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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
41

Synthesis, Oxidation, and Distribution of Polyphenols in Strawberry Fruit During Cold Storage

Kelly, Katrina E. 14 June 2018 (has links)
Plants inherently produce polyphenols (i.e., antioxidants) as a response to reduce oxidative stress caused by abusive environmental pre- and postharvest conditions. These antioxidants, as well as vitamin C, are present in considerable levels in strawberries; however, excessive oxidative stress brought on by improper postharvest handling conditions can reduce the levels of antioxidants in the fruit and shorten the shelf-life of strawberries. Nevertheless, it may be possible to utilize strawberry’s naturally occurring polyphenols to reduce postharvest stress and extend their shelf life. The polyphenolic profile has been previously investigated in several strawberry cultivars, however no studies have determined the unique polyphenolic profiles of three important Florida strawberry cultivars (‘Florida Radiance’, Sweet Sensation® ‘Florida 127’and ‘Florida Beauty’) at harvest and during cold storage. Therefore, in order to better understand the distribution of individual polyphenols within these cultivars and their impact on postharvest shelf-life, this study examined the polyphenolic profiles throughout 7 days of cold storage (1 °C) using an HPLC-DAD. The activity of phenylalanine ammonia lyase (PAL), a key enzyme in the biosynthesis of polyphenols, and polyphenol oxidase (PPO), the enzyme responsible for polyphenol degradation, were also examined during cold storage to understand their possible influences on postharvest synthesis or degradation of polyphenols. This study revealed that the polyphenolic profile of strawberry fruit was genotype dependent; however, pelargonidin 3-glucoside was consistently the anthocyanin found in higher concentrations in the fruit regardless of the cultivar. Apart from the anthocyanins, the flavonols showed the most variation among the three cultivars. PAL was slightly induced during strawberry postharvest storage suggesting that a stress response occurred during cold storage while PPO showed variable induction patterns across all three cultivars most likely due to their different polyphenol profiles. Analysis of the distribution of polyphenols in the cortex and pith of strawberries showed that polyphenols were mostly concentrated in the cortex of the fruit and that the concentration of individual polyphenol in each fruit tissue varied by cultivar. These results indicate that the oxidative stress response varies in each of the strawberry cultivars studied contributing to their unique polyphenolic profile. Results from this study can ultimately help to identify the polyphenols and enzymes related to superior postharvest quality in future studies.
42

Stockage et mobilisation de la tyrosine au cours du développement larvaire de Spodoptera littoralis (Lepidoptère; Noctuidae)

Rahbé, Yvan 13 December 1984 (has links) (PDF)
Résumé à venir
43

Mechanistic and Structural Studies of Phenylalanine Hydroxylase from Chromobacterium violaceum

Panay Escobar, Aram Joel 2010 August 1900 (has links)
The phenylalanine hydroxylase from Chromobacterium violaceum (CvPheH) is a non-heme iron monooxygenase that catalyzes the hydroxylation of phenylalanine. This study presents the use of kinetic isotope effects (KIE) as mechanistic probes to compare the reactivity of CvPheH and that of the eukaryotic aromatic amino acid hydroxylases. This study also describes the use of different spectroscopic and kinetic techniques to identify the hydroxylating intermediate for this enzyme and the assignment of the NMR backbone resonances of CvPheH. Kinetic isotope effects on aromatic and benzylic hydroxylation were used to establish that bacterial and eukaryotic phenylalanine hydroxylases have similar reactivity. The observed KIE on aromatic hydroxylation of 1.4 was shown to be a combination of an inverse isotope effect on the hydroxylation of the amino acid and a normal isotope effect on a subsequent step in the reaction. An isotope effect on benzylic hydroxylation of 10 was found for CvPheH. This result establishes the similar reactivity for CvPheH and the eukaryotic aromatic amino acid hydroxylases and suggests the involvement of a common hydroxylating intermediate. Kinetic isotope effects were used to study the hydroxylation of the aliphatic substrate cyclohexylalanine. The Dkcat value with [1,2,2,3,3,4,4,5,5,6,6-2H11]- cyclohexylalanine is unity with wild-type CvPheH, suggesting that chemistry is not ratelimiting with this substrate. The intramolecular isotope effect calculated using [1,2,3,4,5,6-2H6]-cyclohexylalanine yields a value of 14. This result is evidence for the involvement of a reactive iron species capable of abstracting a hydrogen atom from the aliphatic carbon in cyclohexylalanine. Analysis of the CvPheH reaction using freeze-quench Mössbauer spectroscopy allowed the detection of an Fe(IV) species in the first turnover of the enzyme. Chemical quench and stopped-flow spectrophotometric methods were used to establish the kinetic competency of the Fe(IV) intermediate as the hydroxylating species. The NMR amide backbone resonances in the HSQC spectrum of CvPheH were assigned to the corresponding amino acid residues using a suite of TROSY-based threedimensional triple resonance experiments. We were able to assign 224 residues out of the 278 assignable residues in CvPheH, this constitutes 81 percent of the assignable protein sequence.
44

Neue Ansätze in der Qualitätssicherung von Honig

Beckmann, Klaus 27 January 2009 (has links) (PDF)
Der erste Teil der Dissertation behandelt die Substanz Phenylacetaldehyd, welche im Honig ausgehend von der Aminosäure Phenylalanin als natürlicher Stoff, aber auch als Rückstand nach Einsatz als Bienenvertreibungsmittel vorliegen kann. Die in dieser Arbeit durchgeführten Untersuchungen zeigen, dass der Gehalt an Phenylalanin sowie äußere Bedingungen, denen Honige ausgesetzt sind, für die Konzentration an Phenylacetaldehyd maßgebend sind. Diese Parameter müssen mindestens bekannt sein, um entscheiden zu können, ob Phenylacetaldehyd als Rückstand im Honig vorliegt. Der zweite Teil befasst sich mit der Filtration von Honig, welche in manchen Ländern durchgeführt wird, um eine Kristallisation zu herauszuzögern. Es wurde eine Methode entwickelt, um illegale Beimischungen gefilterter Honige zu ungefilterten Honigen nachzuweisen. Dazu wird das Enzym Saccharase gelchromatographisch isoliert und diese Fraktion elektrophoretisch untersucht. Die Veränderung des Proteinspektrums lässt sich mit Hilfe einer densitometrischen Auswertung quantifizieren und zeigt gefilterten Honig auch in Mischungen bis zu einem Anteil von mindestens 15 % an.
45

Selenium redox cycling isolation and characterization of a stimulatory component from tissue of loblolly pine for multiplication of somatic embryos; development of an assay to measure l-phenylalanine concentration in blood plasma /

DeSilva, Veronica January 2007 (has links)
Thesis (Ph.D)--Chemistry and Biochemistry, Georgia Institute of Technology, 2007. / Committee Chair: Sheldon May; Committee Members: Nicholas Hud, Stanley Pollock, James Powers, and Gerald Pullman. Part of the SMARTech Electronic Thesis and Dissertation Collection.
46

Prenatal Stress, Depression, and Herpes Viral Titers

Hsu, Pao-Chu 01 January 2013 (has links)
Recent studies suggest that some cases of prenatal depression may be associated with reactivation of latent infections of the herpesvirus family. The possible relationships among stress, prenatal depression, and herpes viral reactivation in pregnancy are understudied and the molecular pathways such as the neuroimmune biogenic amine pathway are unidentified. Chronic stress shifts the T helper-1 cell (Th1) cytokine profile to a Th2 profile, which favors virus induced pathogenesis and survival. Pregnancy is also associated with a similar Th2 dominance. In non-pregnant individuals, exposure to psychological or physical stress may be associated with latent herpes viral reactivation and could result in behavioral deficits and depression. Normally, type-1 cytokines such as Interferon-gamma (IFN -gamma) and inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) induce indoleamine-2, 3-dioxygenase (IDO) activation which inhibits herpes virus replication and reactivation, decreases tryptophan production, and alters phenylalanine /tyrosine metabolism. Thus it is possible that prenatal depression may occur from tryptophan stealing through the IDO pathway which results in decreased serotonin as well as increased risk for latent herpes viral reactivation. The purpose of this study is to analyze the relationships among stress, herpes viral titers, depression, and metabolites of IDO activation, which involves tryptophan and guanosine-triphosphate-cyclohydrolase-1(GTP-CH1) pathways. This study builds on Influence of Lactation on Postpartum Stress and Immunity (Grant number: R01-NR05000) which investigated perinatal immune, endocrine, and inflammatory changes in pregnancy and the postpartum. A secondary data analysis was conducted on baseline data from women collected at 16 to 25 gestational weeks. This data set included some herpes viral titers, and additional ones were measured in stored plasma samples. The aim of this study is to examine relationships among stress, herpes viral reactivation, depression, and the IDO activation pathway. The results of this study provide information about the possible role of further relationships of prenatal stress, latent herpes viral reactivation, and depression mechanisms. The results will be important in health promotion and disease prevention during pregnancy.
47

The role of strychnine-sensitive nACHRS in rabbit retinal OFF ganglion cells

Renna, Jordan Michael. January 2008 (has links) (PDF)
Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Feb. 13, 2009). Includes bibliographical references.
48

Hiperfenilalaninemia por deficiência de fenilalanina hidroxilase : avaliação da responsividade ao BH4 em pacientes acompanhados no Serviço de Genética Médica do HCPA e que apresentam controle metabólico adequado

Nalin, Tatiéle January 2011 (has links)
Introdução: Estudos recentes, utilizando vários protocolos, têm demonstrado que pacientes com Hiperfenilalaninemia por deficiência de fenilalanina hidroxilase (HPA-PAH) podem apresentar redução das concentrações plasmáticas de fenilalanina (Phe) mediante a administração de tetrahidrobiopterina (BH4). Objetivo: Determinar, em uma amostra de pacientes brasileiros com HPA-PAH, a responsividade à administração de dose única de BH4 por meio de um protocolo incluindo o teste de sobrecarga simples de Phe e o teste combinado de sobrecarga de Phe+BH4. Métodos: Foram incluídos no estudo pacientes com idade ≥ 4 anos, em tratamento dietético e que possuíam mediana de Phe plasmática inferior a 10mg/dL no ano anterior à inclusão. Foram realizados teste de sobrecarga simples de Phe, utilizando 100mg/kg de L-Phe (Teste 1) e teste combinado de Phe+BH4, utilizando 100mg/kg de L-Phe e 20mg/kg de BH4 (Teste 2), com intervalo de uma semana entre ambos. A ingestão do BH4 ocorreu após três horas da ingestão da Phe. Foram realizadas coletas de sangue no ponto basal e após três, 11 e 27h da ingestão de Phe (T0, T1, T2 e T3 dos testes 1 e 2, respectivamente). Para ser considerado responsivo, o paciente deveria apresentar evidência de redução dos níveis de Phe associada à administração do BH4 de acordo com pelo menos um dos seguintes critérios: critério A – análise das diferenças, em percentual, dos valores de Phe nos pontos T1 e T2 dos Testes 1 e 2; critério B – análise das diferenças, em percentual, dos valores de Phe nos pontos T1 e T3 dos Testes 1 e 2 e critério C – análise da diferença, em percentual, das áreas abaixo da curva de Phe entre os Testes 1 e 2. A classificação de responsividade foi também comparada com quatro critérios adicionais: critério D – análise da diferença, em percentual, dos valores de Phe nos pontos T1 e T2 do Teste 2; critério E – análise da diferença, em percentual, dos valores de Phe nos pontos T1 e T3 do Teste 2; cinco pacientes participaram de estudo anterior do grupo e foram também classificados através do critério F – análise da diferença, em percentual, dos valores de Phe após 8h da sobrecarga simples com BH4 e do critério G – análise da diferença, em percentual, dos valores de Phe após 24h da sobrecarga simples com BH4. Para todos os critérios foi utilizado como ponte de corte redução ≥ 30%. Resultados: Dezoito pacientes, com mediana de idade de 12 anos, participaram do estudo. Dez pacientes apresentavam a forma Leve de HPA-PAH e oito a forma Clássica. Seis pacientes foram considerados responsivos de acordo com os critérios adotados (Clássica: 2; Leve: 4). Houve concordância de responsividade entre os critérios A e B em relação ao C (Índice Kappa=0,557; p=0,017). Dos pacientes com genótipo disponível (n=16), seis possuíam dados de responsividade ao BH4 descritos na literatura, que foram concordantes com os encontrados no presente estudo. Conclusão: Dados relativos à responsividade, tipo de HPA-PAH e genotipagem estão de acordo com descrito na literatura. Haja vista a diferença de responsividade dos pacientes ao BH4 conforme o critério de classificação utilizado, salienta-se a importância de uma definição cautelosa de responsividade e que não seja baseada em um único critério. A comparação entre a sobrecarga simples de Phe e combinada de Phe+BH4 parece ser um critério adequado para avaliar responsividade ao BH4 em pacientes com HPA-PAH que apresentam bom controle metabólico quando em tratamento dietético. / Introduction: Recent studies using different protocols showed that patients with hyperphenylalaninemia due to phenylalanine hydroxylase deficiency (HPA-PAH) may have a reduction in phenilalanine (Phe) plasma concentrations after tetrahydrobiopterin (BH4) administration. Objective: To determine responsiveness to the administration of a single dose of BH4, in a sample of Brazilian patients with HPA-PAH using a protocol that includes the simple Phe loading test and the combined Phe+BH4 loading test. Methods: Patients included in the study were ≥ 4 years of age; their median Phe plasma concentration was ≤ 10mg/dL, and all underwent dietary treatment in the 12 months before inclusion in the study. Participants received a simple Phe loading test using 100mg/kg L-Phe (Test 1) and a combined Phe+BH4 loading test using 100mg/kg L-Phe and 20mg/kg /BH4 (Test 2) at a one-week interval. BH4 was ingested three hours after Phe ingestion. Blood samples were collected at baseline and three, 11 and 27h after Phe ingestion (time points T0, T1, T2 and T3 in Tests 1 and 2). To be classified as responsive, there should be evidence that the patient had a reduction in Phe levels associated with BH4 administration according to at least one of the criteria used: criterion A – analysis of percentage differences of the Phe values at time points T1 and T2 for Tests 1 and 2; criterion B – analysis of percentage differences of Phe values at time points T1 and T3 for Tests 1 and 2; and criterion C – analysis of percentage differences of the areas under the Phe curve for Tests 1 and 2. Responsiveness classifications were also compared according to four additional criteria: criterion D – analysis of percentage differences of the Phe values at time points T1 and T2 for Test 2; criterion E – analysis of percentage differences of Phe values at time points T1 and T3 for Test 2; criterion F – analysis of percentage difference of Phe values 8h after simple BH4 loading used for five patients that participated in a previous study conducted by the same authors; and criterion G – analysis of percentage difference of Phe values 24 h after simple BH4 loading, also used for the patients in the same previous study. The cut-off point for all criteria was a reduction of ≥ 30%. Results: Eighteen patients (median age = 12 years) were included in the study. Ten patients had mild HPA-PAH and eight, classical HPA-PAH. Six patients were responsive according to the criteria used (Classical: 2; Mild: 4). Responsiveness was concordant for criteria A and B when compared with criterion C (kappa=0.557; p=0.017). Of the patients whose genotype was available (n=16), six had data about BH4 responsiveness described in the literature, and these data were in agreement with our findings. Conclusion: Data about responsiveness, HPA-PAH type and genotype were in agreement with those described in the literature. The difference in BH4 responsiveness of patients according to classification criterion emphasizes the importance of a careful definition of responsiveness not based on a single criterion. The comparison of simple Phe loading and combined Phe+BH4 loading seems to be an adequate criterion to evaluate responsiveness to BH4 in patients with HPA-PAH and good metabolic control when following a dietary treatment.
49

Hiperfenilalaninemia por deficiência de fenilalanina hidroxilase : identificação de indivíduos responsivos à administração de tetrahidrobiopterina por via oral

Giugliani, Luciana January 2009 (has links)
Introdução: A Hiperfenilalaninemia por deficiência de fenilalanina hidroxilase (HPAPAH) é um erro inato do metabolismo no qual ocorre aumento dos níveis séricos de fenilalanina (Phe). Estudos recentes, realizados em várias populações, demonstraram que pacientes com HPA-PAH podem apresentar redução das concentrações plasmáticas de Phe mediante a administração oral de tetrahidrobiopterina (BH4). Objetivo: Identificar em uma amostra de pacientes brasileiros com HPA-PAH aqueles que são responsivos à administração de BH4 por via oral. Métodos: Para um paciente ser incluído no estudo, era necessário ter diagnóstico de HPA-PAH e idade igual ou superior a 7 anos, estar em tratamento dietético e apresentar nível de Phe igual ou superior a 6 mg/dL em todas as medidas realizadas no ano anterior à inclusão no estudo. No dia anterior à sobrecarga de BH4 (Dia 1), os pacientes foram submetidos a três coletas de sangue para mensuração dos níveis de Phe. No Dia 2, os pacientes receberam dose única de 20mg/Kg de BH4. As coletas de sangue foram, então, realizadas nos pontos de hora: 0, 4 e 8h (Dia 2) e 24h (Dias 3) após a ingestão do medicamento. Os níveis de Phe foram determinados através da espectrometria de massa in tandem. Foram utilizados dois critérios para definir a presença de responsividade ao BH4: Critério 1: redução 30% de Phe após 8h da administração do medicamento; Critério 2: redução 30% de Phe após 24h da administração do medicamento. Resultados: Dezoito pacientes foram incluídos no estudo, com mediana de idade de 14 anos, sendo 66,7% do sexo masculino. Onze apresentavam a forma clássica da doença e três a forma atípica. Três (forma clássica: 1, forma atípica: 2) e cinco (forma clássica: 2, forma atípica: 2 e forma não-definida: 1) pacientes foram considerados responsivos ao BH4 conforme critérios 1 e 2, respectivamente. Os níveis de Phe plasmáticos do dia anterior ao teste de sobrecarga não demonstraram variação nos pontos de hora (p=0,523). Entretanto, quando comparamos os níveis de Phe nos pontos de hora do dia pré e pós BH4, encontrou-se variação significativa entre eles (p=0,006). A análise da associação genótipo-fenótipo, para os pacientes com dados disponíveis (n=6) mostrou que a mesma é multifatorial. Conclusão: Nossos achados estão de acordo com a literatura, e indicaram que um número considerável de pacientes brasileiros com HPA-PAH poderá ser beneficiado com a administração oral de BH4. / Introduction: Hyperphenylalaninemia by phenylalanine hydroxylase deficiency (HPAPAH) is an inborn error of metabolism in which increased serum levels of phenylalanine (Phe) occur. Recent studies on several populations showed that patients with HPA-PAH can have their serum levels reduced when receiving oral tetrahydrobiopterin (BH4). Objective: to identify in a sample of Brazilian HPA-PAH the patients who are responsive to the oral administration of BH4. Methods: the following inclusion criteria were used: diagnosis of HPA-PAH, age 7 years, on dietary treatment and Phe levels 6 mg/dL in all tests performed one year prior to the inclusion in this study. On the day before the BH4 challenge (Day 1) 3 blood samples were obtained to measure Phe levels. Blood samples were also obtained at time points 0, 4, 8 hours (Day 2) and 24 h (Day 3) after the intake of the medication. Phe levels were determined by tandem mass spectrometry. Criteria used to define responsiveness to BH4 were: Criterion 1: Phe reduction 30% 8 hours after BH4 administration; Criterion 2: Phe reduction 30% 24 hours after BH4 administration. Results: a total of 18 patients with a mean age of 14 years were included in this study; of those, 66.7% were male. Eleven presented the classical form of the disease and 3, the atypical form. Three patients (classical form: 1, atypical form: 2) and 5 (classical form: 2; atypical form: 2; undefined form: 1) were considered responsive to BH4 according to criteria 1 and 2, respectively. Phe serum levels on the Day 1 did not show any change on the established time point schedule (p=0.523). However, when comparing levels of Phe between Days 1 and 2, significant variation was found (p=0.006). The phenotype – genotype association analysis of patients with available data (n=6) showed that the association is multifactorial. Conclusion: In accordance with the literature, our findings show that many Brazilian patients with HPA-PAH can benefit from the oral administration of BH4.
50

Hiperfenilalaninemia por deficiência de fenilalanina hidroxilase : identificação de indivíduos responsivos à administração de tetrahidrobiopterina por via oral

Giugliani, Luciana January 2009 (has links)
Introdução: A Hiperfenilalaninemia por deficiência de fenilalanina hidroxilase (HPAPAH) é um erro inato do metabolismo no qual ocorre aumento dos níveis séricos de fenilalanina (Phe). Estudos recentes, realizados em várias populações, demonstraram que pacientes com HPA-PAH podem apresentar redução das concentrações plasmáticas de Phe mediante a administração oral de tetrahidrobiopterina (BH4). Objetivo: Identificar em uma amostra de pacientes brasileiros com HPA-PAH aqueles que são responsivos à administração de BH4 por via oral. Métodos: Para um paciente ser incluído no estudo, era necessário ter diagnóstico de HPA-PAH e idade igual ou superior a 7 anos, estar em tratamento dietético e apresentar nível de Phe igual ou superior a 6 mg/dL em todas as medidas realizadas no ano anterior à inclusão no estudo. No dia anterior à sobrecarga de BH4 (Dia 1), os pacientes foram submetidos a três coletas de sangue para mensuração dos níveis de Phe. No Dia 2, os pacientes receberam dose única de 20mg/Kg de BH4. As coletas de sangue foram, então, realizadas nos pontos de hora: 0, 4 e 8h (Dia 2) e 24h (Dias 3) após a ingestão do medicamento. Os níveis de Phe foram determinados através da espectrometria de massa in tandem. Foram utilizados dois critérios para definir a presença de responsividade ao BH4: Critério 1: redução 30% de Phe após 8h da administração do medicamento; Critério 2: redução 30% de Phe após 24h da administração do medicamento. Resultados: Dezoito pacientes foram incluídos no estudo, com mediana de idade de 14 anos, sendo 66,7% do sexo masculino. Onze apresentavam a forma clássica da doença e três a forma atípica. Três (forma clássica: 1, forma atípica: 2) e cinco (forma clássica: 2, forma atípica: 2 e forma não-definida: 1) pacientes foram considerados responsivos ao BH4 conforme critérios 1 e 2, respectivamente. Os níveis de Phe plasmáticos do dia anterior ao teste de sobrecarga não demonstraram variação nos pontos de hora (p=0,523). Entretanto, quando comparamos os níveis de Phe nos pontos de hora do dia pré e pós BH4, encontrou-se variação significativa entre eles (p=0,006). A análise da associação genótipo-fenótipo, para os pacientes com dados disponíveis (n=6) mostrou que a mesma é multifatorial. Conclusão: Nossos achados estão de acordo com a literatura, e indicaram que um número considerável de pacientes brasileiros com HPA-PAH poderá ser beneficiado com a administração oral de BH4. / Introduction: Hyperphenylalaninemia by phenylalanine hydroxylase deficiency (HPAPAH) is an inborn error of metabolism in which increased serum levels of phenylalanine (Phe) occur. Recent studies on several populations showed that patients with HPA-PAH can have their serum levels reduced when receiving oral tetrahydrobiopterin (BH4). Objective: to identify in a sample of Brazilian HPA-PAH the patients who are responsive to the oral administration of BH4. Methods: the following inclusion criteria were used: diagnosis of HPA-PAH, age 7 years, on dietary treatment and Phe levels 6 mg/dL in all tests performed one year prior to the inclusion in this study. On the day before the BH4 challenge (Day 1) 3 blood samples were obtained to measure Phe levels. Blood samples were also obtained at time points 0, 4, 8 hours (Day 2) and 24 h (Day 3) after the intake of the medication. Phe levels were determined by tandem mass spectrometry. Criteria used to define responsiveness to BH4 were: Criterion 1: Phe reduction 30% 8 hours after BH4 administration; Criterion 2: Phe reduction 30% 24 hours after BH4 administration. Results: a total of 18 patients with a mean age of 14 years were included in this study; of those, 66.7% were male. Eleven presented the classical form of the disease and 3, the atypical form. Three patients (classical form: 1, atypical form: 2) and 5 (classical form: 2; atypical form: 2; undefined form: 1) were considered responsive to BH4 according to criteria 1 and 2, respectively. Phe serum levels on the Day 1 did not show any change on the established time point schedule (p=0.523). However, when comparing levels of Phe between Days 1 and 2, significant variation was found (p=0.006). The phenotype – genotype association analysis of patients with available data (n=6) showed that the association is multifactorial. Conclusion: In accordance with the literature, our findings show that many Brazilian patients with HPA-PAH can benefit from the oral administration of BH4.

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