Transcript
Page 1: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Biochemistry II - Seminars

Doc. RNDr. Jiří Dostál, CSc.

Department of Biochemistry, Fac. Med., MU Brno

[email protected]

Page 2: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Literature

• J. Tomandl, E. Táborská:

Biochemistry – Seminars II, MU Brno, 1996

selected chapters, see the syllabus

Page 3: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Enzymes in Clinical Biochemistry

Seminar No. 1

- Chapter 4 -

Page 4: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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You are supposed to know …

• Enzymes – main features, properties

• Coenzymes – structures, functions

• Enzyme kinetics

• Enzyme activity

Page 5: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Isoenzymes – General Features

• Genetically determined differences in primary structure

• Catalyze the same reaction

• May have different subcellular distribution

(cytoplasm × mitochondria)

• May have different tissue distribution

• May be combined from more subunits (quarternary structure)

• May differ in kinetic properties (KM)

• Usually are determined by electrophoresis

Page 6: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Q. 2 (p. 27)

Explain the terms: proenzyme, isoenzyme, isoform

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A. 2

• Proenzyme (zymogen) – inactive form of enzyme that

becomes active after partial proteolysis

example: pepsinogen pepsin

• Isoenzyme – see previous page

• Isoform – more general term, includes true isoenzymes

and pseudoisoenzymes (posttranslational variations)

Page 8: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Lactate dehydrogenase (LD)

• Tetramer

• Two different chains (H - heart, M - muscle)

• Five isoenzymes:

LD1 (H4), LD2 (H3M), LD3 (H2M2), LD4 (HM3), LD5 (M4)

• Widely distributed in body

• Total activity determination – nonspecific finding

• LD1 + LD2 ….. marker of myocardial infarction (MI)

• Today is LD assay considered out-of-date

Page 9: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Creatine kinase (CK)• Dimer

• Two different chains (M – muscle, B – brain)

• Three isoenzymes: MM (muscle), MB (heart), BB (brain)

• Major isoenzyme in blood is MM (95 %)

• MB form in blood: 0 – 6 %

• BB in blood: traces (BB cannot pass across blood-brain

barrier)

• MB isoenzyme …. excellent marker of myocardial

infarction

Page 10: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Enzymes in Blood

FeaturePlasmatic enzymes

Secretory enzymes

Intracellular enzymes

Example

Source organ

Function in

coag. factors

liver

blood

amylase, lipase

pancreas

GIT

AST, …

various

cells

Enzyme activity in blood after source organ damage

? ? ?

Page 11: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Enzymes in Blood

FeaturePlasmatic enzymes

Secretory enzymes

Intracellular enzymes

Example

Source organ

Function in

coag. factors

liver

blood

amylase, lipase

pancreas

GIT

AST, …

various

cells

Enzyme activity in blood after source organ damage

Page 12: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Q. 6

Why are low activities of cellular enzymes

detected even in serum of healthy people?

Page 13: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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A. 6

Low activities of intracelular enzymes

in extracelular fluid (blood plasma, serum)

are the consequence

of physiological cell disintegration.

Page 14: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Main Tissue Distribution of Enzymes

AST

ALT

LD

CK

GMT

ALP

ACP

AMS

LPS

CHS

liver, myocard

liver

not specific

myocard, muscles

liver

biliary tract, bones

prostate

pancreas

pancreas

liver

Page 15: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Intracellular Location of Enzymes

Intracellular Location Enzymes

Cytoplasm

Mitochondria

Golgi complex, ER

Lysosome

Membrane

LD, ALT, 30 % AST

70 % AST

CHS, AMS

ACP

GMT, ALP

Page 16: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Consider the AST/ALT ratio

• AST/ALT > 1 ……… severe liver damage

• AST/ALT < 1 ……… mild liver damage

Page 17: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Enzymes of Clinical Significance

Enzyme Source of blood elevation

ALT

AST

GMT

ALP

ACP

CK

AMS

LPS

CHS

hepatopathy

MI, hepatopathy

hepatopathy (alcohol, drugs)

biliary tract diseases, bone diseases

prostatic cancer

MI (CK-MB), muscle diseases

pancreatitis

pancreatitis

hepatopathy (alcohol, drugs) – decreased

Page 18: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Catalytic concentration of some enzymes

Enzyme Reference values (serum)

ALT

AST

LD

CK

0.1 - 0.9 kat/l

0.1 - 0.7 kat/l

up to 7.5 kat/l

up to 4 kat/l

see also the lab manual

Page 19: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Q. 7

What enzymes might appear in blood

a) In mild hepatocellular damage

b) In serious hepatocellular damage

Page 20: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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A. 7

a) Mild hepatocellular damage:

enzymes from cytoplasm and/or membrane are released into ECF – ALT, GMT, ALP

b) Severe hepatocellular damage:

enzymes from mitochondria are released into ECF – AST

Page 21: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Q. 8

Write equations of reactions catalyzed by:

ALT

AST

LD

Page 22: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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ALT Reaction

alanine + 2-oxoglutarate

plné názvy enzymů !!

Page 23: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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ALT Reaction

alanine + 2-oxoglutarate pyruvate + glutamate

Page 24: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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AST reaction

aspartate + 2-oxoglutarate

Page 25: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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AST reaction

aspartate + 2-oxoglutarate oxaloacetate + glutamate

Page 26: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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LD reaction

lactate + NAD+

Page 27: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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LD reaction

lactate + NAD+ pyruvate + NADH + H+

Page 28: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Q. 9

The levels of most blood enzymes are increased

in newborns and infants. What enzyme persists

elevated till puberty?

Page 29: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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A. 9

ALP – the bone isoenzyme activity persists till puberty

Page 30: 1 Biochemistry II - Seminars Doc. RNDr. Jiří Dostál, CSc. Department of Biochemistry, Fac. Med., MU Brno jrdostal@med.muni.cz

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Biochemical Diagnostic of MI

Enzyme / Protein Half-time (hrs)

Myoglobin

Troponine T cardial form

CK-MB

AST

LD12

0,25

2

13

17

110


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