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Pyruvate
Dehydrogenase and
the Citric Acid Cycle
succinyl CoA
• During activity:
– high ADP and pyruvate activate the complex by inhibiting
the kinase.
– Ca2+ stimulates the phosphatase, enhancing pyruvate
dehydrogenase activity.
In Some Tissues, the Phosphatase Is
Regulated by Hormones
• In liver tissue, epinephrine binds to the α-adrenergic
receptor, causing an increase in Ca2+ concentration that
activates the phosphatase.
• In liver and adipose tissue, insulin stimulates the
phosphatase.
Pyruvate Dehydrogenase
Phosphatase Deficiency
• Individuals with pyruvate dehydrogenase phosphatase
deficiency have a pyruvate dehydrogenase complex that
is always phosphorylated (i.e., inactive).
• In these individuals, glucose is processed to lactate
rather than to acetyl CoA.
– resulting in lactic acidosis
– many tissues malfunction in the acidified environment,
including the central nervous system
Diabetic Neuropathy May Be Due to
Inhibition of the Pyruvate
Dehydrogenase Complex
• diabetic neuropathy = numbness, tingling, or pain in the
hands, arm, fingers, toes, feet, and legs
– common complication (~50% of patients) of both type 1
and type 2 diabetes
– can be treated with painkillers, but cannot be cured
– overproduction of lactic acid by cells in the dorsal root
ganglion may be a significant contributor
Diabetic Neuropathy May Be Due to
Inhibition of the Pyruvate
Dehydrogenase Complex, Continued
• hyperglycemia (high glucose concentration) = the
defining feature of diabetes
– increases PDK activity in the cells of the dorsal root
ganglion, leading to inhibition of the pyruvate
dehydrogenase complex