Tyrosinemia type II (Richner-Hanhart syndrome, RHS) is a disease of autosomal recessive inheritance characterized by keratitis, palmoplantar hyperkeratosis, mental retardation, and elevated blood tyrosine levels. The disease results from deficiency in hepatic tyrosine aminotransferase (TAT; L-tyrosine:2-oxoglutarate aminotransferase, EC 2.6.1.5), a 454-amino acid protein encoded by a gene with 12 exons. To identify the causative mutations in five TAT alleles cloned from three RHS patients, chimeric genes constructed from normal and mutant TAT alleles were tested in directing TAT activity in a transient expression assay. DNA sequence analysis of the regions identified as nonfunctional revealed six different point mutations. Three RHS alleles have nonsense mutations at codons 57, 223, and 417, respectively. One "complex" RHS allele carries a GI GG splice donor mutation in intron 8 together with a Gly Val substitution at amino acid 362. A new splice acceptor site in intron 2 ofthe fifth RHS allele leads to a shift in reading frame.Tyrosinemia type II, also known as Richner-Hanhart syndrome (RHS), is an inborn error of metabolism due to a block in the transamination reaction converting tyrosine to p-hydroxyphenylpyruvate, a step catalyzed by the hepatic cytosolic enzyme tyrosine aminotransferase (TAT; L-tyrosine:2-oxoglutarate aminotransferase, EC 2.6.1.5). RHS patients suffer from keratitis, palmar and plantar hyperkeratosis, and sometimes mental retardation, accompanied by highly elevated serum and urine levels of tyrosine and its metabolites. The condition improves rapidly on a tyrosine-and phenylalanine-restricted diet (for reviews see refs. 1 and 2).TAT has been extensively studied in rat and mouse, revealing a complex pattern of regulation. Enzyme activity is virtually absent in fetal rat liver and becomes detectable just after birth (3). The TAT gene is under hormonal control by glucocorticoids and cAMP, which increase the basal transcription rate 5-to 10-fold (4, 5), acting via different response elements in the 5' flanking region of the gene (6, 7). Furthermore, the rodent TAT genes are subject to two trans-acting regulators. Basal expression and hormone inducibility of the Tat gene on mouse chromosome 8 are controlled by a positive trans-acting factor, alf, encoded on mouse chromosome 7 (8). Conversely, the tissue-specific extinguisher locus Tse-J on mouse chromosome 11 encodes a product that represses Tat gene transcription in nonliver cells (9).Little is known about the regulation of the human TAT gene. As in rodents, hepatic TAT activity reaches significant levels shortly after birth, although some activity is present in the fetus (10). Induction of human TAT by glucocorticoids and cAMP has been demonstrated in fetal liver organ cultures (11). Moreover, there is evidence for a Tse-1-like factor on human chromosome 17 (9).The human TAT gene extends over 10.9 kilobases (kb) containing 12 exons, and its 3.0-kb mRNA codes for a 454-amino acid protein of 50.4 kDa (12). We previously described an RHS ...