Hydroxykynurenine accumulation, vitamin

Kynureninase (Figure 11.16) is a pyridoxal phosphate-dependent enzyme, and its activity falls markedly in vitamin deficiency, at least partly because it undergoes a slow mechanism-dependent inactivation that leaves catalytically inactive pyridoxamine phosphate at the active site of the enzyme. The enzyme can only be reactivated if there is an adequate supply of pyridoxal phosphate. This means that in vitamin deficiency there is a considerable accumulation of both hydroxykynurenine and kynurenine, sufficient to permit greater metabolic flux than usual through kynurenine transaminase, resulting in increased formation of kynurenic and xanthurenic acids. 

Inhibition of kynureninase (e.g., by estrogen metabolites) also results in accumulation of kynurenine and hydroxykynurenine, and hence increased formation of kynurenic and xanthurenic acids, again giving results which falsely suggest vitamin Bg deficiency. This has been widely, but incorrectly, interpreted as estrogen-induced vitamin Bg deficiency it is in fact simple competitive inhibition of the enzyme that is the basis of the tryptophan load test by estrogen metabolites. 

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