Disturbances in Metabolism of Phenylalanine and Tyrosine as an Important Factor in the Etiology and Pathogenesis of Psychoneurological Disorders Associated with Liver Diseases

Vadim P. Komov¹; Sergey E. Khalchitsky²; Michael V. Dubina³

¹Saint-Petersburg State Chemical Pharmaceutical Academy; ²Russian Research Center of Radiology and Surgical Technologies; ³Saint-Petersburg Academic University; St. Petersburg, Russia

*Corresponding author: Sergey E. Khalchitsky, PhD, Senior Research Scientist, Russian Research Center of Radiology and Surgical Technologies; St. Petersburg, Russia. E-mail: s_khalchitski@mail.ru

Published: June 25, 2015. DOI: 10.21103/Article5(2)_CR3

Abstract: 

Derangements of phenylalanine and tyrosine metabolism are an important factor in the etiology and pathogenesis of psychoneurological disorders. These disorders are particularly pronounced with monogenic hereditary diseases. In this work, we investigated similar disturbances in widespread and socially significant diseases – viral hepatitis and chronic alcoholism – which are accompanied by liver damage. We found serious derangements in the metabolism of phenylalanine, tyrosine and their derivatives with these diseases and concluded that such derangements make an essential contribution to the development of psychoneurological disorders in the studied pathology. In conclusion, this paper proposes recommendations for correction of such derangements and normalization of the patients’ condition.

Keywords: 
phenylalanine; tyrosine; liver pathology; psychoneurological disorders.
References: 
  1. Brumm VL, Bilder D, Waisbren SE. Psychiatric symptoms and disorders in phenylketonuria. Mol Genet Metab 2010; 99 Suppl 1:S59-63.
  2. Huttenlocher PR. The neuropathology of phenylketonuria: human and animal studies. Eur J Pediatr 2000; 159 Suppl 2:S102–6.
  3. Moyle JJ, Fox AM, Arthur M, Bynevelt M, Burnett JR. Meta-analysis of neuropsychological symptoms of adolescents and adults with PKU. Neuropsychol Rev 2007; 17(2):91–101.
  4. Perez-Duenas B, Pujol J, Soriano-Mas C, Ortiz H, Artuch R, Vilaseca MA, et al. Global and regional volume changes in the brains of patients with phenylketonuria. Neurology 2006; 66(7):1074–8.
  5. Cash WJ, McConville P, McDermott E, McCormick PA, Callender ME,  McDougall NI. Current concepts in the assessment and treatment of hepatic encephalopathy. Q J Med 2010; 103(1):9–16.
  6. Dejong CH, van de Poll MC, Soeters PB, Jalan R, Olde Damink SW. Aromatic amino acid metabolism during liver failure. J Nutr 2007;137(6 Suppl 1):1579S-1585S.
  7. Toris GT, Bikis CN, Tsourouflis GS, Theocharis SE. Hepatic encephalopathy: an updated approach from pathogenesis to treatment. Med Sci Monit 2011; 17(2):RA53-63.
  8.  Ivashkin VT. Liver and Biliary System Diseases. Manual for doctors. M.: Publishing house «M-Vesti», 2005. [Manual in Russian].
  9. Maier KP. Hepatitis – Hepatitisfolgen. Praxis der Diagnostik, Therapie und Prophylaxe akuter und chronischer Lebererkrankungen. Hans Huber Verlag, 6. Aufl. 2010. [Book in German].
  10. Shaposhnikov AM, Khal'chitskiĭ SE, Shvarts EI. Disorders of phenylalanine and tyrosine metabolism in Down's syndrome. Vopr Med Khim 1979; 25(1):15-9.[Article in Russian]
  11. Dooley JS, Lok A, Burroughs AK,  Heathcote J, editors. Sherlock's Diseases of the Liver and Biliary System. Wiley-Blackwell 12th Edition; 2011.
  12. Hörtnagl H, Lochs H, Kleinberger G, Hackl JM, Hammerle AF, Binder H, Wewalka F. Plasma catecholamines in hepatic coma and liver cirrhosis: role of octopamine. Klin Wochenschr 1981; 59(20):1159-64.
  13. Krauns P, Ruge W. Plasma catecholamine levels in liver disease. Z Gastroenterol 1985; 23(2):64-73. [Article in German].
  14. Mukherjee S, Das SK, Vaidyanathan K, Vasudevan DM. Consequences of alcohol consumption on neurotransmitters – an overview. Curr Neurovasc Res 2008; 5(4):266-72.
  15. Sherlock S. Alcoholic liver disease. Lancet 1995; 345(8944):227-9.
  16. Ehomoto N., Takase S., Takada N, Takada A. Alcoholic liver disease in heterozygotes of mutant and normal aldehyde dehydrogenase-2 genes. Hepatology 1991; 13(6):1071-5.
  17. Shaposhnikov AM, Khal'chitskiĭ S.E. Patochemistry of phenylalanine, tyrosine, tryptophan metabolism and activity of liver phenylalanine hydroxylase in viral hepatitis. Natur Tech Science 2007; 2: 137-154 [Article in Russian].
  18. Mukherjee S, Vaidyanathan K, Vasudevan DM, Das SK. Role of plasma amino acids and GABA in alcoholic and non-alcoholic fatty liver disease-a pilot study. Indian J Clin Biochem 2010; 25(1):37-42.
  19. Bulycheva I.A., Khalchitsky S.E. Diagnostic importance of phenylpyruvic acid definition in urine in alcoholic disease. Medical sciences 2010; 2:40-49 [Article in Russian].
  20. Gofman AG. Clinical Narcology. Moscow: Miclosh, 2003, 23-34 [Book in Russian].
  21. Westwood A and Raine DN. Heterozygote detection in phenylketonuria. Measurement of discriminatory ability and interpretation of the phenylalanine loading test by determination of the heterozygote likelihood ratio. J Med Genet 1975; 12(4):327–333.
  22. Shaposhnikov AM, Barashnev IuI, Khal'chitskiĭ SE, Korneĭchuk VV, Okat'ev VS.  Phenylalanine hydroxylase activity in the liver in children with the classic form of phenylketonuria. Vopr Okhr Materin Det 1978;23(6):42-7. [Article in Russian]
  23. Shaposhnikov AM. Biochemical manifestations of genetic heterogeneity in human hereditary enzymopathy. Diss Doctor Med Sci. Leningrad, 1975. [Dissertation in Russian].
  24. Williams RA, Mamotte CD,  Burnett JR. Phenylketonuria: an inborn error of phenylalanine metabolism. Clin Biochem Rev 2008; 29(1):31–41.

The fully formatted PDF version is available.       

Download Article

Int J Biomed. 2015; 5(2):65-70. © 2015 International Medical Research and Development Corporation. All rights reserved.