L12 Biochemistry of Myopathy

Question 1

Myopathy:

Answer 1

Muscular pain or dysfunction

Question 2

There are 3 subtypes of skeletal muscle tissue:

Answer 2

Type I: Slow contraction
Type IIa: Medium contraction
Type III b: Fast contraction

Question 3

Body types in general to proportion of the 3 skeletal muscle types:
Type I:
Type II:
Type III:

Answer 3

Ectomorph
Mesomorph
Endomorph

Question 4

What are the major molecules for muscular force?

Answer 4

ATP/ ADP
Actin
Myosin
Troponin
Tropomyosin
Ca++

Question 5

Sarcolemma

Answer 5

Membrane fiber

Question 6

Sarcoplasmic Reticulum

Answer 6

Stores Ca++ for flooding the myofibrils- a trabecula of vessels

Question 7

Myofibrils

Answer 7

Strands of sarcomeres

Question 8

Sarcoplasm

Answer 8

Cytoplasm of the giant fiber cells

Question 9

Sarcomere

Answer 9

Muscular contraction unit- primarily actin, myosin, tropomyosin, troponin

Question 10

Z line

Answer 10

Stiff protein that organizes and links sarcomeres

Question 11

Actin/ Myosin/ Tropomyosin

Answer 11

Major proteins of sarcomere’s filament bundles- two types: thick and thin

Question 12

Troponin

Answer 12

A protein attached to actin which regulates Ca++

Question 13

Cross bridge and head

Answer 13

Part of myosin protein that does the movement work of muscle tissue; uses ATP

Question 14

Simplified Process of Muscle Contraction

Answer 14

1. The motor neuron sends a signal to the muscle fiber to contract.
2. Calcium in the sarcoplasmic reticulum floods into the sarcoplasm
3. Ca++ attaches to troponin, allowing myosin to attach to actin, myosin breaks the ATP bond, fuelling it’s movements
4. Myosin, in attaching to actin, bends at the cross bridge, shoving actin, and contracting the sarcomere unit.
5. Ca++ is withdrawn, ATP enters myosin head active site causing myosin to release from actin
6. Repeat step 3-4-5 until the sarcomere can’t contract further

Question 15

1. The ____ neuron sends a signal to the muscle to contract.

Answer 15

motor; fiber

Question 16

2. ____ in the sarcoplasmic _____ floods into the sarcoplasm

Answer 16

Calcium; reticulum

Question 17

3. Ca++ attaches to _____ , allowing myosin to attach to _____, myosin breaks the ATP bond, fuelling it’s movements

Answer 17

troponin; actin

Question 18

4. ______, in attaching to actin, bends at the cross bridge, shoving actin, and contracting the _____ unit.

Answer 18

Myosine

sarcomere

Question 19

5. ______ is withdrawn, ATP enters myosin head active site causing myosin to release from ____

Answer 19

Ca++; actin

Question 20

6. Repeat step 3-4-5 until the ______ can’t contract further

Answer 20

sarcomere

Question 21

____ calcium flux into the sarcoplasm will increase contraction

Answer 21

Increasing

Question 22

_____ _____ of calcium out of the sarcoplasm allows ______ of the muscle by countermovement

Answer 22

Active transport

relaxation

Question 23

The stagnation of flow in or out of the _______, whether of Ca++ or nutrients, can keep a muscle fiber contracted

Answer 23

sarcoplasm

Question 24

The inability of to release usually does not affect an entire muscle, hence the formation of “______” in the muscle

Answer 24

knots

Question 25

When in a state of excess or repletion, ___ ___ therapy is done using strong ____ needle technique

Answer 25

trigger point therapy

reducing

Question 26

In treating exhausted muscles that are deficient and contracted, a ___ needling into the tissue stimulates the flow of Qi and Blood to the muscle; Distal ____ or application of tonifiing oil to the local tissue is used

Answer 26

gentle; tonification

Question 27

If there is a problem with a biochemical pathway, a drug could possibly interfere or change that pathway to _____ it better or ___ it

Answer 27

operate; inhibit

Question 28

The signature of the plant (color, taste, part used, character) radiates the medicinal action of the plant

Answer 28

Doctrine of Signatures

Question 29

Supplements or ____ are a substances that are mostly naturally-derived

Answer 29

nutriceuticals

Question 30

many drugs are derived from ___ and other simpler forms of life like ___ and its derivatives

Answer 30

bacteria; penicillin

Question 31

Gan Cao

Answer 31

Glycyrrhizin- Liquorice Root

Question 32

Used in Asia pharmaceutically as antiviral to hepatitis, herpes, HIV; Strong anti-inflammatory properties, protect liver from toxicity, mild laxative (aperient) ; in TCM a Qi Tonic

Answer 32

Glycyrrhizin (Gan Cao) - Liquorice Root

Question 33

Glycyrrhizin has one notable side effect:

Answer 33

Causes a false condition to develop aldosteronism where potassium/sodium balance in bloodstream is changed, creating HBP. The glycyrrhizin molecule can mildy mimic aldosterone, a corticosteroid produced by the adrenal glands. Aldosterone gets KD to excrete more potassium K+ than normal. Imbalance btw K+/Na+ causes the BP to rise and stay elevated- NA+ in the blood brings in more water to the blood

Question 34

NSAIDs:

Answer 34

Non- Steroidal Anti-inflammatory Drugs

Question 35

What are the main uses of NSAIDs?

Answer 35

anti-pyrrhetic (brings down fever)
Anodyne (pain relief)
Anti-inflammatory

Question 36

NSAIDs inhibit the cyclooxygenase enzymes (COX) that make ____. When cyclooxygenase is inhibited, the lack of ___ keeps the body from creating an inflammatory response to pain, this is felt as relief

Answer 36

prostaglandin; prostaglandin

Question 37

There are 2 classes of cyclooxygenase,I and II. NSAIDS generally inhibit both types. COX-II drugs are inhibited because they increase

Answer 37

heart attack risk

Question 38

Common NSAIDS are:

Answer 38

Aspirin, Ibuprofin, Naproxen, Celecoxib

Question 39

NSAIDS side effect:

Answer 39

When inhibits COX I and II in the ST, chief cells are signaled to keep making HCl, and the pH of ST is more acidic than normal homeostasis => stresses pancreas b/c it has to pump out more bicarbonate to neutralize acid => weakens intestines and create leaky gut syndrome where tight seals between intestinal cells are loosened and undigested food leak into interstitial space=> pt becomes malnourished, gains weight, chronic fatigue, qi xu and damp toxin accumulation

Question 40

Statin drugs are designed to:

Answer 40

Lower Serum Cholesterol

Question 41

Fear factor that high serum cholesterol leads to arterial plaque formation which leads to

Answer 41

heart attack and stroke

Question 42

Stains lower cholesterol by:

Answer 42

Inhibiting the enzyme HMG-CoA reductase, which is the rate-limiting enzyme of the mevalonate pathway of cholesterol synthesis. Inhibition of this enzyme in the liver results in decreased cholesterol synthesis which causes increased synthesis of LDL receptors, resulting in an increased clearance of low- density lipoprotein (LDL) from the bloodstream. The first results can be seen after one week of use and the effect is maximal after four to six weeks.

Question 43

Side Effects of Statins:

Answer 43

Muscle symptoms are a common side effect of statins; many
people experience aching in the shoulders, pain in the jaw, or muscle pain in the legs. The muscle pain is a symptom muscle breakdown that is occurring in the body due to the side effect of the statin drug. This sometimes leads to a serious myopathic condition called rhabdomyolysis, where skeletal muscle spontaneously breaks down without warning, and if not stopped, will overload the kidneys with breakdown toxins causing kidney failure and death. No mechanism has yet to be demonstrated. Statins inhibit cellular production of ubiquinone, a major molecule in the electron transport chain, used in making ATP. This molecule is particularly important in heart muscle, and may indicate why long-term statin users have a higher rate of heart attacks.
Other side effects include minor to major amnesia — 2% and peripheral neuropathy – 10%. They are also implicated in inducing Type II diabetes.

Question 44

NAC, or N-acetylcysteine, is an acetylated (add 2 carbons) form of the amino acid cysteine. Western science knows it as a mucolytic, as it helps break up mucus and gets it to flow in the lungs and sinuses. Thus, it is used in cystic fibrosis to loosen the constant phlegm produced in that disease. But it is the mechanism of its action which is most interesting.
On its own, NAC is a useful antioxidant, because of the sulfhydryl group. It has poor absorption in the gut, so large doses are necessary in emergency situations — such as in acetominophen poisoning.
NAC promotes intracellular glutathione production. When
a cell is overwhelmed by oxidative stress, glutathione levels
are taxed, allowing an inflammatory state to get out of
control in the cell. NAC provides the rate-limiting amino acid
cysteine, one of the three amino precursors of glutathione.

Answer 44

Because the precursor cysteine is available, more glutathione can be manufactured, and this enables cells to function optimally. This is important in the lungs during a lung heat condition where phlegm and heat can create an environment perfect for pneumonia development.
NAC is also widely used for treatment of acetaminophen poisoning (paracetamol, or Tylenol). When degraded by hepatocytes, the acetaminophen metabolite is a liver toxin, and if not treated promptly, can severely damage the liver. NAC again promotes the synthesis of glutathione which eliminates the toxic metabolite from the hepatocytes. Other investigational uses of NAC all have to do with its ability to boost glutathione. These are some fields NAC therapy is being studied: nephrotoxicity, schizophrenia, bipolar disorder, obsessive-compulsive disorder, cocaine withdrawal, HIV/AIDS therapeutics and treatment of noise- induced hearing loss.

Question 45

L-Carnitine is another essential molecule involved in energy generation at the level of the mitochondrion. Earlier, we mentioned that acetyl coenzyme A (ACA) is transported into the mitochondrion from the cytoplasm for use in the Krebs cycle. L-carnitine is the coenzyme that moves the acetyl group of ACA across the mitochondrial outer membrane, through the intermembrane space, and into the matrix of the mitochondrion. This is a slightly complex process with the carnitine recycled by the enzymes involved from carnitine to acyl-carnitine back to carnitine.

Answer 45

It is manufactured from lysine and methionine, and is found in many plant foods. It has antioxidant properties, and is especially protective of lipid bilayer membranes to retard lipid peroxidation.