A diverse group of metabolic diseases characterized by errors in the biosynthetic pathway of HEME in the LIVER, the BONE MARROW, or both. They are classified by the deficiency of specific enzymes, the tissue site of enzyme defect, or the clinical features that include neurological (acute) or cutaneous (skin lesions). Porphyrias can be hereditary or acquired as a result of toxicity to the hepatic or erythropoietic marrow tissues.
A group of metabolic diseases due to deficiency of one of a number of LIVER enzymes in the biosynthetic pathway of HEME. They are characterized by the accumulation and increased excretion of PORPHYRINS or its precursors. Clinical features include neurological symptoms (PORPHYRIA, ACUTE INTERMITTENT), cutaneous lesions due to photosensitivity (PORPHYRIA CUTANEA TARDA), or both (HEREDITARY COPROPORPHYRIA). Hepatic porphyrias can be hereditary or acquired as a result of toxicity to the hepatic tissues.
An autosomal dominant porphyria that is due to a deficiency of HYDROXYMETHYLBILANE SYNTHASE in the LIVER, the third enzyme in the 8-enzyme biosynthetic pathway of HEME. Clinical features are recurrent and life-threatening neurologic disturbances, ABDOMINAL PAIN, and elevated level of AMINOLEVULINIC ACID and PORPHOBILINOGEN in the urine.
An autosomal recessive porphyria that is due to a deficiency of UROPORPHYRINOGEN III SYNTHASE in the BONE MARROW; also known as congenital erythropoietic porphyria. This disease is characterized by SPLENOMEGALY; ANEMIA; photosensitivity; cutaneous lesions; accumulation of hydroxymethylbilane; and increased excretion of UROPORPHYRINS and COPROPORPHYRINS.
An autosomal dominant porphyria that is due to a deficiency of protoporphyrinogen oxidase (EC 1.3.3.4) in the LIVER, the seventh enzyme in the 8-enzyme biosynthetic pathway of HEME. Clinical features include both neurological symptoms and cutaneous lesions. Patients excrete increased levels of porphyrin precursors, COPROPORPHYRINS and protoporphyrinogen.
An autosomal dominant or acquired porphyria due to a deficiency of UROPORPHYRINOGEN DECARBOXYLASE in the LIVER. It is characterized by photosensitivity and cutaneous lesions with little or no neurologic symptoms. Type I is the acquired form and is strongly associated with liver diseases and hepatic toxicities caused by alcohol or estrogenic steroids. Type II is the familial form.
An enzyme that catalyzes the tetrapolymerization of the monopyrrole PORPHOBILINOGEN into the hydroxymethylbilane preuroporphyrinogen (UROPORPHYRINOGENS) in several discrete steps. It is the third enzyme in the 8-enzyme biosynthetic pathway of HEME. In humans, deficiency in this enzyme encoded by HMBS (or PBGD) gene results in a form of neurological porphyria (PORPHYRIA, ACUTE INTERMITTENT). This enzyme was formerly listed as EC 4.3.1.8
Porphobilinogen is a porphyrin precursor, specifically the organic compound intermediate in the biosynthesis of heme and chlorophyll, formed by the condensation of two pyrrole molecules in the liver and other tissues.
An enzyme that catalyzes the decarboxylation of UROPORPHYRINOGEN III to coproporphyrinogen III by the conversion of four acetate groups to four methyl groups. It is the fifth enzyme in the 8-enzyme biosynthetic pathway of HEME. Several forms of cutaneous PORPHYRIAS are results of this enzyme deficiency as in PORPHYRIA CUTANEA TARDA; and HEPATOERYTHROPOIETIC PORPHYRIA.
A membrane-bound flavoenzyme that catalyzes the oxygen-dependent aromatization of protoporphyrinogen IX (Protogen) to protoporphyrin IX (Proto IX). It is the last enzyme of the common branch of the HEME and CHLOROPHYLL pathways in plants, and is the molecular target of diphenyl ether-type herbicides. VARIEGATE PORPHYRIA is an autosomal dominant disorder associated with deficiency of protoporphyrinogen oxidase.
A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin.
An enzyme that catalyzes the cyclization of hydroxymethylbilane to yield UROPORPHYRINOGEN III and water. It is the fourth enzyme in the 8-enzyme biosynthetic pathway of HEME, and is encoded by UROS gene. Mutations of UROS gene result in CONGENITAL ERYTHROPOIETIC PORPHYRIA.
Porphyrins with four acetic acid and four propionic acid side chains attached to the pyrrole rings.
An autosomal recessive cutaneous porphyria that is due to a deficiency of UROPORPHYRINOGEN DECARBOXYLASE in both the LIVER and the BONE MARROW. Similar to PORPHYRIA CUTANEA TARDA, this disorder is caused by defects in the fifth enzyme in the 8-enzyme biosynthetic pathway of HEME, but is a homozygous enzyme deficiency with less than 10% of the normal enzyme activity. Cutaneous lesions are severe and mutilating.
Porphyrins with four methyl and four propionic acid side chains attached to the pyrrole rings. Elevated levels of Coproporphyrin III in the urine and feces are major findings in patients with HEREDITARY COPROPORPHYRIA.
An enzyme of the transferase class that catalyzes condensation of the succinyl group from succinyl coenzyme A with glycine to form delta-aminolevulinate. It is a pyridoxyal phosphate protein and the reaction occurs in mitochondria as the first step of the heme biosynthetic pathway. The enzyme is a key regulatory enzyme in heme biosynthesis. In liver feedback is inhibited by heme. EC 2.3.1.37.
An autosomal dominant porphyria that is due to a deficiency of COPROPORPHYRINOGEN OXIDASE in the LIVER, the sixth enzyme in the 8-enzyme biosynthetic pathway of HEME. Clinical features include both neurological symptoms and cutaneous lesions. Patients excrete increased levels of porphyrin precursors, 5-AMINOLEVULINATE and COPROPORPHYRINS.
Porphyrinogens which are intermediates in heme biosynthesis. They have four acetic acid and four propionic acid side chains attached to the pyrrole rings. Uroporphyrinogen I and III are formed from polypyrryl methane in the presence of uroporphyrinogen III cosynthetase and uroporphyrin I synthetase, respectively. They can yield uroporphyrins by autooxidation or coproporphyrinogens by decarboxylation.
A compound produced from succinyl-CoA and GLYCINE as an intermediate in heme synthesis. It is used as a PHOTOCHEMOTHERAPY for actinic KERATOSIS.
Colorless reduced precursors of porphyrins in which the pyrrole rings are linked by methylene (-CH2-) bridges.
Keto acids that are derivatives of 4-oxopentanoic acids (levulinic acid).
An agricultural fungicide and seed treatment agent.
An enzyme that catalyzes the formation of porphobilinogen from two molecules of 5-aminolevulinic acid. EC 4.2.1.24.
Enzymes that catalyze the formation of a carbon-carbon double bond by the elimination of AMMONIA. EC 4.3.1.
Flavoproteins are a type of protein molecule that contain noncovalently bound flavin mononucleotide or flavin adenine dinucleotide as cofactors, involved in various redox reactions and metabolic pathways, such as electron transfer, energy production, and DNA repair.
A mitochondrial enzyme found in a wide variety of cells and tissues. It is the final enzyme in the 8-enzyme biosynthetic pathway of HEME. Ferrochelatase catalyzes ferrous insertion into protoporphyrin IX to form protoheme or heme. Deficiency in this enzyme results in ERYTHROPOIETIC PROTOPORPHYRIA.
The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins.
An antifungal agent used in the treatment of TINEA infections.
An enzyme that catalyzes the oxidative decarboxylation of coproporphyrinogen III to protoporphyrinogen IX by the conversion of two propionate groups to two vinyl groups. It is the sixth enzyme in the 8-enzyme biosynthetic pathway of HEME, and is encoded by CPO gene. Mutations of CPO gene result in HEREDITARY COPROPORPHYRIA.
Porphyrinogens which are intermediates in the heme biosynthesis. They have four methyl and four propionic acid side chains attached to the pyrrole rings. Coproporphyrinogens I and III are formed in the presence of uroporphyrinogen decarboxylase from the corresponding uroporphyrinogen. They can yield coproporphyrins by autooxidation or protoporphyrin by oxidative decarboxylation.
1,4-Dihydro-2,4,6-trimethyl-3,5-pyridinedicarboxylic acid diethyl ester.
'Skin diseases' is a broad term for various conditions affecting the skin, including inflammatory disorders, infections, benign and malignant tumors, congenital abnormalities, and degenerative diseases, which can cause symptoms such as rashes, discoloration, eruptions, lesions, itching, or pain.
A subclass of enzymes which includes all dehydrogenases acting on carbon-carbon bonds. This enzyme group includes all the enzymes that introduce double bonds into substrates by direct dehydrogenation of carbon-carbon single bonds.
An autosomal dominant porphyria that is due to a deficiency of FERROCHELATASE (heme synthetase) in both the LIVER and the BONE MARROW, the last enzyme in the 8-enzyme biosynthetic pathway of HEME. Clinical features include mainly neurological symptoms, rarely cutaneous lesions, and elevated levels of protoporphyrin and COPROPORPHYRINS in the feces.
Abnormal responses to sunlight or artificial light due to extreme reactivity of light-absorbing molecules in tissues. It refers almost exclusively to skin photosensitivity, including sunburn, reactions due to repeated prolonged exposure in the absence of photosensitizing factors, and reactions requiring photosensitizing factors such as photosensitizing agents and certain diseases. With restricted reference to skin tissue, it does not include photosensitivity of the eye to light, as in photophobia or photosensitive epilepsy.
Puncture of a vein to draw blood for therapeutic purposes. Bloodletting therapy has been used in Talmudic and Indian medicine since the medieval time, and was still practiced widely in the 18th and 19th centuries. Its modern counterpart is PHLEBOTOMY.
Porphyrins with four methyl, two vinyl, and two propionic acid side chains attached to the pyrrole rings. Protoporphyrin IX occurs in hemoglobin, myoglobin, and most of the cytochromes.
An allylic compound that acts as a suicide inactivator of CYTOCHROME P450 by covalently binding to its heme moiety or surrounding protein.
Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc.
A disorder of iron metabolism characterized by a triad of HEMOSIDEROSIS; LIVER CIRRHOSIS; and DIABETES MELLITUS. It is caused by massive iron deposits in parenchymal cells that may develop after a prolonged increase of iron absorption. (Jablonski's Dictionary of Syndromes & Eponymic Diseases, 2d ed)
Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing HEMOGLOBIN whose function is to transport OXYGEN.
Pathological processes of the LIVER.
Enzymes that catalyze the addition of a carboxyl group to a compound (carboxylases) or the removal of a carboxyl group from a compound (decarboxylases). EC 4.1.1.

Treatment of congenital erythropoietic porphyria in children by allogeneic stem cell transplantation: a case report and review of the literature. (1/35)

Congenital erythropoietic porphyria (CEP) is a rare autosomal recessive disorder of porphyrin metabolism in which the genetic defect is the deficiency of uroporphyrinogen III cosynthase (UIIIC). Deficiency of this enzyme results in an accumulation of high amounts of uroporphyrin I in all tissues leading to hemolytic anemia, splenomegaly, erythrodontia, bone fragility, exquisite photosensitivity and mutilating skin lesions. We describe the case of a 23-month-old boy who was cured of his CEP by a matched-sibling allogeneic bone marrow transplant, and review the published clinical experience regarding transplantation in this disease. He is alive and disease-free 15 months post transplant. All of his disease manifestations except for the erythrodontia have resolved. His UIIIC level and stool and erythrocyte porphyrin metabolites have almost completely corrected. He is the sixth child reported to be cured of this disease by stem cell transplantation, five cases being long-term survivors. If patients with this disease have an HLA-matched sibling, then stem cell transplantation should be strongly considered because this is currently the only known curative therapy.  (+info)

Uroporphyrinogen III synthase erythroid promoter mutations in adjacent GATA1 and CP2 elements cause congenital erythropoietic porphyria. (2/35)

Congenital erythropoietic porphyria, an autosomal recessive inborn error of heme biosynthesis, results from the markedly deficient activity of uroporphyrinogen III synthase. Extensive mutation analyses of 40 unrelated patients only identified approximately 90% of mutant alleles. Sequencing the recently discovered erythroid-specific promoter in six patients with a single undefined allele identified four novel mutations clustered in a 20-bp region: (a) a -70T to C transition in a putative GATA-1 consensus binding element, (b) a -76G to A transition, (c) a -86C to A transversion in three unrelated patients, and (d) a -90C to A transversion in a putative CP2 binding motif. Also, a -224T to C polymorphism was present in approximately 4% of 200 unrelated Caucasian alleles. We inserted these mutant sequences into luciferase reporter constructs. When transfected into K562 erythroid cells, these constructs yielded 3 +/- 1, 54 +/- 3, 43 +/- 6, and 8 +/- 1%, respectively, of the reporter activity conferred by the wild-type promoter. Electrophoretic mobility shift assays indicated that the -70C mutation altered GATA1 binding, whereas the adjacent -76A mutation did not. Similarly, the -90C mutation altered CP2 binding, whereas the -86A mutation did not. Thus, these four pathogenic erythroid promoter mutations impaired erythroid-specific transcription, caused CEP, and identified functionally important GATA1 and CP2 transcriptional binding elements for erythroid-specific heme biosynthesis.  (+info)

Correction of deficient CD34+ cells from peripheral blood after mobilization in a patient with congenital erythropoietic porphyria. (3/35)

Congenital erythropoietic porphyria (CEP) is an inherited disease due to a deficiency in the uroporphyrinogen III synthase (UROS), the fourth enzyme of the heme pathway. It is characterized by accumulation of uroporphyrin I in the bone marrow, peripheral blood, and other organs. The onset of most cases occurs in infancy and the main symptoms are cutaneous photosensitivity and hemolysis. For severe transfusion-dependent cases, when allogeneic cell transplantation cannot be performed, autografting of genetically modified primitive/stem cells is the only alternative. In the present study, efficient mobilization of peripheral blood primitive CD34(+) cells was performed on a young adult CEP patient. Retroviral transduction of this cell population with the therapeutic human UROS (hUS) gene resulted in both enzymatic and metabolic correction of CD34(+)-derived cells, as demonstrated by the increase in UROS activity and by a 53% drop in porphyrin accumulation. A 10-24% gene transfer efficiency was achieved in the most primitive cells, as demonstrated by the expression of enhanced green fluorescent protein (EGFP) in long-term culture-initiating cells (LTC-IC). Furthermore, gene expression remained stable during in vitro erythroid differentiation. Therefore, these results are promising for the future treatment of CEP patients by gene therapy.  (+info)

Crystal structure of human uroporphyrinogen III synthase. (4/35)

Uroporphyrinogen III synthase, U3S, the fourth enzyme in the porphyrin biosynthetic pathway, catalyzes cyclization of the linear tetrapyrrole, hydroxymethylbilane, to the macrocyclic uroporphyrino gen III, which is used in several different pathways to form heme, siroheme, chlorophyll, F(430) and vitamin B(12). U3S activity is essential in all organisms, and decreased activity in humans leads to the autosomal recessive disorder congenital erythropoetic porphyria. We have determined the crystal structure of recombinant human U3S at 1.85 A resolution. The protein folds into two alpha/beta domains connected by a beta-ladder. The active site appears to be located between the domains, and variations in relative domain positions observed between crystallographically independent molecules indicates the presence of flexibility that may be important in the catalytic cycle. Possible mechanisms of catalysis were probed by mutating each of the four invariant residues in the protein that have titratable side chains. Additionally, six other highly conserved and titratable side chains were also mutated. In no case, however, did one of these mutations abolish enzyme activity, suggesting that the mechanism does not require acid/base catalysis.  (+info)

Late-onset erythropoietic porphyria caused by a chromosome 18q deletion in erythroid cells. (5/35)

The erythropoietic porphyrias, erythropoietic protoporphyria and congenital erythropoietic porphyria, result from germline mutations in the ferrochelatase gene and uroporphyrinogen III synthase gene, respectively. Both conditions normally present in childhood but rare cases with onset past the age of 40 y have been reported. Here we show that late-onset erythropoietic protoporphyria can be caused by deletion of the ferrochelatase gene in hematopoietic cells with clonal expansion as part of the myelodysplastic process. This is the first direct demonstration of porphyria produced by an acquired molecular defect restricted to one tissue. Some other cases of late-onset erythropoietic porphyria may be explained by a similar mechanism.  (+info)

A rare case of porphyria. (6/35)

INTRODUCTION: Congenital erythropoietic porphyria is one of the rare forms of an intriguing group of metabolic disorders known as porphyrias. Less than 200 cases have been reported in the literature. CLINICAL PRESENTATION: We report the case of a 27-year-old gentleman who had the clinical profile suggestive of porphyria, now presenting with anaemia. The type of porphyria was found to be congenital erythropoietic porphyria by biochemical assay and cause for anaemia was haemolysis, a well-known association with the erythropoietic porphyrias. TREATMENT: The management of porphyrias is essentially symptomatic. He was treated with blood transfusions and haematinics. CONCLUSION: The patient improved symptomatically and he is on regular followup. With the development of gene therapy, a specific cure for this rare type of porphyria is expected in the near future.  (+info)

Congenital erythropoietic porphyria: report of a novel mutation with absence of clinical manifestations in a homozygous mutant sibling. (7/35)

In a Palestinian family, four siblings were shown to express typical and severe congenital erythropoietic porphyria (CEP). A new mutation of the uroporphyrinogen III synthase (UROS) gene was evidenced by systematic sequencing of the UROS gene: the substitution of serine by proline at the amino acid residue 47 (S47P) was present at the homozygous state in the four patients. The mother was heterozygous, the father was not examined. Surprisingly, in one unaffected sister, UROS activity was markedly deficient and UROS gene analysis showed a homozygous mutant profile. The deleterious role of the mutant S47P protein on UROS activity was demonstrated by prokaryotic expression. This observation is the first report of a healthy status associated with homozygosity for a mutation of UROS gene in a severely affected family. We then draw hypotheses to explain the protective phenotype in the homozygous healthy subject.  (+info)

A knock-in mouse model of congenital erythropoietic porphyria. (8/35)

Congenital erythropoietic porphyria (CEP) is a recessive autosomal disorder characterized by a deficiency in uroporphyrinogen III synthase (UROS), the fourth enzyme of the heme biosynthetic pathway. The severity of the disease, the lack of specific treatment except for allogeneic bone marrow transplantation, and the knowledge of the molecular lesions are strong arguments for gene therapy. An animal model of CEP has been designed to evaluate the feasibility of retroviral gene transfer in hematopoietic stem cells. We have previously demonstrated that the knockout of the Uros gene is lethal in mice (Uros(del) model). This work describes the achievement of a knock-in model, which reproduces a mutation of the UROS gene responsible for a severe UROS deficiency in humans (P248Q missense mutant). Homozygous mice display erythrodontia, moderate photosensitivity, hepatosplenomegaly, and hemolytic anemia. Uroporphyrin (99% type I isomer) accumulates in urine. Total porphyrins are increased in erythrocytes and feces, while Uros enzymatic activity is below 1% of the normal level in the different tissues analyzed. These pathological findings closely mimic the CEP disease in humans and demonstrate that the Uros(mut248) mouse represents a suitable model of the human disease for pathophysiological, pharmaceutical, and therapeutic purposes.  (+info)

Porphyrias are a group of rare genetic disorders that affect the production of heme, a component in hemoglobin that carries oxygen in the blood. The diseases are caused by mutations in the genes involved in the production of heme, leading to the buildup of porphyrins or their precursors in the body. These substances can be toxic and can cause various symptoms depending on the specific type of porphyria. Symptoms may include abdominal pain, neurological problems, and skin issues. Porphyrias are typically divided into two categories: acute porphyrias, which affect the nervous system, and cutaneous porphyrias, which primarily affect the skin.

Hepatic porphyrias are a group of rare genetic disorders that affect the production of heme in the liver. Heme is a crucial component of hemoglobin, the protein in red blood cells that carries oxygen throughout the body. In hepatic porphyrias, there is a buildup of porphyrins or porphyrin precursors, which are toxic and can cause a variety of symptoms.

The four types of hepatic porphyrias are:

1. Acute Intermittent Porphyria (AIP): This is the most common type of hepatic porphyria. It is characterized by attacks of abdominal pain, nausea, vomiting, constipation, and neurological symptoms such as muscle weakness, seizures, and mental changes.
2. Variegate Porphyria (VP): This type of porphyria is more common in South Africa but can occur worldwide. It is characterized by skin symptoms such as blistering and scarring after exposure to sunlight, as well as acute attacks similar to those seen in AIP.
3. Hereditary Coproporphyria (HCP): This type of porphyria is similar to VP, but the symptoms are usually less severe. It can cause both skin symptoms and acute attacks.
4. ALA Dehydratase Deficiency Porphyria (ADDP): This is the rarest type of hepatic porphyria. It is characterized by severe neurological symptoms and is often diagnosed in infancy or early childhood.

The diagnosis of hepatic porphyrias typically involves measuring the levels of porphyrins and their precursors in the urine, blood, or stool during an attack or between attacks. Treatment may include avoiding trigger factors such as certain medications, alcohol, and smoking, as well as providing supportive care during acute attacks. In some cases, medication to reduce porphyrin production or prevent attacks may be necessary.

Acute Intermittent Porphyria (AIP) is a rare inherited metabolic disorder that affects the production of heme, a component in hemoglobin. This condition is part of a group of disorders known as the porphyrias, which are caused by genetic mutations that result in enzyme deficiencies needed to produce heme.

In AIP, specifically, there is a deficiency in the enzyme porphobilinogen deaminase (PBGD). This leads to the buildup of porphyrin precursors, particularly porphobilinogen and delta-aminolevulinic acid (ALA), in the body. These substances are toxic and can cause acute attacks when they accumulate in high concentrations.

Acute attacks are characterized by severe abdominal pain, nausea, vomiting, constipation or diarrhea, muscle weakness, seizures, and mental changes such as confusion, hallucinations, or anxiety. These symptoms can be triggered by certain factors like drugs, alcohol, hormonal changes, infections, or stress.

It is essential to differentiate AIP from other medical conditions that may present with similar symptoms, as the treatment strategies differ significantly. Diagnosis typically involves measuring porphyrin precursors in urine, especially during an acute attack, and can be confirmed by genetic testing for the PBGD gene mutation.

Treatment of AIP primarily focuses on managing acute attacks with intravenous heme preparations, which help to reduce the production of toxic porphyrin precursors. In addition, providing supportive care such as hydration, pain management, and addressing any triggers or complications is crucial. Long-term management includes avoiding identified triggers, monitoring for early signs of acute attacks, and implementing a low-purine diet in some cases.

Erythropoietic Porphyria (EP) is a rare inherited disorder of the heme biosynthesis pathway, specifically caused by a deficiency of the enzyme uroporphyrinogen III synthase. This results in the accumulation of porphyrin precursors, particularly uroporphyrin I and coproporphyrin I, in erythrocytes (red blood cells), bone marrow, and other tissues. The accumulation of these porphyrins leads to photosensitivity, hemolysis, and iron overload.

The symptoms of EP typically appear in childhood or early adulthood and include severe skin fragility and blistering, particularly on sun-exposed areas, which can result in scarring, disfigurement, and increased susceptibility to infection. Other features may include anemia due to hemolysis, iron overload, and splenomegaly (enlarged spleen).

The diagnosis of EP is based on clinical symptoms, laboratory tests measuring porphyrin levels in blood and urine, and genetic testing to confirm the presence of pathogenic variants in the UROS gene. Treatment for EP includes avoidance of sunlight exposure, use of sun-protective measures, and management of anemia with blood transfusions or erythropoietin injections. In some cases, bone marrow transplantation may be considered as a curative treatment option.

Variegate Porphyria (VP) is a rare inherited metabolic disorder that affects the production of heme, a component in hemoglobin. It is one of the types of porphyrias, which are caused by genetic mutations that result in deficiencies of enzymes needed to synthesize heme.

In variegate porphyria, the deficient enzyme is protoporphyrinogen oxidase (PPOX). This leads to the accumulation of porphyrins and their precursors, particularly coproporphyrin III and protoporphyrin, in the body. These substances can cause neurological symptoms when they are excreted in urine and exposed to light.

Variegate porphyria is characterized by both cutaneous (skin) and neurovisceral (neurological) manifestations. Cutaneous symptoms include skin sensitivity to sunlight, blistering, scarring, and fragility. Neurovisceral symptoms can include abdominal pain, nausea, vomiting, constipation, muscle weakness, seizures, and mental changes such as anxiety, hallucinations, or confusion.

The severity of variegate porphyria can vary widely between individuals, even among family members who carry the same genetic mutation. Symptoms may be triggered by certain medications, hormonal changes, alcohol consumption, infections, or other factors that increase heme synthesis. Diagnosis typically involves measuring porphyrin levels in blood and urine, as well as genetic testing for the PPOX gene mutation. Treatment usually focuses on managing symptoms, avoiding triggers, and providing supportive care during acute attacks.

Porphyria Cutanea Tarda (PCT) is a type of porphyria, a group of rare genetic disorders that affect the production of heme, a component in hemoglobin. PCT is primarily an acquired disorder, although it can have a hereditary component as well.

In PCT, there is a dysfunction in the enzyme uroporphyrinogen decarboxylase (UROD), which leads to the accumulation of porphyrins and porphyrin precursors in the skin. This buildup causes the characteristic symptoms of PCT, which include:

* Blisters, particularly on sun-exposed areas such as the hands and face
* Fragile, thin skin that tears easily
* Scarring
* Hypertrichosis (abnormal hair growth)
* Changes in skin color, including redness, increased pigmentation, or loss of pigment

PCT is typically triggered by factors such as alcohol consumption, estrogen use, hepatitis C infection, and exposure to certain chemicals. Treatment often involves addressing these triggers, along with the use of phlebotomy (removal of blood) or low-dose hydroxychloroquine to reduce porphyrin levels in the body.

It's important to note that PCT is a complex disorder and its diagnosis and management should be done by healthcare professionals with experience in managing porphyrias.

Hydroxymethylbilane Synthase (HMBS) is an enzyme that plays a crucial role in the metabolic pathway known as heme biosynthesis. Heme is an essential component of various proteins, including hemoglobin, which is responsible for oxygen transport in the blood.

The HMBS enzyme catalyzes the conversion of aminolevulinic acid (ALA) and glycine into a linear tetrapyrrole intermediate called hydroxymethylbilane. This reaction is the third step in the heme biosynthesis pathway, and it takes place in the mitochondria of cells.

Deficiencies in HMBS can lead to a rare genetic disorder called acute intermittent porphyria (AIP), which is characterized by neurovisceral attacks and neurological symptoms such as abdominal pain, vomiting, hypertension, tachycardia, and mental disturbances.

Porphobilinogen (PBG) is a bioactive compound that plays a crucial role in the biosynthesis pathway of heme, which is an essential component of hemoglobin and other hemoproteins. It is a porphyrin precursor and is synthesized from aminolevulinic acid (ALA) by the enzyme ALA dehydratase in the second step of heme biosynthesis.

In medical terms, abnormal accumulation or increased levels of PBG in the body can indicate an underlying disorder in heme biosynthesis, such as acute intermittent porphyria (AIP), variegate porphyria (VP), or hereditary coproporphyria (HCP). These disorders are known as porphyrias and are characterized by the buildup of porphyrin precursors in various tissues, leading to neurological and gastrointestinal symptoms.

Therefore, measuring PBG levels in urine or blood can help diagnose and monitor these conditions.

Uroporphyrinogen decarboxylase is a vital enzyme in the biosynthetic pathway of heme, which is a crucial component of hemoglobin in red blood cells. This enzyme is responsible for catalyzing the decarboxylation of uroporphyrinogen III, a colorless porphyrinogen, to produce coproporphyrinogen III, a brownish-red porphyrinogen.

The reaction involves the sequential removal of four carboxyl groups from the four acetic acid side chains of uroporphyrinogen III, resulting in the formation of coproporphyrinogen III. This enzyme's activity is critical for the normal biosynthesis of heme, and any defects or deficiencies in its function can lead to various porphyrias, a group of metabolic disorders characterized by the accumulation of porphyrins and their precursors in the body.

The gene responsible for encoding uroporphyrinogen decarboxylase is UROD, located on chromosome 1p34.1. Mutations in this gene can lead to a deficiency in the enzyme's activity, causing an autosomal recessive disorder known as congenital erythropoietic porphyria (CEP), also referred to as Günther's disease. This condition is characterized by severe photosensitivity, hemolytic anemia, and scarring or thickening of the skin.

Protoporphyrinogen Oxidase (PPO) is a mitochondrial enzyme that plays a crucial role in the heme biosynthesis pathway. It catalyzes the oxidation of protoporphyrinogen IX to protporphyrin IX, which is the penultimate step in the production of heme. This enzyme is the target of certain herbicides, such as those containing the active ingredient diphenyl ether, and genetic deficiencies in PPO can lead to a rare genetic disorder called Protoporphyria.

Porphyrins are complex organic compounds that contain four pyrrole rings joined together by methine bridges (=CH-). They play a crucial role in the biochemistry of many organisms, as they form the core structure of various heme proteins and other metalloproteins. Some examples of these proteins include hemoglobin, myoglobin, cytochromes, and catalases, which are involved in essential processes such as oxygen transport, electron transfer, and oxidative metabolism.

In the human body, porphyrins are synthesized through a series of enzymatic reactions known as the heme biosynthesis pathway. Disruptions in this pathway can lead to an accumulation of porphyrins or their precursors, resulting in various medical conditions called porphyrias. These disorders can manifest as neurological symptoms, skin lesions, and gastrointestinal issues, depending on the specific type of porphyria and the site of enzyme deficiency.

It is important to note that while porphyrins are essential for life, their accumulation in excessive amounts or at inappropriate locations can result in pathological conditions. Therefore, understanding the regulation and function of porphyrin metabolism is crucial for diagnosing and managing porphyrias and other related disorders.

Uroporphyrinogen III Synthase is a crucial enzyme in the biosynthetic pathway of heme and chlorophyll. This enzyme, specifically classified under EC 4.2.1.75, catalyzes the conversion of coproporphyrinogen III to protoporphyrinogen IX, which is a key step in the synthesis of heme.

The reaction it facilitates is:

Coproporphyrinogen III + reduced ferredoxin → Protoporphyrinogen IX + oxidized ferredoxin + CO2

Deficiency or malfunctioning of this enzyme can lead to a rare genetic disorder known as "congenital erythropoietic porphyria" (CEP), also known as Günther's disease, which is characterized by severe photosensitivity and related symptoms.

Uroporphyrins are porphyrin derivatives that contain four carboxylic acid groups. They are intermediates in the biosynthesis of heme, which is a component of hemoglobin and other hemoproteins. Uroporphyrinogen I and III are precursors to uroporphyrin I and III, respectively, through the action of uroporphyrinogen decarboxylase.

Uroporphyrin I and III differ in the position of acetate and propionate side chains on the porphyrin ring. Uroporphyrins are usually elevated in the urine of patients with certain inherited metabolic disorders, such as acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria, due to enzyme deficiencies in the heme biosynthetic pathway.

The measurement of uroporphyrins in urine or other body fluids can be helpful in diagnosing and monitoring these disorders.

Hepatoerythropoietic porphyria (HEP) is a rare inherited metabolic disorder that affects the production of heme, a component in hemoglobin. It is a subtype of porphyria known as "erythropoietic porphyria," which primarily affects the bone marrow and erythroid cells.

In HEP, there are deficiencies in the activity of two enzymes involved in heme biosynthesis: uroporphyrinogen III synthase (UROS) and coproporphyrinogen oxidase (CPOX). This double enzyme deficiency leads to the accumulation of porphyrin precursors, particularly uroporphyrinogen I and coproporphyrinogen I, in erythrocytes, plasma, and tissues.

The main clinical manifestations of HEP include severe cutaneous photosensitivity, blistering, scarring, and hypertrichosis (excessive hair growth) on sun-exposed areas. Other features may include hemolytic anemia, splenomegaly, and liver dysfunction. The condition typically presents in infancy or early childhood, and it can be associated with significant morbidity and mortality if not properly managed.

Diagnosis of HEP is based on the detection of elevated levels of porphyrin precursors in plasma, erythrocytes, and stool, as well as genetic testing to confirm mutations in the UROS and CPOX genes. Treatment involves avoidance of sunlight exposure, use of sun-protective measures, and management of anemia with blood transfusions or other therapies. In some cases, hematopoietic stem cell transplantation may be considered as a curative treatment option.

Coproporphyrins are porphyrin molecules that contain four carboxylic acid groups (four propionic side chains and two acetic side chains). They are intermediates in the biosynthesis of heme, which is a component of hemoglobin and other hemoproteins. Coproporphyrins can be further metabolized to form protoporphyrins, which are converted into heme by the enzyme ferrochelatase.

Coproporphyrins can be excreted in urine and feces, and their levels can be measured in clinical testing. Elevated coproporphyrin levels in urine or feces may indicate the presence of certain medical conditions, such as lead poisoning, porphyrias, or liver dysfunction.

There are two types of coproporphyrins, coproporphyrin I and coproporphyrin III, which differ in the arrangement of their side chains. Coproporphyrin III is the form that is normally produced in the body, while coproporphyrin I is a byproduct of abnormal porphyrin metabolism.

5-Aminolevulinate synthase (ALAS) is an enzyme that catalyzes the first step in heme biosynthesis, a metabolic pathway that produces heme, a porphyrin ring with an iron atom at its center. Heme is a crucial component of hemoglobin, cytochromes, and other important molecules in the body.

ALAS exists in two forms: ALAS1 and ALAS2. ALAS1 is expressed in all tissues, while ALAS2 is primarily expressed in erythroid cells (precursors to red blood cells). The reaction catalyzed by ALAS involves the condensation of glycine and succinyl-CoA to form 5-aminolevulinate.

Deficiencies or mutations in the ALAS2 gene can lead to a rare genetic disorder called X-linked sideroblastic anemia, which is characterized by abnormal red blood cell maturation and iron overload in mitochondria.

Hereditary coproporphyria (HCP) is a rare inherited disorder of the heme biosynthesis pathway, which is the process by which your body produces heme. Heme is a crucial component of various proteins, including hemoglobin, which carries oxygen in red blood cells.

In HCP, there is a deficiency of an enzyme called coproporphyrinogen oxidase. This enzyme is essential for converting coproporphyrinogen III to protoporphyrin IX in the heme biosynthesis pathway. As a result, coproporphyrinogen III accumulates and gets converted to coproporphyrin, which is excreted in urine and stool in abnormally high amounts.

The symptoms of HCP can be diverse and may include both neurological and gastrointestinal manifestations. Neurological symptoms might include abdominal pain, muscle weakness, numbness, tingling, seizures, and psychiatric disturbances. Gastrointestinal symptoms could encompass nausea, vomiting, constipation, or diarrhea. These symptoms are typically triggered by certain factors such as infections, drugs, hormonal changes, or alcohol consumption.

HCP is usually inherited in an autosomal dominant manner, meaning that a child has a 50% chance of inheriting the disease-causing gene from a parent with the disorder. However, some cases may result from de novo mutations, which means the mutation occurs spontaneously without a family history of the condition.

Diagnosis of HCP is usually made through measuring porphyrin levels and their precursors in urine, stool, and blood during an acute attack or between attacks. Genetic testing can confirm the diagnosis by identifying mutations in the CPOX gene, which encodes coproporphyrinogen oxidase.

Treatment for HCP typically involves avoiding triggers, providing supportive care during acute attacks, and using medications to manage symptoms. In some cases, heme arginate or hemine may be given to help decrease porphyrin precursor production. Preventive measures such as avoidance of potential triggers, adequate hydration, and a balanced diet are essential in managing HCP.

Uroporphyrinogens are organic compounds that are intermediate products in the synthesis of heme, which is a crucial component of hemoglobin and other important molecules in the body. Specifically, uroporphyrinogens are tetrapyrroles, which means they contain four pyrrole rings linked together. They have eight carboxylic acid side chains and two propionic acid side chains.

There are two types of uroporphyrinogens: Type I and Type III. Uroporphyrinogen III is the precursor to heme, while uroporphyrinogen I is a dead-end metabolite that is not used in heme synthesis. Defects in the enzymes involved in heme biosynthesis can lead to various porphyrias, which are genetic disorders characterized by the accumulation of porphyrins and their precursors in the body.

Aminolevulinic acid (ALA) is a naturally occurring compound in the human body and is a key precursor in the biosynthesis of heme, which is a component of hemoglobin in red blood cells. It is also used as a photosensitizer in dermatology for the treatment of certain types of skin conditions such as actinic keratosis and basal cell carcinoma.

In medical terms, ALA is classified as an α-keto acid and a porphyrin precursor. It is synthesized in the mitochondria from glycine and succinyl-CoA in a reaction catalyzed by the enzyme aminolevulinic acid synthase. After its synthesis, ALA is transported to the cytosol where it undergoes further metabolism to form porphyrins, which are then used for heme biosynthesis in the mitochondria.

In dermatology, topical application of ALA followed by exposure to a specific wavelength of light can lead to the production of reactive oxygen species that destroy abnormal cells in the skin while leaving healthy cells unharmed. This makes it an effective treatment for precancerous and cancerous lesions on the skin.

It is important to note that ALA can cause photosensitivity, which means that patients who have undergone ALA-based treatments should avoid exposure to sunlight or other sources of bright light for a period of time after the treatment to prevent adverse reactions.

Porphyrinogens are organic compounds that are the precursors to porphyrins, which are ring-shaped molecules found in many important biological molecules such as hemoglobin and cytochromes. Porphyrinogens are themselves derived from the condensation of four pyrrole molecules, and they undergo further reactions to form porphyrins.

In particular, porphyrinogens are intermediates in the biosynthesis of heme, which is a complex organic ring-shaped molecule that contains iron and plays a critical role in oxygen transport and storage in the body. Abnormalities in heme biosynthesis can lead to various medical conditions known as porphyrias, which are characterized by the accumulation of porphyrinogens and other intermediates in this pathway. These conditions can cause a range of symptoms, including neurological problems, skin sensitivity to light, and abdominal pain.

Levulinic acid is not specifically a medical term, but it is a chemical compound with the formula C5H8O2. It is a white crystalline solid that is used in the production of various chemicals and materials. However, I can provide you with some general information about levulinic acid:

Levulinic acid is a saturated carboxylic acid, which means it contains a carboxyl group (-COOH) and is fully saturated with hydrogen atoms. It is an alpha-beta unsaturated carboxylic acid due to the presence of a carbon-carbon double bond (C=C) between the second and third carbon atoms in its structure.

Levulinic acid can be found naturally in small amounts in various fruits, such as apples and grapes, and is also present in some fermented foods like beer and wine. It can be produced industrially from biomass sources, such as cellulose or lignocellulosic materials, through a process called acid hydrolysis.

In the medical field, levulinic acid may have potential applications as an antimicrobial agent due to its ability to inhibit the growth of certain bacteria and fungi. It is also used in the synthesis of pharmaceuticals and other chemical products. However, it is not a substance that is typically directly associated with medical treatment or diagnosis.

Hexachlorobenzene (HCB) is not typically included in standard medical textbooks or resources as it's more of a environmental and industrial chemical. However, I can provide you with an definition from a toxicological perspective:

Hexachlorobenzene (C6Cl6) is an organic compound that consists of a benzene ring with six chlorine atoms attached to it. It is a persistent organic pollutant, which means it does not break down easily and can accumulate in the environment and living organisms. HCB has been used as a pesticide, fungicide, and chemical intermediate in various industrial processes. Exposure to this compound can lead to several health issues, including skin lesions, damage to the nervous system, and impaired immune function. It's also considered a possible human carcinogen by some agencies. Long-term environmental exposure to HCB is of particular concern due to its bioaccumulation in the food chain and potential adverse effects on human health and the environment.

Porphobilinogen Synthase (also known as PBGD or hydroxymethylbilane synthase) is an enzyme that catalyzes the second step in the heme biosynthesis pathway. This enzyme is responsible for converting two molecules of porphobilinogen into a linear tetrapyrrole called hydroxymethylbilane, which is then converted into uroporphyrinogen III by uroporphyrinogen III synthase.

Deficiency in Porphobilinogen Synthase can lead to a rare genetic disorder known as acute intermittent porphyria (AIP), which is characterized by the accumulation of porphobilinogen and other precursors in the heme biosynthesis pathway, resulting in neurovisceral symptoms such as abdominal pain, vomiting, neuropathy, and psychiatric disturbances.

Ammonia-lyases are a class of enzymes that catalyze the removal of an amino group from a substrate, releasing ammonia in the process. These enzymes play important roles in various biological pathways, including the biosynthesis and degradation of various metabolites such as amino acids, carbohydrates, and aromatic compounds.

The reaction catalyzed by ammonia-lyases typically involves the conversion of an alkyl or aryl group to a carbon-carbon double bond through the elimination of an amine group. This reaction is often reversible, allowing the enzyme to also catalyze the addition of an amino group to a double bond.

Ammonia-lyases are classified based on the type of substrate they act upon and the mechanism of the reaction they catalyze. Some examples of ammonia-lyases include aspartate ammonia-lyase, which catalyzes the conversion of aspartate to fumarate, and tyrosine ammonia-lyase, which converts tyrosine to p-coumaric acid.

These enzymes are important in both plant and animal metabolism and have potential applications in biotechnology and industrial processes.

Flavoproteins are a type of protein molecule that contain noncovalently bound flavin mononucleotide (FMN) or flavin adenine dinucleotide (FAD) as cofactors. These flavin cofactors play a crucial role in redox reactions, acting as electron carriers in various metabolic pathways such as cellular respiration and oxidative phosphorylation. Flavoproteins are involved in several biological processes, including the breakdown of fatty acids, amino acids, and carbohydrates, as well as the synthesis of steroids and other lipids. They can also function as enzymes that catalyze various redox reactions, such as oxidases, dehydrogenases, and reductases. Flavoproteins are widely distributed in nature and found in many organisms, from bacteria to humans.

Ferrochelatase is a medical/biochemical term that refers to an enzyme called Fe-chelatase or heme synthase. This enzyme plays a crucial role in the biosynthesis of heme, which is a vital component of hemoglobin, cytochromes, and other important biological molecules.

Ferrochelatase functions by catalyzing the insertion of ferrous iron (Fe2+) into protoporphyrin IX, the final step in heme biosynthesis. This enzyme is located within the inner mitochondrial membrane of cells and is widely expressed in various tissues, with particularly high levels found in erythroid precursor cells, liver, and brain.

Defects or mutations in the ferrochelatase gene can lead to a rare genetic disorder called erythropoietic protoporphyria (EPP), which is characterized by an accumulation of protoporphyrin IX in red blood cells, plasma, and other tissues. This accumulation results in photosensitivity, skin lesions, and potential complications such as liver dysfunction and gallstones.

Heme is not a medical term per se, but it is a term used in the field of medicine and biology. Heme is a prosthetic group found in hemoproteins, which are proteins that contain a heme iron complex. This complex plays a crucial role in various biological processes, including oxygen transport (in hemoglobin), electron transfer (in cytochromes), and chemical catalysis (in peroxidases and catalases).

The heme group consists of an organic component called a porphyrin ring, which binds to a central iron atom. The iron atom can bind or release electrons, making it essential for redox reactions in the body. Heme is also vital for the formation of hemoglobin and myoglobin, proteins responsible for oxygen transport and storage in the blood and muscles, respectively.

In summary, heme is a complex organic-inorganic structure that plays a critical role in several biological processes, particularly in electron transfer and oxygen transport.

Griseofulvin is an antifungal medication used to treat various fungal infections, including those affecting the skin, hair, and nails. It works by inhibiting the growth of fungi, particularly dermatophytes, which cause these infections. Griseofulvin can be obtained through a prescription and is available in oral (by mouth) and topical (on the skin) forms.

The primary mechanism of action for griseofulvin involves binding to tubulin, a protein necessary for fungal cell division. This interaction disrupts the formation of microtubules, which are crucial for the fungal cell's structural integrity and growth. As a result, the fungi cannot grow and multiply, allowing the infected tissue to heal and the infection to resolve.

Common side effects associated with griseofulvin use include gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea), headache, dizziness, and skin rashes. It is essential to follow the prescribing physician's instructions carefully when taking griseofulvin, as improper usage may lead to reduced effectiveness or increased risk of side effects.

It is important to note that griseofulvin has limited use in modern medicine due to the development of newer and more effective antifungal agents. However, it remains a valuable option for specific fungal infections, particularly those resistant to other treatments.

Coproporphyrinogen Oxidase is a mitochondrial enzyme that plays a crucial role in the biosynthesis of heme, which is an essential component of hemoglobin and other hemoproteins. This enzyme catalyzes the oxidative decarboxylation of coproporphyrinogen III to protoporphyrinogen IX, a key step in the heme biosynthetic pathway.

Deficiency or dysfunction of Coproporphyrinogen Oxidase can lead to a rare genetic disorder known as Hereditary Coproporphyria (HCP), which is characterized by the accumulation of coproporphyrinogen III and its derivative, coproporphyrin, in various tissues and body fluids. This accumulation can result in a range of symptoms, including abdominal pain, neurological disturbances, and skin manifestations.

Coproporphyrinogens are intermediates in the biosynthesis of heme, a complex molecule that is essential for various biological processes including oxygen transport and cellular respiration. There are two types of coproporphyrinogens: Coproporphyrinogen I and Coproporphyrinogen III.

Coproporphyrinogen I is an intermediate in the biosynthesis of siroheme, a porphyrin-like molecule that functions as a cofactor for enzymes involved in sulfur and nitrogen metabolism. It is produced from uroporphyrinogen III through the action of coproporphyrinogen oxidase.

Coproporphyrinogen III, on the other hand, is an intermediate in the biosynthesis of heme. It is produced from protoporphyrinogen IX through the action of coproporphyrinogen oxidase and then converted to protoporphyrin IX by the enzyme coproporphyrinogen III decarboxylase. Protoporphyrin IX is then converted to heme by the addition of iron in a reaction catalyzed by ferrochelatase.

Abnormal accumulation of coproporphyrinogens can occur due to various genetic and acquired disorders that affect enzymes involved in heme biosynthesis, leading to the accumulation of porphyrins and their precursors in tissues and bodily fluids. These conditions are known as porphyrias and can present with a variety of symptoms including neuropsychiatric manifestations, skin lesions, and gastrointestinal disturbances.

I apologize, but I am unable to find a medical definition for "dicarbethoxydihydrocollidine." It is possible that this term does not have a specific meaning within the field of medicine. A more general search indicates that dicarbethoxydihydrocollidine may be a chemical compound used in research or industry, but it does not appear to have direct relevance to medical diagnosis, treatment, or health. If you have further questions or need information on a related medical topic, I would be happy to help you with those.

Skin diseases, also known as dermatological conditions, refer to any medical condition that affects the skin, which is the largest organ of the human body. These diseases can affect the skin's function, appearance, or overall health. They can be caused by various factors, including genetics, infections, allergies, environmental factors, and aging.

Skin diseases can present in many different forms, such as rashes, blisters, sores, discolorations, growths, or changes in texture. Some common examples of skin diseases include acne, eczema, psoriasis, dermatitis, fungal infections, viral infections, bacterial infections, and skin cancer.

The symptoms and severity of skin diseases can vary widely depending on the specific condition and individual factors. Some skin diseases are mild and can be treated with over-the-counter medications or topical creams, while others may require more intensive treatments such as prescription medications, light therapy, or even surgery.

It is important to seek medical attention if you experience any unusual or persistent changes in your skin, as some skin diseases can be serious or indicative of other underlying health conditions. A dermatologist is a medical doctor who specializes in the diagnosis and treatment of skin diseases.

Oxidoreductases acting on CH-CH group donors are a class of enzymes within the larger group of oxidoreductases, which are responsible for catalyzing oxidation-reduction reactions. Specifically, this subclass of enzymes acts upon donors containing a carbon-carbon (CH-CH) bond, where one atom or group of atoms is oxidized and another is reduced during the reaction process. These enzymes play crucial roles in various metabolic pathways, including the breakdown and synthesis of carbohydrates, lipids, and amino acids.

The reactions catalyzed by these enzymes involve the transfer of electrons and hydrogen atoms between the donor and an acceptor molecule. This process often results in the formation or cleavage of carbon-carbon bonds, making them essential for numerous biological processes. The systematic name for this class of enzymes is typically structured as "donor:acceptor oxidoreductase," where donor and acceptor represent the molecules involved in the electron transfer process.

Examples of enzymes that fall under this category include:

1. Aldehyde dehydrogenases (EC 1.2.1.3): These enzymes catalyze the oxidation of aldehydes to carboxylic acids, using NAD+ as an electron acceptor.
2. Dihydrodiol dehydrogenase (EC 1.3.1.14): This enzyme is responsible for the oxidation of dihydrodiols to catechols in the biodegradation of aromatic compounds.
3. Succinate dehydrogenase (EC 1.3.5.1): A key enzyme in the citric acid cycle, succinate dehydrogenase catalyzes the oxidation of succinate to fumarate and reduces FAD to FADH2.
4. Xylose reductase (EC 1.1.1.307): This enzyme is involved in the metabolism of pentoses, where it reduces xylose to xylitol using NADPH as a cofactor.

Erythropoietic Protoporphyria (EPP) is a rare inherited disorder of porphyrin metabolism. It results from a deficiency in the ferrochelatase enzyme, which normally catalyzes the insertion of iron into protoporphyrin to form heme. This deficiency leads to an accumulation of protoporphyrin, particularly in red blood cells and plasma.

The accumulated protoporphyrin is sensitive to light, particularly wavelengths between 400-410 nm (blue light). When exposed to this light, the protoporphyrin molecules absorb the light energy and transfer it to molecular oxygen, leading to the formation of highly reactive singlet oxygen. This reaction causes oxidative damage to surrounding tissues, resulting in the symptoms of EPP.

The main symptom is severe, painful burn-like reactions on exposed skin after sunlight exposure, often accompanied by swelling and itching. These symptoms can occur within minutes of sun exposure and can last for several days. Chronic skin changes such as scarring and milia can also occur over time.

EPP is usually diagnosed through the measurement of porphyrins in the blood or stool, and genetic testing can confirm the diagnosis. Treatment typically involves avoiding sunlight exposure, using sun protection measures, and in some cases, oral beta-carotene or cysteine supplements to reduce symptoms. In severe cases, heme arginate or afamelanotide may be used.

Photosensitivity disorders refer to conditions that cause an abnormal reaction to sunlight or artificial light. This reaction can take the form of various skin changes, such as rashes, inflammation, or pigmentation, and in some cases, it can also lead to systemic symptoms like fatigue, fever, or joint pain.

The two main types of photosensitivity disorders are:

1. Phototoxic reactions: These occur when a substance (such as certain medications, chemicals, or plants) absorbs light energy and transfers it to skin cells, causing damage and inflammation. The reaction typically appears within 24 hours of exposure to the light source and can resemble a sunburn.

2. Photoallergic reactions: These occur when the immune system responds to the combination of light and a particular substance, leading to an allergic response. The reaction may not appear until several days after initial exposure and can cause redness, itching, and blistering.

It is important for individuals with photosensitivity disorders to avoid excessive sun exposure, wear protective clothing, and use broad-spectrum sunscreens with a high SPF rating to minimize the risk of phototoxic or photoallergic reactions.

Bloodletting is a medical procedure that was commonly used in the past to balance the four humors of the body, which were believed to be blood, phlegm, black bile, and yellow bile. The procedure involved withdrawing blood from a patient through various methods such as venesection (making an incision in a vein), leeches, or cupping.

The theory behind bloodletting was that if one humor became overabundant, it could cause disease or illness. By removing some of the excess humor, practitioners believed they could restore balance and promote healing. Bloodletting was used to treat a wide variety of conditions, including fever, inflammation, and pain.

While bloodletting is no longer practiced in modern medicine, it was once a common treatment for many different ailments. The practice dates back to ancient times and was used by various cultures throughout history, including the Greeks, Romans, Egyptians, and Chinese. However, its effectiveness as a medical treatment has been called into question, and it is now considered an outdated and potentially harmful procedure.

Protoporphyrins are organic compounds that are the immediate precursors to heme in the porphyrin synthesis pathway. They are composed of a porphyrin ring, which is a large, complex ring made up of four pyrrole rings joined together, with an acetate and a propionate side chain at each pyrrole. Protoporphyrins are commonly found in nature and are important components of many biological systems, including hemoglobin, the protein in red blood cells that carries oxygen throughout the body.

There are several different types of protoporphyrins, including protoporphyrin IX, which is the most common form found in humans and other animals. Protoporphyrins can be measured in the blood or other tissues as a way to diagnose or monitor certain medical conditions, such as lead poisoning or porphyrias, which are rare genetic disorders that affect the production of heme. Elevated levels of protoporphyrins in the blood or tissues can indicate the presence of these conditions and may require further evaluation and treatment.

Allylisopropylacetamide is not a term that has a widely accepted or established medical definition. It is a chemical compound with the formula (CH₂CHCH₂)N(C=O)CH(CH₃)₂, and it may have various chemical or industrial uses, but it is not a term that is commonly used in medical contexts.

If you have any specific questions about this compound or its potential uses or effects, I would recommend consulting with a relevant expert, such as a chemist or toxicologist, who can provide more detailed and accurate information based on their expertise and knowledge of the subject.

In medical terms, "precipitating factors" refer to specific events, actions, or circumstances that trigger the onset of a disease, symptom, or crisis in an individual who is already vulnerable due to pre-existing conditions. These factors can vary depending on the particular health issue, and they may include things like physical stress, emotional stress, environmental triggers, or changes in medication.

For example, in the context of a heart condition, precipitating factors might include strenuous exercise, exposure to extreme temperatures, or the use of certain drugs that increase heart rate or blood pressure. In mental health, precipitating factors for a depressive episode could include significant life changes such as the loss of a loved one, financial difficulties, or a major life transition.

Identifying and managing precipitating factors is an important aspect of preventative healthcare and disease management, as it can help individuals reduce their risk of experiencing negative health outcomes.

Hemochromatosis is a medical condition characterized by excessive absorption and accumulation of iron in the body, resulting in damage to various organs. It's often referred to as "iron overload" disorder. There are two main types: primary (hereditary) and secondary (acquired). Primary hemochromatosis is caused by genetic mutations that lead to increased intestinal iron absorption, while secondary hemochromatosis can be the result of various conditions such as multiple blood transfusions, chronic liver disease, or certain types of anemia.

In both cases, the excess iron gets stored in body tissues, particularly in the liver, heart, and pancreas, which can cause organ damage and lead to complications like cirrhosis, liver failure, diabetes, heart problems, and skin discoloration. Early diagnosis and treatment through regular phlebotomy (blood removal) or chelation therapy can help manage the condition and prevent severe complications.

Erythrocytes, also known as red blood cells (RBCs), are the most common type of blood cell in circulating blood in mammals. They are responsible for transporting oxygen from the lungs to the body's tissues and carbon dioxide from the tissues to the lungs.

Erythrocytes are formed in the bone marrow and have a biconcave shape, which allows them to fold and bend easily as they pass through narrow blood vessels. They do not have a nucleus or mitochondria, which makes them more flexible but also limits their ability to reproduce or repair themselves.

In humans, erythrocytes are typically disc-shaped and measure about 7 micrometers in diameter. They contain the protein hemoglobin, which binds to oxygen and gives blood its red color. The lifespan of an erythrocyte is approximately 120 days, after which it is broken down in the liver and spleen.

Abnormalities in erythrocyte count or function can lead to various medical conditions, such as anemia, polycythemia, and sickle cell disease.

Liver diseases refer to a wide range of conditions that affect the normal functioning of the liver. The liver is a vital organ responsible for various critical functions such as detoxification, protein synthesis, and production of biochemicals necessary for digestion.

Liver diseases can be categorized into acute and chronic forms. Acute liver disease comes on rapidly and can be caused by factors like viral infections (hepatitis A, B, C, D, E), drug-induced liver injury, or exposure to toxic substances. Chronic liver disease develops slowly over time, often due to long-term exposure to harmful agents or inherent disorders of the liver.

Common examples of liver diseases include hepatitis, cirrhosis (scarring of the liver tissue), fatty liver disease, alcoholic liver disease, autoimmune liver diseases, genetic/hereditary liver disorders (like Wilson's disease and hemochromatosis), and liver cancers. Symptoms may vary widely depending on the type and stage of the disease but could include jaundice, abdominal pain, fatigue, loss of appetite, nausea, and weight loss.

Early diagnosis and treatment are essential to prevent progression and potential complications associated with liver diseases.

Carboxy-lyases are a class of enzymes that catalyze the removal of a carboxyl group from a substrate, often releasing carbon dioxide in the process. These enzymes play important roles in various metabolic pathways, such as the biosynthesis and degradation of amino acids, sugars, and other organic compounds.

Carboxy-lyases are classified under EC number 4.2 in the Enzyme Commission (EC) system. They can be further divided into several subclasses based on their specific mechanisms and substrates. For example, some carboxy-lyases require a cofactor such as biotin or thiamine pyrophosphate to facilitate the decarboxylation reaction, while others do not.

Examples of carboxy-lyases include:

1. Pyruvate decarboxylase: This enzyme catalyzes the conversion of pyruvate to acetaldehyde and carbon dioxide during fermentation in yeast and other organisms.
2. Ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO): This enzyme is essential for photosynthesis in plants and some bacteria, as it catalyzes the fixation of carbon dioxide into an organic molecule during the Calvin cycle.
3. Phosphoenolpyruvate carboxylase: Found in plants, algae, and some bacteria, this enzyme plays a role in anaplerotic reactions that replenish intermediates in the citric acid cycle. It catalyzes the conversion of phosphoenolpyruvate to oxaloacetate and inorganic phosphate.
4. Aspartate transcarbamylase: This enzyme is involved in the biosynthesis of pyrimidines, a class of nucleotides. It catalyzes the transfer of a carboxyl group from carbamoyl aspartate to carbamoyl phosphate, forming cytidine triphosphate (CTP) and fumarate.
5. Urocanase: Found in animals, this enzyme is involved in histidine catabolism. It catalyzes the conversion of urocanate to formiminoglutamate and ammonia.

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