Role of Dichloroacetate in the Treatment of Genetic Mitochondrial Diseases
Document Type
Review
Publication Date
10-1-2008
Description
Dichloroacetate (DCA) is an investigational drug for the treatment of genetic mitochondrial diseases. Its primary site of action is the pyruvate dehydrogenase (PDH) complex, which it stimulates by altering its phosphorylation state and stability. DCA is metabolized by and inhibits the bifunctional zeta-1 family isoform of glutathione transferase/maleylacetoacetate isomerase. Polymorphic variants of this enzyme differ in their kinetic properties toward DCA, thereby influencing its biotransformation and toxicity, both of which are also influenced by subject age. Results from open label studies and controlled clinical trials suggest chronic oral DCA is generally well-tolerated by young children and may be particularly effective in patients with PDH deficiency. Recent in vitro data indicate that a combined DCA and gene therapy approach may also hold promise for the treatment of this devastating condition.
Citation Information
Stacpoole, Peter; Kurtz, Tracie L.; Han, Zongchao; and Langaee, Taimour. 2008. Role of Dichloroacetate in the Treatment of Genetic Mitochondrial Diseases. Advanced Drug Delivery Reviews. Vol.60(13-14). 1478-1487. https://doi.org/10.1016/j.addr.2008.02.014 PMID: 18647626 ISSN: 0169-409X