Amino Acid Metabolism (Nitrogen)
Unlock all answers in this set
Unlock answersquestion
            Catabolism of amino acids - Removal of ammonia  Several methods exist:
answer
        Transamination  Oxidative deamination  Nonoxidative deamination  Hydrolytic deamination
question
            Urea Cycle is isolated to what organ and requires what of other tissues
answer
        the liver contains all the urea cycle enzymes; other tissues (extrahepatic tissue) have to come up with other mechanism to handle NH3 output from AA metabolism with later transfer of output (glutamine or alanine) to liver for urea cycle
question
            I. Transamination Action
answer
        transfer the ?-amino group from an ?-amino acid to a ?-keto acid forming a new different amino acid from the alpha-keto acid  transaminase are AA substrate specific
question
            Transamination Characteristics
answer
        a. Enzymes are transaminases  b. Freely reversible  c. Two pairs of ?-ketoacid/?-amino acid  d. In most transaminases, one of the pairs is ?-ketoglutarate/glutamate
question
            transaminases require
answer
        pyridoxal phosphate (PLP) which is derived from vitamin B6
question
            Aspartate transaminase
answer
        The other pair is oxaloacetate/aspartate  This enzyme can also work with other amino acids, but aspartate is preferred  presence in blood indicates muscle damage
question
            Alanine transaminase
answer
        The other pair is pyruvate/alanine  presence in blood indicates muscle damage
question
            if nitrogen is radiolabeled in original AA it will show up in the   if the carbon is radiolabeled in original AA it will show up in
answer
        secondary AA  pyruvate (alanine) or oxaloacetate (aspartate)
question
            All amino acids can undergo transamination with ?-ketoglutarate except
answer
        Lysine, Threonine and Proline
question
            II. Oxidative deamination is catalyzed
answer
        by glutamate dehydrogenase
question
            glutamate dehydrogenase is located in...and utilizes...
answer
        is located in the mitochondria as well as in the cytoplasm. It utilizes either NAD+ or NADP+
question
            Regulation of glutamate dehydrogenase
answer
        The enzyme is under allosteric control  GTP and ATP are allosteric inhibitors; GDP and ADP are activators
question
            Transaminases and glutamate dehydrogenase are
answer
        the most important enzymes to release amino nitrogen from amino acids in the form of ammonia for subsequent conversion into urea.
question
            Nonoxidative deamination of Serine and Threonine via
answer
        Serine dehydratase and threonine dehydratase catalyze the deamination
question
            Hydrolytic deamination: Mainly for the deamination of
answer
        glutamine and asparagine
question
            Hydrolytic deamination enzymes
answer
        glutaminase and asparaginase respectively
question
            Renal glutaminase is an important source of
answer
        ammonia for the neutralization of acidic urine.
question
            Amino acid metabolism can also be
answer
        Organ-specific
question
            Skeletal muscle is a major releaser of
answer
        alanine and glutamine into blood to be handled subsequently by the liver.
question
            Mechanism of Skeletal Muscle alanine and glutamine formation
answer
        Amino acids undergo transamination with:   ?-ketoglutarate to form glutamate, and   pyruvate to form alanine.   Ammonia released from amino acids by other mechanisms is used to convert glutamate into glutamine via glutamine synthetase.
question
            Brain releases significant amounts of
answer
        glutamine into blood
question
            Mechanism of Brain on glutamine formation
answer
        Amino acids are transaminated with ?-ketoglutarate to form glutamate.   Ammonia released from amino acid metabolism via other mechanisms is used to synthesize glutamate from ?-ketoglutarate by the reverse reaction of glutamate dehydrogenase and then to convert glutamate into glutamine via glutamine synthetase.
question
            Thus, brain synthesizes glutamate and glutamine as a means of
answer
        detoxifying ammonia.
question
            Liver takes up
answer
        glutamine released by skeletal muscle and brain and metabolizes it.
question
            Hepatic Encephalopathy
answer
        no alpha-ketoglutarate for TCA as used to get rid of NH4+ > none for TCA > less ATP > neurodegeneration (problem not due to urea)
question
            In liver, ammonia is released from glutamine by glutaminase forming
answer
        Glutamate
question
            Glutamate formed from this reaction is further metabolized by
answer
        glutamate dehydrogenase to release another molecule of ammonia
question
            Ammonia is then converted into
answer
        urea for excretion by the kidney
question
            Alanine released from skeletal muscle is also taken up by the liver and converted into
answer
        into pyruvate and glutamate by transamination
question
            This Glutamate is then broken down to
answer
        ?-ketoglutarate and ammonia
question
            Ammonia is subsequently converted into
answer
        urea
question
            Pyruvate is used for
answer
        gluconeogenesis
question
            Thus, there is an alanine-glucose cycle operating between
answer
        the skeletal muscle and liver
question
            Kidney extracts what from the blood and does what to it?
answer
        Glutamine from blood and converts it into glutamate and ammonia by glutaminase and then alpha-ketoglutarate and ammonia via glutamate DH
question
            Ammonia is then used to
answer
        excrete protons in the form of ammonium ions in urine.  This is critical for the role of kidney in the management of metabolic acidosis
question
            In metabolic acidosis, glutamine extraction by the kidney is
answer
        stimulated and the enzyme glutaminase is induced to facilitate ammonia formation in the tubular epithelial cells to promote the excretion of protons.
question
            The Urea cycle
answer
        The major mechanism of nitrogen disposal in man
question
            The Urea cycle Overal Rxn
answer
        The reaction requires four ATP equivalents.  The reaction is compartmentalized between the cytosol and the mitochondria
question
            Individual steps: In the liver
answer
        Synthesis of carbamoyl phosphate  Formation of Citrulline  Formation of argininosuccinate  Formation of arginine  Formation of urea
question
            Synthesis of carbamoyl phosphate
answer
        1) Carbamoyl phosphate synthetase I  2) Reaction is irreversible  3) Enzyme requires N-acetylglutamate (synthesized by N- acetylglutamate synthetase) for activity (mutation > urea cycle disorder)  4) Enzyme located in the mitochondria
question
            N-acetyglutamate synthesis
answer
        activated by arginine  more arginine > more N-acetyglutamate > more CPS I activity > more urea cycle
question
            Formation of Citrulline
answer
        1) Enzyme is ornithine transcarbamoylase  2) Carbamoyl group is transferred to ornithine  3) Carbamoyl phosphate has a high energy bond which drives the reaction  4) Enzyme is located in the mitochondria
question
            Formation of argininosuccinate
answer
        1) Argininosuccinate synthetase  2) Utilizes Aspartate and ATP  3) AMP and PPi are generated. The hydrolysis of PPi drives the reaction  4) Enzyme is in cytosol.  aspartate is the donor of the second amino group in urea as first comes from NH4+
question
            Formation of arginine
answer
        1) Arginonosuccinase aka arginosuccinate lyase  2) Cleaves arginonosuccinate to arginine and fumarate  3) Located in cytosol  4) Arginine can be synthesized this way  Note that fumarate is formed
question
            Future of Fumarate
answer
        fumurate released in cytosol (not mito for TCA) so cytosolic fumarase converts into malate > oxaloacetate > aspartate via aspartate transaminase to donate another amino group in a later urea cycle
question
            Formation of urea
answer
        1) Arginase  2) Cleaves arginine to urea and ornithine which is used in the cycle  3) Located in the cytosol
question
            Note how the urea cycle and the TCA cycle are connected
answer
        The fumarate formed in the urea cycle can be converted to aspartate in the TCA cycle which is then used again in the Urea cycle
question
            Ammonia toxicity
answer
        1. Urea is produced in the liver whereas ammonia is produced in most tissues.  2. Glutamine acts as a transport molecule for ammonia to the liver and kidney.  3. Loss of function of liver leads to ammonia toxicity (cirrhosis due to alcohol consumption is an example).
question
            Ammonia toxicity leads to
answer
        a. High ammonia leads to depletion of ?-ketoglutarate from the TCA cycle.  b. A decrease in ATP synthesis occurs.  C. Brain is sensitive to decreases in ATP
question
            Deficiencies of enzymes of the urea cycle, including N-acetylglutamate synthetase lead to impaired
answer
        CNS activity and high blood ammonia levels (Hyperammonemia, protein intolerance, neuropsychiatric dysfunction, and mental retardation).
question
            Patients with a total absence of any of the urea cycle enzymes do not
answer
        survive the neonatal period.
question
            The symptoms are more severe with the deficiency of
answer
        the first two enzymes of the cycle (carbamoyl phosphate synthetase I and ornithine transcarbamoylase
question
            Type II hyperammonemia
answer
        CPS II
question
            Symptoms can be improved by
answer
        putting the patients on a low protein diet  administering the ?-ketoacids of the essential amino acids  removing excess ammonia in the form of glycine by administering benzoate or in the form of glutamine by administering phenylacetate
question
            Nitrogen balance describes the
answer
        the difference between body nitrogen gains and losses
question
            premise of nitrogen balance
answer
        nitrogen equilibrium is attained when protein supply is adequate to replace nitrogen loss through the urine, stools, wounds and sweat
question
            A positive nitrogen balance is a reflection that
answer
        nitrogen intake exceeds nitrogen loss
question
            Nitrogen balance is positive in
answer
        growing children, pregnant women, adults gaining weight or recovering from illness or injury
question
            A negative nitrogen balance is a reflection that
answer
        nitrogen loss exceeds nitrogen intake
question
            Nitrogen balance is negative during
answer
        during starvation, catabolism or absence of even single non-essential amino acid.
question
            In a non-stressed patient, urinary urea nitrogen (UUN) accounts for
answer
        80-90% of total urinary nitrogen
question
            measurement of UUN
answer
        Molecular weight of urea is 60 of which 28 is from nitrogen. So UUN is calculated as urinary urea*28/60 which is approximately equal to urinary urea/2.
question
            Equation used to measure nitrogen balance is as follows:
answer
        nitrogen balance (g/day) =   nitrogen intake (g/day) - nitrogen losses (g/day);   where nitrogen intake=dietary protein (g/day)/6.25 and nitrogen losses = UUN + nonurea urinary nitrogen (2 g) + fecal nitrogen (2 g)
question
            Genetic disorders of amino acid transport
answer
        Hartnup disease and Cystinuria
question
            Hartnup disease is due to a
answer
        genetic defect in the amino acid transport system responsible for the absorption of neutral amino acids across the brush border membrane of intestinal mucosal cells and brush border membrane of renal tubular epithelial cells  "Blue Diaper Disease"
question
            This results in the increased
answer
        excretion of neutral amino acids in the urine
question
            Symptoms of the disease in developed countries are
answer
        minor--considered as a benign disorder  niacin deficiency due to decreased availability of tryptophan for endogenous synthesis of the vitamin (pellagra)   no protein malnutrition because protein digestion products are absorbed in the intestinal brush border predominantly as small peptides via PEPT1 rather than as free amino acids.
question
            Symptoms of the disease in underdeveloped countries are more severe
answer
        protein malnutrition   decreased plasma levels of Trp, Phe, and Tyr  niacin deficiency (pellagra)  involvement of central nervous system with severe neurological complications  derangement of neutransmitters such as serotonin, dopamine, and norepinephrine which are synthesized from the above - mentioned aromatic, neutral amino acids.
question
            Cystinuria is due to a genetic defect in the
answer
        amino acid transport system responsible for the absorption of basic amino acids (Lys, Arg, and ornithine) and the disulfide amino acid cystine across the brush border membrane of the intestinal mucosal cells and brush border membrane of the renal tubular epithelial cells
question
            This results in the increased
answer
        increased excretion of lysine, arginine, ornithine, and cystine in the urine.
question
            Symptoms are related to
answer
        the limited water solubility of cystine. When cystine levels go up in the kidney tubules due to the defect in the reabsorption, this amino acid crystallizes and forms kidney stones (calculi), causing kidney damage. This occurs in developed countries as well as in underdeveloped countries.   Plasma levels of cystine are normal.
question
            marasmus
answer
        Deficiency of proteins as well as energy (i.e., carbohydrate and fat) in the diet - (starvation)
question
            sx marasmus
answer
        manifested by stunted growth, loss of adipose tissue, generalized wasting of protein mass, and no edema
question
            Plasma levels of insulin are low while the plasma levels of glucagon and glucocorticoids (cortisol) are
answer
        high
question
            This enhances gluconeogenesis from
answer
        glycerol (increased lipolysis) and glucogenic amino acids (increased muscle protein breakdown) to maintain blood glucose levels to support brain
question
            Increased fatty acid mobilization from adipose tissue to the liver causes
answer
        causes increased production of ketone bodies (ketoacidosis) which can also function as substrates for energy production in the brain
question
            kwashiorkor
answer
        Deficiency of protein in the diet with adequate energy intake in the form of carboydrate and fat.
question
            Sx kwashiorkor
answer
        growth failure, edema, hypoalbuminemia, and fatty liver
question
            Plasma levels of insulin are elevated whereas plasma levels of glucagon and glucocorticoids
answer
        are low
question
            Lipolysis in the adipose tissue is
answer
        inhibited and fatty acid synthesis in liver is enhanced (fatty liver).
question
            Mobilization of amino acids from muscle is
answer
        inhibited due to elevated insulin and decreased glucocorticoids
question
            Deficiency of dietary protein results in
answer
        decreased levels of amino acids in the blood. This causes decreased protein synthesis in the liver, resulting in hypoalbuminemia
question
            hypoalbuminemia produces
answer
        edema due to osmotic water accumulation in extracellular fluid in tissues. There is decreased protein synthesis in the muscle, leading to growth failure.
question
            Biosynthesis of nonessential amino acids:  Alanine is formed from
answer
        the transamination of pyruvate  Pyruvate + Glutamate > Alanine + ?-ketoglutarate.  a. This is the reverse of the catabolism of alanine.  b. Note that alanine is also a product of tryptophan catabolism. This represents a very minor contribution to the synthesis of alanine.
question
            Aspartate is synthesized
answer
        from oxaloacetate via transamination  Oxaloacetate+Glutamate > Aspartate + ?-ketoglutarate  a. The hydrolysis of asparagine by asparaginase also generates aspartate
question
            Asparagine is synthesized from
answer
        aspartate by glutamine dependent asparagine synthetase.  Aspartate + Glutamine + ATP + H2O > Asparagine + Glutamate + AMP + PPi
question
            Cysteine is produced during
answer
        methionine degradation from Cystathionine  a. Note that the sulfur atom comes from homocysteine but the carbon skeleton comes from serine.
question
            Glutamate can be synthesized from
answer
        a number of precursors.  a. The transamination of ?-ketoglutarate.  ?-Ketoglutarate + Aspartate > Oxaloacetate + Glutamate.  b. The reversal of the glutamate dehydrogenase reaction.  ?-Ketoglutarate + NH4+ + NADPH + H+ > Glutamate + NADP+ + H2O.  c. The hydrolysis of glutamine via glutaminase  Glutamine + H2O > Glutamate + NH4+  d. Glutmate is also a product of the catabolism of proline, ornithine, and histidine
question
            Glutamine is synthesized from
answer
        Glutamine is synthesized from   1. Glutamate + ATP + NH4+ > Glutamine + ADP + Pi  a. The regulation of glutamine synthesis plays a major role in controlling nitrogen metabolism.
question
            Glycine is produced from
answer
        serine by serine transhydroxymethylase  Serine + THF > Glycine + Methylene THF + H2O  a. This reaction represents a major souce of one carbon units for transfer by tetrahydrofolate (THF)  b. Enzyme requires pyridoxal phosphate.
question
            Proline is synthesized from
answer
        glutamate by a reversal of the catabolic process
question
            Serine is synthesized from
answer
        3-phosphoglycerate (an intermediate of glycolysis)
question
            Tyrosine is synthesized from
answer
        phenylalanine by phenylalanine hydroxylase  Phenylalanine + O2 + THB > Tyrosine + DHB + H2O  a. Remember PKU is associated with a defect in this enzyme.  b. Enzyme requires tetrahydrobiopterine as a cofactor
