The Comparison of Iodine-Type and MnO2-Type Oxidation for Measuring the Levels of Urine Neopterin and Biopterin in Patients with Hyperphenylalaninemia: A Descriptive-Analytic Study in Iran
- 32 Downloads
Abstract
Fresh urine sample is required for measurement of pterins in patients with hyperphenylalaninemia (HPA) for detection of tetrahydrobiopterin (BH4) coenzyme deficiency. The present study aimed to measure the levels of neopterin and biopterin in the urine of patients with HPA using manganese dioxide (MnO2) and iodine oxidation methods. The levels of neopterin and biopterin in the urine of 124 patients were measured using two methods of oxidation (MnO2 and iodine) and the results were statistically analyzed using correlation test, Roc-Curve and ANOVA in SPSS-20 software. The level of significant was determined to be P > 0.05. Patients age mean ± SD = 4.96 year, neopterin and biopterin mean ± SD in 124 patients were 2.75 mmol/molcr and 2.49 mmol/molcr. Correlation regression between two methods (iodine and MnO2 oxidation) was 0.99. There was no significant difference between the two oxidation methods (P > 0.05). The results of this study showed that MnO2 oxidation can be a suitable alternative method instead of iodine oxidation for measurement of urine neopterin, biopterin and diagnosis of BH4 deficiency.
Keywords
Hyperphenylalaninemia Neopterin MnO2 oxidation HPLCNotes
Acknowledgements
We are thankful for the Genetic Department of Ministry of Health and Medical Education of Iran.
Compliance with Ethical Standards
Conflict of interest
Authors declare that there is any conflict of interest for publishing the data of this study and as the current format.
References
- 1.Zhang C, Xu K, Dave UP, Wang Y, Matsumoto I. Inborn errors of metabolism discovered in Asian department of pediatrics and mental retardation research center. J Chromatogr B Biomed Sci Appl. 2000;746(1):41–9.CrossRefGoogle Scholar
- 2.Albrecht J, Garbade SF, Burgard P. Neuropsychological speed tests and blood phenylalanine levels in patients with phenylketonuria: a meta-analysis. Neurosci Biobehav Rev. 2009;33(3):414–21.CrossRefGoogle Scholar
- 3.Eshraghi P, Abaskhanian A, Mohammadhasani A. Characteristics of patients with phenylketonuria in Mazandaran Province, northern Iran. Casp J Intern Med. 2010;1(2):72–4.Google Scholar
- 4.Williams RA, Mamotte CD, Burnett JR. Phenylketonuria: an inborn error of phenylalanine metabolism. Clin Biochem Rev. 2008;29(1):31.PubMedPubMedCentralGoogle Scholar
- 5.Karamifar H, Ordoei M, Karamizadeh Z, Amirhakimi GH. Incidence of neonatal hyperphenylalaninemia in Fars province, South Iran. Iran J Pediatr. 2010;20(2):216.PubMedPubMedCentralGoogle Scholar
- 6.Vallian S, Barahimi E, Moeini H. Phenylketonuria in Iranian population: a study in institutions for mentally retarded in Isfahan. Mutat Res Fundam Mol Mech Mutagen. 2003;526(1):45–52.CrossRefGoogle Scholar
- 7.Huber C, Batchelor JR, Fuchs D, Hausen A, Lang A, Niederwieser D, et al. Immune response-associated production of neopterin. Release from macrophages primarily under control of interferon-gamma. J Exp Med. 1984;160(1):310–6.CrossRefGoogle Scholar
- 8.Lhee HY, Kim H, Joo KJ, Jung SS, Lee KB. The clinical significance of serum and urinary neopterin levels in several renal diseases. J Korean Med Sci. 2006;21(4):678–82.CrossRefGoogle Scholar
- 9.Aulitzky W, Tilg H, Niederwieser D, Riccabona G, Obendorf L, Margreiter R, et al. Comparison of serum neopterin levels and urinary neopterin excretion in renal allograft recipients. Clin Nephrol. 1988;29(5):248–52.PubMedGoogle Scholar
- 10.Fahey JL, Taylor JM, Detels R, Hofmann B, Melmed R, Nishanian P, et al. The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type 1. N Engl J Med. 1990;322(3):166–72.CrossRefGoogle Scholar
- 11.Halota W, Jaruga B, Pawłowska M. Serum neopterin and beta2-microglobulin concentration as “prognostic markers” of AIDS. Polski merkuriusz lekarski organ Polskiego Towarzystwa Lekarskiego. 2002;13(74):126–8.PubMedGoogle Scholar
- 12.Lin C-Y. Urinary neopterin as a new biochemical marker for the monitoring of disease activity and prognosis in membranous nephropathy associated with hepatitis B surface antigenemia. Nephron. 1989;53(2):115–20.CrossRefGoogle Scholar
- 13.Blau N, Hennermann JB, Langenbeck U, Lichter-Konecki U. Diagnosis, classification, and genetics of phenylketonuria and tetrahydrobiopterin (BH4) deficiencies. Mol Genet Metab. 2011;104:S2–9.CrossRefGoogle Scholar
- 14.Hoang L, Byck S, Prevost L, Scriver CR. PAH mutation analysis consortium database: a database for disease-producing and other allelic variation at the human PAH locus. Nucl Acids Res. 1996;24(1):127–31.CrossRefGoogle Scholar
- 15.Kim N-H, Jeong J-S, Kwon H-J, Lee Y-M, Yoon H-R, Lee KR, et al. Simultaneous diagnostic method for phenylketonuria and galactosemia from dried blood spots using high-performance liquid chromatography-pulsed amperometric detection. J Chromatogr B. 2010;878(21):1860–4.CrossRefGoogle Scholar
- 16.Opladen T, Hoffmann GF, Blau N. An international survey of patients with tetrahydrobiopterin deficiencies presenting with hyperphenylalaninaemia. J Inherit Metab Dis. 2012;35(6):963–73.CrossRefGoogle Scholar
- 17.Blau N, van Spronsen FJ, Levy HL. Phenylketonuria. The Lancet. 2010;376(9750):1417–27.CrossRefGoogle Scholar
- 18.Blau N, Kierat L, Heizmann C, Endres W, Giudici T, Wang M. Screening for tetrahydrobiopterin deficiency in newborns using dried urine on filter paper. J Inherit Metab Dis. 1992;15(3):402–4.CrossRefGoogle Scholar
- 19.Niederwieser A, Staudenmann W, Wetzel E. High-performance liquid chromatography with column switching for the analysis of biogenic amine metabolites and pterins. J Chromatogr A. 1984;290:237–46.CrossRefGoogle Scholar
- 20.Blau N. Inborn errors of pterin metabolism. Annu Rev Nutr. 1988;8(1):185–209.CrossRefGoogle Scholar
- 21.Dhondt J-L. Strategy for the screening of tetrahydrobiopterin deficiency among hyperphenylalaninaemic patients: 15-years experience. J Inherit Metab Dis. 1991;14(2):117–27.CrossRefGoogle Scholar
- 22.Moyle J, Fox A, Arthur M, Bynevelt M, Burnett J. Meta-analysis of neuropsychological symptoms of adolescents and adults with PKU. Neuropsychol Rev. 2007;17(2):91–101.CrossRefGoogle Scholar
- 23.Brumm V, Bilder D, Waisbren S. Psychiatric symptoms and disorders in phenylketonuria. Mol Genet Metab. 2010;99:S59–63.CrossRefGoogle Scholar
- 24.Hanley W, Demshar H, Preston M, Borczyk A, Schoonheyt W, Clarke J, et al. Newborn phenylketonuria (PKU) Guthrie (BIA) screening and early hospital discharge. Early Hum Dev. 1997;47(1):87–96.CrossRefGoogle Scholar
- 25.Leeming R, Barford P, Blair J, Smith I. Blood spots on Guthrie cards can be used for inherited tetrahydrobiopterin deficiency screening in hyperphenylalaninaemic infants. Arch Dis Child. 1984;59(1):58–61.CrossRefGoogle Scholar
- 26.Narisawa K, Hayakawa H, Arai N, Matsuo N, Tanaka T, Naritomi K, et al. Diagnosis of variant forms of hyperphenylalaninemia using filter paper spots of urine. J Pediatr. 1983;103(4):577–9.CrossRefGoogle Scholar
- 27.Naylor EW, Ennis DC, Guettoff M. Eight years of screening for cofactor variants of phenylketonuria in North America. Current trends in infant screening. Amsterdam: Excerpta Medica; 1989. p. 89–93.Google Scholar