HVA

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HVA


Homovanillic acid (HVA) is a major metabolite of dopamine, a key neurotransmitter in the brain. The measurement of HVA levels in the body fluids, such as blood plasma and cerebrospinal fluid, is an important diagnostic tool for assessing the functioning of dopaminergic systems. This is particularly relevant in the diagnosis and monitoring of neurological disorders and psychiatric disorders that are associated with alterations in dopamine metabolism, such as Parkinson's disease, schizophrenia, and certain types of malignant tumors like neuroblastoma.

HVA is produced through the enzymatic breakdown of dopamine by the actions of monoamine oxidase (MAO) and catechol-O-methyl transferase (COMT). The process involves the conversion of dopamine to 3,4-dihydroxyphenylacetic acid (DOPAC) by MAO, followed by the methylation of DOPAC by COMT to produce HVA. This metabolic pathway is crucial for the regulation of dopamine levels in the brain and the proper functioning of dopaminergic neurons.

The analysis of HVA levels, alongside other dopamine metabolites such as DOPAC and vanillylmandelic acid (VMA), can provide valuable insights into the dopaminergic activity within the brain. Elevated levels of HVA in the cerebrospinal fluid can indicate an increased turnover of dopamine, which is observed in conditions like schizophrenia. Conversely, reduced levels of HVA may be seen in disorders such as Parkinson's disease, where there is a degeneration of dopaminergic neurons in the substantia nigra.

In addition to its role in neurological and psychiatric diagnostics, HVA levels are also used in the diagnosis and monitoring of neuroblastoma, a cancer that arises from neuroblasts in the adrenal glands or elsewhere in the nervous system. High levels of HVA and VMA in urine are indicative of neuroblastoma, as the tumor cells produce excessive amounts of catecholamines and their metabolites.

The measurement of HVA is typically performed using techniques such as high-performance liquid chromatography (HPLC) with electrochemical detection, which allows for the sensitive and specific quantification of HVA in body fluids. This analytical method is crucial for the accurate diagnosis and monitoring of diseases associated with alterations in dopamine metabolism.


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Contributors: Prab R. Tumpati, MD