Inosine 5 -phosphate pyrophosphorylase

The reverse phenomenon, decreased enzyme synthesis, can also be the mechanism of drug resistance. The antimetabolite pro-drug 6-mercaptopurine (6MP) is activated to its nucleotide by inosine-5 -phosphate pyrophosphorylase. The enzyme is deleted in resistant neoplastic cells. Resistance to 5-fluorouracil similarly develops by deletion of the enzyme converting this pro-drug to its active nucleotide. A mechanism of resistance by which a drug is excluded from its site of action can also be operative. This has been established for tetracycline antibiotics. Here the permeability of the cellular membrane to the drug is altered so that it cannot penetrate and accumulate within the target cell. Similarly, it has been demonstrated with such a membrane modification in MTX-resistant leukemia cells in mice. 

Human neoplasm cells in culture show a different type of resistance to 6-mercaptopurine from that cited above, in that they delete the enzyme responsible for converting this pro-drug to the therapeutic nucleotide (6-thioinosine 5 -phosphate) (Brockman, 1963). The deleted enzyme is inosine 5 -phosphate pyrophosphorylase. Similarly, resistance to 8-azaguanine is accompanied by loss of the enzyme guanosine 5 -phosphate pyrophosphorylase in human epidermoid carcinoma cells (Brockman et al., 1961). Resistance to 5-fluoro-uracil also depends on the uneconomic cell s ceasing to convert this pro-drug to the nucleotide. 

This enzyme [EC 2.7.7.28], also known as NDP-hexose pyrophosphorylase, catalyzes the reaction of a nucleoside triphosphate with a hexose 1-phosphate to produce a NDP-hexose and pyrophosphate (or, diphosphate). In the reverse reaction the NDP-hexose can be, in decreasing order of activity, guanosine, inosine, and adenosine diphosphate hexoses in which the sugar is either glucose or mannose. 

It was not until 1953 that Goldwasser (9) and Williams and Buchanan (10) showed that purine bases could be converted to ribonucleotides by a one-step process, without the intermediate formation of ribonucleosides. The source of the ribose phosphate moiety was discovered in 1955 to be PP-ribose-P in the course of studies of adenylate synthesis by Kornberg et al. 11), and of inosinate synthesis by Korn et al. 12) extracts of yeast, beef liver, and pigeon liver were employed. The enzymes involved were at first called nucleotide pyrophosphorylases, but are now known as purine phosphoribosyltransferases. The general reaction is... 

Amino-4-imidazole carboxamide ribotide, a precursor only two steps removed (formylation and cycli-zation) from inosinic acid, can be synthesized by the direct condensation of the imidazole with 5-phosphori-bosyl pyrophosphate. The enzyme catalyzing this reaction was purified from an acetone powder of beef liver. The same enzyme (AMP pyrophosphorylase) catalyzes the condensation of adenine, guanine, and hypoxan-thine. Nucleoside phosphorylase is an enzyme that catalyzes the formation of a ribose nucleoside from a purine base and ribose-1-phosphate. Guanine, adenine, xanthine, hypoxanthine, 2,6-diaminopurine, and aminoimidazole carboxamide are known to be converted to their respective nucleosides by such a mechanism. In the presence of a specific kinase and ATP, the nucleoside is then phosphorylated to the corresponding nucleotide. 

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