Heme synthesis and Breakdown

•
Heme in
present in : . Heme in
produced by combination

9 Iron with porphyrin

( al
Hemoglobin
(b)
Myoglobin ring .

(e)
Cytochrome s .
get in a derivative g porphyrin
( di Peroxidase
(e) catalase °
since an atom og
iron in
present ,

if Tryptophan pyrrolase
'
heme in a
fern proto porphyrin .

Nitric oxide
( g, synthase .

Biosynthesis g
Heme

•
site =
Almost all tissues
•

esp
- Norm oblasts ( not
by
matured
erythrocytes )
°

Imp -

steps ( as

b)
PBG
( P BG →
Uno
po
-

phninogen
) U Proto
porphyrin
c
( →
*

/ .F÷÷÷÷
-

(d) Gm corporatism
g
Fe .
Some Great
Doctors

WA Palpate
succinyl -1
Glycine Heart

Cala synthases
coa.ws:
acid ( ALA )
2x S Amino Levulinic
L Pn

znzo #[ ALA dehydratase ] -' 2n

containing ;
gnhibited
by lead .

4 x
Porphobihinogen ( PB h )
' deficiency

Hyjftwnymethglbilane
-

[ Uno porphyrin I synthase]

Acute Inter
en
-

og
-

4 Nh ,
- met tent
lumps )
4717 Porphyria

#orphyrinogen
[porphyrin
Uno
og
em III co
synthase ]
→
deficiency
A P
Y
U HI
( open -
II )
¥¥I congenital
erythnopoeihz
462$
p a

Porphyria .
Cytosol /
~
[ Uno porphyrin og en decarboxylase] Acetyl
t
M p
p
Copnoporphyninogen HI ( CpG Metlife
)mtym
→
-
HI
th NADP p p
Mitochondria
-1¥
!
p m
NADPH [ Co
porphyrin
co 292-7
pro
ogeonwda.gg -

Hereditary cop no
por
physics
Pro porphyrin ogen Mpp Pmopionye
=

HI
( PPG III ) MT TM t

Vinyl
-

TI
-

P v

#
P M
I [Proto
4h porphyrin og en oxidase] -

Deficiency
tho
Va
egate Porphyria
porphyrin II

+ Fe
"µµm[etienne synthase / Ferro chelating →
Deficiency
1
Pro top hernia

*:-

I
inhibits the

:/
.
Heme syn T
StG
.

I [ ALA synthase )
ALA

a co
synthase by acting as

v
repressor
-

GALA
also
! [ ALA dehydratase] o
ALA synthase wi

inhibited
PBG allosteric
hematin
ally by
f EUI -
Curro porphyrin og en
synthase) .

HMB

:÷÷÷÷÷i÷÷÷÷÷÷i :÷÷÷÷÷÷÷÷÷÷÷÷÷ dead

.

PHI by .

So lead toxicity
( P oxidase )
.
causes
I [ Po ] -
-

Anemia .

P
j (F) -

(ferrochelatase)
Heme
→
 Catabolism og Ilene
•

Degradation g Hemoglobin RE
g
liver ,
spleen ,
Bone marrow

•
Macnee phages
Hb
.
uptake g Bilirubin by
f- Globin -
s AA Hepatocytes
Heme
Microsome
.

Conjugation
bile
p og

ftp.fgyne
NA " secretion into
macrophages
)
oxygenase
.

↳ co

( omen Bioliverdin
colour )

( MA "

.nl/CBilinndinRedui.aY!jM
(yellow
Bilirubin ( Unwary 're
Bilirubin )
gated
colour ) ( Toxic)

admin
( Not soluble in water )

- Bilirubin
I ;¥:} ::& :
tcnepatoyl.es )

T
.de/njOpmuntsBaeklowoBilooo-s
o-8.tt
'b}7 :{goat
'T I og Bilirubin to blood .

④ bilirubin in
by facilitated keeps
soluble's ed state Excretion Bilirubin
diffusion ) Active
Process -
g
t water soluble
① conjugated
conjugated
The
Um Bilirubin
-

bilirubin → Bile

1 ( UDP -

glucuronic transferase ) ( Rate limiting step )

( Active Process )
Bilirubin -
Mono
glucuronide ② Excretion g conjugated Bil
f ( UDP -

gluuenonyl transferase) into bile is mediated

by
Bil -

digluwronide ( water soluble )

Nontoxic )
Muelispecilic organic
[ Conjugated Bil I ( Anion Transporter (NOAH
 ③ Intestinal bacteria
dewniugak the conjugated
bit -

⑤ About ①
Urobihinogenlu
g 0134
20 't
CB →
)
Bh
is reabsorbed from
intestine and returned u

stereo bilimogen
blood
to liver
by portal { ( SB h )
Fences ( 250-300
* Normal plasma Bilirubin
level mgldag )
ranges from Img Id '
02 -

⑥ Some
part g UZI
•
The U B 0.2 - o -

7mg Id l t

Coni . B 01 -

0.4
mg 1dL
Kidney
Bilirubin level
butbilin ( Gives Yellow
97 > 1mg 1dL
°

( L 4mg ) colour to
}
Urine )
day )
-

Hyper bilirubin emia

Level Btw I and 2mg 1dL are indicative

y
•

Latent Jaundice .

If Bilirubin >
2mg 1dL ,
it diffuses into tissues ,

producing yellow colour in sclera conjunctiva

, ,
skin and
in Jaundice
mucus memb
resulting .

of V

W t

② Med Notes (med notes .in)

* Revision Notes med notes site
company
-
. .

[ App Available ]