inosinic-acid and Lesch-Nyhan-Syndrome

Topics: Animals; Breast Neoplasms; Chromatography, High Pressure Liquid; Chromatography, Ion Exchange; Deficiency Diseases; Female; Fluorouracil; Guanine; Humans; Inosine Monophosphate; Lesch-Nyhan Syndrome; Leukemia; Nucleosides; Nucleotides; Sarcoma 180; Skin; Thioinosine

Topics: Amidophosphoribosyltransferase; Chemical Phenomena; Chemistry; Glucosephosphate Dehydrogenase Deficiency; Glutathione Reductase; Gout; Humans; Inosine Monophosphate; Lesch-Nyhan Syndrome; Phosphoribosyl Pyrophosphate; Purine-Pyrimidine Metabolism, Inborn Errors; Purines; Uric Acid; Xanthine Oxidase; Xanthines; Xeroderma Pigmentosum

The genetic deficiency of hypoxanthine-guanine phosphoribosyltransferase (HPRT), located on the X chromosome, causes a severe neurological disorder in man, known as Lesch-Nyhan disease (LND). The enzyme HPRT is part of the savage pathway of purine biosynthesis and catalyzes the conversion of hypoxanthine and guanine to their respective nucleotides, IMP and GMP. HPRT deficiency is associated with a relatively selective dysfunction of brain dopamine systems. Several metabolites that accumulate in the patients (phosphoribosylpyrophosphate (PRPP), hypoxanthine, guanine, xanthine, and Z-nucleotides) have been proposed as toxic agents in LND. Some authors have pointed that Z-riboside, derived from the accumulation of ZMP, could be the toxic metabolite in LND. However, the available experimental data support a better hypothesis. I suggest that ZMP (and not Z-riboside) is the key toxic metabolite in LND. ZMP is an inhibitor of the bifunctional enzyme adenylosuccinate lyase, and a deficiency of this enzyme causes psychomotor and mental retardation in humans. Moreover, it has been reported that ZMP inhibits mitochondrial oxidative phosphorylation and induces apoptosis in certain cell types. ZMP is also an activator of the AMP-activated protein kinase (AMPK), a homeostatic regulator of energy levels in the cell. The AMPK has been implicated in the regulation of cell viability, catecholamine biosynthesis and cell structure. I propose that accumulation of ZMP will induce a pleiotropic effect in the brain by (1) a direct inhibition of mitochondrial respiration and the bifunctional enzyme adenylosuccinate lyase, and (2) a sustained activation of the AMPK which in turns would reduce cell viability, decrease dopamine synthesis, and alters cell morphology. In addition, a mechanism to explain the accumulation of ZMP in LND is presented. The knowledge of the toxic metabolite, and the way it acts, would help to design a better therapy.

Topics: Aminoimidazole Carboxamide; Cell Line, Tumor; Humans; Hypoxanthine Phosphoribosyltransferase; Inosine Monophosphate; Lesch-Nyhan Syndrome; Models, Biological; Models, Chemical; Models, Theoretical; Oxidative Phosphorylation; Purines; Ribonucleosides; Ribonucleotides

A purine nucleotide (inosinate) cycle is demonstrated with human lymphoblasts. The lymphoblast requires approximately 50 nmol of purine/10(6) cell increment. When the inosinate cycle is interrupted by the genetic, severe deficiency of either or both purine nucleoside phosphorylase (PNP) or hypoxanthine phosphoribosyltransferase (HPRT), purine accumulates in the culture medium as inosine, guanosine, deoxyinosine, and deoxyguanosine (PNP deficiency or PNP, HPRT deficiency) or hypoxanthine and guanine (HPRT deficiency). This accumulation represents an additional 25 to 32 nmol of purine which must be synthesized per 10(6) cell increment. PNP-deficient lymphoblasts have PPRibP contents characteristic of normal lymphoblasts, about 20 to 25 pmol/10(6) cells. HPRT-deficient lymphoblasts have four times higher PPRibP contents. The lymphoblast deficient for both PNP and HPRT has only a marginal elevation of PPRibP content, 1.5 times normal values. The elevated PPRibP content of HPRT-deficient cells reflects the efficient, unilateral reutilization of the ribose moiety of purine ribonucleotides and is not a cause of purine overproduction. Purine overproduction characterizing PNP-deficient lymphoblasts appears similar to overproduction from deficiency of HPRT, i.e. a break in the inosinate cycle rather than overactive de novo purine synthesis.

Topics: B-Lymphocytes; Cell Line; Humans; Hypoxanthine Phosphoribosyltransferase; Immunologic Deficiency Syndromes; Inosine Monophosphate; Inosine Nucleotides; Lesch-Nyhan Syndrome; Purine Nucleotides; Purine-Nucleoside Phosphorylase; Reference Values

The purine phosphoribosyltransferases have emerged as important enzymes in the metabolic economy of the developing human. Hypoxanthine-guanine phosphoribosyltransferase (HGPRT, EC 2.4.2.8) catalyses the conversion of hypoxanthine and guinine into their respective nucleotides. Inherited variation in HGPRT first became evident through clinical observations with the definition of the Lesch-Nyhan syndrome. In this disorder, HGPRT activity in erythrocytes is almost zero, although the fact that sensitive electrophoretic analysis reveals a tiny amount of activity suggests that a protein of altered structure is present. Furthermore, this variant enzyme has been activated by manipulation in the presence of small amounts of normal enzyme. Nevertheless, no cross-reacting material could be detected in lysates of red cells or fibroblasts of patients with the syndrome when tested with antiserum prepared in rabbits to normal erythrocyte HGPRT. We have tested for the presence of cross-reacting material in 18 patients, and all were negative. More HGPRT variants are coming to light. Most of the patients have renal stone disease or gout but no other feature of the Lesch-Nyhan syndrome. In one family four affected males displayed about 5% of normal activity, and the enzyme migrated electrophoretically more rapidly than normal. Cross-reacting material could not be demonstrated in erythrocyte lysates, although it was clear that a variant protein was present. A boy with renal stone disease has been found to have about 1% of normal erythrocyte activity of HGPRT. Cross-reacting material was found in his erythrocytes. The data indicate that mutations which produce diminished enzyme activity in this protein with a distinct subunit structure may or may not so alter the tertiary state of the protein that immunoreactive sites are no longer available to antibody prepared against the normal enzyme. So far whenever a variant normal HGPRT has been found there has been an identifiable clinical illness. The different forms of illness provide for correlation of molecular structure and function in man.

Topics: 5-Hydroxytryptophan; Erythrocytes; Guanine; Humans; Hypoxanthine Phosphoribosyltransferase; Hypoxanthines; Inosine Monophosphate; Isoenzymes; Kinetics; Lesch-Nyhan Syndrome; Male; Phosphoribosyl Pyrophosphate

Clinical and enzymatic studies on two brothers with severe deficiencies of erythrocyte hypoxanthineguanine phosphoribosyltransferase (HGPRTase) are described, and are compared with similar studies of a classical case of the Lesch-Nyhan syndrome from another family. The two brothers have no neurological abnormalities, only traces of erythrocyte HGPRTase, erythrocyte adenine phosphoribosyltransferase activities approaching the high levels found in the Lesch-Nyhan patient, and similarly raised plasma and urinary concentrations of uric acid. Despite these strong biochemical similarities between the three patients, there were wide differences in the clinical case histories. In both families the enzyme deficiency appeared to be inherited as an X-linked character through asymptomatic carrier females. The relationship of HGPRTase deficiencies to the Lesch-Nyhan syndrome is discussed. Some observations relating to techniques are reported. Cellulose acetate has been found to give much better separations of labelled reaction products in low-level phosphoribosyltransferase assays than filter paper, when used as a supporting medium for electrophoresis. The analysis of hair follicles gives indications of individuals heterozygous for the enzyme deficiency, but the proportion of enzyme-deficient follicles was very small, and the test needs support from studies of other cell types. Using haemolysates, there were signs of a slow indirect conversion of hypoxanthine to inosinic acid, via inosine. Inosine appears to be labelled by a ribosyl-transfer reaction.

Topics: Adenine Phosphoribosyltransferase; Adolescent; Child; Child, Preschool; Diagnosis, Differential; Electrophoresis, Cellulose Acetate; Erythrocytes; Genetic Linkage; Hair; Heterozygote; Humans; Hypoxanthine Phosphoribosyltransferase; Hypoxanthines; Inosine Monophosphate; Lesch-Nyhan Syndrome; Male; Pedigree; Purine-Pyrimidine Metabolism, Inborn Errors; Sex Chromosomes; Uric Acid