Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1982 Aug;19(4):271–276. doi: 10.1136/jmg.19.4.271

Screening for latent acute intermittent porphyria: the value of measuring both leucocyte delta-aminolaevulinic acid synthase and erythrocyte uroporphyrinogen-1-synthase activities.

K E McColl, M R Moore, G G Thompson, A Goldberg
PMCID: PMC1048892  PMID: 7120315

Abstract

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.

Full text

PDF
275

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Astrup E. G. Family studies on the activity of uroporphyrinogen I synthase in diagnosis of acute intermittent porphyria. Clin Sci Mol Med. 1978 Mar;54(3):251–256. doi: 10.1042/cs0540251. [DOI] [PubMed] [Google Scholar]
  2. Bradlow H. L., Gillette P. N., Gallagher T. F., Kappas A. Studies in porphyria. II. Evidence for a deficiency of steroid delta-4-5-alpha-reductase activity in acute intermittent porphyria. J Exp Med. 1973 Oct 1;138(4):754–763. doi: 10.1084/jem.138.4.754. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brodie M. J., Moore M. R., Goldberg A. Enzyme abnormalities in the porphyrias. Lancet. 1977 Oct 1;2(8040):699–701. doi: 10.1016/s0140-6736(77)90507-4. [DOI] [PubMed] [Google Scholar]
  4. Campbell B. C., Brodie M. J., Thompson G. G., Meredith P. A., Moore M. R., Goldberg A. Alterations in the activity of enzymes of haem biosynthesis in lead poisoning and acute hepatic prophyria. Clin Sci Mol Med. 1977 Oct;53(4):335–340. doi: 10.1042/cs0530335. [DOI] [PubMed] [Google Scholar]
  5. Doss M., von Tiepermann R. Uroporphyrinogen-Synthase in Erythrocyten bei akuter intermittierender Porphyrie: Neue pathobiochemische Aspekte. J Clin Chem Clin Biochem. 1978 Feb;16(2):111–118. [PubMed] [Google Scholar]
  6. Frydman R. B., Feinstein G. Studies on porphobilinogen deaminase and uroporphyrinogen 3 cosynthase from human erythrocytes. Biochim Biophys Acta. 1974 Jun 18;350(2):358–373. doi: 10.1016/0005-2744(74)90510-5. [DOI] [PubMed] [Google Scholar]
  7. Grelier M., Grandchamp B., Phung N., de Verneuil H., Noire J., Nordmann Y., Husquinet H., Dodinval P. Détection de la porphyrie aiguë intermittente par le dosage de l'urosynthétase. Bilan de 2 années. Nouv Presse Med. 1977 Mar 26;6(12):1045–1047. [PubMed] [Google Scholar]
  8. Kreimer-Birnbaum M., Bonkowsky H. L., Bottomley S. S. Experience with the red cell uroporphyrinogen synthase (URO-S) assay in kindreds with acute intermittent porphyria (AIP). Int J Biochem. 1980;12(5-6):807–810. doi: 10.1016/0020-711x(80)90167-6. [DOI] [PubMed] [Google Scholar]
  9. LOWRY O. H., ROSEBROUGH N. J., FARR A. L., RANDALL R. J. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951 Nov;193(1):265–275. [PubMed] [Google Scholar]
  10. Lamon J. M., Frykholm B. C., Tschudy D. P. Family evaluations in acute intermittent porphyria using red cell uroporphyrinogen I synthetase. J Med Genet. 1979 Apr;16(2):134–139. doi: 10.1136/jmg.16.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. MAUZERALL D., GRANICK S. The occurrence and determination of delta-amino-levulinic acid and porphobilinogen in urine. J Biol Chem. 1956 Mar;219(1):435–446. [PubMed] [Google Scholar]
  12. McColl K. E., Moore M. R., Thompson G. G., Goldberg A. Induction of delta-aminolaevulinic acid synthase in leucocytes of patients on phenytoin therapy--comparison with changes in rat hepatic tissue. Br J Clin Pharmacol. 1980 Apr;9(4):327–331. doi: 10.1111/j.1365-2125.1980.tb01058.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. McColl K. E., Moore R. The porphyrias: an example of pharmacogenetic disease. Scott Med J. 1981 Jan;26(1):32–40. doi: 10.1177/003693308102600109. [DOI] [PubMed] [Google Scholar]
  14. Moore M. R., Thompson G. G., Goldberg A., Ippen H., Seubert A., Seubert S. The biosynthesis of haem in congenital (erythropoietic) porphyria. Int J Biochem. 1978;9(12):933–938. doi: 10.1016/0020-711x(78)90073-3. [DOI] [PubMed] [Google Scholar]
  15. Sassa S., Granick S., Bickers D. R., Bradlow H. L., Kappas A. A microassay for uroporphyrinogen I synthase, one of three abnormal enzyme activities in acute intermittent porphyria, and its application to the study of the genetics of this disease. Proc Natl Acad Sci U S A. 1974 Mar;71(3):732–736. doi: 10.1073/pnas.71.3.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Strand L. J., Felsher B. F., Redeker A. G., Marver H. S. Heme biosynthesis in intermittent acute prophyria: decreased hepatic conversion of porphobilinogen to porphyrins and increased delta aminolevulinic acid synthetase activity. Proc Natl Acad Sci U S A. 1970 Nov;67(3):1315–1320. doi: 10.1073/pnas.67.3.1315. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. With T. K., Pedersen J. S. Uroporphyrinogen synthetase in erythrocytes. Its diagnostic value in latent acute intermittent porphyria with special regard to the gene penetrance. Dan Med Bull. 1981 Mar;28(1):27–34. [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES