Tetrahydrobiopterin treatment in phenylketonuria: A repurposing approach.

Abstract:

:In phenylketonuria (PKU) patients, early diagnosis by neonatal screening and immediate institution of a phenylalanine-restricted diet can prevent severe intellectual impairment. Nevertheless, outcome remains suboptimal in some patients asking for additional treatment strategies. Tetrahydrobiopterin (BH4 ) could be one of those treatment options, as it may not only increase residual phenylalanine hydroxylase activity in BH4 -responsive PKU patients, but possibly also directly improves neurocognitive functioning in both BH4 -responsive and BH4 -unresponsive PKU patients. In the present review, we aim to further define the theoretical working mechanisms by which BH4 might directly influence neurocognitive functioning in PKU having passed the blood-brain barrier. Further research should investigate which of these mechanisms are actually involved, and should contribute to the development of an optimal BH4 treatment regimen to directly improve neurocognitive functioning in PKU. Such possible repurposing approach of BH4 treatment in PKU may improve neuropsychological outcome and mental health in both BH4 -responsive and BH4 -unresponsive PKU patients.

journal_name

J Inherit Metab Dis

authors

Evers RAF,van Vliet D,van Spronsen FJ

doi

10.1002/jimd.12151

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

189-199

issue

2

eissn

0141-8955

issn

1573-2665

journal_volume

43

pub_type

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