Monoamine
neurotransmitter deficiency has been implicated in the etiology of neuropsychiatric symptoms associated with chronic hyperphenylalaninemia in
phenylketonuria (PKU). Two proposed explanations for
neurotransmitter deficiency in PKU include first, that chronically elevated blood
L-phenylalanine (Phe) inhibits the transport of
L-tyrosine (Tyr) and
L-tryptophan (Trp), the substrates for
dopamine and
serotonin synthesis respectively, into brain. In the second hypothesis, elevated Phe competitively inhibits brain
tyrosine hydroxylase (TH) and
tryptophan hydroxylase (TPH) activities, the rate limiting steps in
dopamine and
serotonin synthesis. Dietary supplementation with large
neutral amino acids (LNAA) including Tyr and Trp has been recommended for individuals with chronically elevated blood Phe in an attempt to restore
amino acid and monoamine homeostasis in brain. As a potential alternative treatment approach, we demonstrate that pharmacologic inhibition of Tyr degradation through
oral administration of
nitisinone (NTBC) yielded sustained increases in blood and brain Tyr, decreased blood and brain Phe, and consequently increased
dopamine synthesis in a murine model of PKU. Our results suggest that Phe-mediated inhibition of TH activity is the likely mechanism of impaired
dopamine synthesis in PKU. Pharmacologic inhibition of Tyr degradation may be a promising adjunct
therapy for CNS monoamine
neurotransmitter deficiency in hyperphenylalaninemic individuals with PKU.