Adenylosuccinate lyase (ADSL) is involved both in the de novo purine synthesis (yellow box) and the purine nucleotide cycle (green box). The deficiency of ADSL causes an accumulation of its substrates, succinyl aminoimidazole carboxamide ribotide (SAICAR) and succinyl-AMP (S-AMP), which are both dephosphorylated and converted to SAICA-riboside (SAICAr) and succinyl-Ado (S-Ado), respectively. The formation of the purinosome complex (blue box) is impaired in cases of ADSL deficiency. Phosphoribosylpyrophosphate (PRPP) is synthesized from ribose-5-phosphate (Rib-5-P) by PRPP synthetase (PRPS). Six enzymes can form the purinosome and catalyze the ten steps required to convert PRPP into IMP: PRPP amidotransferase (PPAT), trifunctional phosphoribosyl glicinamide synthetase/phosphoribosyl glycinamide transformylase/phophoribosyl aminoimidazole synthetase (GART), phosphoribosyl glycinamidine synthase (FGAMS), bifunctional phosphoribosyl aminoimidazole carboxylase/phosphoribosyl aminoimidazole succinocarboxamide synthetase (PAICS), ADSL, and bifunctional 5-aminoimidazole-4-carboxamide ribonucleotide transformylase/IMP cyclohydrolase (ATIC). IMP enters the purine nucleotide cycle composed of adenylosuccinate synthase (ASS), ADSL, and AMP deaminase (AMPD). Asp: Aspartate.