Porphyrins Profile - Urine

Porphyrin Testing: Assessing Effects of Toxicity

The Porphyrins Profile can help identify the severity of heavy metal toxicity or organic chemical exposure in patients. Chemical exposure and a heavy toxic burden can have physiological effects resulting in impaired metabolism and cellular function.

Porphyrin testing also helps you monitor therapy in your patients.

Porphyrin testing helps identify:

• Levels of biochemical damage caused by toxicant exposure
• Physiologic burden of a person's level of toxins
• Levels of porphyrin elevation correlated with levels of toxic interference
• Toxicity of patients before and during chelation therapy
• Toxicity of therapeutic drugs

Why Evaluate Porphyrins?

Porphyrins are proteins involved in the formation of heme measured in urine. Heme is essential for the proper function of many proteins including oxygen transport, energy production, and detoxification. Proper porphyrin production is essential for our body's capacity to detoxify toxins.

Porphyrins are particularly well suited for assessing heavy metal toxicity. First, the heme pathway is a constantly-changing pathway that is active in almost every cell of the body. Any disturbance in the pathway tends to cause rapid and relatively large accumulations of intermediates, such as porphyrins. Second, the enzymes of the pathway are widely distributed in human tissues, and are highly sensitive to the presence of various toxins, creating the large accumulation of porphyrins in the pathway.

Porphyrins and Autism

Studies are demonstrating urinary porphyrin testing is successful in:

• Demonstrating the role of mercury in ASD populations
• Identifing the physiologic burden of children and adults exposed to mercury
• Tracking mercury excretion from affected children undergoing treatment

Test name:	0060 - Porphyrins Profile* *Not available in New York
Description:	The Porphyrins Profile evaluates the biomarkers of toxicity. Patterns of specific porphyrin elevations in urine may serve as functional markers of toxicity from toxic metals, such as mercury, lead, or arsenic, or other organic chemicals. The Porphyrins Profile measures seven porphyrins, total porphyrins, and two ratios to help you differentiate heavy metal toxicity, as well as monitor therapy in your patient.
Method:	LC/MS-MS
Turnaround time:	10 - 14 days, 10 days average
Analytes:	Uroporphyrin I and III Heptacarboxyporphyrinogen Hexacarboxyporphyrinogen Pentacarboxyporphyrinogen Precoproporphyrin* Coproporphyrinogen I Coproporphyrinogen III Total porphyrins Pre/Uro I & III Ratio Copro I/Copro III Ratio *Atypical porphyrin consistent with precoprophyryrin reported in the literature.1,2 Precoproprophyrin is reported as a ratio of peak area to internal standard peak area i units of response/g creatinine 1. J.S. Woods, M.A. Bowers, H.A. Davis, Toxicology and Applied Pharmacology 110, 464-476 (1991). 2. D. Echeverilia et. al., Neurotoxicology and Teratology 28 (2006) 39-48.

84120 x7 - Porphyrin, qualitative 82570 - Creatinine

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	References Porphyrins
	Porphyrin metabolism as indicator of metal exposure and toxicity. Woods JS. In: Goyer RA, Cherian MG, eds. Handbook of experimental pharmacology. Berlin: Springer-Verlag; 1995:19-52. Porphyrinurias induced by mercury and other metals. Fowler BA. Toxicol Sci. Jun 2001;61(2):197-198. Urinary porphyrin profiles as biomarkers of trace metal exposure and toxicity: studies on urinary porphyrin excretion patterns in rats during prolonged exposure to methyl mercury. Woods JS, Bowers MA, Davis HA. Toxicol Appl Pharmacol. Sep 15 1991;110(3):464-476. Urinary porphyrin profiles as a biomarker of mercury exposure: studies on dentists with occupational exposure to mercury vapor. Woods JS, Martin MD, Naleway CA, Echeverria D. J Toxicol Environ Health. Oct-Nov 1993;40(2-3):235-246. Behavioral effects of low-level exposure to elemental Hg among dentists. Echeverria D, Heyer NJ, Martin MD, Naleway CA, Woods JS, Bittner AC, Jr. Neurotoxicol Teratol. Mar-Apr 1995;17(2):161-168. Lead-induced abnormalities of porphyrin metabolism. The relationship with iron deficiency. Piomelli S, Seaman C, Kapoor S. Ann N Y Acad Sci. 1987;514:278-288. Altered porphyrin metabolism as a biomarker of mercury exposure and toxicity. Woods JS. Can J Physiol Pharmacol. Feb 1996;74(2):210-215. Porphyrinuria in childhood autistic disorder: implications for environmental toxicity. Nataf R, Skorupka C, Amet L, Lam A, Springbett A, Lathe R. Toxicol Appl Pharmacol. Jul 15 2006;214(2):99-108. A prospective assessment of porphyrins in autistic disorders: a potential marker for heavy metal exposure. Geier D, Geier M. Neurotoxicity Research. 2006;10(1):6. Biomarkers of exposure and effect as indicators of the interference of selenomethionine on methylmercury toxicity. Dos Santos AP, Mateus ML, Carvalho CM, Batoreu MC. Toxicol Lett. Mar 8 2007;169(2):121-128. Porphyrins, porphyrin metabolism and porphyrias. Thunell S. I. Update. Scand J Clin Lab Invest. Nov 2000;60(7):509-540.