SummaryCase. A female patient with prolidase deficiency was examined.Biochemical studies on human prolidase (EC 3.4.13.9) and prolidase deficiency are described. The urine sample from a 32-year-old female with prolidase deficiency was examined. Diagnosis was based on clinical features and defects of prolidase in her erythrocytes. She excreted massive amounts of iminopeptides, where three major peptides were identified; aspartyl-proline, glutamyl-proline and glycyl-proline. The prolidase was purified a p proximately 10,000-fold from the normal human erythrocytes through an eight step procedure. The purified enzyme consisted of two identical subunits of which the molecular weight was calculated to be 55.000. The relative cleavage rates of the enzvme for, and glycyl-hydroxy-L-proline were 100%, 53%, 27%, 31% and 2%. respectively. he relative substrate specificity of the enzyme offers a reasonable explanation for the presence of a higher level of urinary imidodipeptides in a patient with prolidase deficiency. An attempt at erythrocyte transfusion was performed, aimed at enzyme replacement therapy. After the transfusion (erythrocytes from 800 ml of whole blood), the prolidase activity of the peripheral erythrocyte was elevated to approximately 35% of the normal values and gradually decresed (half-life, 41 days). During this period urinary peptide-bound proline was monitored, but no significant change was observed.
SpeculationThe prolidase activity of transfused erythrocytes is relatively stable; however, intracellular enzyme activity has no effect on net proline loss and skin lesions. Enzyme replacement may be a possible attempt at therapy of the disease, but other forms of replacement should be tried.Prolidase deficiency is a rare genetic disease inherited by an autosomal recessive trait and associated with chronic ulcerative dermatitis, mental retardation and massive urinary excretion of imidodipeptides (22). Since the first case was described by Powell et al. in 1974 (21), additional cases have been reported (3,9, 11,13,20,23). Probable cases of prolidase deficiency suspected by urinary excreted imidodipeptides and characteristic clinical features were reported (5,10,14,17). The disease can be diagnosed by the assay of prolidase activity in erythrocyte (8, 13, 21, 23, 26), leukocyte (21, 20, 26) and cultured skin fibroblasts (23). Some of the properties of human prolidase derived from human erythrocytes was studied by Adams et al. (1). Substrate specificity of purified human prolidase has not been investigated so far. It is known, however, that substrate specificity of prolidase obtained from several animal species is not uniform (2,7,24). In the present report, we describe the biochemical characterization of human erythrocyte prolidase, identification of urinary excreted peptides with a female case of prolidase deficiency and the effect of erythrocyte transfusion on urinary excreted iminopeptides.Although a detaiied clinical bbsewation will bk reported elsewhere, especially on the skin lesions, the case is brie...