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Disease
Symptom
Drug
Enzyme
Compound
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Target Concepts:
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Query: EC:2.4.2.8 (
hypoxanthine-guanine phosphoribosyltransferase
)
2,527
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
An inherited complete deficiency of
hypoxanthine-guanine phosphoribosyltransferase
in male children is associated with a severe neurological disorder characterized by chloroform and athetoid movements, hypertonicity, mental retardation, and
self-injurious behavior
. In the review that follows several possible mechanisms by which the enzyme defect may cause the CNS disorder are discussed. Current evidence suggests that the primary neural deficit in the Lesch-Nyhan syndrome is a deficiency of dopamine in the basal ganglia. It is argued that this neurochemical lesion results from a deficiency of purine nucleotides which impairs arborization of nigrostriatal neurons during perinatal development. Differences in the ontogenetic timing of the neurochemical lesion may be partly responsible for the different neurological symptoms displayed by persons afflicted with the Lesch-Nyhan and Parkinson's syndromes.
...
PMID:The biochemical basis of the behavioral disorder in the Lesch-Nyhan syndrome. 392 93
It has been reported that 9-ethyladenine (9-EA) is an efficient inhibitor of APRT (adenine phosphoribosyltransferase) and that its administration causes
self-injurious behavior
(Lesch-Nyhan Syndrome-like symptoms) in
HPRT
(
hypoxanthine-guanine phosphoribosyltransferase
)-deficient mice. In contrast, we found neither any
self-injurious behavior
(SIB), such as visible injury or hair loss, nor any apparent decrease in APRT activity in
HPRT
-deficient mice treated with 9-EA. We also found that 9-EA has little irreversible or competitive inhibitory effect on APRT in vitro, even at a concentration of 10(-2) M. In light of the negative finding of SIB in APRT/
HPRT
double-deficient mice, it seems unlikely that SIB in
HPRT
-deficient mice is caused by lowered APRT activity. It is concluded that 9-EA is not a sufficient APRT inhibitor and cannot be used in experiments that mimic lowered APRT status in an animal model.
...
PMID:No self-injurious behavior was found in HPRT-deficient mice treated with 9-ethyladenine. 973 33
The enzyme
hypoxanthine-guanine phosphoribosyltransferase
(
HPRT
) catalyzes the reutilization of hypoxanthine and guanine to the purine nucleotides IMP and GMP, respectively.
HPRT
deficiency is an X-linked disorder characterized by uric acid overproduction and variable neurologic impairment. The complete deficiency of
HPRT
is diagnostic of Lesch-Nyhan syndrome manifested by choreoathetosis, spasticity, mental retardation, and
self-injurious behavior
. In some
HPRT
-deficient patients the enzyme defect appeared to be "partial" and the neurologic symptoms mild to severe (Kelley-Seegmiller syndrome). This has prompted the classification of
HPRT
deficiency in 2 distinct groups: Lesch-Nyhan syndrome and Kelley-Seegmiller syndrome, which has created much confusion. A spectrum of clinical consequences of
HPRT
deficiency has been recognized in small series of patients, but the complete spectrum of the neurologic disorder has not been described in a single series of patients examined by the same observers. We analyzed our experience with 22 patients belonging to 18 different families with
HPRT
deficiency diagnosed at "La Paz" University Hospital in Madrid over the past 16 years. The clinical spectrum of these
HPRT
-deficient Spanish patients was similar to the different phenotypes occasionally reported in the literature, in some cases diagnosed as Lesch-Nyhan "variants." The clinical, biochemical, enzymatic, and molecular genetic studies on these 22 patients allowed us to delineate a new classification of
HPRT
deficiency. Based on the neurologic symptoms, dependency for personal care,
HPRT
activity in hemolysate and in intact erythrocytes, and predicted protein size, patients were classified into 4 groups: Group 1 (2 patients), normal development with no neurologic symptoms,
HPRT
activity was detectable in hemolysates and in intact erythrocytes, and the mutation did not affect the predicted protein size. Group 2 (3 patients) mild neurologic symptoms that did not prevent independent lives,
HPRT
activity was detectable in intact erythrocytes, and the protein size was normal. Group 3 (2 patients), severe neurologic impairment that precluded an independent life, no residual
HPRT
activity, and normal protein size. Group 4 (15 patients), clinical characteristics of Lesch-Nyhan syndrome (some may not show
self-injurious behavior
), no residual
HPRT
activity, and in most (7 of 8 patients in whom the mutation could be detected) the mutation affected the predicted protein size. This classification of
HPRT
deficiency into 4 groups may be more useful in terms of accuracy, reproducibility, assessment for treatment trials and prognosis. The study of this Spanish series allows us to conclude that
HPRT
deficiency may be manifested by a wide spectrum of neurologic symptoms; the overall severity of the disease is associated with mutations permitting some degree of residual enzyme activity; and mutation analysis provides a valuable tool for prognosis, carrier identification, and prenatal diagnosis.
...
PMID:The spectrum of hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency. Clinical experience based on 22 patients from 18 Spanish families. 1130 86
Lesch-Nyhan syndrome (LNS) is caused by a severe deficiency of
hypoxanthine-guanine phosphoribosyltransferase
(
HPRT
) and clinically characterized by
self-injurious behavior
and nephrolithiasis; the latter is treatable with allopurinol, an inhibitor of xanthine oxidase which converts xanthine and hypoxanthine into uric acid. In the
HPRT
gene, more than 200 different mutations are known, and de novo mutation occurs at a high rate. Thus, there is a great need to develop a highly specific method to detect patients with
HPRT
dysfunction by quantifying the metabolites related to this enzyme. A simplified urease pretreatment of urine, gas chromatography-mass spectrometry, and stable isotope dilution method, developed for cutting-edge metabonomics, was further applied to quantify hypoxanthine, xanthine, urate, guanine and adenine in 100 microl or less urine or eluate from filter-paper-urine strips by additional use of stable isotope labeled guanine and adenine as the internal standards. In this procedure, the recoveries were above 93% and linearities (r(2)=0.9947-1.000) and CV values (below 7%) of the indicators were satisfactory. In four patients with proven LNS, hypoxanthine was elevated to 8.4-9.0 SD above the normal mean, xanthine to 4-6 SD above the normal mean, guanine to 1.9-3.7 SD, and adenine was decreased. Because of the allopurinol treatment for all the four patients, their level of urate was not elevated, orotate increased, and uracil was unchanged as compared with the control value. It was concluded that even in the presence of treatment with allopurinol, patients with LNS can be chemically diagnosed by this procedure. Abnormality in the levels of hypoxanthine and xanthine was quite prominent and n, the number of standard deviations above the normal mean, combined for the two, was above 12.9.
...
PMID:Chemical diagnosis of Lesch-Nyhan syndrome using gas chromatography-mass spectrometry detection. 1282 5
Mutations in the gene encoding
hypoxanthine-guanine phosphoribosyltransferase
(
HPRT
) cause Lesch-Nyhan disease, which is characterized by hyperuricemia, severe motor disability, and
self-injurious behavior
. Mutations in the same gene also cause less severe clinical phenotypes with only some portions of the full syndrome. A large database of 271 mutations associated with both full and partial clinical phenotypes was recently compiled. Since the original database was assembled, 31 additional mutations have been identified, bringing the new total to 302. The results demonstrate a very heterogeneous collection of mutations for both LND and its partial syndromes. The differences between LND and the partial phenotypes cannot be explained by differences in the locations of mutations, but the partial phenotypes are more likely to have mutations predicted to allow some residual enzyme function. The reasons for some apparent exceptions to this proposal are addressed.
...
PMID:The spectrum of mutations causing HPRT deficiency: an update. 1557 Dec 20
Lesch-Nyhan disease (LND) is an inborn error of purine metabolism caused by defective activity of the enzyme hypoxanthine guanine phosphoribosyl transferase (
HPRT
,
EC 2.4.2.8
), resulting from mutation in the corresponding gene on the long arm of the X chromosome (Xq26). The classic phenotype occurs almost exclusively in males and is characterized by hyperuricemia, mental retardation, severe dystonia, and
self-injurious behavior
. Heterozygous carrier females are usually clinically normal. However, a small number of clinically affected females have been described. In all previous cases there was a mutation in one
HPRT
allele and non-random inactivation of the X chromosome carrying the normal
HPRT
gene. We have analyzed a female MZ twin pair discordant for Lesch-Nyhan disease. The mother and both twins are heterozygous carriers of a
HPRT
splicing mutation (IVS8 + 4A > G; c.609 + 4A > G) and all three express the mutant allele at similar frequencies in peripheral blood T cells. The mother and one sister are clinically normal. In the affected twin, the clinical phenotype is classical for Lesch-Nyhan disease, despite the fact that
HPRT
activity in the blood was also normal. X inactivation analysis showed a skewed pattern in the fibroblasts of the affected twin sister, with the X chromosome carrying the normal
HPRT
allele preferentially inactivated. As in many other reported cases of X-linked diseases, the discordant phenotype of the two monozygous twin sisters suggests that the process responsible for monozygotic twinning can trigger skewed X inactivation.
...
PMID:Lesch-Nyhan disease in a female with a clinically normal monozygotic twin. 1586 83
Deficiency of hypoxanthine-guanine phosphoribosyltransferase (
HPRT
) activity is an inborn error of purine metabolism associated with uric acid overproduction and a continuum spectrum of neurological manifestations depending on the degree of the enzymatic deficiency. The prevalence is estimated at 1/380,000 live births in Canada, and 1/235,000 live births in Spain. Uric acid overproduction is present inall
HPRT
-deficient patients and is associated with lithiasis and gout. Neurological manifestations include severe action dystonia, choreoathetosis, ballismus, cognitive and attention deficit, and self-injurious behaviour. The most severe forms are known as Lesch-Nyhan syndrome (patients are normal at birth and diagnosis can be accomplished when psychomotor delay becomes apparent). Partial
HPRT
-deficient patients present these symptoms with a different intensity, and in the least severe forms symptoms may be unapparent. Megaloblastic anaemia is also associated with the disease. Inheritance of
HPRT
deficiency is X-linked recessive, thus males are generally affected and heterozygous female are carriers (usually asymptomatic). Human
HPRT
is encoded by a single structural gene on the long arm of the X chromosome at Xq26. To date, more than 300 disease-associated mutations in the HPRT1 gene have been identified. The diagnosis is based on clinical and biochemical findings (hyperuricemia and hyperuricosuria associated with psychomotor delay), and enzymatic (
HPRT
activity determination in haemolysate, intact erythrocytes or fibroblasts) and molecular tests. Molecular diagnosis allows faster and more accurate carrier and prenatal diagnosis. Prenatal diagnosis can be performed with amniotic cells obtained by amniocentesis at about 15-18 weeks' gestation, or chorionic villus cells obtained at about 10-12 weeks' gestation. Uric acid overproduction can be managed by allopurinol treatment. Doses must be carefully adjusted to avoid xanthine lithiasis. The lack of precise understanding of the neurological dysfunction has precluded development of useful therapies. Spasticity, when present, and dystonia can be managed with benzodiazepines and gamma-aminobutyric acid inhibitors such as baclofen. Physical rehabilitation, including management of dysarthria and dysphagia, special devices to enable hand control, appropriate walking aids, and a programme of posture management to prevent deformities are recommended.
Self-injurious behaviour
must be managed by a combination of physical restraints, behavioural and pharmaceutical treatments.
...
PMID:Hypoxanthine-guanine phosophoribosyltransferase (HPRT) deficiency: Lesch-Nyhan syndrome. 1806 74
Neurobehavioral manifestations of complete
HPRT
deficiency include severe action dystonia, choreathetosis, alteration of executive functions, and
self-injurious behavior
. Dystonic manifestations are also present in patients with partial
HPRT
deficiency. Pathophysiology of these manifestations is unknown. Guanidinoacetate is a neurotoxin implicated in certain dystonic syndromes. We have examined guanidinoacetate and creatine levels in urine from 11
HPRT
deficient patients (9 with Lesch-Nyhan syndrome and 2 with partial deficiency). Urinary guanidinoacetate and creatine levels in
HPRT
deficient patients were within the normal range. Guanidinoactetate alteration does not seem to be implicated in the pathogenesis of the neurological disease associated with
HPRT
deficiency.
...
PMID:Urinary guanidinoacetate and creatine levels in patients with HPRT deficiency. 1860 May 7
Deficiency of hypoxanthine-guanine phosphoribosyltransferase (
HPRT
) activity is an inborn error of purine metabolism associated with uric acid overproduction and a continuum spectrum of neurological manifestations depending on the degree of enzyme deficiency. The complete deficiency causes Lesch-Nyhan syndrome (LNS). Partial
HPRT
-deficient patients can show a variable degree of neurological manifestations. Both diseases have been associated with mutations in the HPRT1 gene. Documented mutations in
HPRT
deficiency show a high degree of heterogeneity in type and location within the gene. In fact, more than 300 disease-associated mutations have been described. Splice mutations accounts for more that 16% of
HPRT
mutations and in most cases cause a complete LNS phenotype. A 16 year-old boy consulted to La Paz University Hospital because of hyperuricemia (9.4 mg/dL). At age one year he was given a diagnosis of dystonic cerebral palsy. Although he usually employs a wheelchair, under certain circumstances, he is able to stand up and walk by himself. He has never showed
self injurious behavior
. This patient presented a splice mutation (NM_000194.2: c.552 -2 A > G) causing exon 5 exclusion. An exon-5 specific PCR was designed, and a minor amount of normally spliced
HPRT
mRNA was found. Normally spliced
HPRT
mRNA was quantified by real-time PCR in this patient, in control subjects, and in two Lesch Nyhan patient with splice mutations excluding exon 4 (patient B) and exon 8 (patient C) who had clinically a Lesch Nyhan disease phenotype. A minor amount of normally spliced
HPRT
mRNA was found in all the patients. No correlation was found between the percentage of the normally spliced
HPRT
mRNA and the phenotype. We conclude that the partial
HPRT
deficient phenotype of this patient can not be explained by the finding of a minor amount of normally splice
HPRT
mRNA. It is possible that the amount of normally splice mRNA vary among different tissues.
...
PMID:Partial HPRT deficiency phenotype and incomplete splicing mutation. 2054 10
Lesch-Nyhan disease (LND) is a severe X-linked neurological disorder caused by a deficiency of
hypoxanthine phosphoribosyltransferase
(
HPRT
). In contrast,
HPRT
-deficiency in the mouse does not result in the profound phenotypes such as
self-injurious behavior
observed in humans, and the genetic basis for this phenotypic disparity between
HPRT
-deficient humans and mice is unknown. To test the hypothesis that
HPRT
deficiency is modified by the presence/absence of phosphoribosyltransferase domain containing 1 (PRTFDC1), a paralog of
HPRT
that is a functional gene in humans but an inactivated pseudogene in mice, we created transgenic mice that express human PRTFDC1 in wild-type and
HPRT
-deficient backgrounds. Male mice expressing PRTFDC1 on either genetic background were viable and fertile. However, the presence of PRTFDC1 in the
HPRT
-deficient, but not wild-type mice, increased aggression as well as sensitivity to a specific amphetamine-induced stereotypy, both of which are reminiscent of the increased aggressive and
self-injurious behavior
exhibited by patients with LND. These results demonstrate that PRTFDC1 is a genetic modifier of
HPRT
-deficiency in the mouse and could therefore have important implications for unraveling the molecular etiology of LND.
...
PMID:PRTFDC1 is a genetic modifier of HPRT-deficiency in the mouse. 2181 16
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