Clinical Biochemistry Department, Metabolic Vascular Unit, IdiPaz, La Paz University Hospital, Madrid, Spain.
J Inherit Metab Dis. 2012 Nov;35(6):1129-35. doi: 10.1007/s10545-012-9470-5. Epub 2012 Mar 9.
Lesch-Nyhan disease (LND) is caused by complete deficiency of the hypoxanthine-guanine phosphoribosyltransferase enzyme. It is characterized by overproduction of uric acid, jointly with severe motor disability and self-injurious behaviour which physiopathology is unknown. These neurological manifestations suggest a dysfunction in the basal ganglia, and three neurotransmitters have been implicated in the pathogenesis of the disease: dopamine, adenosine and serotonin. All of them are implicated in motor function and behaviour, and act by binding to specific G-protein coupled receptors in the synaptic membrane where they seem to be integrated through receptor-receptor interactions. In this work we have confirmed at protein level the previously reported increased expression of DRD5 and the variably aberrant expression of ADORA2A, in LND PBL respect to control PBL. We have also described, for the first time, a decreased expression and protein level of 5-HTR1A in LND PBL respect to control PBL. If these results were confirmed in the Lesch-Nyhan patients basal ganglia cells, this would support the hypothesis that pathogenesis of neurological manifestations of Lesch-Nyhan patients may be related to an imbalance of neurotransmitters, rather than to the isolated disturbance of one of the neurotransmitters, and this fact should be taken into account in the design of pharmacologic treatment for their motor and behavioural disturbances.
莱施-尼汉病(Lesch-Nyhan disease,LND)是由于次黄嘌呤-鸟嘌呤磷酸核糖转移酶完全缺乏引起的。其特征是尿酸生成过多,伴有严重的运动障碍和自残行为,但其发病机制尚不清楚。这些神经表现提示基底节功能障碍,三种神经递质与疾病的发病机制有关:多巴胺、腺苷和 5-羟色胺。它们都与运动功能和行为有关,通过与突触膜上特定的 G 蛋白偶联受体结合而发挥作用,在那里它们似乎通过受体-受体相互作用而整合。在这项工作中,我们在蛋白质水平上证实了先前报道的 LND PBL 中 DRD5 表达增加,以及 ADORA2A 表达异常,与对照 PBL 相比。我们还首次描述了 LND PBL 中 5-HTR1A 表达和蛋白水平降低,与对照 PBL 相比。如果这些结果在莱施-尼汉病患者的基底节细胞中得到证实,这将支持神经表现的发病机制可能与神经递质失衡有关的假说,而不是与单一神经递质的孤立紊乱有关,这一事实应在为他们的运动和行为障碍设计药物治疗时加以考虑。