Mast cells and transforming growth factor-beta expression: a possible relationship in the development of porphyria cutanea tarda skin lesions.

BACKGROUND: Porphyria cutanea tarda (PCT) is a metabolic disease characterized by vesicles and blisters in sun-exposed areas and scleroderma-like lesions in sun-exposed and non-sun-exposed areas. Mast cells participate in the pathogenesis of bullous diseases and diseases that show sclerosis, including PCT. Moreover, transforming growth factor-beta (TGF-beta) is the main cytokine in the development of tissue sclerosis. The correlation of mast cells and TGF-beta with the lesions of PCT has not been examined, however. The possible role of mast cells and TGF-beta (and the relationship between them) in the development of PCT lesions is discussed. METHODS: To quantify mast cells and cells expressing TGF-beta in skin samples from patients with PCT and controls, immunohistochemical studies were performed in tissue sections allied to morphometric analyses. RESULTS: The numbers of mast cells and cells expressing TGF-beta per square millimeter were increased in the PCT group relative to controls, and there was a direct and significant correlation between the mast cell number and cells expressing TGF-beta in PCT. CONCLUSIONS: The results suggest that the increased number of mast cells and of cells expressing TGF-beta, as well as their direct correlation, may contribute to the pathogenesis of the skin lesions in PCT.

Melatonin formation in pineal gland from rats with hexachlorobenzene experimental porphyria.

Hexachlorobenzene produces an experimental hepatic porphyria in rats, which is similar to human porphyria cutanea tarda, with hyperpigmentation as one of its characteristic features. Alterations in tryptophan metabolism have been previously observed in this chronic porphyria. Melatonin formation from tryptophan via serotonin shows diurnal rhythmicity in the pineal gland, and higher values are observed during the dark phase of an imposed light-dark cycle. The purpose of this study was to determine the contents of tryptophan and its metabolites in pineal gland of normal and hexachlorobenzene-treated rats in order to find alterations potentially related to porphyria cutanea tarda. Results show that in animals with this experimental porphyria some tryptophan metabolite levels (serotonin and 5-hydroxyindoleacetic acid) increase only during the light period, whereas tryptophan content remained equal to the controls. Hydroxyindole-O-methyltransferase activity also increases by light in pineal gland from hexachlorobenzene-treated rats. On the other hand, tryptophan is converted to melatonin in the dark period, but this route is not exacerbated in hexachlorobenzene porphyria. The relevance of these alterations is discussed in relation to hyperpigmentation, neoplastic and oxidative stress processes associated with this porphyria.

Tryptophan metabolism via serotonin in rats with hexachlorobenzene experimental porphyria.

One of the three pathways for the metabolisation of dietary tryptophan is the formation of serotonin. Tryptophan hydroxylase catalyses the formation of 5-hydroxytryptophan, the first and regulatory step of this biosynthesis. The aim of the present work is to study alterations in this tryptophan metabolism in rats with experimental Porphyria Cutanea Tarda induced by hexachlorobenzene. With this purpose, the content of tryptophan and its metabolites related to the serotonin pathway are determined by HPLC techniques, in tissues (brain, liver and gut) and in fluids (blood, plasma and urine) of controls and hexachlorobenzene-porphyric rats. In these experimental-porphyric animals, we determine a significant increase in the excretion of 5-hydroxyindole acetic acid in urine and a decrease in the content of serotonin in small gut, respect to controls. Significant increases in contents of serotonin in 24-hr urine and tryptophan in liver are also found. No other significant variations for the different metabolites are detected in any of the tissues and fluids studied. Brain and liver activities of the rate-limiting enzyme tryptophan hydroxylase can only be measured in porphyric rats. Our results agree with an increased turnover of gastrointestinal serotonin derived from dietary tryptophan and its excretion as urinary 5-hydroxyindole acetic acid, which is formed in liver. An increased serotonin pathway in porphyric livers is confirmed by the measured increase in the activity of hepatic tryptophan hydroxylase. The absence of neurological symptoms in patients with Porphyria Cutanea Tarda could be related to the absence of a statistically significant variation in serotonin content shown in brain.

Abnormal uroporphyrin levels in chronic hepatitis C virus infection.

A strong association between hepatitis C virus (HCV) infection and porphyria cutanea tarda (PCT) has been observed, but the implications of the viral infection in the metabolism of porphyrins in patients without clinical manifestations of PCT are not known. The levels of porphyrin in plasma and uroporphyrin (URO) and coproporphyrin (COPRO) in 24-hour urine were measured in 156 patients with chronic HCV infection showing no clinical evidence of PCT. Levels of URO higher than the upper limit were observed in 35 of 156 patients (22.4%). The range and the mean values +/- standard deviation were 26-1,196 microg/24 hours and 82 +/- 204 microg/24 hours. Increased levels of COPRO and plasma porphyrin were observed in 12 of 156 patients (7.7%) and 2 of 156 patients (1.3%) respectively. There were no differences between patients with increased URO levels and patients with normal URO levels in terms of gender, age, risk factors for HCV infection, alcohol abuse, or hepatitis B viral infection. Transferrin saturation (p = 0.040), gamma glutamyl transpeptidase (p < 0.0001), aspartate aminotransferase (p = 0.006), and alanine aminotransferase (p = 0.040) were significantly higher in patients with abnormal URO than in patients with normal URO. The frequency of cirrhosis was higher, but not significantly different, in patients with increased URO (16.7%) compared with patients with normal URO (3.8%). The authors demonstrated that even without a clinical manifestation of PCT it is possible to detect abnormalities in the metabolism of porphyrins in patients with chronic HCV infection. The implications of these findings deserve additional investigation.

Rat urinary chemiluminescence: effect of ethanol and/or hexachlorobenzene uptake.

Hexachlorobenzene (HCB) administration to rats induces porphyria cutanea tarda, characterized by high levels of urinary porphyrins (> 40 micrograms/day) and accumulation of highly carboxylated porphyrins in liver (> 15 micrograms/g of tissue). Ethanol administration, under the conditions employed, was not porphyrinogenic and was able to diminish some of the responses elicited by HCB. Furthermore, ethanol and/or HCB administration leads to organ disturbances that involve oxidative stress. We have measured the changes in urinary chemiluminescence (CL) levels, as part of a systematic evaluation of the metabolic alterations in rats chronically treated with ethanol and/or HCB. The results, that constitute the first set of urinary CL data obtained from an animal model system, indicate that the measurement of the spontaneous urinary CL can constitute a fast, simple and sensitive method to evaluate disturbances associated with oxidative stress.

Porfiria cutánea tarda asociada a VIH. Reporte de un caso y breve revisión del tema / Porphyria cutanea tarda associated with HIV infection. Case report

Se reporta un caso de porfiria cutánea tarda asociada a infección por virus de inmunodeficiencia humana en un paciente de 34 años de edad con una dermatosis de aspecto monomorfo con predominio en manos, constituida por vesículas y ampollas tensas

Urodecarboxilasa en sangre de pacientes hemodializados / Decarboxylase in blood in hemodialysed patients

En la porfiria cutánea tarda(PCT) hay una falla en la uroporfirinógeno decarboxilasa (Uro-D) hepática, como consecuencia se incrementa la concentración de porfirinas altamente carboxiladas. Enla PCT hereditaria la Uro-D está disminuída en sangre y es normal en la PCT adquirida. Parte de la población hemodializada presenta signos cutáneos que son histológica y morfológicamente semejantes a la PCT, asociado a niveles aumentados de porfirias plasmáticas. Se estudió el contenido de porfirinas plasmáticas y la actividad de la Uro-D eritrocitaria, en 12 pacientes hemodializados sin lesiones cutáneas, uno de ellos portador de PCT hereditaria. El contenido de porfirias en plasma estuvo aumentado(0,084 mas igual 0,,10 ug/ml; uroporfirina igual 80 por ciento, cproporfirina igual 20 por ciento) en 30 por ciento de los pacientes estudiados( valor normal: 0,048 mas igual 0,010 ug/ml; coproporfirina igual 100 por ciento). Las porfirinas plasmáticas del paciente PCT al inicio del tratamiento con S-adenosil-L-metionina fue: 1,71 ug/ml; uroporfirina igual 48 por ciento, firiaporfirina igual 41 por ciento hexaporfirina igual 7 por ciento, pentaporfirina igual 3 por ciento y coproporfirina igual 1 por ciento) y luego de 6 años, al final del tratamiento, los valores fueron: 0,089 ug/ml; uriporfirina igual 80 por ciento, firiaporfirina igual 20 por ciento. La remisión clínica se correlacionó con la bioquímica. En los pacientes hemodializados la actividad de URO_D estuvo dentro de los valores normales(12,45 mas igual 1,o U/ml GR), excepto en el portador de la PCT hereditaria en el cual la actividad estuvodisminuída al 50 por ciento. Estos resultados sugieren que la hemodialisis per se no modificaria a la actividad de URO-D eritrocitaria.

Urodecarboxilasa en sangre de pacientes hemodializados / Decarboxylase in blood in hemodialysed patients

En la porfiria cutánea tarda(PCT) hay una falla en la uroporfirinógeno decarboxilasa (Uro-D) hepática, como consecuencia se incrementa la concentración de porfirinas altamente carboxiladas. Enla PCT hereditaria la Uro-D está disminuída en sangre y es normal en la PCT adquirida. Parte de la población hemodializada presenta signos cutáneos que son histológica y morfológicamente semejantes a la PCT, asociado a niveles aumentados de porfirias plasmáticas. Se estudió el contenido de porfirinas plasmáticas y la actividad de la Uro-D eritrocitaria, en 12 pacientes hemodializados sin lesiones cutáneas, uno de ellos portador de PCT hereditaria. El contenido de porfirias en plasma estuvo aumentado(0,084 mas igual 0,,10 ug/ml; uroporfirina igual 80 por ciento, cproporfirina igual 20 por ciento) en 30 por ciento de los pacientes estudiados( valor normal: 0,048 mas igual 0,010 ug/ml; coproporfirina igual 100 por ciento). Las porfirinas plasmáticas del paciente PCT al inicio del tratamiento con S-adenosil-L-metionina fue: 1,71 ug/ml; uroporfirina igual 48 por ciento, firiaporfirina igual 41 por ciento hexaporfirina igual 7 por ciento, pentaporfirina igual 3 por ciento y coproporfirina igual 1 por ciento) y luego de 6 años, al final del tratamiento, los valores fueron: 0,089 ug/ml; uriporfirina igual 80 por ciento, firiaporfirina igual 20 por ciento. La remisión clínica se correlacionó con la bioquímica. En los pacientes hemodializados la actividad de URO_D estuvo dentro de los valores normales(12,45 mas igual 1,o U/ml GR), excepto en el portador de la PCT hereditaria en el cual la actividad estuvodisminuída al 50 por ciento. Estos resultados sugieren que la hemodialisis per se no modificaria a la actividad de URO-D eritrocitaria. (AU)