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DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

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Page 1: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

DR. Saidunnisa M.D

Associate Professor

Department of Biochemistry

Metabolism of Purines-Lecture

Page 2: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Learning Objectives

At the end of the session the student shall be able to Explain ,enumerate, and define:

1. Enumerate the sources of individual atoms in purine ring.

2. Explain the major steps in the synthesis (denovo and salvage) and catabolism of purine.

3. Explain the Regulation.

4. Interpret disorders like Lesch-Nyhan syndrome, SCID, Adenosine deaminase deficiency and Gout.

Page 3: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Overview

Summary:

1. De novo synthesis of purines

2. Purine catabolism

3. Salvage pathway Disorders:

1. Gout

2. SCID, (Adenosine deaminase deficiency)

3. Lesch-Nyhan syndrome

Page 4: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Nucleic acids

There are two types of nucleic acids namely DNA (Deoxy ribonucleic acid) and RNA (Ribonucleic acid) primarily they serve as transmitters of genetic information.

Nucleic acids are the polymers of nucleotides.

Page 5: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Bases

Purines and pyrimidines are major bases.

Purines are Adenine and Guanine.

Pyrimidines are Cytosine Uracil and Thymine

Page 6: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Bases-Rings

These are planar aromatic heterocyclic compounds.

Page 7: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Purines PyrimidinesPyrimidines

Page 8: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Sugars

Page 9: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Structure of nucleotides

A phosphate group

Nucleotides have three characteristic components:

A nitrogenous base(pyrimidines or purine)

A pentose sugar

Page 10: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Structure of nucleosides

Remove the phosphate group, and you have a nucleoside.

H

Page 11: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Digestion of Nucleic acids

Nucleic acids in the diet are hydrolyzed to a mixture of nucleotides by ribo and deoxy ribonuclease present in pancreatic and intestinal secretions.

Nucleotidases liberate phosphate from nucleotides resulting nucleosides are hdrolysed by nucleosidases forming free bases and pentose sugars.

Page 12: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Purines

Page 13: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Sources of carbon and nitrogen atoms in the purine ring

Purine ring is synthesized from different small components.

Purines: where do the atoms come from?

Page 14: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

De novo synthesis of Purines

These pathways use amino acids as precursors. Liver is the main site of synthesis. Operates in cytoplasm. Starting material is ribose 5-phosphate produced

in the HMP pathway. The Purines are built upon a pre-existing ribose

5-phosphate. Through a series of reactions, add the donated

carbons and nitrogen's.

Page 15: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

The biosynthesis of purine (A and G) begins with the synthesis of the ribose-phosphate

The biosynthesis of purine (A and G) begins with the synthesis of the ribose-phosphate

PRPP Synthase

Pentose phosphatepathway

Preparatory step:Ribose-5phosphate, reacts with ATP to form phosphoribosyl pyrophosphate (PRPP) in the presence of PRPP Synthase.

PRPP common substrate for synthesis of purines and pyrimidines.

Page 16: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Glutamine transfers its amide nitrogen to PRPP to replace pyrophosphate and produce 5-phospho ribosylamine.The enzyme PRPP Glutamyl amido transferase.This reaction is the “committed step” or “rate regulating step”.

PRPP

Glutamine Glutamate

PPiPRPP Glutamyl

amido transferase

*

PRPP Glutamyl amido transferase is an important regulatory enzyme in purine biosynthesis. It is strongly inhibited by the end products IMP, AMP, and GMP.

This type of inhibition is called FEEDBACK INHIBITION.

PRPP Glutamyl amido transferase is an important regulatory enzyme in purine biosynthesis. It is strongly inhibited by the end products IMP, AMP, and GMP.

This type of inhibition is called FEEDBACK INHIBITION.

Step-1

Page 17: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Several amino acids are utilized in purine biosynthesis

Several amino acids are utilized in purine biosynthesis

Mechanism of all the reactions are not required Mechanism of all the reactions are not required

Step 3: Carbon 8 is: N10 methenyl THF4Step-4: Nitrogen 3: GlutamineStep 5: Carbon 6 : CO2Step 6: Nitrogen 1:AsparatateStep 7: Carbon 2 : THF4

Subsequent steps

Page 18: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Purine nucleotide synthesized is IMP is the precursor for both AMP and GMP

Page 19: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Ribose5-phosphate

PRPP Phosphoribosylamine

IMP

AMP

GMP

Inhibited by IMP,AMP, and GMP

Inhibited by AMP

Inhibited by GMP

The regulation of purine biosynthesis is a classic example of negative feedback

The regulation of purine biosynthesis is a classic example of negative feedback

PRPP SynthasePRPP Glutamyl amido transferase

Intracellular concentration of PRPP regulates purine synthesis this in turn is dependent on the availability of ribose-5-phosphate and the enzyme PRPP Synthase.

Page 20: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Formation of purine nucleoside di and tri phosphates:

The nucleoside mono phosphates have to be converted to the corresponding di and tri phosphates to participate in the metabolic reactions.

This is achieved by the transfer of phosphate group from ATP, catalyzed by Nucleoside monophosphate and diphosphate kinases.

Page 21: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Conversion of Ribo to Deoxy nucleotides

Enzyme :- Ribonucleotide reductase

Co enzyme:- Thioredoxin (reduced form is converted to oxidized form) which requires NADP as a result elimination of water occurs in this reaction.

Page 22: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Purine catabolism

End product of purine catabolism is uric acid.

Normal blood levels: females:2-5mg/dl

Males: 3-7mg/dl Daily excretion: 500-

700mg/dl.

Page 23: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Disorders of Purine Metabolism:Disorders of Purine Metabolism:

Disorder Defect Comments

Gout PRPP synthase/ Hyperuricemia HGPRT

Lesch Nyhan lack of HGPRT Hyperuricemia syndrome

SCID ADA High levels of dAMP

von Gierke’s disease glucose -6-PTPase Hyperuricemia

Page 24: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

GOUT (Gouty Arthritis): A defect of purine metabolism

Serum Uric Acid Levels(mg/dl)

Serum Uric Acid Levels(mg/dl)

Incidence of Gout (% of cases)

Incidence of Gout (% of cases)

>9.0 ~10%7-9 0.5-3.5%<7.0 0.1%

Guanine

Xanthine

Hypoxanthine

Urate

xanthine oxidase

xanthine oxidase

Allopurinol:a. decrease urateb. increase xanthine & hypoxanthinec. decrease PRPP

Allopurinol:a. decrease urateb. increase xanthine & hypoxanthinec. decrease PRPP

Page 25: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Gout (hyperuricemia)

Primary: familial

1. Salvage pathway enzymes deficiency

2. Glucose -6 phosphatase deficiency (Von gierkes disease)

Secondary:

1. Rapidly growing malignant cells (leukemias)

2. Renal failure due to decreased excretion

Page 26: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Learning check

Why should Glucose -6 phosphatase deficiency (Von Gierke's disease) results in hyperuricemia and gout?

Page 27: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Clinical findings

1. Due to increased accumulation of uric acid as crystals in synovial fluid results in inflammation and arthritis.

2. At 30degrees the solubility of uric acid is lowered so it gets deposited around joints called tophi typical at metatarsophalangeal joint (big toe).

3. They can also be deposited in the kidneys causing renal calculi.

4. Treatment: Allopurinol compt.Inhibi of Xanthine oxidase decreases uric acid levels.

Page 28: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Gout

Page 29: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Adenosine deaminase (ADA) deficiency causes SCID (severe combined immunodeficiency),

Disorder that affects the immune system leading to malfunction resulting in open to infection from bacteria and viruses.

Caused by a mutation in a gene on chromosome 20.

Page 30: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Adenosine deaminase (ADA) deficiency

Without this enzyme, the body is unable to break down adenosine.

Lymphocytes contain high quantity of ADA.

Deficiency of ADA is manifested as reduced lymphocytes which leads to impaired cellular and Humoral immunity leading to infections.

Page 31: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

How do people get ADA deficiency?

ADA deficiency is an autosomal recessive disorder.

Both parents need to pass the defective gene to their child in order for that child to inherit the deficiency.

Because ADA deficiency affects the immune system, people who have the disorder are more susceptible to all kinds of infections, particularly those of the skin, respiratory system, and gastrointestinal tract.

Sadly, most babies who are born with the disorder die within a few months.

How do people get ADA deficiency?

What are the symptoms of ADA deficiency?

Page 32: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

How to diagnose ADA deficiency?

 Doctors can identify ADA deficiency during the mother's pregnancy:

by taking a tiny sample of tissue from the amniotic sac where the baby develops (called chorionic villus sampling),

by looking at enzyme levels in a fetal blood sample taken from the umbilical cord.

After the child is born, doctors can test a sample of his or her blood to see if it contains ADA.

Page 33: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

How to diagnose ADA deficiency?

PID :Test is now available to reduce the risk of passing on this genetic disorder, to children. 

This test is called Preimplantation Genetic Diagnosis (PGD). 

PGD tests an embryo for genetic defects and determines its sex prior to implantation. 

Through this mechanism, the chance of having an affected child can be significantly reduced.  

Page 34: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

How is ADA deficiency treated? Gene therapy The first person to receive gene therapy for ADA

deficiency was four-year-old Ashanthi DeSilva. The treatment was developed by three

physicians—W. French Anderson, Michael Blaese, and Kenneth Culver.

DeSilva received her first treatment, an infusion of her own T cells implanted with normal ADA genes, on September 14, 1990 at the National Institutes of Health in Bethesda, Maryland.

Page 35: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

How did DeSilva's T cells acquire the normal ADA genes?

retrovirus, (vectors) were made for carrying the normal ADA genes into the T cells.

The retrovirus vectors—carrying normal ADA genes—were mixed with T cells that had been extracted from DeSilva's blood and grown in culture dishes.

The T cells were then infused back into DeSilva's blood where the normal ADA genes in them produced ADA.

However, since T cells have a limited life span, DeSilva needed to receive periodic infusions of their genetically-corrected T cells.

Page 36: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Stem cell therapy

Subsequent research is focusing on developing a permanent cure for ADA deficiency using gene therapy.

Their own stem cells that had been implanted with normal ADA genes.

Stem cells live throughout the patient's life, and thus the patient should have a lifetime supply of ADA without requiring further treatment.

Page 37: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Purine salvage pathway

Salvage pathways for the re-utilization of purines Nucleotides (purine and pyrimidine) are synthesized from intermediates in the degradative pathway for nucleotides.There are 2 salvage enzymes with different specificity;

1.Adenine phosphoribosyl transferase (APRT)

2. Hypoxanthine-guanine phosphoribosyl transferase (HGPRT)

Salvage pathway enzymes recycle 90% of purines.And also that are obtained from the diet.

Page 38: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Importance of salvage pathway

In tissues like RBC and brain where the de novo pathway is not operating.

This pathway economizes intracellular energy expenditure.

Page 39: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Substrates

Nucleoside Enzyme Nucleotide

Hypoxanthine

hypoxanthine/guanine phosphoribosyl transferase (HGPRT)

IMP

Guanine

Adenine

guanine phosphoribosyl transferase (HGPRT)

phosphoribosyltransferase (APRT)

GMP

AMP

Page 40: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Food sources

Purines are found in high concentration in meat and meat products, especially internal organs such as liver and kidney. Plant based diet is generally low in purines.

Examples of high purine sources include: sweetbreads, anchovies, sardines, liver, beef kidneys, brains, meat extracts, herring, mackerel scallops.

Page 41: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Disorders of salvage pathway enzymes Lesch-Nyhan syndrome

Is inherited as an X-linked trait.

It mostly occurs in boys. Deficiency of HGPRT

(hypoxanthine guanine phosphoribosyl transferase)

The body needs this enzyme to recycle purines without it, abnormally high levels of uric acid build up in the body.

The condition affects about 1 in 10,000 males.

Page 42: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Symptoms

Involuntary movements Self mutilation: self-destructive behavior

characterized by chewing off fingertips and lips

Mental retardation. Hyperuricemia: gout-like swelling in some of

their joints. Renal UA crystals Orange crystals in diapers Often deathNeurological manifestations suggest that the brain is

dependent on the salvage pathway for the requirements of IMP and GMP.

Page 43: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Excess uric acid levels cause children to develop gout-like swelling in some of their joints.

Page 44: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Treatment

Investigations: Blood and urine tests may reveal high uric acid levels.

A skin biopsy may show decreased levels of the HGPPT enzyme.

No specific treatment exists for Lesch-Nyhan syndrome.

The gout medication allopurinol successfully decreases uric acid levels, but does not improve the neurological outcome.

Prognosis: The outcome is likely to be poor.

Page 45: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Prevention

Individuals with Lesch-Nyhan Syndrome and their families are recommended to undergo genetic counseling and testing. 

Lesch-Nyhan Syndrome rarely occurs among females and female carriers typically do not show any symptoms but have a 50% chance of passing on the defective gene to her children. 

Page 46: DR. Saidunnisa M.D Associate Professor Department of Biochemistry Metabolism of Purines-Lecture

Purine Metabolism Overview