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Porphyrins
1. Porphyrins
The Distribution Pattern of
Porphyrins in Urine Serves as a
Functional “Fingerprint” of Toxicity
2. What Are Porphyrins?
•Porphyrins, measured in urine, serve as
biomarkers of the effects of toxins on the
biomarkers of the effects of toxins on the
heme biosynthetic pathway.
•Heme is essential for proper functioning of many
pp g y
proteins including oxygen transport, energy
production, and detoxification
5. Why Evaluate Porphyrins?
1. The pathway is highly active, so any disturbance
tends to cause rapid and relatively large
accumulations of intermediates.
2. The enzymes of the porphyrin‐producing pathway
2 Th fh hi di h
are widely distributed in human tissues and some
of them are highly sensitive to the presence of
of them are highly sensitive to the presence of
various toxins.
3. Pathway makes heme and cytochomes (P 450
3 Pathway makes heme and cytochomes (P‐450
enzymes and mitochondrial function). Therefore
damage causes major effects on energetics and
detoxification
6. Porphyrins Testing Can…
Testing Can…
• Identify Level of Biochemical Damage Caused by Toxicant
Exposure
• Identify Level of Mercury’s Effect
• Monitor Patients Before and During Chelation Therapy
• Identify Toxicity of Therapeutic Drugs
• Differentiate Type of Heavy Metal Toxicity
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7. Toxicity Often
Contributes to…
C ib
• Multiple Chemical Sensitivity
• Behavioral and Learning Disorders
Behavioral and Learning Disorders
• Immune Dysfunctions
• Chronic Fatigue
• Neurological and Mental/Emotional Disorders
8. Effects
Effects
of Toxic
Exposures:
Enzyme
Enzyme
Interference
11. Levels of Three Porphyrins Following
Consecutive DMPS Injections
Pingree SD, et al. Toxicol Sci. 2001;61(2):234‐240.
SD, et al. Toxicol Sci. 2001;61(2):234‐
13. Pro‐Oxidant Reactivity of Metals
P O id R ii fM l
and Other Toxic Chemicals Can:
and Other Toxic Chemicals Can:
• Inactivate porphyrinogenic enzymes
p py g y
• Deplete glutathione and other antioxidants
• Increase oxidant stress
Increase oxidant stress
• In addition, porphyrinogens (precursors to
In addition, porphyrinogens (precursors to
porphyrins in the reduced state) are easily
nonenzymatically oxidized to porphyrins by
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toxic metals.
14. Case Study 1
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A patient’s Porphyrins test was unremarkable,
except for a slightly elevated Copro
except for a slightly elevated Copro I/Copro II
II
ratio, which can be indicative of Arsenic
exposure
Case Study 1
Case Study 1
15. The patient followed up with a whole blood
toxic element analysis and was found to have
toxic element analysis and was found to have
slightly elevated Arsenic
Case Study 1
Case Study 1
16. Case Study 2
Case Study 2
Clear Porphyrin Profile in Health Check.
Clear Porphyrin Profile in Health Check
Case Study 2
Case Study 2