Enzyme assays measure the activity or concentration of specific enzymes in blood or tissue samples. Elevated or reduced levels often indicate organ dysfunction or cellular damage.

Enzyme Groups & Their Clinical Significance

The input to fatty acid synthesis is acetyl-CoA, which is carboxylated to malonyl-CoA.

The ATP-dependent carboxylation provides energy input. The CO₂ is lost later during condensation with the growing fatty acid. The spontaneous decarboxylation drives the condensation. 

 fatty acid synthesis
acetyl-CoA + 7 malonyl-CoA + 14 NADPH → palmitate + 7 CO₂ + 14 NADP⁺ + 8 CoA

ATP-dependent synthesis of malonate:
8 acetyl-CoA + 14 NADPH + 7 ATP → palmitate + 14 NADP⁺ + 8 CoA + 7 ADP + 7 P_i

Fatty acid synthesis occurs in the cytosol. Acetyl-CoA generated in the mitochondria is transported to the cytosol via a shuttle mechanism involving citrate

Thyroid Hormones

Thyroid hormones (T4 and T3) are tyrosine-based hormones produced by the follicular cells of the thyroid gland and are regulated by TSH made by the thyrotropes of the anterior pituitary gland, are primarily responsible for regulation of metabolism. Iodine is necessary for the production of T3 (triiodothyronine) and T4 (thyroxine).

A deficiency of iodine leads to decreased production of T3 and T4, enlarges  the thyroid tissue and will cause the disease known as goitre.

Thyroid hormones are transported by Thyroid-Binding Globulin

Thyroxine binding globulin (TBG), a glycoprotein binds T4 and T3 and has the capacity to bind 20 μg/dL of plasma.

Diseases

1. Hyperthyroidism (an example is Graves Disease) is the clinical syndrome caused by an excess of circulating free thyroxine, free triiodothyronine, or both. It is a common disorder that affects approximately 2% of women and 0.2% of men.

2 Hypothyroidism (an example is Hashimoto’s thyroiditis) is the case where there is a deficiency of thyroxine, triiodiothyronine, or both.

The amino acids buffer system

Amino acids contain in their molecule both an acidic (− COOH) and a basic (− NH₂) group. They can be visualized as existing in the form of a neutral zwitterion in which a hydrogen atom can pass between the carboxyl and amino groups. 

By the addition or subtraction of a hydrogen ion to or from the zwitterion, either the cation or anion form will be produced 

Thus, when OH⁻ ions are added to the solution of amino acid, they take up H⁺ from it to form water, and the anion is produced. If H⁺ ions are added, they are taken up by the zwitterion to produce the cation form. In practice, if NaOH is added, the salt H₂N - CH₂ - COONa would be formed. and the addition of HCl would result in the formation of amino acid hydrochloride.

The Hemoglobin Buffer Systems

These buffer systems are involved in buffering CO₂ inside erythrocytes. The buffering capacity of hemoglobin depends on its oxygenation and deoxygenation. Inside the erythrocytes, CO₂ combines with H₂O to form carbonic acid (H₂CO₃) under the action of carbonic anhydrase.

At the blood pH 7.4, H₂CO₃ dissociates into H⁺ and HCO₃ ⁻ and needs immediate buffering.

Positively Charged (Basic)

 Mnemonic: "His Lies Are Basic" (Histidine, Lysine, Arginine)

Negatively Charged (Acidic)

Mnemonic: "Acidic Dragons Eat" (D = Aspartate, E = Glutamate)