Sie sind auf Seite 1von 162

Biochemistry Exam 2 LGT

Heinz Schwarzkopf

LGT Disclaimer:
LGTs are designed by CAP tutors. They are not meant to replace information you
receive in class or textbooks. While it has been reviewed for typos and errors, you
must always remember that your professor and the material given by them
supersede any information presented in the LGT. The LGT serves as a review, and
are not meant to be an all-inclusive presentation.

Bioenergetics and Metabolism

PDH & TCA Cycle
Electron Transport System
Oxidative Phosphorylation

Metabolic pathways are divided into two categories:

Anabolic pathway: Requires energy

Catabolic pathway:

What type of metabolic pathway is

the TCA cycle?



Pathways in Carbohydrate Metabolism

What stops these two pathways from occurring at the same


Metabolic Pathways are:

Driven by the net free energy change of

the sum of individual reactions.



Cytosol / cytoplasm
Glycolysis, portions of gluconeogenesis, glycogen

metabolism, pentose phosphate pathway.

TCA, electron transport, >90% of ATP synthesis,

fatty acid oxidation.


Allosteric effectors (e.g., ATP) VERY FAST!!

Some metabolic enzymes are regulated by allosteric effectors. An
allosteric effector may be a substrate, intermediate or product of the

Short-term (at the protein level): some enzymes are

modified covalently by phosphorylation. This regulatory mechanism
requires a protein kinase (phosphorylating enzyme) and protein
phosphatase (dephosphorylating enzyme).
Covalent modification (e.g. phosphorylation) FAST!....

Long-term (at the DNA level): the amount of the enzyme/protein

is adjusted by a change in its synthesis or degradation.

Change enzyme amounts - SLOW. Metabolic enzymes have life

spans ranging from 1 hour to several days; therefore this is a long-term

Feedback Inhibition and Feedforward Stimulation

Many reaction products are used as the reaction feedback inhibitors
ATP is used as feedback inhibitor in many catabolic processes
Substrate A

Product E

In feedforward stimulation, a
substrate stimulates the pathway by
which it is utilized.

What class of enzyme is a kinase?

Inherited Enzyme Deficiencies cause

Metabolic Diseases
When an enzyme is missing as a result of a genetic
defect, the immediate effects are always the
accumulation of the substrate and the lack of the
If the intracellular degradation of a macromolecule (lipid,
polysaccharide, etc.) by hydrolytic enzymes is blocked,
the undegraded molecule accumulates mostly within the
cells. The result is a "storage disease.

Oxidation-reduction: reactions involve the loss or gain

of electrons (or protons) one reactant gains electrons
and is reduced while the other loses electrons and is
Oxidation reactions generally release energy and are
important in catabolism. (beta Oxidation is an oxidation or
reduction taking place?)
What is the fate of glucose?

6CO2 + 6H2O
When you see Dehydrogenase that is a clue that you are
doing a redox reaction. Then remember that an
NADH/NADPH/FADH2 is either used or produced.



In some enzymes bound covalently, called prosthetic

group, e.g. succinate dehydrogenase.


NAD+ or NADP+ are a soluble co-factor free to diffuse

from one enzyme to another. Both accept two electrons
and one proton. Derived from vitamin B3 niacin
FAD or FMN are coenzyme derived from the vitamin
riboflavin, B2, often tightly bound to specific enzymes
called flavoproteins.



Great majority of NAD+/NADH is located in the



Most of NADP+/NADPH is in the cytosol.

Electron Carriers
Both coenzymes (NAD+ and NADP+) undergo reversible reduction of
the nicotinamide ring.
What can niacin deficiency lead to?
a) Rickets
b) Diarrhea
c) Sterility
d) Dermal sensitivity

Pellagra: Remember Niacin and the four Ds

Rossman fold What it for?

Most dehydrogenases that use NAD or NADP bind the
cofactor in a conserved protein domain, called Rossmann

Flavoproteins are enzymes that catalyze oxidation-reduction
reactions using either FMN or FAD as coenzyme. FAD or
FMN are coenzyme derived from the vitamin B2, riboflavin.

Flavin Adenine Dinucleotide

N-glycosidic bond

In a Healthy Cell




What is NADPH used for?

All major nutrients (carbohydrates, fat, protein, etc.)
are degraded to acetyl coenzyme A (acetyl-CoA)
Think of acetyl-CoA as the center molecule of metabolism

In the mitochondria, the two carbons of the acetyl

group become oxidized to CO2 in the TCA cycle, but
may be used to produce all your other molecules.

Do you remember what vitamins B2 and 3 are for?

Which of the following ways can the

body not obtain glucose?

From the breakdown of glycogen
Glucose synthesis via amino acids
Glucose synthesis via acetyl CoA
Glucose can be obtained from all of these

Sources and Fates of Acetyl-CoA

Glucose: Sources, Uptake, Transport, Storage and

Glucose occupies a central position in the metabolism of plants, animals and
Glucose is the principal transported carbohydrate in humans and most
abundant monosaccharide in dietary carbohydrates.
Glucose can be transported by the blood, but it cannot be stored in the cells.
For storage, it has to be converted to the polysaccharide glycogen.
What are the organs that store glycogen?

Which of the following glucose

transporters is insulin dependent?


What about the kidneys?

If a person is on a salt diet and has not
ingested salt in 3 days can there intestines
still absorb glucose?

Why are certain organs such as the

brain and retinas affected by high
blood glucose levels?
a) Because they run out of glucose transporters
b) Because they dont have a sweet tooth
c) Because glucose freely diffuses into the cells and is
toxic above certain levels
d) Because they cant use insulin


During the well-fed state: decreased levels of glucagon

and elevated levels of insulin
During starvation: elevated levels of glucagon and low
levels of insulin

Glucose metabolism by the liver depends on the

insulin/glucagon but insulin is NOT required for the entry
of glucose into the liver cell. Why?

What about entry into pancreatic islet cells?

Why doesnt the muscular glycogen store

contribute to gluconeogenesis?
a) Muscles are stingy
b) Muscles use up all the glucose before it can leave
c) Because it cant convert glucose-1-phosphate to glucose-6phosphate

d) Because it lacks glucose-6-phosphatase


Which of the following is only depend

on glucose for energy?

Red Blood Cells
Adipose Tissue
Skeletal Muscle

Remember blood glucose maintained at 5 mmol/liter

Which of the following enzymes is involved in an irreversible

step in glycolysis?
A. Hexokinase
B. Phosphoglycerate kinase
C. Glyceraldehyde-3-phosphate DH
D. Enolase
E. Phosphoglycerate mutase
What does the enzyme do?

How many irreversible steps?

Where does glycolysis take place?

Glycolysis: the reactions of

glycolysis, the major catabolic
pathway for glucose. It is active in
the cytoplasm of all cells in the
human body.

6 - Carbon sugar
first priming reaction
Step 1

Breakdown of the six-carbon

glucose into two molecules of
three-carbon pyruvate, occurs in
10 steps and 2 phases:
Step 2

1. energy investment phase:

(steps 1 5)
Phosphorylation of glucose
and its conversion to
glyceraldehyde 3-phosphate

second priming reaction

Step 3

Step 4

3 - Carbon sugar

3 - Carbon sugar

Step 5

2. energy generation phase:

(steps 6 10)
Oxidative conversion of
glyceraldehyde 32
phosphate to pyruvate

Step 6

Oxidation and phosphorylation

Step 7

first ATP forming reaction

Step 8

Be able to walk yourself

Through the steps.

Step 9


No oxygen needed

Second ATP forming reaction

Step 10

Which of the following enzymes is only found in the liver

and pancreas?
A. Hexokinase
B. Phosphoglycerate kinase
C. Glucokinase
D. Aldolase
E. Pyruvate kinase
Remember that a kinase catalyzes and irreversible

Phosphorylation of glucose traps it in the cell (neg charge).

In the liver, the enzyme that converts glucose to glucose-6phosphate is:

A. Inhibited by ATP
B. Inhibited by ADP
C. Inhibited by Glucose 6-phosphate
D. Inhibited by Insulin
E. Inhibited by Fructose-6-phosphate
E. In peripheral tissue, hexokinase is inhibited by its product,
Glucose-6-P, but glucose-6-P has no effect on glucokinase (which
is found in the liver and pancreas)

Glucokinase (Liver & Pancreas)

- Highly specific for glucose.
- High Km for glucose (~10 mM).
- Not saturated at physiological blood glucose concentrations
(4 - 5 mM).

- Inhibited by fructose 6-P, but NOT glucose 6-phosphate.

- Induced by insulin (transcriptionally).

The liver acts like a glucose sponge

Hexokinase (Peripheral Tissues)

- Low specificity - phosphorylates most relevant hexoses
(glucose, fructose, mannose).
- Low Km (0.1 mM); saturated at all plasma glucose

- Inhibited by glucose 6-phosphate.

- Activated by fructose 1-phosphate and glucose.

- Insulin has no effect on expression.

Km of the two isozymes of hexokinase


What are the products of gylcolysis?

Cytosolic NADH+
- It must be re-oxidized:
1. anaerobic conditions: by conversion of pyruvate to lactate by
lactate dehydrogenase, and NADH is re-converted to NAD+,
without oxygen participation.

An increase in intracellular ATP in working muscle would

A. an decrease in glycolysis
B. an decrease in glycogen synthesis
C. An decrease in gluconeogenesis.
D. Activation of pyruvate kinase
E. Activation of PFK-1

Regulation of Glycolysis
- Phosphofructokinase-1 (PFK-1), is the most important regulated
enzyme of glycolysis. PFK is:
- stimulated by insulin and inhibited by glucagon (in the liver).
- inhibited by citrate as well as by low pH.
- inhibited by ATP and stimulated by AMP and ADP.
- Hexokinase / Glucokinase: also regulated
- Pyruvate Kinase: also regulated. Inhibited by ATP.

- In RBCs, rates of glycolysis are regulated by ATP / (AMP+ADP) only.

Remember 1, 3 and 10 those are the

irreversible steps of glycolysis.

- Is the most important regulated enzyme of glycolysis.
- Commits glucose to pyruvate in glycolysis.
- Activated by:
- Fructose 2,6-bisphosphate synthesized by PFK-2
- levels determined by insulin/glucagon
- levels determined by fructose 6-phosphate in muscle
- Inhibited by:
- Citrate
- Glucagon

2,3-bisphosphoglycerate in Red blood cells.

2,3-bisphosphoglycerate is an important allosteric effector of

hemoglobins affinity for oxygen.
It shifts the oxygen binding curve to right = DECREASED affinity,
resulting in more efficient release of oxygen at tissues.

Pyruvate Kinase
In glycolysis, step 10, phosphoenolpyruvate is converted to
pyruvate by pyruvate kinase. Pyruvate kinase is more
active in the fed state than in the fasting state.
- inhibited by:

- ATP, acetyl-CoA, alanine

- activated by:
- Fructose 1,6-bisphosphate

Fates of Pyruvate
Pyruvate formed by glycolysis, is only the first stage in the complete
degradation of glucose.
First route: pyruvate is oxidized, with loss of its carboxyl group as
CO2, to yield acetyl group of acetyl-CoA by PDH. Acetyl group is
then oxidized to CO2 by TCA cycle.
Second route: pyruvate is reduced to lactate by lactate
dehydrogenase via lactic acid fermentation.
Third route: pyruvate catabolism leads to alcohol and CO2, under
hypoxic conditions, a process called alcohol fermentation.

What is the fate of glucose:

a) Will be used up faster under anaerobic
condition than aerobic conditions
b) Will be used up faster under aerobic conditions
than anaerobic conditions
c) Will produce 36-38 ATP in all cells
d) Will be used to produce 2,3-BPG and this is
know as the Warburg effect
What is this phenomenon called and where is it not
What is the Warburg effect?

[1] Lactate Is Produced under

Anaerobic Conditions

a) is highly regulated
b) primarily metabolized by muscle
c) Uses GLUT5 transporter
d) is essential in fructosuria patients




Disorders of Fructose Metabolism


Essential fructosuria: a deficiency of fructokinase.


Hereditary fructose intolerance: a deficiency of fructose

-accumulation in your cells

Pryuvate is formed in the ______ and oxidized in

the ______.
A. cytoplasm
B. mitochondrial matrix
C. cytoplasm
D. mitochondrial inner space
E. cytoplasm

mitochondrial membrane
mitochondrial matrix
mitochondrial matrix

Which of the following is a cofactor for pyruvate

dehydrogenase complex (PDC)?
C. Vitamin B1

What is Thiamin used for?


Pyruvate Dehydrogenase Complex (PDC)

- Pyruvate, derived from glucose and other sugars by glycolysis, is
oxidized to acetyl-CoA and CO2 by PDH complex.
The three enzymes that make up the complex:
E1 pyruvate dehydrogenase; It is inhibited by its products NADH
and acetyl-CoA and stimulated by AMP. It is inactivated by the
phosphorylation and reactivated by dephosphorylation.
E2 dihydrolipoyl transacetylase, catalyzes the transfer of the acetyl
group to coenzyme A, forming acetyl-CoA.
E3 dihydrolipoyl dehydrogenase, catalyzes the regeneration of the
disulfide (oxidized) form of lipoate.
regulatory enzymes: phosphorylate / dephosphorylate E1 (a kinase
and phosphatase). The kinase is activated by ATP, thus ATP
inhibits E1.

The overall reaction is irreversible; fat cannot be converted into


Why cant fat be converted into glucose?

a) As a means to punish people who cant cook
b) Because anaperotic reactions are inhibited during
the fasting state
c) Because the PDH reaction is irreversible
d) Because of an accumulation of oxaloacetate

Key for the future:

Phosphorylation of gluco-metabolic
enzymes tends to correlate with getting
energy out.
Dephosphorylation of gluco-metabolic
enzymes tends to correlate with
producing ATP.

Mechanism of PDH Action

Five consecutive reactions:

TPP lipoic acid CoA FAD NAD
Decarboxylated then transferred to CoA

Pyruvate Dehydrogenase Complex (PDH)

Requires 5 different cofactors:

Thiamine pyrophosphate, TPP (B1) - E1

Lipoic acid (lipoate) - E2
Flavin adenine dinucleotide, FAD (Riboflavin) - E3
Nicotinamide adenine dinucleotide, NAD+ (Niacin)
Coenzyme A (CoA) (synthesized from pantothenic
acid (B5)

Make sure youve read through the details on the PP.

Thiamine Pyrophosphate (TPP)

- removal of carboxyl (-COOH) groups from organic acids
- is a vitamin B1 derivative which is produced by the enzyme thiamine

Thiamine deficiency leads to inability to oxidize pyruvate and thus

has a major neurological impact (Beriberi).

Regulation of PDH
- Inhibition by ATP, acetyl-CoA and NADH.

- Activation by AMP, CoA and NAD+.

- Activation by dephosphorylation
- Inhibition by phosphorylation of E1 (pyruvate
dehydrogenase). Kinase activated by ATP.
Pyruvate is a potent inhibitor of pyruvate
dehydrogenase kinase.

TCA Cycle
Degradation of acetyl-CoA derived from carbohydrates, fatty acids
and amino acids.
- produces most of the CO2 generated in tissues (2).
- is the major source of NADH (3).
- allows excess energy to be used for fatty acid biosynthesis.
- provides precursors for many metabolites.
Most TCA cycle enzymes in the mitochondrial matrix; some in the

inner mitochondrial membrane.

How many molecules of NADH are formed from the

breakdown of 1 molecule of pyruvate during one
complete turn of the TCA cycle?


Remember: 2 in glycolysis, and one more than

that in TCA

TCA Strategy
- Activated 2C fragment (acetyl-CoA) reacts with a 4C oxaloacetic acid, to
yield 6C citrate.
- In a series of seven reactions two carbons are released as CO2 (oxidative
decarboxylations), regenerating oxaloacetate.
- 2 carbons in, 2 carbons out = no net gain.
- Oxaloacetate must be present to "prime" the cycle.
- Four pairs of electrons are transferred during one turn of the cycle: three
pairs of electrons reducing three NAD+ to NADH, and one pair reducing

- One complete turn of the TCA cycle generates only one ATP (GTP) (in the
conversion of succinyl-CoA to succinate), three molecules of NADH and
one molecule of FADH2. Oxidation of one NADH leads to formation of
3 ATP, whereas oxidation of FADH2 yields 2 ATP.

Total 12 ATP generated by one round of TCA cycle from one acetyl residue. From
two acetyl residues, total 24 ATP generated.

Know the 8 steps

TCA Cycle





TCA Cycle



dehydrogenase dehydrogenase

(also called oxoglutarate)




oxidative decarboxylation

Which of the following is an example of substrate

level phosyhorylation:
A. Fumarase.
B. Alpha-Ketogluterate Dehydrogenase
C. Hexokinase
D. Succinyl-CoA Synthetase.
Synthetase vs. Synthase
What is the total ATP yield from glycolysis plus TCA?
-but what about ETC?

Regulation of the
TCA Cycle
Regulation of metabolite flow
from the PDH complex through
the TCA cycle in mammals.
The PDH complex is allosterically
inhibited when [ATP]/[ADP],
[NADH]/[NAD+], and [acetylCoA]/[CoA] ratios are high,
indicating an energy-sufficient
metabolic state. When these ratios
decrease, allosteric activation of
pyruvate oxidation results.

The overall rate of the TCA cycle is controlled

by the rate of conversion of pyruvate to acetyl-CoA.

Anaplerotic Pathways
TCA cycle intermediates
Pyruvate carboxylase, malic enzyme, PEP-carboxykinase. Four rxns

Pyruvate Carboxylase Defficiency

A rare recessively inherited condition (enzyme
deficiencies are normally genetic recessive)
Pyruvate accumulates because pyruvate carboxylase is a
major consumer of pyruvate
Accumulated pyruvate is converted to lactate and alanine
Caused by the inability to convert pyruvate to glucose

Neurological deficits and mental retardation

Dysfunction of TCA cycle due to insufficient oxaloacetate
Energy dysfunction normally results with neurological problems

Antiporters Transport Metabolites Across the

Inner Mitochondrial Membrane
Transport across the inner mitochondrial
membrane usually requires specific carriers
ADP, ATP (but not the other nucleotides);
Pyruvate; Phosphate; Alanine, Aspartate;
Glutamate; Substrates, intermediates and
products of the TCA cycle
except: acetyl-CoA, oxaloacetate, fumarate, NAD,
Does NADH really not need a transporter?


Regeneration of NAD

What about the outer



Skeletal and cardiac muscle

More efficient 1 to 1 transfer

Electron transport chain (respiratory chain)

and oxidative phosphorylation
- Reaction intermediates donate electrons to specific coenzymes, such
as NAD+ and FAD to form the energy-rich reduced coenzymes, NADH
and FADH2.
- These reduced coenzymes can donate a pair of electrons to a electron
carriers, collectively called electron transport chain, and they lose their
free energy, that can be stored by the production of ATP from ADP and Pi,
this process is called oxidative phosphorylation.
- The electron transport chain is present in the inner mitochondrial
- Electron transport chain and oxidative phosphorylation (ATP synthesis): are
tightly coupled processes. Therefore, inhibition of the electron transport
chain also results in inhibition of ATP synthesis.

Oxidative phosphorylation
Oxidative phosphorylation involves the reduction of O2 to H2O with
electrons donated by NADH and FADH2.
Photo-phosphorylation involves the oxidation of H2O to O2, with
NADP+ as electron acceptor.
Oxidative phosphorylation and photo-phosphorylation, both are
mechanistically similar both processes involve the flow of electrons.
Oxidative phosphorylation begins with the entry of electrons into the
respiratory chain.
NADH (carries electrons from catabolic reactions) and NADPH (supplies
electrons to anabolic reactions), are water-soluble electron carriers that
associate reversibly with dehydrogenases.

Major Mitochondrial Electron Carriers

(or Electron-Transfer System or Respiratory Chains)
None of the functional groups in proteins can transfer hydrogen or
electrons, the components of the respiratory chain have to employ
metal ions and coenzymes.
Respiratory chains contains: (e- carriers)

Iron-sulfur proteins
Ubiquinone (UQ) or Coenzyme Q (CoQ)
Protein-bound copper

Note: With the exception of coenzyme Q, all members of this chain

are proteins.


- The FAD or flavin mononucleotide (FMN) in the flavoproteins can
transfer either one- or two-electrons at a time.
- Electron transfer occurs because the flavoprotein has a higher
reduction potential than the compound oxidized.
- They accept hydrogen/electrons from NADH and donate it to the

Prosthetic group (tightly bound) to complex 2

Iron - Sulfur Proteins

(e- carriers)

- also known as non-heme iron proteins. What is a heme?

- anchored in proteins through cysteine.
- both the iron-sulfur proteins and the flavoproteins of the respiratory
chain are integral membrane proteins.

Fe3+ + e- Fe2+

Iron-sulfur complexes in proteins: iron in these complexes can change its

oxidation state reversibly between the ferrous (Fe2+) and ferric (Fe3+) forms.

Cytochromes: Heme proteins (is a complex of protoporphyrin IX and
ferrous iron) that functions as electron carriers in respiration,
photosynthesis and other oxidation-reduction reactions.
- One-electron carriers (Fe3+ Fe2+).
- All but one (cytochrome c) are integral membrane proteins.
- Cytochrome c is a small and water-soluble protein.
What does it do?

Ubiquinone (UQ) or Coenzyme Q (CoQ)

- Ubiquinone, a hydrophobic quinone, is a lipid-soluble benzo-quinone
with a long isoprenoid side chain.

Makes molecule hydrophobic

Match the following

with where they are

A. Fe-S proteins
B. Flavin proteins
C. Cytochrome C
D.Cytrochome b
E. Coenzyme Q

1. Integral
2. Free to diffuse

Which of the following

complexes contain a proteinbound copper?
A.NADH dehydrogenase
B.Succinate Dehydrogenase
C.Cytochrome b-c Complex
D.Cytochrome c Oxidase
What are each of the above
mentioned structures?

Protein-bound copper
- Protein-bound copper participates in the last reaction of
the respiratory chain, the transfer of electrons to molecular
oxygen. It switches between the Cu+ and Cu2+ forms during
these electron transfers. Part of complex 4

Respiratory Chain
Four members of the respiratory chain are freely diffusible:
NADH, ubiquinone, cytochrome c, and molecular oxygen.
1 Complexes I and II catalyze electron transfer to ubiquinone from two
different electron donors: NADH (complex I) and succinate or
FADH2 (complex II).
2 Complex III carries electrons from reduced ubiquinone to cytochrome
c, and
3 Complex IV transferring electrons from cytochrome c to O2.

Which side of the mitochondrion

is the most acidic after oxidative
A.The inner membrane space
B.The matrix
C.Outer membrane space
D.pH is the same across
Cells with high rates of respiration (e.g. heart
muscle) have mitochondria with many
densely packed cristae. Liver cells have
much fewer cristae.




Increasing reduction potential

What happened to the last 2H+ at complex 4?

Complex I

(NADH to Ubiquinone)
- Complex I, also called NADH:ubiquinone oxidoreductase or
dehydrogenase, transfers electrons from NADH to ubiquinone, is a
large enzyme composed of 42 different polypeptide chains, including
FMN-containing flavoprotein and at least six iron-sulfur centers.
-no FAD?
- Electrons are transferred from NADH -> FMN -> ironsulfur -> ubiquinone.

- Amytal (a barbiturate drug), rotenone (a plant product commonly

used as an insecticide), and piericidin A (an antibiotic), inhibit electron
flow from the Fe-S centers of Complex I to ubiquinone.
If you block complex 1 can oxidative phosphorylation take place?

Complex II
(Succinate to Ubiquinone)
Complex II, also called succinate dehydrogenase, is the only
membrane-bound enzyme in the TCA cycle.

- It contain three Fe-S centers, bound FAD

- Electrons from succinate pass through a flavoprotein and several Fe-S
centers to ubiquinone.
- Acyl-CoA dehydrogenase (the first enzyme of oxidation) transfers electrons to ETF
(electron-transferring flavoprotein, FAD), from which they pass to ubiquinone.

Complex III
(Ubiquinone to Cytochrome c)
Complex III, also called cytochrome c oxidoreductase or cytochrome
bc1 complex, couples the transfer of electrons from ubiquinol (QH2) to
cytochrome c.
- It contains cytochrome b, an Fe-S protein, and cytochrome c1.
- Cytochrome c is a soluble protein. After its single heme accepts an
electron from Complex III, cytochrome c moves to Complex IV to
donate electron to a binuclear copper center.


Complex IV
(Cytochrome c to O2)
This is the final step of the respiratory chain. Complex IV, also called
cytochrome oxidase, carries electrons from cytochrome c to molecular
oxygen, reducing it to H2O.
- Complex IV is a large enzyme (13 subunits; Mr 204,000) of the inner
mitochondrial membrane.
- Oxygen is tightly bound between heme a3 and copper, to be released
after its reduction to H2O by the transfer of four electrons.

- Cytochrome oxidase has a very high affinity for oxygen.


ATP Synthase
O for Oligomycin




Proton Gradient
Oxidative phosphorylation proceeds in two steps:
1. Protons are pumped out of the mitochondrion: Proton pumping is
driven by the redox reactions in the respiratory chain, and creates a
electrochemical gradient across the inner mitochondrial membrane.
The inner membrane must be impermeable to protons to maintain
Protons are admitted back into the mitochondrion, down their
concentration gradient, via proton channel: This process drives
ATP synthesis.
- four protons are pumped by the NADH-ubiquinone reductase complex
and another four by the ubiquinone-cytochrome c reductase complex.
- cytochrome oxidase removes four protons from the mitochondrial
matrix, translocating two to the inter-membranous space and other two
consuming in the reduction of O2, thus, four protons leads to the synthesis
of one ATP molecule.
- ATP is synthesized only when protons flow, and protons can flow

only when ATP is synthesized.

Respiratory Control

There is no rate-limiting step in oxidative phosphorylation, but its

rate depends on substrates availability (ADP, inorganic phosphate
and O2), and an oxidizable metabolite, like NADH and/or FADH2.

ATP synthesis is absolutely dependent on continuous electron flow

(electron transport) and electron transport occurs only during ATP

Oxidative phosphorylation produces most of the ATP.

In healthy cells, the level of ATP exceeds that of ADP by a factor of

4 - 10.

High demand for ATP, generates ADP, which stimulates respiration.

At rest, accumulation of ATP depletes ADP levels and suppresses


A. Inhibits the flow of electrons at complex 4
B. lowers the basal metabolic rate
C. Inhibit the flow of electron at complex 2
D. decrease the H+ gradient across the inner
mitochondrial membrane

Uncouplers do which of the following:

A. Diminish the proton gradient

B. Disrupts the electron transport chain
C. Prevent Complex I from transferring electrons from
NADH to ubiquinone
D. Disrupts oxidative phosphorylation but allows ATP
synthesis to occur

Uncouplers of Oxidative Phosphorylation

Uncoupler - Any substance that inhibits ATP synthesis but have no effect on
electron transport.
(Uncouplers means the dissociation of oxidative phosphorylation (not
reduction) from ATP synthesis. The most common uncoupler is 2,4dinitrophenpl (DNP)).
specific chemical agents:

- 2,4-dinitrophenol (DNP) and pentachlorophenol

- Valinomycin: an antibiotic that makes the inner mitochondrial
membrane permeable for potassium.
Oxygen utilization is maintained as electron transport (and H+ pumping)
ATP synthesis is diminished or inhibited, as proton gradient (electronflow) is weak or disrupt, or non-existent.

Uncouplers of Oxidative Phosphorylation

physiological un-couplers:
- Thyroxin: a hormone produced by the thyroid glands to regulate
metabolism by controlling the rate of oxidation in cells.
- Thermogenin: a protein of the inner mitochondrial membrane that
allows trans-membrane movement of protons, also called uncoupling
protein, a membrane-spanning protein that forms a natural
channel to allow proton return.
increases heat generation.
found in specialized tissues (usually hairless, hibernators or coldadapted).
brown fat (particularly high content of cytochromes) localized in
the neck and upper back.

Inhibitors of Electron Transport

Oxidative phosphorylation is inhibited by many poisons.
Electron flow through the respiratory chain, can be blocked by:
Rotenone - an insecticide, blocks flow of electrons from Fe-S complexes in the
NADH-Q reductase complex to ubiquinone through Complex I,
(Parkinsons?). Blocks transfer of electrons associated with NADH.
Amytal (a barbiturate), site of action same as rotenone, also inhibit electronflow through the NADH-Q reductase complex (Complex I).
Antimycin A, an antibiotic, that blocks electron flow from cytochrome b to c1 through cytochrome c oxido-reductase complex (Complex III).
Cyanide - binds to cytochrome oxidase (Complex IV) and prevents electron
transfer to oxygen. Hydrogen sulfide, carbon monoxide and azide also act
as cyanide.

Mitochondrial DNA
Mutations in mitochondrial DNA can cause:
- Lebers hereditary optic neuropathy (LHON): blindness, caused by degeneration
of the optic nerve.
- Myoclonic epilepsy and ragged-red fiber disease (MERRF).
- Mitochondrial DNA has a higher mutation rate than nuclear DNA.


Which of the following can be damaged by

A. Hemoglobin
B. Proteins
D. Cell Membranes
E. All of the above

Reactive Oxygen Species (ROS) Are Formed

During Oxidative Metabolism
Electrons may leak out of the respiratory chain:
Superoxide: O2 + e O2







o Also: Reduced flavoproteins (FADH2) in locations other

than the respiratory chain can produce hydrogen
peroxide (H2O2)

Hydroxyl radical:
H2O2 + Fe2+ + H+ HO + Fe3+ + H2O

Enzymes Evolved to Destroy ROS

Superoxide dismutase (SOD)
2O2 + 2H+


H2O2 + O2

Catalase (a heme-containing enzyme that

destroys H2O2)


2H2O + O2

Glutathione peroxidase (2GSH + H2O2 GSSG + 2H2O)

Many Metabolites, Vitamins, Hormones and

Phytochemicals Can Eliminate Dangerous Free
These molecules form stable free radicals that are
sufficiently reactive to react readily with free radicals
but not sufficiently reactive to damage normal
constituents of the cell.

Uric acid
Ascorbate (Vitamin C)

Carbohydrate Metabolism
Most important function of carbohydrate metabolism is: maintain blood
glucose level at all times.
- Brain alone consumes ~ 120 g of glucose / day. Therefore, a blood glucose
level of 4.0 to 5.5 mmol/liter (70 to 100 mg/dL) must be maintained at all

Only liver glycogen (NOT muscle glycogen), can be used to

maintain the blood glucose level.

- Gluconeogenesis produces glucose from amino acids, lactic acid, and

glycerol. It is the only source of glucose during prolonged fasting.
- Only the liver and kidneys have a complete gluconeogenic pathway.

Liver produces 10 times more glucose than kidney, because the liver is so
much larger than a kidney.

Which of the following cannot be utilized for the

net synthesis of glucose?
A. Leucine
B. Glycerol
C. fatty acids
D. Aspartate
E. Alanine
F. Acetyl CoA

Remember that the 2 L amino

acids are only ketogenic.

Gluconeogenesis new formation of sugar

Glucose stored in the liver and muscle, in the form of glycogen. But this stored glucose
is not sufficient between meals and fasting. At that time, organisms synthesize glucose
from non-carbohydrate (such as pyruvate). This pathway called gluconeogenesis.

- Occurs primarily in the cytosol, although some precursors are

generated in the mitochondria.
- Glucose is a universal fuel and building block in humans, some tissues
(brain, erythrocytes, testes) depend almost completely on glucose
for their metabolic energy.

- Brain alone requires ~ 120 g of glucose each day this is more than
half of all the glucose stored as glycogen in liver and muscle.
- Liver is the major gluconeogenic organ of the body.
- Muscle does NOT contribute to gluconeogenesis, because

no glucose 6-phosphatase and no glucagon receptors

Gluconeogenesis: synthesis of carbohydrate (such as glucose)
from non-carbohydrates such as oxaloacetate or pyruvate
(Synthesis of one molecule of glucose from two molecules of pyruvate
requires energy, equivalent to 6 molecules of ATP)

- An energy-requiring, biosynthetic pathway of generating

glucose, generally from 3- and 4- carbon compounds.
- Gluconeogenesis must get around the highly exergonic
glucokinase, phosphofructokinase-1 (PFK-1) and pyruvate
kinase reactions by a new set of exergonic reactions that
drive the process in the opposite direction. (1, 3 & 10)

Gluconeogenesis and glycolysis are NOT identical pathways,
running in opposite directions. Reverse of glycolysis except
the irreversible (kinase) reactions.
Three reactions of glycolysis are irreversible and cannot be used in

1. Conversion of glucose to glucose 6-phosphate by

2. Phosphorylation of fructose 6-phosphate to fructose 1,6bisphosphate by phosphofructokinase-1 (PFK-1).
3. Conversion of phosphoenolpyruvate to pyruvate by pyruvate

Match the glycolytic enzymes with their gluconeogenic


1. Hexokinase/
2. PFK-1
3. Pyruvate Kinase

A. PEP carboxykinase
B. Fructose -1,6bisphosphatase
C. Pyruvate carboxylase
D. Glucose-6phosphatase




Glycolysis and
Irreversible reactions # [1], [8],
and [10] Know the enzymes.

Notice the use of an ATP and a GTP

Which of the following liver enzymes would be active

in the fasted state?
A. pyruvate kinase
B. PEP carboxykinase
C. Fructose 1,6 bisphosphatase.
D. Both A and B
E.Both B and C

Which of the following metabolic reactions can

pyruvate carboxylase be found?
A. Glycolysis
B. Krebs cycle
C. Glycogen synthesis
D. Gluconeogenesis
E. Both B and D
F. Both A and D

Conversion of Glucose 6-phosphate to Glucose

- The irreversible glucokinase reaction is reversed by the

action of glucose-6 phosphatase (a simple hydrolysis). This
enzyme is located in the ER and is present only in

the liver.
- Glucose can thus leave the liver and enter the blood.
Note: glucose-6 phosphatase is involved in both gluconeogenesis and

Fructose-2, 6-bisphosphate:
A. Stimulates glycolysis
B. Is inhibited by PFK1
C. Is inhibited by PFK2
D. Favors gluconeogenesis
E. Stimulates Fructose-1,6-bisphosphatase

Activates glucose

Overall Gluconeogenesis reaction

- Leading from pyruvate to free glucose:
2 pyruvate + 4 ATP + 2 GTP + 2 NADH + 2 H+ + 4H2O

glucose + 4 ADP + 2 GDP + 6 Pi + 2 NAD+

How do amino acids lead to free


Gluconeogenic Substrates
- Lactate (Pyruvate) Cori cycle. Lactate is released into the blood by
muscle, and by cells that lack mitochondria, such as RBCs and taken
to the liver to be used for gluconeogenesis
- Glucogenic amino acids (all, except leucine and lysine).
- Glycerol (from the breakdown of triglycerides in adipose tissue),

All TCA intermediates (except acetyl-CoA) are substrates of


Cori Cycle

After vigorous exercise, lactate produced by anaerobic glycolysis in muscle

returns to the liver and is converted to glucose, which moves back to muscle
and is converted to glycogen a circuit called the Cori cycle.

Cori Cycle: Shuttling of glucose and lactate between muscle and liver
during physical exercise.

Regulation of Gluconeogenesis
Hormones are important for the regulation of gluconeogenesis:

Insulin: is a hormone, released from pancreatic -cells in

response to hyperglycemia (increased blood glucose
level). Insulin lowers the blood glucose level (stimulates
glycogenesis and glycolysis in liver).
Glucagon: is a polypeptide hormone from the -cells of the
pancreas that stimulates the glucose-producing pathways
of the liver (glycogenolysis & gluconeogenesis). It is
released in response to hypoglycemia (decreased blood
glucose level). Glucagon raises the blood glucose level.

Regulation of Gluconeogenesis
Glucagon and insulin secreted by pancreatic and cells,
respectively. The release of glucagon and insulin is inhibited
by somatostatin, which is secreted by the pancreatic
delta cells.

Epinephrine and norepinephrine: are stress hormones that

are released during physical exertion and cold exposure. In the
liver, they favor gluconeogenesis over glycolysis by inducing
cAMP. EPI->G-protein->adenylyl cyclase->cAMP->PKA
->blood glucose
Glucocorticoids: are also stress hormones that affect gene
transcription. Glucocorticoids stimulate gluconeogenesis by
inducing gluconeogenic enzymes.

Regulation of Gluconeogenesis (3)

Pyruvate kinase is the most important regulated enzyme in the
PEP-pyruvate cycle. It is inhibited by ATP and activated by
fructose 1,6-bisphosphate.
Phosphofructokinase and fructose-1,6-bisphosphatase in the liver
are oppositely regulated. ATP and citrate stimulate fructose-1,6bisphosphatase but inhibit phosphofructokinase (favor

Glucose-phosphorylating enzymes in the liver are

hexokinase/glucokinase the glucose/glucose 6-phosphate reaction.
Just know that when one pathway is activated the other is

Ethanol and Liver Metabolism

-ATP and citrate stimulate fructose 1,6 bisphosphatase but
inhibit phosphofructokinase, means favor
Ethanol increases both, cytosolic and mitochondrial NADH
+ H+ concentrations. Bad if it uses all the NAD+
- Increased NADH + H+ inhibits the conversion of lactate to
pyruvate, thus inhibiting gluconeogenesis.


Gluconeogenesis takes place almost exclusively in the liver, and the

liver receives large quantities of fatty acids from adipose tissue
during fasting. Insulin inhibits lipolysis, thus in fed state the level of
free fatty acids is low and in fasting state, when insulin is low, FFAs
are high.

Fatty acid oxidation is less controlled by feedback inhibition than is

glucose oxidation. Therefore, the levels of ATP and acetyl-CoA in
the liver are actually elevated during fasting.

- Fatty acid oxidation provides the necessary energy

required by liver for gluconeogenesis. What is the

Fatty acid oxidation: The burning of stored fat.

What is the Livers Primary energy


C.Fatty Acid Oxidation
D.A & B

Why Glycogen?
- Fat cannot be as rapidly mobilized in muscle.

- Fat cannot be oxidized to produce energy under

anaerobic conditions.
- Requires energy input to initiate fat oxidation.
- Fat cannot be converted into glucose!
Glycogenesis vs. Glycogenolysis
Liver glycogen only to maintain blood glucose, liver
doesnt use it.

Storage of Glucose and Glycogen

in a normal healthy adult

-Most people have more muscle than liver, the total amount of muscle
glycogen exceeds that in the liver.
There is more glycogen per gram of tissue weight in the liver (it is more
concentrated in the liver)

Glycogen Structure






Know alpha-1,4- linkages (like starch)

-vs. beta which is cellulose
With alpha-1,6-branching
Add glucose molecules at the reducing end,
take them off at non.

Glycogen Synthesis
Glycogen is readily synthesized from glucose.
(Glucose is a most abundant monosaccharide in dietary carbohydrate)
For glycogen synthesis:
- Primer required to initiate synthesis.
- The protein glycogenin (Mr 37 kDa) serves as the primer,
or that primes the synthesis of new glycogen chains.

- Glycogenin is self glycosylating; attaches glucose from

UDP-glucose to tyrosine residue (Tyr194) of glycogenin.

Glycogen Synthesis

2 high energy bonds

Synthesis of uridine diphosphate (UDP)-glucose. UDP-glucose is the

activated form of glucose, or the precursor for glycogen synthesis.

Which of the following favors glycogen synthesis?

A. Binding of epinephrine to alpha2 receptors
B. The activation of Protein Kinase A and its phosphorylation
C. Rising levels of AMP in the muscle
D. Activation of glycogen phosphorylase
E. A high insulin/glucagon ratio
What does glycogen phosphorylase do?

Glycogen Synthesis
Glycogen synthase is the key regulatory enzyme for glycogen synthesis;
creates the -1,4 glycosidic bonds in glycogen by transferring the
glucose residue from UDP-glucose to non-reducing end of the
glycogen molecule.

Glycogen synthase cannot form the -1,6 glycosidic bonds at the branch
points of glycogen. Branching requires a glycogen-branching
enzyme, called transglycosylase or glycosyl-transferase, that breaks
an -1,4 bond and forms an -1,6 bond .
Glycosidic bonds: are covalent bonds, formed between two
monosaccharide molecules by means of a dehydration reaction.

Which of the following enzymes are not found in


Glycogen phosphorylase
All of the above are found in muscle

In the muscle glycogenolysis is

always coupled to glycolysis!!

Regulation of Glycogen Metabolism

Glycogen metabolism is regulated by hormones and metabolites.
- Glycogen synthesis and glycogen degradation should not be active
at the same time to avoid an ATP-consuming futile cycle, achieved
by the phosphorylation/dephosphorylation of the key enzymes
glycogen synthase and glycogen phosphorylase.
- Glycogen synthase is active in the de-phosphorylated state, whereas
glycogen phosphorylase is active in the phosphorylated state.
Phosphorylation state of the enzymes is regulated by:
- Insulin- Dephosphorylated state both in the liver and in muscle.
- Glucagon- Phosphorylated state (only affects liver)
- Norepinephrine and epinephrine are powerful activators of
glycogen breakdown both in muscle and liver.

Regulation of glycogen synthase and glycogen


protein kinase phosphorylates both glycogen

phosphorylase and glycogen synthase &
protein phosphatase de-phosphorylates both glycogen
phosphorylase and glycogen synthase .





Kinase A

Protein Kinase A

Ca++ (muscle)


phosphorylase kinase


Phosphorylase kinase




Phosphorylase b

Phosphorylase a




Glycogen metabolism enzyme deficiencies -> storage diseases

Von-Gierkes disease (type I) Glycogen buildup in liver

Pompe disease (type II) Glycogen buildup in muscle
Cori disease
Anderson disease
McArdle disease
Hers disease
Tarui disease

The binding of epinephrine to receptor on liver cells would result

in intracellular increase in:
A. glucose-6-phosphate dehydrogenase.
C. Glycogen synthetase activity.
D. glycolysis
E. All of the above.

What is the route of energy


Fructose Metabolism in the Liver

Excess fructose is toxic
The liver metabolized fructose faster than it metabolizes
Fructose-1-phosphate tends to accumulate because
fructokinase activity exceeds aldolase B activity
Fructose-1-phosphate directs dietary glucose into glycogen synthesis

Fructose phosphorylation ties up inorganic phosphate (Pi),

which impairs oxidative phosphorylation

A. Maintains an oxidative environment of the
B. Provides electrons for oxidative
C. Is a coenzyme for fatty acid synthesis
D. Is mainly found in the mitochondrion

PPP two general products:

NADPH for biosynthesis
Ribose for nucleic acid synthesis

Primary Function of the

Oxidation of glucose-6-phosphate, makes two important products:
NADPH and ribose-5-phosphate
- occurs in the cytosol of the cell: all the enzymes in the PPP are
located in the cytosol.
- provides NADPH, a coenzyme, for redox reactions or reductive
biosynthetic pathways (such as fatty acid and cholesterol synthesis)
and maintenance of reductive environment of the cytosol -the
defense against oxidative damage or stress.
- provides ribose-5-phosphate for nucleotide (purine and
pyrimidine) and nucleic acid biosynthesis and recycles nucleic
acid-derived pentoses for potential energy use.

Which Tissues?
- all tissues:

- Most active in tissues involved in fatty acid and steroid

synthesis (adrenal gland, liver, adipose tissue and
mammary gland).
- Red blood cells (RBCs): maintain their membrane integrity.
Rapidly dividing cells, such as bone marrow, use ribose
5-phosphate to make RNA, DNA, coenzymes as ATP,
NADH, FADH2 and coenzyme A.

2 phases
Oxidative Phase: oxidative branch of the PPP is concerned
with the synthesis of NADPH. Glucose-6-phosphate
dehydrogenase catalyzes the rate-limiting step. The reaction
is irreversible, maintains a high NADPH / NADP+ ratio.

Non-oxidative Phase: non-oxidative branch of the PPP links

ribulose 5-phosphate (product of the oxidative branch) to the
glycolytic and gluconeogenic pathways. This reaction is
reversible. The most important enzymes in this reaction, are
transketolase and transaldolase.
-Pentose can be recycled or used.

Pentose Phosphate Pathway (PPP)

Glucose 6-phosphate dehydrogenase (G6PDH) is inhibited
by a high NADPH / NADP+ ratio.
G6PDH is the first, and most important, enzyme of the
pentose phosphate pathway.

The amounts of glucose 6-phosphate dehydrogenase and

phosphogluconate dehydrogenase are increased in the wellfed state, and this effect is mediated by insulin.
Why is this enzyme sometimes an

Oxidative reactions of PPP

In some organs, the Pentose Phosphate Pathway ends at
this point, and its overall equation is:
Glucose 6-phosphate + 2 NADP+ + H2O

ribose 5-phosphate + 2 NADPH + 2 H+ + CO2

Non-oxidative reactions of PPP

- Pentose phosphates produced in the oxidative phase, are
recycled into glucose 6-phosphate in non-oxidative phase.

In a series of reactions or rearrangements of the carbon skeletons:

- six 5-carbon sugar phosphates are converted to five 6-carbon
sugar phosphates.
- produces glucose 6-phosphate and NADPH.

Two enzymes are unique in PPP in inter-conversions of sugars:

1. Transketolase: catalyzes the transfer of 2-carbon from a ketose donor to an
aldose acceptor, forming the 7-carbon product sedoheptulose 7-phosphate.
The remaining 3-carbon fragment is glyceraldehyde 3-phosphate.
2. Transaldolase: a 3-carbon fragment is removed from sedoheptulose
7-phosphate and condensed with glyceraldehyde 3-phosphate, forming
fructose 6-phosphate, and finally convert to glucose 6-phosphate by
phosphohexose isomerase.

Balance Sheet
Summary of the flow of 15 C atoms through Pentose Phosphate
Pathway reactions by which 5-C sugars are converted to 3-C and 6C sugars.
C5 + C5 C3 + C7
C3 + C7 C6 + C4
C5 + C4 C6 + C3
3 C5 2 C6 + C3


Glucose 6-phosphate may be regenerated from either the 3-C

glyceraldehyde 3-phosphate or the 6-C fructose 6-phosphate, via
enzymes of gluconeogenesis.

Pentose Phosphate Pathway Scenarios

If nucleic acid synthesis is required (e.g., in actively dividing cells),
the product of the oxidative branch, ribose 5-phosphate (5C), is used
and will not enter the non-oxidative branch.
When the cell needs more NADPH than ribose-5-phosphate, both
the oxidative and non-oxidative branches work in series to yield
NADPH (+CO2) and form fructose-6-phosphate and glyceraldehyde3-phosphate. These products are recycled to glucose-6-phosphate
which goes back to feed the oxidative branch of PPP again, and
again (i.e., all carbons of glucose-6-phosphate may convert to CO2).

If energy is also needed, 5C products are recycled to glucose-6phosphate for glycolysis and repeat PPP reactions (e.g. RBCs).


Role of Cytosolic NADPH

- Maintain reductive environment in the cytosol of cell (GSH,
- Provide reducing equivalents for anabolic pathways (fat,
cholesterol synthesis).
- Provide electrons for the generation of Reactive Oxygen
Species (ROS). Making peroxides
- In red blood cells, NADPH produced by the pentose
phosphate pathway, is very important in preventing
oxidative damage
- Cytosolic environment must be maintained in a reduced
form to maintain enzyme functionality.
Reducing environment: An environment without oxygen available for

- Glutathione (GSH, tripeptide; Glu-Cys-Gly), functions as a
reducing agent.
- Glutathione Peroxidase (GPx) catalyzes degradation of
hydroperoxides by reduction, as two glutathione molecules
(represented as GSH) are oxidized to a disulfide (GSSG).
Only the reduced form of glutathione (GSH) is an antioxidant.
Therefore, the dimeric, oxidized form (GSSG) has to be reduced back
by the enzyme glutathione-reductase (GR). Can be faulty
(GR depends on NADPH from the pentose phosphate pathway)













Active enzyme
Denatured enzyme

Glucose 6-phosphate Dehydrogenase

(G6PDH) Deficiency
- Pentose phosphate pathway is the only source of NADPH in
- G6PDH is the first enzyme of the pentose phosphate pathway.

- G6PDH deficiency has a profound effect on the stability of red

cells, and cannot maintain antioxidant defenses.
- The red cells are unable to handle the additional oxidative stress,
after exposure to drugs (sulfonamides, acetanilid, nalidixic acid,
nitrofurantoin) or food items (fava beans).

Glucose 6-phosphate Dehydrogenase

(G6PDH) Deficiency
- Over 400 genetic variants of G6PDH, mostly coding for less
active/stable enzyme.
- The most common human enzyme deficiency; > 400 million
people affected worldwide, with a shortened life span.
- Confers resistance to malaria. -Sickle cell anemia

Major Organs of Metabolism

Four major organs play a dominant role in fuel metabolism:

3.Muscle, and

Which of the following enzymes are favored by

A. Glycogen synthetase
B. Glycogen phosphorylase
C. Protein Kinase A
D. Cyclic AMP
E. Glucokinase


Insulin: is a hormone, secreted by the cells of pancreas, to

lower blood sugar levels. Insulin is needed to convert sugar,
starches, and other food into glucose (blood sugar) or regulates
storage of glycogen in the liver and accelerates oxidation of sugar
in cells.
Insulin stimulates glycolysis and glycogenesis and
inhibits gluconeogenesis and glycogenolysis.
Insulin: Being a protein, insulin is not orally active because
it is destroyed by digestive enzymes, so mostly used as a
i.p. injection.
Its metabolic effects are anabolic, for example, synthesis of
glycogen, triacylglycerols (TAG), and protein.
The most important hormone for growth and development

Insulin is a Satiety Hormone

- Insulin is the hormone of the well-fed state. Its synthesis and release
are stimulated by glucose, and this effect is further increased by amino
acids. Therefore, the plasma level of insulin is highest after a
carbohydrate-rich meal. During fasting, plasma level of insulin falls.
- Insulin stimulates the utilization of nutrients such as glucose, amino
acids, and triglycerides. It diverts excess nutrients into the synthesis
of glycogen, fat, and protein.

- Insulin regulates the metabolism of fat and protein as well as of

carbohydrate. It induces the conversion of excess carbohydrate to fat
by glycolysis and fatty acid synthesis.

Insulin decreases lipolysis

Puts your energy stores away

Glucagon: is a polypeptide hormone secreted by
the -cells of the pancreas that stimulates the
glucose-producing pathways of the liver. It is
released in response to hypoglycemia (decreased
blood glucose Level, < 40 mg/dl). Hypoglycemia is
a medical emergency.
Glucagon raises the blood glucose level.
Glucagon promotes the release of glucose from the
Glucagon stimulates glycogenolysis and gluconeogenesis
and inhibits glycolysis. in the liver

Glucagon Maintains the Blood

Glucose Level
- Glucagon secretion from the pancreatic cells is increased two to
three fold by hypoglycemia and reduced to half of the basal release by

- Glucagon up-regulates the blood glucose level when dietary

carbohydrate is in short supply. Its actions on glucose metabolism
pathways, are opposite to those of insulin.
- Unlike insulin, glucagon acts exclusively on the liver; it has
negligible effects on adipose tissue, muscle, and other extra-hepatic
For Glucagon think of releasing your energy stores like catecholamines

Which of the following tissues depends upon insulin

for the transport of glucose?
A. brain
B. red blood cells
C. liver
D. Muscle
E. All of the above

What transporter does it use?

What is a normal blood glucose level?

a) 55mmol/liter
b) 90mg/dL
c) 5mg/dL
d) 0.5mmol/liter

Unchecked rise in blood glucose following a

meal would result in severe dehydration, and lead
to hyperosmolar coma.

Fasted State (Liver)

In the fasting state, Glucagon levels are high.
Activation of:

F-2,6 bisphosphatase

Inhibition of:

(loss of fructose-2,6-bisphosphate)


Phosphorylase kinase

Pyruvate kinase

Glycogen phosphorylase

Glycogen synthase

Hormone-sensitive lipase

- The net result is the inhibition of glycolysis and glycogenesis and

- Activation of gluconeogenesis and glycogenolysis.

Fasted State (Liver)

- Four hours after a meal, the liver becomes a net producer of glucose.
Glucose is initially formed by glycogen breakdown, but liver glycogen
lasts for < 1 day.
- During more extended fasting, humans depend entirely on gluconeogenesis to produce ~160 g of glucose per day. At least one half
of this is consumed by the brain.
- Liver supplies glucose and ketone bodies (such as acetoacetate and
-hydroxybutyrate) during fasting.
- Liver first uses glycogen degradation and then gluconeogenesis to
maintain blood glucose levels.
- Under fasting conditions, glucagon is elevated and stimulates

Prolonged Fast / Starvation

- Major adjustment in tissue glucose utilization occurs:
- Brain and muscle adapt to use ketone bodies and fatty acids thus
decreasing the demand for hepatic gluconeogenesis.
- This spares protein; energy requirement is satisfied by fatty acid

- Red cells remain the major glucose utilizers.

The levels of glycolytic enzymes in the liver are very low, and
patients severely starved show profound carbohydrate intolerance.
Therefore, re-feeding should be started slowly.

Ethanol and Liver Metabolism

- Alcohol is metabolized in the liver by two oxidation reactions:
1 Ethanol is first converted to acetaldehyde by alcohol dehydrogenase
in the cytosol, and produces NADH (& uses up cytosolic NAD+).
(The capacity to metabolize ethanol, is thus dependent upon the ability
to shuttle NADH into mitochondria (to regenerate NAD+).

2. Acetaldehyde enters mitochondria and is subsequently oxidized to

acetate by aldehyde dehydrogenase and generates NADH. (Note:
This enzyme is inhibited by disulfiram (antabuse), a drug that has
found use in patients desiring to stop alcohol ingestion.
- Increased NADH inhibits gluconeogenesis and fatty acid oxidation.

Reversal of Glucagon action by Insulin

Inhibition of:

Activation of:

- F-2,6 bisphosphatase

- PFK2

- Phosphorylase kinase

- Pyruvate kinase

- Glycogen phosphorylase

- Glycogen synthase

- Hormone-sensitive lipase

Diabetes is caused by Insulin Deficiency or

Insulin Resistance
Type 1 diabetes (insulin-dependent): usually starts in childhood.
It is an autoimmune disease that leads to the destruction of pancreatic
cells. Without endogenous insulin production, the patients depend on
insulin injections for life. Type 1 diabetes afflicts 1 per 400 individuals.

Type 2 diabetes (insulin-resistant): was a disease of middle-aged

and older individuals. It is more common than type 1, is less severe. The
pancreatic cells are intact, and the plasma level of insulin may be
normal, reduced, or elevated. The problem may be either reduced insulin
secretion or insulin-resistance of the target tissues, or a combination of

Diabetes is caused by Insulin

Deficiency or Insulin Resistance
The complete absence of insulin in type 1 diabetes leads to:

- Diabetic ketoacidosis, with severe ketonemia, acidosis, and

blood glucose levels as high as 1000 mg/dL, in which the blood
becomes acidic due to a buildup of ketones.
- Large amounts of glucose and ketone bodies are lost in the
urine, and osmotic diuresis causes dehydration and
electrolyte imbalances. The coma is caused by dehydration,
electrolyte disturbances, and acidosis.
Major ketone bodies: acetoacetate, b-hydroxy butyrate, acetone
Know what ketonuria is

Diabetes is caused by Insulin

Deficiency or Insulin Resistance

- Patients with type 2 diabetes are not afflicted by ketoacidosis b/c they
have insulin to inhibit the breakdown of Fat to acetyl CoA, Acetyl-CoA
doesnt accumulate, so it doesnt get converted to ketones. It is
characterized by excessive glucosuria (glucose in the urine) with
osmotic diuresis (high glucose levels in the urine leads to concentrated
urine, which pulls water into the urine to dilute it) . If the patient
forgets to drink, the resulting dehydration can become sufficiently
severe to affect the central nervous system.
- The over-treatment of diabetes with insulin or oral anti-diabetic drugs
leads to hypoglycemic shock.

Diabetes leads to late complications

Urinalysis is a quick screening test for diabetes

Eighty percent of Type 2 diabetics are obese. Obesity is

the most common cause of insulin resistance.
What are Xenobiotics?
What is polydipsia?

Monooxygenase reaction catalyzed by cytochrome P-450

(CYP) to metabolize foreign chemicals.