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Ochronotic Pigmentation Is Caused by Homogentisic Acid and Is the Key Event in Alkaptonuria Leading to the Destructive Consequences of the disease-A Review

Lakshminarayan R Ranganath, Brendan P Norman, James A Gallagher

J Inherit Metab Dis. 2019 Sep;42(5):776-792.

PMID: 31282009

Abstract:

Ochronosis is the process in alkaptonuria (AKU) that causes all the debilitating morbidity. The process involves selective deposition of homogentisic acid (HGA)-derived pigment in tissues altering the properties of these tissues, leading to their failure. Some tissues like cartilage are more easily affected by ochronosis while others such as the liver and brain are unaffected for reasons that are still not understood. In vitro and mouse models of ochronosis have confirmed the dose relationships between HGA and ochronosis and also their modulation by p-hydroxyphenylpyruvate dioxygenase inhibition. Ochronosis cannot be fully reversed and is a key factor in influencing treatment decisions. Earlier detection of ochronosis preferably by noninvasive means is desirable. A cause-effect relationship between HGA and ochronosis is discussed. The similarity in AKU and familial hypercholesterolaemia is explored and lessons learnt. More research is needed to more fully understand the crucial nature of ochronosis.

Chemicals Related in the Paper:

Catalog Number Product Name Structure CAS Number Price
AP451138 Homogentisic acid Homogentisic acid 451-13-8 Price
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