section 27.3 
Biosynthesis of Purine Nucleotides
623
o
■Â
1
1
o 
OH 
HO
IMP
O
Guanine
MH
Adenine
Hypoxanthine-guanine
'O 
OH 
HO
GMP
'O 
OH 
HO
AMP
F IG U R E 2 7 -1 0
Salvage pathways of purine nucleotide synthesis. The preformed purines can be converted to mononucleotides in a 
single step, using 
PRPP.
of free hypoxanthine and guanine for conversion to uric 
acid. Deficiency of adenosine deaminase or purine nucle-
oside phosphorylase results in immunodeficiency diseas 
(Chapter 35).
In muscle, a unique nucleotide reutilization pathway, 
known as the 
purine nucleotide cycle,
uses three enzymes: 
myoadenylate deaminase, adenylosuccinate synthetase, 
and adenylosuccinate lyase. In this cycle, AMP is con-
verted to IMP with formation of NH
3
, and IMP is 
then reconverted to AMP. Myoadenylate deaminase de-
ficiency produces a relatively benign disorder of muscle
(Chapter 21), which is characterized by muscle fatigue 
following exercise (see Myoadenylate Deaminase Defi-
ciency).
Nucleoside kinases specific for inosine or guanosine 
have been described. Adenosine kinase is widely dis-
tributed in mammalian tissues.
Dietary Purines
Purines derived from food do not participate significantly 
in the salvage pathways described above; they are mostly
 
    
