2. Ammonia elimination Flashcards

1
Q

What are the sources of ammonia in the ornithine cycle?

A
  1. Intestinal glutaminase, urease
  2. Hepatic transdeamination
  3. Hepatic purine nucleotide cycle
  4. Hepatic direct deamination (Ser, Gly, Thr, His, AA oxidases)
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2
Q

Ammonia and ammonium ion
-> Which one is readily absorbed?

A

Ammonia

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3
Q

How is the absorption of ammonia affected by pH?

A

Decreasing pH decreases the absorption of ammonia

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4
Q

Locations of high activity of purine nucleotide cycle

A

Muscle and brain

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5
Q

What is the net reaction of purine nucleotide cycle?

A

Asp deamination – fumarate – indirect deamination

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6
Q

What is the aim of purine nucleotide cycle?

A

Ammonia for Gln synthesis for the kidney.

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7
Q

Fumarate : anaplerotic for which cycle?

A

the citrate cycle

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8
Q

Asp amino group is funelled into the nucleotide (IMP)
=> Which substances are formed.

A

AMP and fumarate

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9
Q

Ornithine (Urea) cycle
-> Identify 1 - 5

A
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10
Q

Is Arg always converted into urea? Why?

A

Arg is not necessarily converted into urea, Arg can be used for other reactions as well (later).

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11
Q

If the cycle is for Arg synthesis (not for urea synthesis), e.g. in fast protein synthesis, then Arg must be suplied with ___

A

food.

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12
Q

What is the enzyme involving in Allosteric regulation of the ornithin cycle?

A

Carbamoylphosphate Synthetase by N-acetylglutamate

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13
Q

What is the localization of Allosteric regulation of the ornithin cycle? (Carbamoylphosphate Synthetase by N-acetylglutamate)

A

mitochondria

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14
Q

What is the activator of CPS1?

A

N-acetyl-glutamate

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15
Q

Production of N-acetyl-glutamate is stimulated by ____

A

dietary Arg (Arg) is also a direct precursor of urea in the cycle)

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16
Q

CPS1 activity increases both with ____ (2 CONDITIONS)

A

protein-rich food and in starvation

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17
Q

Glucagon prevents the exit of ___ from the mitochondria.

A

N-acetylglutamate

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18
Q

Does allosteric regulation of the ornithin cycle have product inhibition?

A

No

19
Q

Fumarate produced by the urea cycle can regenerate ____ via enzymes involved in the tricarboxylic acid (TCA) cycle

A

aspartate

20
Q

Fumarate produced by the urea cycle can regenerate aspartate via enzymes involved in ____ (which cycle?)

A

the tricarboxylic acid (TCA) cycle

21
Q

Which organ produces Arg?

A

Gut-kidney axis

22
Q

Citrulline synthesis in __ (which organ?)

A

the intestine

23
Q

Arg is produced from citrulline in ___ (which organ?)

A

the kidney

24
Q

What happen to production of Arg if there is small intestine or kidney damage?

A

less Arg is synthesized than needed. Arg - essential AS.

25
Q

Long term regulation (transcriptional and regulation with sirtuin-deacetilation)

A
  1. Fasting, protein rich food, but also high cortisol levels and cAMP increases the transcription of urea cycle enzymes
  2. Sirtuins: NAD dependent deacetylases: Deacetylated CPS, OTC - active
  3. SIRT-5 deacetylates and activates CPS, SIRT-3 – OTC.
26
Q

The role of SIRT-5

A

SIRT-5 deacetylates and activates CPS, SIRT-3 – OTC.

27
Q

What is the deffect in type I hyperammonemia?

A

deffect: carbamoyl phosphate synthetase

28
Q

What is the deffect in type II hyperammonemia?

A

deffect: ornithine transcarbamoylase

29
Q

What are transporter deficiencies in Hyperammonemia?

A

+ transporter deficiencies – ORNT1 (Orn/Citr exchanger), CITRlN (Asp/Glu exchanger)

30
Q

Name of these syntheses?

A
31
Q

Metabolism of ammonia in the periportal and pericentral hepatocytes

Periportal hepatocytes: urea cycle eliminates ___ (percentage) of NH3

A

70%

32
Q

Metabolism of ammonia in the periportal and pericentral hepatocytes

Periportal hepatocytes: urea cycle eliminates 70% of NH3
=> rest of NH3 will become ___

A

substrate of Gln synthetase

33
Q

What are the 2 possibilities of incorporation of free ammonia in the liver?

A

1: Ornithine cycle CP synthetase reaction (ATP) 2: Glutamine synthetase (ATP)

34
Q

Special role of Gln in the metabolism

___ (g?) Gln/day is metabolized

A

100

35
Q

What are the sources of Gln?

A
  • Food: only 50% gets into the circulation
  • Muscle: 80g
36
Q

Ammonia is transported in the form of ___ in the blood

A

Gln

37
Q

____ (percentage) of the total amino acids in the blood is Gln

A

25%

38
Q

Glutamine
1. Mainly from ___
2. Mainly serve for ___

A
  1. Muscle, degradation of BBCA
  2. Energy
39
Q

Ammonia elimination in the brain

The high ammonia cc. (hyperammonemia) puts a huge strain on ____ (which reactions?), especially in the brain.

A

ammonia-eliminating reactions

40
Q

What are The possibilities of elimination in the brain?

A

Glutamine synthetase
Glutamate dehydrogenase

41
Q

Ammonia elimination in the brain

α-Ketoglutarate is used up to reduce ___

A

The ammonia, the citrate cycle is exhausted, the ATP level is low: fatigue, coma

42
Q

What are some therapies for Brain oedema?

A
  • Osmolytes against brain oedema
  • Inhibit N-Absorption in the gut – Lactulose ( not digested disacharid, gives protons)
  • Antibiotics to inhibit bacteria in the gut
  • Synthetic products to eliminate NH3: biotransformation
  • Arginine or Ornithine to complete the cycle.
43
Q

What happen during acidosis?

A

the ornithine cycle slows down, less HCO3 is used, NH3 – NH4+.
– CPS1 reaction is inhibited, NAG synthesis and glutaminase slow down, more ammonia
enters the pericentral hepatocytes. More Gln comes out of the liver - into the kidneys.