Nitrogen and Amino Acid Metabolism Flashcards

1
Q

Urea vs. Uric Acid

A

Urea is formed from ammonia in the liver as an end product of nitrogen metabolism (urea cycle)

Uric Acid is the end product of purine degredation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Transamination and Deamination

A

2 ways to remove amino groups from AA in the process of removing AA from the overall “amino pool” (AA degredation)

Transamination transfers an amino group to another alpha-keto acid. Requires Vitamin B6 (PLP) as a cofactor

Deamination removes an amino group from the AA forming free ammonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Alanine Aminotransferase

A

ALT

Glucogenic reaction that converts Alanine to pyruvate via transamination transferring the amino group to alpha-ketogluterate forming glutamate.

requires PLP (vitamin B6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 Enzymes that can link free ammonia

A

Glutamate sythatase - forming glutamine from glutamate

Glutamate Dehydrogenase - reversible reaction converting between Glutamate (tissue) and Alpha-Ketogluterate (Liver)

CPT1 - Converts Ammonia (NH2) and Bicarb (HCO3) to Carbamyl-P in the urea cycle. Requires 2ATP and N-acetylglutamate (NAG) as a cofactor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Essential Amino Acids

A

Phenylalanine
Valine
Trypophan

Threonine
Isoleucine
Methionine

Histadine
Arginine (conditionally essential)
Leucine
Lysine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Glutamate Dehydrogenase

A

Reversible reaction

In Liver:
forms alpha-ketogluterate and free NH3 from Glutamate. Requires NAD+

In Peripheral Tissue:
Forms Glutamate from Alpha-ketogluterate and free NH3 . Requires NADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Glutamate synthatase

A

In Peripheral Tissue:

Forms Glutamine from glutamate and free NH3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Glutaminase

A

In Renal Tubule and Liver:

Forms Glutamate and free NH3 from Glutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cystinurea

A

Tubular reabsorption of cystine is decreased (along with ornithine, arginine, lysine) Due to a genetic deficiency of the cystine transporter

Increased cystine in the urine

Cystine precipitates in renal tubules forming stones
One of the causes of renal stones in children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hartnup’s Disease

A

Inherited defect in the transport of the neutral amino acids such as Tryptophan

Decreased absorption and increased excreation of tryptophan.

Most patients are normal as enough dibasic AA to meet the bodies needs. however some may develop NAD+ deficiency (Pallegra)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pallegra

A

NAD+ deficiency resulting in decreased Tryptophan &/or Niacin in the body. (niacin is synthesized from Tryptophan)

Results in: (4 D's)
Diarrhea
Dermatitis
Dementia 
Death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Alanine Metabolism

A

Major transport form of AA from the muscle (important during starvation)

Alanine is the major precursor for gluconeogenesis during starvation (forms pyruvate)

converts Alanine to pyruvate via transamination transfering the amino group to alpha-ketogluterate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Glucose-Alanine Cycle

A

Pyruvate is formed in the muscle by glycolysis and is transaminated (ALT) to Alanine.

Alanine is transported to the liver and converted back to pyruvate (via ALT) for gluconeogenesis

Glucose is then released into the blood for use in other tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Aspartate Metabolism

A

Asparagine is converted to Aspartate via aspariginase.

Aspartate is then converted to OAA via AST, a transaminase that requires PLP as a cofactor.

Aspartate can be converted back to Asparagine with the addition of NH3 from a glutamine donor.
This takes place with the enzyme Asparagine Synthetase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Amino Acid Pool

A

Contributors/sources of Amino Acids:
Dietary Protein from Digestion
Synthesis of non essential Amino Acids
Tissue Protein Catabolism

Utilization of Amino Acids:
Synthesis of Tissue Proteins
Amino Acid Catabolism
Synthesis of Nitrogen containing compounds (purines, pyrimadines, neurotransmitters, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Asparagine Synthetase

A

Forms Asparagine from Aspartate. Requires glutamine as a NH3 donor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Asparaginase

A

Forms Aspartate and free NH3 from Asparagine.

Used to treat leukemia as the lack of asparagine will starve the tumor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Aspartate Transaminse

A

AST

Reversible reaction

Interconverts Aspartate and OAA. Requires transfer of NH3 to Alpha-ketoglutarate forming glutamine (or the reversible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Phenylketonuria

A

PKU

Type I:
Deficiency of phenylalanine hydroxylase that converts Phe to Tyr. (BH4 as a cofactor)

Type II: (more severe)
Deficiency of dihydrobiopterin synthesis or dihydrobiopterin reductase(BH2/BH4)

Elevated phenylalanine levels in the blood.

Can cause: Mental problems (low IQ), Seizures, Spasticity, Autistic behaviors, Hypopigmentation, and Skin rashes

Presents with mousey odor of urine (phenylpyruvic acid), decreased skin and hair pigment (tyr converted to melanin)

Treated by a low Phe diet. (no eggs, milk, meat, aspartame) and sapropterin (synthetic BH4) for mild forms of PKU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Alkaptonuria

A

Deficiency of Homogentistic Acid Oxidase that converts homogensistic acid maleylacetoacetate in phenylalanine-tyrosine catabolism to fumarate and Acetoacetate

homogentistic acid deposits in connective tissue and cartilage (Ochronosis). Causes severe arthritis

presents with brown urine and Ochranosis (Acid pigment deposits in cartilage)

treatment by low Phe and Tyr in diet. (difficult due to restriction of 2 essential amino acids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tyrosinemia Type I

A

Deficiency of Fumaryl Acetoacetate Hydrolase
that converts fumaryl acetoacetate to fumarate and acetoacetate in phenylalanine-tyrosine catabolism

Manifestations are severe and usually fatal
–Liver failure
–Renal failure
–Cabbage like odor of the urine

Treatment by dietary restriction of Phe& Tyr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Maple Syrup Urine Disease

A

Deficiency in Branched Chain Alpha-Keto Acid Dehydrogenase that catabolises BC Keto Acids to corresponding Acyl CoA using TPP (B1) as a cofactor

BCAA build up in the blood and BC Keto Acids in the urine.

Presents with poor feeding, vomiting, poor weight gain and increasing lethargy.

Ketosis and the characteristic odor of maple syrup in the urine are usually present when the first symptoms develop

Can result in coma and death if not treated.

Treated by dietary restriction of BCAAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Methylmalonic Aciduria

A

Deficiency of Methylmalonyl CoA Mutase that converts methymalonyl CoA to Succinyl CoA in the catabolism of Odd chain FA, Val, Ise and Met.(requires cobalamin (B12) as a cofactor)

neurological manifestations: seizures, encephalopathy

In some cases methylmalonyl CoA mutase enzyme has a reduced affinity for the B12 coenzyme. therefore can be treated with B12.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Homocystinuria

A

Deficiency of cystathionine synthase that converts homocysteine to Cystathione in the conversion of Met to Cys. Requires PLP as a cofactor.

Characterized by dislocation of lens (ectopialentis), Skeletal abnomalities, Mental retardation, premature arterial disease (lipid oxidation and platelet aggregation that leads to fibrosis & calcification of atherosclerotic plaques)

25
Fates of Homocysteine
Converted back to Met via Vitamin B12 (Cobalaine) and folate (adds a methyl group) Converted to Cysteine for excretion (multistep) requiring 2 Vitamin B6 (PLP) reactions.
26
Urea Cycle (overview)
Forms urea from ammonia in the liver. 2 reactions take place in liver cell mitochondria and 3 reactions take place in the cytosol. The first nitrogen of urea is donated by ammonia, the second by aspartate (formation of asp from OAA)
27
Carbamoyl Phosphate Synthetase I
CPS I Forms Carbamoyl Phosphate from ammonia and HCO3 in the mitochondria. Requires N-acetylglutmate (NAG) Requires 2 ATP First step in Urea Cycle. Rate limiting step.
28
N-acetylglutamate
NAG Allosteric activator of CPS I in the urea cycle
29
Ornithine Transcarbamoylase
OTC Forms Citruline in the mitochondria from Carbamoyl Phosphate and Ornithine. Second step in Urea Cycle Citruline is then transported out of the mitochondria into the cytosol
30
Argininosuccinate Synthetase
ASS Forms Argininosuccinate from Aspartate and Citrulline in liver cytosol. Requires ATP Third step in Urea Cycle
31
Argininosuccinate Lyase
ASL Frees Arginine from Argininosuccinate forming Fumarate (enters TCA or oxidized back to OAA) Fourth step in Urea Cycle
32
Arginase
ARG Releases Urea from arginine and forms Ornithine Fifth step in Urea Cycle Ornithine is transported into the mitochondria to complete the Urea Cycle
33
Hyperammonemia Type I
CPS I deficiency Characterized by hyperammonemia and neurological manifestations May be able to treat with arginine (stimulate the formation of NAG)
34
Hyperamonemia Type II
OTC Deficiency X-linked recessive Characterized by hyperammonemia, increased Orotic acid in urine Elevated carbamoyl phosphate drives pyrimidine biosynthesis –orotic acid is elevated in the serum & urine Most common Urea Cycle disorder
35
Management of Hyperammonemias
Dialysis Administration of Benzoic Acid: Combines with glycine to form Hippuric Acid that is excreted in urine (1 nitrogen per molecule) Phenylbutyrate: drug that combines with glycine then condenses with glutamate to remove 2 nitrogens per molecule Minimize nitrogen by a low protein diet. Liver transplant
36
Acquired Hyperammonemia
Liver disease due to viral or drug induced hepatitis, alcoholic cirrhosis In cirrhosis, there is porto-systemic shunting of blood –Portal blood enters the systemic circulation without going to the liver –Ammonia produced in the intestine directly enters circulation and results in neurotoxicity
37
Treatment of acquired hyperammonemia
Low protein diet. Lactulose: Normal flora digest in the colon, produce lactic acid, lactic acid is neutralized by NH4+ Neomycin: Reduction of bacterial ureases in the gut.
38
Citrullinemia
Argininosuccinate synthetase (ASS) deficiency hyperammonemia, with very high levels of serum citrulline, and citrullinein the urine Treatment mayinclude arginineAdministration: –Enhances urinary citrullineexcretion –sometimes allows the urea cycle to progress due to high levels of substrate
39
Argininosuccinic aciduria
ASL deficiency Hyperammonemia, Increased argininosuccinate levels in plasma and CSF Sometimes treated with surplus of arginine –May allow urinary excretion of argininosuccinate –May raise levels of intermediates to allow urea cycle to function (km)
40
Argininemia (Hyperargininemia)
Arginase deficiency Elevated serum ammonia and elevated arginine
41
Fate of Urea
Urea is transported to the kidney where it is excreted in urine •Some urea is degraded in the gut, the ammonia reenters circulation and the liver must detoxify it •Kidney failure leads to elevated BUN –(blood urea nitrogen)
42
Effects of elevated blood ammonia
Glutamate is converted to glutamine –Glutamine synthetase –Results in high circulating glutamine levels •Reduced GABA and glutamate levels in the brain –GABA is major inhibitory NT (formed from glutamate) –GLU itself is a major excitatory NT
43
Tyrosine Hydroxylase
Forms DOPA from Tyrosine. Requires BH4 Found in Epinephrine formation from Phe and Tyr
44
DOPA Decarboxylase
Forms Dopamine from DOPA. requires PLP Found in Epinephrine formation from Phe and Tyr
45
Dopamine Hydroxylase
Forms norepinephrine from Dopamine. Requires Vitamin C Found in Epinephrine formation from Phe and Tyr
46
Phenylethanolamine N methyl transferase
Forms Epinephrine from Norepinephrine. requires SAM Found in Epinephrine formation from Phe and Tyr
47
Parkinson's Disease
Neurodegenerative disorder •Loss of dopamine producing cells in the basal ganglia * Characterized by movement disorders: spasticity, tremors, loss of memory, mood disturbances, postural instability * Symptoms are improved by administration of L-DOPA. L-Dopais converted to Dopamine in the brain, that improves the symptoms
48
Catacholamine Degradation
Norepinephrine and epinephrine are degraded by Monoamine Oxidase (MAO) and Catechol O-methyl transferase (COMT) to form Vanillyl Mandelic acid (VMA) that is excreted in urine. •Urinary VMA levels may be measured to estimate levels of epinephrine & norepinephrine produced
49
Pheochromocytoma
High urinary VMA and catecholamines Characterized by overproduction of catecholamines (epi, norepi) –Adrenal medulla tumor •Predominant episodic symptoms include: –Headache, Sweating, Tachycardia, hypertension •Must use 24 hour urinary measurement –During a symptom episode
50
Serotonin Synthesis and Metabolism
Serotonin is synthesized in the gut, platelets and CNS Tryptophan Hydroxylase Forms 5 hydroxy tryptophan from tryptophan. requires BH4 Amino acid Decarboxylase forms SEROTONIN (5-hydroxy tryptamine). Requires PLP Serotonin is metabolized to 5-hydroxyindole acetic acid (5-HIAA) by Monoamine Oxidase (MAO)
51
Carcinoid syndrome
Tumor of serotonin producing cells in Gastrointestinal tract (APUD cells) •Cutaneous flushing, sometimes accompanied by sweating, Gastrointestinal hypermotility causing diarrhea, Bronchospasm Increased serotonin metabolite 5-HIAA in urine
52
Melatonin
Sleep inducing hormone produced via small modifications to serotonin Regulates Circadian rhythm,Light / dark cycles
53
GABA
Gamma Amino Butyric Acid Inhibitory neurotransmitter in central nervous system Formed from Glutamic acid via Glutamate decarboxylase (PLP as cofactor)
54
Reactions requiring tetrahydrobiopterin
1. Phenylalanine hydroxylase(converts Phe to Tyr) 2. Tyrosine hydroxylase (converts Tyr to DOPA) 3. Tryptophan hydroxylase (converts Trpto 5-hydroxy tryptophan) Deficiency of BH2 synthase or BH2 reductase results in hyperphenylalaninemia & decreased synthesis of neurotransmitters (catecholamines, serotonin). –Results in delayed mental development and seizures
55
Creatine
Found in muscle, cardiac, brain * Synthesized from Arginine, Glycine & SAM (S-Adenosyl Methionine) * Accepts Phosphate groups from ATP when the muscle is resting and donates phosphate groups to ADP when muscle is contracting. (via Creatine phosphokinase(CPK)) * Creatine is converted to Creatinine (spontaneous event) and excreted in urine
56
Histamine
Produced during allergic & inflammatory reactions by mast cells •Histamine is a vasodilator Formed from histadine via AA Decarboxylase (PLP as cofactor) antihistamines do not reduce the formation of histamine, they reduce the ability of histamine to function as signal to other pathways –Receptor antagonist
57
Nitric Oxide synthase
Forms NO from Arginine and releases citrulline NO causes local vasodilation •Nitroglycerin used in treatment of myocardial ischemia is converted to NO that results in vasodilation of coronary blood vessels and improvement of blood flow to heart
58
Albinism
Deficiency of the TYROSINASE enzyme –Deficient conversion of Tyrosine to MELANIN Results in lower visual acuity and photophobia •light colored skin and hair •Increased risk of skin damage on exposure to sunlight and increased risk of skin cancer
59
Glutathione
Tripeptide composed of Glutamate, Cysteine, and Glycine an intracellular reducing agent (antioxidant) •Important for detoxification of toxic hydrogen peroxide (H2O2) especially in the red blood cells