Effects of delta-aminolaevulinic acid on contractile activity in the isolated small intestine of the rabbit. Role of adrenergic receptors

Urinary 5-aminolevulinic acid in lead-exposed children

Lead intoxication can interfere with haem synthesis and alter the concentration of haem precursors, such as the neurotoxin 5-aminolevulinic acid, in plasma and urine. The relationship between blood lead concentration (PbB), a biomarker of lead exposure, and 5-aminolevulinic acid concentration in urine (ALAU), a biomarker of the early biological effect of lead, was examined in lead-exposed children. ALAU was assayed by chemical derivatization and high performance liquid chromatography with fluorescence detection. The study subjects were 79 children with moderate to high lead exposure recruited from a lead-poisoning prevention clinic. Their urine had been previously analysed for creatinine (CR) concentration and the benzene metabolite trans,trans- muconic acid, and their blood had been analysed for lead. We found that ALAU was not correlated with PbB (Spearman r=0.088, p=0.44), but the ratio ALAU/CR was correlated with PbB (Spearman r=0.22, p=0.054). Creatinine and ALAU concentrations were higher in urine samples collected in the afternoon than those collected in the morning, a finding that is consistent with known diurnal variation. However the ratio ALAU/CR was not different in morning and afternoon urines, supporting the use of creatinine adjustment of ALAU analysis of spot urine samples. In view of the neurotoxic properties of ALA, future validation studies of biomarkers of lead exposure and effect in children should include ALAU or ALAU/CR as potential markers of lead effect.

Environmental lead exposure and activity of delta-aminolevulinic acid dehydratase (ALA-D) in maternal and cord blood

The hypothesis that environmental lead exposure measured from blood (Pb-B) inhibits delta-aminolevulinic acid dehydratase activity (ALA-D) from whole blood was tested in 241 urban mothers and their newborns. Geometric means and (5th and 95th Percentiles) for maternal and cord Pb-B were 6.4 microg dl(-1) (3.4-11.9) and 4.6 microg dl(-1) (2.8-9.2). Spearman correlations between mother and cord Pb-B and ALA-D were all negative but statistically significant only for cord Pb-B and mother ALA-D. A potential lead threshold, was identified between 3.2 and 4.8 microg dl(-1), above which ALA-D may be inhibited by lead, and below which ALA-D may be insensitive or even activated. In conclusion, low environmental exposure to lead is responsible for a demonstrable biochemical effect. This potential ALA-D inhibition may lead to neurotoxic effects, especially in newborns who have high level of neurogenesis.

Plasma 5-aminolevulinic acid concentration and lead exposure in children

The relationship between concentration of 5-aminolevulinic acid in plasma (ALAP) and other biomarkers of lead exposure and effect was investigated in lead-exposed children. We measured ALAP by chemical derivatization and high-performance liquid chromatography with fluorescence detection. The study population consisted of 103 children: 78 from a referral clinic for children with lead poisoning and 25 from a general pediatric clinic. Blood lead concentration (PbB), age, and ALAP were higher in lead clinic subjects than in general clinic subjects. ALAP was significantly correlated with PbB (Spearman r=0.38, P=0.0007) and free erythrocyte protoporphyrin concentration (r=0.41, P=0.0002) in lead clinic subjects. PbB was a significant predictor of ALAP (P=0.0001) by multiple linear regression in all subjects. The average PbB in the 3- to 12-month period prior to blood collection correlated with ALAP to the same degree that current PbB correlated with ALAP. Possible associations between ALAP and adverse health outcomes, particularly neurobehavioral effects, should be investigated in children to assess the predictive value of ALAP for these endpoints.

Effect of the delta-aminolevulinate dehydratase polymorphism on the accumulation of lead in bone and blood in lead smelter workers

Lead inhibition of the zinc metalloenzyme delta-aminolevulinate dehydratase (ALAD) is one of the most sensitive indicators of blood lead levels. ALAD is polymorphic, with about 20% of Caucasians expressing the rarer ALAD2 allele. Previous studies indicated that this polymorphism may be a genetic factor in lead transport, metabolism, and/or distribution. Whole blood lead, serum lead, and ALAD genotype were determined for 381 lead smelter workers, including 70 workers expressing the ALAD2 allele, whose blood lead elevations were observed for more than 20 years of employment. The same employees demonstrated higher serum lead levels. Using a cumulative blood lead index (CBLI) for each worker, based on individual blood lead histories, and in vivo X-ray fluorescence measurements of bone lead to estimate total lead body burden, the slopes of linear relations of bone lead to CBLI were greater for workers homoallelic for ALAD1, indicating more efficient uptake of lead from blood into bone. This effect was most significant in calcaneus bone and for workers hired since 1977 [ALAD1-1: 0.0528 +/- 0.0028 and ALAD1-2 or 2-2: 0.0355 +/- 0.0031 (P < 0.001)]. Decreased transfer of blood lead into bone in individuals expressing the ALAD2 allele contrasted with increased blood lead. Thus the ALAD genotype affected lead metabolism and potentially modified lead delivery to target organs including the brain; however, the ALAD genotype did not significantly affect the net accumulation of lead in bone.

Pharmacological activities of delta-aminolaevulinic acid, protoporphyrin IX and haemin in isolated preparations of rabbit gastric fundus and jejunum

1. Pharmacological effects of delta-aminolaevulinic acid (ALA), protoporphyrin IX and haemin were examined in isolated preparations of rabbit jejunum and gastric fundus suspended in oxygenated Ringer-Locke solution at pH 7.0. 2. In jejunal preparations, delta-aminolaevulinic acid (3.0-4.5 mM), protoporphyrin IX (1.1-2.2 mM) and haemin (3.0-4.5 mM) dose-dependently reduced the amplitude of contractions and increased resting length. Pretreatment with prazosin (10(-7) M) inhibited effects produced by delta-aminolaevulinic acid (3 mM) and protoporphyrin IX (1.1 mM) but not those of haemin (3 mM). 3. In fundic preparations, dose-dependent contracture occurred in response to delta-aminolaevulinic acid (0.1-3.0 mM) protoporphyrin IX (0.1-2.2 mM) and haemin (0.6-6.3 mM). Effects qualitatively resembled those of noradrenaline (0.1-0.4 microM). Prazosin (10(-7) M) attenuated these effects, depressing the maximum response and causing a rightward shift of the concentration-response curves. 4. It is concluded that actions of delta-aminolaevulinic acid at alpha 1-adrenoceptor sites are unlikely to be related to the autonomic neuropathy of acute porphyria. Its in vitro effects occurred only at comparatively high concentrations and were mimicked by protoporphyrin IX and haemin. It is suggested that ALA is more likely to modify autonomic functions by an indirect action, since it is known at low dose levels to influence GABA-ergic functioning.

delta-Aminolevulinic acid dehydratase isozymes and lead toxicity

ALAD is a zinc metalloenzyme whose inhibition by lead is the first and most sensitive indicator of lead exposure and whose decreased activity has been implicated in the pathogenesis of lead poisoning. This heme biosynthetic enzyme is encoded by a gene located at chromosome 9q34, which has two codominant alleles, ALAD1 and ALAD2. The occurrence of two frequent alleles for ALAD stimulated an investigation into the possible pharmacogenetic role of the enzyme polymorphism in lead poisoning. In a New York City population at high risk for lead exposure, individuals heterozygous or homozygous for the less common allele, ALAD2, had blood lead levels greater than or equal to 30 micrograms/dl more frequently than expected. These findings suggest a potential genetic susceptibility to lead poisoning in individuals with the ALAD 1-2 and 2-2 phenotypes.

Pharmacological effects of haem biosynthetic intermediates in isolated intestinal preparations

Spontaneous contractile activity of isolated rabbit jejunal preparations bathed in oxygenated Ringer-Locke buffered to pH 7.0 was inhibited by haemin and by all haem biosynthetic intermediates tested, there being decreases in tone or amplitude of contractions. Effects were concentration-dependent. The minimal effective concentrations were 0.4 mM for porphobilinogen, 0.6 mM for protoporphyrin IX, 0.8 mM for haemin, 3.0 mM for delta-aminolaevulinic acid (ALA), 4.5 mM for coproporphyrin I, 3.0 mM for glycine and 6.0 mM for succinate. Inhibition was short-lasting, other than for protoporphyrin (2.3 mM) and haemin (3.0 mM). Leucine at concentrations up to 12 mM had no significant effect. Inhibitory effects of ALA were followed by contractions of increased amplitude; pretreatment of preparations with indomethacin (56 microM) prevented this enhancement of contractile activity. Tone in isolated preparations of human taenia coli bathed in oxygenated Ringer-Locke was decreased by ALA (1.5-6.0 mM). A significant increase of tone followed the initial inhibitory effect. The relevance of these findings to acute porphyria is discussed.