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Non-Physiological Amino Acid enu2 (NPAA) Therapy in Pah Mice Relevance to PKU Therapy Mike Gibson, Professor and Head Section of Clinical Pharmacology Washington State University (WSU) Spokane College of Pharmacy, Spokane WA Disclosures: None Rationale and Goals • To Selectively Lower Brain Phenylalanine – NPAAs targeting L and A systems (BBB and gut) – Maintain Other LNAAs at or Near Normal Levels • Adjuvant Therapy, Target Cognitive Improvements Mammalian System L Transporters Specific for LNAAs Transporter Expression Amino AcidsTransported LAT-1 Li (fetal), BM, Br, Pl, Te L-I-V-F-Y-W-M-H LAT-2 Je, Ile, Ki, Pl, Br, Te, Sp L-F-W-T-N-I-C-S-Y-V-Q LAT-3 Pa, Li (fetal, adult), SM L-I-V-F LAT-4 Pl, Ki, Leuc L-F-I-M Non-Physiological Amino Acids A=Norleucine B=2-Aminoisobutyrate C=N-Methyl-2aminoisobutyrate D=2-aminonorbornane2-carboxylic acid Only NL previously used in a mammalian system Km values of LNAAs for LAT(s) may lead to NPAA concentrations that selectively lower Phe while minimally altering other LNAAs Brain Amino Acid Transport Systems • ~ Amino Acid Specificity • Considerable Overlap • Glutamine (Q): Numerous • Na Dependent/Independent • A ~ Smaller Amino Acids • L ~ Larger Amino Acids Approach • Dietary Administration-Clinical Relevance • Control Nitrogen Load with Casein • Monitor Brain LNAAs and Monoamines – Monitor Behavior/Movement in Future • Blood Chemistries (Safety) – Assess Effects on Nitrogen Load • Develop Methods to Quantify NPAAs LNAA Metabolic Roles Pilot Studies-Effect on Phe/Tyr Phenylalanine Tyrosine Results for Monoamines Serotonin Dopamine Additional LNAA Outcomes Tryptophan Total Branched Chain AAs Effects on 1-Methyl Transfer Methionine SAMe Conclusions • Proof-of-Principle: Feasibility – Phe Reduction with NL, NB and MAIB – Other LNAA Effects: Lower Levels of NL and NB – Movement Effects of 3-5% NL Prominent – First Use of These in an Murine PKU Model • MAIB is a Selective A System Inhibitor – Can Clearly Reduce Phe, However – Not Previously Documented – More Benign Effects than 5% NL, 0.5% NB Goals in Future Studies • • • • • • Different Concentrations of NPAAs Combinatorial Administration (BBB-Gut) NPAA Characterization in High/Low Protein Address Variability in Some LNAA Levels Evaluate Method of Sacrifice Characterize Behavior during NPAA Intervention Acknowledgements Colleagues/Funding • • • • • • • Alliance Support Kara Vogel Brandi Wasek Erland Arning Terry Bottiglieri R01 HD 58553 U54 DK 83916