
Research
Molecular Genetics of the Inherited Porphyrias
The biosynthesis of heme in man requires eight enzymatic steps to convert succinyl-CoA and glycine to the final product, heme. All eight enzymes are encoded by nuclear genes and four of the reactions occur in the cytosol, while four take place in the mitochondrion. Studies on the tissue-specific regulation of heme biosynthesis, and in particular the role of the first and rate-limiting enzyme in the pathway are discussed under the research description by Dr. D.F. Bishop. The focus of my research, in collaboration with Dr. R. J. Desnick, is the investigation of the inborn errors of heme biosynthesis, the inherited porphyrias. Each of these disorders results from the deficient activity of a particular heme biosynthetic enzyme. The inborn errors of heme biosynthesis provide the opportunity to investigate the effects of dominant mutations and the action of environmental factors, since most of these diseases are latent until exacerbated by an environmental or pharmacologic stress.Past accomplishments of the porphyria laboratory in the study of the human porphyrias have included the following: 1) Development of specific assays for the first four enzymes in the pathway, ALA-synthase, ALA-dehydratase, HMB-synthase and URO-synthase, 2) purification to homogeneity and characterization of the physical and kinetic properties of human ALA-dehydratase, HMB-synthase and URO-synthase, 3) isolation and characterization of the full-length cDNAs encoding human ALA-synthase (erythroid and hepatic cDNAs, see Dr. Bishop's research description), ALA-dehydratase, HMB-synthase and URO-synthase, 4) regional chromosomal assignment of the genes encoding ALA-synthase (erythroid and hepatic), ALA-dehydratase, HMB-synthase and URO-synthase, 5) demonstration of normal isozymes for ALA-dehydratase and identification of their role in the susceptibility to lead poisoning, 6) demonstration of the genetic heterogeneity in unrelated families with acute intermittent porphyria (AIP) by the immunologic identification of different mutations resulting in the presence or absence of the non-functional enzyme proteins, and 7) characterization of the molecular defects causing congenital erythropoietic porphyria.
Current efforts in our laboratory are focused at: 1) identification of the molecular lesions in patients with six porphyrias: acute intermittent porphyria, congenital erythropoietic porphyria, porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria and erythroprotoporhyria 3) expression of unique/interesting mutations found in any of the six porphyrias using an E. coli expression system and 4) establishment of a murine knock-out models for acute intermittent porphyria.
Publications
Berry AA, Desnick RJ, Astrin KH, Shabbeer J, Lucky AW. Two brothers with mild congenital erythropoietic porphyria due to a novel genotype. Arch Dermatol Res 2005; 141: 1575-1579.
Glass RB, Astrin K, Norton KI, Parsons R, Eng CM, Banikazemi M, Desnick RJ. Fabry disease: Renal sonographic and magnetic resonance imaging findings in affected males and carrier females with the classic and cardiac variant phenotypes. J Comput Assist Tomogr 2004; 28: 158-168.
Solis C, Aizencang GI, Astrin KH, Desnick RJ. Uroporphyrinogen III synthase erythroid promoter mutations in adjacent GATA1 and CP2 elements cause congenital erythropoietic porphyria. J Clin Invest 2001; 107(6): 753-762.
Aizencang G, Astrin KH, Desnick R. Uroporphyrinogen III synthase. An alternative promoter controls erythroid-specific expression in the murine gene. J Biol Chem 2000 Jan 28; 275(4): 2295-304.
Ashton-Prolla P, Tong B, Shabbeer M, Astrin KH, Eng CM, Desnick R. Fabry disease: twenty-two novel mutations in the a-galactosidase A gene and genotype/phenotype correlations in severely and mildly affected hemizygotes and heterozygotes. J Investig Med 2000 Jul; 48(4): 227-35.
Solis C, Lopez-Echaniz I, Sefarty-Graneda D, Astrin K, Desnick R. Identification and expression of mutations in the hydroxymethylbilane synthase gene causing acute intermittent porphyria (AIP). Mol Med 1999 Oct; 5(10): 664-71.
Topaloglu AK, Ashley GA, Tong B, Shabbeer M, Astrin KH, Eng CM, Desnick RJ. Twenty novel mutations in the a-galactosidase A gene causing Fabry disease. Mol Med 1999 Dec; 5(12): 806-11.
Desnick R, Glass IA, Xu W, Solis C, Astrin KH. Molecular genetics of congenital erythropoietic porphyria. Semin Liver Dis 1998; 18(1): 77-84.
Kauppinen R, Glass IA, Aizencang G, Astrin K, Atweh G, Desnick R. Congenital erythropoietic porphyria: prolonged high-level expression and correction of the heme biosynthetic defect by retroviral-mediated gene transfer into porphyric and erythroid cells. Mol Genet Metab 1998 Sep; 65(1): 10-7.
Xu W, Astrin KH, Desnick R. Molecular basis of congenital erythropoietic porphyria: mutations in the human uroporphyrinogen III synthase gene. Hum Mutat 1996; 7(3): 187-92.
Industry Relationships
Physicians and scientists on the faculty of the Icahn School of Medicine at Mount Sinai often interact with pharmaceutical, device and biotechnology companies to improve patient care, develop new therapies and achieve scientific breakthroughs. In order to promote an ethical and transparent environment for conducting research, providing clinical care and teaching, Mount Sinai requires that salaried faculty inform the School of their relationships with such companies.
Dr.Astrin is not currently required to report Industry relationships.
Mount Sinai's faculty policies relating to faculty collaboration with industry are posted on our website at http://icahn.mssm.edu/about-us/services-and-resources/faculty-resources/handbooks-and-policies/faculty-handbook. Patients may wish to ask their physician about the activities they perform for companies.
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