a large subpopulation of infants that tested positive for histidinemia were found to have normal IQ and speech characteristics; as such histidinemia has since been reclassified as a benign inborn error of metabolism.^[2]

Molecular characteristics

Histidinemia occurs as the result of an inborn error of metabolism that may result in either an inactive or a severely reduced Histidine ammonia-lyase enzyme activity. The gene that encodes for Histidine ammonia-lyase (HAL) spans a roughly 25 kb and consists of 21 exons^[6] located at the 12q22-q24.1 position of human chromosome 12.^[4] There are 8 mutations currently associated with autosomal recessive histidinemia, that include: four missense mutations, two exonic polymorphisms and two intronic polymorphisms.^[4]

Treatment

It has been suggested that a possible method of treatment for histidinemia is through the adoption of a diet that is low in histidine intake. However, the requirement for such dietary restrictions is typically unnecessary for 99% of all cases of histidinemia.^[3]

References

^ ^a ^b Taylor RG, Levi HL, McInnes RR (1991). "Histidase and histidinemia. Clinical and molecular considerations". Mol Bio Med. 8 (1): 101–116. PMID 1943682.
^ ^a ^b Lam WK, Cleary MA, Wraith JE, Walter JH (1996). "Histidinemia: a benign metabolic disorder". Archives of Disease in Childhood 74: 343–346. doi:10.1136/adc.74.4.343.
^ ^a ^b ^c ^d ^e ^f ^g Levy H (2004). "Histidinemia" (PDF). Orphanet.
^ ^a ^b ^c Kawai Y, Moriyama A, Asai K, Coleman-Campbell CM, Morishita H, Suchi M (2005). "Molecular characterization of histidinemia: identification of four missense mutations in the histidase gene". Hum Genet. 116 (5): 340–346. doi:10.1007/s00439-004-1232-5. PMID 15806399.
^ Kitagawa T, Owada M, Sakiyama T, Kojima T, Kondo T (1981). "Experience and problems of newborn mass screening for inborn errors of metabolism in Japan". Acta. Paediatr. Jpn. 23 (1): 24–34. doi:10.1111/j.1442-200x.1981.tb01242.x.
^ Suchi M, Sano H, Mizuno H, Wada Y (1995). "Molecular cloning and structural characterization of the human histidase gene (HAL)". Genomics 29 (1): 98–104. doi:10.1006/geno.1995.1219. PMID 8530107.

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1. 新生児スクリーニング newborn screening
2. 点頭てんかんの病因および発症機序 etiology and pathogenesis of infantile spasms

English Journal

Effect of histidine administration to female rats during pregnancy and lactation on enzymes activity of phosphoryltransfer network in cerebral cortex and hippocampus of the offspring.

Rojas DB, de Andrade RB, Gemelli T, Oliveira LS, Campos AG, Dutra-Filho CS, Wannmacher CM.SourceDepartamento de Bioquímica, Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600 anexo, 90035-003, Porto Alegre, RS, Brazil.
Metabolic brain disease.Metab Brain Dis.2012 May 27. [Epub ahead of print]
Histidinemia is an inborn error of metabolism of amino acids caused by deficiency of histidase activity in liver and skin with consequent accumulation of histidine in plasma and tissues. Histidinemia is an autosomal recessive trait usually considered harmless to patients and their offspring, but som
PMID 22638695

Administration of histidine to female rats induces changes in oxidative status in cortex and hippocampus of the offspring.

Rojas DB, Gemelli T, de Andrade RB, Campos AG, Dutra-Filho CS, Wannmacher CM.SourcePrograma de Pós-Graduação em Ciências Biológicas: Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600 anexo, Porto Alegre, RS 90035-003, Brazil.
Neurochemical research.Neurochem Res.2012 May;37(5):1031-6. Epub 2012 Jan 12.
Histidinemia is an inherited metabolic disorder biochemically characterized by high concentrations of histidine in biological fluids. Usually affected patients are asymptomatic although some individuals have mental retardation and speech disorders. Considering the high prevalence of histidinemia and
PMID 22237970