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Granick S, Beale SI. Hemes, chlorophylls, and related compounds: biosynthesis and metabolic regulation. ADVANCES IN ENZYMOLOGY AND RELATED AREAS OF MOLECULAR BIOLOGY 2006; 46:33-203. [PMID: 345768 DOI: 10.1002/9780470122914.ch2] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Lane PR, Massey KL, Worobetz LJ, Jutras MN, Hull PR. Acute hereditary coproporphyria induced by the androgenic/anabolic steroid methandrostenolone (Dianabol). J Am Acad Dermatol 1994; 30:308-12. [PMID: 8294588 DOI: 10.1016/s0190-9622(94)70029-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Acute attacks of porphyria can be induced by certain drugs. We report a case of acute coproporphyria induced by methandrostenolone. This is the first report of acute porphyria induced by an androgenic, anabolic steroid.
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Affiliation(s)
- P R Lane
- University of Saskatchewan, Saskatoon, Canada
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Herrick AL, McColl KE, Wallace AM, Moore MR, Goldberg A. Elevation of hormone-binding globulins in acute intermittent porphyria. Clin Chim Acta 1990; 187:141-8. [PMID: 2107988 DOI: 10.1016/0009-8981(90)90340-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Sex hormone-binding globulin (SHBG), thyroxine-binding globulin (TBG) and cortisol-binding globulin (CBG) were measured in plasma of 26 patients with acute intermittent porphyria (AIP). Twelve patients had clinically manifest disease and all had elevated SHBG levels. All but one of 14 patients with latent porphyria had normal SHBG levels. TBG was elevated in 9 of the patients with clinically manifest porphyria and CBG elevated in three. Levels of TBG and CBG were either normal or only slightly elevated in those with latent porphyria. In a prospective study of 30 attacks of AIP in 7 patients, SHBG levels fell between admission and discharge, the fall being significant in the group of 21 attacks treated with haem arginate (p less than 0.001). Our findings suggest that a close correlation exists between elevated SHBG and clinical expression of AIP.
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Affiliation(s)
- A L Herrick
- University Department of Medicine, Gardiner Institute, Western Infirmary, UK
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Affiliation(s)
- R A Galbraith
- Rockefeller University Hospital, New York, New York 10021
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Affiliation(s)
- P B Disler
- Department of Community Health, University of Cape Town, South Africa
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Sassa S, Kappas A. Genetic, metabolic, and biochemical aspects of the porphyrias. ADVANCES IN HUMAN GENETICS 1981; 11:121-231. [PMID: 7023204 DOI: 10.1007/978-1-4615-8303-5_3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Graef V, Golf SW, Goerz G. Effect of hexachlorobenzene on enzymes of the steroid metabolism in rat liver. Arch Toxicol 1979; 43:115-20. [PMID: 43717 DOI: 10.1007/bf00333618] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Adult female Wistar rats were fed with a diet containing 0.05% hexachlorobenzene. On the 60th day of this treatment the specific activities of NADPH: delta 4-3-oxosteroid-5 alpha-reductase and the 3-hydroxysteroid dehydrogenases in rat liver microsomes were diminished compared to control rats. The cytoplasmatic 5 beta-reduction was higher in HCB treated rats than in control rats. These alterations of the steroid metabolism lead to increased formation of 5 beta-H-steroids which are known to be inducers of the porphyrin biosynthesis.
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Brodie MJ, Moore MR, Thompson GG, Goldberg A, Low RA. Pregnancy and the acute porphyrias. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1977; 84:726-31. [PMID: 921907 DOI: 10.1111/j.1471-0528.1977.tb12480.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
An analysis is presented of the obstetric histories of 50 women with acute porphyria, comprising 39 with acute intermittent porphyria, 3 with variegate porphyria and 8 with hereditary coporporphyria. Fifty-four per cent of the women with acute intermittent porphyria had an acute attack of porphyria in pregnancy and/or the puerperium. Only one maternal death was recorded. One patient with variegate prophyria and two with hereditary coproporphyria had an attack related to pregnancy. The total fetal wastage was 13 per cent. The babies born to mothers with acute intermittent porphyria, who experienced an acute attack during pregnancy, were smaller than those in which no such attack occurred (P less than 0.001). In 13 non-porphyric primigravidae there was a rise in urinary excretion of delta-aminolaevulinic acid, porphobilinogen and coproporphyrin up to the 28th week of gestation. It is probable that pregnancy has some deleterious effects in acute prophyria but the prognosis of the porphyric pregnancy is much better than the literature suggests.
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Kappas A, Bradlow HL, Bickers DR, Alvares AP. Induction of a deficiency of steroid delta 4-5 alpha-reductase activity in liver by a porphyrinogenic drug. J Clin Invest 1977; 59:159-64. [PMID: 830660 PMCID: PMC333343 DOI: 10.1172/jci108614] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The hepatic enzymes that catalyze drug oxidations and the reductive metabolism of steroid hormones to 5alpha-derivatives are localized in membranes of the endoplasmic reticulum. Phenobarbital, which exacerbates acute intermittent porphyria in man, induces drug-oxidizing enzymes in liver. Additionally, patients in whome the primary gene defect (uroporphyrinogen-I-synthetase deficiency) of acute intermittent porphyria has become clinically expressed have low levels of hepatic steroid delta4-5alpha-reductase activity. This 5alpha-reductase deficiency in acute intermittent porphyria leads to the disproportionate generation of 5beta-steroid metabolites from precursor hormones; such steroid metabolites have significant porphyria-inducing action experimentally. In this study the effects of phenobarbital on drug oxidation and steroid 5alpha-reduction in man were examined to determine if this drug could produce changes in steroid 5alpha-reductase activity which mimicked those seen in patients with acute intermittent porphyria. Metabolic studies with [14C]-testosterone and 11beta-[3H]hydroxyandrostenedione were carried out in five normal volunteers. In all five subjects phenobarbital administration (2 mg/kg/per day for 21 days) enhanced plasma removal of the test drugs antipyrine and phenylbutazone as expected; but in four subjects phenobarbital also substantially depressed 5alpha-metabolite formation from [14C]testosterone and resulted in a pattern of hormone biotransformation characterized by a high ratio of 5beta/5alpha-metabolite formation. Studies with 11beta-[3H]hydroxy-androstenedione in three subjects confirmed that phenobarbital produced this high 5beta/5alpha ratio of steroid metabolism by depressing 5alpha-reductase activity for steroid hormones in liver. The high ratio of 5beta/5alpha-metabolites formed in normals after drug treatment mimicks the high 5beta/5alpha-steroid metabolite ratio formed from endogenous hormones in acute intermittent porphyria. The proximate mechanism by which phenobarbital induces reciprocal changes in activities of the microsomal enzymes which catalyze drug oxidations and steroid 5alpha-reductions is not known. This action of phenobarbital raises the possibility, however, that certain drugs which provoke exacerbations of human porphyria may do so, in part, by producing deleterious shifts in the patterns of endogenous steroid hormone metabolism.
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Lane SE, Gidari AS, Levere RD. Cytoplasmic receptor protein for etiochalanolone in chick embryo liver. J Biol Chem 1975. [DOI: 10.1016/s0021-9258(19)40836-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Rifkind AB, Sassa S, Merkatz IR, Winchester R, Harber L, Kappas A. Stimulators and inhibitors of hepatic porphyrin formation in human sera. J Clin Invest 1974; 53:1167-77. [PMID: 4856053 PMCID: PMC333103 DOI: 10.1172/jci107655] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Human sera were found to contain factors that stimulate and factors that inhibit porphyrin formation by cultured avian liver cells. The capacity of sera to stimulate or inhibit porphyrin formation varied in different hormonal states and in the porphyrias. Sera from 31 post partum women, eight of whom were not lactating, inhibited porphyrin formation to a mean level 30% below the level in control cultures and also inhibited drug and steroid stimulation of porphyrin formation. In contrast, mean porphyrin formation compared to control cultures was increased between 9 and 21% by sera from 52 normal subjects, 16 women on oral contraceptives, and 11 pregnant women. It was increased 193% by sera from nine subjects with acute intermittent porphyria and 172% by sera from 13 subjects with porphyria cutanea tarda. Heated sera or ethanol extracts of sera from all groups of subjects further increased the mean porphyrin stimulation by sera and, for the post partum subjects, eliminated the inhibitory effect. Ethanol extracts of sera from 28 oral contraceptive-treated women caused significantly greater mean stimulation of porphyrin formation than did extracts of sera from 30 normal women. While sera from 17 out of 22 porphyric subjects contained both stimulatory and inhibitory factors, 5 out of 22 had no evidence of an inhibitory component. There appeared to be heterogeneity in the occurrence of the factors among porphyrics.The factor(s) in sera responsible for porphyrin stimulation were heat-stable and insensitive to trypsin; were present in the supernates after ethanol precipitation of plasma proteins; were extractable in ethyl acetate and nondialyzable; and they migrated with the albumincontaining fraction of serum during electrophoresis. The factor(s) responsible for porphyrin inhibition were heat labile, sensitive to trypsin, and resistant to neuraminidase; were present in the ethanol precipitates of sera and were nondialyzable; and they migrated with the gamma globulin fraction of serum during electrophoresis. Inhibition of porphyrin formation was not attributable to heme, free or bound as hemoglobin, hemopexin, or hemalbumin.
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Weissman EB, Cheng LC, Orten JM. The combined effects of pregnanolone and porphyrinogenic agents on hepatic delta-aminolevulinic acid synthetase in mice. BIOCHEMICAL MEDICINE 1974; 9:334-41. [PMID: 4832201 DOI: 10.1016/0006-2944(74)90068-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Peters HA, Cripps DJ, Reese HH. Porphyria: theories of etiology and treatment. INTERNATIONAL REVIEW OF NEUROBIOLOGY 1974; 16:301-55. [PMID: 4606919 DOI: 10.1016/s0074-7742(08)60199-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Pinelli A, Pozzo G, Formento ML, Favalli L, Coglio G. Effect of vitamin e on urine porphyrin and steroid profiles in porphyria cutanea tarda; report of four cases. Eur J Clin Pharmacol 1972. [DOI: 10.1007/bf00561753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kappas A, Bradlow HL, Gillette PN, Gallagher TF. Studies in porphyria. I. A defect in the reductive transformation of natural steroid hormones in the hereditary liver disease, acute intermittent porphyria. J Exp Med 1972; 136:1043-53. [PMID: 4263649 PMCID: PMC2139305 DOI: 10.1084/jem.136.5.1043] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A variety of 5beta steroid metabolites derived from hormones natural to man are potent inducers experimentally of delta-aminolevulinate synthetase, the rate-limiting enzyme in porphyrin-heme formation. This mitochondrial enzyme is found at high levels of activity in the livers of patients with the genetic disease, acute intermittent porphyria (AIP). In this study the metabolism of (14)C-labeled testosterone was examined in AIP patients to determine whether there was a disproportionate conversion of the hormone to its 5beta, compared to its 5alpha metabolite. The results indicate that AIP subjects do generate a substantially greater than normal fraction of 5beta metabolite from this steroid; the excessive degree of ring A reduction of testosterone taking place via the 5beta pathway in the porphyric patients averages 350% greater than in the nonporphyric subjects. In one asymptomatic AIP patient the disproportionate generation of 5beta metabolite from the hormone reached a level 10 times the normal mean. Studies with a second (14)C-labeled hormone, dehydroisoandrosterone, whose metabolism in man resembles that of testosterone, confirmed the derangement in reductive transformation of steroids found in the individuals carrying the genetic lesion of AIP. These findings define a new endocrine abnormality in AIP patients and raise the possibility that endogenously derived 5beta steroids may contribute by an induction mechanism to the increased levels of hepatic delta-aminolevulinate synthetase activity found in AIP patients.
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Strand LJ, Meyer UA, Felsher BF, Redeker AG, Marver HS. Decreased red cell uroporphyrinogen I synthetase activity in intermittent acute porphyria. J Clin Invest 1972; 51:2530-6. [PMID: 5056653 PMCID: PMC332949 DOI: 10.1172/jci107068] [Citation(s) in RCA: 111] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Intermittent acute porphyria has recently been distinguished biochemically from other genetic hepatic porphyrias by the observation of diminished hepatic uroporphyrinogen I synthetase activity and increased delta-aminolevulinic acid synthetase activity. Since deficient uroporphyrinogen I synthetase may be reflected in nonhepatic tissues, we have assayed this enzyme in red cell hemolysates from nonporphyric subjects and from patients with genetic hepatic porphyria. Only patients with intermittent acute porphyria had decreased erythrocyte uroporphyrinogen I synthetase activity which was approximately 50% of normal. The apparent K(m) of partially purified uroporphyrinogen I synthetase was 6 x 10(-6)m in both nonporphyrics and patients with intermittent acute porphyria. These data provide further evidence for a primary mutation affecting uroporphyrinogen I synthetase in intermittent acute porphyria. Further-more, results of assay of red cell uroporphyrinogen I synthetase activity in a large family with intermittent acute porphyria suggest that this test may be a reliable indicator of the heterozygous state.
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Lyberatos C, Chalevelakis G, Platis A, Gardikas C. Urinary porphyrins and their precursors in human pregnancy and after delivery. THE JOURNAL OF OBSTETRICS AND GYNAECOLOGY OF THE BRITISH COMMONWEALTH 1972; 79:921-3. [PMID: 5085833 DOI: 10.1111/j.1471-0528.1972.tb12189.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Hunter JA, Khan SA, Hope E, Beattie AD, Beveridge GW, Smith AW, Goldberg A. Hereditary coproporphyria. Photosensitivity, jaundice and neuropsychiatric manifestations associated with pregnancy. Br J Dermatol 1971; 84:301-10. [PMID: 5575195 DOI: 10.1111/j.1365-2133.1971.tb14223.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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McIntyre N, Pearson AJ, Allan DJ, Craske S, West GM, Moore MR, Beattie AD, Paxton J, Goldberg A. Hepatic delta-aminolaevulinic acid synthetase in an attack of hereditary coproporphyria and during remission. Lancet 1971; 1:560-4. [PMID: 4100900 DOI: 10.1016/s0140-6736(71)91161-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Pindyck J, Kappas A, Levere RD. Recent advances in porphyrin metabolism. CRC CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 1971; 2:639-57. [PMID: 4944524 DOI: 10.3109/10408367109151320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Adlercreutz H, Tenhunen R. Some aspects of the interaction between natural and synthetic female sex hormones and the liver. Am J Med 1970; 49:630-48. [PMID: 4924590 DOI: 10.1016/s0002-9343(70)80130-9] [Citation(s) in RCA: 145] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Kappas A, Song CS, Sassa S, Levere RD, Granick S. The occurrence of substances in human plasma capable of inducing the enzyme delta-aminolevulinate synthetase in liver cells. Proc Natl Acad Sci U S A 1969; 64:557-64. [PMID: 5261033 PMCID: PMC223380 DOI: 10.1073/pnas.64.2.557] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
We have demonstrated the presence, in the plasma of several patients with acute intermittent porphyria, of a substance which strongly induced the synthesis of porphyrins in chick embryo liver cells growing in primary culture. The induction response evoked by this humoral agent was in all respects similar to that elicited by drugs and hormones which are known to enhance porphyrin production by inducing the de novo formation of delta-aminolevulinate synthetase, the rate-limiting enzyme in this pathway. Inducing properties were not found in the plasma of normal individuals or in that from porphyric patients in remission. Significant inducing activity was, however, found in the plasma of some normal subjects ingesting drugs or contraceptive steroid mixtures. The occurrence of a potent inducer of delta-aminolevulinate synthetase in the plasma of certain porphyric patients may have clinical significance for these genetically susceptible individuals. It will also permit chemical characterization of those humoral agents which may be related to the episodic exacerbations of this hereditary liver disease.
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Bush IE. Determination of estrogens, androgens, progesterone, and related steroids in human plasma and urine. Adv Clin Chem 1969; 12:57-139. [PMID: 5373130 DOI: 10.1016/s0065-2423(08)60258-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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