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Principles of Medical Biochemistry

Principles of Medical Biochemistry

9780323296168
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For nearly 30 years, Principles of Medical Biochemistry has integrated medical biochemistry with molecular genetics, cell biology, and genetics to provide complete yet concise coverage that links biochemistry with clinical medicine. The 4th Edition of this award-winning text by Drs. Gerhard Meisenberg and William H. Simmons has been fully updated with new clinical examples, expanded coverage of recent changes in the field, and many new case studies online. A highly visual format helps readers retain complex information, and USMLE-style questions (in print and online) assist with exam preparation.

Product Details
Elsevier
58719
9780323296168
9780323296168

Data sheet

Publication date
2016
Issue number
4
Cover
paperback
Pages count
657
Dimensions (mm)
216 x 276
Weight (g)
1650
  • Part ONE PRINCIPLES OF MOLECULAR STRUCTURE AND FUNCTION 1
    Chapter 1 INTRODUCTION TO BIOMOLECULES
    Water Is the Solvent of Life
    Water Contains Hydronium Ions and Hydroxyl Ions
    Ionizable Groups Are Characterized by Their pK Values
    The Blood pH is Tightly Regulated
    Acidosis and Alkalosis Are Common in Clinical Practice
    Bonds Are Formed by Reactions between Functional Groups
    Isomeric Forms Are Common in Biomolecules
    Properties of Biomolecules Are Determined by Their Noncovalent
    Interactions
    Triglycerides Consist of Fatty Acids and Glycerol
    Monosaccharides Are Polyalcohols with a Keto Group or an
    Aldehyde Group
    Monosaccharides Form Ring Structures
    Complex Carbohydrates Are Formed by Glycosidic Bonds
    Polypeptides Are Formed from Amino Acids
    Nucleic Acids Are Formed from Nucleotides
    Most Biomolecules Are Polymers
    Summary
    Chapter 2 INTRODUCTION TO PROTEIN STRUCTURE
    Amino Acids Are Zwitterions
    Amino Acid Side Chains Form Many Noncovalent
    Peptide Bonds and Disulfide Bonds Form the Primary Structure of
    Proteins
    Proteins Can Fold Themselves into Many Shapes
    ?-Helix and ?-Pleated Sheet Are the Most Common Secondary
    Structures in Proteins
    Globular Proteins Have a Hydrophobic Core
    Proteins Lose Their Biological Activities When Their Higher-Order
    Structure Is Destroyed
    The Solubility of Proteins Depends on pH and Salt
    Concentration
    Proteins Absorb Ultraviolet Radiation
    Proteins Can Be Separated by Their Charge or Their Molecular
    Weight
    Abnormal Protein Aggregates Can Cause Disease
    Neurodegenerative Diseases Are Caused by Protein Aggregates
    Protein Misfolding Can Be Contagious
    Chapter 3 OXYGEN TRANSPORTERS: HEMOGLOBIN AND MYOGLOBIN
    The Heme Group Is the Oxygen-Binding Site of Hemoglobin and
    Myoglobin Is a Tightly Packed Globular Protein
    Red Blood Cells Are Specialized for Oxygen Transport
    The Hemoglobins Are Tetrameric Proteins
    Oxygenated and Deoxygenated Hemoglobin Have Different
    Quaternary Structures
    Oxygen Binding to Hemoglobin Is Cooperative
    2,3-Bisphosphoglycerate Is a Negative Allosteric Effector of
    Oxygen Binding to Hemoglobin
    Fetal Hemoglobin Has a Higher Oxygen-Binding Affinity than
    Does Adult Hemoglobin
    The Bohr Effect Facilitates Oxygen Delivery
    Most Carbon Dioxide Is Transported as Bicarbonate
    Summary 38
    Chapter 4 ENZYMATIC REACTIONS 39
    The Equilibrium Constant Describes the Equilibrium of the
    Reaction
    The Free Energy Change Is the Driving Force for Chemical
    Reactions
    The Standard Free Energy Change Determines the Equilibrium
    Enzymes Are Both Powerful and Selective
    The Substrate Must Bind to Its Enzyme before the Reaction Can
    Proceed
    Rate Constants Are Useful for Describing Reaction Rates
    Enzymes Decrease the Free Energy of Activation
    Many Enzymatic Reactions Can Be Described by Michaelis-Menten
    Kinetics
    Km and Vmax Can Be Determined Graphically
    Substrate Half-Life Can Be Determined for First-Order but Not
    Zero-Order Reactions
    Kcat/Km Predicts the Enzyme Activity at Low Substrate
    Allosteric Enzymes Do Not Conform to Michaelis-Menten
    Enzyme Activity Depends on Temperature and pH
    Different Types of Reversible Enzyme Inhibition Can Be
    Distinguished Kinetically
    Enzymes Stabilize the Transition State
    Chymotrypsin Forms a Transient Covalent Bond during
    Catalysis
    Chapter 5 COENZYMES
    Enzymes Are Classified According to Their Reaction Type
    Adenosine Triphosphate Has Two Energy-Rich Bonds
    ATP Is the Phosphate Donor in Phosphorylation Reactions
    ATP Hydrolysis Drives Endergonic Reactions
    Cells Always Try to Maintain a High Energy Charge
    Dehydrogenase Reactions Require Specialized Coenzymes
    Coenzyme A Activates Organic Acids
    S-Adenosyl Methionine Donates Methyl Groups
    Many Enzymes Require a Metal Ion

    Part TWOGENETIC INFORMATION: DNA, RNA, AND PROTEIN SYNTHESIS
    Chapter 6 DNA, RNA, AND PROTEIN SYNTHESIS
    All Living Organisms Use DNA as Their Genetic Databank
    DNA Contains Four Bases
    DNA Forms a Double Helix
    DNA Can Be Denatured
    DNA Is Supercoiled
    DNA Replication Is Semiconservative
    DNA Is Synthesized by DNA Polymerases
    DNA Polymerases Have Exonuclease Activities
    Unwinding Proteins Present a Single-Stranded Template to the
    DNA Polymerases
    One of the New DNA Strands Is Synthesized Discontinuously
    RNA Plays Key Roles in Gene Expression
    The ? Subunit Recognizes Promoters
    DNA Is Faithfully Copied into RNA
    Some RNAs Are Chemically Modified after Transcription
    The Genetic Code Defines the Structural Relationship between mRNA and Polypeptide
    Transfer RNA Is the Adapter Molecule in Protein Synthesis
    Amino Acids Are Activated by an Ester Bond with the 3 Terminus
    of the tRNA
    Many Transfer RNAs Recognize More than One Codon
    Ribosomes Are the Workbenches for Protein Synthesis
    The Initiation Complex Brings Together Ribosome, Messenger
    RNA, and Initiator tRNA
    Polypeptides Grow Stepwise from the Amino Terminus to the
    Carboxyl Terminus
    Protein Synthesis Is Energetically Expensive
    Gene Expression Is Tightly Regulated
    A Repressor Protein Regulates Transcription of the lac Operon
    in E. coli
    Anabolic Operons Are Repressed by the End Product of the
    Pathway
    Glucose Regulates the Transcription of Many Catabolic
    Operons
    Transcriptional Regulation Depends on DNA-Binding
    Chapter 7
    THE HUMAN GENOME
    Chromatin Consists of DNA and Histones
    The Nucleosome Is the Structural Unit of Chromatin
    Covalent Histone Modifications Regulate DNA Replication and
    Transcription
    DNA Methylation Silences Genes
    All Eukaryotic Chromosomes Have a Centromere, Telomeres, and
    Replication Origins
    Telomerase Is Required (but Not Sufficient) for Immortality
    Eukaryotic DNA Replication Requires Three DNA
    Polymerases
    Most Human DNA Does Not Code for Proteins
    Gene Families Originate by Gene Duplication
    The Genome Contains Many Tandem Repeats
    Some DNA Sequences Are Copies of Functional RNAs
    Many Repetitive DNA Sequences Are (or Were) Mobile
    L1 Elements Encode a Reverse Transcriptase
    Alu Sequences Spread with the Help of L1 Reverse
    Transcriptase
    Mobile Elements Are Dangerous
    Humans Have Approximately 20,000 Genes
    Transcriptional Initiation Requires General Transcription
    Factors
    Genes Are Surrounded by Regulatory Sites
    Gene Expression Is Regulated by DNA-Binding Proteins
    Long Non-coding RNAs Play Roles in Gene Expression
    mRNA Processing Starts during Transcription
    Translational Initiation Requires Many Initiation Factors
    mRNA Processing and Translation Are Often Regulated
    Small RNA Molecules Inhibit Gene Expression
    Mitochondria Have Their Own DNA
    Human Genomes Are Very Diverse
    Human Genomes Have Many Low-Frequency Copy Number
    Variations
    Chapter 8 PROTEIN TARGETING AND PROTEOSTASIS
    A Signal Sequence Directs Polypeptides to the Endoplasmic
    Reticulum
    Glycoproteins Are Processed in the Secretory Pathway
    The Endocytic Pathway Brings Proteins into the Cell
    Lysosomes Are Organelles of Intracellular Digestion
    Autophagy Recycles Cellular Proteins and Organelles
    Poorly Folded Proteins Are Either Repaired or Destroyed
    Ubiquitin Markes Proteins for Destruction
    The Proteostatic System Protects Cells from Abnormal Proteins
    Chapter 9 INTRODUCTION TO GENETIC DISEASES
    Four Types of Genetic Disease
    Mutations Occur in the Germline and in Somatic Cells
    Mutations Are an Important Cause of Poor Health
    Small Mutations Lead to Abnormal Proteins
    Most Mutations Are Caused by Replication Errors
    Mutations Can Be Induced by Radiation and Chemicals
    Mismatch Repair Corrects Replication Errors
    Missing Bases and Abnormal Bases Need to Be Replaced
    Nucleotide Excision Repair Removes Bulky Lesions
    Repair of DNA Double-Strand Breaks Is Difficult
    Hemoglobin Genes Form Two Gene Clusters
    Many Point Mutations in Hemoglobin Genes Are Known
    Sickle Cell Disease Is Caused by a Point Mutation in the b-Chain
    Gene
    SA Heterozygotes Are Protected from Tropical Malaria
    ?-Thalassemia Is Most Often Caused by Large Deletions
    Many Different Mutations Can Cause ?-Thalassemia
    Fetal Hemoglobin Protects from the Effects of ?-Thalassemia and
    Sickle Cell Disease
    Chapter 10 VIRUSES
    Viruses Can Replicate Only in a Host Cell
    Bacteriophage T4 Destroys Its Host Cell
    DNA Viruses Substitute Their Own DNA for the Host Cell
    DNA
    ? Phage Can Integrate Its DNA into the Host Cell
    Chromosome
    RNA Viruses Require an RNA-Dependent RNA Polymerase
    Retroviruses Replicate Through a DNA Intermediate
    Plasmids Are Small Accessory Chromosomes or Symbiotic
    Viruses of Bacteria
    Bacteria Can Exchange Genes by Transformation and
    Transduction
    Jumping Genes Can Change Their Position in the Genome
    Chapter 11 DNA TECHNOLOGY
    Restriction Endonucleases Cut Large DNA Molecules into Smaller
    Fragments
    Large Probes Are Used to Detect Copy Number Variations
    Small Probes Are Used to Detect Point Mutations
    Southern Blotting Determines the Size of Restriction
    DNA Can Be Amplified with the Polymerase Chain Reaction
    PCR Is Used for Preimplantation Genetic Diagnosis
    Allelic Heterogeneity Is the Greatest Challenge for Molecular
    Genetic Diagnosis
    Normal Polymorphisms Are Used as Genetic Markers
    Tandem Repeats Are Used for DNA Fingerprinting
    DNA Microarrays Can Be Used for Genetic Screening
    DNA Microarrays Are Used for the Study of Gene Expression
    DNA Is Sequenced by Controlled Chain Termination
    Massively Parallel Sequencing Permits Cost-Efficient
    Whole-Genome Genetic Diagnosis
    Gene Therapy Targets Somatic Cells
    Viruses Are Used as Vectors for Gene Therapy
    Retroviruses Can Splice a Transgene into the Cell’s Genome
    Genome Editing Is Based on the Making and Healing of DNA Double Strand Breaks
    Designer Nucleases Are Used for Genome Editing
    Antisense Oligonucleotides Can Block the Expression of Rogue
    Genes
    Genes Can Be Altered in Animals
    Tissue-Specific Gene Expression Can Be Engineered into
    Animals
    Human Germline Genome Editing is Technically Possible

    Part THREE CELL AND TISSUE STRUCTURE
    Chapter 12 BIOLOGICAL MEMBRANES
    Membranes Consist of Lipid and Protein
    Phosphoglycerides Are the Most Abundant Membrane Lipids
    Most Sphingolipids Are Glycolipids
    Cholesterol Is the Most Hydrophobic Membrane Lipid
    Membrane Lipids Form a Bilayer
    The Lipid Bilayer Is a Two-Dimensional Fluid
    The Lipid Bilayer Is a Diffusion Barrier
    Membranes Contain Integral and Peripheral Membrane
    Membranes Are Asymmetrical
    Membranes Are Fragile
    Membrane Proteins Carry Solutes across the Lipid Bilayer
    Transport against an Electrochemical Gradient Requires Metabolic
    Energy
    Active Transport Consumes ATP
    Sodium Cotransport Brings Molecules into the Cell
    Chapter 13 THE CYTOSKELETON
    The Erythrocyte Membrane Is Reinforced by a Spectrin
    Network
    Keratins Give Strength to Epithelia
    Actin Filaments Are Formed from Globular Subunits
    Striated Muscle Contains Thick and Thin Filaments
    Myosin Is a Two-Headed Molecule with ATPase Activity
    Muscle Contraction Requires Calcium and ATP
    The Cytoskeleton of Skeletal Muscle Is Linked to the Extracellular
    Matrix
    Microtubules Consist of Tubulin
    Eukaryotic Cilia and Flagella Contain a 9 + 2 Array of
    Microtubules
    Cells Form Specialized Junctions with Other Cells and with the
    Extracellular Matrix
    Chapter 14 THE EXTRACELLULAR MATRIX
    Collagen Is the Most Abundant Protein in the Human Body
    Tropocollagen Molecule Forms a Long Triple Helix
    Collagen Fibrils Are Staggered Arrays of Tropocollagen
    Molecules
    Collagen Is Subject to Extensive Posttranslational Processing
    Collagen Metabolism Is Altered in Aging and Disease
    Many Genetic Defects of Collagen Structure and Biosynthesis Are
    Known
    Elastic Fibers Contain Elastin and Fibrillin
    The Amorphous Ground Substance Contains Hyaluronic Acid
    Sulfated Glycosaminoglycans Are Covalently Bound to Core
    Cartilage Contains Large Proteoglycan Aggregates
    Proteoglycans Are Synthesized in the ER and Degraded in
    Lysosomes
    Mucopolysaccharidoses Are Caused by Deficiency of
    Glycosaminoglycan-Degrading Enzymes
    Bone Consists of Calcium Phosphates in a Collagenous
    Basement Membranes Contain Type IV Collagen, Laminin,
    and Heparan Sulfate Proteoglycans
    Fibronectin Glues Cells and Collagen Fibers Together

    Part FOUR MOLECULAR PHYSIOLOGY
    Chapter 15 EXTRACELLULAR MESSENGERS
    Steroid Hormones Are Made from Cholesterol
    Progestins Are the Biosynthetic Precursors of All Other Steroid
    Hormones
    Thyroid Hormones Are Synthesized from Protein-Bound
    Tyrosine
    T4 Becomes Activiated to T3 in the Target Tissues
    Both Hypothyroidism and Hyperthyroidism Are Common
    Disorders
    Insulin Is Released Together with the C-Peptide
    Proopiomelanocortin Forms Several Active Products
    Angiotensin Is Formed from Circulating Angiotensinogen
    Immunoassays Are Used for Determination of Hormone Levels
    Catecholamines Are Synthesized from Tyrosine
    Indolamines Are Synthesized from Tryptophan
    Histamine Is Produced by Mast Cells and Basophils
    Neurotransmitters Are Released at Synapses
    Acetylcholine Is the Neurotransmitter of the Neuromuscular
    Junction
    There Are Many Neurotransmitters
    Chapter 16 INTRACELLULAR MESSENGERS
    Receptor-Hormone Interactions Are Noncovalent, Reversible,
    and Saturable
    Many Neurotransmitter Receptors Are Ion Channels
    Steroid and Thyroid Hormones Bind to Transcription Factors
    Seven-Transmembrane Receptors Are Coupled to G Proteins
    Adenylate Cyclase Is Regulated by G Proteins
    Hormones Can Both Activate and Inhibit the cAMP Cascade
    Cytoplasmic Calcium Is an Important Intracellular Signal
    Phospholipase C Generates Two Second Messengers
    Both cAMP and Calcium Regulate Gene Transcription
    Muscle Contraction and Exocytosis Are Triggered by Calcium
    Atrial Natriuretic Factor Acts through a Membrane-Bound Guanylate Cyclase
    Nitric Oxide Stimulates a Soluble Guanylate Cyclase
    cGMP Is a Second Messenger in Retinal Rod Cells
    Receptors for Insulin and Growth Factors Are Tyrosine-Specific
    Protein Kinases
    Growth Factors and Insulin Trigger Multiple Signaling
    Cascades
    Cytokin Receptors Use the JAK-Stat Pathway
    Many Receptors Become Desensitized after Overstimulation
    Chapter 17 PLASMA PROTEINS
    Plasma Proteins Are Both Synthesized and Destroyed in the
    Liver
    Albumin Prevents Edema
    Albumin Binds Many Small Molecules
    Some Plasma Proteins Are Specialized Carriers of Small
    Deficiency of ?1-Antiprotease Causes Lung Emphysema
    Levels of Plasma Proteins Are Affected by Many Diseases
    Blood Components Are Used for Transfusions
    Blood Clotting Must Be Tightly Controlled
    Platelets Adhere to Exposed Subendothelial Tissue
    Insoluble Fibrin Is Formed from Soluble Fibrinogen
    Thrombin Is Derived from Prothrombin
    Factor X Can Be Activated by the Extrinsic and Intrinsic
    Pathways
    Negative Controls Are Necessary to Prevent Thrombosis
    Plasmin Degrades the Fibrin Clot
    Heparin and the Vitamin K Antagonists Are Used as
    Anticoagulants
    Clotting Factor Deficiencies Cause Abnormal Bleeding
    Tissue Damage Causes Release of Cellular Enzymes into
    Blood
    Serum Enzymes Are Used for the Diagnosis of Many Diseases
    Chapter 18 Defense Mechanisms
    Lipophilic Xenobiotics Are Metabolized to Water-soluble Products
    Cytochrome P-450 Is Involved in Phase I Metabolism
    Phase II Metabolism Makes Xenobiotics Water-Soluble for Excretion
    Phase III Metabolism Excretes Xenobiotic Metabolites
    Drug Metabolizing Enzymes Are Inducible
    The Innate Immune System Uses Pattern Recognitino Receptors
    Infection Triggers Inflammation
    Lymphocytes Possess Antigen Receptors
    B Lymphocytes Produce Immunoglobulins
    Antiboidies Consist of Two Light Chains and Two Heavy Chains
    Different Immunoglobulin Classes Have Different Properties
    Adaptive Immune Responses Are Based on Clonal Selection
    Immunoglobulin genes Are Rearranged During B-Cell Development
    The T-Cell Receptor Recruits Cytosolic Tyrosine Protein Kinases
    Mediatros of Inflammation Are Produced form Arachidonic Acid
    Prostaglandins Are Synthesized in All Tissues
    Prostanoids Participate in Many Physiological Processes
    Leukotrienes Are Produced by the Lipoxygenase Pathway
    Anti-Inflammatory Drugs Inhibit the Synthesis of Eicosanoids
    Chapter 19 CELLULAR GROWTH CONTROL AND CANCER
    The Cell Cycle Is Controlled at Two Checkpoints
    Cells Can Be Grown in Culture
    Cyclins Play Key Roles in Cell Cycle Control
    Retinoblastoma Protein Guards the G1 Checkpoint
    Cell Proliferation Is Triggered by Mitogens
    Mitogens Regulate Gene Expression
    Cells Can Commit Suicide
    Cancers Are Monoclonal in Origin
    Cancer Is Caused by Activation of Growth-Promoting Genes
    and Inactivation of Growth-Inhibiting Genes
    Some Retroviruses Contain an Oncogene
    Retroviruses Can Cause Cancer by Inserting Themselves Next
    to a Cellular Proto-Oncogene
    Many Oncogenes Code for Components of Mitogenic Signaling
    Cancer Susceptibility Syndromes Are Caused by Inherited
    Mutations in Tumor Suppressor Genes
    Many Tumor Suppressor Genes Are Known
    Components of the Cell Cycle Machinery Are Abnormal in Most
    Cancers
    DNA Damage Causes Either Growth Arrest or Apoptosis
    Most Spontaneous Cancers Are Defective in p53 Action
    The P13K/Protein Kinase B Pathway Is Activated in Many
    The Products of Some Viral Oncogenes Neutralize the Products
    of Cellular Tumor Suppressor Genes
    Tumors Become More Malignant through Darwinian Selection
    Intestinal Polyps Are Benign Lesions
    Intestinal Polyps Can Evolve into Colon Cancer

    Part FIVE METABOLISM
    Chapter 20 DIGESTIVE ENZYMES
    Saliva Contains ?-Amylase and Lysozyme
    Protein and Fat Digestion Start in the Stomach
    The Pancreas Is a Factory for Digestive Enzymes
    Fat Digestion Requires Bile Salts
    Some Digestive Enzymes Are Anchored to the Surface of the
    Microvilli
    Poorly Digestible Nutrients Cause Flatulence
    Many Digestive Enzymes Are Released as Inactive
    Precursors
    Chapter 21 INTRODUCTION TO METABOLIC PATHWAYS
    Alternative Substrates Can Be Oxidized in the Body Metabolic Processes Are Compartmentalized
    Free Energy Changes in Metabolic Pathways Are
    Additive
    Most Metabolic Pathways Are Regulated
    Feedback Inhibition and Feedforward Stimulation Are the Most
    Important Regulatory Principles
    Metabolism Is Regulated to Ensure Homeostasis
    Inherited Enzyme Deficiencies Cause Metabolic Diseases
    Vitamin Deficiencies, Toxins, and Endocrine Disorders Can Disrupt
    Metabolic Pathways
    Chapter 22 GLYCOLYSIS, TRICARBOXYLIC ACID CYCLE, AND OXIDATIVE PHOSPHORYLATION
    Glucose Uptake into the Cells Is Regulated
    Glucose Degradation Begins in the Cytoplasm and Ends in the
    Mitochondria
    Glycolysis Begins with ATP-Dependent Phosphorylations
    Most Glycolytic Intermediates Have Three Carbons
    Phosphofructokinase Is the Most Important Regulated Enzyme
    of Glycolysis
    Lactate Is Produced under Anaerobic Conditions
    Pyruvate Is Decarboxylated to Acetyl-CoA in the
    The TCA Cycle Produces Two Molecules of Carbon Dioxide for
    Each Acetyl Residue
    Reduced Coenzymes Are the Most Important Products of the TCA
    Cycle
    Oxidative Pathways Are Regulated by Energy Charge and
    [NADH]/[NAD+] Ratio
    TCA Cycle Provides an Important Pool of Metabolic
    Intermediates
    Antiporters Transport Metabolites across the Inner Mitochondrial
    Membrane
    The Respiratory Chain Channels Electrons fromNADH
    and FADH2 to Molecular Oxygen
    Standard Reduction Potential Is the Tendency to Donate
    Electrons
    The Respiratory Chain Contains Flavoproteins, Iron-Sulfur
    Proteins, Cytochromes, Ubiquinone, and Protein-Bound
    Copper
    The Respiratory Chain Contains Large Multiprotein
    Complexes
    The Respiratory Chain Creates a Proton Gradient
    The Proton Gradient Drives ATP Synthesis
    The Efficiency of Glucose Oxidation Is Close to 40%
    Oxidative Phosphorylation Is Limited by the Supply of
    ADP
    Brown Adipose Tissue Contains an Uncoupling Protein
    Mutations in Mitochondrial DNA Can Cause Disease
    Chapter 23 Oxygen Deficiency and Oxygen Toxicity
    Ischemia Leads to Infarction
    Oxidative Phosphorylation Is Inhibited by Many Poisons
    Hypoxia Inducible Factor Adjusts Cell Metabolism to Hypoxia
    Reactive Oxygen Derivatives Are Formed during Oxidative Metabolism
    The Respiratory Chain Is a Major Source of Superoxide
    Cells Have Specialized Enzymes to Destroy Reactive Oxygen Species
    Free Radical Formation Is Affected by Energy Supply and Energy Consumption
    Some Vitamins and Phytochemicals Can Scavange Free Radicals
    The NRF2 Transcription Factor Coordinates Defenses against Reactive Oxygen Species
    Phagocytic Cells Use Reactive Oxygen Species for Intracellular Killing
    Chapter 24 CARBOHYDRATE METABOLISM
    An Adequate Blood Glucose Level Must Be Maintained at All
    Times
    Gluconeogenesis Bypasses the Three Irreversible Reactions of
    Glycolysis
    Fatty Acids Cannot Be Converted into Glucose
    Glycolysis and Gluconeogenesis Are Regulated by Hormones
    Glycolysis and Gluconeogenesis Are Fine Tuned by Allosteric
    Effectors and Hormone-Induced Enzyme
    Phosphorylations
    Fructose-2,6-biphosphate Switches the Liver from Gluconeogenesis to Glycolysis
    Glucokinase Is Regulated by Two Regulatory Proteins
    Carbohydrate Is Stored as Glycogen
    Glycogen Is 0Synthesized from Glucose
    Glycogen Is Degraded by Phosphorolytic Cleavage
    Glycogen Metabolism Is Regulated by Hormones and
    Metabolites
    Glycogen Accumulates in Several Enzyme Deficiencies
    Fructose Is Channeled into Glycolysis/Gluconeogenesis
    Excess Fructose Is Problematic
    Excess Galactose Is Channeled into the Pathways of Glucose
    The Pentose Phosphate Pathway Supplies NADPH and
    Ribose-5-Phosphate
    Fructose Is the Principal Sugar in Seminal Fluid
    Amino Sugars and Sugar Acids Are Made from Glucose
    Chapter 25 THE METABOLISM OF FATTY ACIDS AND TRIGLYCERIDES
    Fatty Acids Differ in Their Chain Length and Number of
    Double Bonds
    Chylomicrons Transport Triglycerides from the Intestine to Other
    Tissues
    Adipose Tissue Is Specialized for the Storage of Triglycerides
    Fat Metabolism in Adipose Tissue Is under Hormonal
    Control
    Fatty Acids Are Transported into the Mitochondrion
    ?-Oxidation Produces Acetyl-CoA, NADH, and FADH2
    Special Fatty Acids Require Special Reactions
    The Liver Converts Excess Fatty Acids to Ketone Bodies
    Fatty Acids Are Synthesized from Acetyl-CoA
    Acetyl-CoA Is Shuttled into the Cytoplasm as Citrate
    Fatty Acid Synthesis Is Regulated by Hormones and
    AMP-Activated Protein Kinase Adapts Metabolic Pathways to Cellular Energy Status
    Most Fatty Acids Can Be Synthesized from Palmitate
    Fatty Acids Regulate Gene Expression
    Polyunsaturated Fatty Acids Can Be Oxidized
    Nonenzymatically
    Chapter 26 THE METABOLISM OF MEMBRANE LIPIDS
    Phosphatidic Acid Is an Intermediate in Phosphoglyceride
    Synthesis
    Phosphoglycerides Are Remodeled Continuously
    Sphingolipids Are Synthesized from Ceramide
    Deficiencies of Sphingolipid-Degrading Enzymes Cause Lipid
    Storage Diseases
    Cholesterol Is the Least Soluble Membrane Lipid
    Cholesterol Is Derived from Both Endogenous Synthesis and the
    Diet
    Cholesterol Biosynthesis Is Regulated at the Level of HMG-CoA
    Reductase
    Bile Acids Are Synthesized from Cholesterol
    Bile Acids Are Subject to Extensive Enterohepatic Circulation
    Most Gallstones Consist of Cholesterol
    Chapter 27 LIPID TRANSPORT
    Most Plasma Lipids Are Components of Lipoproteins
    Lipoproteins Have Characteristic Lipid and Protein
    Compositions
    Dietary Lipids Are Transported by Chylomicrons
    VLDL Is a Precursor of LDL
    LDL Is Removed by Receptor-Mediated Endocytosis
    Cholesterol Regulates Its Own Metabolism
    HDL Is Needed for Reverse Cholesterol Transport
    Lipoproteins Can Initiate Atherosclerosis
    Lipoproteins Respond to Diet and Lifestyle
    Hyperlipoproteinemias Are Grouped into Five Phenotypes
    Hyperlipidemias Are Treated with Diet and Drugs
    AMINO ACID METABOLISM
    Amino Acids Can Be Used for Gluconeogenesis and
    Ketogenesis
    The Nitrogen Balance Indicates the Net Rate of Protein
    The Amino Group of Amino Acids Is Released as Ammonia
    Ammonia Is Detoxified to Urea
    Urea Is Synthesized in the Urea Cycle
    Hyperammonemia Can Be Treated with Diet and Drugs
    Some Amino Acids Are Closely Related to Common Metabolic
    Glycine, Serine, and Threonine Are Glucogenic
    Proline, Arginine, Ornithine, and Histidine Are Degraded to
    Glutamate
    Methionine and Cysteine Are Metabolically Related
    Valine, Leucine, and Isoleucine Are Degraded by Transamination
    and Oxidative Decarboxylation
    Phenylalanine and Tyrosine Are Both Glucogenic and
    Ketogenic
    Melanin Is Shesized from Tyrosine
    Lysine and Tryptophan Have Lengthy Catabolic Pathways
    The Liver Is the Most Important Organ of Amino Acid
    Glutamine Participates in Renal Acid-Base Regulation
    Chapter 29 METABOLISM OF IRON AND HEME
    Iron Is Conserved Very Efficiently in the Body
    Iron Uptake by Cells Is Regulated
    Dietary Iron Is Absorbed in the Duodenum
    Dietary Iron Absorption Is Regulated
    Iron Deficiency Is the Most Common Micronutrient Deficiency Worldwide
    Bone Marrow and Liver Are the Most Important Sites of Heme
    Heme Is Synthesized from Succinyl-Coenzyme A and Glycine
    Porphyrias Are Caused by Deficiencies of Heme-Synthesizing
    Enzymes
    Heme Is Degraded to Bilirubin
    Bilirubin Is Conjugated and Excreted by the Liver
    Elevations of Serum Bilirubin Cause Jaundice
    Many Diseases Can Cause Jaundice
    Chapter 30 THE METABOLISM OF PURINES AND
    PYRIMIDINES
    Purine Synthesis Starts with Ribose-5-Phosphate
    Purines Are Degraded to Uric Acid
    Free Purine Bases Can Be Salvaged
    Pyrimidines Are Synthesized from Carbamoyl Phosphate and
    Aspartate
    DNA Synthesis Requires Deoxyribonucleotides
    Many Antineoplastic Drugs Inhibit Nucleotide Metabolism
    Uric Acid Has Limited Water Solubility
    Hyperuricemia Causes Gout
    Abnormalities of Purine-Metabolizing Enzymes Can Cause
    Gout
    Gout Can Be Treated with Drugs
    Chapter 31 MICRONUTRIENTS
    Riboflavin Is a Precursor of Flavin Mononucleotide
    and Flavin Adenine Dinucleotide
    Niacin Is a Precursor of NAD and NADP
    Thiamin Deficiency Causes Weakness and Amnesia
    Vitamin B6 Plays a Key Role in Amino Acid Metabolism
    Pantothenic Acid Is a Building Block of Coenzyme A
    Biotin Is a Coenzyme in Carboxylation Reactions
    Folic Acid Deficiency Causes Megaloblastic Anemia
    Vitamin B12 Requires Intrinsic Factor for Its Absorption
    Vitamin C Is a Water-Soluble Antioxidant
    Retinol, Retinal, and Retinoic Acid Are the Active Forms of
    Vitamin A
    Vitamin D Is a Prohormone
    Vitamin E Prevents Lipid Oxidation
    Many Vitamins and Phytochemicals Are Antioxidants
    Vitamin K Is Required for Blood Clotting
    Zinc Is a Constituent of Many Enzymes
    Copper Participates in Reactions of Molecular Oxygen
    Some Trace Elements Serve Very Specific Functions
    Chapter 32 INTEGRATION OF METABOLISM
    Insulin Is Released in Response to Elevated Glucose
    Insulin Stimulates the Utilization of Nutrients
    Protein Synthesis Is Coordinated by the mTOR Complex
    Glucagon Maintains the Blood Glucose Level
    Catecholamines Mediate the Flight-or-Fight Response
    Glucocorticoids Are Released in Chronic Stress
    Energy Is Expended Continuously
    Stored Fat and Glycogen Are Degraded between Meals
    Adipose Tissue Is the Most Important Energy Depot
    The Liver Converts Dietary Carbohydrates to Glycogen
    and Fat after a Meal
    The Liver Maintains the Blood Glucose Level during Fasting
    Ketone Bodies Provide Lipid-Based Energy during
    Fasting
    Obesity Is Common
    in All Affluent Countries
    Appetite Control Is the Most Important Determinant of Obesity
    Obesity Is Related to Insulin Resistance
    Diabetes Is Caused by Insulin Deficiency or Insulin
    Resistance
    In Diabetes, Metabolism Is Regulated as in
    Starvation
    Diabetes Is Diagnosed with Laboratory Tests
    Diabetes Leads to Late Complications
    Many Drugs Are Available for Diabetes Treatment
    Contracting Muscle Has Three Energy Sources
    Catecholamines Coordinate Metabolism during Exercise
    Physical Exercise Leads to Adaptive Changes
    Ethanol Is Metabolized to Acetyl-CoA in the Liver
    Liver Metabolism Is Deranged by Alcohol
    Alcoholism Leads to Fatty Liver and Liver Cirrhosis
    Most Diseases of Civilization Are Caused by Aberrant
    Livestyles
    Aging Is the Greatest Challenge for Medical Research
    Anti-Aging Treatments Are Being Investigated

    ANSWERS TO QUESTIONS
    GLOSSARY
    CREDITS
    EXTRA ONLINE-ONLY CASE STUDIES {more new Cases to be added, to come}
    The Mafia Boss
    Viral Gastroenteritis
    Death in Installments
    A Mysterious Death
    To Treat or Not to Treat?
    Yellow Eyes
    An Abdominal Emergency
    Shortness of Breath
    Itching
    Abdominal Pain
    Rheumatism
    A Bank Manager in Trouble
    Kidney Problems
    Gender Blender
    Man Overboard!
    Spongy Bones
    Blisters
    The Sunburned Child
    Too Much Ammonia
    ANSWERS TO CASE STUDIES
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