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The deduced polypeptide sequence of open reading frame slr1736 reveals homology to chlorophyll synthase and 1,4-dihydroxy-2-naphthoic acid phytyltransferase in Synechocystis sp. strain PCC 6803. In tocopherol and plastoquinone biosynthesis, a condensation reaction mechanistically similar to that of these two enzymes is performed. To analyze the function of this novel prenyltransferase, a deletion mutant of slr1736 was generated by homologous recombination. The mutant showed a markedly decreased tocopherol content, while plastoquinone levels remained unchanged. Since the aromatic precursor homogentisic acid accumulated in the mutant, the function of the enzyme was proven to be a novel tocopherol phytyltransferase.

A glutathione transferase (GST) similar to zeta GSTs in animals and fungi has been cloned from Arabidopsis thaliana using RT-PCR. The Arabidopsis zeta GST (AtGSTZ1) was expressed in Escherichia coli as his-tagged polypeptides, which associated together to form the 50-kDa AtGSTZ1-1 homodimer. Following purification, AtGSTZ1-1 was assayed for a range of activities and compared with other purified recombinant plant GSTs from the phi, tau, and theta classes. AtGSTZ1-1 differed from the other GSTs in showing no glutathione conjugating activity toward xenobiotics and no glutathione peroxidase activity toward organic hydroperoxides. Uniquely among the plant GSTs, AtGSTZ1-1 showed activity as a maleylacetone isomerase (MAI). This glutathione-dependent reaction is analogous to the cis-trans isomerization of maleylacetoacetate to fumarylacetoacetate, which occurs in the course of tyrosine catabolism to acetoacetate and fumarate. Thus, rather than functioning as a conventional GST, AtGSTZ1-1 appears to be involved in tyrosine degradation. In addition to the MAI activity, the AtGSTZ1-1 also catalyzed the glutathione-dependent dehalogenation of dichloroacetic acid to glyoxylic acid. This latter activity was used to demonstrate the presence of functional AtGSTZ1-1 inplanta.

When human erythrocytes were incubated with o-aminophenol at pH 7.0 at 37 degrees C for 46 hours, intracellular oxyhemoglobin was completely oxidized to methemoglobin during the initial 6 hours, and methemoglobin formed was then reduced to oxyhemoglobin during the following 20 hours. This was demonstrated by the changes in absorption spectra of intracellular hemoglobin. Such oscillatory behavior of intracellular hemoglobin during reaction with o-aminophenol was explained by the fact that o-aminophenol has the ability to both oxidize oxyhemoglobin and reduce methemoglobin. In order to study the mechanism of oxido-reductive reactions of hemoglobin with aromatic reductants including o-aminophenol, the oxidation of ferrous hemoglobin and reduction of methemoglobin with various aromatic reductants such as o-aminophenol, 2-amino-4-methyl-phenol, 2-amino-5-methylphenol, and homogentisic acid were investigated under various conditions. It was found that oxyhemoglobin was oxidized by these aromatic compounds, and the oxidation rate was accelerated in the presence of inositol hexaphosphate, but was not affected in the presence of catalase and superoxide dismutase, except for the case with homogentisic acid. The oxidation of ferrous hemoglobin by these compounds did not proceed under anaerobic conditions. Methemoglobin was reduced by these aromatic compounds, and the reduction rate was much accelerated in the presence of inositol hexaphosphate, but was not affected in the presence of catalase and superoxide dismutase, except for the case with homogentisic acid. The reduction of methemoglobin by these compounds proceeded under anaerobic conditions, suggesting that ferric heme of hemoglobin reacts directly with aromatic reductants. On the basis of these results, the mechanism of oxido-reductive reaction of ferrous and ferric hemoglobin with aromatic reductants was proposed.

Homogentisic acid (HGA) causes oxidation of human oxyhemoglobin and reduction of methemoglobin. The rate of oxidation of oxyhemoglobin by HGA is greatly accelerated in the presence of myo-inositol hexakis-phosphate (P6-inositol) or superoxide dismutase (SOD), but is inhibited in the presence of catalase. The reduction rate of methemoglobin by HGA is accelerated in the presence of P6-inositol but is greatly inhibited in the presence of SOD. It is suggested that the semiquinone and quinone form of HGA and oxygen radicals may be involved in the mechanism of oxido-reductive reactions of human hemoglobin with HGA. In addition, a new anodic hemoglobin found by isoelectric focusing electrophoresis was produced during the reaction of oxyhemoglobin with HGA. When human erythrocytes were exposed to HGA for several hours at 37 degrees C (pH 7.4), the anodic oxyhemoglobin (HGA-modified hemoglobin) and its half met-form hemoglobin [(alpha3+beta2+)2 of HGA-modified hemoglobin] were produced in significant amounts. HGA-modified hemoglobin was stably purified and showed increased oxygen affinity, absence of titratable sulfhydryl groups, and the absorption spectrum of normal oxyhemoglobin. Our results demonstrate that HGA shows multiple effects on human hemoglobin and erythrocytic hemoglobin, which is consistent with the evidence that HGA is involved in various pathological conditions such as arthritis and carcinogenesis in humans.

Sinorhizobium meliloti strain N4 carries a Tn5luxAB insertion in a gene which is induced by nitrogen and carbon deprivation as well as in the presence of tyrosine. The Tn5luxAB-tagged locus was found to share significant similarity with the human hmgA gene and the corresponding Aspergillus nidulans gene, encoding the enzyme homogentisate dioxygenase, which is involved in the degradation of tyrosine. Extended DNA sequence analysis of the tagged locus revealed the presence of several ORFs, including one encoding a polypeptide sharing a high degree of similarity with human and fungal maleylacetoacetate isomerases. Strain N4 was found to be unable to use tyrosine as carbon source, to lack homogentisate dioxygenase activity, to produce a melanin-like pigment and to be affected in stationary-phase survival. This is believed to be the first report of a hmgA-homologous gene in bacteria.

The relationship between L-tyrosine catabolism and melanin formation was studied in the Vibrio cholerae strains ATCC 14035 and CECT 557. It is shown that both strains degrade L-tyrosine by the same pathway as eukaryotic cells, giving homogentisate as intermediate. ATCC 14035, an O1 strain, which is not able to grow using L-tyrosine as sole carbon and energy source, but it forms pyomelanin from homogentisate. The second strain, which is non-O1, is able to grow using L-tyrosine as sole carbon and energy source, but it does not form any pigment. Both strains contain all the enzymes involved in the L-tyrosine catabolism. The three late enzymes of the pathway, homogentisate oxygenase, maleylacetoacetate isomerase and fumarylacetoacetate hydrolase, are induced by L-tyrosine, but the degree of induction is much lower in the ATCC 14035 strain. Thus, the distal part of the pathway becomes the rate-limiting steps in the L-tyrosine catabolism, explaining homogentisate accumulation and pyomelanogenesis in this strain. It is proposed that V. cholerae might be a useful prokaryotic model to show that alkaptonuria and other diseases related to L-tyrosine metabolism could occur in animals even when no particular enzyme involved in that pathway is lacking.

Alkaptonuria is a rare metabolic disease in which homogentisic acid deposits occur in various body tissues. We present a case of alkaptonuria which resulted in aortic stenosis and coronary artery disease due to homogentisic acid deposition.

The presence of homogentisic acid (HGA) in urine is diagnostic for alkaptonuria, a classical example of a biochemical lesion resulting from a single gene trait. We describe here simple culture conditions which induce the synthesis of high levels of homogentisate dioxygenase activity in mycelia from the filamentous ascomycete Aspergillus nidulans. Crude enzyme preparations, showing an apparent Km of 9 microM for homogentisate and an optimal pH of 6.5-7.0 are rather stable and highly specific for homogentisate. Thus, the reaction is not competed by a large molar excess of a number of substrate structural analogues, including phenylacetate and its 2-, 3-, and 4-hydroxy derivatives, phenylalanine, tyrosine, phenylpyruvate, and gentisate. We demonstrate how this enzyme preparation can be used in sensitive, spectrophotometric enzymatic determination of this compound. The accuracy is almost indistinguishable from that obtained by HPLC. The method can be applied to routine determination of homogentisate in human urine. A 1-liter culture of the mold provides sufficient enzyme activity for 1500 enzymatic assays.

We report here the first characterization of a gene encoding a homogentisate dioxygenase, the Aspergillus nidulans hmgA gene. The HmgA protein catalyzes an essential step in phenylalanine catabolism, and disruption of the gene results in accumulation of homogentisate in broths containing phenylalanine. hmgA putatively encodes a 448-residue polypeptide (Mr = 50,168) containing 21 histidine and 23 tyrosine residues. This polypeptide has been expressed in Escherichia coli as a fusion to glutathione S-transferase, and the affinity-purified protein has homogentisate dioxygenase activity. A. nidulans, an ascomycete amenable to classical and reverse genetic analysis, is a good metabolic model to study inborn errors in human Phe catabolism. One such disease, alkaptonuria, was the first human inborn error recognized (Garrod, A. E. (1902) Lancet 2, 1616-1620) and results from loss of homogentisate dioxygenase. Here we take advantage of the high degree of conservation between the amino acid sequences of the fungal and higher eukaryote enzymes of this pathway to identify expressed sequence tags encoding human and plant homologues of HmgA. This is a significant advance in characterizing the genetic defect(s) of alkaptonuria and illustrates the usefulness of our fungal model.

The nature of the pigment formed by Vibrio cholerae and the characterization of its biosynthetic pathway is shown. This microorganism is able to synthesize melanin-like pigment when cultured in the presence of L-tyrosine. Other phenolic chemicals related to L-tyrosine do not lead to pigment production. The microorganism has no tyrosine hydroxylase activity, and the levels of dopa oxidase activity are very low, making the existence of a tyrosinase very unlikely. However, Vibrio cholerae contained transaminases that transforms L-tyrosine into p-hydroxyphenylpyruvate. Moreover, Vibrio cholerae is able to go further in the catabolic pathway, releasing a great amount of homogentisic acid. This acid can spontaneously be oxidized to its p-quinone form, which subsequently polymerizes leading to pigment formation. It is concluded that the pigment formed by Vibrio cholerae is not synthesized by the Raper-Mason pathway, but by a L-tyrosine catabolism pathway leading to homogentisic acid. Some simple properties of that melanin are compared to model eu- and pheomelanin, but no clear distinction could be stated, indicating the similarity between all these pigments.

The enzyme p-hydroxyphenylpyruvate hydroxylase (HPPH) is involved in pigmentation (pyomelanin) via homogentisic acid (HGA). Pyomelanin formation is correlated with HGA production and expression of HPPH in three disparate marine species: Vibrio cholerae, a Hyphomonas strain, and Shewanella colwelliana. Induction of pigmentation in V. cholerae 569B by nutrient limitation also correlated with production of HGA.

A 1.5-kb genomic fragment isolated from Streptomyces avermitilis that directs the synthesis of a brown pigment in Escherichia coli was characterized. Since pigment production in recombinant E. coli was enhanced by the addition of tyrosine to the medium, it had been inferred that the cloned DNA might be associated with melanin biosynthesis. Hybridization studies, however, showed that the pigment gene isolated from S. avermitilis was unrelated to the Streptomyces antibioticus melC2 determinant, which is the prototype of melanin genes in Streptomyces spp. Sequence analysis of the 1.5-kb DNA that caused pigment production revealed a single open reading frame encoding a protein of 41.6 kDa (380 amino acids) that resembled several prokaryotic and eukaryotic 4-hydroxyphenylpyruvate dioxygenases (HPDs). When this open reading frame was overexpressed in E. coli, a protein of about 41 kDa was detected. This E. coli clone produced homogentisic acid (HGA), which is the expected product of the oxidation of 4-hydroxyphenylpyruvate catalyzed by an HPD, and also a brown pigment with characteristics similar to the pigment observed in the urine of alkaptonuric patients. Alkaptonuria is a genetic disease in which inability to metabolize HGA leads to increasing concentrations of this acid in urine, followed by oxidation and polymerization of HGA to an ochronotic pigment. Similarly, the production of ochronotic-like pigment in the recombinant E. coli clone overexpressing the S. avermitilis gene encoding HPD is likely to be due to the spontaneous oxidation and polymerization of the HGA accumulated in the medium by this clone.

When urine samples from alkaptonuria patients are allowed to stand, they turn black, presumably owing to the oxidation of homogentisic acid to a melanin-like substance. We report the characterization of the pigments formed by polymerization of (a) the components in the urine from a patient with alkaptonuria and (b) homogentisic acid. The absorption spectra and electron spin resonance signals of these pigments are similar to those of eumelanins. Irradiation of the pigments with nitroblue tetrazolium caused reduction of the tetrazolium; this was partially inhibited by superoxide dismutase. Irradiation of Ehrlich ascites carcinoma cells with the pigments from homogentisic acid or urine caused cell lysis. Since this lysis was inhibited by catalase, we have concluded that it was mediated by H2O2. A similar pigment was also extracted from the tissue from an alkaptonuria patient. It is suggested that the degeneration of tissue in vivo may be due to the deposition of melanin-like pigments in the tissues, probably in combination with metal ions.

Radiologic examination of an Egyptian mummy showed characteristic radiologic changes seen in ochronosis. Desiring to confirm the diagnosis of ochronosis, punch biopsy samples of ochronotic mummy bone were removed for biochemical analysis. An organic solvent extraction procedure was developed to selectively isolate mummy ochronotic pigment, and spectroscopic methods were used to characterize the pigment as a homogentisic-acid--derived polymer.

A total of four pathways are known for the catabolism by microorganisms of gentisate (2,5-dihydroxybenzoate) and homogentisate (2,5-dihydroxyphenylacetate). Both of these dihydric phenols can be degraded by either a glutathione-dependent or a glutathione-independent reaction sequence. We found that it is not always possible to unequivocally assign glutathione dependence or independence to a particular catabolic sequence by using the well-established spectrophotometric assays at 330 nm (gentisate pathway) or 320 nm (homogentisate pathway). This paper reports a modification of the classical spectrophotometric assays that allowed an unequivocal differentiation between glutathion-dependent and glutathione-independent pathways, even when crude cell extracts contained significant quantities of cell-derived, reduced glutathione. This was accomplished by performing assays in the presence of an approximately 10(-3) M solution of the sulfhydryl-binding agent N-ethylmaleimide.

The metabolic disorder, alkaptonuria, is distinguished by elevated serum levels of 2,5-dihydroxyphenylacetic acid (homogentisic acid), pigmentation of cartilage and connective tissue and, ultimately, the development of inflammatory arthritis. Oxygen radical generation during homogentisic acid autoxidation was characterized in vitro to assess the likelihood that oxygen radicals act as molecular agents of alkaptonuric arthritis in vivo. For homogentisic acid autoxidized at physiological pH and above, yielding superoxide (O2-)2 and hydrogen peroxide (H2O2), the homogentisic acid autoxidation rate was oxygen dependent, proportional to homogentisic acid concentration, temperature dependent and pH dependent. Formation of the oxidized product, benzoquinoneacetic acid was inhibited by the reducing agents, NADH, reduced glutathione, and ascorbic acid and accelerated by SOD and manganese-pyrophosphate. Manganese stimulated autoxidation was suppressed by diethylenetriaminepentaacetic acid (DTPA). Homogentisic acid autoxidation stimulated a rapid cooxidation of ascorbic acid at pH 7.45. Hydrogen peroxide was among the products of cooxidation. The combination of homogentisic acid and Fe3+-EDTA stimulated hydroxyl radical (OH.) formation estimated by salicylate hydroxylation. Ferric iron was required for the reaction and Fe3+-EDTA was a better catalyst than either free Fe3+ or Fe3+-DTPA. SOD accelerated OH. production by homogentisic acid as did H2O2, and catalase reversed much of the stimulation by SOD. Catalase alone, and the hydroxyl radical scavengers, thiourea and sodium formate, suppressed salicylate hydroxylation. Homogentisic acid and Fe3+-EDTA also stimulated the degradation of hyaluronic acid, the chief viscous element of synovial fluid. Hyaluronic acid depolymerization was time dependent and proportional to the homogentisic acid concentration up to 100 microM. The level of degradation observed was comparable to that obtained with ascorbic acid at equivalent concentrations. The hydroxyl radical was an active intermediate in depolymerization. Thus, catalase and the hydroxyl radical scavengers, thiourea and dimethyl sulfoxide, almost completely suppressed the depolymerization reaction. The ability of homogentisic acid to generate O2-, H2O2 and OH. through autoxidation and the degradation of hyaluronic acid by homogentisic acid-mediated by OH. production suggests that oxygen radicals play a significant role in the etiology of alkaptonuric arthritis.

The enzymes of the tyrosine oxidase (TO) system of rat liver were measured during pre- and postnatal development. At all ages, the rate of tyrosine oxidation was limited by the activity of tyrosine aminotransferase (TAT). TAT of liver was undetectable from 4 days to 1 day before birth and was lower than p-hydroxyphenylpyruvate oxidase (pHPPO) and homogentisate oxidase (HO) postnatally. At birth, TAT, pHPPO, and HO were 2.9, 13, and 40% of adult values, respectively. Relative levels in fetal liver were HO greater than pHPPO greater than TAT. When enzyme activities were adjusted to compensate for dilution by hematopoietic cells, absolute activities increased, but other relationships remained the same. pHPPO rose at 15-17 days after birth and exceeded adult values at 31 days. HO was unchanged after birth. We conclude that each enzyme of TO follows a unique developmental path, with no concerted control of the entire TO system.

The enzyme 4-hydroxyphenylacetate, NAD(P)H:oxygen oxidoreductase (1-hydroxylating) (EC 1.14.13 ...; 4-hydroxyphenylacetate 1-monooxygenase; referred to here as 4-HPA 1-hydroxylase) was induced in Pseudomonas acidovorans when 4-hydroxyphenylacetate (4-PHA) was utilized as carbon source for growth; homogentisate and maleylacetoacetate were intermediates in the degradation of 4-HPA. A preparation of the hydroxylase that was free from homogentisate dioxygenase and could be stored at 4 C in the presence of dithioerythritol with little loss of activity was obtained by ultracentrifuging cell extracts; but when purified 18-fold by affinity chromatography the enzyme became unstable. Flavin adenine dinucleotide and Mg2+ ions were required for full activity. 4-HPA 1-hydrocylase was inhibited by KCl, which was uncompetitive with 4-HPA. Values of Ki determined for inhibitors competitive with 4-HPA were 17 muM dl-4-hydroxymandelic acid, 43 muM 3,4-dihydroxyphenylacetic acid, 87 muM 4-hydroxy-3-methylphenylacetic acid, and 440 muM 4-hydroxyphenylpropionic acid. Apparent Km values for substrates of 4-HPA 1-hydroxylase were 31 muM 4-HPA, 67 muM oxygen, 95 muM reduced nicotinamide adenine dinucleotide (NADH); AND 250 muM reduced nicotinamide adenine dinucleotide phosphate (NADPH). The same maximum velocity was given by NADH and NADPH. A chemical synthesis is described for 2-deutero-4-hydroxyphenylacetic acid. This compound was enzymatically hydroxylated with retention of half the deuterium in the homogentisic acid formed. Activity as substrate or inhibitor of 4-HPA 1-hydroxylase was shown only by those analogues of 4-HPA that possessed a hydroxyl group substituent at C-4 of the benze nucleus. A mechanism is suggested that accounts for this structural requirement and also for the observation that when 4-hydroxyphenoxyacetic acid was attacked by the enzyme, hydroquinone was formed by release of the side chain, probably as glycolic acid. Only one enantiometer of racemic 4-hydroxyhydratropic acid was attacked by 4-HPA 1-hydroxylase; the product, alpha-methylhomogentisic acid (2-(2,5-dihydroxyphenyl)-propionic acid), exhibited optical activity. This observation suggests that, during its shift from C-1 to C-2 of the nucleus, the side chain of the substrate remains bound to a site on the enzyme while a conformational change of the protein permits the necessary movement of the benzene ring.

Chloroform-soluble extracts of unpurified chloroplast preparations of lettuce, pea and spinach and of class I lettuce chloroplasts that have been incubated in the light with [methylene-3H]homogentisate contain 3H-labelled plastoquinones-9 and -8 (minor homologue), 2-demethyplastoquinones-9 and -8 (minor homologue), pytylplastoquinone and 2-demethylphytylplastoquinone. The absence of demethylquinols, the presumed precursors of the dimethylquinones, from the extracts to the fact that no precautions were taken in the extraction procedure to present their oxidation to the corresponding quinones. In unpurified lettuce chloroplasts the synthesis of these compounds from [methylene-3H]homogentisate is Mg2+-dependent and it is stimulated by light. The addition of isopentenyl pyrophosphate to the incubation mixtures increases the amounts of both groups of quinones (polyprenyl quinones and phytyl quinones) synthesised in the light and the amounts of polyprenyl quinones synthesised in the dark. Replacement of isopentenyl pyrophosphate with a source of preformed polyprenyl pyrophosphates brings about a marked rise in the amounts of polyprenyl quinones synthesized. This rise in polyprenyl quinone synthesis is further increased if the chloroplasts are subjected to osmotic shock. The presence of S-adenosylmethionine increases the amounts of dimethylquinones synthesized at the expense of the demethylquinones. The implied precursor-product relationships between 2-demethylphytylplastoquinone (quinol?) and phytylplastoquinone and between the 2-demethylplastoquinones (quinols) and plastoquinones were verified in a pulse-labelling experiment. Confirmation that these quinones, or their corresponding quinols, are synthesized in the chloroplast is provided by the fact that they are made in class I lettuce chloroplasts. In none of the many incubations carried out in the course of the study were any [3H]tocopherols produced.

The enzymatic defect leading to alcaptonuria is well known. However, the pathogenesis of the associated arthropathy is poorly understood. From clinical and morphological observations it is assumed that the breakdown of ochronotic cartilage is due to an increased fragility. To test the hypothesis that polymerisation products of homogentisic acid change the biomechanical behaviour of hyalin cartilage, investigations on natural ochronotic cartilage and tissues following in vitro incubation with homogentisic acid were performed. It could be demonstrated that the "ochronotic situation" is associated with an increased hardness and a decreased elasticity of the hyalin cartilage. For the pathogenesis of ochronotic arthropathy it is assumed that these alterations, in association with mechanical stress to the joints, lead to cartilage destruction.

Chloroplast-rich particles of sugar beet and Euglena gracilis are able to carry out the light-, H(2)O(2)- and O(2)-independent syntheses of a nonaprenyltoluquinol, an octaprenyltoluquinol and a phytyltoluquinol from homogentisate and nonaprenyl, octaprenyl and phytyl pyrophosphate. The formation of these compounds probably takes place by the concomitant polyprenylation (or phytylation) and non-oxidative decarboxylation of homogentisate.

Homogentisic acid elevations have been found in urine and serum of patients on long term heavy salicylate therapy and those acutely intoxicated with acetylsalicylic acid. Loading of two normal volunteers with single oral acetylsalicylate doses produced transient elevations in urinary homogentisic acid excretion. These findings suggest that heavy salicylate use results in the partial inhibition of homogentisic acid oxidase in vivo.

The metabolic pathways whereby strains of Moraxella and Bacillus degrade homogentisate (2,5-dihydroxyphenylacetate) are delineated. The Moraxella (strain OA3) is shown to degrade homogentisate via the pathway previously described in liver: homogentisate is cleaved by a 1,2-dioxygenase (E.C 1.13.11.5) yielding maleylacetoacetate which is isomerized by a GSH-dependent isomerase to fumarylacetoacetate before hydrolysis to acetoacetate and fumarate. A strain of Bacillus (B11c) is shown to catabolize homogentisate via a previously undescribed version of the above sequence: homogentisate is cleaved by a 1,2-dioxygenase (E.C 1.13.11.5) yielding maleylacetoacetate which is hydrolyzed directly to acetoacetate and maleate.

Non-enzymatic oxidation in alkaline media of homogentisinic acid, excreted with urine in alkaptonuria, involved free radical mechanism. The oxidative process was accompanied by production of superoxide anion O2- and required metal cations. Free radical destruction of cells and biopolymers via O2- or homogentisinic acid semiquinone appears to be one of pathogenetic mechanisms responsible for impairment of connective tissue structures in patients with alkaptonuria.

Mutations at the bwnA locus of Dictyostelium discoideum were found to result in drastically reduced levels of activity of the enzyme homogentisic acid oxidase. It is proposed that the brown phenotype associated with these mutations results from the accumulation of an intermediate in the tyrosine degradative pathway, homogentisic acid, and its subsequent spontaneous oxidation. This knowledge is used to devise improved screening procedures potentially useful in the parasexual genetics system of this organism.

A proposed intermediate in the metabolic transformation of p-hydroxyphenylpyruvic acid into homogentisic acid has been synthetized. In an experiment with radioactive material in pig liver homogenate it could be shown that this compound does not occur as a free intermediate.

A 59-year-old woman with previously documented alkaptonuria was examined for extensive ochronosis of recent onset. The cause of the extensive skin pigmentations were thought to be secondary to decreased renal clearance of homogentisic acid because of a decline in the patient's renal function. If extensive or rapidly progressive skin pigmentation is noted in a patient with alkaptonuria, then evaluation of the patient's renal status should be done because unrelated renal disease has been reported in patients with severe ochronosis.

The metabolic fate of [4-3H]phenylalanine incubated with isolated hepatocytes has been investigated. Analysis of 3H2O production and fluorimetric estimation of tyrosine production has allowed calculation of flux through phenylalanine hydroxylase and homogentisate oxidase. The resulting flux determinations are physiologically relevant and hormonally sensitive.