Essential Biochemistry for Medicine

Essential Biochemistry for Medicine......Page 5
Contents......Page 7
Preface......Page 17
1.1 Carbohydrates and sugars......Page 19
1.2 Glycogen......Page 20
1.4 Lipids......Page 21
1.5 Proteins and amino acids......Page 24
1.7 Other energy sources......Page 25
1.8 Vitamins......Page 26
1.9 Minerals......Page 29
2.1 A metabolic strategy......Page 31
2.2 Carbohydrate metabolism (catabolic)......Page 32
2.3 Glycolysis......Page 33
2.6 Brown adipose tissue and heat generation......Page 35
2.7 Glycogenolysis......Page 36
2.10 Glycogenesis......Page 38
2.11 Fatty acid catabolism......Page 40
2.12 Amino acid catabolism......Page 41
2.13 Blood glucose homeostasis......Page 42
2.15 Glucose transporters......Page 45
2.16 Diabetes mellitus......Page 46
2.17 Type 1 diabetes......Page 47
2.18 Type 2 diabetes......Page 48
2.19 Insulin/Glucagon effects on metabolism......Page 50
2.21 Glycation......Page 51
2.22 The polyol pathway......Page 53
3.2 Weight regulation......Page 55
3.4 Pre-gastric factors......Page 56
3.6 Enteric nervous system......Page 57
3.7 The central nervous system......Page 58
3.9 CNS factors......Page 59
3.10 Lifestyle changes......Page 60
3.11 The basics of dieting......Page 62
3.12 Medical and surgical treatment......Page 63
4.1 The gastrointestinal tract......Page 65
4.2 Gastric acid production......Page 66
4.3 Proton pump inhibitors......Page 68
4.4 Helicobacter pylori......Page 69
4.6 The gastrointestinal barrier......Page 70
4.7 Paneth cells......Page 71
4.8 The enteric endocrine system......Page 72
4.10 Absorption in the small intestine: general principles......Page 73
4.11 Crossing the gastrointestinal barrier......Page 75
4.12 Absorption and secretion of water and electrolytes......Page 76
4.13 Pathophysiology of diarrhoea......Page 77
4.15 Absorption of sugars and amino acids......Page 78
4.16 Absorption of amino acids and peptides......Page 80
4.18 Absorption of minerals and metals......Page 81
4.19 Malabsorption syndromes......Page 83
4.22 Glucose–galactose malabsorption......Page 88
4.25 The large intestine......Page 89
5.1 Fatty acid synthesis......Page 93
5.3 Triacylglycerols......Page 95
5.6 Intestinal uptake of lipids......Page 96
5.8 Apolipoproteins......Page 97
5.10 Role of HDL in lipid metabolism......Page 100
5.12 LDL receptors......Page 102
5.15 Pharmacologic intervention......Page 103
6.2 Storage diseases......Page 109
6.4 General liver metabolism......Page 110
6.5 Production and excretion of bile......Page 111
6.6 Pattern and control of bile secretion......Page 114
6.9 Regulating cholesterol synthesis......Page 115
6.10 Regulating sterol synthesis......Page 116
6.11 Drug metabolism......Page 117
6.13 Bilirubin......Page 120
6.15 Protein metabolism – albumin......Page 122
6.16 Protein metabolism – nitrogen metabolism and the urea cycle......Page 123
6.18 Regulation of the urea cycle......Page 127
6.20 Neurotoxicity associated with ammonia......Page 129
7.1 The alcohol dehydrogenase system......Page 131
7.4 The consequence of alcohol intake......Page 133
7.6 Long-term consequences of chronic alcohol intake......Page 134
7.8 Complications of cirrhosis......Page 136
8.3 Protein interactions......Page 139
8.5 Types of protein structure......Page 141
8.8 Protein folding......Page 142
8.9 Carbohydrates and lipid association with protein......Page 143
8.12 The study of proteins......Page 144
8.13 Defects in protein structure and function......Page 145
8.14 Glycolipid degradation......Page 146
8.16 Transformation and carcinogenesis......Page 147
9.1 Enzyme nomenclature......Page 149
9.3 Lowering the activation energy......Page 150
9.4 Reactions, rates and equilibria......Page 151
9.6 Lineweaver–burk......Page 152
9.7 Isoenzymes......Page 153
9.8 Enzyme inhibitors......Page 154
9.9 The control of enzyme activity......Page 155
9.11 Covalent modification of enzymes......Page 156
9.12 Control proteins......Page 157
9.13 Enzymes in medicine......Page 158
9.14 Biomarkers and enzymes in diagnosis......Page 160
9.15 Enzymes in the diagnosis of pathology......Page 161
9.16 Liver-function tests......Page 162
10.2 Kidney function......Page 165
10.3 Diuretics......Page 168
10.5 Aquaporins......Page 169
11.1 Blood vessel trauma......Page 171
11.4 The tissue factor (TF) pathway......Page 172
11.5 The contact activation pathway......Page 173
11.8 Co-factors in coagulation......Page 174
11.9 Regulators of coagulation......Page 175
11.10 Breaking down the clot......Page 176
11.11.2 Disorders of coagulation......Page 177
11.12 Pharmacology of haemostasis......Page 178
12.2 Osteoblasts......Page 185
12.4 Bone structure......Page 186
12.6 Collagen......Page 187
12.7 Bone disorders......Page 188
12.8 Contributing factors to bone disorders......Page 189
12.11 Endocrine regulation of [Ca2+]ECF......Page 190
12.12 Parathyroid hormone......Page 191
12.13 Vitamin D......Page 192
13.1 Hormones......Page 193
13.2 The hierarchical nature of hormonal control......Page 194
13.3 Hormone synthesis and secretion......Page 196
13.4 Hormonal control......Page 197
13.5 Types of chemical messenger......Page 199
13.7.1 Cell-surface receptors......Page 200
13.7.2 Intracellular receptors......Page 203
13.8 Second messengers......Page 205
13.10 The gastrin receptor......Page 208
14.1 The acute inflammatory response......Page 211
14.2 Leukocyte transmigration......Page 212
14.3 Chronic inflammation......Page 214
14.5 Acute-phase proteins......Page 215
14.7 Inflammatory disorders......Page 217
15.2 Innate immunity......Page 227
15.2.1 The complement system......Page 228
15.2.2 Complement deficiency......Page 229
15.4.1 The humoral immune response......Page 231
15.4.3 Antibodies......Page 232
15.4.4 The Cell-mediated immune response......Page 234
15.4.7 Major histocompatibility complex (MHC)......Page 237
15.4.8 Autoimmunity......Page 239
15.4.9 Tolerance......Page 240
15.4.10 Overcoming tolerance......Page 241
15.4.11 Treating autoimmune disease......Page 242
16.2 Non-Mendelian inheritance......Page 249
16.3 Mitochondrial cytopathies......Page 250
16.5 Mitochondria and ageing......Page 252
16.6 Diagnosis of mitochondrial myopathies......Page 253
17.2 The nerve message......Page 255
17.3 Diseases of the nervous system......Page 258
17.4 Specific neural disorders......Page 259
17.5 Muscle types......Page 264
17.6 The neuromuscular junction......Page 265
17.7 Neuromuscular disease......Page 266
17.8 Sarcomeres and focal adhesions......Page 267
17.9 Dystrophin......Page 268
17.10 Intrinsic cardiomyopathy......Page 269
17.11 Metabolic diseases of muscle......Page 270
18.2 Intermediate filaments......Page 273
18.4 Spectrin......Page 274
18.5 Alzheimer’s disease......Page 275
18.7 Synapsins......Page 276
19.2 Chromosome banding......Page 277
19.4 The spectral karyotype: fluorescence in situ hybridisation (FISH)......Page 278
19.6 Genetic disorders......Page 280
19.7 Gene testing......Page 281
19.8 The human genome project......Page 282
19.9 Gene therapy......Page 283
19.9.1 Current status......Page 284
19.10 The next step: functional genomics......Page 285
19.11 Pharmacogenomics......Page 286
19.12.1 The tools and terminology of the genetic engineer......Page 288
19.12.2 Transferring genes......Page 289
19.13 The polymerase chain reaction (PCR)......Page 290
19.15 DNA probes......Page 291
19.16 DNA sequencing......Page 292
19.18 Commercial gene products......Page 294
19.20 Controlling gene expression......Page 296
19.21 Transcription factors......Page 298
19.23 Genes and cancer: the cell cycle......Page 299
19.23.1 Checkpoints and cell-cycle regulation......Page 300
19.23.3 Genes controlling the cell cycle......Page 301
19.24 Viruses and cancer......Page 302
19.26 Caspases......Page 303
20.1 Horizontal gene transfer......Page 309
20.2 Penicillin resistance......Page 310
20.3 Sulphonamide resistance......Page 312
20.4 Bacterial efflux pumps......Page 314
20.6 Vancomycin......Page 315
20.8 Clostridium difficile......Page 316
Index......Page 317