Dihydrobiopterin reductase, defect

The same pool of tetrahydrobiopterin and the same dihydrobiopterin reductase are involved in the central nervous system in the hydroxylation of all three aromatic amino acids. Classical phenylketonuria, which involves a defect... 

FIGURE 40-2 The phenylalanine hydroxylase (PAH) pathway. Phenylketonuria usually is caused by a congenital deficiency of PAH (reaction 1), but it also can result from defects in the metabolism of biopterin, which is a cofactor for the hydroxylase. Enzymes (1) Phenylalanine hydroxylase (2) Dihydropteridine reductase (3) GTP cyclohydrolase (4) 6-pyruvoyltetrahydrobiopterin synthase. BH4, tetrahydrobiopterin DEDT, o-erythro-dihydroneopterin triphosphate QH2, dihydrobiopterin. 

Rarely, phenylketonuria results from a defect in the metabolism of biopterin, a cofactor for the phenylalanine hydroxylase pathway. The electron donor for phenylalanine hydroxylase is tetrahydrobiopterin (BH4), which transfers electrons to molecular oxygen to form tyrosine and dihydrobiopterin (QH2 Fig. 40-2 reaction 2). BH4 is regenerated from QH2 in an NADH-dependent reaction that is catalyzed by dihydropteridine reductase (DHPR), which is widely distributed. In the brain, this... 

The provision of reducing equivalents to phenylalanine hydroxylase is dependent on reduction of dihydrobiopterin by NADH catalyzed by the enzyme dihydropteridine reductase, as shown in Figure 38-2. This reduction is dependent on the availability of biopterin and therefore on the biopterin synthetic pathway. Thus any genetic or protein folding defect in either dihydropteridine reductase or the biopterin biosynthetic enzymes would compromise the efficacy of phenylalanine hydroxylation to tyrosine resulting in hyperphenylalaninemia and also phenylketonuria resulting from inaease transamination of phenylalanine to phenylpyruvate. 

The de novo biosynthesis of the BH4 cofactor is carried out by three classical enzymes as described below. In addition, a hypothetical alternative way to circumvent the last enzymatic step by involving other reductases is presented (from 41 to 45 in Figure 11). Part of this alternative pathway is also called salvage pathway, which feeds BH4 from dihydrobiopterin through the NADPH-dependent dihydrofolate reductase. As will be discussed later, this alternative pathway seems to compensate for a genetic defect in the last biosynthetic step at least in peripheral tissues. 

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