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Hipertriptofanemia
ORPHA:2224CID-10 · E70.8CID-11 · 5C50.3OMIM 600627DOENÇA RARA

A hipertriptofanemia familiar é caracterizada por déficit intelectual associado a problemas comportamentais: alterações periódicas de humor, respostas afetivas exageradas e comportamento sexual anormal. Doze casos foram relatados até agora. Anormalidades congênitas no metabolismo do triptofano parecem ser responsáveis ​​pela triptofanemia e triptofanúria.

Mantido por Agente Raras·Colaborar como especialista →

Introdução

O que você precisa saber de cara

📋

A hipertriptofanemia familiar é caracterizada por déficit intelectual associado a problemas comportamentais: alterações periódicas de humor, respostas afetivas exageradas e comportamento sexual anormal. Doze casos foram relatados até agora. Anormalidades congênitas no metabolismo do triptofano parecem ser responsáveis ​​pela triptofanemia e triptofanúria.

Publicações científicas
13 artigos
Último publicado: 2023 Dec 20

Escala de raridade

CLASSIFICAÇÃO ORPHANET · BRASIL 2024
<1 / 1 000 000
Ultra-rara
<1/50k
Muito rara
1/20k
Rara
1/10k
Pouco freq.
1/5k
Incomum
1/2k
Prevalência
0.0
Worldwide
Casos conhecidos
12
pacientes catalogados
Início
Childhood
+ infancy, neonatal
🏥
SUS: Cobertura mínimaScore: 15%
CID-10: E70.8
🇧🇷Dados SUS / DATASUS
PROCEDIMENTOS SIGTAP (6)
0202010279
Dosagem de aminoácidos (erros inatos)metabolic_test
0202010295
Dosagem de ácidos orgânicos na urinagenetic_test
0202010490
Teste de triagem para erros inatos do metabolismonewborn_screening
0202010694
Sequenciamento completo do exoma (WES)rehabilitation
0202080013
Teste do pezinho (triagem neonatal)
0301070040
Atendimento em reabilitação — doenças raras
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Entender a doença

Do básico ao detalhe, leia no seu ritmo

Preparando trilha educativa...

Sinais e sintomas

O que aparece no corpo e com que frequência cada sintoma acontece

Partes do corpo afetadas

🧠
Neurológico
6 sintomas
👁️
Olhos
3 sintomas
🦴
Ossos e articulações
3 sintomas
🩸
Sangue
1 sintomas
👂
Ouvidos
1 sintomas
😀
Face
1 sintomas

+ 7 sintomas em outras categorias

Características mais comuns

100%prev.
Aumento da serotonina sérica
Muito frequente (99-80%)
100%prev.
Hipertriptofanemia
Muito frequente (99-80%)
100%prev.
Início neonatal
Obrigatório (100%)
90%prev.
Triptofanúria
Muito frequente (99-80%)
Amplificação do comportamento sexual
Miopia
23sintomas
Muito frequente (4)
Muito raro (2)
Sem dados (17)

Os sintomas variam de pessoa para pessoa. Abaixo estão as 23 características clínicas mais associadas, ordenadas por frequência.

Aumento da serotonina séricaIncreased serum serotonin
Muito frequente (99-80%)100%
HipertriptofanemiaHypertryptophanemia
Muito frequente (99-80%)100%
Início neonatalNeonatal onset
Obrigatório (100%)100%
TriptofanúriaTryptophanuria
Muito frequente (99-80%)90%
Amplificação do comportamento sexualAmplification of sexual behavior

Linha do tempo da pesquisa

Publicações por ano — veja quando o interesse científico cresceu
Anos de pesquisa3desde 2023
Total histórico13PubMed
Últimos 10 anos10publicações
Pico20172 papers
Linha do tempo
2023Hoje · 2026
Publicações por ano (últimos 10 anos)

Encontrou um erro ou informação desatualizada? Sugira uma correção →

Genética e causas

O que está alterado no DNA e como passa nas famílias

Genes associados

1 gene identificado com associação a esta condição. Padrão de herança: Autosomal recessive.

TDO2Tryptophan 2,3-dioxygenaseDisease-causing germline mutation(s) inTolerante
FUNÇÃO

Heme-dependent dioxygenase that catalyzes the oxidative cleavage of the L-tryptophan (L-Trp) pyrrole ring and converts L-tryptophan to N-formyl-L-kynurenine. Catalyzes the oxidative cleavage of the indole moiety

LOCALIZAÇÃO

VIAS BIOLÓGICAS (1)
Tryptophan catabolism
MECANISMO DE DOENÇA

Hypertryptophanemia

An autosomal recessive condition characterized by persistent hypertryptophanemia and hyperserotoninemia.

VIAS REACTOME (1)
EXPRESSÃO TECIDUAL(Tecido-específico)
Fígado
174.6 TPM
Pituitária
4.4 TPM
Intestino delgado
2.6 TPM
Pulmão
1.9 TPM
Brain Frontal Cortex BA9
1.3 TPM
OUTRAS DOENÇAS (1)
familial hypertryptophanemia
HGNC:11708UniProt:P48775

Variantes genéticas (ClinVar)

33 variantes patogênicas registradas no ClinVar.

🧬 TDO2: NM_005651.4(TDO2):c.838+35A>T ()
🧬 TDO2: NM_005651.4(TDO2):c.431+134G>T ()
🧬 TDO2: GRCh37/hg19 4q27-35.2(chr4:123399154-190957473)x3 ()
🧬 TDO2: GRCh37/hg19 4q24-35.2(chr4:101203509-190957473)x3 ()
🧬 TDO2: GRCh37/hg19 4p12-q35.2(chr4:45455621-191003541)x3 ()
Ver todas no ClinVar

Vias biológicas (Reactome)

1 via biológica associada aos genes desta condição.

Diagnóstico

Os sinais que médicos procuram e os exames que confirmam

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Tratamento e manejo

Remédios, cuidados de apoio e o que precisa acompanhar

Carregando informações de tratamento...

Onde tratar no SUS

Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)

🇧🇷 Atendimento SUS — Hipertriptofanemia

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Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.

Pesquisa ativa

Ensaios clínicos abertos e novidades científicas recentes

Pesquisa e ensaios clínicos

Nenhum ensaio clínico registrado para esta condição.

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Publicações mais relevantes

🥇Melhor nível de evidência: Revisão sistemática
Timeline de publicações
5 papers (10 anos)
#1

Initiation of Brain Extract Fibrillation and Effective Cellular Internalization of Tryptophan Fibrils Unveils Its Neurotoxicity Risk.

ACS chemical neuroscience2023 Dec 20

Recent discoveries on the self-assembly of aromatic amino acids into amyloid-like neurotoxic nanostructures have initiated a quest to decode the molecular mechanisms for the initiation of neurodegeneration. Moreover, the multicomponent nature of the amyloid deposits still questions the existing and well-defined amyloid cascade hypothesis. Hence, deciphering the neurotoxicity of amyloid-like nanostructures of aromatic amino acids becomes crucial for understanding the etiology of amyloidogenesis. Here, we demonstrate the cellular internalization and consequential damaging effects of self-assembled amyloid-like tryptophan nanostructures on human neuroblastoma cells. The cell-damaging potential of tryptophan nanostructure seems to be facilitated via ROS generation, necrosis and apoptosis mediated cell death. Further, tryptophan nanostructures were found to be seeding competent conformers, which triggered aggressive aggregation of brain extract components. The early stage intermediate nanostructures possess a higher cross-seeding efficacy than the seeding potential of the matured tryptophan fibrils. In addition to the cell-damaging and cross-seeding effects, tryptophan fibrils were found to catalyze oxidation of neuromodulator dopamine. These findings add more insights into the specific role of tryptophan self-assembly during the pathogenesis of hypertryptophanemia and other amyloid-associated neurodegenerative complications.

#2

Systemic tryptophan homeostasis.

Frontiers in molecular biosciences2022

Tryptophan is an essential amino acid, which is not only a building block for protein synthesis, but also a precursor for the biosynthesis of co-enzymes and neuromodulators, such as NAD/NADP(H), kynurenic acid, melatonin and serotonin. It also plays a role in immune homeostasis, as local tryptophan catabolism impairs T-lymphocyte mediated immunity. Therefore, tryptophan plasmatic concentration needs to be stable, in spite of large variations in dietary supply. Here, we review the main checkpoints accounting for tryptophan homeostasis, including absorption, transport, metabolism and elimination, and we discuss the physiopathology of disorders associated with their dysfunction. Tryptophan is catabolized along the kynurenine pathway through the action of two enzymes that mediate the first and rate-limiting step of the pathway: indoleamine 2,3-dioxygenase 1 (IDO1) and tryptophan 2,3-dioxygenase (TDO). While IDO1 expression is restricted to peripheral sites of immune modulation, TDO is massively expressed in the liver and accounts for 90% of tryptophan catabolism. Recent data indicated that the stability of the TDO protein is regulated by tryptophan and that this regulation allows a tight control of tryptophanemia. TDO is stabilized when tryptophan is abundant in the plasma, resulting in rapid degradation of dietary tryptophan. In contrast, when tryptophan is scarce, TDO is degraded by the proteasome to avoid excessive tryptophan catabolism. This is triggered by the unmasking of a degron in a non-catalytic tryptophan-binding site, resulting in TDO ubiquitination by E3 ligase SKP1-CUL1-F-box. Deficiency in TDO or in the hepatic aromatic transporter SLC16A10 leads to severe hypertryptophanemia, which can disturb immune and neurological homeostasis.

#3

Tryptophan self-assembly yields cytotoxic nanofibers containing amyloid-mimicking and cross-seeding competent conformers.

Nanoscale2022 Nov 10

Dietary consumption of Trp via protein-based foods is essential for the maintenance of crucial metabolic processes including the synthesis of proteins and several vital metabolites such as serotonin, melatonin, acetyl CoA, and NADP. However, the abnormal build-up of Trp is known to cause familial hypertryptophanemia and several brain-related medical complications. The molecular mechanism of the onset of such Trp-driven health issues is largely unknown. Here, we show that Trp, under the physiologically mimicked conditions of temperature and buffer, undergoes a concentration driven self-assembly process, yielding amyloid-mimicking nanofibers. Viable H-bonds, π-π interactions and hydrophobic contacts between optimally coordinated Trp molecules become important factors for the formation of a Trp nanoassembly that displays a hydrophobic exterior and a hydrophilic interior. Importantly, Trp nanofibers were found to possess high affinity for native proteins, and they act as cross-seeding competent conformers capable of nucleating amyloid formation in globular proteins including whey protein β-lactoglobulin and type II diabetes linked insulin hormone. Moreover, these amyloid mimicking Trp nanostructures showed toxic effects on neuroblastoma cells. Since the key symptoms in hypertryptophanemia such as behavioural defects and brain-damaging oxidative stress are also observed in amyloid related disorders, our findings on amyloid-like Trp-nanofibers may help in the mechanistic understanding of Trp-related complications and these findings are equally important for innovation in applied nanomaterials design and strategies.

#4

Unusual Aggregates Formed by the Self-Assembly of Proline, Hydroxyproline, and Lysine.

ACS chemical neuroscience2021 Sep 01

There is a plethora of significant research that illustrates toxic self-assemblies formed by the aggregation of single amino acids, such as phenylalanine, tyrosine, tryptophan, cysteine, and methionine, and their implication on the etiology of inborn errors of metabolisms (IEMs), such as phenylketonuria, tyrosinemia, hypertryptophanemia, cystinuria, and hypermethioninemia, respectively. Hence, studying the aggregation behavior of single amino acids is very crucial from the chemical neuroscience perspective to understanding the common etiology between single amino acid metabolite disorders and amyloid diseases like Alzheimer's and Parkinson's. Herein we report the aggregation properties of nonaromatic single amino acids l-proline (Pro), l-hydroxyproline (Hyp), and l-lysine hydrochloride (Lys). The morphologies of the self-assembled structures formed by Pro, Hyp, and Lys were extensively studied by various microscopic techniques, and controlled morphological transitions were observed under varied concentrations and aging times. The mechanism of structure formation was deciphered by concentration-dependent 1H NMR analysis, which revealed the crucial role of hydrogen bonding and hydrophobic interactions in the structure formation of Pro, Hyp, and Lys. MTT assays on neural (SHSY5Y) cell lines revealed that aggregates formed by Pro, Hyp, and Lys reduced cell viability in a dose-dependent manner. These results may have important implications in the understanding of the patho-physiology of disorders such as hyperprolinemia, hyperhydroxyprolinemia, and hyperlysinemia since all these IEMs are associated with severe neurodegenerative symptoms, including intellectual disability, seizures, and psychiatric problems. Our future studies will endeavor to study these biomolecular assemblies in greater detail by immuno-histochemical analysis and advanced biophysical assays.

#5

Hypertryptasemia and Mast Cell-Related Disorders in Severe Osteoporotic Patients.

Mediators of inflammation2020

Systemic mastocytosis (SM) is characterized by a clonal proliferation of neoplastic mast cells (MCs) in one or more extracutaneous organs including the bone marrow (BM). SM is often associated with osteoporosis (OP) and fractures. Hypertryptasemia usually occurs in SM. We investigated the prevalence of hypertryptasemia in a series of severe osteoporotic patients, the performance of the tryptase test in diagnosing SM in these patients, and their bone features. The medical records of 232 patients (168 females and 64 males) with a diagnosis of OP (50.4% with fractures) and a serum tryptase assessment were reviewed. BM assessment was performed in a subset of hypertryptasemic patients; clinical, biochemical, and radiographic data were collected. Hypertryptasemia was detected in 33 patients. BM assessment (n = 16) was normal in 8 hypertryptasemic patients, while BM criteria for the diagnosis of SM were met in 3 patients, MC alterations were detected in 4 patients, and one patient presented a polycythemia vera. Serum tryptase levels were higher than 11.4 ng/ml in all patients with BM alterations. The best cut-off of tryptase level related to BM alterations was 17.9 ng/ml, with a sensibility and sensitivity of 75% (AUC = 0.797 and P = 0.015 by ROC analysis). All osteoporotic patients with hypertryptasemia experienced at least one vertebral fracture associated with a severe reduction of the lumbar bone mineral density. The prevalence of MC-related disorders in severe OP was 3.0%, accounting for the 7.4% of the secondary causes of OP. MC-related disorders may be involved in bone fragility and assessment of serum tryptase is useful to detect MC-related disorders.

Publicações recentes

Ver todas no PubMed

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Doenças relacionadas

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Referências e fontes

Bases de dados externas citadas neste artigo

Publicações científicas

Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.

  1. Initiation of Brain Extract Fibrillation and Effective Cellular Internalization of Tryptophan Fibrils Unveils Its Neurotoxicity Risk.
    ACS chemical neuroscience· 2023· PMID 37962955mais citado
  2. Systemic tryptophan homeostasis.
    Frontiers in molecular biosciences· 2022· PMID 36188218mais citado
  3. Tryptophan self-assembly yields cytotoxic nanofibers containing amyloid-mimicking and cross-seeding competent conformers.
    Nanoscale· 2022· PMID 36300424mais citado
  4. Unusual Aggregates Formed by the Self-Assembly of Proline, Hydroxyproline, and Lysine.
    ACS chemical neuroscience· 2021· PMID 34406754mais citado
  5. Hypertryptasemia and Mast Cell-Related Disorders in Severe Osteoporotic Patients.
    Mediators of inflammation· 2020· PMID 33144848mais citado
  6. Hypertryptophanemia due to tryptophan 2,3-dioxygenase deficiency.
    Mol Genet Metab· 2017· PMID 28285122recente

Bases de dados e fontes oficiais

Identificadores e referências canônicas usadas para montar este verbete.

  1. ORPHA:2224(Orphanet)
  2. OMIM OMIM:600627(OMIM)
  3. MONDO:0010907(MONDO)
  4. GARD:2871(GARD (NIH))
  5. Variantes catalogadas(ClinVar)
  6. Busca completa no PubMed(PubMed)
  7. Q5958803(Wikidata)

Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.

Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar

Hipertriptofanemia
Compêndio · Raras BR

Hipertriptofanemia

ORPHA:2224 · MONDO:0010907
Prevalência
<1 / 1 000 000
Casos
12 casos conhecidos
Herança
Autosomal recessive
CID-10
E70.8 · Outros distúrbios do metabolismo de aminoácidos aromáticos
CID-11
Início
Childhood, Infancy, Neonatal
Prevalência
0.0 (Worldwide)
MedGen
UMLS
C2931837
Repurposing
11 candidatos
azacitidineDNA methyltransferase inhibitor
cyanocobalaminmethylmalonyl CoA mutase stimulant|vitamin B
decitabineglucocorticoid receptor agonist
+8 outros
EuropePMC
Wikidata
Papers 10a
Evidência
🥇 Rev. sistemática
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