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Disease Management in Individuals with Phenylketonuria

Year 2024, Volume: 14 Issue: 2, 572 - 581, 28.06.2024
https://doi.org/10.33808/clinexphealthsci.1360624

Abstract

Phenylketonuria (PKU), one of the most common metabolic diseases, is a recessive, congenital and hereditary disease that occurs with the absence or deficiency of the enzyme called phenylalanine hydroxylase, which converts phenylalanine to tyrosine. Therefore, the aim of this review was to discuss the disease management in individuals with phenylketonuria. As a result of the inability to metabolize phenylalanine amino acid in patients with PKU, the level of phenylalanine increases in the systemic circulation and brain, which may lead to neurocognitive activity and psychosocial dysfunctions and various disorders. If infants with PKU, who are indistinguishable from healthy babies at first birth, are fed like normal babies, phenylalanine accumulates in the body and symptoms occur and gradually worsen. To keep the blood sugar phenylalanine level at the desired range various medical treatment methods (pharmacological treatment and gene therapy), especially nutritional therapy, can be preferred. However, alternative treatment methods should be carried out in combination with diet therapy. Some dietary restrictions are maintained for life, while patients follow a strict diet in dietary protein intake to prevent high plasma phenylalanine levels and neurological damage. In this review, the definition, classification and phenylalanine-restricted diet treatments of phenylketonuria are discussed.

References

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  • van Calcar SC, Ney DM. Food products made with glycomacropeptide, a low-phenylalanine whey protein, provide a new alternative to amino Acid-based medical foods for nutrition management of phenylketonuria. J Acad Nutr Diet. 2012;112(8):1201-1210. DOI:10.1016/j.jand.2012.05.004
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Year 2024, Volume: 14 Issue: 2, 572 - 581, 28.06.2024
https://doi.org/10.33808/clinexphealthsci.1360624

Abstract

References

  • MacDonald A, van Wegberg AMJ, Ahring K, Beblo S, Bélanger-Quintana A, Burlina A, Campistol J, Coşkun T, Feillet F, Giżewska M, Huijbregts SC, Leuzzi V, Maillot F, Muntau AC, Rocha JC, Romani C, Trefz F, van Spronsen FJ. PKU dietary handbook to accompany PKU guidelines. Orphanet J Rare Dis. 2020;15(1):171. DOI:10.1186/s13023-020-01391-y
  • Dijkstra AM, van Vliet N, van Vliet D, Romani C, Huijbregts SCJ, van der Goot E, Hovens IB, van der Zee EA, Kema IP, Heiner-Fokkema MR, van Spronsen FJ. Correlations of blood and brain biochemistry in phenylketonuria: Results from the Pah-enu2 PKU mouse. Mol Genet Metab. 2021;134(3):250-256. DOI:10.1016/j.ymgme.2021.09.004
  • Brown CS, Lichter-Konecki U. Phenylketonuria (PKU): A problem solved?. Mol Genet Metab Rep. 2015;6:8-12. DOI:10.1016/j.ymgmr.2015.12.004
  • van Calcar SC, Ney DM. Food products made with glycomacropeptide, a low-phenylalanine whey protein, provide a new alternative to amino Acid-based medical foods for nutrition management of phenylketonuria. J Acad Nutr Diet. 2012;112(8):1201-1210. DOI:10.1016/j.jand.2012.05.004
  • Blau N, van Spronsen FJ, Levy HL. Phenylketonuria. Lancet. 2010;376(9750):1417-1427. DOI:10.1016/S0140-6736(10)60961-0
  • Evans S, Daly A, Chahal S, MacDonald J, MacDonald A. Food acceptance and neophobia in children with phenylketonuria: a prospective controlled study. J Hum Nutr Diet. 2016;29(4):427-433. DOI:10.1111/jhn.12346
  • Williams RA, Mamotte CD, Burnett JR. Phenylketonuria: An inborn error of phenylalanine metabolism. Clin Biochem Rev. 2008;29(1):31-41.
  • Millington DS, Kodo N, Norwood DL, Roe CR. Tandem mass spectrometry: a new method for acylcarnitine profiling with potential for neonatal screening for inborn errors of metabolism. J Inherit Metab Dis. 1990;13(3):321-324. DOI:10.1007/BF01799385
  • Vockley J, Andersson HC, Antshel KM, Braverman NE, Burton BK, Frazier DM, Mitchell J, Smith WE, Thompson BH, Berry SA; American College of Medical Genetics and Genomics Therapeutics Committee. Phenylalanine hydroxylase deficiency: diagnosis and management guideline. Genet Med. 2014;16(2):188-200. DOI:10.1038/gim.2013.157
  • Al Hafid N, Christodoulou J. Phenylketonuria: A review of current and future treatments. Transl Pediatr. 2015;4(4):304-317. DOI:10.3978/j.issn.2224-4336.2015.10.07
  • ten Hoedt AE, de Sonneville LM, Francois B, ter Horst NM, Janssen MC, Rubio-Gozalbo ME, Wijburg FA, Hollak CE, Bosch AM. High phenylalanine levels directly affect mood and sustained attention in adults with phenylketonuria: A randomised, double-blind, placebo-controlled, crossover trial. J Inherit Metab Dis. 2011;34(1):165-171. DOI:10.1007/s10545-010-9253-9
  • Mitchell JJ, Trakadis YJ, Scriver CR. Phenylalanine hydroxylase deficiency. Genet Med. 2011;13(8):697-707. DOI:10.1097/GIM.0b013e3182141b48
  • American Academy of Pediatrics; Rose SR; Section on Endocrinology and Committee on Genetics, American Thyroid Association; Brown RS; Public Health Committee, Lawson Wilkins Pediatric Endocrine Society; Foley T, Kaplowitz PB, Kaye CI, Sundararajan S, Varma SK. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics 2006;117(6):2290-2303. DOI:10.1542/peds.2006-0915
  • Ashe K, Kelso W, Farrand S, Panetta J, Fazio T, De Jong G, Walterfang M. Psychiatric and cognitive aspects of phenylketonuria: the limitations of diet and promise of new treatments. Front Psychiatry 2019;10:561. DOI:10.3389/fpsyt.2019.00561
  • van Wegberg AMJ, MacDonald A, Ahring K, Bélanger-Quintana A, Blau N, Bosch AM, Burlina A, Campistol J, Feillet F, Giżewska M, Huijbregts SC, Kearney S, Leuzzi V, Maillot F, Muntau AC, van Rijn M, Trefz F, Walter JH, van Spronsen FJ. The Complete European guidelines on phenylketonuria: Diagnosis and treatment. Orphanet J Rare Dis. 2017;12(1):162. DOI:10.1186/s13023-017-0685-2
  • Blau N, Bélanger-Quintana A, Demirkol M, Feillet F, Giovannini M, MacDonald A, Trefz FK, van Spronsen FJ. Optimizing the use of sapropterin (BH(4) in the management of phenylketonuria. Mol Genet Metab. 2009;96(4):158-163. DOI:10.1016/j.ymgme.2009.01.002
  • Mahan KC, Gandhi MA, Anand S. Pegvaliase: A novel treatment option for adults with phenylketonuria. Curr Med Res Opin. 2019;35(4):647-651. DOI:10.1080/03007995.2018.1528215
  • Banta-Wright SA, Shelton KC, Lowe ND, Knafl KA, Houck GM. Breast-feeding success among infants with phenylketonuria. J Pediatr Nurs. 2012;27(4):319-327. DOI:10.1016/j.pedn.2011.03.015
  • Al Hafid N, Christodoulou J. Phenylketonuria: A review of current and future treatments. Transl Pediatr. 2015;4(4):304-317. DOI:10.3978/j.issn.2224-4336.2015.10.07
  • Strisciuglio P, Concolino D. New Strategies for the Treatment of Phenylketonuria (PKU). Metabolites. 2014;4(4):1007–1017. DOI:10.3390/metabo4041007
  • Sailer M, Elizondo G, Martin J, Harding CO, Gillingham MB. Nutrient intake, body composition, and blood phenylalanine control in children with phenylketonuria compared to healthy controls. Mol Genet Metab Rep. 2020;23:100599. DOI:10.1016/j.ymgmr.2020.100599
  • van Spronsen FJ, van Rijn M, Bekhof J, Koch R, Smit PG. Phenylketonuria: Tyrosine supplementation in phenylalanine-restricted diets. Am J Clin Nutr. 2001;73(2):153-157. DOI:10.1093/ajcn/73.2.153
  • Firman S, Witard OC, O'Keeffe M, Ramachandran R. Dietary protein and protein substitute requirements in adults with phenylketonuria: A review of the clinical guidelines. Clin Nutr. 2021;40(3):702-709. DOI:10.1016/j.clnu.2020.11.003
  • MacDonald A, Rocha JC, van Rijn M, Feillet F. Nutrition in phenylketonuria. Mol Genet Metab. 2011;104 Suppl:S10-S18. DOI:10.1016/j.ymgme.2011.08.023
  • Elhawary NA, AlJahdali IA, Abumansour IS, Elhawary EN, Gaboon N, Dandini M, Madkhali A, Alosaimi W, Alzahrani A, Aljohani F, Melibary EM, Kensara OA. Genetic etiology and clinical challenges of phenylketonuria. Hum Genomics 2022;16(1):22. DOI: 10.1186/s40246-022-00398-9.
  • Newbould E, Pinto A, Evans S, Ford S, O'Driscoll M, Ashmore C, Daly A, MacDonald A. Accidental Consumption of Aspartame in Phenylketonuria: Patient Experiences. Nutrients. 2021;13(2):707. DOI:10.3390/nu13020707
  • Araújo ACMF, Araújo WMC, Marquez UML, Akutsu R, Nakano EY. Table of Phenylalanine Content of Foods: Comparative Analysis of Data Compiled in Food Composition Tables. JIMD Rep. 2017;34:87-96. DOI:10.1007/8904_2016_12
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  • Dokoupil K, Gokmen-Ozel H, Lammardo AM, Motzfeldt K, Robert M, Rocha JC, van Rijn M, Ahring K, Bélanger-Quintana A, MacDonald A. Optimising growth in phenylketonuria: current state of the clinical evidence base. Clin Nutr. 2012;31(1):16-21. DOI:10.1016/j.clnu.2011.09.001
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There are 59 citations in total.

Details

Primary Language English
Subjects Nutritional Science, Clinical Nutrition, Nutrition and Dietetics (Other), Pediatric Metabolism Diseases
Journal Section Review
Authors

Esra Gül 0000-0003-1891-8701

Ayşe Güneş Bayır 0000-0002-9993-7850

Publication Date June 28, 2024
Submission Date September 18, 2023
Published in Issue Year 2024 Volume: 14 Issue: 2

Cite

APA Gül, E., & Güneş Bayır, A. (2024). Disease Management in Individuals with Phenylketonuria. Clinical and Experimental Health Sciences, 14(2), 572-581. https://doi.org/10.33808/clinexphealthsci.1360624
AMA Gül E, Güneş Bayır A. Disease Management in Individuals with Phenylketonuria. Clinical and Experimental Health Sciences. June 2024;14(2):572-581. doi:10.33808/clinexphealthsci.1360624
Chicago Gül, Esra, and Ayşe Güneş Bayır. “Disease Management in Individuals With Phenylketonuria”. Clinical and Experimental Health Sciences 14, no. 2 (June 2024): 572-81. https://doi.org/10.33808/clinexphealthsci.1360624.
EndNote Gül E, Güneş Bayır A (June 1, 2024) Disease Management in Individuals with Phenylketonuria. Clinical and Experimental Health Sciences 14 2 572–581.
IEEE E. Gül and A. Güneş Bayır, “Disease Management in Individuals with Phenylketonuria”, Clinical and Experimental Health Sciences, vol. 14, no. 2, pp. 572–581, 2024, doi: 10.33808/clinexphealthsci.1360624.
ISNAD Gül, Esra - Güneş Bayır, Ayşe. “Disease Management in Individuals With Phenylketonuria”. Clinical and Experimental Health Sciences 14/2 (June 2024), 572-581. https://doi.org/10.33808/clinexphealthsci.1360624.
JAMA Gül E, Güneş Bayır A. Disease Management in Individuals with Phenylketonuria. Clinical and Experimental Health Sciences. 2024;14:572–581.
MLA Gül, Esra and Ayşe Güneş Bayır. “Disease Management in Individuals With Phenylketonuria”. Clinical and Experimental Health Sciences, vol. 14, no. 2, 2024, pp. 572-81, doi:10.33808/clinexphealthsci.1360624.
Vancouver Gül E, Güneş Bayır A. Disease Management in Individuals with Phenylketonuria. Clinical and Experimental Health Sciences. 2024;14(2):572-81.

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