PURPOSE: To investigate the effects of dexamethasone (DEX) on the production of nitric oxide (NO) and its enzymatic synthetic pathway in cultured human trabecular meshwork (HTM) cells. METHODS: Primarily cultured HTM cells were exposed to 0, 10, 100, 1000 nM of DEX for 3 days. In addition, 100 micrometer sepiapterin, 100 micrometer ascorbic acid, and 10 micrometer methotrexate were co-exposed to DEX. The cellular survival and nitrite production rates were assessed by MTT assay and Griess assay, respectively. RESULTS: DEX did not significantly affect the survival of cultured HTM cells. DEX decreased the NO production in a dose-dependent manner. With co-exposure of DEX, ascorbic acid nullified the DEX-induced decrease of NO production. Sepiapterin and methotrexate did not affect DEX-induced decrease of NO production. CONCLUSIONS: DEX decreased NO production in HTM cells and the de novo pathway of tetrahydrobiopterin may be involved. This decrease may raise intraocular pressure by decreasing trabecular outflow.
Ascorbic Acid ; Biopterin ; Dexamethasone ; Humans ; Intraocular Pressure ; Methotrexate ; Nitric Oxide ; Pterins ; Trabecular Meshwork

PURPOSE: To investigate the effects of dexamethasone (DEX) on the production of nitric oxide (NO) and its enzymatic synthetic pathway in cultured human trabecular meshwork (HTM) cells. METHODS: Primarily cultured HTM cells were exposed to 0, 10, 100, 1000 nM of DEX for 3 days. In addition, 100 micrometer sepiapterin, 100 micrometer ascorbic acid, and 10 micrometer methotrexate were co-exposed to DEX. The cellular survival and nitrite production rates were assessed by MTT assay and Griess assay, respectively. RESULTS: DEX did not significantly affect the survival of cultured HTM cells. DEX decreased the NO production in a dose-dependent manner. With co-exposure of DEX, ascorbic acid nullified the DEX-induced decrease of NO production. Sepiapterin and methotrexate did not affect DEX-induced decrease of NO production. CONCLUSIONS: DEX decreased NO production in HTM cells and the de novo pathway of tetrahydrobiopterin may be involved. This decrease may raise intraocular pressure by decreasing trabecular outflow.
Ascorbic Acid ; Biopterin ; Dexamethasone ; Humans ; Intraocular Pressure ; Methotrexate ; Nitric Oxide ; Pterins ; Trabecular Meshwork

PURPOSE: To investigate the effect of high glucose (HG) on the oxidative stress in cultured human trabecular meshwork cells (HTMC). METHODS: Primarily cultured HTMC were exposed to low glucose (5 mM) and HG (25 mM) for 7 days. Additionally, 1 mM L-arginine, 5 mM DAHP, 10 microgram/ml insulin, 100 micrometer L-ascorbic acid, 10, and 100 micrometer sepiapterin were co-exposed. The cellular survival and nitric oxide (NO) production were assessed by MTT assay and Griess assay, respectively. Superoxide production was measured by modified cytochrome c assay. RESULTS: HG did not affect the survival of cultured HTMC significantly. HG decreased NO production. Co-exposed DAHP decreased but DAHP and insulin increased NO production. In addition, HG increased superoxide production, which was decreased by insulin, L-ascorbic acid, and sepiapterin. CONCLUSIONS: HG decreased NO production accompanied with increased superoxide production in HTMC. Thus HG induces oxidative stress in HTMC and may cause cellular dysfunction and damage of the trabecular meshwork.
Arginine ; Ascorbic Acid ; Cytochromes c ; Glucose ; Humans ; Insulin ; Nitric Oxide ; Oxidative Stress ; Pterins ; Sugar Acids ; Superoxides ; Trabecular Meshwork

INTRODUCTION: Phenylketonuria (PKU), an autosomal recessive metabolic disorder caused by phenylalanine hydroxylase (PAH) deficiency, leads to hyperphenylalaninemia and neurological damage if untreated. This is the first study in the Philippines to identify the disease-causing mutations in the PAH gene of clinically diagnosed Filipino PKU patients.

METHODS: The study included four unrelated PKU patients detected by the Philippine Newborn Screening Program from 1996 to 2008. Plasma amino acid analyses for all patients showed increased phenylalanine and low to normal tyrosine levels consistent with the diagnosis of PKU. Mutations in the PAH gene were identified by genomic DNA extraction from dried blood spots of the patients, PAH exon amplification by polymerase chain reaction and subsequent bi-directional DNA sequence analysis.

RESULTS: All patients presented with significantly elevated phenylalanine levels on bacterial inhibition assay and thin layer chromatography. Urinary pterins confirmed the diagnosis of Tetrahydrobiopterin deficiency in two patients while the other 2 patients had the Classical PKU phenotype. Four previously identified mutations in the PAH gene (p.I65T, p.R413P, p.EX6-96A>G, p.R243Q) were identified in those with Classical PKU.

CONCLUSION: The present results confirm the heterogeneity of mutations at the PAH locus in Filipinos. Neonatal screening and the use of molecular diagnosis significantly aid in the medical management and genetic counseling of patients and their families.

Phenylalanine Hydroxylase ; Phenylalanine ; Neonatal Screening ; Genetic Counseling ; Tyrosine ; Pterins ; Chromatography, Thin Layer ; Philippines ; Phenylketonurias ; Exons ; Sequence Analysis, Dna ; Phenotype ; Dna

Tetrahydrobiopterin(BH4) deficiency is a rare type of hyperphenylalaninemia and usually leads to a progressive neurologic deterioration despite early dietary control of blood phenylalanine concentration. We experienced two cases of BH4 deficiency in brother and sister, confirmed by biochemical study of blood and urine. They had suffered from a progressive neurologic illness such as mental retardation, severe hypotonia, seizure, and athetotic movements started at 3 months of their age. Blood amino-acid analysis showed mild hyperphenylalaninemia with elevated urinary neopterin, and reduced urinary biopterin. Their neurologic deteriorations were dramatically improved after replacement of BH4 and dopamine agonist.
Biopterin ; Dopamine Agonists ; Humans ; Intellectual Disability ; Muscle Hypotonia ; Neopterin ; Phenylalanine ; Phenylketonurias* ; Seizures ; Siblings

Hyperphenylalaninemia can result from defects in either the phenylalanine hydroxylase (PAH) enzyme or in the synthesis or recycling of the active pterin, tetrahydrobiopterin (BH4), which is an obligate co-factor for the PAH enzyme, as well as tyrosine hydroxylase and tryptophan hydroxylase. One of the most common causes of BH4 deficiency is a defect in the synthesis of 6-pyruvoyltetrahydropterin synthase (PTPS) enzyme. Patients present with progressive neurological disease such as mental retardation, convulsions and disturbance of tone and posture despite strict adherence to diet and good metabolic control. The authors report the first two cases of PTPS deficiency in the Philippines. Both are females with initial phenylalanine levels of more than 1300 umol/L who continued to develop neurologic deterioration despite good metabolic control and strict adherence to diet. Further investigation showed that they both had PTPS deficiency. Treatment was started with BH4, L-dopa/carbidopa, and 5-hydroxytryptophan (5HT) with concomitant significant improvements in their neurologic and developmental outcomes.

Human ; Female ; Child Preschool ; Infant ; Phenylalanine Hydroxylase ; Carbidopa ; Tyrosine 3-monooxygenase ; 5-hydroxytryptophan ; Tryptophan Hydroxylase ; Levodopa ; Sapropterin ; Intellectual Disability ; Philippines ; Phenylketonurias ; Pterins ; Seizures ; Diet ; Posture

OBJECTIVETo determine the gene mutation spectrum of patients with 6-pyruvoyltetrahydrobiopterin synthesis deficiency (PTPSD) in Mainland China.

METHODSThe 6-pyruvoyltetrahydrobiopterin synthesis gene lz(PTS)lz was analyzed in 55 PTPSD patients by using PCR-restriction fragment length polymorphism (PCR-RFLP) and direct DNA sequencing. The relationship between the genotype and phenotype was analyzed.

RESULTSEighteen mutations were identified and the detection rate of gene mutation was 95.28%. Four hot-spot mutations, namely P87S (40.57%), N52S(13.21%), D96N(12.26%) and IVS1nt-291A to G(10.38%) were found in this study, and the first three were associated with severe phenotype. The P87L was reported firstly in Chinese patients, and the Q13X, M80T, IVS4nt-2A to G, L93M and K131N were novel mutations.

CONCLUSIONThe P87S, N52S, D96N and IVS1nt-291A to G mutations are the hot-spots mutations of the PTS gene in Chinese PTPSD patients. Using PCR-RFLP technique to screen the mutations in the PTS gene can increase the efficiency of gene diagnosis.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; DNA Mutational Analysis ; Female ; Genotype ; Humans ; Male ; Metabolic Diseases ; genetics ; Mutation ; Pedigree ; Phenylalanine Hydroxylase ; genetics ; metabolism ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Pregnancy ; Pterins ; metabolism ; Steroid 21-Hydroxylase ; genetics ; metabolism

BACKGROUND: Methotrexate (MTX) is an antifolate antagonist that is widely used for treating various malignancies and non-malignant diseases. MTX levels should be monitored when used in high concentration to determine when to start leucovorin rescue. In this study, we evaluated the analytical performance of the EMIT Methotrexate Assay on a 200FR NEO Chemistry Analyzer (Toshiba Medical System Co., Japan) and compared it with Viva-E Drug Testing System (Siemens Healthcare, Germany). METHODS: According to the Clinical Laboratory and Standards Institute (CLSI) Evaluation Protocol (EP) 5-A2, three concentrations of the Liquichek Therapeutic Drug Monitoring Control (Bio-Rad Laboratories, USA) were analyzed twice a day for 20 days to monitor assay precision. The 200FR NEO and Viva-E instruments were compared using 40 patients' sera, according to CLSI EP9-A2. The linearity and carry-over rate were also evaluated. RESULTS: Between-run CVs for low-, medium-, and high-level controls were 4.9%, 0.9%, and 2.0%, respectively, whereas between-day CVs for low-, medium-, and high-level controls were 8.1%, 1.3%, and 3.5%, respectively. In the linearity test, the coefficient of determination (R2) was 0.98 (0.06-1.92 micromol/L). In the comparison study, R2 was 0.955, showing good correlation between the 200FR NEO and Viva-E instruments. The carry-over rate was 0.9%. CONCLUSIONS: The EMIT assay showed good precision, linearity, and carry-over rate on the Toshiba 200FR. An excellent correlation was observed when comparing results obtained using the Toshiba and Viva-E instruments. In conclusion, the Syva EMIT MTX assay can be readily used for MTX monitoring on the Toshiba 200FR NEO.
Chemistry ; Delivery of Health Care ; Drug Monitoring ; Leucovorin ; Methotrexate*

High-dose methotrexate (MTX) chemotherapy extends the duration of hospitalization and introduces the risks of serious complications related to delayed MTX excretion. The treatment of delayed MTX excretion is largely dependent on invasive measures such as hemodialysis because the clinical data regarding the efficacy or safety of carboxypetidase G2 is limited. We report here on the cases of two pediatric osteosarcoma patients with delayed MTX excretion and who were successfully managed using supportive measures. Potential life-threatening complications were prevented by administering high doses of leucovorin.
Child ; Hospitalization ; Humans ; Leucovorin ; Methotrexate ; Osteosarcoma ; Renal Dialysis

No abstract available.
Methotrexate*