Similä S, von Wendt L, Linna S L
J Neurol Sci. 1980 Feb;45(1):83-6. doi: 10.1016/s0022-510x(80)80009-8.
Dipropylacetate (DPA) is an anticonvulsant, which has been successfully used in the treatment of several types of epilepsy. The mode of action has not yet been definitely elucidated, although evidence of influence on gamma aminobutyric acid (GABA) turnover in brain has been presented. Several recent reports of the occurrence of hyperglycinemia in association with DPA-treatment indicate that this agent also influences other areas of amino acid metabolism. In the present study of 10 patients receiving DPA for epilepsy, high concentrations of glycine in plasma and CSF were observed, whereas the levels of all other amino acids remained virtually unchanged. The effect of DPA on urinary excretion of amino acids seems to be of considerable significance as marked elevation of urine concentrations of alanine, asparagine, cystine, glycine, histidine, isoleucine and leucine, phenylalanine and tyrosine were observed. This secondary hyperglycinemia could be due to suppression of glycine conjugation reactions, whereas DPA or its metabolites might interfere with tubular reabsorption of various amino acids, thereby causing hyperaminoaciduria.
二丙乙酸酯(DPA)是一种抗惊厥药,已成功用于治疗多种类型的癫痫。尽管已有证据表明其对大脑中γ-氨基丁酸(GABA)代谢有影响,但其作用模式尚未完全阐明。最近有几篇关于DPA治疗导致高甘氨酸血症的报道表明,这种药物也会影响氨基酸代谢的其他方面。在本研究中,对10例接受DPA治疗癫痫的患者进行观察,发现血浆和脑脊液中甘氨酸浓度较高,而其他所有氨基酸水平基本保持不变。DPA对氨基酸尿排泄的影响似乎相当显著,因为观察到尿液中丙氨酸、天冬酰胺、胱氨酸、甘氨酸、组氨酸、异亮氨酸和亮氨酸、苯丙氨酸和酪氨酸的浓度明显升高。这种继发性高甘氨酸血症可能是由于甘氨酸结合反应受到抑制,而DPA或其代谢产物可能会干扰各种氨基酸的肾小管重吸收,从而导致高氨基酸尿症。