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The Pathophysiology and Treatment of Hereditary Tyrosinemia Type 1
Abstract
The topic of this review is hepatorenal tyrosinemia (hereditary tyrosinemia type 1 [HT1], or fumarylacetoacetate hydrolase deficiency; OMIM# 276700). HT1 is the most serious and common of the genetic defects in tyrosine degradation. In addition, this disorder has importance as a model of spontaneous self-correction of liver disease, as a model of liver repopulation by transplanted cells and gene therapy, and as a genetic cause of hepatocarcinoma. However, other forms of hypertyrosinemia exist; hence, the differential diagnosis also will be described briefly. Recent years have seen much progress in our understanding of the molecular basis, the pathophysiology, and especially the treatment of HT1. The current intervention with 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione (NTBC) therapy has improved the outcome of this once devastating disorder. The successful repopulation of the HT1 liver with transplanted cells and positive results in the use of gene therapy in animal models may someday lead to therapy in humans that will obviate the need for life-long dietary and pharmacological therapy.
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“When a FAH deficiency exists, toxic metabolites such as fumarylacetoacetate accumulate in hepatocytes and renal proximal tubules causing death in a cell-autonomous manner.22”
From Adeno‐associated virus gene repair corrects a mouse model of hereditary tyrosinemia in vivo†‡ (2010) · cites this paper as [22]
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“Hereditary tyrosinemia type I (HT1; OMIM #276700) is an autosomal-recessive inborn error of metabolism caused by deficiency in fumarylacetoacetate hydrolase (FAH), an enzyme that catalyzes the last step of tyrosine metabolism.[1-4] Absence of FAH causes accumulation of the toxic metabolite fumarylacetoacetate (FAA) in…”
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“These guidelines are based on our personal experience as well as extensive (albeit scarce) literature review (Couce et al. 2010, Grompe 2001, Sniderman King et al. 1993) and are detailed in Table 1 to 4.”
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“FAH deficiency impairs tyrosine catabolism, induces accumulation of toxic metabolic intermediates in the liver, and has a cytotoxic effect on hepatocytes (Grompe, 2001).”
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“MAA and FAA have short half-lives and do not leave the cells where they are produced (Grompe, 2017).”
Background
Metadata
- Authors
- Grompe, M.
- Affiliations
- Oregon Health & Science University (US)
- Corresponding author
- Grompe, Markus
- ORCID
- Grompe, Markus
- Venue
- Seminars in Liver Disease
- Publisher
- Georg Thieme Verlag KG
- Published
- 2001
- Volume
- 21
- Issue
- 04
- Pages
- 563-572
- ISSN
- 0272-8087 (ISSN-L)
- 1098-8971
- OpenAlex
- W2022449977
- Semantic Scholar
- b052e17377cc56df7ac16c995702a40e45e433db
- Cited by
- 167
- References
- 78
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 3 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 5 · 2018: 6 · 2017: 9 · 2016: 6 · 2015: 7 · 2014: 3 · 2013: 3 · 2012: 9
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Seminars in Liver Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Amino Acid Enzymes and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Glycogen Storage Diseases and Myoclonus
- Keywords
- tyrosinemia type I, fumarylacetoacetate hydrolase deficiency, tyrosine degradation, liver transplantation, gene therapy, hepatocellular carcinoma, hypertyrosinemia, differential diagnosis, pathophysiology, dietary therapy
- MeSH terms
- Animals, Humans, Infant, Newborn, Tyrosinemias, Mice
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