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Ascorbic acid (ascorbate) participates in critical steps of the biosynthesis of norepinephrine, including those mediated by tyrosine hydroxylase (TH) and dopamine-β-hydroxylase (DBH). For example, DBH is responsible for the conversion of dopamine into norepinephrine in noradrenergic terminals and requires the activity of the ascorbate-coupled cytochrome b561 protein (CYB561). The recent identification of 2 families harboring CYB561 gene mutations manifested with longstanding orthostatic hypotension (OH)1,2 resembling the phenotype of DBH deficiency3,4 emphasizes the important role of ascorbic acid–related processes in sympathetic control of blood pressure.
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Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the article.
- Received September 15, 2020.
- Accepted in final form September 15, 2020.
- © 2020 American Academy of Neurology
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