title: Evidence for a tetrahydrobiopterin deficit in schizophrenia.
abstract: Tetrahydrobiopterin (BH(4)) is a vital cofactor maintaining availability of the amine neurotransmitters [dopamine (DA), noradrenaline (NA), and serotonin (5-HT)], regulating the synthesis of nitric oxide (NO) by nitric oxide synthase (NOS), and stimulating and modulating the glutamatergic system (directly and indirectly). These BH(4) properties and their potential relevance to schizophrenia led us to investigate the hypothesis of a study group (healthy controls, n=37; schizophrenics, n=154) effect on fasting plasma total biopterin levels (a measure of BH(4)). Study analysis showed a highly significant deficit of total biopterins for the schizophrenic sample after partialling out the effects of potential confounds of gender, age, ethnicity, neuroleptic use history and dose of current use, 24-hour dietary phenylalanine/protein ratio (a dietary variable relevant to BH(4) synthesis), and plasma phenylalanine (which stimulates BH(4) synthesis). A mean decrement of 34% in plasma total biopterins for schizophrenics from control values supports clinical relevance for the finding. In a subsample (21 controls and 23 schizophrenics), sequence analysis was done of the GTP cyclohydrolase I feedback regulatory gene and no mutations were found in the coding region of the gene. A deficiency of BH(4) could lead to hypofunction of the systems of DA, NA, 5-HT, NOS/NO, and glutamate, all of which have been independently implicated in schizophrenia psychopathology. Further, evidence has been accumulating which implicates the critical interdependence of these neurotransmitter systems in schizophrenia; this concept, along with the present study finding of a biopterin deficit, suggests that further study of the BH(4) system in schizophrenia is warranted and desirable.
authors.affiliation: The Nathan S. Kline Institute for Psychiatric Research, New York State Office of Mental Health, Orangeburg, NY 10962, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Richardson
authors.forename: Laura L
authors.initials: LL
authors.lastname: Read
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Taylor Clelland
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Reilly
authors.forename: Helen M
authors.initials: HM
authors.lastname: Chao
authors.forename: Robert W
authors.initials: RW
authors.lastname: Guynn
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Suckow
authors.forename: James D
authors.initials: JD
authors.lastname: Clelland
mesh_terms: D000328:Adult; D001708:Biopterins / Q000031:analogs & derivatives* / Q000096:biosynthesis / Q000097:blood / Q000172:deficiency; D003710:Demography; D005260:Female; D006136:GTP Cyclohydrolase / Q000235:genetics / Q000378:metabolism; D015971:Gene Expression Regulation, Enzymologic / Q000235:genetics; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D010649:Phenylalanine / Q000097:blood; D011506:Proteins / Q000235:genetics; D012559:Schizophrenia / Q000201:enzymology / Q000235:genetics / Q000378:metabolism*; D017422:Sequence Analysis, DNA
chemical_list: C101092:GCHFR protein, human; D047908:Intracellular Signaling Peptides and Proteins; D011506:Proteins; D001708:Biopterins; D009569:Nitric Oxide; D010649:Phenylalanine; D006136:GTP Cyclohydrolase; C003402:sapropterin