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    كيمياء سريرية المحاضرة 2

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    MohamedErrmali
    Enzymes play important roles in metabolism, diagnosis, and therapeutics. They catalyze biochemical reactions and their levels in blood can indicate diseases. Enzyme activity can be measured in international units and is affected by factors like substrate concentration, pH, temperature, and inhibitors. Common enzymes measured include creatine kinase and lactate dehydrogenase for heart and muscle conditions, alanine transaminase and aspartate transaminase for liver function, alkaline phosphatase for bone and liver diseases, and gamma glutamyl transferase for liver conditions.

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    كيمياء سريرية المحاضرة 2

    Uploaded by

    MohamedErrmali
    37 views19 pages
    Enzymes play important roles in metabolism, diagnosis, and therapeutics. They catalyze biochemical reactions and their levels in blood can indicate diseases. Enzyme activity can be measured in international units and is affected by factors like substrate concentration, pH, temperature, and inhibitors. Common enzymes measured include creatine kinase and lactate dehydrogenase for heart and muscle conditions, alanine transaminase and aspartate transaminase for liver function, alkaline phosphatase for bone and liver diseases, and gamma glutamyl transferase for liver conditions.

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    Enzymes play important roles in metabolism, diagnosis, and therapeutics. They catalyze biochemical reactions and their levels in blood can indicate diseases. Enzyme activity can be measured in international units and is affected by factors like substrate concentration, pH, temperature, and inhibitors. Common enzymes measured include creatine kinase and lactate dehydrogenase for heart and muscle conditions, alanine transaminase and aspartate transaminase for liver function, alkaline phosphatase for bone and liver diseases, and gamma glutamyl transferase for liver conditions.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    37 views19 pages

    كيمياء سريرية المحاضرة 2

    Uploaded by

    MohamedErrmali
    Enzymes play important roles in metabolism, diagnosis, and therapeutics. They catalyze biochemical reactions and their levels in blood can indicate diseases. Enzyme activity can be measured in international units and is affected by factors like substrate concentration, pH, temperature, and inhibitors. Common enzymes measured include creatine kinase and lactate dehydrogenase for heart and muscle conditions, alanine transaminase and aspartate transaminase for liver function, alkaline phosphatase for bone and liver diseases, and gamma glutamyl transferase for liver conditions.

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    © All Rights Reserved
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    of 19

    Medical enzymes

    * Enzymes play an important role in Metabolism,


    Diagnosis, and Therapeutics.
    * All biochemical reactions are enzyme catalyzed
    in the living organism.
    * Level of enzyme in blood are of diagnostic
    importance e.g. it is a good indicator in disease
    such as myocardial infarction.
    * Enzyme can be used therapeutically such as
    digestive enzymes.
    * Enzymes are proteins that increase the rate of
    reaction by lowering the energy of activation

    * They catalyze nearly all the chemical reactions


    taking place in the cells of the body.

    * Not altered or consumed during reaction.

    * Reusable.
    ENZYME CLASSIFICATION
    TRANSFERASE (HEXOKINASE)
    (2) OXIDOREDUCTASE (ALCOHOL
    DEHYDROGENASE)
    (3) HYDROLASE (ATPase)
    (4) LYASE (PYRUVATE DECARBOXYLASE)
    (5) LIGASE (PYRUVATE CARBOXYLASE)
    (6) ISOMERASE (MALEATE ISOMERASE)
    (7) HYDROLASE (PHOSPHOENOL PYRUVATE
    CARBOXYKINAS)
    -Active site :
    The area on the enzyme where the
    substrate or substrates attach to is
    called the active site.
    Enzymes are usually very large proteins and the
    active site is just a small region of the enzyme
    molecule.
    In the lock-and-key model of enzyme action:

    This explains enzyme specificity


    This explains the loss of activity when
    enzymes denature
    -The Induced Fit Hypothesis :
    • Some proteins can change their shape
    (conformation)
    • Substrate + enzyme, induces a change in
    the enzyme’s conformation
    Structure of enzymes
    Enzymes

    Complex or holoenzymes (protein Simple (only protein)


    part and nonprotein part – cofactor)

    Apoenzyme (protein
    part) Cofactor

    Prosthetic groups Coenzyme


    -usually small inorganic -large organic
    molecule or atom; molecule
    -usually tightly bound -loosely bound to
    to apoenzyme apoenzyme
    - Factors affecting Enzymes

    • substrate concentration
    • pH
    • temperature
    • inhibitors.
    Enzymes routinely measured
    NAME OF THE ENZYME PRESENT IN

    Aspartate Amino transferase (AST) Heart and Liver


    Or glutamate-oxaloacetate transaminase
    (SGOT)
    Alanine Amino transferase (ALT) Heart and Liver
    or glutamate-pyruvate transaminase
    (SGPT)
    Alkaline Phosphatase (ALP) Bone, intestine and other tissues
    Acid Phosphatase (ACP) Prostate
     glutamyl Transferase ( GT) Liver
    Creatine kinase (CK) Muscle Including cardiac muscle
    Lactate Dehydrogenase (LDH) Heart, liver, muscle, RBC
     Amylase Pancreas
    Measurement of enzyme activity
    • Enzyme activity is expressed in
    International unit (IU)
    It corresponds to the amount of enzymes that
    catalyzes the conversion of one micromole (mol)
    of substrate to product per minute
    CREATINE KINASE (CK)

    Creatine + ATP CK posphocreatine + ADP


    (Phosphocreatine – serves as energy reserve during muscle
    contraction)
    ▪ Creatine kinase is a dimer made of 2 monomers
    occurs in the tissues
    ▪ Skeletal muscle contains M subunit, Brain contains
    B subunits
    ▪ Three different isoenzymes are formed
    LACTATE DEHYDROGENASE (LDH)

    Pyruvate Lactate (anaerobic glycolysis)


    ▪ LDH is elevated in myocardial infarction, blood disorders
    ▪ It is a tetrameric protein and made of two types of subunits
    namely H = Heart, M = skeletal muscle
    ▪ It exists as 5 different
    isoenzymes with various
    combinations of H and M subunits
    ALANINE TRANSAMINASE (ALT) AND ASPARTATE
    TRANSAMINASE( AST)

    - Oxoglutarate + L-aspartate - Oxoglutarate + L-alanine


    Aspartate Alanine
    aminotransferase aminotransferase
    (AST) (ALT)
    L- glutamate + oxaloacetate L - glutamate + pyruvate
     Alanine transaminase (ALT) and Aspartate transaminase (AST) enzymes are
    the most abundantly present in the liver and is elevated in blood as a result of
    leakage from damaged cells
     Measurement of these transaminases is useful for the diagnosis
    of liver diseases
     In viral hepatitis the enzyme levels are increased 20-50 times
    above the upper limit of the normal range
     Alanine transaminase (ALT) increase is specific for liver
    damage involving hepatocellular damage
     Aspartate transaminase (AST) is moderately increased in
    Muscular dystrophy and acute myocardial infarction
    ALKALINE PHOSPHATASE (ALP)

    * Is a group of enzymes that have maximal activity at a


    high pH 9.0-10.5
    * Widely distributed throughout the body
    * High levels are seen is liver, bone, placenta and
    intestine and useful to assess hepatobiliary and bone
    diseases
    CREATINE KINASE (CK)
    Creatine + ATP phosphocreatine + ADP
    (Phosphocreatine – serves as energy reserve during muscle
    contraction)
    ▪ Creatine kinase is a dimer made of 2 monomers
    occurs in the tissues
    ▪ Skeletal muscle contains M subunit, Brain contains
    B subunits
    ▪ Three different isoenzymes are formed
    AMYLASE
    - Is the digestive enzymes from the pancreas and salivary
    glands to digest complex carbohydrates.
    - Elevated in acute pancreatitis.
    - It is used as a marker to detect acute pancreatitis,
    appendicitis.
    Acid phosphatase :
    - Is a group of enzymes that have maximal activity at pH 5.0-
    6.0

    - It is present in prostate gland, liver, spleen and RBC.

    - The main source of ACP is prostate gland and so can be


    used as a marker for prostate disease.
     glutamyltransferase ( GT)
    Amino acid + Glutathione 
    ( GT)
    -glutamyl amino acid +
    Cysteinylglycine

    It is involved in amino acid transport across the membranes.


    Found mainly in biliary ducts of the liver, kidney and pancreas.
    Enzyme activity is induced by a number of drugs and in particular
    alcohol.

    -GT increased in liver diseases especially in obstructive jaundice.


    -GT levels are used as a marker of alcohol induced liver disease and in
    liver cirrhosis.

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