Skip to main content
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1985 Aug;76(2):752–756. doi: 10.1172/JCI112031

Markedly increased circulating pyridoxal-5'-phosphate levels in hypophosphatasia. Alkaline phosphatase acts in vitamin B6 metabolism.

M P Whyte, J D Mahuren, L A Vrabel, S P Coburn
PMCID: PMC423894  PMID: 4031070

Abstract

Markedly increased circulating concentrations of pyridoxal-5'-phosphate (PLP) were found in each of 14 patients representing all clinical forms of hypophosphatasia, an inborn error characterized by deficient activity of the tissue nonspecific (bone/liver/kidney) isoenzyme of alkaline phosphatase (AP). The mean PLP concentration in plasma was 1174 nM (range, 214-3839 nM) in the patients and 57 +/- 26 nM (mean +/- SD) in 38 control subjects. In four affected children, urinary excretion of the PLP degradation product, 4-pyridoxic acid, was unremarkable during consumption of normal quantities of dietary vitamin B6. Our findings identify increased circulating PLP concentration as a marker for hypophosphatasia and provide further evidence that tissue nonspecific AP acts in vitamin B6 metabolism. Tissue nonspecific AP appears to function as an ectoenzyme to regulate extracellular but not intracellular levels of PLP substrate. Performing assays of circulating PLP concentration alone to assess vitamin B6 nutrition may be misleading in disorders associated with altered AP activity.

Full text

PDF
752

Selected References

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

  1. Anderson B. B., O'Brien H., Griffin G. E., Mollin D. L. Hydrolysis of pyridoxal-5'-phosphate in plasma in conditions with raised alkaline phosphate. Gut. 1980 Mar;21(3):192–194. doi: 10.1136/gut.21.3.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Chabner B., Livingston D. A simple enzymic assay for pyridoxal phosphate. Anal Biochem. 1970 Apr;34(2):413–423. doi: 10.1016/0003-2697(70)90126-0. [DOI] [PubMed] [Google Scholar]
  3. Coburn S. P., Mahuren J. D. A versatile cation-exchange procedure of measuring the seven major forms of vitamin B6 in biological samples. Anal Biochem. 1983 Mar;129(2):310–317. doi: 10.1016/0003-2697(83)90555-9. [DOI] [PubMed] [Google Scholar]
  4. Coburn S. P., Schaltenbrand W. E., Mahuren J. D., Clausman R. J., Townsend D. Effect of megavitamin treatment on mental performance and plasma vitamin B6 concentrations in mentally retarded young adults. Am J Clin Nutr. 1983 Sep;38(3):352–355. doi: 10.1093/ajcn/38.3.352. [DOI] [PubMed] [Google Scholar]
  5. Contractor S. F., Shane B. Blood and urine levels of vitamin B6 in the mother and fetus before and after loading of the mother with vitamin B6. Am J Obstet Gynecol. 1970 Jun 15;107(4):635–640. doi: 10.1016/s0002-9378(16)33952-7. [DOI] [PubMed] [Google Scholar]
  6. Eberle F., Hartenfels S., Pralle H., Käbisch A. Adult hypophosphatasia without apparent skeletal disease: "odontohypophosphatasia" in four heterozygote members of a family. Klin Wochenschr. 1984 Apr 16;62(8):371–376. doi: 10.1007/BF01716257. [DOI] [PubMed] [Google Scholar]
  7. Labadarios D., Rossouw J. E., McConnell J. B., Davis M., Williams R. Vitamin B6 deficiency in chronic liver disease--evidence for increased degradation of pyridoxal-5'-phosphate. Gut. 1977 Jan;18(1):23–27. doi: 10.1136/gut.18.1.23. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Lumeng L., Brashear R. E., Li T. K. Pyridoxal 5'-phosphate in plasma: source, protein-binding, and cellular transport. J Lab Clin Med. 1974 Sep;84(3):334–343. [PubMed] [Google Scholar]
  9. Lumeng L., Li T. K. Characterization of the pyridoxal 5'-phosphate and pyridoxamine 5'-phosphate hydrolase activity in rat liver. Identity with alkaline phosphatase. J Biol Chem. 1975 Oct 25;250(20):8126–8131. [PubMed] [Google Scholar]
  10. Lumeng L., Li T. K. Vitamin B6 metabolism in chronic alcohol abuse. Pyridoxal phosphate levels in plasma and the effects of acetaldehyde on pyridoxal phosphate synthesis and degradation in human erythrocytes. J Clin Invest. 1974 Mar;53(3):693–704. doi: 10.1172/JCI107607. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lumeng L., Schenker S., Li T. K., Brashear R. E., Compton M. C. Clearance and metabolism of plasma pyridoxal 5'-phosphate in the dog. J Lab Clin Med. 1984 Jan;103(1):59–69. [PubMed] [Google Scholar]
  12. Mahuren J. D., Coburn S. P. Pyridoxal phosphate in lymphocytes, polymorphonuclear leukocytes, and platelets in Down's syndrome. Am J Clin Nutr. 1974 May;27(5):521–527. doi: 10.1093/ajcn/27.5.521. [DOI] [PubMed] [Google Scholar]
  13. Potera C., Rose D. P., Brown R. R. Vitamin B6 deficiency in cancer patients. Am J Clin Nutr. 1977 Oct;30(10):1677–1679. doi: 10.1093/ajcn/30.10.1677. [DOI] [PubMed] [Google Scholar]
  14. Rodda R. A. Bone growth changes in pyridoxine-deficient rats. J Pathol. 1975 Nov;117(3):131–137. doi: 10.1002/path.1711170302. [DOI] [PubMed] [Google Scholar]
  15. Schaumburg H., Kaplan J., Windebank A., Vick N., Rasmus S., Pleasure D., Brown M. J. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med. 1983 Aug 25;309(8):445–448. doi: 10.1056/NEJM198308253090801. [DOI] [PubMed] [Google Scholar]
  16. Shideler C. E. Vitamin B6: an overview. Am J Med Technol. 1983 Jan;49(1):17–22. [PubMed] [Google Scholar]
  17. Smith G. P., Anderson B. B., Peters T. J. Levels and subcellular localisation of pyridoxal and pyridoxal phosphate in human polymorphonuclear leukocytes and their relationship to alkaline phosphatase activity. Clin Chim Acta. 1983 Mar 28;129(1):13–18. doi: 10.1016/0009-8981(83)90146-8. [DOI] [PubMed] [Google Scholar]
  18. Whyte M. P., McAlister W. H., Patton L. S., Magill H. L., Fallon M. D., Lorentz W. B., Jr, Herrod H. G. Enzyme replacement therapy for infantile hypophosphatasia attempted by intravenous infusions of alkaline phosphatase-rich Paget plasma: results in three additional patients. J Pediatr. 1984 Dec;105(6):926–933. doi: 10.1016/s0022-3476(84)80079-7. [DOI] [PubMed] [Google Scholar]
  19. Whyte M. P., Murphy W. A., Fallon M. D. Adult hypophosphatasia with chondrocalcinosis and arthropathy. Variable penetrance of hypophosphatasemia in a large Oklahoma kindred. Am J Med. 1982 Apr;72(4):631–641. doi: 10.1016/0002-9343(82)90474-0. [DOI] [PubMed] [Google Scholar]
  20. Whyte M. P., Teitelbaum S. L., Murphy W. A., Bergfeld M. A., Avioli L. V. Adult hypophosphatasia. Clinical, laboratory, and genetic investigation of a large kindred with review of the literature. Medicine (Baltimore) 1979 Sep;58(5):329–347. [PubMed] [Google Scholar]
  21. Whyte M. P., Vrabel L. A., Schwartz T. D. Alkaline phosphatase deficiency in cultured skin fibroblasts from patients with hypophosphatasia: comparison of the infantile, childhood, and adult forms. J Clin Endocrinol Metab. 1983 Oct;57(4):831–837. doi: 10.1210/jcem-57-4-831. [DOI] [PubMed] [Google Scholar]
  22. Wilson P. D., Smith G. P., Peters T. J. Pyridoxal 5'-phosphate: a possible physiological substrate for alkaline phosphatase in human neutrophils. Histochem J. 1983 Mar;15(3):257–264. doi: 10.1007/BF01006240. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES