Transcript Slide 1

Information about BH4:
What it is and how it works
Sponsored by: Singh Research Group
Emory University Department of Human Genetics
Updated on November 20th, 2008
General Information about BH4
• KuvanTM is a pharmaceutical (prescription drug) with a
structure very similar to a natural compound humans make
called Tetrahydrobiopterin (BH4).
• KuvanTM comes in pill form and is usually taken once a day
with meals.
• Response to KuvanTM is currently defined by the medical
community as a 30% or greater decrease in plasma Phe
levels.
• Approximately 50% of all people with PKU respond this
way to KuvanTM.
• Both severe and mild forms of PKU can respond to
KuvanTM, however, those with milder forms of PKU do
have a greater chance of responding
BH4 Molecule Structures
BH4
(Tetrahydrobiopterin)
As it is naturally made by the body
KuvanTM
(Sapropterin Dihydrochloride)
Pharmaceutical with structure similar to
natural BH4
Reference for structures: http://chem.sis.nlm.nih.gov/chemidplus/chemidheavy.jsp
How BH4 works to convert Phe to Tyrosine
• Phenylalanine (Phe) and Tyrosine (Tyr) are essential amino acids that
the body must have to function properly. But too much of these amino
acids in the blood can be toxic.
• BH4 is a cofactor naturally made by the body which the PAH
(phenylalanine hydroxylase) enzyme uses to convert Phe into Tyr. For
most people, this keeps the body’s Phe and Tyrosine in a healthy
balance.
PAH
Phe
Tyr
BH4
How can taking KuvanTM help someone with PKU?
• People with PKU make the same amount of natural BH4 as
people without PKU. However, in PKU the PAH enzyme is
malformed and does not function very well. This can cause
Phe to increase to toxic levels inside the body.
• Providing extra BH4, in the form of KuvanTM, has been
shown to increase the ability of the defective PAH enzyme
to convert Phe into Tyrosine for some people who have PKU
Phe
Tyr
BH4
BH4
BH4
How do I know if I would respond to
KuvanTM?
At the Emory Genetics Clinic:
1. We obtain a baseline plasma Phe level
2. You are prescribed 20mg/kg/day dose of KuvanTM
3. For the next several days you must not change
your diet or formula.
4. Your blood Phe levels will be checked several times
during this period to look for a response to
KuvanTM
5. A response to the medicine can take anywhere
from two days to 4 weeks
Where can I find more information
about…?
• PKU
– http://www.marchofdimes.com/pnhec/4439_1219.asp
• KuvanTM
– http://www.kuvan.com/
• The BH4 and PKU clinical trial at Emory
– You can contact the research coordinator Mary Jane
Kennedy (404-778-8522).
– You may also visit the BH4 and PKU study website:
www.genetics.emory.edu/NUTRITION/BH4andPKU