When the conversion of phenylalanine to tyrosine is blocked, phenylalanine that is not used for protein synthesis accumulates in body fluids or is converted to other metabolites. Although these pathways exist in unaffected individuals, high levels of these by-products are not normally produced. The exact mechanism of mental retardation in untreated PKU is unknown, but phenylalanine probably is the initiator of harm. The fact that PKU is most often accompanied by mental retardation, whereas permanent mild HPA is not, suggests that there is a threshold level of phenylalanine in extracellular fluids above which persistent postnatal or fetal HPA causes irreversible brain damage (2).
PKU and HPA are inherited in an autosomal recessive manner. The active PAH is a tetramer of the protein encoded by the PAH gene. About 500 mutations are known and most PKU patients are compound heterozygotes. This genetic heterogeneity may explain in part the large phenotypic variability encountered in the patient population (3,4).
When the conversion of phenylalanine to tyrosine is blocked, phenylalanine that is not used for protein synthesis accumulates in body fluids or is converted to other metabolites. Although these pathways exist in unaffected individuals, high levels of these by-products are not normally produced. The exact mechanism of mental retardation in untreated PKU is unknown, but phenylalanine probably is the initiator of harm. The fact that PKU is most often accompanied by mental retardation, whereas permanent mild HPA is not, suggests that there is a threshold level of phenylalanine in extracellular fluids above which persistent postnatal or fetal HPA causes irreversible brain damage (2).
PKU and HPA are inherited in an autosomal recessive manner. The active PAH is a tetramer of the protein encoded by the PAH gene. About 500 mutations are known and most PKU patients are compound heterozygotes. This genetic heterogeneity may explain in part the large phenotypic variability encountered in the patient population (3,4).
การแปล กรุณารอสักครู่..
