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<title>
Entry
- *608348 - BRANCHED-CHAIN KETO ACID DEHYDROGENASE E1, ALPHA POLYPEPTIDE; BCKDHA
- OMIM
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<span class="h4">*608348</span>
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<strong>Table of Contents</strong>
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<a href="#title"><strong>Title</strong></a>
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<a href="#geneMap"><strong>Gene-Phenotype Relationships</strong></a>
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<a href="#text"><strong>Text</strong></a>
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<a href="#description">Description</a>
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<a href="#cloning">Cloning and Expression</a>
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<a href="#geneStructure">Gene Structure</a>
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<a href="#mapping">Mapping</a>
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<a href="#geneFunction">Gene Function</a>
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<li role="presentation" style="margin-left: 1em">
<a href="#molecularGenetics">Molecular Genetics</a>
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<a href="#allelicVariants"><strong>Allelic Variants</strong></a>
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<a href="#mimProteinLinksFold" id="mimProteinLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<span id="mimProteinLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5">&#9658;</span> Protein
</a>
</span>
</span>
</div>
<div id="mimProteinLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://hprd.org/summary?hprd_id=02009&isoform_id=02009_1&isoform_name=Isoform_1" class="mim-tip-hint" title="The Human Protein Reference Database; manually extracted and visually depicted information on human proteins." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HPRD', 'domain': 'hprd.org'})">HPRD</a></div>
<div><a href="https://www.proteinatlas.org/search/BCKDHA" class="mim-tip-hint" title="The Human Protein Atlas contains information for a large majority of all human protein-coding genes regarding the expression and localization of the corresponding proteins based on both RNA and protein data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HumanProteinAtlas', 'domain': 'proteinatlas.org'})">Human Protein Atlas</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/protein/29391,179360,232479,386841,548403,5705948,8176547,11386135,14043871,14286270,18645155,52545799,62089242,119577443,119577444,189055345,194389886,258645172,924443798,924443800,2037090389,2037090391,2037090393,2037090395" class="mim-tip-hint" title="NCBI protein data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Protein', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Protein</a></div>
<div><a href="https://www.uniprot.org/uniprotkb/P12694" class="mim-tip-hint" title="Comprehensive protein sequence and functional information, including supporting data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UniProt', 'domain': 'uniprot.org'})">UniProt</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimGeneInfo">
<span class="panel-title">
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<div id="mimGeneInfoLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Gene Info</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimGeneInfoLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="http://biogps.org/#goto=genereport&id=593" class="mim-tip-hint" title="The Gene Portal Hub; customizable portal of gene and protein function information." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'BioGPS', 'domain': 'biogps.org'})">BioGPS</a></div>
<div><a href="https://www.ensembl.org/Homo_sapiens/Gene/Summary?db=core;g=ENSG00000248098;t=ENST00000269980" class="mim-tip-hint" title="Orthologs, paralogs, regulatory regions, and splice variants." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Ensembl', 'domain': 'ensembl.org'})">Ensembl</a></div>
<div><a href="https://www.genecards.org/cgi-bin/carddisp.pl?gene=BCKDHA" class="mim-tip-hint" title="The Human Genome Compendium; web-based cards integrating automatically mined information on human genes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GeneCards', 'domain': 'genecards.org'})">GeneCards</a></div>
<div><a href="http://amigo.geneontology.org/amigo/search/annotation?q=BCKDHA" class="mim-tip-hint" title="Terms, defined using controlled vocabulary, representing gene product properties (biologic process, cellular component, molecular function) across species." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GeneOntology', 'domain': 'amigo.geneontology.org'})">Gene Ontology</a></div>
<div><a href="https://www.genome.jp/dbget-bin/www_bget?hsa+593" class="mim-tip-hint" title="Kyoto Encyclopedia of Genes and Genomes; diagrams of signaling pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'KEGG', 'domain': 'genome.jp'})">KEGG</a></div>
<dd><a href="http://v1.marrvel.org/search/gene/BCKDHA" class="mim-tip-hint" title="Model organism Aggregated Resources for Rare Variant ExpLoration." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MARRVEL', 'domain': 'marrvel.org'})">MARRVEL</a></dd>
<dd><a href="https://monarchinitiative.org/NCBIGene:593" class="mim-tip-hint" title="Monarch Initiative." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Monarch', 'domain': 'monarchinitiative.org'})">Monarch</a></dd>
<div><a href="https://www.ncbi.nlm.nih.gov/gene/593" class="mim-tip-hint" title="Gene-specific map, sequence, expression, structure, function, citation, and homology data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Gene', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Gene</a></div>
<div><a href="https://genome.ucsc.edu/cgi-bin/hgGene?db=hg38&hgg_chrom=chr19&hgg_gene=ENST00000540732.3&hgg_start=41397818&hgg_end=41425002&hgg_type=knownGene" class="mim-tip-hint" title="UCSC Genome Bioinformatics; gene-specific structure and function information with links to other databases." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UCSC', 'domain': 'genome.ucsc.edu'})">UCSC</a></div>
</div>
</div>
</div>
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<div id="mimClinicalResourcesLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Clinical Resources</div>
</div>
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<div id="mimClinicalResourcesLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel" aria-labelledby="clinicalResources">
<div class="panel-body small mim-panel-body">
<div><a href="https://search.clinicalgenome.org/kb/genes/HGNC:986" class="mim-tip-hint" title="A ClinGen curated resource of ratings for the strength of evidence supporting or refuting the clinical validity of the claim(s) that variation in a particular gene causes disease." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinGen Validity', 'domain': 'search.clinicalgenome.org'})">ClinGen Validity</a></div>
<div><a href="https://medlineplus.gov/genetics/gene/bckdha" class="mim-tip-hint" title="Consumer-friendly information about the effects of genetic variation on human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MedlinePlus Genetics', 'domain': 'medlineplus.gov'})">MedlinePlus Genetics</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/gtr/all/tests/?term=608348[mim]" class="mim-tip-hint" title="Genetic Testing Registry." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GTR', 'domain': 'ncbi.nlm.nih.gov'})">GTR</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimVariation">
<span class="panel-title">
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<span id="mimVariationLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5">&#9660;</span> Variation
</a>
</span>
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<div id="mimVariationLinksFold" class="panel-collapse collapse in mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.ncbi.nlm.nih.gov/clinvar?term=608348[MIM]" class="mim-tip-hint" title="ClinVar aggregates information about sequence variation and its relationship to human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">ClinVar</a></div>
<div><a href="https://gnomad.broadinstitute.org/gene/ENSG00000248098" class="mim-tip-hint" title="The Genome Aggregation Database (gnomAD), Broad Institute." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'gnomAD', 'domain': 'gnomad.broadinstitute.org'})">gnomAD</a></div>
<div><a href="https://www.ebi.ac.uk/gwas/search?query=BCKDHA" class="mim-tip-hint" title="GWAS Catalog; NHGRI-EBI Catalog of published genome-wide association studies." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GWAS Catalog', 'domain': 'gwascatalog.org'})">GWAS Catalog&nbsp;</a></div>
<div><a href="https://www.gwascentral.org/search?q=BCKDHA" class="mim-tip-hint" title="GWAS Central; summary level genotype-to-phenotype information from genetic association studies." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GWAS Central', 'domain': 'gwascentral.org'})">GWAS Central&nbsp;</a></div>
<div><a href="http://www.hgmd.cf.ac.uk/ac/gene.php?gene=BCKDHA" class="mim-tip-hint" title="Human Gene Mutation Database; published mutations causing or associated with human inherited disease; disease-associated/functional polymorphisms." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HGMD', 'domain': 'hgmd.cf.ac.uk'})">HGMD</a></div>
<div><a href="https://evs.gs.washington.edu/EVS/PopStatsServlet?searchBy=Gene+Hugo&target=BCKDHA&upstreamSize=0&downstreamSize=0&x=0&y=0" class="mim-tip-hint" title="National Heart, Lung, and Blood Institute Exome Variant Server." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NHLBI EVS', 'domain': 'evs.gs.washington.edu'})">NHLBI EVS</a></div>
<div><a href="https://www.pharmgkb.org/gene/PA25297" class="mim-tip-hint" title="Pharmacogenomics Knowledge Base; curated and annotated information regarding the effects of human genetic variations on drug response." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PharmGKB', 'domain': 'pharmgkb.org'})">PharmGKB</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimAnimalModels">
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<div id="mimAnimalModelsLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Animal Models</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimAnimalModelsLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.alliancegenome.org/gene/HGNC:986" class="mim-tip-hint" title="Search Across Species; explore model organism and human comparative genomics." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Alliance Genome', 'domain': 'alliancegenome.org'})">Alliance Genome</a></div>
<div><a href="https://flybase.org/reports/FBgn0037709.html" class="mim-tip-hint" title="A Database of Drosophila Genes and Genomes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'FlyBase', 'domain': 'flybase.org'})">FlyBase</a></div>
<div><a href="https://www.mousephenotype.org/data/genes/MGI:107701" class="mim-tip-hint" title="International Mouse Phenotyping Consortium." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'IMPC', 'domain': 'knockoutmouse.org'})">IMPC</a></div>
<div><a href="http://v1.marrvel.org/search/gene/BCKDHA#HomologGenesPanel" class="mim-tip-hint" title="Model organism Aggregated Resources for Rare Variant ExpLoration." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MARRVEL', 'domain': 'marrvel.org'})">MARRVEL</a></div>
<div><a href="http://www.informatics.jax.org/marker/MGI:107701" class="mim-tip-hint" title="Mouse Genome Informatics; international database resource for the laboratory mouse, including integrated genetic, genomic, and biological data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MGI Mouse Gene', 'domain': 'informatics.jax.org'})">MGI Mouse Gene</a></div>
<div><a href="https://www.mmrrc.org/catalog/StrainCatalogSearchForm.php?search_query=" class="mim-tip-hint" title="Mutant Mouse Resource & Research Centers." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MMRRC', 'domain': 'mmrrc.org'})">MMRRC</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/gene/593/ortholog/" class="mim-tip-hint" title="Orthologous genes at NCBI." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Orthologs', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Orthologs</a></div>
<div><a href="https://omia.org/OMIA000627/" class="mim-tip-hint" title="Online Mendelian Inheritance in Animals (OMIA) is a database of genes, inherited disorders and traits in 191 animal species (other than human and mouse.)" target="_blank">OMIA</a></div>
<div><a href="https://www.orthodb.org/?ncbi=593" class="mim-tip-hint" title="Hierarchical catalogue of orthologs." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'OrthoDB', 'domain': 'orthodb.org'})">OrthoDB</a></div>
<div><a href="https://wormbase.org/db/gene/gene?name=WBGene00012713;class=Gene" class="mim-tip-hint" title="Database of the biology and genome of Caenorhabditis elegans and related nematodes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name'{'name': 'Wormbase Gene', 'domain': 'wormbase.org'})">Wormbase Gene</a></div>
<div><a href="https://zfin.org/ZDB-GENE-050522-376" class="mim-tip-hint" title="The Zebrafish Model Organism Database." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ZFin', 'domain': 'zfin.org'})">ZFin</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimCellLines">
<span class="panel-title">
<span class="small">
<a href="#mimCellLinesLinksFold" id="mimCellLinesLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<div style="display: table-row">
<div id="mimCellLinesLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Cell Lines</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimCellLinesLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://catalog.coriell.org/Search?q=OmimNum:608348" class="definition" title="Coriell Cell Repositories; cell cultures and DNA derived from cell cultures." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'CCR', 'domain': 'ccr.coriell.org'})">Coriell</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimCellularPathways">
<span class="panel-title">
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<div id="mimCellularPathwaysLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Cellular Pathways</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimCellularPathwaysLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.genome.jp/dbget-bin/get_linkdb?-t+pathway+hsa:593" class="mim-tip-hint" title="Kyoto Encyclopedia of Genes and Genomes; diagrams of signaling pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'KEGG', 'domain': 'genome.jp'})">KEGG</a></div>
<div><a href="https://reactome.org/content/query?q=BCKDHA&species=Homo+sapiens&types=Reaction&types=Pathway&cluster=true" class="definition" title="Protein-specific information in the context of relevant cellular pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {{'name': 'Reactome', 'domain': 'reactome.org'}})">Reactome</a></div>
</div>
</div>
</div>
</div>
</div>
</div>
<span>
<span class="mim-tip-bottom" qtip_title="<strong>Looking for this gene or this phenotype in other resources?</strong>" qtip_text="Select a related resource from the dropdown menu and click for a targeted link to information directly relevant.">
&nbsp;
</span>
</span>
</div>
<div class="col-lg-8 col-lg-pull-2 col-md-8 col-md-pull-2 col-sm-8 col-sm-pull-2 col-xs-12">
<div>
<a id="title" class="mim-anchor"></a>
<div>
<a id="number" class="mim-anchor"></a>
<div class="text-right">
&nbsp;
</div>
<div>
<span class="h3">
<span class="mim-font mim-tip-hint" title="Gene description">
<span class="text-danger"><strong>*</strong></span>
608348
</span>
</span>
</div>
</div>
<div>
<a id="preferredTitle" class="mim-anchor"></a>
<h3>
<span class="mim-font">
BRANCHED-CHAIN KETO ACID DEHYDROGENASE E1, ALPHA POLYPEPTIDE; BCKDHA
</span>
</h3>
</div>
<div>
<br />
</div>
<div>
<a id="alternativeTitles" class="mim-anchor"></a>
<div>
<p>
<span class="mim-font">
<em>Alternative titles; symbols</em>
</span>
</p>
</div>
<div>
<h4>
<span class="mim-font">
BCKD, E1-ALPHA SUBUNIT; BCKDE1A
</span>
</h4>
</div>
</div>
<div>
<br />
</div>
</div>
<div>
<a id="approvedGeneSymbols" class="mim-anchor"></a>
<p>
<span class="mim-text-font">
<strong><em>HGNC Approved Gene Symbol: <a href="https://www.genenames.org/tools/search/#!/genes?query=BCKDHA" class="mim-tip-hint" title="HUGO Gene Nomenclature Committee." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HGNC', 'domain': 'genenames.org'})">BCKDHA</a></em></strong>
</span>
</p>
</div>
<div>
<a id="cytogeneticLocation" class="mim-anchor"></a>
<p>
<span class="mim-text-font">
<strong>
<em>
Cytogenetic location: <a href="/geneMap/19/730?start=-3&limit=10&highlight=730">19q13.2</a>
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : <a href="https://genome.ucsc.edu/cgi-bin/hgTracks?db=hg38&position=chr19:41397818-41425002&dgv=pack&knownGene=pack&omimGene=pack" class="mim-tip-hint" title="UCSC Genome Browser; reference sequences and working draft assemblies for a large collection of genomes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UCSC Genome Browser', 'domain': 'genome.ucsc.edu'})">19:41,397,818-41,425,002</a> </span>
</em>
</strong>
<a href="https://www.ncbi.nlm.nih.gov/" target="_blank" class="small"> (from NCBI) </a>
</span>
</p>
</div>
<div>
<br />
</div>
<div>
<a id="geneMap" class="mim-anchor"></a>
<div style="margin-bottom: 10px;">
<span class="h4 mim-font">
<strong>Gene-Phenotype Relationships</strong>
</span>
</div>
<div>
<table class="table table-bordered table-condensed table-hover small mim-table-padding">
<thead>
<tr class="active">
<th>
Location
</th>
<th>
Phenotype
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="1">
<span class="mim-font">
<a href="/geneMap/19/730?start=-3&limit=10&highlight=730">
19q13.2
</a>
</span>
</td>
<td>
<span class="mim-font">
Maple syrup urine disease, type Ia
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/248600"> 248600 </a>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="Autosomal recessive">AR</abbr>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="3 - The molecular basis of the disorder is known">3</abbr>
</span>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div>
<div class="btn-group">
<button type="button" class="btn btn-success dropdown-toggle" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">
PheneGene Graphics <span class="caret"></span>
</button>
<ul class="dropdown-menu" style="width: 17em;">
<li><a href="/graph/linear/608348" target="_blank" onclick="gtag('event', 'mim_graph', {'destination': 'Linear'})"> Linear </a></li>
<li><a href="/graph/radial/608348" target="_blank" onclick="gtag('event', 'mim_graph', {'destination': 'Radial'})"> Radial </a></li>
</ul>
</div>
<span class="glyphicon glyphicon-question-sign mim-tip-hint" title="OMIM PheneGene graphics depict relationships between phenotypes, groups of related phenotypes (Phenotypic Series), and genes.<br /><a href='/static/omim/pdf/OMIM_Graphics.pdf' target='_blank'>A quick reference overview and guide (PDF)</a>"></span>
</div>
<div>
<br />
</div>
<div>
<a id="text" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<span class="mim-tip-floating" qtip_title="<strong>Looking For More References?</strong>" qtip_text="Click the 'reference plus' icon &lt;span class='glyphicon glyphicon-plus-sign'&gt;&lt;/span&gt at the end of each OMIM text paragraph to see more references related to the content of the preceding paragraph.">
<strong>TEXT</strong>
</span>
</span>
</h4>
<div>
<a id="description" class="mim-anchor"></a>
<h4 href="#mimDescriptionFold" id="mimDescriptionToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
<span id="mimDescriptionToggleTriangle" class="small mimTextToggleTriangle">&#9660;</span>
<span class="mim-font">
<strong>Description</strong>
</span>
</h4>
</div>
<div id="mimDescriptionFold" class="collapse in ">
<span class="mim-text-font">
<p>The BCKDHA gene encodes the E1-alpha subunit of the branched-chain alpha-keto acid (BCAA) dehydrogenase complex (BCKD; <a href="https://enzyme.expasy.org/EC/1.2.4.4" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'EC\', \'domain\': \'expasy.org\'})">EC 1.2.4.4</a>), an inner-mitochondrial enzyme complex that catalyzes the oxidative decarboxylation of the branched-chain alpha-ketoacids derived from isoleucine, leucine, and valine. This reaction is the second major step in the catabolism of the branched-chain amino acids (<a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al., 1998</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The BCKD complex consists of 3 catalytic components: a heterotetrameric (alpha2-beta2) branched-chain alpha-keto acid decarboxylase (E1), a homo-24-meric dihydrolipoyl transacylase (E2; <a href="/entry/248610">248610</a>), and a homodimeric dihydrolipoamide dehydrogenase (E3; <a href="/entry/238331">238331</a>). E1 is a thiamine pyrophosphate (TPP)-dependent enzyme. The reaction is irreversible and constitutes the first committed step in BCAA oxidation. The BCKDHB gene (<a href="/entry/248611">248611</a>) encodes the beta subunit of E1. The complex also contains 2 regulatory enzymes, a kinase and a phosphorylase.</p>
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<div>
<a id="cloning" class="mim-anchor"></a>
<h4 href="#mimCloningFold" id="mimCloningToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
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<span class="mim-font">
<strong>Cloning and Expression</strong>
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</h4>
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<div id="mimCloningFold" class="collapse in mimTextToggleFold">
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<p><a href="#15" class="mim-tip-reference" title="Tiu, A. B., Naujokas, M., Eisenstein, R., Francke, U., Barton, D. E., Hoganson, G. E. &lt;strong&gt;Cloning and chromosome mapping of a cDNA encoding the E1-alpha subunit of branched chain ketoacid dehydrogenase (BCKAD). (Abstract)&lt;/strong&gt; Am. J. Hum. Genet. 43: A17 only, 1988."None>Tiu et al. (1988)</a> cloned the gene for the E1-alpha subunit of branched-chain keto acid dehydrogenase, which they symbolized BCKAD. They found 91% amino acid sequence homology to the rat protein and noted that the phosphorylation site described in other species was conserved in human. Northern blot analysis of human liver showed a single 1.6-kb mRNA transcript. <a href="#17" class="mim-tip-reference" title="Zhang, B., Crabb, D. W., Harris, R. A. &lt;strong&gt;Nucleotide and deduced amino acid sequence of the E1-alpha subunit of human liver branched-chain alpha-ketoacid dehydrogenase.&lt;/strong&gt; Gene 69: 159-164, 1988.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/3224821/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;3224821&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/0378-1119(88)90390-3&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="3224821">Zhang et al. (1988)</a> isolated a cDNA corresponding to the BCKDHA gene from a human liver cDNA library. The deduced 378-amino acid protein shows 96% identity to the rat enzyme subunit, and the amino acid residues surrounding the phosphorylation site are completely conserved between human and rat. Northern blot analysis demonstrated a single 1.8-kb mRNA transcript, with a higher level of transcript in liver than in normal fibroblasts. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=3224821" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#9" class="mim-tip-reference" title="Fisher, C. W., Chuang, J. L., Griffin, T. A., Lau, K. S., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular phenotypes in cultured maple syrup urine disease cells: complete E(1)-alpha cDNA sequence and mRNA and subunit contents of the human branched chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; J. Biol. Chem. 264: 3448-3453, 1989.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2914958/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2914958&lt;/a&gt;]" pmid="2914958">Fisher et al. (1989)</a> found that the E1-alpha subunit comprises 400 amino acids with a calculated molecular mass of approximately 46 kD. <a href="#5" class="mim-tip-reference" title="Dariush, N., Fisher, C. W., Cox, R. P., Chuang, D. T. &lt;strong&gt;Structure of the gene encoding the entire mature E1-alpha subunit of human branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; FEBS Lett. 284: 34-38, 1991. Note: Erratum: FEBS Lett. 291: 376 only, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2060625/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2060625&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/0014-5793(91)80755-r&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2060625">Dariush et al. (1991)</a> reported the complete sequence of the 3-prime untranslated region of the BCKDHA gene and found that the gene has multiple transcription initiation sites at bases +1, +18, and +22. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=2060625+2914958" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The BCKDHA protein has a molecular mass of 45.5 kD (<a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al., 1998</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<div>
<a id="geneStructure" class="mim-anchor"></a>
<h4 href="#mimGeneStructureFold" id="mimGeneStructureToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
<span id="mimGeneStructureToggleTriangle" class="small mimTextToggleTriangle">&#9660;</span>
<span class="mim-font">
<strong>Gene Structure</strong>
</span>
</h4>
</div>
<div id="mimGeneStructureFold" class="collapse in mimTextToggleFold">
<span class="mim-text-font">
<p><a href="#5" class="mim-tip-reference" title="Dariush, N., Fisher, C. W., Cox, R. P., Chuang, D. T. &lt;strong&gt;Structure of the gene encoding the entire mature E1-alpha subunit of human branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; FEBS Lett. 284: 34-38, 1991. Note: Erratum: FEBS Lett. 291: 376 only, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2060625/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2060625&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/0014-5793(91)80755-r&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2060625">Dariush et al. (1991)</a> determined that the BCKDHA gene contains 9 exons. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2060625" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
</span>
<div>
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</div>
</div>
<div>
<a id="mapping" class="mim-anchor"></a>
<h4 href="#mimMappingFold" id="mimMappingToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
<span id="mimMappingToggleTriangle" class="small mimTextToggleTriangle">&#9660;</span>
<span class="mim-font">
<strong>Mapping</strong>
</span>
</h4>
</div>
<div id="mimMappingFold" class="collapse in mimTextToggleFold">
<span class="mim-text-font">
<p>Using somatic cell hybrids, <a href="#15" class="mim-tip-reference" title="Tiu, A. B., Naujokas, M., Eisenstein, R., Francke, U., Barton, D. E., Hoganson, G. E. &lt;strong&gt;Cloning and chromosome mapping of a cDNA encoding the E1-alpha subunit of branched chain ketoacid dehydrogenase (BCKAD). (Abstract)&lt;/strong&gt; Am. J. Hum. Genet. 43: A17 only, 1988."None>Tiu et al. (1988)</a> mapped the E1-alpha gene to human chromosome 19 and mouse chromosome 7. <a href="#4" class="mim-tip-reference" title="Crabb, D. W., Deaven, L. L., Luedemann, M., Zhang, B., Harris, R. A. &lt;strong&gt;Assignment of the gene for the E1-alpha subunit of branched chain alpha-ketoacid dehydrogenase to chromosome 19.&lt;/strong&gt; Cytogenet. Cell Genet. 50: 40-41, 1989.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2743816/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2743816&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1159/000132715&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2743816">Crabb et al. (1989)</a> also mapped the human BCKDHA gene to chromosome 19. By in situ hybridization, <a href="#6" class="mim-tip-reference" title="Fekete, G., Plattner, R., Crabb, D. W., Zhang, B., Harris, R. A., Heerema, N., Palmer, C. G. &lt;strong&gt;Localization of the human gene for the El-alpha subunit of branched chain keto acid dehydrogenase (BCKDHA) to chromosome 19q13.1-q13.2.&lt;/strong&gt; Cytogenet. Cell Genet. 50: 236-237, 1989.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2805821/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2805821&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1159/000132768&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2805821">Fekete et al. (1989)</a> assigned the BCKDHA gene to 19q13.1-q13.2. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=2805821+2743816" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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</div>
<div>
<a id="geneFunction" class="mim-anchor"></a>
<h4 href="#mimGeneFunctionFold" id="mimGeneFunctionToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
<span id="mimGeneFunctionToggleTriangle" class="small mimTextToggleTriangle">&#9660;</span>
<span class="mim-font">
<strong>Gene Function</strong>
</span>
</h4>
</div>
<div id="mimGeneFunctionFold" class="collapse in mimTextToggleFold">
<span class="mim-text-font">
<p><a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> performed functional studies of the wildtype E1-alpha protein in an E. coli expression system augmented by the chaperonins GroEL (HSPD1; <a href="/entry/118190">118190</a>) and GroES (HSPE1; <a href="/entry/600141">600141</a>), which are essential for efficient folding and assembly of the E1 tetramer in E. coli. Studies of the wildtype protein showed that E1-alpha and E1-beta assembled in 10 to 20 minutes. Alpha-beta heterodimers (80 kD) were formed at 1 hour, and a minor species of alpha2-beta2 tetramers (165 kD) appeared at 2 hours. At 3 hours and 20 hours, the major species were alpha2-beta2 tetramers, and the minor species were alpha-beta dimers. The data indicated that the subunits initially formed dimers, which later slowly dimerize to produce heterotetramers. Alpha-beta dimers had no enzyme activity. Further studies of mutant E1-alpha proteins demonstrated that the E1-alpha C-terminal aromatic residues, phe364, tyr368, and tyr393, are crucial for complete and proper assembly with E1-beta to form tetrameric E1. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<div>
<a id="molecularGenetics" class="mim-anchor"></a>
<h4 href="#mimMolecularGeneticsFold" id="mimMolecularGeneticsToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
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<strong>Molecular Genetics</strong>
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</h4>
</div>
<div id="mimMolecularGeneticsFold" class="collapse in mimTextToggleFold">
<span class="mim-text-font">
<p>In a patient with the classic type of maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), Zhang et al. (<a href="#18" class="mim-tip-reference" title="Zhang, B., Edenberg, H. J., Crabb, D. W., Harris, R. A. &lt;strong&gt;Evidence for both a regulatory mutation and a structural mutation in a family with maple syrup urine disease.&lt;/strong&gt; J. Clin. Invest. 83: 1425-1429, 1989.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2703538/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2703538&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI114033&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2703538">1989</a>, <a href="#19" class="mim-tip-reference" title="Zhang, B., Zhao, Y., Harris, R. A., Crabb, D. W. &lt;strong&gt;Molecular defects in the E1-alpha subunit of the branched-chain alpha-ketoacid dehydrogenase complex that cause maple syrup urine disease.&lt;/strong&gt; Molec. Biol. Med. 8: 39-47, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1943689/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1943689&lt;/a&gt;]" pmid="1943689">1991</a>) identified a mutation in the BCKDHA gene (<a href="#0001">608348.0001</a>). <a href="#2" class="mim-tip-reference" title="Chuang, J. L., Fisher, C. R., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular basis of maple syrup urine disease: novel mutations at the E1-alpha locus that impair E1(alpha-2-beta-2) assembly or decrease steady-state E1-alpha mRNA levels of branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; Am. J. Hum. Genet. 55: 297-304, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8037208/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8037208&lt;/a&gt;]" pmid="8037208">Chuang et al. (1994)</a> later identified a second mutation in the BCKDHA gene in this patient (<a href="#0002">608348.0002</a>). Each parent was heterozygous for 1 of the mutations. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=8037208+1943689+2703538" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>In 3 of 4 unrelated Hispanic Mexican patients with intermediate MSUD, <a href="#1" class="mim-tip-reference" title="Chuang, J. L., Davie, J. R., Chinsky, J. M., Wynn, R. M., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular and biochemical basis of intermediate maple syrup urine disease: occurrence of homozygous G245R and F364C mutations at the E1-alpha locus of Hispanic-Mexican patients.&lt;/strong&gt; J. Clin. Invest. 95: 954-963, 1995.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7883996/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7883996&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI117804&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7883996">Chuang et al. (1995)</a> identified a homozygous mutation in the BCKDHA gene (<a href="#0003">608348.0003</a>). The fourth patient was homozygous for a different mutation in the same gene (<a href="#0004">608348.0004</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=7883996" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="allelicVariants" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<span href="#mimAllelicVariantsFold" id="mimAllelicVariantsToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
<span id="mimAllelicVariantsToggleTriangle" class="small mimTextToggleTriangle">&#9660;</span>
<strong>ALLELIC VARIANTS (<a href="/help/faq#1_4"></strong>
</span>
<strong>9 Selected Examples</a>):</strong>
</span>
</h4>
<div>
<p />
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<a href="/allelicVariants/608348" class="btn btn-default" role="button"> Table View </a>
&nbsp;&nbsp;<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=608348[MIM]" class="btn btn-default mim-tip-hint" role="button" title="ClinVar aggregates information about sequence variation and its relationship to human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">ClinVar</a>
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<a id="0001" class="mim-anchor"></a>
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<strong>.0001&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, TYR393ASN
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs137852870 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs137852870;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs137852870?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs137852870" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs137852870" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000002473 OR RCV000055825 OR RCV000079229 OR RCV002514533" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000002473, RCV000055825, RCV000079229, RCV002514533" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000002473...</a>
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<p>In a classic case of maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), Zhang et al. (<a href="#18" class="mim-tip-reference" title="Zhang, B., Edenberg, H. J., Crabb, D. W., Harris, R. A. &lt;strong&gt;Evidence for both a regulatory mutation and a structural mutation in a family with maple syrup urine disease.&lt;/strong&gt; J. Clin. Invest. 83: 1425-1429, 1989.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2703538/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2703538&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI114033&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2703538">1989</a>, <a href="#19" class="mim-tip-reference" title="Zhang, B., Zhao, Y., Harris, R. A., Crabb, D. W. &lt;strong&gt;Molecular defects in the E1-alpha subunit of the branched-chain alpha-ketoacid dehydrogenase complex that cause maple syrup urine disease.&lt;/strong&gt; Molec. Biol. Med. 8: 39-47, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1943689/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1943689&lt;/a&gt;]" pmid="1943689">1991</a>) identified a T-A transversion in the E1-alpha subunit gene, resulting in a tyr394-to-asn (TYR394ASN) substitution. The patient's unaffected father was heterozygous for this mutant allele, while the patient's unaffected mother did not carry the mutation, but still expressed only about half of the normal mRNA and protein. The patient was heterozygous for the Y394N mutation, although only the abnormal allele was expressed as mRNA. <a href="#18" class="mim-tip-reference" title="Zhang, B., Edenberg, H. J., Crabb, D. W., Harris, R. A. &lt;strong&gt;Evidence for both a regulatory mutation and a structural mutation in a family with maple syrup urine disease.&lt;/strong&gt; J. Clin. Invest. 83: 1425-1429, 1989.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2703538/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2703538&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI114033&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2703538">Zhang et al. (1989)</a> concluded that the patient was a compound heterozygote, inheriting from the father the mutant Y394N allele, and from the mother a different allele perhaps containing a defect in regulation which abolished the expression of one of the E1-alpha alleles. On further study of the same family, however, <a href="#2" class="mim-tip-reference" title="Chuang, J. L., Fisher, C. R., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular basis of maple syrup urine disease: novel mutations at the E1-alpha locus that impair E1(alpha-2-beta-2) assembly or decrease steady-state E1-alpha mRNA levels of branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; Am. J. Hum. Genet. 55: 297-304, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8037208/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8037208&lt;/a&gt;]" pmid="8037208">Chuang et al. (1994)</a> demonstrated that the affected child and his mother were heterozygous for an 8-bp deletion in exon 7 of the E1-alpha subunit gene (887-894del; <a href="#0002">608348.0002</a>), resulting in a nonsense codon at 255. <a href="#2" class="mim-tip-reference" title="Chuang, J. L., Fisher, C. R., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular basis of maple syrup urine disease: novel mutations at the E1-alpha locus that impair E1(alpha-2-beta-2) assembly or decrease steady-state E1-alpha mRNA levels of branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; Am. J. Hum. Genet. 55: 297-304, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8037208/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8037208&lt;/a&gt;]" pmid="8037208">Chuang et al. (1994)</a> noted that the second allele had previously been postulated to be a regulatory mutation, and that the patient and his mother were heterozygous for an A-T transversion in the promoter regulatory region of the gene, but this was found to be a normal polymorphism. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=8037208+1943689+2703538" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>In cell lines from 2 Mennonite cases of MSUD1A, <a href="#10" class="mim-tip-reference" title="Matsuda, I., Nobukuni, Y., Mitsubuchi, H., Indo, Y., Endo, F., Asaka, J., Harada, A. &lt;strong&gt;A T-to-A substitution in the E1-alpha subunit gene of the branched-chain alpha-keto acid dehydrogenase complex in two cell lines derived from Menonite (sic) maple syrup urine disease patients.&lt;/strong&gt; Biochem. Biophys. Res. Commun. 172: 646-651, 1990.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2241958/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2241958&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/0006-291x(90)90723-z&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2241958">Matsuda et al. (1990)</a> demonstrated the same Y394N mutation. They noted that although the E1-beta subunit gene is normal, no crossreacting material associated with this gene could be demonstrated, suggesting that the mutation in the E1-alpha gene results in instability of the E1-beta subunit. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2241958" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>On reporting additional information about BCKDHA gene structure and sequence, <a href="#5" class="mim-tip-reference" title="Dariush, N., Fisher, C. W., Cox, R. P., Chuang, D. T. &lt;strong&gt;Structure of the gene encoding the entire mature E1-alpha subunit of human branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; FEBS Lett. 284: 34-38, 1991. Note: Erratum: FEBS Lett. 291: 376 only, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2060625/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2060625&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/0014-5793(91)80755-r&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2060625">Dariush et al. (1991)</a> concluded that exon 9 contains the Mennonite mutation, referred to by them as tyr393-to-asn (Y393N), reflecting a difference in numbering system. They reported that the homozygous mutation appears to cause skipping of exon 6 in the mutant E1-alpha transcript. Fisher et al. (<a href="#7" class="mim-tip-reference" title="Fisher, C. R., Chuang, J. L., Cox, R. P., Fisher, C. W., Star, R. A., Chuang, D. T. &lt;strong&gt;Maple syrup urine disease in Mennonites: evidence that the Y393N mutation in E1-alpha impedes assembly of the E1 component of branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; J. Clin. Invest. 88: 1034-1037, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1885764/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1885764&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI115363&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="1885764">1991</a>, <a href="#8" class="mim-tip-reference" title="Fisher, C. R., Fisher, C. W., Chuang, D. T., Cox, R. P. &lt;strong&gt;Occurrence of a tyr393-to-asn (Y393N) mutation in the E1-alpha gene of the branched-chain alpha-keto acid dehydrogenase complex in maple syrup urine disease patients from a Mennonite population.&lt;/strong&gt; Am. J. Hum. Genet. 49: 429-434, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1867199/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1867199&lt;/a&gt;]" pmid="1867199">1991</a>) also identified the Y393N mutation in Pennsylvania Mennonites with MSUD1A, and presented evidence that the Y393N mutation impedes assembly of the E1 component. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=1867199+2060625+1885764" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#11" class="mim-tip-reference" title="Mitsubuchi, H., Matsuda, I., Nobukuni, Y., Heidenreich, R., Indo, Y., Endo, F., Mallee, J., Segal, S. &lt;strong&gt;Gene analysis of Mennonite maple syrup urine disease kindred using primer-specified restriction map modification.&lt;/strong&gt; J. Inherit. Metab. Dis. 15: 181-187, 1992.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1356170/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1356170&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1007/BF01799628&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="1356170">Mitsubuchi et al. (1992)</a> described a technique involving primer-specific restriction map modification for the rapid and easy detection of the mutant BCKDHA gene in the Pennsylvania Mennonite population. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=1356170" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> performed detailed functional expression studies of the Y393N mutant protein in E. coli. The mutant protein showed slow assembly kinetics with the E1-beta protein compared to wildtype protein (over 2 hours versus 10 to 20 minutes) and only formed dimers with a molecular mass of 83 kD, not complete tetramers. There was no residual enzyme activity, and thermal stability of the mutant protein was decreased compared to wildtype. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#12" class="mim-tip-reference" title="Puffenberger, E. G. &lt;strong&gt;Genetic heritage of the Old Order Mennonites of southeastern Pennsylvania.&lt;/strong&gt; Am. J. Med. Genet. 121C: 18-31, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12888983/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12888983&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ajmg.c.20003&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12888983">Puffenberger (2003)</a> reported that the Y393N mutation has a high frequency in the Old Order Mennonites of southeastern Pennsylvania. From 1985 to 1994, 19 of 6,810 Old Order Mennonite children were born with MSUD1A (0.279%, or approximately 1 in 358 births). <a href="#12" class="mim-tip-reference" title="Puffenberger, E. G. &lt;strong&gt;Genetic heritage of the Old Order Mennonites of southeastern Pennsylvania.&lt;/strong&gt; Am. J. Med. Genet. 121C: 18-31, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12888983/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12888983&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ajmg.c.20003&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12888983">Puffenberger (2003)</a> estimated the carrier frequency as 7.96% and the mutant allele frequency as 4.15%. The average inbreeding coefficient for all Old Order Mennonite MSUD1A sibships was 2.19%. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12888983" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0002&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, 8-BP DEL, 887-894
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs794727847 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs794727847;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs794727847" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs794727847" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000002474 OR RCV000179782 OR RCV000724580" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000002474, RCV000179782, RCV000724580" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000002474...</a>
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<p>For discussion of the 8-bp deletion (887_894del) in the BCKDHA gene that was found in compound heterozygous state in patients with classic maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>) by <a href="#2" class="mim-tip-reference" title="Chuang, J. L., Fisher, C. R., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular basis of maple syrup urine disease: novel mutations at the E1-alpha locus that impair E1(alpha-2-beta-2) assembly or decrease steady-state E1-alpha mRNA levels of branched-chain alpha-keto acid dehydrogenase complex.&lt;/strong&gt; Am. J. Hum. Genet. 55: 297-304, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8037208/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8037208&lt;/a&gt;]" pmid="8037208">Chuang et al. (1994)</a>, see <a href="#0001">608348.0001</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8037208" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0003&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, GLY245ARG
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs137852871 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs137852871;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs137852871?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs137852871" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs137852871" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000179775 OR RCV000790729 OR RCV001175041" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000179775, RCV000790729, RCV001175041" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000179775...</a>
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<p>In 3 of 4 unrelated Hispanic Mexican patients with intermediate maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), <a href="#1" class="mim-tip-reference" title="Chuang, J. L., Davie, J. R., Chinsky, J. M., Wynn, R. M., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular and biochemical basis of intermediate maple syrup urine disease: occurrence of homozygous G245R and F364C mutations at the E1-alpha locus of Hispanic-Mexican patients.&lt;/strong&gt; J. Clin. Invest. 95: 954-963, 1995.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7883996/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7883996&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI117804&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7883996">Chuang et al. (1995)</a> found homozygosity for an 895G-A transition in exon 7 of the BCKDHA gene, resulting in a gly245-to-arg (G245R) substitution. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=7883996" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> performed detailed functional expression studies of the G245R mutant protein in E. coli. The mutant protein showed moderately slow assembly kinetics with the E1-beta protein compared to wildtype protein (30 to 40 versus 10 to 20 minutes), but the G245R protein formed complete tetramers. There was some residual enzyme activity at 2.66% of normal controls. Thermal stability of the mutant protein was decreased compared to wildtype. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0004&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, PHE364CYS
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs137852872 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs137852872;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs137852872" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs137852872" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV001378888" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV001378888" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV001378888</a>
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<p>In a Hispanic Mexican patient with intermediate maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), <a href="#1" class="mim-tip-reference" title="Chuang, J. L., Davie, J. R., Chinsky, J. M., Wynn, R. M., Cox, R. P., Chuang, D. T. &lt;strong&gt;Molecular and biochemical basis of intermediate maple syrup urine disease: occurrence of homozygous G245R and F364C mutations at the E1-alpha locus of Hispanic-Mexican patients.&lt;/strong&gt; J. Clin. Invest. 95: 954-963, 1995.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7883996/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7883996&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI117804&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7883996">Chuang et al. (1995)</a> identified a homozygous 1253T-G transversion in the BCKDHA gene, resulting in a phe364-to-cys (F364C) substitution. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=7883996" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> performed detailed functional expression studies of the F364C mutant protein in E. coli. The mutant protein showed slow assembly kinetics with the E1-beta protein compared to wildtype protein (over 2 hours versus 10 to 20 minutes) and only formed dimers, not complete tetramers. There was no residual enzyme activity, and thermal stability of the mutant protein was decreased compared to wildtype. <a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> stated that the associated phenotype was classic MSUD. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="0005" class="mim-anchor"></a>
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<strong>.0005&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, ARG220TRP
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs137852873 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs137852873;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs137852873?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs137852873" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs137852873" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000393620 OR RCV001379690 OR RCV004566672" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000393620, RCV001379690, RCV004566672" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000393620...</a>
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<p>In fibroblasts derived a patient with classic maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), <a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> identified compound heterozygosity for 2 mutations in the BCKDHA gene: a C-to-T transition resulting in an arg220-to-trp (R220W) substitution and Y393N (<a href="#0001">608348.0001</a>). Detailed functional expression studies in E. coli found that the R220W protein showed normal assembly kinetics with the E1-beta subunit and formed a complete tetramer. However, there was no detectable enzyme activity and mildly decreased thermal stability. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0006&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, GLY204SER
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs137852874 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs137852874;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs137852874?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs137852874" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs137852874" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV001064270 OR RCV001818118 OR RCV004566673" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV001064270, RCV001818118, RCV004566673" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV001064270...</a>
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<p>In fibroblasts derived from a patient with classic maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), <a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> identified compound heterozygosity for 2 mutations in the BCKDHA gene: a G-to-A transition resulting in a gly204-to-ser (G204S) substitution and Y393N (<a href="#0001">608348.0001</a>). Detailed functional expression studies in E. coli found that the G204S protein showed slow assembly kinetics with the E1-beta subunit compared to wildtype (over 2 hours versus 10 to 20 minutes), although tetramers were formed. Enzyme activity was undetectable and the G204S protein showed decreased thermal stability compared to wildtype. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="0007" class="mim-anchor"></a>
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<strong>.0007&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, THR265ARG
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs137852875 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs137852875;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs137852875?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs137852875" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs137852875" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000179776 OR RCV002222336 OR RCV005016224" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000179776, RCV002222336, RCV005016224" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000179776...</a>
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<p>In fibroblasts derived from a patient with classic maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), <a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> identified compound heterozygosity for 2 mutations in the BCKDHA gene: a C-to-G transversion resulting in a thr265-to-arg (T265R) substitution and a truncation mutation. Detailed functional expression studies in E. coli found that the T265R protein was insoluble and failed to coassemble with the E1-beta subunit at 37 degrees C. However, the T265R protein did assemble with E1-beta at 28 degrees C and formed small amounts of complete tetramers with no enzyme activity. The T265R protein also showed significantly decreased thermal stability compared to wildtype. <a href="#16" class="mim-tip-reference" title="Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T. &lt;strong&gt;Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.&lt;/strong&gt; J. Biol. Chem. 273: 13110-13118, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9582350/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9582350&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.273.21.13110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9582350">Wynn et al. (1998)</a> suggested that the thr265 residue is important for proper folding. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0008&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, CYS219TRP
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs137852876 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs137852876;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs137852876?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs137852876" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs137852876" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV002512677 OR RCV005024992" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV002512677, RCV005024992" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV002512677...</a>
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<p>In an Israeli boy with classic maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>), <a href="#3" class="mim-tip-reference" title="Chuang, J. L., Wynn, R. M., Moss, C. C., Song, J., Li, J., Awad, N., Mandel, H., Chuang, D. T. &lt;strong&gt;Structural and biochemical basis for novel mutations in homozygous Israeli maple syrup urine disease patients.&lt;/strong&gt; J. Biol. Chem. 279: 17792-17800, 2004.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/14742428/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;14742428&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.M313879200&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="14742428">Chuang et al. (2004)</a> identified a homozygous C-to-G transversion in the BCKDHA gene, resulting in a cys219-to-trp (C219W) substitution. In vitro functional expression studies with the C219W mutant subunit showed no catalytic activity with defective BCKD subunit assembly and reduced binding affinity for the cofactor thiamine. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=14742428" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0009&nbsp;MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
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BCKDHA, 1-BP DEL, 117C
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs398123489 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs398123489;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs398123489?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs398123489" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs398123489" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000079223 OR RCV000175640 OR RCV001193901" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000079223, RCV000175640, RCV001193901" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000079223...</a>
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<p>In 11 children with classic maple syrup urine disease (MSUD1A; <a href="/entry/248600">248600</a>) from a Gypsy community in southern Portugal, <a href="#14" class="mim-tip-reference" title="Quental, S., Macedo-Ribeiro, S., Matos, R., Vilarinho, L., Martins, E., Teles, E. L., Rodrigues, E., Diogo, L., Garcia, P., Eusebio, F., Gaspar, A., Sequeira, S., Furtado, F., Lanca, I., Amorim, A., Prata, M. J. &lt;strong&gt;Molecular and structural analyses of maple syrup urine disease and identification of a founder mutation in a Portuguese Gypsy community.&lt;/strong&gt; Molec. Genet. Metab. 94: 148-156, 2008.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/18378174/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;18378174&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.ymgme.2008.02.008&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="18378174">Quental et al. (2008)</a> identified a homozygous 1-bp deletion (117delC) in the BCKDHA gene, resulting in a frameshift and a truncated protein with only 61 residues. The mutation likely results in nonsense-mediated mRNA decay. By haplotype analysis, <a href="#13" class="mim-tip-reference" title="Quental, S., Gusmao, A., Rodriguez-Pombo, P., Ugarte, M., Vilarinho, L., Amorim, A., Prata, M. J. &lt;strong&gt;Revisiting MSUD in Portuguese Gypsies: evidence for a founder mutation and for a mutational hotspot within the BCKDHA gene.&lt;/strong&gt; Ann. Hum. Genet. 73: 298-303, 2009.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/19456321/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;19456321&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1469-1809.2009.00518.x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="19456321">Quental et al. (2009)</a> showed that the 117delC mutation is a founder mutation in Portuguese Gypsies with a carrier frequency estimated to be 1.4%. An unrelated Spanish patient with the deletion who was not of Gypsy origin did not share the haplotype, indicating that it occurred independently. The deletion occurs within a poly-C tract and may represent a mutation hotspot in the BCKDHA gene. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=19456321+18378174" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>REFERENCES</strong>
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<a id="1" class="mim-anchor"></a>
<a id="Chuang1995" class="mim-anchor"></a>
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Chuang, J. L., Davie, J. R., Chinsky, J. M., Wynn, R. M., Cox, R. P., Chuang, D. T.
<strong>Molecular and biochemical basis of intermediate maple syrup urine disease: occurrence of homozygous G245R and F364C mutations at the E1-alpha locus of Hispanic-Mexican patients.</strong>
J. Clin. Invest. 95: 954-963, 1995.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/7883996/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">7883996</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=7883996" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1172/JCI117804" target="_blank">Full Text</a>]
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<a id="2" class="mim-anchor"></a>
<a id="Chuang1994" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Chuang, J. L., Fisher, C. R., Cox, R. P., Chuang, D. T.
<strong>Molecular basis of maple syrup urine disease: novel mutations at the E1-alpha locus that impair E1(alpha-2-beta-2) assembly or decrease steady-state E1-alpha mRNA levels of branched-chain alpha-keto acid dehydrogenase complex.</strong>
Am. J. Hum. Genet. 55: 297-304, 1994.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/8037208/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">8037208</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8037208" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
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<a id="Chuang2004" class="mim-anchor"></a>
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Chuang, J. L., Wynn, R. M., Moss, C. C., Song, J., Li, J., Awad, N., Mandel, H., Chuang, D. T.
<strong>Structural and biochemical basis for novel mutations in homozygous Israeli maple syrup urine disease patients.</strong>
J. Biol. Chem. 279: 17792-17800, 2004.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/14742428/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">14742428</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=14742428" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1074/jbc.M313879200" target="_blank">Full Text</a>]
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<a id="Crabb1989" class="mim-anchor"></a>
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Crabb, D. W., Deaven, L. L., Luedemann, M., Zhang, B., Harris, R. A.
<strong>Assignment of the gene for the E1-alpha subunit of branched chain alpha-ketoacid dehydrogenase to chromosome 19.</strong>
Cytogenet. Cell Genet. 50: 40-41, 1989.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/2743816/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">2743816</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2743816" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1159/000132715" target="_blank">Full Text</a>]
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<a id="Dariush1991" class="mim-anchor"></a>
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Dariush, N., Fisher, C. W., Cox, R. P., Chuang, D. T.
<strong>Structure of the gene encoding the entire mature E1-alpha subunit of human branched-chain alpha-keto acid dehydrogenase complex.</strong>
FEBS Lett. 284: 34-38, 1991. Note: Erratum: FEBS Lett. 291: 376 only, 1991.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/2060625/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">2060625</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2060625" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1016/0014-5793(91)80755-r" target="_blank">Full Text</a>]
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<a id="Fekete1989" class="mim-anchor"></a>
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Fekete, G., Plattner, R., Crabb, D. W., Zhang, B., Harris, R. A., Heerema, N., Palmer, C. G.
<strong>Localization of the human gene for the El-alpha subunit of branched chain keto acid dehydrogenase (BCKDHA) to chromosome 19q13.1-q13.2.</strong>
Cytogenet. Cell Genet. 50: 236-237, 1989.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/2805821/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">2805821</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2805821" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1159/000132768" target="_blank">Full Text</a>]
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<a id="Fisher1991" class="mim-anchor"></a>
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Fisher, C. R., Chuang, J. L., Cox, R. P., Fisher, C. W., Star, R. A., Chuang, D. T.
<strong>Maple syrup urine disease in Mennonites: evidence that the Y393N mutation in E1-alpha impedes assembly of the E1 component of branched-chain alpha-keto acid dehydrogenase complex.</strong>
J. Clin. Invest. 88: 1034-1037, 1991.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/1885764/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">1885764</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=1885764" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1172/JCI115363" target="_blank">Full Text</a>]
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<a id="Fisher1991" class="mim-anchor"></a>
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<p class="mim-text-font">
Fisher, C. R., Fisher, C. W., Chuang, D. T., Cox, R. P.
<strong>Occurrence of a tyr393-to-asn (Y393N) mutation in the E1-alpha gene of the branched-chain alpha-keto acid dehydrogenase complex in maple syrup urine disease patients from a Mennonite population.</strong>
Am. J. Hum. Genet. 49: 429-434, 1991.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/1867199/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">1867199</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=1867199" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
</p>
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<a id="9" class="mim-anchor"></a>
<a id="Fisher1989" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Fisher, C. W., Chuang, J. L., Griffin, T. A., Lau, K. S., Cox, R. P., Chuang, D. T.
<strong>Molecular phenotypes in cultured maple syrup urine disease cells: complete E(1)-alpha cDNA sequence and mRNA and subunit contents of the human branched chain alpha-keto acid dehydrogenase complex.</strong>
J. Biol. Chem. 264: 3448-3453, 1989.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/2914958/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">2914958</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2914958" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
</p>
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<a id="10" class="mim-anchor"></a>
<a id="Matsuda1990" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Matsuda, I., Nobukuni, Y., Mitsubuchi, H., Indo, Y., Endo, F., Asaka, J., Harada, A.
<strong>A T-to-A substitution in the E1-alpha subunit gene of the branched-chain alpha-keto acid dehydrogenase complex in two cell lines derived from Menonite (sic) maple syrup urine disease patients.</strong>
Biochem. Biophys. Res. Commun. 172: 646-651, 1990.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/2241958/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">2241958</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2241958" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1016/0006-291x(90)90723-z" target="_blank">Full Text</a>]
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<a id="Mitsubuchi1992" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Mitsubuchi, H., Matsuda, I., Nobukuni, Y., Heidenreich, R., Indo, Y., Endo, F., Mallee, J., Segal, S.
<strong>Gene analysis of Mennonite maple syrup urine disease kindred using primer-specified restriction map modification.</strong>
J. Inherit. Metab. Dis. 15: 181-187, 1992.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/1356170/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">1356170</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=1356170" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1007/BF01799628" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="12" class="mim-anchor"></a>
<a id="Puffenberger2003" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Puffenberger, E. G.
<strong>Genetic heritage of the Old Order Mennonites of southeastern Pennsylvania.</strong>
Am. J. Med. Genet. 121C: 18-31, 2003.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/12888983/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">12888983</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12888983" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1002/ajmg.c.20003" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="13" class="mim-anchor"></a>
<a id="Quental2009" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Quental, S., Gusmao, A., Rodriguez-Pombo, P., Ugarte, M., Vilarinho, L., Amorim, A., Prata, M. J.
<strong>Revisiting MSUD in Portuguese Gypsies: evidence for a founder mutation and for a mutational hotspot within the BCKDHA gene.</strong>
Ann. Hum. Genet. 73: 298-303, 2009.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/19456321/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">19456321</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19456321" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1111/j.1469-1809.2009.00518.x" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="14" class="mim-anchor"></a>
<a id="Quental2008" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Quental, S., Macedo-Ribeiro, S., Matos, R., Vilarinho, L., Martins, E., Teles, E. L., Rodrigues, E., Diogo, L., Garcia, P., Eusebio, F., Gaspar, A., Sequeira, S., Furtado, F., Lanca, I., Amorim, A., Prata, M. J.
<strong>Molecular and structural analyses of maple syrup urine disease and identification of a founder mutation in a Portuguese Gypsy community.</strong>
Molec. Genet. Metab. 94: 148-156, 2008.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/18378174/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">18378174</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=18378174" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1016/j.ymgme.2008.02.008" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="15" class="mim-anchor"></a>
<a id="Tiu1988" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Tiu, A. B., Naujokas, M., Eisenstein, R., Francke, U., Barton, D. E., Hoganson, G. E.
<strong>Cloning and chromosome mapping of a cDNA encoding the E1-alpha subunit of branched chain ketoacid dehydrogenase (BCKAD). (Abstract)</strong>
Am. J. Hum. Genet. 43: A17 only, 1988.
</p>
</div>
</li>
<li>
<a id="16" class="mim-anchor"></a>
<a id="Wynn1998" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T.
<strong>Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.</strong>
J. Biol. Chem. 273: 13110-13118, 1998.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/9582350/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">9582350</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9582350" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1074/jbc.273.21.13110" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="17" class="mim-anchor"></a>
<a id="Zhang1988" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Zhang, B., Crabb, D. W., Harris, R. A.
<strong>Nucleotide and deduced amino acid sequence of the E1-alpha subunit of human liver branched-chain alpha-ketoacid dehydrogenase.</strong>
Gene 69: 159-164, 1988.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/3224821/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">3224821</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=3224821" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1016/0378-1119(88)90390-3" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="18" class="mim-anchor"></a>
<a id="Zhang1989" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Zhang, B., Edenberg, H. J., Crabb, D. W., Harris, R. A.
<strong>Evidence for both a regulatory mutation and a structural mutation in a family with maple syrup urine disease.</strong>
J. Clin. Invest. 83: 1425-1429, 1989.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/2703538/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">2703538</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2703538" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1172/JCI114033" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="19" class="mim-anchor"></a>
<a id="Zhang1991" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Zhang, B., Zhao, Y., Harris, R. A., Crabb, D. W.
<strong>Molecular defects in the E1-alpha subunit of the branched-chain alpha-ketoacid dehydrogenase complex that cause maple syrup urine disease.</strong>
Molec. Biol. Med. 8: 39-47, 1991.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/1943689/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">1943689</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=1943689" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
</p>
</div>
</li>
</ol>
<div>
<br />
</div>
</div>
</div>
<div>
<a id="contributors" class="mim-anchor"></a>
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<div class="col-lg-2 col-md-2 col-sm-4 col-xs-4">
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<a href="#mimCollapseContributors" role="button" data-toggle="collapse"> Contributors: </a>
</span>
</div>
<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Cassandra L. Kniffin - updated : 11/2/2009
</span>
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<div class="row collapse" id="mimCollapseContributors">
<div class="col-lg-offset-2 col-md-offset-4 col-sm-offset-4 col-xs-offset-2 col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Cassandra L. Kniffin - updated : 6/14/2007<br>Cassandra L. Kniffin - updated : 12/29/2003
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<a id="creationDate" class="mim-anchor"></a>
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<div class="col-lg-2 col-md-2 col-sm-4 col-xs-4">
<span class="text-nowrap mim-text-font">
Creation Date:
</span>
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<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Cassandra L. Kniffin : 12/17/2003
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<a id="editHistory" class="mim-anchor"></a>
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<a href="#mimCollapseEditHistory" role="button" data-toggle="collapse"> Edit History: </a>
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<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
carol : 02/09/2024
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<div class="row collapse" id="mimCollapseEditHistory">
<div class="col-lg-offset-2 col-md-offset-2 col-sm-offset-4 col-xs-offset-4 col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
carol : 10/20/2016<br>carol : 05/23/2012<br>wwang : 11/6/2009<br>ckniffin : 11/2/2009<br>wwang : 6/27/2007<br>ckniffin : 6/14/2007<br>alopez : 6/13/2005<br>terry : 11/4/2004<br>ckniffin : 8/24/2004<br>carol : 1/28/2004<br>ckniffin : 12/29/2003
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<div class="container visible-print-block">
<div class="row">
<div class="col-md-8 col-md-offset-1">
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<div>
<h3>
<span class="mim-font">
<strong>*</strong> 608348
</span>
</h3>
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<h3>
<span class="mim-font">
BRANCHED-CHAIN KETO ACID DEHYDROGENASE E1, ALPHA POLYPEPTIDE; BCKDHA
</span>
</h3>
</div>
<div>
<br />
</div>
<div>
<div >
<p>
<span class="mim-font">
<em>Alternative titles; symbols</em>
</span>
</p>
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<div>
<h4>
<span class="mim-font">
BCKD, E1-ALPHA SUBUNIT; BCKDE1A
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<p>
<span class="mim-text-font">
<strong><em>HGNC Approved Gene Symbol: BCKDHA</em></strong>
</span>
</p>
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<div>
<p>
<span class="mim-text-font">
<strong>
<em>
Cytogenetic location: 19q13.2
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : 19:41,397,818-41,425,002 </span>
</em>
</strong>
<span class="small">(from NCBI)</span>
</span>
</p>
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<div>
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</div>
<div>
<h4>
<span class="mim-font">
<strong>Gene-Phenotype Relationships</strong>
</span>
</h4>
<div>
<table class="table table-bordered table-condensed small mim-table-padding">
<thead>
<tr class="active">
<th>
Location
</th>
<th>
Phenotype
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="1">
<span class="mim-font">
19q13.2
</span>
</td>
<td>
<span class="mim-font">
Maple syrup urine disease, type Ia
</span>
</td>
<td>
<span class="mim-font">
248600
</span>
</td>
<td>
<span class="mim-font">
Autosomal recessive
</span>
</td>
<td>
<span class="mim-font">
3
</span>
</td>
</tr>
</tbody>
</table>
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</div>
<div>
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</div>
<div>
<h4>
<span class="mim-font">
<strong>TEXT</strong>
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</h4>
<div>
<h4>
<span class="mim-font">
<strong>Description</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>The BCKDHA gene encodes the E1-alpha subunit of the branched-chain alpha-keto acid (BCAA) dehydrogenase complex (BCKD; EC 1.2.4.4), an inner-mitochondrial enzyme complex that catalyzes the oxidative decarboxylation of the branched-chain alpha-ketoacids derived from isoleucine, leucine, and valine. This reaction is the second major step in the catabolism of the branched-chain amino acids (Wynn et al., 1998). </p><p>The BCKD complex consists of 3 catalytic components: a heterotetrameric (alpha2-beta2) branched-chain alpha-keto acid decarboxylase (E1), a homo-24-meric dihydrolipoyl transacylase (E2; 248610), and a homodimeric dihydrolipoamide dehydrogenase (E3; 238331). E1 is a thiamine pyrophosphate (TPP)-dependent enzyme. The reaction is irreversible and constitutes the first committed step in BCAA oxidation. The BCKDHB gene (248611) encodes the beta subunit of E1. The complex also contains 2 regulatory enzymes, a kinase and a phosphorylase.</p>
</span>
<div>
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</div>
<div>
<h4>
<span class="mim-font">
<strong>Cloning and Expression</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Tiu et al. (1988) cloned the gene for the E1-alpha subunit of branched-chain keto acid dehydrogenase, which they symbolized BCKAD. They found 91% amino acid sequence homology to the rat protein and noted that the phosphorylation site described in other species was conserved in human. Northern blot analysis of human liver showed a single 1.6-kb mRNA transcript. Zhang et al. (1988) isolated a cDNA corresponding to the BCKDHA gene from a human liver cDNA library. The deduced 378-amino acid protein shows 96% identity to the rat enzyme subunit, and the amino acid residues surrounding the phosphorylation site are completely conserved between human and rat. Northern blot analysis demonstrated a single 1.8-kb mRNA transcript, with a higher level of transcript in liver than in normal fibroblasts. </p><p>Fisher et al. (1989) found that the E1-alpha subunit comprises 400 amino acids with a calculated molecular mass of approximately 46 kD. Dariush et al. (1991) reported the complete sequence of the 3-prime untranslated region of the BCKDHA gene and found that the gene has multiple transcription initiation sites at bases +1, +18, and +22. </p><p>The BCKDHA protein has a molecular mass of 45.5 kD (Wynn et al., 1998). </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Gene Structure</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Dariush et al. (1991) determined that the BCKDHA gene contains 9 exons. </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Mapping</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Using somatic cell hybrids, Tiu et al. (1988) mapped the E1-alpha gene to human chromosome 19 and mouse chromosome 7. Crabb et al. (1989) also mapped the human BCKDHA gene to chromosome 19. By in situ hybridization, Fekete et al. (1989) assigned the BCKDHA gene to 19q13.1-q13.2. </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Gene Function</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Wynn et al. (1998) performed functional studies of the wildtype E1-alpha protein in an E. coli expression system augmented by the chaperonins GroEL (HSPD1; 118190) and GroES (HSPE1; 600141), which are essential for efficient folding and assembly of the E1 tetramer in E. coli. Studies of the wildtype protein showed that E1-alpha and E1-beta assembled in 10 to 20 minutes. Alpha-beta heterodimers (80 kD) were formed at 1 hour, and a minor species of alpha2-beta2 tetramers (165 kD) appeared at 2 hours. At 3 hours and 20 hours, the major species were alpha2-beta2 tetramers, and the minor species were alpha-beta dimers. The data indicated that the subunits initially formed dimers, which later slowly dimerize to produce heterotetramers. Alpha-beta dimers had no enzyme activity. Further studies of mutant E1-alpha proteins demonstrated that the E1-alpha C-terminal aromatic residues, phe364, tyr368, and tyr393, are crucial for complete and proper assembly with E1-beta to form tetrameric E1. </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Molecular Genetics</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>In a patient with the classic type of maple syrup urine disease (MSUD1A; 248600), Zhang et al. (1989, 1991) identified a mutation in the BCKDHA gene (608348.0001). Chuang et al. (1994) later identified a second mutation in the BCKDHA gene in this patient (608348.0002). Each parent was heterozygous for 1 of the mutations. </p><p>In 3 of 4 unrelated Hispanic Mexican patients with intermediate MSUD, Chuang et al. (1995) identified a homozygous mutation in the BCKDHA gene (608348.0003). The fourth patient was homozygous for a different mutation in the same gene (608348.0004). </p>
</span>
<div>
<br />
</div>
</div>
<div>
<h4>
<span class="mim-font">
<strong>ALLELIC VARIANTS</strong>
</span>
<strong>9 Selected Examples):</strong>
</span>
</h4>
<div>
<p />
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0001 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, TYR393ASN
<br />
SNP: rs137852870,
gnomAD: rs137852870,
ClinVar: RCV000002473, RCV000055825, RCV000079229, RCV002514533
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a classic case of maple syrup urine disease (MSUD1A; 248600), Zhang et al. (1989, 1991) identified a T-A transversion in the E1-alpha subunit gene, resulting in a tyr394-to-asn (TYR394ASN) substitution. The patient's unaffected father was heterozygous for this mutant allele, while the patient's unaffected mother did not carry the mutation, but still expressed only about half of the normal mRNA and protein. The patient was heterozygous for the Y394N mutation, although only the abnormal allele was expressed as mRNA. Zhang et al. (1989) concluded that the patient was a compound heterozygote, inheriting from the father the mutant Y394N allele, and from the mother a different allele perhaps containing a defect in regulation which abolished the expression of one of the E1-alpha alleles. On further study of the same family, however, Chuang et al. (1994) demonstrated that the affected child and his mother were heterozygous for an 8-bp deletion in exon 7 of the E1-alpha subunit gene (887-894del; 608348.0002), resulting in a nonsense codon at 255. Chuang et al. (1994) noted that the second allele had previously been postulated to be a regulatory mutation, and that the patient and his mother were heterozygous for an A-T transversion in the promoter regulatory region of the gene, but this was found to be a normal polymorphism. </p><p>In cell lines from 2 Mennonite cases of MSUD1A, Matsuda et al. (1990) demonstrated the same Y394N mutation. They noted that although the E1-beta subunit gene is normal, no crossreacting material associated with this gene could be demonstrated, suggesting that the mutation in the E1-alpha gene results in instability of the E1-beta subunit. </p><p>On reporting additional information about BCKDHA gene structure and sequence, Dariush et al. (1991) concluded that exon 9 contains the Mennonite mutation, referred to by them as tyr393-to-asn (Y393N), reflecting a difference in numbering system. They reported that the homozygous mutation appears to cause skipping of exon 6 in the mutant E1-alpha transcript. Fisher et al. (1991, 1991) also identified the Y393N mutation in Pennsylvania Mennonites with MSUD1A, and presented evidence that the Y393N mutation impedes assembly of the E1 component. </p><p>Mitsubuchi et al. (1992) described a technique involving primer-specific restriction map modification for the rapid and easy detection of the mutant BCKDHA gene in the Pennsylvania Mennonite population. </p><p>Wynn et al. (1998) performed detailed functional expression studies of the Y393N mutant protein in E. coli. The mutant protein showed slow assembly kinetics with the E1-beta protein compared to wildtype protein (over 2 hours versus 10 to 20 minutes) and only formed dimers with a molecular mass of 83 kD, not complete tetramers. There was no residual enzyme activity, and thermal stability of the mutant protein was decreased compared to wildtype. </p><p>Puffenberger (2003) reported that the Y393N mutation has a high frequency in the Old Order Mennonites of southeastern Pennsylvania. From 1985 to 1994, 19 of 6,810 Old Order Mennonite children were born with MSUD1A (0.279%, or approximately 1 in 358 births). Puffenberger (2003) estimated the carrier frequency as 7.96% and the mutant allele frequency as 4.15%. The average inbreeding coefficient for all Old Order Mennonite MSUD1A sibships was 2.19%. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0002 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, 8-BP DEL, 887-894
<br />
SNP: rs794727847,
ClinVar: RCV000002474, RCV000179782, RCV000724580
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the 8-bp deletion (887_894del) in the BCKDHA gene that was found in compound heterozygous state in patients with classic maple syrup urine disease (MSUD1A; 248600) by Chuang et al. (1994), see 608348.0001. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0003 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, GLY245ARG
<br />
SNP: rs137852871,
gnomAD: rs137852871,
ClinVar: RCV000179775, RCV000790729, RCV001175041
</span>
</div>
<div>
<span class="mim-text-font">
<p>In 3 of 4 unrelated Hispanic Mexican patients with intermediate maple syrup urine disease (MSUD1A; 248600), Chuang et al. (1995) found homozygosity for an 895G-A transition in exon 7 of the BCKDHA gene, resulting in a gly245-to-arg (G245R) substitution. </p><p>Wynn et al. (1998) performed detailed functional expression studies of the G245R mutant protein in E. coli. The mutant protein showed moderately slow assembly kinetics with the E1-beta protein compared to wildtype protein (30 to 40 versus 10 to 20 minutes), but the G245R protein formed complete tetramers. There was some residual enzyme activity at 2.66% of normal controls. Thermal stability of the mutant protein was decreased compared to wildtype. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0004 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, PHE364CYS
<br />
SNP: rs137852872,
ClinVar: RCV001378888
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a Hispanic Mexican patient with intermediate maple syrup urine disease (MSUD1A; 248600), Chuang et al. (1995) identified a homozygous 1253T-G transversion in the BCKDHA gene, resulting in a phe364-to-cys (F364C) substitution. </p><p>Wynn et al. (1998) performed detailed functional expression studies of the F364C mutant protein in E. coli. The mutant protein showed slow assembly kinetics with the E1-beta protein compared to wildtype protein (over 2 hours versus 10 to 20 minutes) and only formed dimers, not complete tetramers. There was no residual enzyme activity, and thermal stability of the mutant protein was decreased compared to wildtype. Wynn et al. (1998) stated that the associated phenotype was classic MSUD. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0005 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, ARG220TRP
<br />
SNP: rs137852873,
gnomAD: rs137852873,
ClinVar: RCV000393620, RCV001379690, RCV004566672
</span>
</div>
<div>
<span class="mim-text-font">
<p>In fibroblasts derived a patient with classic maple syrup urine disease (MSUD1A; 248600), Wynn et al. (1998) identified compound heterozygosity for 2 mutations in the BCKDHA gene: a C-to-T transition resulting in an arg220-to-trp (R220W) substitution and Y393N (608348.0001). Detailed functional expression studies in E. coli found that the R220W protein showed normal assembly kinetics with the E1-beta subunit and formed a complete tetramer. However, there was no detectable enzyme activity and mildly decreased thermal stability. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0006 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, GLY204SER
<br />
SNP: rs137852874,
gnomAD: rs137852874,
ClinVar: RCV001064270, RCV001818118, RCV004566673
</span>
</div>
<div>
<span class="mim-text-font">
<p>In fibroblasts derived from a patient with classic maple syrup urine disease (MSUD1A; 248600), Wynn et al. (1998) identified compound heterozygosity for 2 mutations in the BCKDHA gene: a G-to-A transition resulting in a gly204-to-ser (G204S) substitution and Y393N (608348.0001). Detailed functional expression studies in E. coli found that the G204S protein showed slow assembly kinetics with the E1-beta subunit compared to wildtype (over 2 hours versus 10 to 20 minutes), although tetramers were formed. Enzyme activity was undetectable and the G204S protein showed decreased thermal stability compared to wildtype. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0007 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, THR265ARG
<br />
SNP: rs137852875,
gnomAD: rs137852875,
ClinVar: RCV000179776, RCV002222336, RCV005016224
</span>
</div>
<div>
<span class="mim-text-font">
<p>In fibroblasts derived from a patient with classic maple syrup urine disease (MSUD1A; 248600), Wynn et al. (1998) identified compound heterozygosity for 2 mutations in the BCKDHA gene: a C-to-G transversion resulting in a thr265-to-arg (T265R) substitution and a truncation mutation. Detailed functional expression studies in E. coli found that the T265R protein was insoluble and failed to coassemble with the E1-beta subunit at 37 degrees C. However, the T265R protein did assemble with E1-beta at 28 degrees C and formed small amounts of complete tetramers with no enzyme activity. The T265R protein also showed significantly decreased thermal stability compared to wildtype. Wynn et al. (1998) suggested that the thr265 residue is important for proper folding. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0008 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, CYS219TRP
<br />
SNP: rs137852876,
gnomAD: rs137852876,
ClinVar: RCV002512677, RCV005024992
</span>
</div>
<div>
<span class="mim-text-font">
<p>In an Israeli boy with classic maple syrup urine disease (MSUD1A; 248600), Chuang et al. (2004) identified a homozygous C-to-G transversion in the BCKDHA gene, resulting in a cys219-to-trp (C219W) substitution. In vitro functional expression studies with the C219W mutant subunit showed no catalytic activity with defective BCKD subunit assembly and reduced binding affinity for the cofactor thiamine. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0009 &nbsp; MAPLE SYRUP URINE DISEASE, TYPE IA</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
BCKDHA, 1-BP DEL, 117C
<br />
SNP: rs398123489,
gnomAD: rs398123489,
ClinVar: RCV000079223, RCV000175640, RCV001193901
</span>
</div>
<div>
<span class="mim-text-font">
<p>In 11 children with classic maple syrup urine disease (MSUD1A; 248600) from a Gypsy community in southern Portugal, Quental et al. (2008) identified a homozygous 1-bp deletion (117delC) in the BCKDHA gene, resulting in a frameshift and a truncated protein with only 61 residues. The mutation likely results in nonsense-mediated mRNA decay. By haplotype analysis, Quental et al. (2009) showed that the 117delC mutation is a founder mutation in Portuguese Gypsies with a carrier frequency estimated to be 1.4%. An unrelated Spanish patient with the deletion who was not of Gypsy origin did not share the haplotype, indicating that it occurred independently. The deletion occurs within a poly-C tract and may represent a mutation hotspot in the BCKDHA gene. </p>
</span>
</div>
<div>
<br />
</div>
</div>
</div>
<div>
<h4>
<span class="mim-font">
<strong>REFERENCES</strong>
</span>
</h4>
<div>
<p />
</div>
<div>
<ol>
<li>
<p class="mim-text-font">
Chuang, J. L., Davie, J. R., Chinsky, J. M., Wynn, R. M., Cox, R. P., Chuang, D. T.
<strong>Molecular and biochemical basis of intermediate maple syrup urine disease: occurrence of homozygous G245R and F364C mutations at the E1-alpha locus of Hispanic-Mexican patients.</strong>
J. Clin. Invest. 95: 954-963, 1995.
[PubMed: 7883996]
[Full Text: https://doi.org/10.1172/JCI117804]
</p>
</li>
<li>
<p class="mim-text-font">
Chuang, J. L., Fisher, C. R., Cox, R. P., Chuang, D. T.
<strong>Molecular basis of maple syrup urine disease: novel mutations at the E1-alpha locus that impair E1(alpha-2-beta-2) assembly or decrease steady-state E1-alpha mRNA levels of branched-chain alpha-keto acid dehydrogenase complex.</strong>
Am. J. Hum. Genet. 55: 297-304, 1994.
[PubMed: 8037208]
</p>
</li>
<li>
<p class="mim-text-font">
Chuang, J. L., Wynn, R. M., Moss, C. C., Song, J., Li, J., Awad, N., Mandel, H., Chuang, D. T.
<strong>Structural and biochemical basis for novel mutations in homozygous Israeli maple syrup urine disease patients.</strong>
J. Biol. Chem. 279: 17792-17800, 2004.
[PubMed: 14742428]
[Full Text: https://doi.org/10.1074/jbc.M313879200]
</p>
</li>
<li>
<p class="mim-text-font">
Crabb, D. W., Deaven, L. L., Luedemann, M., Zhang, B., Harris, R. A.
<strong>Assignment of the gene for the E1-alpha subunit of branched chain alpha-ketoacid dehydrogenase to chromosome 19.</strong>
Cytogenet. Cell Genet. 50: 40-41, 1989.
[PubMed: 2743816]
[Full Text: https://doi.org/10.1159/000132715]
</p>
</li>
<li>
<p class="mim-text-font">
Dariush, N., Fisher, C. W., Cox, R. P., Chuang, D. T.
<strong>Structure of the gene encoding the entire mature E1-alpha subunit of human branched-chain alpha-keto acid dehydrogenase complex.</strong>
FEBS Lett. 284: 34-38, 1991. Note: Erratum: FEBS Lett. 291: 376 only, 1991.
[PubMed: 2060625]
[Full Text: https://doi.org/10.1016/0014-5793(91)80755-r]
</p>
</li>
<li>
<p class="mim-text-font">
Fekete, G., Plattner, R., Crabb, D. W., Zhang, B., Harris, R. A., Heerema, N., Palmer, C. G.
<strong>Localization of the human gene for the El-alpha subunit of branched chain keto acid dehydrogenase (BCKDHA) to chromosome 19q13.1-q13.2.</strong>
Cytogenet. Cell Genet. 50: 236-237, 1989.
[PubMed: 2805821]
[Full Text: https://doi.org/10.1159/000132768]
</p>
</li>
<li>
<p class="mim-text-font">
Fisher, C. R., Chuang, J. L., Cox, R. P., Fisher, C. W., Star, R. A., Chuang, D. T.
<strong>Maple syrup urine disease in Mennonites: evidence that the Y393N mutation in E1-alpha impedes assembly of the E1 component of branched-chain alpha-keto acid dehydrogenase complex.</strong>
J. Clin. Invest. 88: 1034-1037, 1991.
[PubMed: 1885764]
[Full Text: https://doi.org/10.1172/JCI115363]
</p>
</li>
<li>
<p class="mim-text-font">
Fisher, C. R., Fisher, C. W., Chuang, D. T., Cox, R. P.
<strong>Occurrence of a tyr393-to-asn (Y393N) mutation in the E1-alpha gene of the branched-chain alpha-keto acid dehydrogenase complex in maple syrup urine disease patients from a Mennonite population.</strong>
Am. J. Hum. Genet. 49: 429-434, 1991.
[PubMed: 1867199]
</p>
</li>
<li>
<p class="mim-text-font">
Fisher, C. W., Chuang, J. L., Griffin, T. A., Lau, K. S., Cox, R. P., Chuang, D. T.
<strong>Molecular phenotypes in cultured maple syrup urine disease cells: complete E(1)-alpha cDNA sequence and mRNA and subunit contents of the human branched chain alpha-keto acid dehydrogenase complex.</strong>
J. Biol. Chem. 264: 3448-3453, 1989.
[PubMed: 2914958]
</p>
</li>
<li>
<p class="mim-text-font">
Matsuda, I., Nobukuni, Y., Mitsubuchi, H., Indo, Y., Endo, F., Asaka, J., Harada, A.
<strong>A T-to-A substitution in the E1-alpha subunit gene of the branched-chain alpha-keto acid dehydrogenase complex in two cell lines derived from Menonite (sic) maple syrup urine disease patients.</strong>
Biochem. Biophys. Res. Commun. 172: 646-651, 1990.
[PubMed: 2241958]
[Full Text: https://doi.org/10.1016/0006-291x(90)90723-z]
</p>
</li>
<li>
<p class="mim-text-font">
Mitsubuchi, H., Matsuda, I., Nobukuni, Y., Heidenreich, R., Indo, Y., Endo, F., Mallee, J., Segal, S.
<strong>Gene analysis of Mennonite maple syrup urine disease kindred using primer-specified restriction map modification.</strong>
J. Inherit. Metab. Dis. 15: 181-187, 1992.
[PubMed: 1356170]
[Full Text: https://doi.org/10.1007/BF01799628]
</p>
</li>
<li>
<p class="mim-text-font">
Puffenberger, E. G.
<strong>Genetic heritage of the Old Order Mennonites of southeastern Pennsylvania.</strong>
Am. J. Med. Genet. 121C: 18-31, 2003.
[PubMed: 12888983]
[Full Text: https://doi.org/10.1002/ajmg.c.20003]
</p>
</li>
<li>
<p class="mim-text-font">
Quental, S., Gusmao, A., Rodriguez-Pombo, P., Ugarte, M., Vilarinho, L., Amorim, A., Prata, M. J.
<strong>Revisiting MSUD in Portuguese Gypsies: evidence for a founder mutation and for a mutational hotspot within the BCKDHA gene.</strong>
Ann. Hum. Genet. 73: 298-303, 2009.
[PubMed: 19456321]
[Full Text: https://doi.org/10.1111/j.1469-1809.2009.00518.x]
</p>
</li>
<li>
<p class="mim-text-font">
Quental, S., Macedo-Ribeiro, S., Matos, R., Vilarinho, L., Martins, E., Teles, E. L., Rodrigues, E., Diogo, L., Garcia, P., Eusebio, F., Gaspar, A., Sequeira, S., Furtado, F., Lanca, I., Amorim, A., Prata, M. J.
<strong>Molecular and structural analyses of maple syrup urine disease and identification of a founder mutation in a Portuguese Gypsy community.</strong>
Molec. Genet. Metab. 94: 148-156, 2008.
[PubMed: 18378174]
[Full Text: https://doi.org/10.1016/j.ymgme.2008.02.008]
</p>
</li>
<li>
<p class="mim-text-font">
Tiu, A. B., Naujokas, M., Eisenstein, R., Francke, U., Barton, D. E., Hoganson, G. E.
<strong>Cloning and chromosome mapping of a cDNA encoding the E1-alpha subunit of branched chain ketoacid dehydrogenase (BCKAD). (Abstract)</strong>
Am. J. Hum. Genet. 43: A17 only, 1988.
</p>
</li>
<li>
<p class="mim-text-font">
Wynn, R. M., Davie, J. R., Chuang, J. L., Cote, C. D., Chuang, D. T.
<strong>Impaired assembly of E1 decarboxylase of the branched-chain alpha-ketoacid dehydrogenase complex in type IA maple syrup urine disease.</strong>
J. Biol. Chem. 273: 13110-13118, 1998.
[PubMed: 9582350]
[Full Text: https://doi.org/10.1074/jbc.273.21.13110]
</p>
</li>
<li>
<p class="mim-text-font">
Zhang, B., Crabb, D. W., Harris, R. A.
<strong>Nucleotide and deduced amino acid sequence of the E1-alpha subunit of human liver branched-chain alpha-ketoacid dehydrogenase.</strong>
Gene 69: 159-164, 1988.
[PubMed: 3224821]
[Full Text: https://doi.org/10.1016/0378-1119(88)90390-3]
</p>
</li>
<li>
<p class="mim-text-font">
Zhang, B., Edenberg, H. J., Crabb, D. W., Harris, R. A.
<strong>Evidence for both a regulatory mutation and a structural mutation in a family with maple syrup urine disease.</strong>
J. Clin. Invest. 83: 1425-1429, 1989.
[PubMed: 2703538]
[Full Text: https://doi.org/10.1172/JCI114033]
</p>
</li>
<li>
<p class="mim-text-font">
Zhang, B., Zhao, Y., Harris, R. A., Crabb, D. W.
<strong>Molecular defects in the E1-alpha subunit of the branched-chain alpha-ketoacid dehydrogenase complex that cause maple syrup urine disease.</strong>
Molec. Biol. Med. 8: 39-47, 1991.
[PubMed: 1943689]
</p>
</li>
</ol>
<div>
<br />
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Cassandra L. Kniffin - updated : 11/2/2009<br>Cassandra L. Kniffin - updated : 6/14/2007<br>Cassandra L. Kniffin - updated : 12/29/2003
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