Metabolism of deoxynucleosides by lymphocytes in long-term culture deficient in different purine enzymes

The metabolism of 8-14C-labelled 2'-deoxyadenosine (dAR) and 2'-deoxyguanosine (dGR) has been investigated using lymphocytes in long-term culture transformed by Epstein-Barr (EB) virus (B-cells) from eight patients with different inherited purine enzyme defects. The use of such lines enabled accurate mapping of the route of metabolism by acting as a 'trap' for the radiolabel at specific points. With either substrate (25 microM) most of the label was recovered in the medium. Using dAR, less than 30% of the radiolabel was incorporated into cellular nucleotides. For dGR, values were less than 18%. Studies with dAR alone confirmed the principal route of metabolism was to hypoxanthine, with further metabolism (by lines with intact salvage pathways) to ATP and GTP in the ratio of approximately 4:1. Lack of accumulation of deoxyinosine in the purine nucleoside phosphorylase (PNP) deficient line, or hypoxanthine in the hypoxanthine guanine phosphoribosyltransferase (HGPRT) deficient line, using dAR together with the adenosine deaminase (ADA) inhibitor 2'-deoxycoformycin (dCF) at 10 microM, confirmed the effectiveness of ADA inhibition. Nevertheless, some ATP was still formed by all lines in the presence of dCF by a route as yet unknown. Only the ADA deficient lines formed dATP with dAR alone. However, some dATP was formed by all lines in the presence of dCF. A partially HGPRT deficient line formed extremely high dATP levels, well in excess of those formed by the T-cell line CEM. Studies with dGR revealed some interesting differences, a large proportion of the substrate being metabolized predominantly to xanthine by most enzyme deficient lines. In the PNP deficient line most of the substrate remained unmetabolized, but some dGTP was formed. No other enzyme deficient line formed any dGTP--with or without the PNP inhibitor 8-aminoguanosine (8-NH2GR)--with one exception. Again this was the partially HGPRT deficient line, which with the inhibitor again formed more dGTP than the T-cell line. Within the cells most of the substrate was metabolized to GTP, except in the PNP, and totally HGPRT deficient lines. Levels of GTP formed were not altered by the inhibitor, reflecting the lack of effective PNP inhibition by 8-NH2GR. Some counts were also found in ATP and IMP, confirming the existence of this route in mammalian cells of lymphoid origin. The results also support previous studies by us using cell lines with intact purine pathways, which demonstrated that, contrary to current beliefs, some B-cell lines are capable of accumulating high levels of deoxynucleotides.(ABSTRACT TRUNCATED AT 400 WORDS)

Myoadenylate deaminase deficiency: an enzyme defect in search of a disease

The frequency of MAD deficiency in cases with exercise intolerance compared with the frequency in series of consecutive muscle biopsies suggests a relation between the deficiency and exercise intolerance. Deficiency cases can be presumed by an impaired NH3 production during ischaemic exercise. The ischaemic exercise test also gives information concerning the familial character of the deficiency.

Pregnancy in xanthinuria: demonstration of fetal uric acid production?

This paper reports biochemical studies in a pregnant xanthinuric female (McKusick 27830) and compares the results with findings in three other xanthinurics studied by us, including a previously unreported female who had a nephrectomy for xanthine stones. The findings of raised levels of uric acid in plasma and urine at presentation in the third trimester of pregnancy, and the subsequent fall to almost undetectable levels 6 weeks post-partum, is regarded as evidence of the extent of fetal uric acid production and clearance by the maternal circulation.

Maternal beta-adrenoceptor blockade reduces fetal tolerance to asphyxia. A study in pregnant sheep

Maternal and fetal beta 1-adrenoceptor blockade was induced in sheep by infusing i.v. 11 pregnant ewes with metoprolol in doses producing maternal plasma concentrations of metoprolol comparable to those obtained in clinical use. Ten other ewes and their fetuses served as controls. Under acute anaesthesia the fetus was exteriorized and subjected to two levels of controlled asphyxia by intermittent, complete obstruction of the maternal placental blood flow. Fetal haemodynamic reactions were assessed by measuring fetal heart rate, cardiac contractility, cardiac output and cerebral blood flow. The metabolic reactions were evaluated from blood gases, pH, lactate and hypoxanthine concentrations, while the electrophysiological status of the brain was evaluated from the somatosensory evoked EEG potentials (SEP). Already during the period of moderate asphyxia the beta-blocked fetuses demonstrated a blunted haemodynamic response, in comparison with the control fetuses, resulting in an accelerating lactic acidosis, signs of a breakdown of intra-cellular energy-rich phosphates and an impaired cerebral function. During the period of severe asphyxia, both groups of fetuses exhibited signs of extensive cerebral deterioration. During the ensuing recovery phase, 80% of the control fetuses regained their brain function, as assessed by SEP, whereas this was true for only 30% of the beta 1-blocked fetuses. It is concluded that the ovine fetus relies heavily on greatly increased sympatho-adrenal activity to adapt itself to asphyxia and that blockade of the fetal beta 1-adrenoreceptors by maternal medication is a hazard to the potentially asphyctic fetus.

High performance liquid chromatographic profiles of nucleosides, bases and tryptophan in the plasma of the Tasmanian devil and four other marsupial species

Plasma profiles of nucleosides, bases and trytophan of five marsupial species were established using the reversed-phase mode of high performance liquid chromatography (RHPLC). Within each species, the profiles were highly reproducible and between species there were distinct differences. In the Tasmanian devil, the circulating levels of constituents examined with one exception, were generally lower than in the other marsupials. The exception was a constituent present in large amounts and having the characteristics of a purine nucleoside derivative which was found only in the plasma of the devil.

Contribution of heart muscle, liver, skeletal muscle and placenta to the asphyxial hypoxanthine elevation in the acutely exteriorised fetal lamb

The metabolic response to different degrees of hypoxia was studied in 14 lamb fetuses. We have previously found a substantial rise in the fetal arterial plasma hypoxanthine (HX) level, in parallel with alterations of other hypoxia indices during induced asphyxia. Measurements of the arterio-venous (A-V) difference in the HX level across the CNS demonstrated a late efflux of this substance from the fetal brain, with a high resistance to asphyxia. In this study, the effluxes of HX, lactate, and in some cases glucose, from the myocardium, liver, hindleg (skeletal muscle) and placenta were investigated in acutely exteriorised sheep fetuses with graded asphyxia. The main findings were as follows: (a) myocardium: a release of HX early during asphyxia, the magnitude of which paralelled the amount of mechanical work performed by the heart; a significant lactate influx into the heart during normoxia and recovery period; (b) liver: hepatic HX release even during normoxia, increasing to substantial amounts in connection with increasing asphyxia; (c) hindleg: release of HX only during the recovery period; lactate efflux during all periods apart from severe asphyxia, when an influx was seen for both substances; (d) placenta: production of lactate during normoxia, and an efficient clearance of both lactate and HX from the fetal plasma in combination with their concentration increasing during asphyxia. It is concluded that the myocardium and liver are the main contributors to the elevated HX level during fetal asphyxia among the fetal organs investigated, while skeletal muscle releases HX mostly during the period of reoxygenation.

Allopurinol metabolism in a patient with xanthine oxidase deficiency

A patient with complete deficiency of xanthine oxidase would not be expected to oxidase allopurinol to oxipurinol if allopurinol did not have any alternative metabolic pathway. 400 mg of allopurinol was administered to a patient with xanthine oxidase deficiency, and plasma allopurinol, oxipurinol, hypoxanthine, and xanthine levels were determined serially by the use of high-performance liquid chromatography (HPLC). Plasma oxipurinol as well as allopurinol was increased after the administration of allopurinol, and oxipurinol reached a maximum level of 13.1 micrograms/ml at 6 hours after the administration. This was the same pattern as that of normal controls. This result demonstrated the existence of some other oxidising enzyme of allopurinol than xanthine oxidase.

Fluorometric determination of hypoxanthine and xanthine in biological fluids by high-performance liquid chromatography using enzyme reactors

A selective and sensitive assay of hypoxanthine and xanthine in biological fluids by high-performance liquid chromatography coupled with immobilized-enzyme reactors was developed. The separations were achieved by reversed-phase liquid chromatography. Hydrogen peroxide produced from hypoxanthine and xanthine by immobilized xanthine oxidase was determined fluorometrically using immobilized peroxidase and p-hydroxyphenylacetic acid. Immobilized enzymes were prepared by intermolecular cross-linking to controlled-pore glass. Assay of allopurinol was also possible by the present method. The method was applied to serum and urine. The detection limits of hypoxanthine and xanthine were approximately 50 and 120 pg per injection, respectively.

[Changes of the acid-base status, serum lactate concentration and purine metabolism in reconstructive arterial surgery]

Hypoxic damages are normally determined by acid-base status as well as lactate and pyruvate levels. Since several other illnesses lead also to raised levels of these parameter, they are not specific for tissue hypoxia. In animal experiments it was shown that purine metabolites, especially hypoxanthine, are a very exact indicator for hypoxia. To test its validity in clinical situations the changes in acid-base status, lactate, pyruvate and purine metabolism were measured in 17 patients undergoing reconstructive aortic surgery. Blood samples were taken just before and after declamping of the aorta systemically and from the femoral vein. After declamping especially the systemic hypoxanthine levels increased 3 fold, due to a 20 times higher hypoxanthine concentration in the femoralis vein. The concentration changes of hypoxanthine in percent correlated very good with the aorta clamping time (R = 0,85). The changes in acid-base status and lactate levels were erratic and showed no correlation with the duration of ischemic period. Systemic hypoxanthine concentrations are a more specific and reliable parameter for hypoxic damages.

Circadian variations of adenosine level in blood and liver and its possible physiological significance

The role of adenosine as a possible physiological modulator was explored by measuring its concentration in different tissues during a 24-hour period. Initially the circadian variations of adenosine and other purine compounds such as inosine, hypoxanthine, uric acid and adenine nucleotides were studied in the rat blood. A daily cyclic response was observed, with low levels of adenosine from 08.00 - 20.00 h, followed by an increase from this time on. Inosine and hypoxanthine levels were elevated during the day and low at night. The uric acid changes observed indicate that the decrease in purine catabolism coincides with a decrease in inosine and hypoxanthine levels and an increase in adenosine. The blood adenine nucleotides, energy charge and phosphorylation potential remained constant during the day and showed oscillatory changes during the night. Similar studies were made in the liver, a primary source of circulating purines. Liver adenosine was high during the night while inosine and hypoxanthine remained low along the 24 hours. The results suggest that liver purine metabolism might participate in the maintenance and renewal of the blood purine pool and in the energy state of erythrocytes in vivo.

Radioimmunoassay of the immunomodulator erythro-9-(2-hydroxy-3-nonyl)-hypoxanthine in human serum and urine

A radioimmunoassay was developed for the measurement in human serum and urine of erythro-9-(2-hydroxy-3-nonyl)-hypoxanthine. Antisera were produced in rabbits by immunization with an erythro-9-(2-hydroxy-3-nonyl)-hypoxanthine hemisuccinate-bovine serum albumin conjugate. The competitive antigen was erythro-9-(2-hydroxy-3-nonyl)-hypoxanthine labeled with carbon-14 on the purine ring. Cross-reactivities were measured against three metabolites and the naturally occurring purine bases inosine and hypoxanthine. Sensitivity of the method was 1 ng/ml in serum and 10 ng/ml in urine. Precision at clinical levels was +/- 15% in serum at 2 ng/ml and +/- 3% in urine at 200 ng/ml.

Adenine-induced hypoxanthine release from IMP-enriched human erythrocytes

Adenine uptake and hypoxanthine release by IMP-enriched human erythrocytes has been studied. The presence of IMP within the erythrocytes leads to an increase in the rate of adenine incorporation. Adenine is taken up by IMP-enriched erythrocytes as AMP, even when intracellular 5-phosphoribosyl-1-pyrophosphate concentration is undetectable and too low to allow IMP synthesis from hypoxanthine. During adenine uptake and AMP synthesis, hypoxanthine is released by the cells. The possibility that 5-phosphoribosyl-1-pyrophosphate, necessary for AMP synthesis, is formed through the hypoxanthine guanine phosphoribosyltransferase-catalyzed IMP pyrophosphorolysis is considered.

Hypoxanthine and xanthine levels determined by high-performance liquid chromatography in plasma, erythrocyte, and urine samples from healthy subjects: the problem of hypoxanthine level evolution as a function of time

The levels of hypoxanthine and xanthine are determined in plasma, erythrocyte, and urine samples by a reverse-phase high-performance liquid chromatographic (HPLC) method. The hypoxanthine concentration increases in erythrocyte and plasma samples when whole blood is stored at room temperature between sampling and centrifugation. Furthermore, the hypoxanthine concentration increases in erythrocyte samples when they are kept apart at room temperature before analysis, whereas the plasma hypoxanthine level remains constant. This result proves an endogenous formation of hypoxanthine in erythrocytes with time, at room temperature. These studies show the necessity of rigorous conditions for the collection, transport, and treatment of blood samples. In order to achieve accurate results, the blood must be centrifuged immediately after collection. The erythrocyte and plasma samples must be stored frozen until deproteinization and HPLC analysis. Under these conditions, the concentrations of hypoxanthine and xanthine in plasma are 2.5 +/- 1 and 1.4 +/- 0.7 microM, respectively. In erythrocyte samples, hypoxanthine concentration reaches 8.0 +/- 6.2 microM.

Hypoxanthine and Mcardle disease: a clue to metabolic stress in the working forearm

Forearm exercise in a patient with myophosphorylase deficiency resulted in abnormally high levels of hypoxanthine in the venous blood. The post-exercise hypoxanthine response may reflect ATP depletion in the muscle and provides a useful screening test in muscle diseases with abnormal energy metabolism.

Arterial cord blood hypoxanthine: a measure of intrauterine hypoxia?

In order to evaluate the concentration of hypoxanthine in the cord blood as an indicator of intrauterine hypoxia, hypoxanthine was determined in the arterial and venous cord blood of 49 randomly chosen newborns and in the peripheral venous blood of their mothers. In addition, 5 young, nonpregnant women were investigated. Term babies with signs of probable intrauterine hypoxia (fetal distress, scalp blood or arterial cord blood pH less than 7.19, and/or Apgar score of less than 5 at 1 min) had hypoxanthine levels (19.8 +/- 3.5 mumol/l) consistently above the mean for normals. However, there was a large variability of hypoxanthine values in normal babies (16.1 +/- 5.7 mumol/l) and in those with isolated signs of fetal distress (14.6 +/- 6.9 mumol/l). There was no general correlation between the levels of hypoxanthine in arterial cord blood and arterial cord blood pH (r = -0.15) or between the levels of hypoxanthine in arterial cord blood and the Apgar score at 1 min (r = -0.05) or between the levels of hypoxanthine in arterial cord blood and the Apgar score at 1 min (r = -0.05). At delivery, all mothers had higher levels of hypoxanthine than nonpregnant women (16.0 +/- 6.8 vs. 7.6 +/- 2.1 mumol/l; p less than 0.001). The maternal hypoxanthine values correlated closely with those of the venous cord blood (r = 0.72; p less than 0.001). Positive arterio-venous differences in the cord blood increased with progressively higher levels of hypoxanthine in arterial cord blood (r = 0.53; p less than 0.001), indicating a clearance through the placenta.(ABSTRACT TRUNCATED AT 250 WORDS)

Xanthine oxidase deficiency and 'Dalmatian' hypouricaemia: incidence and effect of exercise

In order to study the effects of raising the hypoxanthine concentration in plasma on its metabolism and renal handling, the effects of intense exercise have been investigated in a patient with xanthine oxidase deficiency. Despite the 90-fold increased concentration of hypoxanthine in plasma above resting levels in normal individuals, the intracellular concentration of the initial product of hypoxanthine in cells, IMP, was unaffected. Evolution may have stabilized intracellular nucleotide concentrations against the large fluctuations in plasma hypoxanthine which occur during exercise. The renal handling of hypoxanthine is consistent with 'filtration'. In contrast, xanthine clearances may exceed those for creatinine and urinary concentrations do not correlate with those for creatinine; 'secretion' may be involved. Xanthine excretion may reflect guanine breakdown. A retrospective survey of urate concentrations in blood from 47 420 patients followed by further selected investigations detected 2 women with persistent marked hypouricaemia and high urinary urate clearances, 'Dalmatian' hypouricaemia. High pressure liquid chromatographic analysis of plasma extracts can distinguish xanthine oxidase deficiency from other causes of hypouricaemia.

High-performance liquid chromatographic determination of hypoxanthine and xanthine in biological fluids

A rapid and selective reversed-phase high-performance liquid chromatographic method for the simultaneous determination of hypoxanthine and xanthine in biological fluids was developed. The identification of hypoxanthine and xanthine was confirmed by xanthine oxidase reaction. This method was applied to the investigation of purine metabolism in subjects with xanthine oxidase deficiency or gout. Hypoxanthine concentrations three to ten times higher than those determined in plasma were found in erythrocyte samples from normal subjects and from patients with xanthine oxidase deficiency or hyperuricemia under allopurinol therapy.

HPLC analysis of aromatic amino acids, nucleosides, and bases in plasma of acute lymphocytic leukemia on chemotherapy

Plasma chromatograms--obtained by the reversed-phase mode of high performance liquid chromatography (HPLC)--of 19 subjects with acute lymphocytic leukemia (ALL) were compared to those of 19 normal individuals. ALL patients were in remission and on a methotrexate and 6-mercaptopurine maintenance regimen. The concentrations of the aromatic amino acids L-phenylalanine and L-tyrosine, the nucleosides uridine, adenosine, inosine, and guanosine, as well as the bases hypoxanthine and xanthine, were elevated in the leukemic in comparison to the normal chromatograms. Highest inosine levels corresponded to leukemic subjects whose condition severely deteriorated with time. Patients with lower inosine levels are still in continuous remission.

Secretion defect in platelets stored at 4 degrees C

To understand the functional changes induced by storage, we have examined the adenine nucleotides of platelets stored for 72 hr at 22 degrees C and 4 degrees C. Ten platelet concentrates (PC) were stored at each temperature with five in each group having a final volume of 50 ml and 30 ml. The total ATP and ADP content of platelets decreased following storage in all 4 groups of PC, with the decrease being greater in the PC stored at 22 degrees C than those at 4 degrees C. The mean thrombin secretable ATP + ADP content of platelets from PC stored at 22 degrees C and 4 degrees C were 29.7% and 19.7% of the total content, respectively (p less than 0.001). Thus, cold stored platelets have a higher total content of ATP + ADP but secrete distinctly lesser amounts than 22 degrees C stored platelets. Labeling of the metabolic pool adenylates with 14C-adenine revealed a greater decrease in the adenylate energy charge of the platelets stored at 4 degrees C. The secretion defect demonstrated in cold stored platelets may be related to the inability of these platelets to maintain ATP homeostasis.

Forearm exercise increases plasma hypoxanthine

Plasma hypoxanthine was measured in three normal subjects during aerobic forearm exercise. The comparative increase of hypoxanthine greatly exceeded that of ammonia or lactate. It is proposed that hypoxanthine production reflects ATP breakdown in muscle. The test may prove useful in the investigation of patients with metabolic muscle disease.