“…In 1965, Tschudy, Perlroth, Marver, Collins, Hunter, and Rechcigl reported marked increase in the activity of ALA-S, the rate-limiting enzyme of hepatic protohaem synthesis, in the liver of a patient who had died from acute intermittent porphyria. This finding, since confirmed in other patients using liver tissue obtained by open surgical or needle biopsy (Nakao, Wada, Kitamura, Uono, and Urata, 1966;Dowdle, Mustard, and Eales, 1967;Masuya, 1969;Strand et al, 1970), provided the first direct evidence in support of the suggestion of Watson, Runge, Taddeini, Bossenmaier, and Cardinal (1964) that acute intermittent porphyria is an 'overproduction' disease in which excessive amounts of porphyrin precursors are produced due to an inherited defect in the regulation of ALA-S activity. An increase in the activity of this enzyme in the liver has since been found in variegate porphyria (Dowdle et al, 1967;Strand et al, 1970) and in hereditary coproporphyria (Kaufman and Marver, 1970; McIntyre, Pearson, Allan, Craske, West, Moore, Paxton, Beattie, and Goldberg, 1971.…”