Alkaptonuria is an inherited genetic disorder in which the body is unable to break down a specific type of amino acid, phenylalanine, due to lack of the enzymes homogentisate oxidase (HGO) and homogentisate 1,2-dioxygenase (HGD). As a result, the by-product of phenylalanine metabolism, homogentisic acid (HGA), accumulates in the body and can cause a number of health problems.
The biochemical pathway of alkaptonuria begins with the ingestion of dietary phenylalanine, which is then converted to tyrosine by the enzyme phenylalanine hydroxylase. Tyrosine is then metabolized to homogentisic acid via three reactions catalyzed by HGO and HGD. Normally, HGA is further broken down to maleylacetoacetate and fumarylacetoacetate by the enzymes maleylacetoacetate isomerase and fumarylacetoacetate hydrolase. However, in alkaptonuria, due to the lack of HGO and HGD, HGA accumulates in the body and can cause a variety of symptoms, such as dark urine, joint pain, and kidney stones.
In addition to the classic symptoms, alkaptonuria can also cause a buildup of HGA in the connective tissues of the body, leading to a condition known as ochronosis. Ochronosis is characterized by a blue-black discoloration of the skin, especially in areas such as the ears, in areas of skin exposed to sunlight, and in areas of joint movement.
Alkaptonuria is an autosomal recessive disorder, which means that it is inherited from both parents. There is currently no cure for alkaptonuria, but the symptoms can be managed through lifestyle changes, such as avoiding certain foods and beverages that contain phenylalanine, and taking medications to reduce the levels of HGA in the body.