Dihydropyrimidine dehydrogenase deficiency leading to thymine-uraciluria. An inborn error of pyrimidine metabolism.

Three unrelated patients with excessive thymine-uraciluria due to dihydropyrimidine dehydrogenase deficiency are described. Excretory values (mmol/g creatinine) were: uracil 2.0-10.5, thymine 2.3-7.5, 5-hydroxymethyluracil 0.2-0.9. Orally administered (index patient) uracil and thymine were excreted for the greater part whilst dihydrouracil and S-dihydrothymine were mainly metabolised. Dihydropyrimidine dehydrogenase activities (nmol X h-1 X mg-1 protein) in leucocytes were 0.04, 0.01 and less than 0.01 in the patients, 0.31-1.66 in their parents, and 1.01-4.46 in controls (n = 4). The patients presented with a non-specific clinical picture of cerebral dysfunction.

Deficiency of fumarylacetoacetase in a patient with hereditary tyrosinemia.

A patient is described with type I tyrosinemia characterized by urinary excretion of succinylacetone together with increased excretion of tyrosine, p-hydroxyphenyllactic, p-hydroxyphenylpyruvic and p-hydroxyphenylacetic acids. Fumarylacetoacetase was measured in a liver biopsy and found to be very low compared to control liver. Furthermore the mass spectra of succinylacetone and fumarylacetoacetate (methoxime-TMS derivatives) are reported. Control jejunal mucosa, leucocytes and fibroblasts showed no enzyme activity; hence the prenatal diagnosis of this disease by measuring the fumarylacetoacetase activity in cultured amniotic fluid cells is not possible at present.

Effect of cyclic nucleotides on weight of gastrocnemius and creatine kinase activity after denervation of muscle in young rats.

Denervation of the gastrocnemius muscle at various stages of development reduces muscle weight and creatine kinase activity. An inverse relationship between the muscle-specific enzyme, creatine kinase, and the lysosomal enzyme, acid phosphatase, was shown. An increased percentage of the BB isoenzyme of creatine kinase is observed after long-term denervation. Apparently the muscle tissue has the ability to regenerate and presumptive myoblasts are formed from satellite cells. When the denervated muscle is treated with dibutyryl-cyclic-GMP administration new muscle tissue has been formed. Similar effects could not be demonstrated with either cyclic AMP or succinylcholine. The higher percentage of the BB isoenzyme after dibutyryl-cyclic-GMP administration supports the theory that presumptive myoblasts are derived from satellite cells. Succinylcholine also causes an increase of the B-type of creatine kinase. It can be concluded that cyclic GMP, generated via the nerve, has an important role in maintaining muscle weight.

Quantitative analysis of morphological changes in skeletal muscle of the rat after hormone administration.

Thyroxine and cortisone acetate administration of rats of 4--7 days of age is not only accompanied by the induction of the muscle-specific enzyme, creatine kinase, but the hormones also induce morphological changes in the gastrocnemius during this period. Administration of thyroxine to these rats causes a splitting of myofibrils as shown by stereological measurements on electron micrographs. This splitting of myofibrils was not observed upon cortisone acetate administration and when both hormones were given simultaneously. It is suggested that cortisone acetate counteracts the effect of thyroxine. Both thyroxine and cortisone acetate increase the volume percentage taken by the mitochondria at 7 days of age. The effect of the simultaneous injection of both hormones is equal to the sum of the separate effects of these hormones. These changes in volume percentage of the mitochondria were compared with changes in a mitochondrial marker enzyme, i.e. citrate synthase. The difference between the morphological measurements and citrate synthase activity is due to a change in the specific activity of citrate synthase in the mitochondria.

Effect of hormones on the development of creatine kinase activity in rat skeletal muscle.

Various approaches have been used in order to determine whether or not a certain hormone is a stimulus for the development of the muscle-specific enzyme, creatine kinase. Both thyroxine and glucocorticoids can be considered as naturally occurring stimuli for the synthesis of creatine kinase. The maximum increase of creatine kinase activity after stimulation by glucocorticoids (about 25%) occurs between 5 and 7 days after birth. A single injection of thyroxine has virtually no effect during this period. However, when a pretreatment with thyroxine is given, cortisone acetate administration increases creatine kinase activity to about 155%. The effect of cortisone acetate is due to de novo synthesis of creatine kinase. The augmentation of the effect of cortisone acetate by thyroxine is dependent on DNA synthesis. Thyroxine administration apparently causes the formation of more competent muscle cells. The effects of both hormones are age-dependent. Thyroxine and cortisone acetate administration to fetuses can prematurely evoke to MM isoenzyme of creatine kinase. Both hormones probably play a role in the activation of the M gene during embryonic development. Sex hormones are able to influence neither creatine kinase activity nor muscle growth. However, castration of male rats immediately after birth causes an impairment of growth at older ages. The androgen production by the testes immediately after birth seems to be of main importance for body growth development. It can be concluded from these results that creatine kinase in muscle is under multiple hormonal control, just as is observed for a number of enzymes in other tissues.

The development of creatine kinase in rat skeletal muscle. Changes in isoenzyme ratio, protein, RNA and DNA during development.

The activity of cytosolic creatine kinase in rat skeletal muscle rises stepwise during development. The increases occur simultnaeously with transient increases in DNA content. The second increase is accompanied by a rise in total protein, soluble sarcoplasmic protein and RNA/DNA ratio. Such changes are not observed at 20 days after birth, when creatine kinase finally accumulates to the adult level. Transient higher amounts of the MB and BB isoenzymes are observed after the first and second stepwise increase. The increase in creatine kinase activity observed after birth is predominantly due to an activation of the M gene. The BB isoenzyme is still present in adult skeletal muscle, but contributes little to the total activity.