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Case Reports
. 2017 May;54(5):330-337.
doi: 10.1136/jmedgenet-2016-104132. Epub 2016 Oct 31.

ACBD5 deficiency causes a defect in peroxisomal very long-chain fatty acid metabolism

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Case Reports

ACBD5 deficiency causes a defect in peroxisomal very long-chain fatty acid metabolism

Sacha Ferdinandusse et al. J Med Genet. 2017 May.

Abstract

Background: Acyl-CoA binding domain containing protein 5 (ACBD5) is a peroxisomal membrane protein with a cytosolic acyl-CoA binding domain. Because of its acyl-CoA binding domain, ACBD5 has been assumed to function as an intracellular carrier of acyl-CoA esters. In addition, a role for ACBD5 in pexophagy has been suggested. However, the precise role of ACBD5 in peroxisomal metabolism and/or functioning has not yet been established. Previously, a genetic ACBD5 deficiency was identified in three siblings with retinal dystrophy and white matter disease. We identified a pathogenic mutation in ACBD5 in another patient and studied the consequences of the ACBD5 defect in patient material and in ACBD5-deficient HeLa cells to uncover this role.

Methods: We studied a girl who presented with progressive leukodystrophy, syndromic cleft palate, ataxia and retinal dystrophy. We performed biochemical, cell biological and molecular studies in patient material and in ACBD5-deficient HeLa cells generated by CRISPR-Cas9 genome editing.

Results: We identified a homozygous deleterious indel mutation in ACBD5, leading to complete loss of ACBD5 protein in the patient. Our studies showed that ACBD5 deficiency leads to accumulation of very long-chain fatty acids (VLCFAs) due to impaired peroxisomal β-oxidation. No effect on pexophagy was found.

Conclusions: Our investigations strongly suggest that ACBD5 plays an important role in sequestering C26-CoA in the cytosol and thereby facilitates transport into the peroxisome and subsequent β-oxidation. Accordingly, ACBD5 deficiency is a novel single peroxisomal enzyme deficiency caused by impaired VLCFA metabolism, leading to retinal dystrophy and white matter disease.

Keywords: acyl-CoA binding domain containing protein 5; peroxisomal beta-oxidation; peroxisomal single enzyme deficiency; pexophagy; very long-chain fatty acids.

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Conflict of interest statement

Competing interests: None declared.

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