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A novel approach that combines information provided by the metabolism of pteridines and that of phenylalanine has been applied to the detection of heterozygotes for phenylketonuria. Phenylalanine, tyrosine, biopterin and neopterin have been measured in serum from normal controls and heterozygotes for classical phenylketonuria, before and after a phenylalanine oral load. Significant differences in neopterin and biopterin mean values in fasting serum and in the mean increase of biopterin induced by the phenylalanine load were found between groups. Inclusion of pteridine data in the discriminant analysis significantly improved the resolution of the classical phenylalanine loading test for the detection of heterozygotes for phenylketonuria.

SummaryThe effect of an oral load of phenylalanine (100 mg/kg body weight) on the levels of neopterin and biopterin in urine has been determined in 8 heterozygotes for classical phenylketonuria and 25 supposed normal controls. In basal conditions, neopterin and biopterin levels were significantly different between males and females. A significant increase in urinary biopterin was found two hours after the phenylalanine load, both in heterozygotes and in normal homozygotes. This increase was maintained at least until the fourth hour. Neopterin leve ls did not suffer any change during that period.Comparison of urinary pteridines from normal controls and phenylketonuria carriers showed that there were no significant differences between both groups neither before nor after the phenylalanine load. From these data we concluded that measurement of biopterin and neopterin in urine cannot help in the identification of heterozygotes for phenylketonuria.