Search PubMed⌕ Search

Biomedical subjects

I H Fox

Publications and source records attributed to I H Fox.

At least 127 records · Page 7Linked to original sources

Arthropathy as the major clinical indicator of occult iron storage disease.

Chronic arthritis was the only symptom that led to the detection of increased iron stores in four patients. In these persons, the serum iron was ordered at the time of initial examination, and ranged from 212 to 237 microgram/dl with a transferrin saturation of 83% to 100%. Liver biopsy specimens showed hepatocyte iron deposition in each person, with definite cirrhosis in only one patient. These cases illustrate that a chronic arthropathy may be the first clinical manifestation of iron overload, and can lead to discovery of the disease in patients and their family members. Treatment may then be initiated before extensive tissue damage has occurred.

Adult↗

Purine nucleoside phosphorylase deficiency: altered kinetic properties of a mutant enzyme.

Erythrocyte purine nucleoside phosphorylase from two brothers had 0.5% of normal activity. It differed from the normal enzyme by a tenfold increase in the Michaelis constant for inosine, an inability of inosine to protect against thermal lability, and a more positive net charge. The altered kinetic properties may account for the milder disease in the patients compared to the previously described cases. The data provide evidence for a structural gene mutation and genetic heterogeneity in the new disease of purine nucleoside phosphorylase deficiency and T cell dysfunction.

Child↗

Electrophoretic variation in the partial deficiency of hypoxanthine-guanine phosphoribosyltransferase.

Mutant hypoxanthine-guanine phosphoribosyltransferase from four patients with a partial deficiency of this enzyme has been studied by isoelectric focusing. The isoenzymes found in these hemolysates were different from the normal isoenzymes and were different from each other. These observations suggest that electrophoretic variation is a common occurrence in this disorder and they support the existence of structural gene mutations with genetic heterogeneity in this X-linked hyperuricemia.

Blood Protein Electrophoresis↗

Inhibition of phosphoribosylpyrophosphate synthesis by purine nucleosides in human erythrocytes.

The effects of purine nucleosides on 5-phosphoribosylpyrophosphate (PP-ribose-P) synthesis were investigated in human erythrocytes in vitro. Previous observations have shown an increase of PP-ribose-P formation with nucleoside when inorganic phosphate (Pi) exceeded 20 mM. In contrast, when external Pi varied from 0 to 25 mM adenosine, inosine, guanosine, or 6-methylmercaptopurine riboside 1.25 mM decreased intracellular PP-ribose-P. The mechanism of this nucleoside effect on P-ribose-P concentration was investigated. Decreased synthesis rather than increased utilization accounted for the nucleoside effect. A decrease of erythrocyte Pi from the control values of 0.5 to 2.4 mM accompanied the nucleoside-related diminution of PP-ribose-P synthesis. This reduction of Pi was capable of decreasing the activity of PP-ribose-P synthetase which is known to be sensitive to small changes of Pi. The decrease of erythrocyte Pi levels was caused both by those nucleosides which were eventually degraded via purine nucleoside phosphorylase (adenosine, inosine, and guanosine) and by those nucleosides which were substantially phosphorylated initially by adenosine kinase (methylmercaptopurine riboside and adenosine with erythro-9(2-hydroxyl-3-nonyl)-adenine). Twenty-five per cent of methylmercaptopurine riboside was converted to the monophosphate derivative during the incubation. The presence of this compound, capable of inhibiting PP-ribose-P synthetase, provided evidence for a second mechanism of inhibition of PP-ribose-P synthesis by methylmercaptopurine riboside. No substantial increase of AMP, ADP, 2,3-diphosphoglycerate, or cyclic AMP nor a decrease of ribose 5-phosphate was found. These observations suggest that under physiological Pi concentrations nucleosides diminish PP-ribose-P synthesis mainly by decreasing intracellular Pi. Regulation of PP-ribose-P formation by alterations of intracellular Pi levels may be an important control mechanism and may account for a number of biological effects of nucleosides.

Erythrocytes↗

Renal excretion of uric acid during prolonged fasting.

Serum and urine uric acid were evaluated during prolonged therapeutic fasting in 15 obese patients. With increasing ketonemia the serum uric acid rose from a control value of 5.9 +/- 0.4 to 12.5 +/- 1.0 mg/100 ml at 7 days and then decreased progressively to 7.7 +/- 1.3 mg/100 ml by 28 days despite sustained ketonemia. The uric acid clearance were 5.5 +/- 0.9, 1.8 +/- 0.2, and 4.4 +/- 1.5 ml/min at days 0, 7, and 25 of fasting. At the same times the creatinine clearances were 114 +/- 11, 80 +/- 6, and 64 +/- 6.3 ml/min. There was no evidence of a renal tubular abnormality as assessed by glycosuria, bicarbonaturia, or increased phosphaturia. Urate binding to plasma proteins remained unchanged. Acute studies of the renal handling of uric acid revealed a uricosuric response to the administration of sodium lactate or sodium bicarbonate by intravenous infusion and low-dose acetylsalicylic acid orally. This renal tubular response departs significantly from that observed during the overnight fasted state and could not be accounted for by extracellular fluid volume expansion or the induced acid-base changes.

Adolescent↗

Acquired increases of human erythrocyte purine enzymes.

The alterations of three erythrocyte purine enzymes were studied in 12 patients with diseases associated with reticulocytosis, two patients with a partial deficiency of hypoxanthine-guanine phosphoribosyltransferase, seven patients with severe megaloblastic anemia, and 14 normal subjects. The specific activity of adenine phosphoribosyltransferase was positively correlated (r = 0.81) with the reticulocyte percentate in ten patients with a normal hypoxanthine-guanine phosphoribosyltransferase. Two apparent types of alterations of this enzyme were distinguished: (1) increased specific activity with a normal half life as in megaloblastic anemia, and (2) a prolonged half life with or without an elevation of specific activity as in the deficiency of hypoxanthine-guanine phosphoribosyltransferase. Hypoxanthine-guanine phosphoribosyltransferase and phosphoribosylpyrophosphate synthetase were increased in megaloblastic anemia, but were not correlated with the reticulocyte percentage and did not have a consistent change in the half life in the other disorders studied. The data show that acquired disorders associated with reticulocytosis may cause an elevation of the specific activity of purine enzymes in peripheral circulating erythrocytes. Therefore, these factors must be carefully considered in the interpretation of an elevated level of enzyme activity.

Adenine Phosphoribosyltransferase↗