Alkylresorcinol metabolite concentrations in spot urine samples correlated with whole grain and cereal fiber intake but showed low to modest reproducibility over one to three years in U.S. women.

Two alkylresorcinol (AR) metabolites, 3, 5-dihydroxybenzoic acid (DHBA) and 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA), in urine have been suggested as biomarkers of whole grain (WG) and cereal fiber intake but the long-term reproducibility and correlation with habitual intake has not been determined. Therefore, we evaluated the long-term reproducibility of AR metabolites in spot urine samples and investigated their correlation with habitual WG and cereal fiber intake in U.S. women. AR metabolites were analyzed in 104 women participating in the Nurses' Health Study II and WG and fiber intakes were assessed using a FFQ. Long-term reproducibility was assessed by calculating the intra-class correlation coefficients (ICC) using samples taken 1-3 y (mean 1.8 y) apart. The observed Spearman correlation coefficients (r(s)) and r(s) adjusted for within-participant variation in the biomarker were calculated between WG and fiber intake and biomarkers. The long-term reproducibility was poor for DHBA [ICC = 0.17 (95% CI: 0.05, 0.43)] and modest for DHPPA [ICC = 0.31 (95% CI: 0.17, 0.51)]. The correlation between WG intake in 1995 and DHPPA measured 2 y later was 0.37 (P < 0.0001); the adjusted correlation was 0.60 (95% CI: 0.37, 0.76). Cereal fiber and WG intake were similarly correlated to the biomarkers. DHPPA in spot urine samples reflected WG intake despite relatively low intake of food sources of AR. The poor to modest reproducibility may limit the use of single measurements of these biomarkers in cohort studies in the US, where WG intake is relatively low and has changed over time. But DHPPA in repeated samples may be useful for validating WG intake and assessing compliance in WG intervention studies.

Protein Substitutes in PKU; Their Historical Evolution.

Protein substitutes developed for phenylketonuria (PKU) are a synthetic source of protein commonly based on L-amino acids. They are essential in the treatment of phenylketonuria (PKU) and other amino acid disorders, allowing the antagonistic amino acid to be removed but with the safe provision of all other amino acids necessary for maintaining normal physiological function. They were first formulated by a chemist and used experimentally on a 2-year-old girl with PKU and their nutritional formulations and design have improved over time. Since 2008, a bioactive macropeptide has been used as a base for protein substitutes in PKU, with potential benefits of improved bone and gut health, nitrogen retention, and blood phenylalanine control. In 2018, animal studies showed that physiomimic technology coating the amino acids with a polymer allows a slow release of amino acids with an improved physiological profile. History has shown that in PKU, the protein substitute's efficacy is determined by its nutritional profile, amino acid composition, dose, timing, distribution, and an adequate energy intake. Protein substitutes are often given little importance, yet their pharmacological actions and clinical benefit are pivotal when managing PKU.

Determination of unconjugated aromatic acids in urine by capillary electrophoresis with dual electrochemical detection--potential application in fast diagnosis of phenylketonuria.

A novel method of CE coupled with dual electrochemical detection has been developed for the determination of pathological metabolites of phenylalanine in urine samples. Factors influencing the separation and detection were examined and optimized. Five aromatic acid metabolites and a major coexisting interfering compound uric acid could be well separated within 23 min at a separation voltage of 16 kV using a 35 mmol/L SDS/60 mmol/L H(3)BO(3)-Na(2)B(4)O(7) running buffer (pH 8.2). Highly linear response was obtained for these five biomarker compounds over three orders of magnitude with detection limits ranging from 6.6 to 0.064 µg/mL (S/N=3). The average recovery and RSD were within the range of 92.6-121.0 and 1.0-12.0%, respectively. The proposed method has been used to detect the unconjugated aromatic acids simultaneously in urine samples with the advantages of obtaining more information about target analytes and avoiding redundant measurements and high assay cost, thus could find potential applications involving assays of biomarker compounds for the purpose of fast diagnose of some metabolic diseases including phenylketonuria.

Clinical, biochemical, and genetic analysis of a Korean neonate with hereditary tyrosinemia type 1.

BACKGROUND: Hereditary tyrosinemia type 1 (HT1; MIM 276700) is caused by mutations in the fumarylaceto-acetate hydrolase (FAH) gene, and is the most severe disorder associated with the tyrosine catabolic pathway. HT1 is a very rare disorder and no genetically confirmed case of HT1 in Korea has yet been reported. In this study, we present a Korean neonate with clinical and biochemical features of HT1. METHODS: A female neonate was admitted to our hospital for further work-up of an abnormal newborn screening test. We analyzed amino acids and organic acids in the patient's blood and urine. To confirm the presence of the genetic abnormality, all the coding exons of the FAH gene and the flanking introns were amplified by polymerase chain reaction (PCR). RESULTS: The patient's newborn screening test revealed increased concentrations of methionine and tyrosine. Subsequent urine organic acid analysis showed increased urinary excretion of 4-hydroxyphenyllactate, 4-hydroxyphenylpyruvate, succinate, and succinylacetone. Gap-PCR and sequence analysis of the FAH gene revealed a homozygous large deletion mutation encompassing exons 12-14. The patient's parents were not consanguineous but were heterozygous carriers of the same mutation. CONCLUSIONS: The patient had a novel, large deletion mutation of FAH and is the first report of genetically confirmed HT1 in Korea.

Interference of hydroxyphenylpyruvic acid, hydroxyphenyllactic acid and tyrosine on routine serum and urine clinical chemistry assays; implications for biochemical monitoring of patients with alkaptonuria treated with nitisinone.

OBJECTIVES: We have assessed the effect of elevated concentrations of hydroxyphenylpyruvic acid (HPPA), hydroxyphenyllactic acid (HPLA) and tyrosine, on a range of chemistry tests in serum and urine to explore the potential for chemical interference on routine laboratory analyses in patients with alkaptonuria (AKU) treated with nitisinone and similarly implications for patients with hereditary tyrosinemia type 1 (HT-1). MATERIALS AND METHODS: HPPA, HPLA and tyrosine were added separately to pooled serum from subjects without AKU in a range of assays with Roche Modular chemistries. Effects on urine were assessed by changes in urine strip chemistries after mixing a positive control urine with various amounts of the test compounds and reading on a Siemens urine strip meter. RESULTS: No significant effect (p > 0.1) was observed up to 225 µmol/L of HPPA and HPLA, and up to 5000 µmol/L tyrosine, on any of the serum-based assays including those with peroxidase-coupled reaction systems of enzymatic creatinine, urate, total cholesterol, HDL cholesterol and triglyceride. Both the monohydroxy HPPA, and the dihydroxy homogentisic acid (HGA), at increased urine concentrations typical of nitisinone-treated AKU and non-treated AKU respectively, did however show marked negative interference in strip assays for glucose and leucocytes; i.e. those with peroxide-linked endpoints. The effect of increased HPLA was less marked. CONCLUSIONS: In patients with AKU or on nitisinone treatment and HT-1 patients on nitisinone, urine strip chemistry testing should be used sparingly, if at all, to avoid false negative reporting. It is recommended that urine assays should be organised with a suitable specialist laboratory.

Investigation of ketoacidurias by two-dimensional paper chromatography.

A simple paper chromatographic method was found to be effective for the study of phenylketonuria and tyrosyluria. It proved to be much more reliable than conventional tests for the detection of abnormal amounts of ketoacids in urine and was suitable and convenient for following the effects of dietary variations on the excretion of these compounds. Information obtained about ketones other than those of primary importance to the conditions studied included confirmation of the excretion of p-hydroxyphenylpyruvic acid in phenylketonuria. A modification of the method applicable to histidinaemia was devised.

Improvement of the FeCl3 test for phenylpyruvic acid.

A simple alternative colorimetric method has been developed for quantitative determination of phenylpyruvic acid in urine based on the improved stability of the ferric complex of enol-phenylpyruvate in water-dimethylsulfoxide 50% vol. mixed solvent. The method can be applied directly to urine or to a dry ether-extract of urine. Operating on the dry ether-extract of urine, detection of phenylpyruvic acid is possible at an amount of as low as 1 mg/100 ml. Whereas, if urine samples are processed, detection is possible for a concentration of as low as 5 mg/100 ml and quantitative determination for a concentration greater than 10 mg/100 ml. The test carried out on a diaper wet with urine retains the same sensitivity and shows instantaneous development of the green colour.

An artifact in the gas chromatographic analysis of urinary organic acids from phenylketonuric children: decarboxylation of the phenylpyruvic acid during extraction.

Phenylpyruvic acid is converted at least partially to phenylacetic acid during the normal extraction procedure used to obtain urinary organic acid profiles of phenylketonuric children by gas chromatography. This decarboxylation reaction can be reduced or completely eliminated by forming oxime derivatives prior to extraction.

D-serine-induced nephrotoxicity: possible interaction with tyrosine metabolism.

D-serine selectively damages renal proximal tubule cells in rats by a mechanism that is not fully understood. Recent proteomic analysis identified that D-serine elevated plasma fumarylacetoacetate hydrolase (FAH). FAH is involved in tyrosine catabolism; hence, this pathway may be involved in mediating the toxicity. This work examines whether 2-(2-nitro-4-trifluoromethylbenzoyl)-cyclohexane-1,3-dione (NTBC), a potent inhibitor of the enzyme 4-hydroxyphenylpyruvate dioxygenase (HPPD) located upstream of FAH, modulates D-serine-induced nephrotoxicity. Rats were pretreated with NTBC (0.5 mg/kg p.o.) or corn oil and then 30 min later given either D-serine (250 mg/kg i.p.) or water. Urine was collected every 12 h until termination (48 h) and analysed by 1H NMR spectroscopy and principal component analysis (PCA). Markers of proximal tubule injury were evident in urine following treatment with D-serine and NTBC + D-serine. PCA could not distinguish between these urine samples suggesting that NTBC does not effect the development of nephrotoxicity. Clinical chemistry analysis of urine and terminal plasma samples and histopathological examination of the kidneys confirmed this. NTBC alone caused a marked increase in the excretion of 4-hydroxyphenylpyruvate (HPPA) and 4-hydroxyphenyllactate (HPLA); however, HPPA and HPLA excretion was minimal following NTBC + D-serine. Instead marked tyrosinuria was observed suggesting that D-serine-induced renal damage markedly affects the handling of increased levels of HPPA and HPLA resulting from the inhibition of HPPD.

Changes in albumin levels in blood and urine of Microtus montanus chronically infected with Trypanosoma brucei gambiense.

Serum albumin and glucose concentrations and urinary excretion of alpha-keto acids and proteins were determined in samples obtained throughout a chronic Trypanosoma brucei gambiense infection in Microtus montanus. An increase in urinary excretion of alpha-keto acids and proteins during the terminal stage of disease was accompanied by a decrease in serum glucose concentration. This terminal hypoglycemia reflected a depletion of liver glycogen in most animals. In contrast (and the major focus of this study) serum albumin concentration was decreased by the second week of infection and in the final sample obtained was less than 50% of that measured in preinfection samples. Female animals survived approximately 1 wk longer than males and were less susceptible during the acute phase of disease. This relative resistance was most likely due to the fact that female animals were relatively more efficient in limiting parasitemia during the first week of infection. The similarity between humans and voles in terms of protein and alpha-keto acid excretion and changes in serum concentrations of glucose and albumin during trypanosome infection further validate the use of Microtus as an experimental model for trypanosomiasis in humans.

Increased excretion of aromatic amino acid catabolites in animals infected with Trypanosoma brucei evansi.

Aromatic amino acid catabolism by Trypanosoma brucei evansi was investigated in vivo using C3HeB/FeJ mice. The major catabolites detected by gas chromatography in the urines of infected animals were phenylpyruvic acid, 4-hydroxyphenylpyruvic acid, and indole-3-pyruvic acid. Identity of each compound was confirmed by gas chromatography-mass spectrometry. Concentrations of catabolites in urine of infected mice were correlated with parasitemia and returned to normal following suramin treatment. Other aromatic amino acid metabolites, including indole-3-acetic acid, indole-3-lactic acid, and 4-hydroxyphenyllactic acid, were detected in urine from infected animals by gas chromatography mass spectrometry, although quantities were too low to be quantified reproducibly. Both phenylpyruvic acid and 4-hydroxyphenylpyruvic acid were also detected in urine of dogs and donkeys experimentally infected in Egypt with a recent field isolate of T. b. evansi. Tryptophan metabolites could not be assayed in dog and urine samples because formalin, which degraded the indole acids, had to be added before the samples could be imported into the U.S. Finally, concentrations of urinary catabolites during infection were correlated with the tyrosine aminotransferase activity in infected mouse sera.

Effects of dietary protein level and ascorbic acid supplementation on the contents of tyrosine metabolites in droppings and plasma of chicks fed a diet containing excess tyrosine.

A study on chickens was conducted to investigate whether or not: a) excess dietary tyrosine increases the content of tyrosine metabolites in plasma and excreta, b) these elevations of tyrosine metabolites are presented by increasing dietary protein level or supplementing with ascorbic acid (AA), and c) urine is a major excretory route of tyrosine metabolites. Chicks fed a 10% protein diet with excess tyrosine developed external foot lesions accompanied by retarded growth and depressed feed intake. These adverse effects were alleviated by elevating dietary protein level or supplementing with AA. Excreta and plasma of chicks fed the 10% protein diet contained small or undetectable amounts of free tyrosine, 4-hydroxyphenylpyruvate (4-HPP), 4-hydroxyphenylacetate (4-HPL), and 4-hydroxyphenylacetate (4-HPA), while these metabolites were markedly increased by the addition of excess tyrosine to the 10% protein diet. From the results with colostomized cocks, the major source of 4-HPP, 4-HPL, and 4-HPA excreted by chicks fed a tyrosine excess diet was considered more likely to be of urinary than fecal origin. Elevated contents of tyrosine and its metabolites in plasma were partially counteracted by increasing dietary protein level or AA supplementation. In excreta, elevated contents of tyrosine and its metabolites caused by excess tyrosine were reduced by increasing dietary protein level and supplementing with AA when expressed in the proportion of tyrosine intake. These results suggest that the beneficial effects of increased dietary protein level and supplementation with AA are related to enhanced ability of chicks to degrade excessively ingested tyrosine.

Asbjørn Følling and the discovery of phenylketonuria.

In 1934, the Norwegian biochemist and physician Asbjørn Følling described an inherited metabolic disorder characterized by severe intellectual impairment, motor problems, and skin abnormalities. He found that affected individuals could be identified by the abnormal excretion of phenylpyruvic acid in their urine. The disorder, which Følling initially termed imbecillitas phenylpyrouvica, would later come to be known as phenylketonuria or PKU. The present paper focuses on the story of Følling's discovery and his subsequent contributions to the area of study. In the years that have followed, research on PKU has continued to play a major role in the neurosciences, shaping our understanding of genetic disorders, human metabolism, and brain development.

[Characteristics of tyrosine balance and oxidation in oligophrenia of different origin]. / Kharakteristika balansa i okisleniia tirozina pri oligofrenii razlichnogo proiskhozhdeniia

The author conducted a study of the tyrosine balance and the urine excretion of its metabolites: paraoxyphenylpyruvic and homogentistic acid in 39 oligophrenic patients of a nontypical and of 90 with an exogenous genesis. In exogenic forms of oligophrenia the oxidation of tyrosine was characterized by hypertyrosinemia, hypertyrosinuria, a drop of paraoxyphenylpyruvic acid excretion. In genotypical oligophrenia the most typical were high indices of tyrosinemia, tyrosinuria, excretion of paraphenylpyruvic acid and homogentistic acid.

[Clinical and biochemical heterogenicity of phenylketonuria in adults]. / Klinicheskaia i biokhimicheskaia geterogennost' fenilketonurii u vzroslykh liudei

The authors carried out a clinical and biochemical investigation of 23 phenylketonuric patients at the age of 17--49 who were not treated specifically. The clinical examination showed that behavioural reactions, attacks of psychomotor excitation, neurological status, presence or absence of strokes and other symptoms of the disease were heterogenous. It has been established that disturbances of acid, protein, adipose and carbohydrate metabolism have different degrees of expressiveness. The clinical manifestation of the disease is conditioned by heterogeneity of monolocus mutations of the PAH gene.

[Phenylalanine-4-hydroxylase activity in the liver in viral hepatitis]. / Aktivnost' fenilalanin-4-gidroksilazy v pecheni bol'nykh virusnym gepatitom.

Phenylalanine-4-hydroxylase activity was studied in liver tissue, obtained by biopsy from 5 patients with viral hepatitis and from 8 persons without parthological alterations of liver. The enzymatic activity was estimated by formation of 14C-tyrosine in presence and in absence of added cofactor 2-amine-4-hydroxy-6,7-dimethyltetrahydropteridine. Without addition of the cofactor the phenylalanine hydroxylase activity was of the same order of magnitude in liver tissue of the patients and of healthy persons. In presence of the cofactor the enzyme activity in liver of the patients with the hepatitis of moderate severity constituted 44% of the activity found in the control group. The rate of phenylalanine hydroxylation was 0.19 with 10-2 min-1 in patients with hepatitis and 0.5 with 10-2 min-1--in the control group. In severe and moderate forms of viral hepatitis the impairment of phenylalanine metabolism was due to decrease in the activity of phenylalanine-4-hydroxylase in liver tissue.

[Utilization of excess phenylalanine in the diet of rats to obtain an experimental model of phenylketonuria]. / K voprosu ob ispol'zovanii izbytka fenilalanina v ratsione krys dlia polucheniia éksperimental'noi modeli fenilketonurii

An excess of phenylalanine in the diet of rats was found to produce toxic action, especially strongly pronounced in animals receiving low-protein ration. A protein-rich diet is shown to produce a definite protective effect in acute poisoning with phenylalanine. In the blood and hepatic tissue of rats receiving for 15-30 days a diet containing 24 per cent of caseine and 7 per cent of phenylalanine there occurred a marked disproportion of free amino acids, i.e. a state of endogenous amino acids imbalance. The nature of biochemical disorders arising in the blood of these animals essentially differs from changes characteristic of the blood of the children suffering from phenylketonuria.

[Effects of ultraviolet irradiation of blood and sodium hypochlorite on aromatic amino acid metabolism in phlegmons of the maxillofacial region]. / Vliianie ul'trafioletovogo oblucheniia krovi i natriia gipokhlorita na metabolizm aromaticheskikh aminokislot pri flegmonakh cheliustno-litsevoi oblasti.

The investigation was performed in 39 patients with the severe course of phlegmons of the maxillofacial area. The concentration of the phenyl-pyruvic and para-hydroxyphenyl-pyruvic acids in the diurnal urine was found to be elevated which suggested the disturbed functional state of the liver. Treatment including the ultraviolet irradiation of blood and sodium hypochlorite resulted in rapid normalization of the level of para-hydroxyphenyl-pyruvic acid and in lower concentration of phenyl-pyruvic acid.

Development of antibodies for determination of alkylresorcinol metabolites in human urine and elucidation of ELISA cross-reactivity.

Alkylresorcinols (ARs) are amphiphilic phenolic lipids and their two main metabolites, 3-(3,5-dihydroxyphenyl)-propanoic acid (DHPPA) and 3,5-dihydroxybenzoic acid (DHBA), can be used as biomarkers of whole grain wheat and rye intake. The aim of this study was to develop antibodies against DHBA and DHPPA for use in ELISA analysis. Good calibration curves were obtained for ELISA using alkaline phosphatase (AP) conjugates. The highest sensitivity for DHPPA was found using a reagent combination of anti-DHPPA-BSA and DHPAA-AP in a direct ELISA (IC50=1.5µmol/L), and for DHBA using a reagent combination of anti-DHBA-OV and DHBA-AP (IC50=1.3µmol/L). Calibration was conducted in the linear range (0.3-27.4µmol/L), with limit of detection (LOD) 0.1µmol/L. Intra and inter CVs was in the range of 0.7-7.2% and 5.1-11.5%, respectively, for DHPPA and 1.3-9.4% and 3.5-20%, respectively, for DHBA. Mean recovery was 104% for DHPPA and 102% for DHBA. The ELISA method developed was then used for analysis of 120 urine samples from free-living men and women that had previously been analysed by gas chromatography-mass spectrometry (GC-MS). ELISA produced several-fold higher values than GC-MS. Application of high-resolution Orbitrap mass spectrometry (HR Orbitrap MS) allowed several compounds, including novel putative AR metabolites, to be identified, synthesised and confirmed as compounds with high ELISA cross-reactivity.

Study on urinary metabolic profile of phenylketonuria by micellar electrokinetic capillary chromatography with dual electrochemical detection--potential clinical application in fast diagnosis of phenylketonuria.

The urinary metabolic marker compounds, namely phenylpyruvic acid (PPA), 2-hydroxyphenylacetic acid (oOPAA), 4-hydroxyphenylacetic acid (pOPAA), phenyllactic acid (PLA) and phenylacetic acid (PAA) of phenylketonuric individuals were detected by a novel method of micellar electrokinetic capillary chromatography with capacitively coupled contactless conductivity detection and amperometric detection (MECC-C(4)D/AD). Electrophoretic runs were performed in a 35 mmol L(-1) SDS/60 mmol L(-1) H(3)BO(3)-Na(2)B(4)O(7) running buffer (pH 8.2) at a separation voltage of 16 kV, and five marker compounds and the major coexisting compound uric acid (UA) could be well separated within 23 min. Highly linear response was obtained for five marker compounds over three orders of magnitude with detection limits ranging from 6.6×10(-6) to 6.4×10(-8) g mL(-1) (S/N=3). The proposed method has been used to detect the marker compounds simultaneously in urine samples with the advantages of obtaining more information about target analytes and avoiding redundant measurements and high assay cost. Urinary patterns in phenylketonuric babies were distinct and easily distinguished from those of healthy newborns. The proposed MECC-C(4)D/AD method could find clinical application in early noninvasive diagnosis of phenylketonuria (PKU), as significant differences could be found in the urinary content of five marker compounds among the phenylketonuric babies without or with dietotherapy and the healthy babies.