Document Detail


Tin protoporphyrin prolongs the biochemical remission produced by heme arginate in acute hepatic porphyria.
MedLine Citation:
PMID:  8335204     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In acute porphyria, repletion of intrahepatic heme, with exogenously administered heme, suppresses the overproduction of delta-aminolaevulinic acid (ALA) and porphobilinogen (PBG). The effect of reducing heme breakdown has been assessed by administering tin protoporphyrin, a competitive inhibitor of heme oxygenase. METHODS: The effect of tin protoporphyrin, 1 mumol/kg, and heme arginate, 3 mg/kg, individually and combined was compared with placebo in patients with an acute porphyric crisis. The treatments were given by intravenous infusion on three successive mornings. Thirty-four attacks were studied in 8 patients (9 placebo, 10 heme arginate alone, 4 tin protoporphyrin alone, and 11 combination treatments). RESULTS: Placebo and tin protoporphyrin alone had little effect on ALA and PBG excretion. Following heme arginate alone or combined with tin protoporphyrin, there was a marked and similar suppression of both ALA and PBG excretion (P < 0.005 for each, compared with pretreatment values). However, on the 5th day after discontinuing treatment, the excretion of ALA and PBG were both lower following combination therapy than following heme arginate alone (P < 0.005 and P < 0.01, respectively). CONCLUSIONS: These findings suggest that inhibition of heme oxygenase by tin protoporphyrin prolongs the biochemical remission induced by heme arginate in the porphyric crisis.
Authors:
S B Dover; M R Moore; E J Fitzsimmons; A Graham; K E McColl
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastroenterology     Volume:  105     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-08-26     Completed Date:  1993-08-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  500-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Arginine / adverse effects,  therapeutic use*
Drug Synergism
Drug Therapy, Combination
Female
Heme / adverse effects,  therapeutic use*
Humans
Male
Metalloporphyrins / adverse effects,  therapeutic use*
Porphyrias, Hepatic / drug therapy*,  metabolism
Protoporphyrins / adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Metalloporphyrins; 0/Protoporphyrins; 100438-92-4/heme arginate; 14325-05-4/tin protoporphyrin IX; 14875-96-8/Heme; 74-79-3/Arginine
Comments/Corrections
Comment In:
Gastroenterology. 1993 Aug;105(2):590-4   [PMID:  8335213 ]

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