Clinical Test of Pyrroles in Psychiatric Disorders: Association with Nutritional, Immunological and Metabolic Markers

Abstract

Background: Psychiatrists started using urine pyrroles (hydroxyhemopyrrolin-2-one, HPL) to diagnose psychiatric disorders many years ago. The biological origins of HPL are not known, nor are the causes of elevated urinary pyrrole excretion well understood. Methods: In the present study we analyzed the level of pyrroles in 148 patients with schizophrenia, 135 patients with bipolar disorder, 97 patients with depression, 119 patients with ADHD and compared these data with the results of pyrrole tests for patients with non-psychiatric conditions and healthy volunteers. Results: According to our data, urinary pyrrole concentrations tended to be high in patients with psychiatric disorders, but elevated level of pyrroles was not specific for only these patients. We found evidence of an allergy related component in the fact that elevated pyrrole levels were significantly more prevalent in subjects with elevated histamine values. A role of intestinal bacteria, or imbalances in intestinal bacterial metabolism, was also suggested based on the found relationship between elevated pyrrole levels and elevations in indicans and urobilinogens. In addition, our data demonstrated that subjects with severely elevated pyrrole levels were deficient in nutrients such as zinc, vitamin B3, and vitamin C. Conclusion: Thus, pyrrole excretion seems to be a component of illness in general and not strictly psychiatric disorders.

Sixty years of conjecture over a urinary biomarker: a step closer to understanding the proposed link between anxiety and urinary pyrroles

“…This finding contradicts previous studies 5 , 25 , 27 , 28 , 37–42 that identify the urine component responsible for the Ehrlich’s mauve reaction as HPL. Interestingly, none of the previous studies used a pure, authentic HPL standard and so based their conclusions on a possible misinterpretation of the chemistry of the Ehrlich’s reaction.…”

“…A cross-sectional analysis of pyrroles in psychiatric disorders 28 suggested that there is a correlation between histamine levels and pyrrole levels. Histamine itself is unlikely to react with Ehrlich’s reagent as it does not have a free β-carbon.…”

A Metabolomic Approach for Predicting Diurnal Changes in Cortisol

“…Elevated hydroxyhemopyrrolin-2-one (HPL) in urine has long been associated with psychiatric disorders, first recorded in schizophrenic patients, with similar findings regarding bipolar disorder, depression, hyperactivity disorder, Down Syndrome, and chronic fatigue syndrome [31,32]. Pyrrole (Figure 3), a precursor to HPL, is known to play a role in some biological pathways, including porphyrin synthesis for heme and cytochrome macromolecules.…”

Molecular Mechanisms Provide a Landscape for Biomarker Selection for Schizophrenia and Schizoaffective Psychosis

“…Haeme porphyrin is then degraded by haeme oxidase in an oxidative process that is conjectured to contribute to urine excretion of the porphyrin pyrrole biomarker, hydroxypyrroline-2-one (HPL). High levels of this molecule have been detected in the urine of patients with schizophrenia and particularly in those who do not possess the homozygous MTHFR 677 polymorphism [81,126]. Elevated urine HPL levels are reportedly reduced by vitamin B6 (PLP) and zinc supplementation, though the exact mechanism of this effect is yet to be established [127].…”