Sugar Utilization

A) There are basically 4 disaccharides we are concerned about
    1) Maltose
     a) Cleaved by maltase into 2 glucose
     b) glucose enters glycolysis directly

    2) trehalose
     a) Cleaved by trehalase into 2 glucose
     b) glucose enters glycolysis directly

    3) Sucrose
     a) Cleaved by sucrase into fructose and glucose
     b) glucose enters glycolysis directly
     c) fructose must undergo distinct metabolic modification for utilization in glycolysis

    4) lactose
     a) cleaved by lactase into galactose and glucose
     b) glucose enters glycolysis directly
     c) galactose must undergo distinct metabolic modification for utilization in glycolysis
     d) lactase defficiency is the most common defect in disaccharide metabolism
     d1) 10% of public is affected to some degree
     d2) lactase is in the brush border of the small intestine
     d3) undigested lactose has an osmotic effect causing cramps and diarhea
     d4) undigested lactose is utilized by bacteria to generate methane, CO2 and H2

B) Fructose metabolism
    1) Fructose has a non insulin depedent uptake by cells. This uncontrolled utilization can lead to increased glycolytic activity: lactate acidosis.
    2) Hexokinase: works on fructose trapping it in the cell

Fructose + ATP--> Fructose 6 Phosphate (F6P) + ADP

     a) This is the same hexokinase discussed in glycolysis
     b) F6P generated in this way enters glycolysis directly at F6P
     c) However, hexokinase has a very low affinity for fructose (high Km) so this is not the major mechanism of fructose utilization.

    3) Fructokinase: traps fructose in the cell.

Fructose + ATP --> Fructose 1 phosphate (F1P) + ADP

    4) F1P Aldolase: cleaves 6C sugar into 2 3C sugars

F1P ---> DHAP + glyceraldehyde

     a) DHAP is the dihydroxy acetone phosphate generated in glycolysis. It can enter glycolysis directly at thatstep and is converted to glyceraldehyde 3 phosphate.

    5) triose kinase: converts glyceraldehyde to a usable form

glyceraldehyde + ATP --> Glyceraldehyde 3 phosphate (G3P) + ADP

     a) G3P enters glycolysis directly at that step.

    6) Since 1 ATP was used at fructose kinase and one was used at triose kinase, there is a net utilization of 2ATP per 6C sugar identical to Glucose.

C) Galactose Metabolism

    1) Hexokinase: traps galactose in cell

Galactose + ATP --> Galactose 1 phosphate + ADP

    2) Galactose 1P uridyl transferase (Galactose 1P UT): transfers a UDP to galactose

Galactose 1P + UDP-glucose --> UDP-Galactose + Glucose 1P

     a) UDP-glucose is the substrate for glycogen synthesis
     b) Glucose 1P is generated normally in glycogenolysis
     c) UDP-galactose can be used directly in lactose synthesis in the mammary glands
     d) mutations in Galactose 1P UT cause hereditary galactosemia: vomitting, diarrhea, liver enlargement and retardation

    3) UDP-glacatose epimerase: converts glactose to its epimer glucose

UDP Galactose --> UDP-Glucose

     a) UDP-glucose can be used in the formation of glycogen
     b) UDP-glucose can be converted to glucose 1 phosphate for conversion to glucose or utilization in glycolysis (from G6P).
     c) ATP was expended at hexokinase and another high energy bond was used in the formation of UDP-glucose used at Galactose 1P UT (UTP --> UDP) so a Net of 2 high energy bonds was used before galactose even enters glycolysis.

Pentose Phosphate Shunt
    -occurs in cytosol

A) Glucose 6 Phosphate Dehydrogenase (G6PD)

G6P + 2NADP + H2O --> ribose-5-phosphate (R5P) + CO2 + 2NADPH + 2H+

    1) G6P is generated in the first step of glycolysis
    2) R5P is required for nucleotide synthesis
    3) NADPH are the major cytosolic reducing equivalents while NADH are the major mitochodrial reducing equivalents
     a) NADP/NADPH = 0.01 in fed hepatocytes
     b) NAD/NADH = 700 in cytosol

B) NADPH is is used in numerous synthetic and maintenace functions

    1) Mixed functin oxidases (p450 mono-oxygenases)
     a) liver enzymes which use NADPH as cosubstrates for hydroxylation

RH + O2 + NADPH + H --> NADP + H20 + ROH

     b) when R is saturated (-CH2-), hydroxylation is the first step in drug detoxification
     c) -OH is then esterified to glucuronic acid or sulfate which makes the compounds soluble and easily excreted

    2) Fatty acid biosynthesis

8 Acetyl CoA + 7ATP + 14 NADPH + 6 H --->
     Palmitate (16C) + 14 NADP + 8 CoA + 7 ADP + 6 H20 + 7 Pi

    3) Hydroxylations which require molecular oxygen use NADPH

progesterone --> cortisol
progesterone --> corticosterone

     a) Pentose phosphate pathway is elevated in tissues which carry out these reactions
     a1) gonads --> testosterone
     a2) adrenal cortex --> corticoids
     a3) adipocytes --> FA biosynthesis

    4) Maintenance of reduced glutathione (GSH)
     a) GSH is used to eliminate or repair oxidative damage

GSH + Ox --> GSSG

     b) oxidized glutathione GSSG is not usable so GSH must be regenerated using NADPH

GSSG + NADPH + H --> GSH + NADP + H20

     c) GSH is critical for maintaining the integrity of RBC membrane because it repairs its continual oxidative damage. In addition GSH is required to maintain Heme iron in the ferrous state.
     d) in G6PD defficiency, NADPH is not made in RBCs, so GSSG accumulates and RBC membrane integrity falls leading to hemolytic anemia.
     d1) G6PD defficiencys are one of the most common metabolic defects in humans: 200 million affected.


C) transketolases and transaldolases allow non oxidative interconversion of sugars

C7 + C3 --> C4 + F6P
C5 + C4 --> Glyceraldehyde 3 P + F6P

    1) These pathways allow "odd" sugars to enter glycolysis
    2) Ribose 5 phosphate would be a C5 example. RBCs must use pentose phosphate shunt to maintain membrane integrity. However, they don't have a nucleus, so they don't need to synthesize nucleotides. The R5P formed can be converted to G3P and F6P (with the input of a 4C sugar) and used in glycolysis.

Glycogen Metabolism

A) Glcogen Synthesis

    1) Insulin triggers glycogen synthesis and glucagon inhibits it.
    2) Phosphoglucomutase: conversion of G6P

Glucose 6 Phosphate --> Glucose 1 Phosphate

     a) G6P is from glycolysis

    3) UDP Glucose pyrophosphorylase: UDP is attatched to G1P

G1P + UTP --> UDP-Glucose + Pi

     a) UDP-Glucose is an essential substrate leading to the formation of UDP Glucuronate which is used in numerous pathways of synthesis and detoxification.

    4) Glycogen synthase: attaches glucose monomers alpha1,4

UDP-Glucose + n residue glycogen --> n+1 residue glycogen + UDP

     a) Glycogen synthase is the regulated step in glycogen synthase.
     b) Phosphorylation of Glycogen Synthase a (active) by cAMP dependent protein Kinase forms Glycogen Synthase b (inactive). Glucagon or epinephrine trigger cAMP cascade which inhibits glycogen synthesis.
     c) Glycogen synthase b can be partially activated by elevated G6P. If it is not being used to make ATP we should store it.

    5) Branching enzymes (4,6 tansferases) form an alpha1,6 branch every 6-8 alpha 1,4 additions. Increases number of "ends" available, accelerating synthesis and breackdown.
     a) Andersens disease: a1,4 --> a1,6 branching enzyme mutation
     a1) liver and spleen affected
     a2) normal glycogen level with long outer branches
     a3) progressive cirhossis of liver, liver failure and death by 2

B) Glycogenolysis
    1) Glucagon triggers glycogenolysis
    2) Glycogen Phosphorylase: cleaves glycogen into monomers at alpha 1,4 bonds.

N+1 residue glycogen --> Glucose 1 Phosphate + n-residue glycogen

     a) Glycogen phosphorylase is the regulated step in glycogenolysis.
     b) phosphorylation of Glycogen phosphorylase b (inactive) by glycogen phosphorylase kinase forms glycogen phosphorylase a (active). Glucagon or epinephrine triggers phosphorylation leading to activation of glycogen phosphorylase.
     c) AMP can partially activate Glycogen Phosphorylase b. Low energy, make glucose.
     d) ATP is a competitive inhibitor of AMP activation. Enegy status is high, glucose must be available, don't make more.
     e) G6P is a competitive inhibitor of AMP activation. Intemediates are accumulating in glycolysis, don't feed it more glucose.
     f) Pompes Disease: lysosomal alpha 1,4 glucosidase mutation
     f1) all organs affected
     f2) increased glycogen
     f3) Cardiorespiratory failure, death before 2
     g) McArdles Disease: mutation in phosphorylase
     g1) muscle
     g2) moderately increased amount of glycogen
     g3) limited ability tdo perform excersize due to cramping
     g4) require continuous food intake
     h) Hers Disease: mutation in phosphorylase muatation
     h1) liver
     h2) similar to McArdles disease
    3) Debranching enzymes (4,4 transferase and 1,6 glucosidase) cleaves alpha 1,6 bonds.
     a) Coris disease: Amylo-1,6glucosidase mutation
     a1) muscle and liver affected
     a2) increased glycogen with short outer branches
     a3) similar to but milder than Von Gierkes disease

    4) Phosphoglucomutase

G1P --> G6P

     a) G6P can enter glycolysis directly at that step

    5) Glucose 6 Phosphatase: formation of glucose

G6P --> Glucose + Pi

     a) if glucose 6 phosphatase and glucokinase both worked in the cytosol, a futile cycle of glucose --> G6P --> glucose would be established. Therefore, the two activities are separated with glucokinase in the cytosol and G6 phosphatase in the ER.
     b) Von Gierke' disease: Glucose 6 Phosphatase mutation
     b1) liver and kidney
     b2) increased glycogen
     b3) enlarged liver, hypoglycemia, ketosis, hyperurecemia, hyperlipemia

C) Differential regulation of Glycogen synthesis and Glycogenolysis by phosphorylation.

    1) Glycogen Synthesis and Glycogenolysis have opposite effects so one is turned on when the other is turned off.
    2) The primary regulatory factors for these enzymes are glycogen synthase and glycogen phosphorylase.
     a) "a" forms of both enzymes are active and "b" forms are inactive.
     b) phosphorylated glycogen synthase is glycogen synthase b. It is off and glycogen is not ynthesized.
     c) phosphorylated glycogen phosphorylase is glycogen phosphorylase a. It is on and glycogneolysis ensues.
    3) Both glycogen synthase b and glycogen phosphorylase a are dephosphorylated by Protein Phosphotase I (PPI).
     a) dephosphorylated glycogen synthase is glycogen synthase a. It is on and glycogen is synthesized.
     c) dephosphorylated glycogen phosphorylase is glycogen phosphorylase b. It is off and glycogneolysis does not occur.
    4) Inhibitor I, inhibits PPI only when Inhibitor I is phosphorylated.
     a) cAMP Protein Kinase phosphoryates Inhibitor I.
     b) if Inhibitor I is phosphorylated, PPI is inactive so the phosphorylation status of glycogen synthase b (off) and glycogen phosphorylase a (on) is maintained.
     c) if inhibitor 1 is dephosphorylated, PPI is active and the phosphorylation of glycogen synthase and glycogen phosphorylase is eliminated. Glycogen synthase a (on) and glycogen phosphorylase b (off) are formed.

    5) Glucagon binds to its receptor:
     a) adenylate cyclase induced to produce cAMP.
     b) rising cAMP activates cAMP dependent Protein Kinase (PK)
     c) PK:
     c1) phosphorylates glycogen phosphorylase kinase turning it on.
     c2) phosphorylates glycogen synthase turning it off (b form)
     c3) phosphorylates inhibitor 1 turning it on. PPI is inhibited so phosphoryation status of cascade enzymes are maintained.
     d) glycogen phosphorylase kinase phosphorylates glycogen phosphorylase turning it on (a form).
     e) glycogen synthesis halted, glycogenolysis activated.

    6) Glucagon receptor not occupied (insulin and glucose high):
     a) adenylate cyclase does not produce cAMP.
     b) falling cAMP levels no longer activate cAMP dependent Protein Kinase (PK)
     c) low PK activity:cannot maintain inhibitor 1 phosphorylation so it turns off.
     d) PPI is no longer inhibited so it becomes active and reverses the phosphoryation status of cascade enzymes.
     d1) Protein Kinase dephosphorylated and inactivaated
     d2) glycogen phosphorylase kinase dephosphorylates turnig it off.
     c3) glycogen synthase is dephosphorylated turning it on (a form)
     d4) glycogen phosphorylase dephosphorylated turning it off (b form).
     e) glycogen synthesis begins, glycogenolysis halted.

    7) High glucose can rapidly activate glycogen synthesis and inhibit glycogenolysis even before cAMP falls.
     a) glucose binds glycogen phosphorylase a.
     b) phosphorylase a conformation altered and phosphorylated serines exposed.
     c) PPI is associated with phosphorylase a and rapidly dephosphorylates it to glycogen phosphorylase b.
     d) PPI cannot associate with phosphorylase b so it dissociates and binds glycogen synthase b.
     e) glycogen synthase b is dephosphorylated to glycogen synthase a.

    8) Muscle glycogen
     a) Ca2+ increase triggers contraction and binds to Ca*ý