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Aceruloplasminemia: molecular characterization of this disorder of iron metabolism.
Open accessAbstract
Ceruloplasmin is an abundant alpha 2-serum glycoprotein that contains 95% of the copper found in the plasma of vertebrate species. We report here on the identification of a genetic defect in the ceruloplasmin gene in a patient previously noted to have a total absence of circulating serum ceruloplasmin in association with late-onset retinal and basal ganglia degeneration. In this patient T2 (transverse relaxation time)-weighted magnetic resonance imaging of the brain revealed basal ganglia densities consistent with iron deposition, and liver biopsy confirmed the presence of excess iron. Although Southern blot analysis of the patient's DNA was normal, PCR amplification of 18 of the 19 exons composing the human ceruloplasmin gene revealed a distinct size difference in exon 7. DNA sequence analysis of this exon revealed a 5-bp insertion at amino acid 410, resulting in a frame-shift mutation and a truncated open reading frame. The validity of this mutation was confirmed by analysis of DNA from the patient's daughter, which revealed heterozygosity for this same 5-bp insertion. The presence of this mutation in conjunction with the clinical and pathologic findings demonstrates an essential role for ceruloplasmin in human biology and identifies aceruloplasminemia as an autosomal recessive disorder of iron metabolism. These findings support previous studies that identified ceruloplasmin as a ferroxidase and are remarkably consistent with recent studies on the essential role of a homologous copper oxidase in iron metabolism in yeast. The clinical and laboratory findings suggest that additional patients with movement disorders and nonclassical Wilson disease should be examined for ceruloplasmin gene mutations.
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“As reported by Harris and colleagues, 184 iron deficiency results from lack of ferroxidase activity needed to mobilize iron from storage.”
From Forging a field: the golden age of iron biology. (2008) · cites this paper as [184]
In the citing paper
“In iron-replete cells, IRP1, which has ∼30% homology to mitochondrial aconitase based on amino acid alignments, loses its affinity for the IRE, and converts to a cytosolic aconitase (127, 263).”
From Intracellular iron transport and storage: from molecular mechanisms to health implications (2008) · cites this paper as [127]
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“Other NBIA disorders, such as aceruloplasminaemia, which is caused by mutations in the CP gene, and neuroferritinopathy, which is caused by mutations in the FTL gene, appear to affect specific, small NBIA sub-populations [61,62].”
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“Aceruloplasminemia is an autosomal recessive disorder characterized by progressive neurodegeneration of the retina and basal ganglia associated with specific inherited mutations in the ceruloplasmin gene [6].”
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“Aceruloplasminemia is a rare autosomal recessive iron overload disease caused by mutations in the gene of the ferroxidase ceruloplasmin (Cp) (Harris et al., 1995).”
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“Aceruloplasminemia is caused by mutations in the CP gene, which encodes CP (5).”
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“Excessive iron deposition resembling hemosiderosis in liver, brain, and pancreas has been observed upon histological examination of tissues from patients diagnosed with aceruloplasminemia (Harris et al. 1995; Harris et al. 1998; Harris and Gitlin 1996; Yoshida et al. 1995).”
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BackgroundTherapeutic applications of chelating drugs in iron metabolic disorders of the brain and retina
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“Aceruloplasminemia is an uncommon adult-onset autosomal recessive disorder caused by disruption in a gene that encodes ceruloplasmin, an enzyme that plays role in cellular iron homeostasis (Harris et al., 1995).”
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Neurobehavioural deficits following postnatal iron overload: II instrumental learning performance
Archer, T., Schoröder, N., & Fredriksson, A. (2003) · Neurotoxicity Research · doi:10.1007/bf03033374 · Cited by 13
Early onset insulin‐dependent diabetes mellitus as an initial manifestation of aceruloplasminaemia
MUROI, R., Yagyu, H., Kobayashi, H., Nagata, M., Sato, N. S., Ideno, J., Fujita, N., Ando, A., Okada, K., Takiyama, Y., et al. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01883.x · Cited by 13
Hofmann, W. P., Hofmann, W. P., Welsch, C., Takahashi, Y., Miyajima, H., Mihm, U., Krick, C. M., Zeuzem, S., & Sarrazin, C. (2007) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520701278810 · Cited by 13
“Cp catalyzes the oxidation of ferrous iron to ferric iron, a step required for iron coupling to transferrin [4].”
BackgroundHypocaeruloplasminaemia with heteroallelic caeruloplasmin gene mutation: MRI of the brain
Daimon, M., Moriai, S., Susa, S., Yamatani, K., Hosoya, T., & Kato, T. (1999) · Neuroradiology · doi:10.1007/s002340050730 · Cited by 13
Hémochromatose HFE : approche pathogénique et diagnostique
Brissot, P., Lan, C. L., Troadec, M., Lorho, R., Ropert, M., Lescoat, G., & Loréal, O. (2005) · Transfusion Clinique et Biologique · doi:10.1016/j.tracli.2005.04.040 · Cited by 14
Other autosomal recessive and childhood ataxias
Michele, G. D., & Filla, A. (2011) · Handbook of clinical neurology · doi:10.1016/b978-0-444-51892-7.00021-8 · Cited by 12
Harris, Z. L. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-810532-0.00009-4 · Cited by 15
Yin, E. P., & Dieriks, B. V. (2025) · Journal of Parkinson s Disease · doi:10.1177/1877718x241304814 · Cited by 12
“…include increased sub-stantia nigra echogenicity, which is indicative of higher iron levels and posited as a vulnerability marker for PD. 164,165 In animal studies, heterozygote PINK1 knockout mice were unabletoproducelong-termpotentiationdespite repetitivecor-tical inputs to striatal…”
Peng, C. C., Yan, J. Y., Dong, B., Zhu, L., Tian, Y., & Gong, L. M. (2016) · Asian-Australasian Journal of Animal Sciences · doi:10.5713/ajas.16.0182 · Cited by 11
“Cu affects a wide spectrum of biological activities such as catalyzing the formation of hydroxyl radicals, which can lead to lipid peroxidation [9], and it plays a critical role in iron and zinc homeostasis [6,10].”
BackgroundBiometals and Alzheimer’s Disease
Mot, A. I., & Crouch, P. J. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-804562-6.00001-4 · Cited by 11
Aceruloplasminemia and putaminal cavitation
Riboldi, G. M., Anstett, K., Jain, R., Lau, H., & Swope, D. (2018) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2018.03.003 · Cited by 11
Aceruloplasminemia: a case report
Raimondo, D. D., Pinto, A. V., Tuttolomondo, A., Fernández, P., Camaschella, C., & Licata, G. (2008) · Internal and Emergency Medicine · doi:10.1007/s11739-008-0150-2 · Cited by 11
“Aceruloplasminemia, after the first description, has been reported mainly in Japanese patients [1, 2, 9–18] and rarely in whites [10, 19].”
BackgroundDivalent cation binding to ceruloplasmin
Musci, G., di Patti, M. C. B., Petruzzelli, R., GIARTOSIO, A., & Calabrese, L. (1996) · BioMetals · doi:10.1007/bf00188092 · Cited by 11
“A role for ceruloplasmin in iron metabolism, mediated by its ferroxidase activity, has recently received a confirmation (Harris et al. 1995).”
BackgroundSerúlópasmín og járn. Tengsl við Alzheimersjúkdóm og Parkinsonsjúkdóm
Jóhannesson, Þ., Kristinsson, J., Þórsdóttir, G., Snædal, J., & Snædal, J. (2012) · Læknablaðið · doi:10.17992/lbl.2012.10.457 · Cited by 11
Inherited iron overload disorders
Andrews, N. C. (2000) · Current Opinion in Pediatrics · doi:10.1097/00008480-200012000-00015 · Cited by 11
Naquin, E. R., Garg, R., Chen, W. J., Karmakar, E., Prasad, A., Mandadi, S., Depala, K. S., Gopianand, J. S., & Gnana‐Prakasam, J. P. (2025) · Nutrients · doi:10.3390/nu17182964 · Cited by 10
Lenartowicz, M., Starzyński, R. R., Krzeptowski, W., Grzmil, P., Bednarz, A., Ogórek, M., Pierzchała, O., Staroń, R., Gajowiak, A., & Lipiński, P. (2014) · PLoS ONE · doi:10.1371/journal.pone.0107641 · Cited by 10
“The role of Cp in iron metabolism has been reported in the congenital human disease acaeruloplasminemia, in which mutations in the caeruloplasmin gene lead to hypoferraemia and iron loading in the liver [12,13].”
BackgroundSakajiri, T., Nakatsuji, M., Teraoka, Y., Furuta, K., Ikuta, K., Shibusa, K., Sugano, E., Tomita, H., Inui, T., & Yamamura, T. (2021) · Metallomics · doi:10.1093/mtomcs/mfab065 · Cited by 11
Animal Models of Hereditary Iron Transport Disorders
Andrews, N. C. (2002) · Advances in experimental medicine and biology · doi:10.1007/978-1-4615-0593-8_1 · Cited by 10
Ketata, I., & Ellouz, E. (2023) · Rare · doi:10.1016/j.rare.2023.100010 · Cited by 9
Age-dependent expression of hephaestin in the brain of ceruloplasmin-deficient mice
Cui, R., Duan, X., Anderson, G. J., Qiao, Y.-T., Yu, P., Qian, Z., Yoshida, K., Takeda, S., Guo, P., Yang, Z.-L., et al. (2009) · Journal of Trace Elements in Medicine and Biology · doi:10.1016/j.jtemb.2009.05.004 · Cited by 9
“All patients eventually succumb to the effects of increased iron accumulation within the basal ganglia [3–6].”
BackgroundMolecular analysis of Ceruloplasmin in a South African cohort presenting with oesophageal cancer
Strickland, N. J., Matsha, T. E., Erasmus, R., & Zaahl, M. G. (2011) · International Journal of Cancer · doi:10.1002/ijc.26418 · Cited by 10
Functional Characterization of Rare RAB12 Variants and Their Role in Musician’s and Other Dystonias
Hebert, E., Borngräber, F., Schmidt, A., Raković, A., Brænne, I., Weißbach, A., Hampf, J., Vollstedt, E., Größer, L., Schaake, S., et al. (2017) · Genes · doi:10.3390/genes8100276 · Cited by 9
“Furthermore, in several genetic forms of neurodegeneration with brain iron accumulation (NBIA), dystonia (DYT) is a prominent feature of the disease such as in NBIA/DYT-PANK2 [37], NBIA/DYT/PARK-PLA2G6 [38], NBIA/DYT/PARK-CP [39], and NBIA/DYT-DCAF17 [31,40].”
BackgroundGene regulation by copper and the basis for copper homeostasis
Mercer, J. F. B. (1997) · Nutrition · doi:10.1016/s0899-9007(96)00323-1 · Cited by 9
Metadata
- Authors
- Harris, Z. L., Takahashi, Y., Miyajima, H., Serizawa, M., MacGillivray, R. T., & Gitlin, J. D.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 1995-03-28
- Volume
- 92
- Issue
- 7
- Pages
- 2539-2543
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC42253
- OpenAlex
- W2132544275
- Cited by
- 558
- References
- 29
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 15 · 2020: 9 · 2019: 12 · 2018: 17 · 2017: 10 · 2016: 13 · 2015: 16 · 2014: 16 · 2013: 22 · 2012: 20
- FWCI
- 16.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl041536-13)
- National Heart, Lung, and Blood Institute (HL41536)
- Topics
- Life Sciences › Neuroscience › Neurology › Neurological diseases and metabolism
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- aceruloplasminemia, ceruloplasmin, frameshift mutation, iron metabolism, iron accumulation, basal ganglia degeneration, retinal degeneration, ferroxidase, copper oxidase, autosomal recessive disorder, movement disorders, heterozygosity
- MeSH terms
- Amino Acid Sequence, Animals, Basal Ganglia, Base Sequence, Blepharospasm, Ceruloplasmin, DNA, Exons, Female, Humans, Iron, Magnetic Resonance Imaging, Metal Metabolism, Inborn Errors, Middle Aged, Molecular Sequence Data, Reference Values, Retinal Degeneration, Vertebrates, Polymerase Chain Reaction, DNA Primers
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