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Why is the patient with lead intoxication not light sensitive?

B Haeger-Aronsen

    Acta Dermato-Venereologica. Supplementum
    |January 1, 1982
    PubMed
    Summary

    Lead exposure increases red blood cell protoporphyrin (PP). Unlike in porphyria, zinc-bound PP (ZPP) in lead poisoning remains in cells, preventing light sensitivity. This explains why lead workers do not develop photosensitivity.

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    Area of Science:

    • Biochemistry
    • Toxicology
    • Hematology

    Background:

    • Lead exposure is known to increase protoporphyrin (PP) levels in red blood cells.
    • Individuals with lead poisoning do not exhibit the photosensitivity characteristic of porphyria, despite elevated PP concentrations.
    • The mechanism behind this lack of photosensitivity has been a long-standing question in medical research.

    Purpose of the Study:

    • To elucidate the reason for the absence of photosensitivity in lead poisoning.
    • To differentiate the form of protoporphyrin involved in lead poisoning from that in porphyria.

    Main Methods:

    • Investigated the state of protoporphyrin in erythrocytes of lead-exposed individuals.
    • Compared the properties and cellular localization of protoporphyrin in lead poisoning versus porphyria.

    Main Results:

    • Erythrocyte protoporphyrin in lead poisoning is primarily bound to zinc, forming zinc protoporphyrin (ZPP).
    • Free protoporphyrin, characteristic of porphyria, can exit red blood cells and cause photosensitivity.
    • ZPP remains sequestered within red blood cells, preventing its accumulation in tissues and subsequent light-induced damage.

    Conclusions:

    • The binding of protoporphyrin to zinc in lead poisoning prevents its release from erythrocytes.
    • This cellular confinement of ZPP explains the lack of photosensitivity observed in lead-exposed workers.
    • Understanding the differential binding of PP is crucial for explaining clinical manifestations in toxicological and genetic disorders.

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