Gene delivery corrects N-acetylglutamate synthase deficiency and enables insights in the physiological impact of L-arginine activation of N-acetylglutamate synthase

Sci Rep. 2021 Feb 11;11(1):3580. doi: 10.1038/s41598-021-82994-8.

Abstract

The urea cycle protects the central nervous system from ammonia toxicity by converting ammonia to urea. N-acetylglutamate synthase (NAGS) catalyzes formation of N-acetylglutamate, an essential allosteric activator of carbamylphosphate synthetase 1. Enzymatic activity of mammalian NAGS doubles in the presence of L-arginine, but the physiological significance of NAGS activation by L-arginine has been unknown. The NAGS knockout (Nags-/-) mouse is an animal model of inducible hyperammonemia, which develops hyperammonemia without N-carbamylglutamate and L-citrulline supplementation (NCG + Cit). We used adeno associated virus (AAV) based gene transfer to correct NAGS deficiency in the Nags-/- mice, established the dose of the vector needed to rescue Nags-/- mice from hyperammonemia and measured expression levels of Nags mRNA and NAGS protein in the livers of rescued animals. This methodology was used to investigate the effect of L-arginine on ureagenesis in vivo by treating Nags-/- mice with AAV vectors encoding either wild-type or E354A mutant mouse NAGS (mNAGS), which is not activated by L-arginine. The Nags-/- mice expressing E354A mNAGS were viable but had elevated plasma ammonia concentration despite similar levels of the E354A and wild-type mNAGS proteins. The corresponding mutation in human NAGS (NP_694551.1:p.E360D) that abolishes binding and activation by L-arginine was identified in a patient with NAGS deficiency. Our results show that NAGS deficiency can be rescued by gene therapy, and suggest that L-arginine binding to the NAGS enzyme is essential for normal ureagenesis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Amino-Acid N-Acetyltransferase / genetics*
  • Amino-Acid N-Acetyltransferase / metabolism
  • Animals
  • Arginine / metabolism
  • Arginine / pharmacology
  • Citrulline / metabolism
  • Citrulline / pharmacology
  • Dependovirus / genetics
  • Disease Models, Animal
  • Gene Transfer Techniques*
  • Glutamates / metabolism
  • Glutamates / pharmacology
  • Humans
  • Hyperammonemia / genetics*
  • Hyperammonemia / metabolism
  • Hyperammonemia / pathology
  • Hyperammonemia / therapy
  • Mice
  • Mice, Knockout
  • Mutant Proteins / genetics
  • Urea / metabolism
  • Urea Cycle Disorders, Inborn / genetics*
  • Urea Cycle Disorders, Inborn / metabolism
  • Urea Cycle Disorders, Inborn / pathology
  • Urea Cycle Disorders, Inborn / therapy

Substances

  • Glutamates
  • Mutant Proteins
  • N-carbamylglutamate
  • Citrulline
  • Urea
  • Arginine
  • Amino-Acid N-Acetyltransferase

Supplementary concepts

  • N-acetyl glutamate synthetase deficiency