Organic acids of urine in multiple sclerosis

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Abstract
The urinary excretion of organic acids was examined in 50 patients with multiple sclerosis [MS] and in 50 age- and sex-matched controls. The concentrations of the acids were related to creatinine. No differences were found for the compounds glycolic acid, 2-methyl-3-hydroxybutyric acid, 2-ethylhydracrylic acid, 4-hydroxyphenylacetic aicd, suberic acid and many other acids. The mean excretion of 2-hydroxy-2-methyl-3-butenoic acid was increased 2-fold in the MS group. Two MS cases had a very high excretion of 3-methylglutaconic acid, and another 6 cases had moderate elevations, which were fairly constant over a time period of several months. Moderate elevations were also noted in 2 healthy controls. A MS case had a very high excretion of 3-hydroxyisovaleric acid. MS cases (7) and none in the control group, had elevated excretion of adipic acid. Differences were also noted for lactic acid, succinic acid, aconitic acid and 3-methyladipic acid. An oral dose of deuterium-labeled acetate was given to one of the patients with high excretion of 3-methylglutaconic acid. Deuterium was incorporated into this metabolite. 3-methylglutaconic acid, 2-hydroxy-2-methyl-3-butenoic acid, 3-hydroxyisovaleric acid and 3-methyladipic acid are all potential isoprenoid metabolites. A possible defect in the pathway of isoprenoid biosynthesis is discussed.