Lecture 52 Flashcards

1
Q

What are the Heme containins proteins and what are their functions?

A

1) Hemoglobin – Binding, transport of O2
2) Myoglobin – Binding, storage of O2
3) Catalase – Breakdown of H2O2
4) Cytochromes c, b & a – Electron transport
5) Cytochrome P450 – Hydroxylation
6) Chlorophyll (Mg2+) – Absorption of light

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2
Q

What occurs in diseases of heme synthesis/degradation?

A

1) Porphyrias: Rare but fatal

2) Jaundices: Common & Diagnostic

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3
Q

What are characteristics of the heme structure?

A

1) It is called Porphyrin 9 because of the structure
2) It has 4 pyrrole rings, 2 of which contain a methyl + vinyl group, and 2 of which contain a methyl & propionyl group
3) The double bonds are conjugated

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4
Q

What is the first reaction of heme formation?

A

1) Succinyl CoA + Glycine → delta-Aminolevulinic Acid (occurs in the mitochondria; uses delta-aminolevulinic acid synthase)
2) The amount of heme controls the regulation of this reaction. More heme = negative inhibition

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5
Q

What is the second reaction of heme formation?

A

1) delta-aminolevulinic acid moves from the mitochondria to the cytoplasm
2) delta-aminolevulinic acid → porphobilinogen (uses delta-aminolevulinic acid dehydrase)

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6
Q

What are the third reaction and fourth reactions of heme formation?

A

1) porphobilinogen is deaminated (uses porphobilinogen deaminase)
2) uro synthase 1 or 3 is used to produce either uroporphyrinogen 1 or 3

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7
Q

What must be done when Uroporphyrinogen 1 is formed?

A

1) A pyrrole and amino group must be switched to make the molecule nonsymmetrical and allow the addition of more pyrrole groups to make the tetrapyrrole intermediate
2) This requires Uro 3 Cosynthase to produce Uroporyphrinogen 3 from Uroporphyrinogen 1

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8
Q

What happens to Uroporphyrinogen 3 once it is formed?

A

1) Uroporphyrinogen 3 → Coproporphyrinogen 3 (uses Uro 3 decarboxylase)
2) Coproporphyrinogen 3 → Protoporphyrinogen 9 (uses Copro 3 oxidase)

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9
Q

What must occur to Protoporyphrinogen 9 once it is formed?

A

1) It undergoes oxidation to produce resonance between the double bonds
2) Enzyme is Protoporphyrin 9 oxidase
3) Fe2+ must be added to finalize the heme group
4) Enzyme is ferrochelatase

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10
Q

What are diseases of heme synthesis that cause a blockage of the tetrapyrrole intermediate being formed and an accumulation of porphobilinogen?

A

Porphyrias:

1) Acute Intermittent: rxn 3 (porphobilinogen to uroporphyrinogen 1)
2) Congenital Erythropoietic: rxn 4 (uroporphyrinogen 1 to uroporphyrinogen 3)
3) Cutanea Tarda: rnx 5 (uroporphyrinogen 3 to coproporyphyrinogen 3)
4) Lead poisoning rxns 2 & 8 (delta-aminolevulinic acid to porphobilinogen & addition of Fe2+ to protoporphyrinogen 9)

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11
Q

What is the first step in heme degradation?

A

1) Occurs in Reticuloendothelial system cell (RES Cell: spleen, liver, bone marrow): fixed mononuclear phagocytes
2) Hemoglobin → Globin + Heme
3) Globin is broken down into amino acids
4) Heme → biliverdin + Fe3+ + CO (uses Heme oxygenase)
5) Biliverdin + NADPH → Bilirubin (insoluble) + NADP+

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12
Q

What happens to bilirubin once it is made in an RES Cell?

A

It is transferred into the blood where it is transported by albumin to the liver

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13
Q

Why is bilirubin insoluble?

A

Because bilirubin serves as a reductant in the blood as it travels to the liver for degradation (does so to minimize the formation of plaque)

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14
Q

What happens to bilirubin in the liver?

A

In the liver, the insoluble bilirubin is conjugated to 2 molecules of glucuronic acid to form bilirubin diglucuronide (comes from glucuronyl-UDP)

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15
Q

What happens to bilirubin diglucuronide in the liver?

A

1) It is soluble and travels through the bile duct to the small intestine
2) Bacteria convert bilirubin diglucuronide to urobilinogen to stercobilin (brown) (excreted as feces)
3) Urobilinogen → Urobilin in the urine (makes urine yellow)

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16
Q

What is jaundice and when does it occur?

A

1) Bilirubin in plasma imparts a yellowish tint to skin & conjunctiva:
2) Pre-hepatic: hemolytic (all elevated levels of bilirubin intermediates, but all in the correct bodily location)
3) Hepatic: neonatal (UDP-glucuronyl transferase), transport, viral hepatitis, cirrhosis, & Crigler-Najjar (UDP-glucuronyl transferase); UDP-glucuronyl transerfase activity is decreased causing a backup of bilirubin; liver is leaky allowing bilirubin diglucuronide to enter the blood and urine (wrong place); decrease in urobilinogen, stercobolin, and urobilin in feces, but an increase in urobilinogen & urobilin in urine
4) Post-hepatic: cholestasis, stones, spasms, & neoplasm; block in gall bladder prevents things from getting into small intestine, causing elevated blood and urine levels of bilirubin diglucuronide. Decreased levels of urobilinogen, stercobilin, & urobilin in feces & urine

17
Q

What is the van den bergh reaction (clinical test)?

A

1) Clinical test for measuring bilirubin
2) Uses diazonium salts (azide salts that are colorless and can react when bilirubin when it is soluble)
3) Bilirubin (soluble) + diazonium salts (no color) → azo dye (bluish color)
4) Direct test (serum):
a) Conjugated (soluble) produces color
b) Unconjugated (insoluble) no color
5) Total test (serum + alcohol):
a) Conjugated (soluble) produces color
b) Unconjugated (solubilized by alcohol) produces color
6) Total – Direct = Indirect/Unconjugated