Skip to main content
Log in

Clinical application of genotypic diagnosis for phenylketonuria: theoretical considerations

  • Review
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Identification of mutations within the phenylalanine hydroxylase gene which cause phenylketonuria has introduced the possibility of diagnosing phenylketonuria by direct analysis of the genome. Genotypic analysis could be used for identifying homozygotes in the newborn period, for prenatal diagnosis, or for heterozygote detection in general populations. Establishing the clinical utility of genotypic diagnosis, however, will require characterization of the cohort of patients identified by genotypic diagnosis, correlation of mutant genotypes with specific biochemical and developmental phenotypes, and consideration of how genotypic diagnosis might contribute to improving the clinical outcome in individuals at risk for mental retardation due to hyperphenylalaninemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

HPA:

hyperphenylalaninemia

M:

mild alleles

N:

normal alleles

PAH:

phenylalanine hydroxylase

PKU:

phenylketonuria

S:

severe alleles

References

  1. Abadie V, Lyonnet S, Maurin N, Berthelon M, Caillaud C, Giraud F, Mattei JF, Rey F, Munnich A (1989) CpG dinucleotides are mutation hot spots in phenylketonuria. Genomics 5:936–939

    Article  PubMed  Google Scholar 

  2. Avigad S, Cohen BE, Bauer S, Schwartz G, Frydman M, Woo SLC, Niny Y, Shiloh Y (1990) Single origin of phenylketonuria in Yemenite Jews. Nature 344:168–170

    Article  PubMed  Google Scholar 

  3. Bartholome K, Olek K, Trefz F (1984) Compound heterozygotes in hyperphenylalaninaemia. Hum Genet 65:405–406

    Article  PubMed  Google Scholar 

  4. DiLella AG, Kwok SCM, Ledley FD, Marvit J, Woo SLC (1986a) Molecular structure and polymorphic map of the human phenylalanine hydroxylase gene. Biochemistry 25:743–749

    Article  PubMed  Google Scholar 

  5. DiLella AG, Marvit J, Lidsky AS, Güttler F, Woo SLC (1986b) Tight linkage between a splicing mutation and a specific DNA haplotype in phenylketonuria. Nature 322:799–803

    Article  PubMed  Google Scholar 

  6. DiLella AG, Marvit J, Brayton K, Woo SLC (1987) An amino-acid substitution involved in phenylketonuria is in linkage disequilibrium with DNA haplotype 2. Nature 327:333–336

    Article  PubMed  Google Scholar 

  7. Güttler F (1980) Hyperphenylalaninemia: diagnosis and classification of the various types of phenylalanine hydroxylase deficiency in childhood. Acta Paediatr Scand 280 [Suppl]:1–80

    Google Scholar 

  8. Güttler F, Lidsky AS, Ledley FD, DiLella AG, Sullivan SE, Woo SLC (1987) Correlation between polymorphic DNA haplotypes at phenylalanine hydroxylase locus and clinical phenotypes to phenylketonuria. J Pediatr 110:68–71

    PubMed  Google Scholar 

  9. Hsia DY, O'Flynn ME, Berman JL (1968) Atypical phenylketonuria with borderline or normal intelligence. Am J Dis Child 116:143–157

    PubMed  Google Scholar 

  10. John SW, Rozen R, Laframboise R, Laberge C, Scriver CR (1989) Novel PKU mutation on haplotype 2 in French-Canadians. Am J Hum Genet 45:905–909

    PubMed  Google Scholar 

  11. Kaufman S (1983) Phenylketonuria and its variants. Adv Hum Genet 13:217–297

    PubMed  Google Scholar 

  12. Kaufman S, Max EE, Kang ES (1975) Phenylalanime hydroxylase activity in liver biopsies from hyperphenylalaninemia heterozygotes: deviation for proportionality with gene dosage. Pediatr Res 9:632–634

    PubMed  Google Scholar 

  13. Kwok SCM, Ledley FD, LiLella AG, Robson KJH, Woo SLC (1985) Nucleotide sequence of a full-length cDNA clone and amino acid sequence of human phenylalanine hydroxylase. Biochemistry 24:556–561

    Article  PubMed  Google Scholar 

  14. Ledley FD, Levy H, Woo SLC (1986) Molecular analysis of the inheritance of phenylketonuria and mild hyperphenylalaninemia in families with both disorders. N Engl J Med 314:1276–1280

    PubMed  Google Scholar 

  15. Levy HL (1989) Molecular genetics of phenylketonuria and its implications. Am J Hum Genet 45:667–670

    PubMed  Google Scholar 

  16. Lichter-Konecki U, Konecki DS, DiLella AG, Brayton K, Marvit J, Hahn TM, Trefz FK, Woo SLC (1988) Phenylalanine hydroxylase deficiency caused by a single base, substitution in an exon of the human phenylalanine hydroxylase gene. Biochemistry 27:2881–2885

    Article  PubMed  Google Scholar 

  17. Marvitt J, DiLella AG, Brayton K, Ledley FD, Robson KJ, Woo SLC (1987) GT to AT transition at a splice donor site causes skipping of the preceding exon in phenylketonuria. Nucleic Acids Res 15:5613–5628

    PubMed  Google Scholar 

  18. Okano Y, Wang T, Eisensmith RC, Steinmann B, Gitzelmann R., Woo SLC (1990) Missense mutations associated with RFLP haplotypes 1 and 4 of the human phenylalanine hydroxylase gene. Am J Hum Genet 46:18–25

    PubMed  Google Scholar 

  19. Robson KJ, Chandra T, MacGillivray RT, Woo SLC (1982) Polysome immunoprecipitation of phenylalanine hydroxylase mRNA from rat liver and cloning of its cDNA. Proc Natl Acad Sci USA 79:4701–4705

    PubMed  Google Scholar 

  20. Scriver CR, Kaufman S, Woo SLC (1989) The hyperphenylalaninemias. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic basis of inherited disease. McGraw Hill, New York, pp 495–546

    Google Scholar 

  21. Wang T, Okano Y, Eisensmith R, Huang SZ, Zeng YT, Lo WH, Woo SLC (1989) Molecular genetics of phenylketonuria in Orientals: linkage disequilibrium between a termination mutation and haplotype 4 of the phenylalanine hydroxylase gene. Am J Hum Genet 45:675–680

    PubMed  Google Scholar 

  22. Wang T, Okano Y, Eisensmith RC, Fekete G, Schuler D, Berencsi G, Nasz I, Woo SLC (1990) Molecular genetics of PKU in eastern Europe: a nonsense mutation associated with haplotype 4 of the phenylalanine hydroxylase gene. Somat Cell Mol Genet 16:85–90

    Article  PubMed  Google Scholar 

  23. Woo SLC, Lidsky AS, Güttler F, Chandra T, Robson KJ (1983) Cloned human phenylalanine hydroxylase gene allows prenatal diagnosis and carrier detection of classical phenylketonuria. Nature 306:151–155

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ledley, F.D. Clinical application of genotypic diagnosis for phenylketonuria: theoretical considerations. Eur J Pediatr 150, 752–756 (1991). https://doi.org/10.1007/BF02026704

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02026704

Key words

Navigation