Biomedical subjects
Publications and source records attributed to G G Thompson.
Explore the source record for details and available documents.
Acute intermittent porphyria (AIP) is an autosomal dominantly inherited disorder of haem biosynthesis characterised by reduced activity of the enzyme uroporphyrinogen-1-(URO) synthase and compensatory increased activity of the rate controlling enzyme delta-aminolaevulinic acid (ALA) synthase. Subjects with the disorder should be identified as they are at risk of developing severe porphyric attacks if exposed to a variety of drugs or chemicals. We have assessed the value of measuring the activities of ALA synthase and URO synthase in peripheral blood cells as a means of identifying latent cases in affected families. In AIP subjects, ALA synthase activity was increased and URO synthase decreased compared to controls, through there was considerable overlap between the two groups when either enzyme was examined alone. When both enzymes were examined together, all but one of the 19 AIP patients had both increased ALA synthase activity (greater than 250 nmol ALA/g protein/h) and reduced URO synthase activity (less than 25.1 nmol URO/l RBC/h), whereas none of the 62 controls showed this enzyme pattern. Examination of 35 asymptomatic first degree blood relatives of AIP patients showed that 17 (49%) had the porphyric enzyme pattern with no sex bias. The combined study of these two enzymes permits accurate detection of latent cases of AIP and confirms its autosomal dominant inheritance.
The Harderian gland of the female golden hamster contains an average of forty times more mast cells in the interstitial tissue than the male gland. A similar sex difference occurs in the connective tissue capsule of the gland. Mast cell numbers in the male Harderian gland increase greatly between two and five months after castration, reaching levels comparable to those found in the female. This postcastrational rise in mast cell numbers is prevented by androgen administration; furthermore, if mast cell numbers are allowed to increase in castrates, subsequent androgen administration will reverse the rise. There is no obvious relationship between mast cell numbers in the Harderian gland of the female hamster and the porphyrin content of the gland.
The activities of six of the enzymes of haem biosynthesis have been examined in eleven chronic alcoholics admitted to hospital for alcohol withdrawal. The mitochondrial enzymes delta-aminolaevulinic acid (ALA) synthase, coproporphyrinogen oxidase and ferrochelatase were monitored in peripheral leucocytes and the cytosolic enzymes ALA dehydratase, uroporphyrinogen-1-synthase and uroporphyrinogen decarboxylase in peripheral erythrocytes. Compared with control subjects the activity of the initial and rate controlling enzyme of the pathway, ALA synthase, was increased (P less than 0.01) and the activities of ALA dehydratase and uroporphyrinogen decarboxylase depressed (P less than 0.01, P less than 0.02 respectively) on the day after admission but all returned to normal by the tenth to twentieth days after alcohol withdrawal. This stimulation of ALA synthase and inhibition of uroporphyrinogen decarboxylase explains the mechanism by which chronic alcohol ingestion may precipitate cutaneous hepatic porphyria. Two of the alcoholics were anaemic without evidence of haematinic deficiency and this was associated with depressed ferrochelatase activity and iron and porphyrin accumulation. The anaemia and related biochemical abnormalities in these two subjects were all corrected with alcohol withdrawal. It is proposed that inhibition of ferrochelatase activity is the biochemical basis of alcohol related sideroblastic anaemia.
We report our experience with intravenous haematin in the treatment of 13 attacks of acute porphyria in eight patients. Seven patients had acute intermittent porphyria and one variegate porphyria. Peripheral neuropathy was a feature of nine of the attacks and in two the neuropathy necessitated assisted ventilation. The haematin lowered the urinary excretion of porphyrins and precursors in all patients by approximately 50 per cent of the pre-haematin values. It also repressed the activity of delta-aminolaevulinic acid synthetase, the rate-controlling enzyme of haem biosynthesis, in peripheral leucocytes in seven of the nine patients in whom it was monitored. The clinical response was less consistent, with clinical improvement accompanying only half of the courses. The two patients with respiratory paralysis died. There was localized phlebitis at the injection site following five of the courses but no other side-effects were noted. Previously published reports of haematin therapy for acute porphyria are reviewed. These consist of 45 courses in 32 patients. Biochemical improvement was a consistent finding. Clinical response has been less consistent. Twenty-four of the courses were associated with sustained improvement, ten with temporary improvement--relapse occurring within two to 14 days (three fatal). In eleven there was no improvement and three died.
Explore the source record for details and available documents.
1 In rats daily phenytoin (DPH) administration resulted in an increase in hepatic cytochrome P450 content. The rise in cytochrome P450 was associated with a temporary increase in the acitvity of hepatic delta-aminolaevulinic acid (ALA) synthase. 2 In patients newly commenced on DPH anticonvulsant therapy the activity of ALA synthase in peripheral leucocytes showed a marked temporary increase during the first 10 days of therapy. 3 These findings suggest that DPH induces a haem-requiring eenzyme system in peripheral leucocytes as well as in hepatic tissue.
The effects of acute ethanol ingestion on the activities of the enzymes of haem biosynthesis in peripheral blood cells have been monitored in eight healthy subjects. The mitochondrial enzymes delta-aminolaevulinic acid (ALA) synthase, coproporphyrinogen oxidase and ferrochelatase were measured in leucocytes and the cytosolic enzymes ALA dehydratase, porphobilinogen (PBG) deaminase and uroporphyrinogen decarboxylase in erythrocytes. Ingestion of 1 . 316 mol ethanol resulted in increased activity of the rate-controlling enzymes ALA synthase and PBG deaminase and decreased activity of the other four enzymes. There was also increased urinary excretion of coproporphyrin. These observations may be relevant to the biochemical mechanisms involved in the ethanol-related conditions, sideroblastic anaemia, cutaneous hepatic porphyria and hepatic siderosis.
Explore the source record for details and available documents.
The Harderian gland, which is situated within the bony orbit, is usually thought of as a source of lubrication for the eye. However, recent studies have suggested links with reproductive function. In the male golden hamster, both gland histology and activity are known to be under hormonal influence, and the present experiment was undertaken to examine gland weight and activity (as measured by the production of porphyrins) over the oestrous cycle and during pregnancy and early lactation in the female hamster. Gland weight, the number of solid intraluminal porphyrin accretions, and concentrations of copro- and proto-porphyrin were all maximal on day 1 of the cycle (oestrous) and at their lowest on day 2 (or jointly on days 2 and 3), rising gradually thereafter. Porphyrin concentrations are considerably higher during pregnancy and early lactation than during the cycle, and the solid porphyrin accretions, although diminished in number, are larger. Although there is no indication of either the function or the physiological basis of these changes during the cycle or pregnancy, these findings do suggest that in the female golden hamster, as in the male, there is a link between Harderian gland activity and reproductive function.
The activities of the enzymes of heme biosynthesis (except protoporphyrin oxidase) have been followed during the induction of Friend cells in culture. All the enzyme activities increased after induction with dimethyl sulfoxide. The activities of the intermediate enzymes were much higher than those of delta-aminolevulinate synthase [succinyl-CoA:glycine C-succinyltransferase (decarboxylating), EC 2.3.1.37], the initial enzyme, or ferrochelatase (protoheme ferro-lyase, EC 4.99.1.1), the final enzyme of the pathway. Ferrochelatase activity was not detectable in the uninduced cell. delta-Aminolevulinate synthase activity increased during the first 24 hr of induction; porphobilinogen deaminase activity began to increase after 48 hr and ferrochelatase activity, after 72 hr. However, the induction of heme synthesis followed the same time course as that of ferrochelatase activity, not that of delta-aminolevulinate synthase activity. The cellular growth medium was found to contain traces of protoporphyrins. Thus, ferrochelatase is shown to be rate limiting for heme synthesis during early stages of Friend cell induction. A Friend cell variant (Fw), which is not inducible except in the presence of exogenous hemin, was also studied. All the enzymes of heme synthesis except ferrochelatase were inducible by butyric acid. Ferrochelatase was not inducible by butyric acid or hemin plus butyric acid. These cells also excrete protoporphyrin, The failure to induce ferrochelatase activity is believed to be the cause of, not a consequence of, the noninducibility of this cell line.
The enzymes of haem biosynthesis have been measured in the peripheral blood of 13 patients with cutaneous hepatic porphyria. The activity of leucocyte delta-aminolaevulinic acid synthase was significantly elevated (p less than 0.001) as was that of erythrocyte porphobilinogen deaminase (p less than 0.05). Leucocyte ferrochelatase activity was depressed (p less than 0.001) and the activity of erythrocyte uroporphyrinogen decarboxylase did not significantly differ from control values. Similar enzyme activities were assayed in 12 chronic alcoholics and 8 patients with liver disease and the results differed markedly from those obtained from the porphyric patients. It is unlikely that the raised leucocyte delta-amino-laevulinic acid synthase activity can be attributed to alcohol ingestion or liver disease. A defect in the activity of uroporphyrinogen decarboxylase may exist in cutaneous hepatic porphyria but this could not be demonstrated in erythrocytes in this study.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The activity of the haem biosynthetic enzymes delta-aminolaevulinic acid synthetase (ALA.S) and delta-aminolaevulinic acid dehydratase (ALA.D) were measured in the peripheral blood of a group of lead workers and control subjects. The haem precursor delta-aminolaevulinic acid (ALA) was measured in blood and urine, whilst lead levels were measured in whole blood. The inter-relationships between all these parameters were examined and quantified. The results demonstrate that above a blood lead concentration of 2 mumole/l and below an erythrocyte ALA.D activity of 18 nmole ALA utlized/min/ml red blood cells (R.B.C.), Haem synthesis is depressed to such an extent that the activity of leucocyte ALA.S, the rate-limiting enzyme of haem biosynthesis, is increased by negative feedback.
The activities in blood of six enzymes of the haem biosynthetic pathway have been determined in 12 patients with rheumatoid disease, six of whom were anaemic. The porphyrin and porphyrin-precursor intermediary products of haem biosynthesis were also determined in blood, urine and faeces. No significant differences were found between anaemic and non-anaemic subjects. Failure of delta-amino-laevulinate synthase activity to increase in response to anaemia may be the nature of the marrow unresponsiveness suggested as one factor in the causation of the anaemia. Normal ferrochelatase activity and normal concentrations of free protoporphyrin support the view that iron is effectively unavailable although present in normal amounts. Coproporphyrinogen oxidase activity was significantly depressed.
1 Pretreatment of rats with intraperitoneal injections of lead was shown to result in a depression of the microsomal mixed function oxidase system, as assessed by a decrease in hepatic microsomal P-450 and b5 content and by a decrease in the activity of the enzymes aniline hydroxylase and aminopyrine demethylase. Lead had a more marked effect on cytochrome P-450 than b5. 2 The activity of the rate-limiting enzyme of haem biosynthesis, delta-aminolaevulinic acid synthase, was inversely correlated with the microsomal cytochrome P-450 content. 3 The activity of the haem biosynthetic enzymes delta-aminolaevulinic acid dehydratase, coproporphyrinogen oxidase and ferrochelatase were decreased by increasing lead pretreatment. 4 The activity of the haem catabolic enzyme, haem oxygenase, was increased by lead pretreatment.
Explore the source record for details and available documents.