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Porphyrin and Heme Metabolism HLS Biochemistry, 2018

Porphyrin and Heme Metabolism - كلية الطب · 1. Recognize the precursors of heme synthesis, key steps of heme synthesis 2. Recognize the regulatory step in heme synthesis

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Text of Porphyrin and Heme Metabolism - كلية الطب · 1. Recognize the precursors of heme synthesis,...

  • Porphyrin and Heme Metabolism

    HLS Biochemistry, 2018

  • Objectives

    You should be able to

    1. Recognize the precursors of heme synthesis, key

    steps of heme synthesis

    2. Recognize the regulatory step in heme synthesis

    and how it is regulated

    3. Know some types of porphyria's and the enzymes

    which are involved with these disorders

    4. Describe regulation of heme synthesis

    5. Know types and causes of erythropiotic porphyrias

  • HEME-CONTAINING PROTEINS

    Hemoglobin

    Myoglobin

    Cytochromes

    Catalase

    Some peroxidases

  • STRUCTURE OF HEME

    • Ferrous iron (Fe2+)

    • Protoporphyrin IX: contains

    4 pyrrole rings linked

    together by methenyl bridges

  • Heme

    8

    8

    Succinyl CoA

    Glycine**

    HEME SYNTHESIS

    ** Amino acid (building blocks of protein) synthesized in your body

  • Heme synthesis

  • HEME SYNTHESIS: Red blood cells

    •85% of total heme synthesis occurs in red blood

    cells (RBC)

    •Ceases when RBC’s mature

    •Erythroid-specific ALA synthase is regulated by

    an IRE in the mRNA – binding of IRBP inhibits

    mRNA translation

  • HEME SYNTHESIS

  • ** *

    In RBCS, heme synthesis is also regulated at the level of the en-zymes ferrochelatase* and porphobilinogen deaminase**

  • HEME SYNTHESIS: Liver

    • The liver is the main non-RBC source of heme

    synthesis

    • Heme produced in the liver is used mainly for the

    synthesis of the cytochrome P450 class of enzymes

    that are involved in detoxification

    • Regulated at level of ALA synthase: Formation of 5-ALA is the rate-limiting step in heme synthesis in the liver

  • Regulation of ALA Synthase

    Level of enzyme synthesis

    Enzyme synthesis, as well as its transport to the mitochondria, is inhibited by elevated levels of heme and hemin, the Fe3+ oxidation product of heme

    Enzyme synthesis is upregulated by a large number of drugs including barbiturates, steroids with a 4,5 double bond (e.g. testosterone) and some oral contraceptives: These drugs are metabolized by the microsomal cytochrome P450 mono-oxygenase system, a heme- containing protein.

    Level of enzyme activity

    Heme and hemin inhibit ALA synthase activity Requires pyridoxal phosphate (Vitamin B6) as a

    coenzyme

  • Disorders of Heme Synthesis

    • Acquired: Lead poisoning

    • Congenital: Porphyrias

    • Deficiency of heme has far-reaching effects

    (hemoglobin, cytochromes, etc.)

  • LEAD TOXICITY

    Symptoms Irritability Poor appetite

    Lethargy Abdominal pain (with or

    Sleeplessness without vomiting)

    Headaches Constipation

    Pathophysoiology

    Binds to any compound with a sulfhydryl group Inhibits multiple enzyme reactions including those

    involved in heme biosynthesis (PBG synthase &

    ferrochelatase)

    One symptom of lead toxicity is increases in 5-ALA

    without concomitant increases in PBG

  • PORPHYRIAS

    A group of rare disorders caused by deficiencies of enzymes of the heme biosynthetic pathway

    The majority of the porphyrias are inherited in a autosomal

    dominant fashion - thus, affected individuals have 50% normal levels

    of the enzymes, and can still synthesize some heme

    Affected individuals have an accumulation of heme precursors

    (porphyrins), which are toxic at high concentrations

    Attacks of the disease are triggered by certain drugs, chemicals,

    and foods, and also by exposure to sun

    Treatment involves administration of hemin, which provides

    negative feedback for the heme biosynthetic pathway, and therefore,

    prevents accumulation of heme precursors

  • Scriver et al., The Metabolic & Molecular Basis of Inherited Disease, 8th edition, 2001.