Section V (Chapters 30-33) Flashcards
What is the overall importance of fatty acids as fuels?
Due to reduced structure, FA allow for optimal oxidation/fuel production via beta-oxidation
How does fatty acids transport into mitochondria?
Long chain FA become activated by actyl CoA synthetase (thiokinase), which cleaves the beta-bond of ATP for oxidation
From there, FA enters mitochondria via facilitated diffusion, getting linked to carnitine by CPTI through the inner membrane via translocase
What inhibits CPT1?
Malonyl-CoA
What is the importance of carnitine in fatty acid metabolism?
- Serves as carrier to transport activated fatty acyl groups into inner mitochondrial membrane
- Transporters transport these into mitochondria
- Obtained from diet or synthesized from side chain of lysine, begins in muscle and is completed in liver
- Stored in skeletal muscle
What is the process of beta-oxidation? Where does it occur?
In mitochondrial matrix
4 steps:
(1) Trans double bond form between α and β-C => FADH2
(2) H2O is added, H to α & OH to β-carbon
(3) β-carbon is oxidized to keto group by hydroxyl group of β-carbon => NADH
(4) Cleavage of 2-C acetyl-CoA unit
How many ATPs are produced by the completed oxidation of palmitate via B-oxidation?
Palmitate (16C) = 8 acetyl-CoA + 7 NADH + 7FADH2 = 8(10 ATP) + 7(2.5 ATP) +7(1.5 ATP) -2 = 106 ATP
The -2 stands for activation of palmitic acid to palmitoyl CoA
Fed state hormonal & allosteric controls over fatty acids
Insulin activates acetyl-CoA carboxylase which converts acetyl CoA => malonyl-CoA to inhibit CPTI preventing fatty acyl transport into mitochondrial matrix
Fasting state hormonal & allosteric controls over fatty acids
Glucagon activates lipolysis => triacylglycerides are released to be oxidized
What occurs when there is an increased energy demand?
↑AMP which activates AMPK that inactivates acetyl-CoA carboxylase =↓malonyl-CoA => CPTI activated for FA oxidation
What occurs when there is high energy present?
High energy (ATP/ADP ratio high) slows down ETC, which results in excess of NADH or FAD2H, inhibiting oxidation of fatty acids
What additional step is needed for unsaturated fat?
Need isomerase & NADPH-reductase to convert cis-trans double bond
What additional step is needed odd fatty chain?
Need vitaminB12 to turn propionyl-CoA => succinyl-CoA
What additional step is needed for very-long chain?
Exclusively oxidized in peroxisomes by β-α oxidation:
- Step 1: oxidase = generate H2O2, remaining 3 are same as β-oxidation => 1 NADH & acetyl-CoA per turn until a 4-6 carbon chain remains & get sent to mt to finish up
What additional step is needed for long-chain branched fatty acids?
Also oxidized in peroxisome to 8C chain and sent to mt
What is Zellweger syndrome?
Due to defective peroxisomal biogenesis = elevated long-chain FA in plasma = complex developmental/metabolic phenotypes
What is Refsum disease?
Caused by defect in a specific enzyme (phytanoyl coenzyme A hydroxylase) for phytanic acid (diet) metabolism, thus builds up, improved with decreasing in diet
What is ω-oxidation?
Oxidation of terminal methyl group in ER
What occurs in ω-oxidation?
ω-carbon is oxidized to alcohol by cytochrome P450/oxygen/NADPH => dehydrated to dicarboxylic acid by dehydrogenase=> β-oxidation forming 6-10 carbon chains that are water soluble and enter blood => can be further oxidized or excreted in urine
What can speed up ω-oxidation?
↑substrate concentration/defect in β-oxidation increase the rate of this process
How are ketone bodies formed in the liver, and utilized by extra hepatic tissues?
2 acetyl-CoA react by enzyme thiolase => acetoacetyl CoA (release Co-ASH) react with HMG-CoA synthase and third acetyl CoA => (release Co-ASH) HMG-CoA reacts with HMG CoA lyase => (release Acetyl CoA) acetoacetate => conversion to β-hydroxybutyrate by dehydrogenase or spontaneously to acetone
Acetoacetate/β-hydroxybutyrate => tissue => convert to acetyl-CoA and oxidize in TCA
What is the regulation mechanism for ketogenesis?
Glucagon activates β-oxidation due to ↑ NADH/NAD+ ratio which diverts acetyl-CoA away from TCA & towards ketogenesis; NADH also divert oxaloacetate => malate => gluconeogenesis
What is ketosis? Why are children more prone to ketosis?
State of elevated ketone bodies in body tissues; children are more prone to ketosis than adults because their bodies enter the fasting state more rapidly by using more energy
What is the occurrence of diabetic ketoacidosis in patients with Type 1 diabetes?
DKA results from a high glucagon: insulin ratio (insulin not being secreted so high blood glucose too) => ketogenesis in liver = elevated KB; metabolic stress caused by EPI/cortisol release = elevate blood glucose levels; hyperosmolarity of blood => diuresis, metabolic acidosis, CNS dysfunction/coma and death if untreated
What is the molecular pathology & clinical manifestation of MCAD?
MCAD deficiency results from mutated dehydrogenase that prevent medium-chain FA oxidation; sx include hypoketotic hypoglycemia when fasting (prevents full oxidation from occurring)
What occurs in hypoglycin exposure (Jamaican vomiting disease)?
Hypoglycin exposure inhibits acetyl-CoA dehydrogenase, first enzyme in β-oxidation to activate FA; leads to severe hypoglycemia & death (prevents oxidation from even starting)
What are the causes of carnitine deficiencies?
- liver disease resulting in decreased synthesis of carnitine
- malnutrition or strictly vegetarian diets
- increased requirement for carnitine (pregnancy, severe infections, burns, or trauma)
- hemodialysis, which removes carnitine from the blood
congenital deficiencies in renal tubular reabsorption of carnitine - congenital deficiencies in carnitine uptake by cells
What does carnitine deficiency impact?
Affects the liver, where an inability to oxidize fatty acids impairs gluconeogenesis during a fast, leading to severe hypoglycemia, coma, and death. CPT-II deficiency occurs primarily in cardiac and skeletal muscle, where symptoms of carnitine deficiency range from cardiomyopathy to muscle weakness with myoglobinemia following prolonged exercise
What is the treatment for carnitine diseases?
Supplementation with carnitine
Who does MCAD commonly occur in?
1/4,000 Northern Europeans and between 1/13,000 and 1/26,000 of the general public.
MCAD is an autosomal … genetic disease
Recessive
What has been associated with MCAD deficiency?
SCID
What is non-ketotic hypoglycemia?
Results because after fasting has depleted the glycogen in the liver, the liver depends on ATP generated by fatty acid oxidation to provide the energy for gluconeogenesis. Therefore no β-oxidation, no gluconeogenesis with resulting severe hypoglycemia.
What are the carbon sources for fatty acid synthesis?
Fed state = FA synthesis in liver (>adipose tissue) with dietary carb/proteins: glucose or AA that can covert to pyruvate which is converted to acetyl-CoA and oxaloacetate, then to citrate = building block for FA by FA synthase complex
What is the role of acetyl CoA in FA synthesis?
Precursor for citrate via conversion of acetyl CoA & oxaloacetate
What are the metabolic NADPH sources for FA synthesis?
NADPH (from pentose phosphate pathway & oxaloacetate recycling) is used by FA synthase complex to reduce rxns
Oxaloacetate recycling is conversion to malate by malate dehydrogenase (NAD+) then oxidation and decarboxylation by malate dehydrogenase/malic enzyme (NADP+)
What is the role of acetyl-CoA carboxylase in FA synthesis?
Acetyl-CoA carboxylase convert acetyl-CoA to malonyl-CoA, which adds to growing FA chain; regulated by phosphorylation/inactivated (AMPK), dephosphorylation/activated (insulin), allosteric activation (citrate) or inactivation (palmitoyl-CoA), & induction and repression of its synthesis
What is required for acetyl-CoA carboxylase?
Biotin, ATP, and CO2
What is the structure & function of FA synthesis?
2 identical subunits, each with acyl carrier protein (ACP) with free SH-group which acts to condense acetyl & malonyl moieties => 5C keto group that is then reduced to form double-bond (repeated until 16 long =palmitate) 2 NADPH required as the reducing equivalents
What will be effected with carnitine deficiency?
Carnitine is required for FA oxidation = decreased fatty acid oxidation and gluconeogensis in fasting state
What will be effected with biotin deficiency?
Acetyl-CoA carboxylase requires biotin = unrestricted FA oxidation because no malonyl CoA preventing carnitine uptake into mitochondria for oxidation; also slower synthesis because less malonyl to give carbon
What will be effected with pantothenic acid deficiency?
Pantothenic acid is a precursor to coenzyme A (CoA) & FA synthase = prevents fatty acid elongation and synthesis