Funding, Deals & Partnerships: BIOLOGICS & MEDICAL DEVICES; BioMed e-Series; Medicine and Life Sciences Scientific Journal – http://PharmaceuticalIntelligence.com
New Diabetes Treatment Using Smart Artificial Beta Cells
Reporter: Irina Robu, PhD
Researchers from University of North Carolina and North Carolina State University developed a patient friendly option that treats type 1 diabetes and in some cases type two diabetes by using “artificial beta cells, AβCs” to release insulin automatically into the bloodstream when glucose levels rise. These artificial beta cells mimic functions of the body’s natural glucose controllers, the insulin secreting beta cells of the pancreas. The AβCs could be subcutaneously implanted into patients, which would be replaced every few days or by a disposable skin patch. According to the principal investigator, Zhen Gu, PhD at joint UNC/NC State Department of Biomedical Engineering, they plan to optimize the procedure to develop a skin patch delivery system and test diabetes in patients.
Currently, the major problem with the insulin diabetes treatment is that they can’t be delivered efficiently in a pill and the only option is either by injection or a mechanical pump. Delivering the insulin treatments via transplants of pancreatic cells can solve that problem in some cases. Nevertheless, such cell transplants are expensive, require donor cells that are in short supply, require immune-suppressing drugs and fail due to the destruction of the transplanted cells.
Gu’s AβCs are built with a basic version of a normal cell’s two-layered lipid membrane and show a rapid receptiveness to excess glucose levels in lab dish test and diabetic mice without beta cells. The key novelty is what these cells contain insulin-stuffed vesicles. An increase in blood glucose levels leads to chemical changes in the vesicle coating, producing the vesicles to start fusing with the AβC’s outer membrane thus releasing the insulin.
↵* Present address: Department of Biological Sciences, New York City College of Technology, City University of New York, Brooklyn, NY 11201, USA, and Arthritis and Tissue Degeneration Program and David Z. Rosensweig Genomics Research Center, Hospital for Special Surgery, New York, NY 10021, USA.
A few years ago, Jihye Yun, then a graduate student at Johns Hopkins University in Baltimore, Maryland, found that colon cancer cells whose growth is driven by mutations in the gene KRAS or a less commonly mutated gene,BRAF, make unusually large amounts of a protein that transports glucose across the cell membrane. The transporter, GLUT1, supplies the cells with the high levels of glucose they need to survive. GLUT1 also transports the oxidized form of vitamin C, dehydroascorbic acid (DHA), into the cell, bad news for cancer cells, because Yun found that DHA can deplete a cell’s supply of a chemical that sops up free radicals. Because free radicals can harm a cell in various ways, the finding suggested “a vulnerability” if the cells were flooded with DHA, says Lewis Cantley at Weill Cornell Medicine in New York City, where Yun is now a postdoc.
Cantley’s lab and collaborators found that large doses of vitamin C did indeed kill cultured colon cancer cells with BRAF or KRAS mutations by raising free radical levels, which in turn inactivate an enzyme needed to metabolize glucose, depriving the cells of energy. Then they gave daily high dose injections—equivalent to a person eating 300 oranges—to mice engineered to develop KRAS-driven colon tumors. The mice developed fewer and smaller colon tumors compared with control mice.
This is the portion of the discussion in a series of articles that began with signaling and signaling pathways. There are features on the functioning of enzymes and proteins, on sequential changes in a chain reaction, and on conformational changes that we shall return to. These are critical to developing a more complete understanding of life processes. I have indicated that many of the protein-protein interactions or protein-membrane interactions and associated regulatory features have been referred to previously, but the focus of the discussion or points made were different. Even though I considered placing this after the discussion of proteins and how they play out their essential role, I needed to lay out the scope of metabolic reactions and pathways, and their complementary changes. These may not appear to be adaptive, if the circumstances and the duration is not clear. The metabolic pathways map in total is in interaction with environmental conditions – light, heat, external nutrients and minerals, and toxins – all of which give direction and strength to these reactions. I shall again take from Wikipedia, as needed, and also follow mechanisms and examples from the literature, which give insight into the developments in cell metabolism. A developing goal is to discover how views introduced by molecular biology and genomics don’t clarify functional cellular dynamics that are not related to the classical view. The work is vast.
Signaling and signaling pathways
Signaling transduction tutorial.
Carbohydrate metabolism
Lipid metabolism
Protein synthesis and degradation
Subcellular structure
Impairments in pathological states: endocrine disorders; stress hypermetabolism; cancer.
The most important carbohydrate is glucose, a simple sugar (monosaccharide) that is metabolized by nearly all known organisms. Glucose and other carbohydrates are part of a wide variety of metabolic pathways across species: plants synthesize carbohydrates from carbon dioxide and water by photosynthesis storing the absorbed energy internally, often in the form of starch or lipids. Plant components are consumed by animals and fungi, and used as fuel for cellular respiration. Oxidation of one gram of carbohydrate yields approximately 4 kcal of energy and from lipids about 9 kcal. Energy obtained from metabolism (e.g. oxidation of glucose) is usually stored temporarily within cells in the form of ATP.[1] Organisms capable of aerobic respiration metabolize glucose and oxygen to release energy with carbon dioxide and water as byproducts.
Complex carbohydrates contain three or more sugar units linked in a chain, with most containing hundreds to thousands of sugar units. They are digested by enzymes to release the simple sugars.
I shall not go into the digestion, breakdown and absorption of these sugar molecules. Carbohydrates are used for short-term fuel, and the most important is glucose. Even though they are simpler to metabolize than fats or those amino acids (components of proteins) that can be used for fuel, they do not produce as effect an energy yield measured by ATP. In animals, The concentration of glucose in the blood is linked to the pancreatic endocrine hormone, insulin.
Carbohydrates are typically stored as long polymers of glucose molecules with glycosidic bonds for structural support (e.g. chitin, cellulose) or for energy storage (e.g. glycogen, starch). However, the strong affinity of most carbohydrates for water makes storage of large quantities of carbohydrates inefficient due to the large molecular weight of the solvated water-carbohydrate complex. In most organisms, excess carbohydrates are regularly catabolised to form acetyl-CoA, which is a feed stock for the fatty acid synthesis pathway; fatty acids, triglycerides, and other lipids are commonly used for long-term energy storage. The hydrophobic character of lipids makes them a much more compact form of energy storage than hydrophilic carbohydrates. However, animals, including humans, lack the necessary enzymatic machinery and so do not synthesize glucose from lipids, though glycerol can be converted to glucose.[6]
Metabolic pathways in eukaryotes
Carbon fixation, or photosynthesis, in which CO2 is reduced to carbohydrate. [omitted]
Glycolysis – the metabolism of glucose molecules to obtain ATP and pyruvate[7] by way of first splitting a six-carbon into two three csrbon chains, which are converted to lactic acid from pyruvate in the lactic dehydrogenase reaction. The reverse conversion is by a separate unidirectional reaction back to pyruvate after moving through pyruvate dehydrogenase complex.[8]
Krebs, tricarboxylic acic, or citric acid cycle
Typically, a breakdown of one molecule of glucose by aerobic respiration (i.e. involving both glycolysis and Kreb’s cycle) is about 33-35 ATP.[1] This is categorized as:
Glycogenolysis – the breakdown of glycogen into glucose, which provides a glucose supply for glucose-dependent tissues.
Glycogenolysis in liver provides circulating glucose short term.
Glycogenolysis in muscle is obligatory for muscle contraction.
Anaerobic breakdown by glycolysis – yielding 8-10 ATP
Aerobic respiration by kreb’s cycle – yielding 25 ATP
The pentose phosphate pathway (shunt) converts hexoses into pentoses and regenerates NADPH.[9] NADPH is an essential antioxidant in cells which prevents oxidative damage and acts as precursor for production of many biomolecules.
Gluconeogenesis – de novo synthesis of glucose molecules from simple organic compounds. An example in humans is the conversion of a few amino acids in cellular protein to glucose.
Metabolic use of glucose is highly important as an energy source for muscle cells and in the brain, and red blood cells.
Glucoregulation
The hormone insulin is the primary glucose regulatory signal in animals. It mainly promotes glucose uptake by the cells, and causes liver to store excess glucose as glycogen. Its absence turns off glucose uptake, reverses electrolyte adjustments, begins glycogen breakdown and glucose release into the circulation by some cells, begins lipid release from lipid storage cells, etc. The level of circulatory glucose (known informally as “blood sugar”) is the most important signal to the insulin-producing cells. Because the level of circulatory glucose is largely determined by the intake of dietary carbohydrates, diet controls major aspects of metabolism via insulin. In humans, insulin is made by beta cells in the pancreas, fat is stored in adipose tissue cells, and glycogen is both stored and released as needed by liver cells. Regardless of insulin levels, no glucose is released to the blood from internal glycogen stores from muscle cells.
The hormone glucagon, on the other hand, opposes that of insulin, forcing the conversion of glycogen in liver cells to glucose, and then release into the blood. Muscle cells, however, lack the ability to export glucose into the blood. The release of glucagon is precipitated by low levels of blood glucose. Other hormones, notably growth hormone, cortisol, and certain catecholamines (such as epinepherine) have glucoregulatory actions similar to glucagon. These hormones are referred to as stress hormones because they are released under the influence of catabolic proinflammatory (stress) cytokines – interleukin-1 (IL1) and tumor necrosis factor α (TNFα).
Tumor necrosis factor as a mediator of shock, cachexia and inflammation. Cerami A. Blood Purif. 1993; 11(2):108-17.
Mediators of cytokine-induced insulin resistance in obesity and other inflammatory settings. Marette A. Curr Opin Clin Nutr Metab Care. 2002 Jul; 5(4):377-83.
Inflammation: the link between insulin resistance, obesity and diabetes. Dandona P, Aljada A, Bandyopadhyay A. Trends Immunol. 2004 Jan; 25(1):4-7
Cellular respiration involves breaking the bonds of glucose to produce energy in the form of ATP (adenosine triphosphate). The total energy produced during glucose metabolism is described at Energetics of Cellular Respiration. Glycolysis is the most critical phase in glucose metabolism during cellular respiration. The term “glycolysis” literally means breakdown of glucose and sugars. Biochemically, it involves the breakdown of glucose to pyruvate (or pyruvic acid) via a series of enzymes. Glycolysis does not require molecular oxygen and is hence considered anaerobic. Therefore, it is a common pathway for all living organisms.
Glycolysis is followed by
Kreb’s cycle in the stages of cellular respiration.
Glycolysis is said to occur in two phases:
The Preparatory Phase: From glucose till formation of Glyceraldehyde 3-Phosphate (GADP)
The Pay-off Phase: From Glyceraldehyde-3-Phosphate (GADP) to the final product pyruvate
.
.
The animation below gives an outline of the entire pathway of glucose metabolism by glycolysis
Note – The animation is best played in full screen. To go forward in the animation, press the Play button. To skip the whole section press the forward button. To go back press the rewind button.
The Preparatory Phase
In this stage of the cycle, ATP or energy is actually consumed and is hence also known as the investment phase of glycolysis.
Step 1, involves the conversion of glucose to glucose-6-phosphate (G6P) with the help of the enzyme hexokinase and the consumption of 1 molecule of ATP. This reaction helps keep the concentration of glucose low in the cell, allowing for more absorption of glucose into it. Additionally, G6P is not transported out of the cell as there are no G6P transporters on the cell.
Step 2 involves the rearrangement of glucose-6-phosphate to fructose-6-phosphate (F6P) with the help of the enzyme phosphohexose isomerase in a reversible manner. Fructose can directly enter the glycolysis pathway at this point. This isomerization to a keto-sugar such as fructose is essential for carbanion stabilization required for the next step.
Step 3 involves the phosphorylation of fructose-6-phosphate to fructose-1,6-biphosphate (F1,6BP) by the use of 1 molecule of ATP and the enzyme phosphofructokinase-1 (PPK1). This phosphorylation step destabilizes the molecule and helps drive the next reaction which ensures breakdown of the molecule to a 3-carbon unit.
Step 4 involves the breakdown of fructose-1,6-biphosphate (6 carbons) to two molecules of 3-carbon units i.e. glyceralde 3-phosphate (GADP) and Dihydroxyacetone phosphate (DHAP). The GADP can be interconverted to DHAP by enzyme triose phosphate isomerase.
The Pay-Off Phase
In this stage of the cycle, ATP or energy is produced either in the form of ATP alone or in the form of NADH + H+ which can be later converted to ATP via the electron transport chain (ETS). In this since energy is restored it is known as the pay-off phase of glycolysis. All steps in this phase occur with 2 molecules of the substrates each as indicated in the brackets by the name of the molecules.
Step 1, involves the dehydrogenation of glyceraldehyde-3-phosphate (GADP) to 1,3-biphophoglycerate (1,3BPG) by the use of 2 molecules of inorganic phosphate (Pi) with the production of 2 molecules of NADH + H+ in the presence of the enzyme glyceraldehyde 3-phosphate dehydrogenase.
Step 2, in this step dephosphorylation of 1,3-biphosphoglycerate (1,3BPG) to 3-phospoglycerate (3PG) produces 2 molecules of ATP by the enzyme phosphoglycerate kinase.
Step 3, involves the isomerisation of 3-phosphoglycerate (3PG) to 2-phosphoglycerate (2PG) by the enzyme phosphoglycerate mutase in a reversible manner.
Step 4 involves the enolization of 2-phosphoglycerate (2PG) to phosphoenolpyruvate (PEP) with the loss of one molecule of water in the presence of enzyme enolase.
Step 5 is the final step of the glycolysis pathway and it involves the dephosphorylation of the phosphoenolpyruvate (PEP) to pyruvate by enzyme pyruvate kinase to produce 2 more molecules of ATP.
Net Yield of Glycolysis
The preparatory phase consumes 2 ATP
The pay-off phase produces 4 ATP.
The gross yield of glycolysis is therefore
4 ATP – 2 ATP = 2 ATP
The pay-off phase also produces 2 molecules of NADH + H+ which can be further converted to a total of 5 molecules of ATP* by the electron transport chain (ETC) during oxidative phosphorylation.
Thus the net yield during glycolysis is 7 molecules of ATP.
* This is calculated assuming one NADH molecule gives 2.5 molecules of ATP during oxidative phosphorylation.
References
David L. Nelson and Michael M. Cox, Lehninger Principles of Biochemistry, 4th Ed.
Jeremy M. Berg, John L. Tymockzo and Luber Stryer, Biochemistry, 7th Ed.
Cellular respiration involves 3 stages for the breakdown of glucose – glycolysis, Kreb’s cycle and the electron transport system. The total energy produced during glucose metabolism is described at Energetics of Cellular Respiration. We have seen the glycolysis pathway with animation previously. The Kreb’s cycle is named after Adolf Krebs who studied the utilization of oxygen in a pigeon. It is also commonly known as the citric acid cycle or the tricarboxylic acid cycle. Kreb’s cycle is a very important step in the metabolic pathway as it produces about 60-70% of ATP for release of energy in the body. It directly or indirectly connects with all the other individual pathways in the body too. It takes place in the mitochondria as all the enzymes and co-enzymes required are present there.
The Kreb’s Cycle occurs in two stages:
1. Conversion of Pyruvate to Acetyl CoA
Glycolysis of 1 molecule of glucose produces 2 molecules of pyruvate. Each pyruvate in the presence of pyruvate dehydrogenase (PDH) complex in the mitochondria gets converted to acetyl CoA which in turn enters the Kreb’s cycle. This reaction is called as oxidative decarboxylation as the carboxyl group is removed from the pyruvate molecule in the form of CO2 thus yielding 2-carbon acetyl group which along with the coenzyme A forms acetyl CoA.
The pyruvate dehydrogenase complex (PDH) comprises of three enzymes – pyruvate dehydrogenase, dihydrolipoyl transacetylase and dihydrolipoyl dehydrogenase each one playing an important role in the reaction as shown below. The PDH requires the sequential action of five co-factors or co-enzymes for the combined action of dehydrogenation and decarboxylation to take place. These five are TPP (thiamine phosphate), FAD (flavin adenine dinucleotide), NAD (nicotinamide adenine dinucleotide), coenzyme A (denoted as CoA-SH at times to depict role of -SH group) and lipoamide.
Conversion of pyruvate to acetyl CoA by the pyruvate dehydrogenase complex
Conversion of pyruvate to acetyl CoA by the pyruvate dehydrogenase complex
Pyruvate reacts with the TPP (Thiamine Phosphate) bound part of pyruvate dehydrogenase and undergoes decarboxylation to give hydroxyethyl-TPP.
This hydroxyethyl-TPP in turn gets oxidised to acetyl lipoamide by the same enzyme pyruvate dehydrogenase by the transfer of two electrons. These electrons then reduce the disulfide bond of the enzyme dihydrolipoyl transacetylase with the transfer of the acetyl group as highlighted in purple.
Dihydrolipoyl transacetylase catalyses the transesterification forming acetyl CoA by transfer of acetyl group to coenzyme A.
When acetyl CoA is being formed, at the same time reduced lipoamide is getting converted to oxidised lipoamide due to enzyme dihydrolipoyl dehydrogenase by the transfer of 2 hydrogen atoms to FAD.
Dihydrolipoyl dehydrogenase transfers the reduced equivalents (2 hydrogen atoms) to FAD thus forming FADH2. FADH2 in turn transfers a hydride ion to NAD+ to form NADH+H+.
2. Acetyl CoA Enters the Kreb’s Cycle
The acetyl CoA produced from the pyruvate dehydrogenase complex enters the Kreb’s cycle.
The animation below describes the Kreb’s cycle in detail followed by the discussion. A static image of the cycle can be found next to the discussion for reference. Press the play button to progress in the animation.
Discussion
The Kreb’s Cycle or Citric Acid Cycle or Tricarboxylic Acid Cycle in a static image version of the animation.
Acetyl CoA condenses with oxaloacetate (4C) to form a citrate (6C) by transferring its acetyl group in the presence of enzyme citrate synthase. The CoA liberated in this reaction is ready to participate in the oxidative decarboxylation of another molecule of pyruvate by PDH complex.
Citrate is then isomerised to Isocitrate by the enzyme aconitase through the formation of the intermediate cis-aconitate. This is a reversible reaction as aconitase has an iron-sulfur center which can promote reversible addition of H2O to the double bond of enzyme-bound cis-aconitate in 2 different ways, one forming citrate and the other isocitrate.
Isocitrate undergoes oxidative decarboxylation by the enzyme isocitrate dehydrogenase to form oxalosuccinate (intermediate- not shown) which in turn forms α-ketoglutarate (also known as oxoglutarate) which is a five carbon compound. CO2 and NADH are released in this step.
α-ketoglutarate (5C) undergoes oxidative decarboxylation once again to form succinyl CoA (4C) catalysed by the enzyme α-ketoglutarate dehydrogenase complex. α-ketoglutarate dehydrogenase complex is similar to PDH complex and is made up of 3 enzymes and is dependent on five co-enzymes TPP, FAD, NAD, bound lipoate and conenzyme A. In this step once again NADH and CO2 are liberated. So in all 2 molecules of NADH and 2 molecules of CO2 is produced till now.
Succinyl CoA is then converted to succinate by succinate thiokinase or succinyl coA synthetase in a reversible manner. This reaction involves an intermediate step in which the enzyme gets phosphorylated and then the phosphoryl group which has a high group transfer potential is transferred to GDP to form GTP. This GTP is converted to ATP by the enzyme nucleoside diphosphate kinase by donating its phosphoryl group to ADP. This reaction which involves the formation of GTP is a substrate level phosphorylation as it happens by using the energy formed by the oxidative decarboxylation of α-ketoglutarate.
Succinate then gets oxidised reversibly to fumarate by succinate dehydrogenase. The enzyme contains iron-sulfur clusters and covalently bound FAD which when undergoes electron exchange in the mitochondria causes the production of FADH2.
Fumarate is then by the enzyme fumarase converted to malate by hydration(addition of H2O) in a reversible manner.
Malate is then reversibly converted to oxaloacetate by malate dehydrogenase which is NAD linked and thus produces NADH.
The oxaloacetate produced is now ready to be utilized in the next cycle by the citrate synthase reaction and thus the equilibrium of the cycle shifts to the right.
Schrodingers_cat
Energetics of the Kreb’s Cycle
Keeping in mind that 1 molecule of glucose would produce 2 molecules of pyruvate via glycolysis. Hence the net energy produced by the Kreb’s cycle for each molecule of pyruvate is doubled for each molecule of glucose. Thus net energy yield in Kreb’s cycle can be summarized as follows for each molecule of glucose:
Reaction Number of ATP or Number of ATP
reduced coenzyme formed ultimately formed
2 Pyruvate → 2 acetyl CoA 2 NADH 5
2 Isocitrate → 2 α- ketoglutarate 2 NADH 5
2 α- ketoglutarate → 2 succinyl CoA 2 NADH 5
2 Succinyl CoA → 2 succinate 2 ATP 2
2 Succinate → 2 fumarate 2 FADH2 3
2 Malate → 2 oxaloacetate 2 NADH 5
TOTAL 25 ATP
* Note- This is calculated as 2.5 ATP per NADH and 1.5 ATP per FADH2. This is because there are multiple electron transport shuttle pathways through which these can be broken to ATP.
Regulation of Kreb’s Cycle
The amount of ADP and ATP largely control the citric acid cycle along with the activity of three key enzymes within the cycle:
Availability of ADP: ADP is a key substrate which finally gets converted to ATP that is essential for the energetics of the cell. A drop in ADP levels would result in inhibition of the electron transport system leading to accumulation of NADH and FADH2. These in turn inhibit the enzymes below.
Citrate Synthase: inhibited by ATP, acetyl CoA, NADH, and succinyl CoA.
Isocitrate Dehydrogenase: activated by ADP, and inhibited by NADH and ATP.
α-ketoglutarate dehydrogenase: inhibited by NADH and succinyl CoA.
Recommended Texts
David L. Nelson and Michael M. Cox, Lehninger Principles of Biochemistry 6th Edition
Jeremy M. Berg, John L. Tymockzo and Luber Stryer, Biochemistry 7th Edition
Important Note: The NADH formed in the cytosol can yield variable amounts of ATP depending on the shuttle system utilized to transport them into the mitochondrial matrix. This NADH, formed in the cytosol, is impermeable to the mitochondrial inner-membrane where oxidative phosphorylation takes place. Thus to carry this NADH to the mitochondrial matrix there are special shuttle systems in the body. The most active shuttle is the malate-aspartate shuttle via which 2.5 molecules of ATP are generated for 1 NADH molecule. This shuttle is mainly used by the heart, liver and kidneys. The brain and skeletal muscles use the other shuttle known as glycerol 3-phosphate shuttle which synthesizes 1.5 molecules of ATP for 1 NADH.
Note: The above calculations are done considering that one NADH molecules produces 2.5 ATP and one FADH2 molecule produces 1.5 ATP in the ETS cycle (See full reasoning above). This is because the Kreb’s cycle occurs within the mitochondria and therefore does not require any shuttle pathway for the transport of the NADH into the mitochondrial matrix. Hence there is optimal conversion of NADH to ATP.
Development of the acetylation problem: a personal account
FRITZ LI P M A N N Nobel Prize 1953
After my apprenticeship with Otto Meyerhof, a first interest on my own became the phenomenon we call the Pasteur effect, this peculiar depression of the wasteful fermentation in the respiring cell. By looking for a chemical explanation of this economy measure on the cellular level, I was prompted into a study of the mechanism of pyruvic acid oxidation, since it is at the pyruvic stage where respiration branches off from fermentation. For this study I chose as a promising system a relatively simple looking pyruvic acid oxidation enzyme in a certain strain of Lactobacillus delbrueckii1.
The most important event during this whole period, I now feel, was the accidental observation that in the L. delbrueckii system, pyruvic acid oxidation was completely dependent on the presence of inorganic phosphate. This observation was made in the course of attempts to replace oxygen by methylene blue. To measure the methylene blue reduction manometrically,
I had to switch to a bicarbonate buffer instead of the otherwise routinely used In bicarbonate, to my surprise, as shown in Fig. 1, pyruvate oxidation was very slow, but the addition of a little phosphate caused a remarkable increase in rate. The next figure, Fig. 2, shows the phosphate effect more drastically, using a preparation from which all phosphate was removed by washing with acetate buffer. Then it appeared that the reaction was really fully dependent on phosphate.
In spite of such a phosphate dependence, the phosphate balance measured by the ordinary Fiske-Subbarow procedure did not at first indicate any phosphorylative step. Nevertheless, the suspicion remained that phosphate in some manner was entering into the reaction and that a phosphorylated intermediary was formed. As a first approximation, a coupling of this pyruvate oxidation with adenylic acid phosphorylation was attempted. And,indeed, addition of adenylic acid to the pyruvic oxidation system brought out a net disappearance of inorganic phosphate, accounted for as adenosine triphosphate (Table 11).
I now concluded that the missing link in the reaction chain was acetyl phosphate. In partial confirmation it was shown that a crude preparation of acetyl phosphate, synthesized by the old method of Kämmerer and Carius 2 would transfer phosphate to adenylic acid (Table 2). However, it still took quite some time from then on to identify acetyl phosphate definitely as the initial product of the pyruvic oxidation in this system3,4
At the time when these observations were made, about a dozen years ago,there was, to say the least, a tendency to believe that phosphorylation was rather specifically coupled with the glycolytic reaction. Here, however, we had found a coupling of phosphorylation with a respiratory system. This observation immediately suggested a rather sweeping biochemical significance, of transformations of electron transfer potential, respiratory or fermentative, to phosphate bond energy and therefrom to a wide range of biosynthetic reactions7.
There was a further unusual feature in this pyruvate oxidation system in that the product emerging from the process not only carried an energy-rich phosphoryl radical such as already known, but the acetyl phosphate was even more impressive through its energy-rich acetyl. It rather naturally became a contender for the role of “active” acetate, for the widespread existence of which the isotope experience had already furnished extensive evidence. I became, therefore, quite attracted by the possibility that acetyl phosphate could serve two rather different purposes, either to transfer its phosphoryl group into the phosphate pool, or to supply its active acetyl for biosynthesisof carbon structures. Thus acetyl phosphate should be able to serve as acetyldonor as well as phosphoryl donor, transferring, as shown in Fig. 3, on either side of the oxygen center, such as indicated by Bentley’s early experiments on cleavage7a of acetyl phosphate in H218O.
Phosphate dependence of pyruvate oxidation
These two novel aspects of the energy problem, namely
(1) the emergence of an energy-rich phosphate bond from a purely
respiratory reaction; and
(2) the presumed derivation of a metabolic building-block through this same
reaction, prompted me to propose not only
the generalization of the phosphate bond as a versatie energy distributing system, but also to
aim from there towards
a general concept of transfer of activated groupings by carrier as the fundamental reaction in
biosynthesis8,9.
Although in the related manner the appearance of acetyl phosphate as a
metabolic intermediary first
focused attention to possible mechanisms for the metabolic elaboration of group activation,
it soon turned out that the relationship between acetyl phosphate and
acetyl transfer was much more complicated than anticipated.
Although acetylation was found with rabbit liver homogenate, the
reaction was rather weak. In search of a more active system, Pigeon
liver homogenate was tried and found to harbour an exceedingly potent
acetylation system (Ref. 11, cf. also Ref. 12). This finding of a particularly
active acetylation reaction in cell-free pigeon liver preparations was most
fortunate and played a quite important part in the development of the
acetylation problem.
[portion of lecture]
The pentose phosphate pathway is the major source for the NADPH
required for anabolic processes.Pentose Phosphate Pathway
The main molecule in the body that makes anabolic processes possible is NADPH. Because of the structure of this molecule it readily donates hydrogen ions to metabolites thus reducing them and making them available for energy harvest at a later time. The PPP is the main source of synthesis for NADPH. The pentose phosphate pathway (PPP) is also responsible for the production of Ribose-5-phosphate which is an important part of nucleic acids. Finally the PPP can also be used to produce glyceraldehyde-3-phosphate which can then be fed into the TCA and ETC cycles allowing for the harvest of energy. Depending on the needs of the cell certain enzymes can be regulated and thus increasing or decreasing the production of desired metabolites. The enzymes reasonable for catalyzing the steps of the PPP are found most abundantly in the liver (the major site of gluconeogenesis) more specifically in the cytosol. The cytosol is where fatty acid synthesis takes place which is a NADPH dependent process.
Oxidation Phase
The beginning molecule for the PPP is glucose-6-P which is the second intermediate metabolite in glycolysis. Glucose-6-P is oxidized in the presence of glucose-6-P dehydrogenase and NADP+. This step is irreversible and is highly regulated. NADPH and fatty acyl-CoA are strong negative inhibitors to this enzyme. The purpose of this is to decrease production of NADPH when concentrations are high or the synthesis of fatty acids is no longer necessary.
The metabolic product of this step is gluconolactone which is hydrolytrically unstable. Gluconolactonase causes gluconolactone to undergo a ring opening hydrolysis. The product of this reaction is the more stable sugar acid, 6-phospho-D-gluconate.
6-phospho-D-gluconate is oxidized by NADP+ in the presence of 6-phosphogluconate dehydrogenase which yields ribulose-5-phosphate.
The oxidation phase of the PPP is solely responsible for the production of the NADPH to be used in anabolic processes.
Isomerization Phase
Ribulose-5-phosphate can then be isomerized by phosphopentose isomerase to produce ribose-5-phosphate. Ribose-5-phosphate is one of the main building blocks of nucleic acids and the PPP is the primary source of production of ribose-5-phosphate.
If production of ribose-5-phosphate exceeds the needs of required ribose-5-phosphate in the organism, then phosphopentose epimerase catalyzes a chiralty rearrangement about the center carbon creating xylulose-5-phosphate.
The products of these two reactions can then be rearranged to produce many different length carbon chains. These different length carbon chains have a variety of metabolic fates.
Rearrangement Phase
There are two main classes of enzymes responsible for the rearrangement and synthesis of the different length carbon chain molecules. These are transketolase and transaldolase.
Transketolase is responsible for the cleaving of a two carbon unit from xylulose-5-P and adding that two carbon unit to ribose-5-P thus resulting in glyceraldehyde-3-P and sedoheptulose-7-P.
Transketolase is also responsible for the cleaving of a two carbon unit from xylulose-5-P and adding that two carbon unit to erythrose-4-P resulting in glyceraldehyde-3-P and fructose-6-P.
Transaldolase is responsible for cleaving the three carbon unit from sedoheptulose-7-P and adding that three carbon unit to glyceraldehyde-3-P thus resulting in erythrose-4-P and fructose-6-P.
The end results of the rearrangement phase is a variety of different length sugars which can be fed into many other metabolic processes. For example, fructose-6-P is a key intermediate of glycolysis as well as glyceraldehyde-3-P.
References
Garrett, H., Reginald and Charles Grisham. Biochemistry. Boston: Twayne Publishers, 2008.
Glycogen is a readily mobilized storage form of glucose. It is a very large, branched polymer of glucose residues (Figure 21.1) that can be broken down to yield glucose molecules when energy is needed. Most of the glucose residues in glycogen are linked by α-1,4-glycosidic bonds. Branches at about every tenth residue are created by α-1,6-glycosidic bonds. Recall that α-glycosidic linkages form open helical polymers, whereas β linkages produce nearly straight strands that form structural fibrils, as in cellulose (Section 11.2.3).
Glycogen Structure. In this structure of two outer branches of a glycogen molecule, the residues at the nonreducing ends are shown in red and residue that starts a branch is shown in green. The rest of the glycogen molecule is represented by R.
Glycogen is not as reduced as fatty acids are and consequently not as energy rich. Why do animals store any energy as glycogen? Why not convert all excess fuel into fatty acids? Glycogen is an important fuel reserve for several reasons. The controlled breakdown of glycogen and release of glucose increase the amount of glucose that is available between meals. Hence, glycogen serves as a buffer to maintain blood-glucose levels. Glycogen’s role in maintaining blood-glucose levels is especially important because glucose is virtually the only fuel used by the brain, except during prolonged starvation. Moreover, the glucose from glycogen is readily mobilized and is therefore a good source of energy for sudden, strenuous activity. Unlike fatty acids, the released glucose can provide energy in the absence of oxygen and can thus supply energy for anaerobic activity.
Gluconeogenesis is much like glycolysis only the process occurs in reverse. However, there are exceptions. In glycolysis there are three highly exergonic steps (steps 1,3,10). These are also regulatory steps which include the enzymes hexokinase, phosphofructokinase, and pyruvate kinase. Biological reactions can occur in both the forward and reverse direction. If the reaction occurs in the reverse direction the energy normally released in that reaction is now required. If gluconeogenesis were to simply occur in reverse the reaction would require too much energy to be profitable to that particular organism. In order to overcome this problem, nature has evolved three other enzymes to replace the glycolysis enzymes hexokinase, phosphofructokinase, and pyruvate kinase when going through the process of gluconeogenesis:
The first step in gluconeogenesis is the conversion of pyruvate to phosphoenolpyruvic acid (PEP). In order to convert pyruvate to PEP there are several steps and several enzymes required. Pyruvate carboxylase, PEP carboxykinase and malate dehydrogenase are the three enzymes responsible for this conversion. Pyruvate carboxylase is found on the mitochondria and converts pyruvate into oxaloacetate. Because oxaloacetate cannot pass through the mitochondria membranes it must be first converted into malate by malate dehydrogenase. Malate can then cross the mitochondria membrane into the cytoplasm where it is then converted back into oxaloacetate with another malate dehydrogenase. Lastly, oxaloacetate is converted into PEP via PEP carboxykinase. The next several steps are exactly the same as glycolysis only the process is in reverse.
The second step that differs from glycolysis is the conversion of fructose-1,6-bP to fructose-6-P with the use of the enzyme fructose-1,6-phosphatase. The conversion of fructose-6-P to glucose-6-P uses the same enzyme as glycolysis, phosphoglucoisomerase.
The last step that differs from glycolysis is the conversion of glucose-6-P to glucose with the enzyme glucose-6-phosphatase. This enzyme is located in the endoplasmic reticulum.
Glycolysis
Regulation
Because it is important for organisms to conserve energy, they have derived ways to regulate those metabolic pathways that require and release the most energy. In glycolysis and gluconeogenesis seven of the ten steps occur at or near equilibrium. In gluconeogenesis the conversion of pyruvate to PEP, the conversion of fructose-1,6-bP, and the conversion of glucose-6-P to glucose all occur very spontaneously which is why these processes are highly regulated. It is important for the organism to conserve as much energy as possible. When there is an excess of energy available, gluconeogenesis is inhibited. When energy is required, gluconeogenesis is activated.
The conversion of pyruvate to PEP is regulated by acetyl-CoA. More specifically pyruvate carboxylase is activated by acetyl-CoA. Because acetyl-CoA is an important metabolite in the TCA cycle which produces a lot of energy, when concentrations of acetyl-CoA are high organisms use pyruvate carboxylase to channel pyruvate away from the TCA cycle. If the organism does not need more energy, then it is best to divert those metabolites towards storage or other necessary processes.
The conversion of fructose-1,6-bP to fructose-6-P with the use of fructose-1,6-phosphatase is negatively regulated and inhibited by the molecules AMP and fructose-2,6-bP. These are reciprocal regulators to glycolysis’ phosphofructokinase. Phosphofructosekinase is positively regulated by AMP and fructose-2,6-bP. Once again, when the energy levels produced are higher than needed, i.e. a large ATP to AMP ratio, the organism increases gluconeogenesis and decreases glycolysis. The opposite also applies when energy levels are lower than needed, i.e. a low ATP to AMP ratio, the organism increases glycolysis and decreases gluconeogenesis.
The conversion of glucose-6-P to glucose with use of glucose-6-phosphatase is controlled by substrate level regulation. The metabolite responsible for this type of regulation is glucose-6-P. As levels of glucose-6-P increase, glucose-6-phosphatase increases activity and more glucose is produced. Thus glycolysis is unable to proceed.
Diabetes currently affects more than 336 million people worldwide, with healthcare costs by diabetes and its complications of up to $612 million per day in the US alone. The islets of Langerhans, miniature endocrine organs within the pancreas, are essential regulators of blood glucose homeostasis and play a key role in the pathogenesis of diabetes. Islets of Langerhans are composed of several types of endocrine cells. The α- and β-cells are the most abundant and also the most important in that they secrete hormones (glucagon and insulin, respectively) crucial for glucose homeostasis (Bosco D, et al, Diabetes, May 2010;59(5):1202-10).
Diabetes is a ‘bihormonal’ disease, involving both insulin deficiency and excess glucagon. For decades, insulin deficiency was considered to be the sole reason for diabetes; however, recent studies emphasize excess glucagon as an important part of diabetes etiology. Thus, insulin-secreting β cells and glucagon-secreting α cells maintain physiological blood glucose levels, and their malfunction drives diabetes development. Increasing the number of insulin-producing β cells while decreasing the number of glucagon-producing α cells, either in vitro in donor pancreatic islets before transplantation into type 1 diabetics or in vivo in type 2 diabetics, is a promising therapeutic avenue. A huge leap has been taken in this direction by the researchers at the University of Pennsylvania (Philadelphia, PA) in collaboration with Oregon Health and Science University (Portland, OR), USA by demonstrating that α to β cell reprogramming could be promoted by manipulating the histone methylation signature of human pancreatic islets. In fact, the treatment of cultured pancreatic islets with a histone methyltransferase inhibitor leads to colocalization of both glucagon and insulin and glucagon and insulin promoter factor 1 (PDX1) in human islets and colocalization of both glucagon and insulin in mouse islets. The research findings were published in the Journal of Clinical Investigation.
Study design: First step was to study and analyze the epigenetic and transcriptional landscape of human pancreatic human pancreatic α, β, and exocrine cells using ChIP and RNA sequencing. Study design for determination of the transcriptome and differential histone marks included the dispersion and FACS to of human islets to obtain cell populations highly enriched for α, β, and exocrine (duct and acinar) cells. Then, chromatin was prepared for ChIP analysis using antibodies for histone modifications, H3K4me3 (represents gene activation) and H3K27me3 (represents gene repression). RNA-Sequencing analysis was then performed to determine mRNA and lncRNA. Sample purity was confirmed using qRT-PCR of insulin and glucagon expression levels of the individual α and β cell population revealing high sample purity.
Results:
Long noncoding transcripts: Long noncoding RNA molecules have been implicated as important developmental regulators, cell lineage allocators, and contributors to disease development. The authors discovered 12 cell–specific and 5 α cell–specific noncoding (lnc) transcripts, indicative of the valuable research resource represented from transcriptome data. Recently discovered lncRNA molecules in islets are regulated during development and dysregulated in type 2 diabetic islets.
Monovalent histone modification landscapes shared among three cell types: Monovalent H3K4me3-enriched regions, indicative of gene activation, were identified and compared in α, β, and exocrine cells. Strikingly, the vast majority of monovalently H3K4me3-marked genes were shared among the 3 pancreatic cell lineages (83%–95%), reflecting both their related function in protein secretion and common embryonic descent. Similarly, a high degree of overlap was observed in H3K27me3 modification patterns in all the three cell types (73%–83%).
Bivalent histone modifications (H3K4me3 and H3K27me3) were high in α cells: Bernstein colleagues observed bivalent marks to be common in undifferentiated cells, such as ES cells and pluripotent progenitor cells, and in most cases, one of the histone modification marks was lost during differentiation, accompanying lineage specification (Bernstein BE, et al, Cell, 21 Apr 2006; 125(2):315-26). α cells exhibited many more genes bivalently marked, followed by β cells and exocrine cells. Bivalent state was remarkably similar to that of hESC, suggesting a more plastic epigenomic state for α cells.
Monovalent histone modifications were high in β cells: Thousands of the genes that were in bivalent state in α cells were in a monovalent state, carrying only the activating or repressing mark.
Inhibition of histone methyltransferases led to partial cell-fate conversion: Adenosine dialdehye (Adox), a drug that interferes with histone methylation and decreases H3K27me3, when administered in human islet tissue, led to decrease of H3K27me3 enrichment at the 3 gene loci that are originally expressed bivalently in α cells and monovalently in β cells: MAFA, PDX1 and ARX. Adox resulted in the occasional cooccurrence of glucagon and insulin granules within the same islet cell, which was not observed in untreated islets. Thus, inhibition of histone methyltransferases leads to partial endocrine cell-fate conversion.
Conclusion: α cells have been reprogrammed into β cell fate in various mouse models. The reason, as proposed by the authors, might be the presence of more bivalently marked genes that confers a more plastic epigenomic state of the cells that probably drives them to the β cell fate. Therefore, using epigenomic information of different cell types in pancreatic islets and harnessing it for subsequent manipulation of their epigenetic signature could be utilized to reprogram cells and hence provide a path for diabetes therapy.
Biochemical role: AA serves a basic biochemical role of accelerating hydroxylation in several biochemical reactions. It provides electrons to metal ions, the reduced forms of which are required for the full enzymatic activity of some enzymes. Most emphasized role of AA is as a cofactor for the enzyme required for the biosynthesis of collagen.
Molecular structure and the oxidized form of AA, dihydroascorbic acid, bear similarity to that of glucose.
Biological role: AA is an essential vitamin for humans and its deficiency leads to disease called Scurvy characterized by initial symptoms of malaise and lethargy, followed by formation of spots on the skin, spongy gums, and bleeding from the mucous membranes. As scurvy advances, there can be open, suppurating wounds, loss of teeth, jaundice, fever, neuropathy and death. AA is water soluble and found in high concentrations in several tissues including eye lens, WBCs, adrenal glad and pituitary gland. Some of the roles of ascorbate include:
Possibly an ergogenic aid (Ergogenic aids are substances, devices, or practices that enhance an individual’s energy use, production, or recovery.)
Vitamin C and Cancer
As early as in 1949, vitamin C was implicated in cancer therapy. Since then, several research articles have been published exploring the role of ascorbate in cancer therapy. Among the plethora of literature discussing the relationship between vitamin C and cancer, one of the very significant and comprehensive reviews was published in 1979 in Cancer Research (2).
Mechanisms of action of AA (1) with respect to cancer have been divided and subdivided into the following:
Ascorbate acts as a cancer preventive agent by virtue of its strong antioxidant activities. Being one of the strongest reductants and radical scavenger, it absorbs unstable oxygen, nitrogen, and sulphur-centered radicals. AA can prevent biomembranes from peroxidative damage from peroxyl radicals. Ascorbate can trap peroxyl radicals and lead to their peroxidation in the aqueous phase before they reach the lipid rich biomembranes and cause damage. Ascorbate has been speculated to have a biomembrane protective action by its synergistic antioxidant activity with vitamin E (tocopherol). Vitamin E is lipid-soluble and tocopheroxyl radical is generated in the cell membranes as a result of its antioxidant activity. Ascorbate reacts with the tocopheroxyl radical and regenerates tocopherol transferring the oxidative challenge to the aqueous phase. At this point, the less active ascorbate radical might be reduced to AA by an NADP-dependent system. The probably mechanism might explain the reduction of nitrates via ascorbate to prevent the formation of carcinogenic nitrosamines.
Anticancer mechanisms
1. Primary anticancer mechanisms
i. Oxidative, oxidant and pro-oxidant properties: Ascorbate has been reported to be cytotoxic at high concentrations, which has been demonstrated in a number of malignant cell lines. Transcription factor NFkB is potentially activated via ascorbate and its radicals leading to the inhibition of cell growth. Also, ascorbate inhibits certain prostaglandins leading to decrease in cell proliferation.
ii. Hydrogen peroxide: On oxidation with oxygen, ascorbate produces a hydrogen peroxide, a reactive oxygen species. Hydrogen peroxide can generate several other reactive species and can have several damaging effects on cells including decrease in cell viability by damaging cell membranes of malignant cells. The amount of these reactive species produced via oxidation is limited in healthy cells unlike that in malignant cells where they exist in large amounts. The amount of hydrogen peroxide generated has been correlated to the amount of ascorbate in the cells. The reactive species can lead to multiple negative effects on cells including DNA strand breaks, lipid peroxidation leading to membrane function disruption, cellular ATP depletion.
Authors state that “the failure to maintain high ATP production may be a consequence of oxidative inactivation of key enzymes especially those related to the Krebs cycle and the electron transport chain.” This might result in alteration of transmembrane potential and distortion of mitochondrial function, suggestive of the important role of mitochondria in the process of carcinogenesis. In this paper, vitamin C has been correlated with cancer with the involvement of altered mitochondrial function. In addition, ascorbate has been detected in mitochondria where it is also regenerated. Different aspects of mitochondrial involvement in cancer have been discussed in several posts published earlier (3-8).
iii. Other oxidation products of AA: Other oxidation products of AA include 2,3-diketoglutonic acid, and 5-methyl 1-3, 4-dehydrotetrone and other degradation products, have demonstrated antitumor activity. Additionally, some degradation and oxidation products of AA, gamma-cronolactone and 3-hydroxyl-2-pyrone, have been found to inhibit tumor growth. The mechanism of their antitumor actions is complex and might involve multitude of steps, including generation of reactive oxygen species, lipid peroxidation, inducing structural changes in important cellular proteins, inhibition of mitosis and so on.
iv. Intracellular transport of ascorbate and its tumor specificity: Oxidized ascorbate, dihydroascorbic acid, is transported intracellularly where it is reduced back to ascorbate. Owing to its structural similarity with glucose, dihydroascorbic transport is facilitated via glucose transporters (GLUTs). Ascrobate in its reduced form is transported through a sodium-dependent cotransporter in some cells. Tumor cells require large amounts of glucose, which leads to an increase in the number of GLUTs, hence, resulting in an increase in ascorbate concentration within cancer cells. Because of this selective increased uptake of ascorbate and its cytotoxic effects in cancer cells (generation of hydrogen peroxide, DNA damage, other cytotoxic effects), AA has become a selective, nontoxic chemotherapeutic agent. The difference in the levels of catalase enzyme has been found to lead to intracellular tumor selectivity in cancer cells.
Ascorbate induced cytotoxicity in cancer cells involves its final electron acceptor, oxygen, which interferes with the anaerobic respiration within malignant cells. This gives an important clue for the involvement of mitochondria in malignant cells.
v. Intravenous AA: High concentrations of AA in plasma (>200mg/dL) have been found to be cytotoxic to cancer cells. Clinically high plasma concentrations of AA can be achieved by its intravenous administration. It was observed that 60g infusion of AA given to cancer patients for 60 minutes followed by 20g given over the next 60 minutes resulted in a 240 minutes high plasma AA concentration of >400mg/dL, that is known to be cytotoxic.
Lipoic acid when administered with AA, is able to reduce the high-dose requirement of AA for its cytotoxic activity reducing it from 700mg/dL to 120mg/dL. Lipoic acid can recycle vitamin C, mediate the reduction of dihydroascorbic acid and improves mitochondrial function. Thus, energy intermediates such as coenzyme Q, vitamin K3, B-complex vitamins, alpha-ketoglutarate aspartate, magnesium might aid in cancer therapy by intercting with ascorbate, directly or indirectly, thereby stimuating/interacting/correcting aerobic mitochondrial respiration.
Hence, the pro-oxidant activity of vitamin C is being referred to as the primary mechanism of anticancer action.
2. Secondary anticancer mechanisms
i. AA and intracellular matrix: Collagen is an important constituent of the matrix and its concentration determines the strength of the tissue along with its resistance to the infiltration of malignant cancer cells. In Scurvy, a disease resulting from a chronic deficiency of vitamin C, there is generalized tissue disintegration, dissolution of intercellular ground substance and the disruption of collagen bundles. This disintegration leads to ulceration; bacterial colonization and general undifferentiated cellular proliferation with specialized cells reverting back to their primitive form, very much like cancer. Lack of ascorbate causes a reduction in the hydroxylation of prolyl and lysyl residues into hydroxyproline and hydroxylysine, leading to instability of the collagen triple helix, a common feature in scurvy and also in cancer. Thus, a secondary mechanism of ascorbic acid anticancer mechanism would be to repair these sites, which is emphasized by its role in wound healing, including surgical recovery and other traumatic injuries.
ii. Ascorbate and immunocompetence: Ascorbate plays several roles for the efficient functioning of immune system in ways that are invoved in both humoral and cell-mediated. Ascorbate provides humoral immunocompetence as it is essential for immunoglobulin synthesis. In addition, lymphocytes, seminal cells involved in cell-mediated immunity have been found to contain high concentrations of ascorbate. Other immune system roles include, aid in active phagocytosis and enhancing of interferon production.
Classical vitamin C and Cancer controversy-A possible explanation
Conflicting results were obtained from the studies performed by Pauling (Pauling Institute) and Cameron (Mayo Clinic) with vitamin C and its effect on cancer, the issue was debated a few decades ago. Both the studies, however, used oral doses of ascorbate (10g). Gonzalez et al, authors of the review on which the post is based, analyzed and expressed their views on the controversy. They state that the plasma concentration cannot be replicated when the dose is given orally as opposed to when the dose is given intravenously. According to their research, when AA is administered intravenously, higher plasma levels of ascorbate are achieved that could be retained for longer time periods. Also, the authors advocate the use of substantially higher doses (25-200g) to be given intravenously for selective toxicity towards cancer cells.
Modern vitamin C and Cancer controversy-Chemotherapy and radiation
A recent concern regarding the antioxidants like vitamin C is that they might reduce the effectiveness of chemotherapy and radiation by reducing the potency of free radicals necessary for killing cells. A publication by Agus et al (13) has a major role to play in this misconception. The authors describe how cancer cells acquire and concentrate vitamin C providing malignant cells with metabolic advantage. However, details or explanations regarding the theory are missing. Some studies, on the other hand, explain that high concentrations of AA in cancer cells is cytotoxic and is achieved because of similarity in structure between AA and glucose. Cancer cells uptake AA derivative, dehydroascorbic acid via glucose transporters (GLUTs).
In a case report published in PNAS in 1985 (12), two patients with ovarian cancer stage IIIC were found to respond positively to chemotherapy along with high-dose of antioxidants. Antioxidant, AA was administered intravenously to maintain a high plasma dose of 200 mg/dL. The two patients didn’t show disease recurrence after three years of chemotherapy and vitamin C administration. Vast literature exists on the topic indicating that antioxidants, including ascorbate, provide beneficial effects in several cancers without reducing the efficacy of chemotherapy or radiation during treatment of these cancers. Some data, in fact, suggests increase in effectiveness of chemotherapy when supplemented with antioxidants along with an increase in adverse effects. The topic has been summarized and discussed in a series of articles by Lawson and Brignall (9-11).
REFERENCES
The post is primarily based on the following two review articles:
Overview of New Strategy for Treatment of T2DM: SGLT2 Inhibiting Oral Antidiabetic Agents
Author and Curator: Aviral Vatsa, PhD, MBBS
Type 2 diabetes mellitus (T2DM) is a chronic disease, which is affecting widespread populations in epidemic proportions across the globe 1. It is characterised by hyperglycemia, which if not controlled adequately, eventually leads to microvascular and metabolic complications (Fig 1). Traditionally, T2DM management includes alteration in lifestyle, oral hypoglycemic agents and/or insulin. The present pharmacological approaches predominantly target glucose metabolism by compensating for reduction in insulin secretion and/or insulin action. However, these approaches are often limited by inadequate glucose control and the the possibility of severe adverse effects such as hypoglycemia, weight gain, nausea, and sometimes lactic acidosis 2–4 (Fig 1). Hence the search for new drugs with different mechanism of action and with little side affects is key in providing better glycemic control in T2DM patients and hence offering better prognosis with reduced morbidity and mortality.
Figure 1 (credit: aviral vatsa): Short overview of Type 2 diabetes mellitus (T2DM): complications, present therapeutic approaches and their limitations.
Along with pancreas, our kidneys play a vital role in regulating glucose levels in the plasma. Under physiological conditions, kidneys absorb 99% of the plasma glucose filtered through the renal glomeruli tubules. Majority i.e. 80-90% of this renal glucose resorbtion is mediated via the sodium glucose co-transporter 2 (SGLT2) 5,6. SGLT2 is a high-capacity low-affinity transporter that is mainly located in the proximal segment S1 of the proximal convoluted tubule 6. Inhibition of SGLT2 activity can thus induce glucosuria which inturn can lower blood glucose levels without targeting insulin resistance and insulin secretion pathways of glucose modulation (Fig 2).
Figure 2 (credit: aviral vatsa): Schematic overview of regulation of plasma glucose by sodium glucose co-transporter (SGLT).
Thus inhibition of SGLT2 provides a novel way to modulate blood glucose levels and consequently limit long term complications of hyperglycemia 7,8. Moreover, SGLT2 inhibitors will selectively target the renal glucose transportation and spare the counter regulatory hormones involved in glucose metabolism because SGLT2 is almost exclusively located in the kidneys. This novel way of glucose modulation will likely avoid severe side affects, e.g. hypoglycemia and weight gain, that are seen with present antidiabetic pharmacological agents.
Agents currently under development
Table below gives an overview of the SGLT2 inhibotors in development.
(Credit: Chao et al 2010)
In summary, increasing urinary glucose excretion represents a new approach to addressing the challenge of hyperglycaemia. SGLT2 inhibitors may have indications both in the prevention and treatment of T2DM, and perhaps T1DM, with a possible application in obesity. Further studies in large numbers of human subjects are necessary to delineate efficacy, safety and how to most effectively use these agents in the treatment of diabetes.
Sticking yourself in the finger day after day: For many diabetics, this means of checking blood glucose is an everyday part of life. Especially for patients with Type-1 diabetes, who always have to keep a close eye on their levels, since their bodies are incapable of producing the insulin to break down the glucose in the blood. Several times a day, they have to place a tiny drop of blood on a test strip. It is the only way they can ascertain the blood glucose value, so they can inject the correct amount of insulin needed. And this pricking is not only a burdensome: it may also cause inflammation or cornification of the skin. And for pain-sensitive patients, the procedure is agony.
The daily sticking of the finger may soon become a thing of the past, thanks to a diagnostic system with Fraunhofer technology built-in. The underlying concept is a biosensor that is located on the patient’s body. It is also able to measure glucose levels continuously using tissue fluids other than blood, such as in sweat or tears. The patient could dispense with the constant needle pricks. In the past, such bioelectric sensors were too big, too imprecise and consumed too much power. Researchers at the Fraunhofer Institute for Microelectronic Circuits and Systems IMS in Duisburg have recently achieved a major breakthrough: They have developed a biosensor in nano-form that circumvents these hurdles.
Diagnostic system in miniature
The principle of measurement involves an electrochemical reaction that is activated with the aid of an enzyme. Glucose oxidase converts glucose into hydrogen peroxide (H2O2) and other chemicals whose concentration can be measured with a potentiostat. This measurement is used for calculating the glucose level. The special feature of this biosensor: the chip, measuring just 0.5 x 2.0 mm, can fit more than just the nanopotentiostat itself. Indeed, Fraunhofer researchers have attached the entire diagnostic system to it. “It even has an integrated analog digital converter that converts the electrochemical signals into digital data,” explains Tom Zimmermann, business unit manager at IMS. The biosensor transmits the data via a wireless interface, for example to a mobile receiver. Thus, the patient can keep a steady eye on his or her glucose level. “In the past, you used to need a circuit board the size of a half-sheet of paper,” says Zimmermann. “And you also had to have a driver. But even these things are no longer necessary with our new sensor.”
Durable biosensor
The minimal size is not the only thing that provides a substantial advantage over previous biosensors of this type. In addition, the sensor consumes substantially less power. Earlier systems required about 500 microamperes at five volts; now, it is less than 100 microamperes. That increases the durability of the system – allowing the patient to wear the sensor for weeks, or even months. The use of a passive system makes this durability possible. The sensor is able to send and receive data packages, but it can also be supplied with power through radio frequency.
The glucose sensor was engineered by the researchers at Noviosens, a Dutch medical technology firm. Since it can be manufactured so cost-effectively, it is best suited for mass production. These non-invasive measuring devices for monitoring blood glucose levels may become the basis for a particularly useful further development in the future: The biochip could control an implanted miniature pump that, based on the glucose value measured, indicates the precise amount of insulin to administer. That way, diabetes patients could say goodbye to incessant needle-pricks forever.
Researchers have created a new type of biosensor that can detect minute concentrations of glucose in saliva, tears, and urine, and might be manufactured at low cost because it does not require many processing steps to produce.
“It’s an inherently noninvasive way to estimate glucose content in the body,” says Jonathan Claussen, a former Purdue University doctoral student and now a research scientist at the U.S. Naval Research Laboratory. “Because it can detect glucose in the saliva and tears, it’s a platform that might eventually help to eliminate or reduce the frequency of using pinpricks for diabetes testing. We are proving its functionality.”
Claussen and Purdue doctoral student Anurag Kumar led the project, working with Timothy Fisher, a Purdue professor of mechanical engineering; D. Marshall Porterfield, a professor of agricultural and biological engineering; and other researchers at the university’s Birck Nanotechnology Center.
Findings are detailed in a research paper published in Advanced Functional Materials.
“Most sensors typically measure glucose in blood,” Claussen says. “Many in the literature aren’t able to detect glucose in tears and the saliva. What’s unique is that we can sense in all four different human serums: the saliva, blood, tears, and urine. And that hasn’t been shown before.”
The paper, featured on the journal’s cover, was written by Claussen, Kumar, Fisher, Porterfield, and Purdue researchers David B. Jaroch, M. Haseeb Khawaja, and Allison B. Hibbard.
The sensor has three main parts: layers of nanosheets resembling tiny rose petals made of a material called graphene, which is a single-atom-thick film of carbon; platinum nanoparticles; and the enzyme glucose oxidase.
Each petal contains a few layers of stacked graphene. The edges of the petals have dangling, incomplete chemical bonds, defects where platinum nanoparticles can attach. Electrodes are formed by combining the nanosheet petals and platinum nanoparticles. Then the glucose oxidase attaches to the platinum nanoparticles. The enzyme converts glucose to peroxide, which generates a signal on the electrode.
“Typically, when you want to make a nanostructured biosensor you have to use a lot of processing steps before you reach the final biosensor product,” Kumar says. “That involves lithography, chemical processing, etching, and other steps. The good thing about these petals is that they can be grown on just about any surface, and we don’t need to use any of these steps, so it could be ideal for commercialization.”
In addition to diabetes testing, the technology might be used for sensing a variety of chemical compounds to test for other medical conditions.
“Because we used the enzyme glucose oxidase in this work, it’s geared for diabetes,” Claussen says. “But we could just swap out that enzyme with, for example, glutemate oxidase, to measure the neurotransmitter glutamate to test for Parkinson’s and Alzheimer’s, or ethanol oxidase to monitor alcohol levels for a breathalyzer. It’s very versatile, fast, and portable.”
The technology is able to detect glucose in concentrations as low as 0.3 micromolar, far more sensitive than other electrochemical biosensors based on graphene or graphite, carbon nanotubes, and metallic nanoparticles, Claussen says.
“These are the first findings to report such a low sensing limit and, at the same time, such a wide sensing range,” he says.
The sensor is able to distinguish between glucose and signals from other compounds that often cause interference in sensors: uric acid, ascorbic acid and acetaminophen, which are commonly found in the blood. Unlike glucose, those compounds are said to be electroactive, which means they generate an electrical signal without the presence of an enzyme.
Glucose by itself doesn’t generate a signal but must first react with the enzyme glucose oxidase. Glucose oxidase is used in commercial diabetes test strips for conventional diabetes meters that measure glucose with a finger pinprick.
2012pharmaceutical
Amandeep Kaur
Aashir Awan, Phd
Abhisar Anand
Adina Hazan
Alan F. Kaul, PharmD., MS, MBA, FCCP
alexcrystal6
anamikasarkar
apreconasia
aviralvatsa
David Orchard-Webb, PhD
danutdaagmailcom
Demet Sag, Ph.D., CRA, GCP
Dror Nir
dsmolyar
Ethan Coomber
evelinacohn
Gail S Thornton
Irina Robu
jayzmit48
jdpmd
jshertok
kellyperlman
Ed Kislauskis
larryhbern
Madison Davis
marzankhan
megbaker58
ofermar2020
Dr. Pati
pkandala
ritusaxena
Rick Mandahl
sjwilliamspa
Srinivas Sriram
stuartlpbi
Dr. Sudipta Saha
tildabarliya
vaishnavee24
zraviv06
zs22
