1.2.1.31 malfunction alpha-AASA dehydrogenase deficiency results in the accumulation of pathognomonic alpha-aminoadipic semialdehyde (in cerebrospinal fluid, plasma and urine) and pipecolic acid (cerebrospinal fluid and plasma) in affected patients 712017 1.2.1.31 malfunction enzyme deficiency causes pyridoxine-dependent epilepsy 763341 1.2.1.31 malfunction mutations in the ALDH7A1 gene can cause the autosomal recessive metabolic disease pyridoxine-dependent epilepsy (PDE), which is characterized by seizure activity within days of birth. Although PDE symptoms can be mitigated with high doses of pyridoxine (vitamin B6) and a lysine-restricted diet, many patients have long-lasting and untreatable cognitive disability. The molecular basis of PDE is thought to be due to a buildup of DELTA1-piperideine-6-carboxylate, the cyclic form of the aldehyde substrate of ALDH7A1 763029 1.2.1.31 metabolism human aldehyde dehydrogenase 7A1 (ALDH7A1) catalyzes the final step in lysine catabolism, the NAD+-dependent oxidation of alpha-aminoadipate semialdehyde to alpha-aminoadipate 763029 1.2.1.31 metabolism key enzyme in lysine oxidation 763341 1.2.1.31 physiological function the catalytically active oligomer of ALDH7A1 is assembled on demand in response to cofactor availability 763029