flavin-adenine-dinucleotide and pyridoxine-5-phosphate

Riboflavin status is commonly measured by the in vitro stimulation of erythrocyte glutathione reductase with flavin adenine dinucleotide and expressed as an erythrocyte glutathione reductase activation coefficient (EGRAC). However, this assay is insensitive to poor riboflavin status in subjects with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Because G6PD deficiency is common in parts of the world where ariboflavinosis is endemic, it is important to have a measure of riboflavin status that is unaffected by differences in G6PD status.. The objective was to further develop and validate a fluorometric assay for pyridoxamine phosphate oxidase (PPO) activity as a measure of riboflavin status.. A fluorometric assay was optimized for the flavin-dependent enzyme PPO in erythrocytes. Hemolysates from a previous riboflavin intervention study (2- and 4-mg riboflavin supplements) were used to investigate the responsiveness of the method to changes in riboflavin intake.. PPO activity and the PPO activation coefficient (PPOAC) were used to assess riboflavin status. Both PPO activity and PPOAC responded to riboflavin supplements (P < 0.01), but only PPO showed a dose response (P < 0.001). The change from baseline to after the intervention in PPOAC and PPO enzyme activity was significantly inversely correlated (P < 0.001). Both PPO activity and PPOAC were strongly correlated with EGRAC (P < 0.001). Additionally, both PPOAC and EGRAC showed a significant inverse correlation with dietary riboflavin intake (P < 0.01); PPO activity was positively correlated with riboflavin intake (P < 0.01).. PPO activity could be used as a biomarker for measuring riboflavin status, especially in populations with a high prevalence of G6PD deficiency. This trial is registered at www.isrctn.org as ISRCTN35811298.

Topics: Enzyme Activation; Erythrocytes; Flavin-Adenine Dinucleotide; Glutathione Reductase; Hemolysis; Humans; Pyridoxal Phosphate; Pyridoxaminephosphate Oxidase; Riboflavin

Per cent stimulation of GR activity by FAD in vitro and PNP oxidase activity were measured in G6PD deficiency, heterozygous beta-thalassaemia and controls. It is confirmed that, in contrast to the high stimulation of GR by FAD commonly found in in thalassaemia indicating red-cell deficiency of FAD, and shown here to be greater in the Italian subjects, GR is usually saturated with FAD in G6PD deficiency, leading to high in vitro activity. Unexpectedly, on the other hand, low FMN-dependent PNP oxidase activity due to red-cell deficiency of FMN, confirmed by response to oral riboflavin, was found in the majority of subjects with G6PD deficiency, similar to that found in heterozygous beta-thalassaemia. Whereas this is explained in thalassaemia by an inherited slow red-cell metabolism of riboflavin to FMN, it is suggested that in G6PD deficiency an increased rate of red-cell metabolism of FMN to FAD leads to the low FMN and high FAD. When G6PD deficiency occurs with heterozygous beta-thalassaemia, GR is usually saturated with FAD as in G6PD deficiency alone, unless there is an inherited, very slow red-cell metabolism of riboflavin to FMN. The part played by GR in haemolytic crises in G6PD deficiency is discussed.

Topics: Erythrocytes; Flavin Mononucleotide; Flavin-Adenine Dinucleotide; Flavoproteins; Glucosephosphate Dehydrogenase Deficiency; Glutathione Reductase; Heterozygote; Humans; Oxidoreductases Acting on CH-NH Group Donors; Pedigree; Pyridoxal Phosphate; Pyridoxaminephosphate Oxidase; Riboflavin; Thalassemia