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Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria
BACKGROUND: Although changes in the tyrosine pathway during nitisinone therapy are known, a complete characterization of the induced tyrosinaemia is lacking to improve disease management. PATIENTS AND METHODS: Our research aims were addressed by 24-h blood sampling. 40 patients with alkaptonuria (AK...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856922/ https://www.ncbi.nlm.nih.gov/pubmed/35242577 http://dx.doi.org/10.1016/j.ymgmr.2022.100846 |
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author | Ranganath, L.R. Milan, A.M. Hughes, A.T. Davison, A.S. Khedr, M. Norman, B.P. Bou-Gharios, G. Gallagher, J.A. Gornall, M. Jackson, R. Imrich, R. Rovensky, J. Rudebeck, M. Olsson, B. |
author_facet | Ranganath, L.R. Milan, A.M. Hughes, A.T. Davison, A.S. Khedr, M. Norman, B.P. Bou-Gharios, G. Gallagher, J.A. Gornall, M. Jackson, R. Imrich, R. Rovensky, J. Rudebeck, M. Olsson, B. |
author_sort | Ranganath, L.R. |
collection | PubMed |
description | BACKGROUND: Although changes in the tyrosine pathway during nitisinone therapy are known, a complete characterization of the induced tyrosinaemia is lacking to improve disease management. PATIENTS AND METHODS: Our research aims were addressed by 24-h blood sampling. 40 patients with alkaptonuria (AKU), treated with 0, 1, 2, 4 and 8 mg nitisinone daily (n = 8), were studied over four weeks. Serum homogentisic acid (sHGA), tyrosine (sTYR), phenylalanine (sPHE), hydroxyphenylpyruvate (sHPPA), hydroxyphenyllactate (sHPLA) and nitisinone (sNIT) were measured at baseline and after four weeks. RESULTS: sNIT showed a clear dose-proportional response. sTYR increased markedly but with less clear-cut dose responses after nitisinone. Fasting and average 24-h (C(av)) sTYR responses were similar. Individual patient sTYR 24-h profiles showed significant fluctuations during nitisinone therapy. At week 4, sTYR, sHPPA and sHPPL all showed dose-related increases compared to V0, with the greatest difference between 1 and 8 mg nitisinone seen for HPLA, while there was no change from V0 in sPHE. sHGA decreased to values around the lower limit of quantitation. DISCUSSION: There was sustained tyrosinaemia after four weeks of nitisinone therapy with significant fluctuations over the day in individual patients. Diet and degree of conversion of HPPA to HPLA may determine extent of nitisinone-induced tyrosinaemia. CONCLUSION: A fasting blood sample is recommended to monitor sTYR during nitisinone therapy Adaptations in HPPA metabolites as well as the inhibition of tyrosine aminotransferase could be contributing factors generating tyrosinaemia during nitisinone therapy. |
format | Online Article Text |
id | pubmed-8856922 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-88569222022-03-02 Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria Ranganath, L.R. Milan, A.M. Hughes, A.T. Davison, A.S. Khedr, M. Norman, B.P. Bou-Gharios, G. Gallagher, J.A. Gornall, M. Jackson, R. Imrich, R. Rovensky, J. Rudebeck, M. Olsson, B. Mol Genet Metab Rep Research Paper BACKGROUND: Although changes in the tyrosine pathway during nitisinone therapy are known, a complete characterization of the induced tyrosinaemia is lacking to improve disease management. PATIENTS AND METHODS: Our research aims were addressed by 24-h blood sampling. 40 patients with alkaptonuria (AKU), treated with 0, 1, 2, 4 and 8 mg nitisinone daily (n = 8), were studied over four weeks. Serum homogentisic acid (sHGA), tyrosine (sTYR), phenylalanine (sPHE), hydroxyphenylpyruvate (sHPPA), hydroxyphenyllactate (sHPLA) and nitisinone (sNIT) were measured at baseline and after four weeks. RESULTS: sNIT showed a clear dose-proportional response. sTYR increased markedly but with less clear-cut dose responses after nitisinone. Fasting and average 24-h (C(av)) sTYR responses were similar. Individual patient sTYR 24-h profiles showed significant fluctuations during nitisinone therapy. At week 4, sTYR, sHPPA and sHPPL all showed dose-related increases compared to V0, with the greatest difference between 1 and 8 mg nitisinone seen for HPLA, while there was no change from V0 in sPHE. sHGA decreased to values around the lower limit of quantitation. DISCUSSION: There was sustained tyrosinaemia after four weeks of nitisinone therapy with significant fluctuations over the day in individual patients. Diet and degree of conversion of HPPA to HPLA may determine extent of nitisinone-induced tyrosinaemia. CONCLUSION: A fasting blood sample is recommended to monitor sTYR during nitisinone therapy Adaptations in HPPA metabolites as well as the inhibition of tyrosine aminotransferase could be contributing factors generating tyrosinaemia during nitisinone therapy. Elsevier 2022-02-01 /pmc/articles/PMC8856922/ /pubmed/35242577 http://dx.doi.org/10.1016/j.ymgmr.2022.100846 Text en © 2022 Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Paper Ranganath, L.R. Milan, A.M. Hughes, A.T. Davison, A.S. Khedr, M. Norman, B.P. Bou-Gharios, G. Gallagher, J.A. Gornall, M. Jackson, R. Imrich, R. Rovensky, J. Rudebeck, M. Olsson, B. Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria |
title | Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria |
title_full | Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria |
title_fullStr | Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria |
title_full_unstemmed | Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria |
title_short | Characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria |
title_sort | characterization of changes in the tyrosine pathway by 24-h profiling during nitisinone treatment in alkaptonuria |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856922/ https://www.ncbi.nlm.nih.gov/pubmed/35242577 http://dx.doi.org/10.1016/j.ymgmr.2022.100846 |
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