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MINI REVIEW article

Front. Mol. Neurosci.

Sec. Brain Disease Mechanisms

Volume 18 - 2025 | doi: 10.3389/fnmol.2025.1695490

LYSINE α-KETOGLUTARATE REDUCTASE AS A THERAPEUTIC TARGET FOR SACCHAROPINE PATHWAY RELATED DISEASES

Provisionally accepted
  • 1Center for Medicinal Chemistry, Universidade Estadual de Campinas, Campinas, Brazil
  • 2Center for Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas, Campinas, Brazil
  • 3Department of Genetics and Molecular Biology, Institute of Biology, State University of Campinas, Campinas, Brazil

The final, formatted version of the article will be published soon.

The saccharopine pathway (SacPath) and the pipecolate pathway (PipPath) catabolize lysine to α-aminoadipate. Although the PipPath has been highlighted as the prominent route operating in the brain, recent work has demonstrated that the SacPath plays a major role in lysine catabolism in the brain. The first two enzymatic steps of the SacPath involve the bifunctional enzyme α-aminoadipate semialdehyde synthase (AASS) harboring the lysine-ketoglutarate reductase (LKR) and the saccharopine dehydrogenase (SDH) domains that convert lysine to -aminoadipate semialdehyde. Thereafter, the semialdehyde is converted to -aminoadipate by -aminoadipate semialdehyde dehydrogenase (AASADH). Mutations abolishing the enzymatic activities of LKR, SDH, and AASADH lead to the genetic diseases hyperlysinemia type I and II, and pyridoxine-dependent epilepsy (PDE), respectively. Hyperlysinemia type I accumulates lysine and causes a benign phenotype without clinical significance. Hyperlysinemia type II accumulates saccharopine, which leads to neuronal disorders and intellectual disability. PDE accumulates α-aminoadipate semialdehyde and its cyclic isomer piperideine-6-carboxylate, which binds pyridoxal 5'-phosphate, disturbs synapses, and causes seizures along with developmental disorders. Another genetic disease, glutaric aciduria type I (GA1), localizes just downstream of the SacPath and is caused by mutations abolishing the enzymatic activity of glutaryl-CoA dehydrogenase (GCDH). GA1 accumulates glutarate and 3-hydroxyglutarate, which are neurotoxic molecules that cause irreversible brain damage. Downregulation of LKR has been shown to reduce the metabolic flux through SacPath and alleviate PDE and GA1 symptoms. This review discusses the role of SacPath and its enzymes as potential targets for developing drugs to treat PDE and GA1, as well as other diseases

Keywords: Saccharopine pathway, lysine catabolism, Rare genetic diseases, Pyridoxin-dependent epilepsy, Glutaric aciduria, Saccharopinuria

Received: 29 Aug 2025; Accepted: 06 Oct 2025.

Copyright: © 2025 Valderrama, Moreira and Arruda. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Paulo Arruda, parruda@unicamp.br

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