Urea Cycle Disorders Clinical Trial
Official title:
Oxidative Stress, Inflammation and Acute Decompensation in Urea Cycle Disorders
The primary purpose of the proposed study is to characterize the oxidative stress and inflammatory cytokine status in UCD during baseline and decompensated states.
Protein turnover is a cyclic process with a net loss of protein in the fasting state and a
net gain in the fed state contributing to nitrogen balance. These physiologic processes are
impacted during infection; whole-body protein catabolism exceeds protein synthesis,
resulting in net loss of whole-body protein. Patients with urea cycle disorders suffer
episodes of periodic hyperammonemic crisis, often in association with intercurrent
infections. The immediate cause of this decompensation is the increase in endogenous protein
catabolism that is the endpoint of a cascade triggered by intercurrent illness. This
increase in protein catabolism leads to elevations of serum amino acids and ammonia
production, which cannot be eliminated by a dysfunctional urea cycle.
It is well known that infectious illnesses play a significant role in precipitating
metabolic crises in urea cycle defects, presumably by triggering a cascade of events
involving the release of inflammatory cytokines that lead to increased protein catabolism.
Cytokines have also been implicated as distant mediators of oxidative stress. However, the
correlation between oxidative stress, cytokine levels, and severity of a crisis is currently
unclear.
The primary purpose of the proposed study is to characterize the oxidative stress and
inflammatory cytokine status in UCD during baseline and decompensated states. The
investigators will undertake measurements of selected markers of oxidative stress and
cytokines in serum and urine during baseline and decompensated states in subjects with UCD
in order to establish their prognostic value as biomarkers for disease severity and/or
predictors of metabolic decompensation.
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Observational Model: Cohort, Time Perspective: Prospective
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