Adenine and guanine are the two nucleotides classified as purines. In purine synthesis, PRPP is turned into inosine monophosphate, or IMP. Production of IMP from PRPP requires glutamine, glycine, aspartate, and 6 ATP, among other things. IMP is then converted to AMP (adenosine monophosphate) using GTP and aspartate, which is converted into fumarate. While IMP can be directly converted to AMP, synthesis of GMP (guanosine monophosphate) requires an intermediate step, in which NAD+ is used to form the intermediate xanthosine monophosphate, or XMP. XMP is then converted into GMP by using the hydrolysis of 1 ATP and the conversion of glutamine to glutamate. AMP and GMP can then be converted into ATP and GTP, respectively, by kinases that add additional phosphates.
ATP stimulates production of GTP, while GTP stimulates production of ATP. This cross regulation keeps the relative amounts of ATP and GTP the same. Excess of either nucleotide could increase the likelihood of DNA mutations, where the wrong purine nucleotide is inserted.
Lesch–Nyhan syndrome is caused by a deficiency in hypoxanthine-guanine phosphoribosyltransferase or HGPRT, the enzyme that catalyzes the reversible reaction of producing guanine from GMP. This is a sex-linked congenital defect that causes overproduction of uric acid along with mental retardation, spasticity, and an urge to self-mutilate.