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Pathway Description
Fructose Intolerance, Hereditary
Homo sapiens
Disease Pathway
Hereditary fructose intolerance, also called hereditary fructose-1-phosphate aldolase deficiency or hereditary fructosemia, is rare inborn error of metabolism (IEM) and autosomal recessive disorder of the fructose and mannose degradation pathway. It is caused by a mutation in the ALDOB gene, which encodes fructose-bisphosphatse aldolase B, also known as aldolase B or liver-type aldolase. This enzyme normally cleaves fructose 1,6-bisphosphate into dihydroxyacetone phosphate and D-glyceraldehyde 3-phosphate, isomers of one another that are later used in glycolysis. Hereditary fructose intolerance is characterized by an accumulation of fructose-1-phosphate in the liver, as well as a depletion of ATP due to glycolysis having less input than necessary. Symptoms of this disorder include hypoglycemia, abdominal pain and vomiting as well as other symptoms after ingesting fructose. After repeated ingestion of fructose, liver and kidney damage can occur, as well as growth retardation, seizures, and even death. Hereditary fructose intolerance can be treated by eliminating fructose from the diet, and multivitamins can be prescribed to make up for the lack of fruits, a major source of fructose, in the diet. It is estimated that hereditary fructose intolerance affects 1 in between 20,000 and 30,000 individuals.
References
Fructose Intolerance, Hereditary References
Perheentupa J, Raivio KO, Nikkila EA: Hereditary fructose intolerance. Acta Med Scand Suppl. 1972;542:65-75.
Pubmed: 4579755
Oppelt SA, Sennott EM, Tolan DR: Aldolase-B knockout in mice phenocopies hereditary fructose intolerance in humans. Mol Genet Metab. 2015 Mar;114(3):445-50. doi: 10.1016/j.ymgme.2015.01.001. Epub 2015 Jan 22.
Pubmed: 25637246
Fructose and Mannose Degradation References
Lehninger, A.L. Lehninger principles of biochemistry (4th ed.) (2005). New York: W.H Freeman.
Salway, J.G. Metabolism at a glance (3rd ed.) (2004). Alden, Mass.: Blackwell Pub.
Sharma V, Ichikawa M, Freeze HH: Mannose metabolism: more than meets the eye. Biochem Biophys Res Commun. 2014 Oct 17;453(2):220-8. doi: 10.1016/j.bbrc.2014.06.021. Epub 2014 Jun 12.
Pubmed: 24931670
Sun SZ, Empie MW: Fructose metabolism in humans - what isotopic tracer studies tell us. Nutr Metab (Lond). 2012 Oct 2;9(1):89. doi: 10.1186/1743-7075-9-89.
Pubmed: 23031075
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