Podcast
Questions and Answers
Which of the following is true regarding the function of cytochrome P450?
Which of the following is true regarding the function of cytochrome P450?
- It catalyzes the hydroxylation of xenobiotics. (correct)
- It is involved in oxygen storage in muscle tissues.
- It is primarily responsible for oxygen transport in blood.
- It mainly transports electrons in the cytoplasm.
What is a shared function of both hemoglobin and myoglobin?
What is a shared function of both hemoglobin and myoglobin?
- They both degrade hydrogen peroxide.
- They both catalyze the oxidation of tryptophan.
- They are both involved in the transport of carbon dioxide.
- They both bind and transport oxygen within different environments. (correct)
The effects of lead poisoning on heme synthesis can best be described as:
The effects of lead poisoning on heme synthesis can best be described as:
- Inhibition of iron incorporation into heme. (correct)
- Stimulating the production of cytochrome c.
- Enhanced production of heme.
- Increased activity of porphyrin enzymes.
Which metal ion is essential in the formation of heme porphyrin structures?
Which metal ion is essential in the formation of heme porphyrin structures?
Which of the following statements is accurate regarding the presence of heme proteins in cells?
Which of the following statements is accurate regarding the presence of heme proteins in cells?
What specific role does ALA synthase play in heme biosynthesis?
What specific role does ALA synthase play in heme biosynthesis?
Which metabolic disorder is directly associated with mutations in the gene encoding enzyme 1 of heme synthesis?
Which metabolic disorder is directly associated with mutations in the gene encoding enzyme 1 of heme synthesis?
How does lead poisoning affect the heme synthesis pathway?
How does lead poisoning affect the heme synthesis pathway?
Elevated levels of which of the following substances can be indicative of a metabolic block in heme synthesis?
Elevated levels of which of the following substances can be indicative of a metabolic block in heme synthesis?
Which of the following statements about porphyrias is true?
Which of the following statements about porphyrias is true?
What is the implication of identifying intermediates that accumulate prior to a metabolic block in heme synthesis?
What is the implication of identifying intermediates that accumulate prior to a metabolic block in heme synthesis?
Which enzyme is responsible for catalyzing the conversion of 2-aminolevulinic acid (ALA) to porphobilinogen?
Which enzyme is responsible for catalyzing the conversion of 2-aminolevulinic acid (ALA) to porphobilinogen?
Which of the following metals can significantly inhibit heme synthesis by complexing with essential thiol groups?
Which of the following metals can significantly inhibit heme synthesis by complexing with essential thiol groups?
What is the primary consequence of mutations in genes involved in heme synthesis?
What is the primary consequence of mutations in genes involved in heme synthesis?
Which substance may help patients with photosensitivity by reducing free radical production?
Which substance may help patients with photosensitivity by reducing free radical production?
In the catabolism of heme in human adults, what approximate weight of hemoglobin is turned over daily?
In the catabolism of heme in human adults, what approximate weight of hemoglobin is turned over daily?
What effect does lead poisoning have on heme synthesis?
What effect does lead poisoning have on heme synthesis?
What is the primary underlying mechanism when ALA and PBG accumulate due to heme synthesis disorders?
What is the primary underlying mechanism when ALA and PBG accumulate due to heme synthesis disorders?
How do porphyrinogens in skin relate to neurological symptoms?
How do porphyrinogens in skin relate to neurological symptoms?
What is one function of heme proteins that may be impaired due to heme synthesis disorders?
What is one function of heme proteins that may be impaired due to heme synthesis disorders?
What is the consequence of spontaneous oxidation of porphyrinogens?
What is the consequence of spontaneous oxidation of porphyrinogens?
Which of the following is not a result of heme catabolism?
Which of the following is not a result of heme catabolism?
What is the optical property associated with hematoporphyrin that is potentially useful in medical applications?
What is the optical property associated with hematoporphyrin that is potentially useful in medical applications?
What is the primary substrate for the synthesis of ALA in heme biosynthesis?
What is the primary substrate for the synthesis of ALA in heme biosynthesis?
What is the effect of phenobarbital on heme biosynthesis?
What is the effect of phenobarbital on heme biosynthesis?
What indicates intrahepatic or posthepatic obstructive jaundice in urinary analysis?
What indicates intrahepatic or posthepatic obstructive jaundice in urinary analysis?
Which enzyme is not regulated by heme levels?
Which enzyme is not regulated by heme levels?
What is the major site of expression for inherited porphyrias?
What is the major site of expression for inherited porphyrias?
Which of the following conditions is associated with the increased production of urobilinogen?
Which of the following conditions is associated with the increased production of urobilinogen?
Lead poisoning can lead to which type of porphyria?
Lead poisoning can lead to which type of porphyria?
Which symptom is commonly associated with porphyrias?
Which symptom is commonly associated with porphyrias?
What is the implication of a complete obstruction of the bile duct on bilirubin levels?
What is the implication of a complete obstruction of the bile duct on bilirubin levels?
What color change is observed in urine during hemolytic jaundice?
What color change is observed in urine during hemolytic jaundice?
What structural difference exists between heme c and heme b?
What structural difference exists between heme c and heme b?
Which of the following intermediates are essential in heme biosynthesis?
Which of the following intermediates are essential in heme biosynthesis?
In what way do porphyrins interact with metal ions?
In what way do porphyrins interact with metal ions?
Which of the following diseases may cause jaundice, resulting from elevated plasma bilirubin levels?
Which of the following diseases may cause jaundice, resulting from elevated plasma bilirubin levels?
What is a notable characteristic of vertebrate heme proteins regarding heme binding?
What is a notable characteristic of vertebrate heme proteins regarding heme binding?
What aspect of heme c synthesis distinguishes it from other heme forms?
What aspect of heme c synthesis distinguishes it from other heme forms?
What process is affected by lead poisoning that influences heme synthesis?
What process is affected by lead poisoning that influences heme synthesis?
Which statement about porphyrin ring structure is accurate?
Which statement about porphyrin ring structure is accurate?
What is a common function of heme proteins in biological systems?
What is a common function of heme proteins in biological systems?
Which of the following statements about the side chains of porphyrins is incorrect?
Which of the following statements about the side chains of porphyrins is incorrect?
What does the presence of conjugated bilirubin in urine indicate?
What does the presence of conjugated bilirubin in urine indicate?
Which enzyme is primarily responsible for the regulation of heme biosynthesis?
Which enzyme is primarily responsible for the regulation of heme biosynthesis?
What is the likely outcome in the urine of a patient with hemolytic jaundice?
What is the likely outcome in the urine of a patient with hemolytic jaundice?
How does phenobarbital influence heme biosynthesis?
How does phenobarbital influence heme biosynthesis?
Which statement is true regarding the inheritance of porphyrias?
Which statement is true regarding the inheritance of porphyrias?
What biochemical findings are markedly increased in cases of hereditary coproporphyria?
What biochemical findings are markedly increased in cases of hereditary coproporphyria?
Which enzyme deficiency is associated with variegate porphyria?
Which enzyme deficiency is associated with variegate porphyria?
Which symptom is most characteristically associated with protoporphyria?
Which symptom is most characteristically associated with protoporphyria?
What condition is characterized by elevated fecal protoporphyrin IX?
What condition is characterized by elevated fecal protoporphyrin IX?
Which of the following statements about photosensitivity in porphyrias is incorrect?
Which of the following statements about photosensitivity in porphyrias is incorrect?
What factor influences enzyme translocation between cellular compartments in porphyrias?
What factor influences enzyme translocation between cellular compartments in porphyrias?
Which of the following conditions is considered rare compared to the others in the context of porphyrias?
Which of the following conditions is considered rare compared to the others in the context of porphyrias?
Which enzyme is referred to as PBG deaminase?
Which enzyme is referred to as PBG deaminase?
Which of these porphyrias reflects a low or absent activity of enzymes in heme synthesis?
Which of these porphyrias reflects a low or absent activity of enzymes in heme synthesis?
What is the major cause of kernicterus related to bilirubin?
What is the major cause of kernicterus related to bilirubin?
Which form of bilirubin can be found in urine?
Which form of bilirubin can be found in urine?
How do intestinal bacteria affect bilirubin in the gastrointestinal tract?
How do intestinal bacteria affect bilirubin in the gastrointestinal tract?
Which form of hyperbilirubinemia is associated with biliary obstruction?
Which form of hyperbilirubinemia is associated with biliary obstruction?
What primarily causes jaundice in Dubin-Johnson syndrome?
What primarily causes jaundice in Dubin-Johnson syndrome?
What role do hepatocyte proteins play in bilirubin metabolism?
What role do hepatocyte proteins play in bilirubin metabolism?
What is a characteristic feature of acholuric jaundice?
What is a characteristic feature of acholuric jaundice?
Which bilirubin type is unable to cross the blood-brain barrier?
Which bilirubin type is unable to cross the blood-brain barrier?
What is indicated by the presence of choluric jaundice?
What is indicated by the presence of choluric jaundice?
What is the primary purpose of conjugating bilirubin with glucuronic acid?
What is the primary purpose of conjugating bilirubin with glucuronic acid?
Which of the following statements best describes the role of glutathione S-transferase in bilirubin metabolism?
Which of the following statements best describes the role of glutathione S-transferase in bilirubin metabolism?
What type of drugs should be avoided in patients with porphyria?
What type of drugs should be avoided in patients with porphyria?
How does bilirubin's binding to albumin affect its disposition in the body?
How does bilirubin's binding to albumin affect its disposition in the body?
What is the effect of administering large amounts of carbohydrates in the context of porphyrias?
What is the effect of administering large amounts of carbohydrates in the context of porphyrias?
What is the consequence of bilirubin not being conjugated in the liver?
What is the consequence of bilirubin not being conjugated in the liver?
What role does the facilitated transport system play in bilirubin metabolism?
What role does the facilitated transport system play in bilirubin metabolism?
What happens to the metabolic rate of bilirubin when there are pathological conditions affecting transport?
What happens to the metabolic rate of bilirubin when there are pathological conditions affecting transport?
What is a characteristics of bilirubin that necessitates its conversion to a more polar form?
What is a characteristics of bilirubin that necessitates its conversion to a more polar form?
What is the role of cytosolic proteins in bilirubin metabolism?
What is the role of cytosolic proteins in bilirubin metabolism?
What is the role of uroporphyrinogen decarboxylase in heme biosynthesis?
What is the role of uroporphyrinogen decarboxylase in heme biosynthesis?
What structural transformation occurs when uroporphyrinogen III undergoes decarboxylation?
What structural transformation occurs when uroporphyrinogen III undergoes decarboxylation?
In what cellular compartment do the final three reactions of heme biosynthesis occur?
In what cellular compartment do the final three reactions of heme biosynthesis occur?
Why are porphyrinogens colorless, despite the presence of double bonds?
Why are porphyrinogens colorless, despite the presence of double bonds?
What happens to porphyrinogens over time, leading to the formation of colored compounds?
What happens to porphyrinogens over time, leading to the formation of colored compounds?
Which of the following correctly describes the relationship between uroporphyrinogen I and uroporphyrinogen III in heme biosynthesis?
Which of the following correctly describes the relationship between uroporphyrinogen I and uroporphyrinogen III in heme biosynthesis?
What is the chemical byproduct of the decarboxylation of uroporphyrinogen III?
What is the chemical byproduct of the decarboxylation of uroporphyrinogen III?
Match the type of heme with its main characteristic:
Match the type of heme with its main characteristic:
Match the condition with its cause regarding jaundice:
Match the condition with its cause regarding jaundice:
Match the component with its role in heme biosynthesis:
Match the component with its role in heme biosynthesis:
Match the type of porphyrin with its property:
Match the type of porphyrin with its property:
Match the heme-related protein with its characteristic:
Match the heme-related protein with its characteristic:
Match the enzyme involved in porphyrin metabolism with its associated condition:
Match the enzyme involved in porphyrin metabolism with its associated condition:
Match the laboratory test results with their corresponding major signs and symptoms:
Match the laboratory test results with their corresponding major signs and symptoms:
Match the porphyria type with its enzyme involvement:
Match the porphyria type with its enzyme involvement:
Match the metabolic disorder with its OMIM number:
Match the metabolic disorder with its OMIM number:
Match the major symptoms with their respective types of porphyria:
Match the major symptoms with their respective types of porphyria:
Flashcards
Uroporphyrinogen I synthase
Uroporphyrinogen I synthase
An enzyme that plays a role in heme synthesis, a process in which porphyrins are produced.
Porphobilinogen
Porphobilinogen
An intermediate, a molecule that is formed during a chemical process and is then processed further to create something else.
ALA dehydratase
ALA dehydratase
Enzyme catalyzing the reaction to convert 2 molecules of ALA to one molecule of porphobilinogen.
ALA
ALA
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ALA synthase
ALA synthase
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Succinyl-CoA + Glycine
Succinyl-CoA + Glycine
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Heme synthesis
Heme synthesis
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Genetic porphyrias
Genetic porphyrias
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Lead poisoning
Lead poisoning
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Porphyria
Porphyria
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Heme synthesis
Heme synthesis
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ALA and PBG accumulation
ALA and PBG accumulation
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Porphyrinogens
Porphyrinogens
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Hemoglobin Turnover
Hemoglobin Turnover
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Photosensitivity
Photosensitivity
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Mutations in heme synthesis genes
Mutations in heme synthesis genes
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Catabolism of Heme
Catabolism of Heme
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Heme c vs Heme b
Heme c vs Heme b
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Jaundice Cause
Jaundice Cause
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Porphyrins Structure
Porphyrins Structure
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Heme synthesis precursors
Heme synthesis precursors
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Heme proteins distribution
Heme proteins distribution
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Porphyrin function
Porphyrin function
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Heme protein function
Heme protein function
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Heme biosynthesis
Heme biosynthesis
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Hemoglobin
Hemoglobin
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Myoglobin
Myoglobin
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Cytochrome c
Cytochrome c
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Cytochrome P450
Cytochrome P450
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Catalase
Catalase
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Tryptophan pyrrolase
Tryptophan pyrrolase
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Heme Synthesis
Heme Synthesis
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ALAS1
ALAS1
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Urobilinogen
Urobilinogen
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Bilirubin
Bilirubin
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Obstructive Jaundice
Obstructive Jaundice
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Hemolytic Jaundice
Hemolytic Jaundice
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Porphyrias
Porphyrias
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ALAS2
ALAS2
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Increased Urine Urobilinogen
Increased Urine Urobilinogen
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Uroporphyrinogen III
Uroporphyrinogen III
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Decarboxylation
Decarboxylation
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Coproporphyrinogen III
Coproporphyrinogen III
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Uroporphyrinogen Decarboxylase
Uroporphyrinogen Decarboxylase
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Porphyrinogens
Porphyrinogens
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Methyne bridges
Methyne bridges
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Heme biosynthesis
Heme biosynthesis
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Protoporphyrinogen III
Protoporphyrinogen III
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Protoporphyrin III
Protoporphyrin III
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Coproporphyrinogen oxidase (EC 1.3.3.3)
Coproporphyrinogen oxidase (EC 1.3.3.3)
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Hereditary coproporphyria (hepatic)
Hereditary coproporphyria (hepatic)
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Protoporphyrinogen oxidase (EC 1.3.3.4)
Protoporphyrinogen oxidase (EC 1.3.3.4)
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Variegate porphyria (hepatic)
Variegate porphyria (hepatic)
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Ferrochelatase (EC 4.99.1.1)
Ferrochelatase (EC 4.99.1.1)
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Protoporphyria (erythropoietic)
Protoporphyria (erythropoietic)
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Photosensitivity
Photosensitivity
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Urinary ALA and PBG
Urinary ALA and PBG
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Increased fecal coproporphyrin III
Increased fecal coproporphyrin III
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Increased fecal protoporphyrin IX
Increased fecal protoporphyrin IX
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Increased red cell protoporphyrin IX
Increased red cell protoporphyrin IX
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Bilirubin Treatment
Bilirubin Treatment
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Bilirubin Metabolism
Bilirubin Metabolism
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Bilirubin Uptake
Bilirubin Uptake
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Bilirubin Conjugation
Bilirubin Conjugation
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Bilirubin Secretion
Bilirubin Secretion
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Conjugated Bilirubin
Conjugated Bilirubin
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Unconjugated Bilirubin
Unconjugated Bilirubin
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Jaundice
Jaundice
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Bile Duct Blockage
Bile Duct Blockage
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Hyperbilirubinemia
Hyperbilirubinemia
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Urobilinogen
Urobilinogen
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Bile
Bile
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Heme Synthesis
Heme Synthesis
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ALAS1
ALAS1
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Urobilinogen
Urobilinogen
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Bilirubin
Bilirubin
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Obstructive Jaundice
Obstructive Jaundice
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Hemolytic Jaundice
Hemolytic Jaundice
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Porphyrias
Porphyrias
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Increased Urine Urobilinogen
Increased Urine Urobilinogen
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Heme c structure
Heme c structure
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Heme b
Heme b
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Porphyrin structure
Porphyrin structure
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Porphyrin biosynthesis precursors
Porphyrin biosynthesis precursors
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Jaundice cause
Jaundice cause
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Heme protein distribution
Heme protein distribution
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Heme Synthesis Location
Heme Synthesis Location
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ALA synthase 2 deficiency
ALA synthase 2 deficiency
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ALA dehydratase deficiency
ALA dehydratase deficiency
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Acute intermittent porphyria
Acute intermittent porphyria
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Congenital erythropoietic porphyria
Congenital erythropoietic porphyria
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Porphyria cutanea tarda
Porphyria cutanea tarda
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Laboratory Tests in Porphyrias
Laboratory Tests in Porphyrias
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Study Notes
Porphyrins and Bile Pigments
- Porphyrins are cyclic compounds formed by linking four pyrrole rings through methyne bridges.
- Heme is synthesized from porphyrins and iron.
- Bile pigments and iron are products of heme degradation.
- Porphyrias are diseases arising from abnormalities in porphyrin biosynthesis.
- Jaundice is a clinical condition caused by elevated plasma bilirubin, resulting from either overproduction of bilirubin or failure of its excretion.
- Hemes are tetrapyrroles, often b or c, with varied functions like oxygen transport and storage (hemoglobin, myoglobin), and electron transport (cytochromes).
- Heme b has vinyl groups, while heme c is covalently linked to an apoprotein.
- Heme synthesis occurs in most mammalian cells, primarily in erythroid precursor cells of bone marrow (~85%) and hepatocytes.
- Heme synthesis begins with the condensation of succinyl-CoA and glycine, a pyridoxal phosphate-dependent reaction, catalyzed by mitochondrial 6-aminolevulinate synthase (ALA synthase).
- ALA dehydratase (porphobilinogen synthase, EC 4.2.1.24) condenses two molecules of ALA into porphobilinogen.
- ALA dehydratase is a zinc metalloprotein susceptible to lead inhibition.
- Hydroxymethylbilane synthase (uroporphyrinogen I synthase) condenses four molecules of porphobilinogen to form the linear tetrapyrrole hydroxymethylbilane.
- Uroporphyrinogen III synthase converts the linear hydroxymethylbilane to uroporphyrinogen III.
- Uroporphyrinogen III undergoes decarboxylation to form coproporphyrinogen III, a reaction catalyzed by uroporphyrinogen decarboxylase.
- Coproporphyrinogen III is converted to protoporphyrinogen III, and then to protoporphyrin III through mitochondrial reactions.
- Ferrochelatase (heme synthase) incorporates iron into protoporphyrin III, forming heme.
- Porphyrins and porphyrinogens are different; porphyrinogens are colorless while porphyrins are colored, due to the conjugated system in porphyrins.
- Porphyrins and their precursors are detected through spectrophotometry, measuring their absorption/fluorescence spectra.
- Porphyrias result from defects in specific enzymes in heme synthesis leading to accumulation of porphyrin precursors, causing clinical symptoms.
- Some types are acute intermittent porphyria, congenital erythropoietic porphyria.
Heme Biosynthesis
- Heme synthesis involves both cytosolic and mitochondrial reactions.
- Heme synthesis occurs in most mammalian cells except mature erythrocytes.
- ALA synthase (ALAS1) is the rate-limiting enzyme in hepatic porphyrin synthesis, regulated by heme.
Catabolism of Heme
- Heme is degraded, primarily in reticuloendothelial cells of the liver, spleen, and bone marrow.
- Heme oxygenase (EC 1.14.18.1) catalyzes the degradation of heme.
- Heme oxygenase converts heme to biliverdin and carbon monoxide (releasing iron), requiring oxygen and electrons from NADH/NADPH.
- Biliverdin reductase reduces biliverdin to bilirubin.
- Bilirubin is transported to the liver bound to serum albumin.
- Bilirubin is conjugated with glucuronide, becoming water-soluble.
- Conjugated bilirubin is secreted into bile.
- Intestinal bacteria convert conjugated bilirubin to urobilinogen.
- Urobilinogen is converted to urobilin, excreted in feces.
- Some urobilinogen is reabsorbed and returned to the liver, completing the enterohepatic cycle.
Disorders of Bilirubin Metabolism
- Neonatal physiologic jaundice: Immature hepatic system for bilirubin uptake/conjugation/secretion.
- Gilbert syndrome: Reduced bilirubin UDP-glucuronosyltransferase activity.
- Crigler-Najjar syndrome (types I and II): Absent or reduced bilirubin UDP-glucuronosyltransferase activity, resulting in severe hyperbilirubinemia and potential neurological damage.
- Obstructive jaundice: Blockage of bile ducts, causing conjugated bilirubin to accumulate in the blood, leading to characteristic symptoms and lab test results.
- Toxic hyperbilirubinemia: Toxin-induced liver dysfunction, resulting in impaired bilirubin conjugation.
Hyperbilirubinemia
- Hyperbilirubinemia (excess bilirubin in the blood) causes jaundice (yellowing of tissues).
- Hyperbilirubinemia arises from increased bilirubin production or impaired liver function.
- Unconjugated and conjugated hyperbilirubinemia have different clinical presentations due to the different pathways of excretion.
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