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Biomedical subjects

E W Naylor

Publications and source records attributed to E W Naylor.

At least 37 records · Page 2Linked to original sources
PubMed1993

Neonatal screening for cystic fibrosis: addition of molecular diagnostics to increase specificity.

Newborn screening for cystic fibrosis (CF) has been carried out on approximately 106,000 neonates in western Pennsylvania since 1987 using the immunoreactive trypsinogen (IRT) assay on dried filter paper blood specimens (DBS). Molecular analysis utilizing a duplicate DBS from the same sample was implemented in November 1989 for newborns having elevated IRT levels. DNA is amplified directly from the DBS and the amplified products are tested for the delta F508 deletion and several common exon 11 mutations. Substituting dUTP for dTTP in the PCR reaction and an initial treatment with uracil N-glycosylase (UNG) virtually eliminates PCR carryover contamination. The number of confirmed cases of CF is 20, giving an estimated incidence of 1:5287 in the western Pennsylvania population. Eight of the CF patients are homozygous and 12 are compound heterozygotes for the delta F508 deletion and a second mutation. Two of the compound heterozygotes carry the G551D mutation and one has the R553X mutation. Twenty-one additional neonates that are heterozygous for the delta F508 mutation are normal carriers for CF. In approximately 55% of the cases, molecular analysis of the CF gene confirmed the diagnosis of CF prior to sweat testing. The incorporation of molecular analysis into our CF screening program increases the specificity of the screening strategy and has the potential to decrease the false positive and sweat test referral rate, reduce parental anxiety, and bring CF infants to the attention of physicians more rapidly.

Cystic Fibrosis↗
PubMed1993

Mutation in the 4a-carbinolamine dehydratase gene leads to mild hyperphenylalaninemia with defective cofactor metabolism.

Hyperphenylalaninemias represent a major class of inherited metabolic disorders. They are most often caused by mutations in the phenylalanine hydroxylase gene and, less frequently but with usually more serious consequences, in genes necessary for the synthesis and regeneration of the cofactor, tetrahydrobiopterin. This cofactor is absolutely required for all aromatic amino acid hydroxylations, and, recently, nitric oxide production from L-arginine has also been found to be dependent on tetrahydrobiopterin. Phenylalanine hydroxylase catalyzes a coupled reaction in which phenylalanine is converted to tyrosine and in which tetrahydrobiopterin is converted to the unstable carbinolamine, 4a-hydroxytetrahydrobiopterin. The enzyme, carbinolamine dehydratase, catalyzes the dehydration of the carbinolamine to quinonoid dihydropterin. A decreased rate of dehydration of this compound has been hypothesized to be responsible for the production of 7-biopterin found in certain mildly hyperphenylalaninemic individuals. We have now identified nonsense and missense mutations in the 4a-carbinolamine dehydratase gene in a hyperphenylalaninemic child who excretes large amounts of 7-biopterin. This finding is consistent with the role of the carbinolamine dehydratase in the phenylalanine hydroxylation reaction. Together with previously identified inherited disorders in phenylalanine hydroxylase and dihydropteridine reductase, there are now identified mutations in the three enzymes involved in the phenylalanine hydroxylation system. In addition, the genetics of this system may have broader implications, since the product of the dehydratase gene has previously been shown to play an additional role (as dimerization cofactor for hepatocyte nuclear factor-1 alpha) in the regulation of transcription, through interaction with hepatocyte nuclear factor-1 alpha.

Amino Acid Metabolism, Inborn Errors↗
PubMed1989

Repetitive recycling of guanosine triphosphate cyclohydrolase I for synthesis of dihydroneopterin triphosphate.

A procedure for enzymatic production of dihydroneopterin triphosphate is described that allows GTP cyclohydrolase I to be reused repetitively. The reaction takes place in an ultrafiltration cell, and the product is collected in the filtrate, whereas the enzyme remains in the cell to be reused with additional substrate. This is repeated until the enzyme activity drops below a desirable level. The purity of the dihydroneopterin triphosphate is satisfactory for utilization of this compound for studies on enzymes involved in the synthesis of tetrahydrobiopterin and drosopterin. A procedure for purification of dihydroneopterin triphosphate is described that uses C18-silica and silica cartridges.

Aminohydrolases↗
PubMed1988

Sepiapterin reductase in human amniotic and skin fibroblasts, chorionic villi, and various blood fractions.

Sepiapterin reductase activity has been measured in amniotic fibroblasts by two procedures: one photometric and the other HPLC-fluorimetric. Both can be used for quantitative measurements, but the latter has considerable advantages including smaller standard deviation, much lower detection limit, and less volume of sample required. Sepiapterin reductase activity was also assayed in skin fibroblasts, chorionic villi and various blood fractions including stimulated mononuclear blood cells. Red blood cells have a low specific activity compared to unstimulated mononuclear blood cells, although the latter have a mean value with a high standard deviation. When the mononuclear blood cells were cultured for 5 days, the mean specific activity increased and the range became tighter. Enzyme stability and N-acetylserotonin inhibition were also studied.

Alcohol Oxidoreductases↗
PubMed1987

Sepiapterin reductase in cultured human cells.

Sepiapterin reductase, an enzyme involved in the synthesis of tetrahydrobiopterin (the natural cofactor for phenylalanine, tyrosine and tryptophan hydroxylases), has been assayed in cultured human amniotic fibroblasts and in cultured mononuclear blood cells. In both cases, the Michaelis constants for sepiapterin and NADPH were essentially equal; 20 microM and 6 microM respectively for stimulated mononuclear blood cells and 22 microM and 5 microM respectively for amniotic fibroblasts. The inhibition by N-acetylserotonin was also similar in both cases. The concentration that produced 50% inhibition in stimulated mononuclear blood cells and in amniotic fibroblasts was 2 microM. The results strongly suggest that the same enzyme is acting in both types of cells, at least when grown in culture.

Alcohol Oxidoreductases↗
PubMed1987

Plasma phenylethylamine and phenylalanine in chronic schizophrenic patients.

The hypothesis that phenylethylamine (PEA) is an endogenous psychotogen in schizophrenics, particularly those with the paranoid subtype, has been previously studied by measuring PEA levels in urine and cerebrospinal fluid (CSF) of schizophrenic patients. However, plasma PEA may more accurately reflect simultaneous alterations of PEA in many organ systems, as might occur in a genetic disorder of PEA metabolism. No study to date has examined phenylalanine (Phe), which is thought to be a precursor of PEA, in the same patients who had PEA measured. In this study, we measure both plasma PEA and Phe in 17 drug-free schizophrenic patients and 17 matched controls. Plasma PEA in normal controls was found to be lower by three orders of magnitude compared to normal controls from previous studies--a finding that has not previously been reported. PEA was significantly lower in those schizophrenic patients who had a Research Diagnostic Criteria diagnosis of paranoid schizophrenia. PEA did not differ between patients and controls, and the correlation between plasma Phe and PEA was not significant.

Adult↗
PubMed1987

Guanosine triphosphate cyclohydrolase I deficiency: early diagnosis by routine urine pteridine screening.

A deficiency of hepatic guanosine triphosphate cyclohydrolase I is reported in a 4-month-old infant in whom positive results on a Guthrie phenylketonuria test in the neonatal period were found. Because of the significantly elevated serum phenylalanine levels a diagnosis of classical phenylketonuria was made, and dietary therapy was started. Urinary pteridine screening for cofactor variants, however, revealed extremely low levels of both neopterin and biopterin. This suggested the possibility of guanosine triphosphate cyclohydrolase I deficiency and led to additional confirmatory assays. Repeat urine, serum, and CSF pteridine profiles, combined with tetrahydrobiopterin-loading studies and the assay of guanosine triphosphate cyclohydrolase I activity in a liver biopsy, confirmed the defect. It is significant to note that the diagnosis was made before the onset of major clinical symptoms. This case illustrates the need for routine cofactor variant screening of all infants in whom hyperphenylalaninemia is diagnosed in the neonatal period.

Aminohydrolases↗
PubMed1985

Dihydropteridine reductase in schizophrenic patients.

The activity of the enzyme dihydropteridine reductase (DHPR) has been recently found to be one of the factors controlling the rate of synthesis of dopamine, norepinephrine, and serotonin, thought to be involved in the etiology of schizophrenia. Several lines of evidence suggest that peripheral and brain DHPR enzymes may be identical. In addition, peripheral DHPR activity has been hypothesized to be important in determining the level of phenylethylamine, a putative psychotogen that is produced peripherally and crosses the blood-brain barrier. Since DHPR activity has never been investigated in schizophrenic patients, we measured the whole blood activity in 20 schizophrenic patients and 20 matched controls. There was no difference between the groups in DHPR activity.

Adult↗
PubMed1985

Simplified procedure for producing Bacillus subtilis spores for the Guthrie phenylketonuria and other microbiological screening tests.

Bacillus subtilis ATCC 6051 and ATCC 6633 spores used in bacterial inhibition screening assays for genetic metabolism defects in newborn infants were produced by using liquid synthetic replacement sporulation media. These media allowed a high degree of sporulation, as judged by direct cell counts. Sporulation took place within 23 to 27 h with these media. Also, a more rational procedure for selecting the most sensitive clones of these organisms to the various inhibitors used in the microbiological screening assays is presented.

Bacillus subtilis↗
PubMed1984

A rapid screening test for Duchenne muscular dystrophy using dried blood specimens.

A very simple fluorescent spot screening test for the detection of elevated creatine kinase activity in dried blood specimens is described. The assay uses reagents commercially available in kit form and modifies the procedure for use with whole blood spotted on filter paper. Additional amounts of diadenosine pentaphosphate had to be added to the reaction mixture to inhibit the excess adenylate kinase present in erythrocytes. The sensitivity and reliability of the test is demonstrated. This qualitative assay has the potential for use as a mass neonatal screening test for Duchenne muscular dystrophy.

Clinical Enzyme Tests↗
PubMed1982

Neonatal urine screening for metabolic disease with auxotrophic strains of Bacillus subtilis.

A simplified method for neonatal urine screening for metabolic diseases is described. This procedure involves the use of two bacterial inhibition assays which can detect uracil, lysine, and homocystine, in combination with two other assays utilizing spores of amino acid auxotrophic mutants of Bacillus subtilis which can detect several amino acids and purines. These four tests have the capability to detect several treatable inherited metabolic diseases, including three disorders of the urea cycle, using a urine specimen on filter paper. This method results in savings of cost and time over chromatographic screening procedures, since only four agar trays (56 specimens per tray) are used, which can be processed with one cycle through a semi-automated punch index machine.

Bacillus subtilis↗
PubMed1982

Screening test for alpha 1-antitrypsin in dried-blood specimens.

We describe a fluorescent spot test for detecting alpha 1-antitrypsin activity in dried-blood specimens. The eluate of a blood disc is mixed with carbobenzoxy-L-arginine-7-amino-4-methylcoumarin amide and trypsin at the appropriate pH. In the absence of alpha 1-antitrypsin, aminomethylcoumarin, a strongly fluorescent compound, is released. The reaction mixture, when spotted on chromatography paper and viewed under ultraviolet light, exhibits a bright fluorescence only in the case of specimens with alpha 1-antitrypsin deficiency. alpha 1-Antitrypsin activity so estimated correlated well with quantitative assays of dried-blood spots and serum. The procedure is simple and inexpensive, and has the potential for use as a screening test.

Adult↗
PubMed1982

A neonatal screening test for argininosuccinic acid lyase deficiency and other urea cycle disorders.

A simple enzyme-multiple auxotroph assay has been developed for the identification of newborn infants with several of the inherited metabolic defects in the Krebs cycle for the detoxification of ammonia and in the ornithine metabolic pathway. This mass screening test is used with dried filter paper blood specimens and can easily be added to existing multiple testing programs presently used in screening for phenylketonuria or congenital hypothyroidism. This assay can be used to detect patients with citrullinemia, argininosuccinic acid lyase deficiency, and argininemia. In addition to these urea cycle disorders, the several types of ornithinemia, which can result in gyrate atrophy of the retina or mental retardation, should be detectable with this assay. The strengths and weaknesses of this assay are discussed and a large-scale pilot screening trial is proposed.

Amino Acid Metabolism, Inborn Errors↗