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Advances in understanding the pathogenesis of congenital erythropoietic porphyria.

Abstract
Congenital erythropoietic porphyria (CEP) is a rare genetic disease resulting from the remarkable deficient activity of uroporphyrinogen III synthase, the fourth enzyme of the haem biosynthetic pathway. This enzyme defect results in overproduction of the non-physiological and pathogenic porphyrin isomers, uroporphyrin I and coproporphyrin I. The predominant clinical characteristics of CEP include bullous cutaneous photosensitivity to visible light from early infancy, progressive photomutilation and chronic haemolytic anaemia. The severity of clinical manifestations is markedly heterogeneous among patients; and interdependence between disease severity and porphyrin amount in the tissues has been pointed out. A more pronounced endogenous production of porphyrins concomitant to activation of ALAS2, the first and rate-limiting of the haem synthesis enzymes in erythroid cells, has also been reported. CEP is inherited as autosomal recessive or X-linked trait due to mutations in UROS or GATA1 genes; however an involvement of other causative or modifier genes cannot be ruled out.
AuthorsElena Di Pierro, Valentina Brancaleoni, Francesca Granata
JournalBritish journal of haematology (Br J Haematol) Vol. 173 Issue 3 Pg. 365-79 (05 2016) ISSN: 1365-2141 [Electronic] England
PMID26969896 (Publication Type: Journal Article, Review, Research Support, Non-U.S. Gov't)
Copyright© 2016 John Wiley & Sons Ltd.
Chemical References
  • GATA1 Transcription Factor
  • GATA1 protein, human
  • Porphyrins
  • Heme
  • Uroporphyrinogen III Synthetase
Topics
  • GATA1 Transcription Factor (genetics)
  • Heme (biosynthesis)
  • Humans
  • Mutation
  • Phenotype
  • Porphyria, Erythropoietic (etiology, genetics, metabolism, pathology)
  • Porphyrins (biosynthesis, metabolism)
  • Uroporphyrinogen III Synthetase

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