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Borysova 2019 MiPschool Coimbra

From Bioblast
Olga Borysova
Lactate/pyruvate ratio as a marker of mitochondrial dysfunction in patients with autistic spectrum disorders.

Link: MitoEAGLE

Borysova O, Bakhchevan O (2019)

Event: MiPschool Coimbra 2019

COST Action MitoEAGLE

The lactate / pyruvate ratio is an important criterion for determining possible disturbances in mitochondrial metabolism, especially in patients with neurological dysfunctions [3].

Lactate elevation occurs because the flux through glycolysis overwhelms the utilization of pyruvate in the mitochondria. Several studies have shown that in patients with primary mitochondrial disease, truly elevated lactate levels have sensitivity between 34 and 62% and specificity between 83 and 100%. The blood lactate/pyruvate ratio is most reliable in differentiating electron transport chain (ETC) disease from disorders of pyruvate metabolism, but itโ€™s a question whether itโ€™s important only when lactate levels are high [1]. The sensitivity of this ratio is 31%, with a specificity of 100 [4].

A consensus statement from the Mitochondrial Medicine Society from 2014 states lactate:pyruvate ratio as one of the important diagnostic tools for the mitochondrial diseases [2].

We determined the level of lactate, pyruvate and the lactate / pyruvate ratio in 30 children with neurological disorders and suspected mitochondrial dysfunction. Blood sampling was performed with a test tube with NaF system Venosafe. The analysis was performed by spectrophotometry.

According to the obtained data, 83 % of patients have elevated lactate-pyruvate ratio, but only 20% from them have also elevated lactate level. Patients with elevated lactate level had lactate/pyruvate ratio elevation about 3 times higher than upper reference, estimated by the laboratory.

So lactate/pyruvate ratio is a more sensitive marker, but it needs further investigation for approving itsโ€™ clinical significance. It is also important to re-estimate reference for this indicator.


โ€ข Bioblast editor: Plangger M


Labels: MiParea: mt-Medicine, Patients  Pathology: Autism 







Affiliations

Odessa National Univ nd.a. Mechnikov I.I., Biology Dept, Odessa, UA. - [email protected]

References

  1. Debray FG, Mitchell GA, Allard P, Robinson BH, Hanley JA, Lambert M (2007) Diagnostic accuracy of blood lactate-to-pyruvate molar ratio in the differential diagnosis of congenital lactic acidosis. Clin Chem 53:916-921.
  2. Parikh S, Goldstein A, Koenig MK, Scaglia F, Enns GM, Saneto R, Anselm I, Cohen BH, Falk MJ, Greene C, Gropman AL, Haas R, Hirano M, Morgan P, Sims K, Tarnopolsky M, Van Hove JL, Wolfe L, DiMauro S (2015) Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society. Genet Med 17:689-701.
  3. Roumen RM, Redl H, Schlag G, Sandtner W, Koller W, Goris RJ (1993) Scoring systems and blood lactate concentrations in relation to the development of adult respiratory distress syndrome and multiple organ failure in severely traumatized patients. J Trauma 35:349-55.
  4. Suomalainen A (2011) Biomarkers for mitochondrial respiratory chain disorders. J Inherit Metab Dis 34:277-82.