significance of metabolism in medicine ● hereditary enzyme defects ● diabetes, atherosclerosis,...
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Significance of metabolism in medicine
● hereditary enzyme defects
● diabetes, atherosclerosis, gout
● antimetabolites in the chemotherapy of cancers and infections
● inactivation and elimination of xenobiotics and drugs
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Catabolic and anabolic reactions
© Michael Palmer 2014
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Diversity of metabolism: pathways in plants and bacteria
© Michael Palmer 2014
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Types of foodstuffs
● carbohydrates
● protein
● fat
● nucleic acids
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Breakdown of foodstuffs: Overview
© Michael Palmer 2014
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The digestive system
© Michael Palmer 2014
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Intestinal organs: functional overview
© Michael Palmer 2014
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The portal circulation
© Michael Palmer 2014
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Liver tissue structure
© Michael Palmer 2014
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Blood flow and bile flow within the liver lobule
© Michael Palmer 2014
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The stomach: functions of gastric acid
● HCl, pH 1–2
● secreted by specialized cells in the mucous membrane (parietal cells)
● kills germs contained in food; patients with lack of gastric acid are at increased risk of intestinal infection
● denatures food proteins and makes them accessible to cleavage by proteases
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Gastric acid and pepsin in protein digestion
© Michael Palmer 2014
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Function of the exocrine pancreas
● secretion of digestive enzymes
○ amylase
○ proteases, peptidases
○ lipases
○ DNAse, RNAse
● secretion of bicarbonate to neutralize gastric acid
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Roles of bile in digestion
● Bile acids solubilize triacylglycerol and make it accessible to pancreatic lipase
● Bicarbonate contributes to the neutralization of gastric acid
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The small intestine
© Michael Palmer 2014
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Microscopic structure of the small intestine
© Michael Palmer 2014
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Amylose and amylopectin are polymers of α-D-glucose
© Michael Palmer 2014
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Amylase breaks down starch to maltose and isomaltose
© Michael Palmer 2014
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Mechanism of glucose uptake from the gut
© Michael Palmer 2014
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The large intestine
● Anaerobic milieu—99% of all bacteria in the large intestine are strict anaerobes
● Bacteria degrade non-utilized foodstuffs, reducing osmotic activity of gut content
● Mucous membrane recovers water and electrolytes
● Bacterial metabolism releases potentially toxic products (e.g. ammonia), which are taken up and inactivated by the liver
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© Michael Palmer 2014
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A more realistic metabolic map
© Michael Palmer 2014