Trends in enzyme therapy for phenylketonuria.
Phenylketonuria (PKU) is an inborn error of amino acid metabolism caused by phenylalanine hydroxylase (PAH) deficiency. Dietary treatment has been the cornerstone for controlling systemic phenylalanine (Phe) levels in PKU for the past 4 decades. Over the years, it has become clear that blood Phe concentration needs to be controlled for the life of the patient, a difficult task taking into consideration that the diet becomes very difficult to maintain. Therefore alternative models of therapy are being pursued. This review describes the progress made in enzyme replacement therapy for PKU. Two modalities are discussed, PAH and phenylalanine ammonia-lyase PAH. Developing stable and functional forms of both enzymes has proven difficult, but recent success in producing polyethylene glycol-modified forms of active and stable PAH shows promise.
Kim
Woomi
W
Department of Molecular and Experimental Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA.
Erlandsen
Heidi
H
Surendran
Sankar
S
Stevens
Raymond C
RC
Gamez
Alejandra
A
Michols-Matalon
Kimberlee
K
Tyring
Stephen K
SK
Matalon
Reuben
R
D001708:Biopterins / Q000031:analogs & derivatives* / Q000494:pharmacology; D002214:Capsules / Q000737:chemistry; D004358:Drug Therapy / Q000379:methods / Q000639:trends; D006801:Humans; D010650:Phenylalanine Ammonia-Lyase / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use*; D010651:Phenylalanine Hydroxylase / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use*; D010661:Phenylketonurias / Q000188:drug therapy* / Q000378:metabolism; D011092:Polyethylene Glycols / Q000737:chemistry
D002214:Capsules; D001708:Biopterins; D011092:Polyethylene Glycols; D010651:Phenylalanine Hydroxylase; D010650:Phenylalanine Ammonia-Lyase; C003402:sapropterin