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7. Kane lecture 11/10
BrownMed
54
Chemical Engineering
Undergraduate 3
11/10/2010

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Term
3 targets of oxidant attack
Definition
proteins, lipids, DNA
Term
what happens when oxidants attack lipids? (2)
Definition
1. peroxidation of plasma and intracellular membranes (phospholipids, mitochondrial membrane etc.), 2. free radicals attack double bonds of unsaturated fatty acids
Term
what makes oxidant attack on lipids so dangerous?
Definition
it's a chain reaction that keeps propagating
Term
final blow resulting in irreversible injury to a cell
Definition
peroxidative damage to the plasma membrane permeability barrier
Term
what happens when oxidants attack DNA? (3)
Definition
1. oxidation of bases, 2. DNA crosslinks, 3. DNA breaks
Term
what type of cell damage causes cancer? in absence of what?
Definition
oxidative damage to DNA, in absence of adequate cell repair mechanisms
Term
p53 basics, not actions (3)
Definition
1. protein that is a major regulatory switch in the cellular response to oxidant-induced DNA damage. 2. a nuclear phosphoprotein. 3. a sensor of DNA damage
Term
mutation in p53 gene
Definition
leads to cancer (no DNA repair)
Term
when p53 is activated, what does it do?
Definition
1. binds to DNA, 2. transcriptionally up-regulates genes for p21, GADD45 and BAX
Term
what activates p53? (2)
Definition
DNA damage and hypoxia
Term
what regulates which gene (that is activated by p53) wins?
Definition
the extent of the DNA damage
Term
p21
Definition
CDK inhibitor that promotes cell cycle stage G1 arrest, leading to successful repair (along with GADD45)
Term
where is p53 located?
Definition
in the cytoplasm. in response to DNA damage, it stabilizes and translocates to the nucleus.
Term
risk=
Definition
hazard x exposure! Paracelsus: 15th century, "the dose makes the poison"
Term
carbon tetrachloride (2) / site of attack (4)
Definition
1. like ethanol, becomes toxic when metabolized. 2. halogenated hydrocarbon. / the organ where metabolism occurs - usually the liver - or site of excretion of the reactive metabolites - kidney or bladder.
Term
cytochrome P450 mixed function oxidase system
Definition
= a major site of drug and chemical metabolism
Term
hydrocarbons
Definition
CCl4 is one. they are abundant as fuels, paints, cleaners, lubricants, rubber cement, and various solvents.
Term
metabolism of lipophilic toxicants to hydrophilic metabolites
Definition
toxicant>phase I reactions>primary metabolite> (elimination in urine bile or feces, or) phase II reactions>secondary metabolite>elimination
Term
phase I reactions of metabolism of lipophilic toxicants (3)
Definition
hydrolysis, reduction, oxidation
Term
phase II reactions of metabolism of lipophilic toxicants (4)
Definition
glucoronidation, sulfation, methylation, conjugation
Term
when does hepatotoxicity of chlorinated hydrocarbonds occur
Definition
after phase I metabolism, which results in free radical formation
Term
why does hepatotoxicity of chlorinated hydrocarbonds occur
Definition
free radicals from phase I metabolism interact with hepatic macromolecules, initiating lipid peroxidation
Term
centrilobular necrosis (3)
Definition
zone iii necrosis due to CCl4, acetaminophen or ethanol
Term
clinically significant symptoms of acute toxicity
Definition
jaundice and raised serum transaminase levels
Term
jaundice
Definition
decreased bile acid synthesis (bilirubin metabolism)
Term
P450 2E1 drug substrates and carcinogens/toxicants
Definition
ds - acetaminophen. ct - CCl4, ethanol
Term
what is metabolized in the P450 system? (4)
Definition
testosterone and other steroids, xenobiotics, bile acids
Term
where is the P450 system located? what's special about it?
Definition
sER of liver. highly inducible by its substrates.
Term
inducers of P450 (3)
Definition
(substrates) ethanol, barbiturates, St. John's Wort
Term
St. John's Wort
Definition
induces P450, which can accelerate catabolism of drugs like birth control and HIV therapy, decreasing their therapeutic effect
Term
t/f everyone's p450 and stuff reacts the same
Definition
false - lots of individual variation
Term
t/f all drugs cause the same morphological pattern of liver injury
Definition
f - pericentral hepatic injury vs. diffuse hepatitis vs. bile stasis and gall stones
Term
trichloromethyl free radical
Definition
derived from CCl4
Term
what does lipid peroxidation cause (2)
Definition
fatty liver and inactivation of mitochondria and enzymes / denaturation of proteins
Term
why does fat build up in liver? / pathway
Definition
because peroxidation results in no apoproteins in which to escort fat out of liver cells. / lipid peroxidation>membrane damage to rER>polysome detachment>down-regulated apoprotein synthesis>fatty liver
Term
why does protein denaturation etc. occur in liver in response to lipid peroxidation? (pathway)
Definition
release of lipid products>damage to plasma membrane>^permeability to water calcium and sodium>cell swelling>calcium influx>mito/enzyme deactivation + protein denaturation
Term
can toxic exposure be prevented?
Definition
yes = requires money
Term
chronic toxicity of not alcohol causes
Definition
liver cancer. acute = necrosis, ethanol>cirrhosis
Term
useful applications of ethanol (4)
Definition
versatile solvent, antiseptic, medicines/food flavoring, motor fuel
Term
consequences of ethanol abuse
Definition
brain/muscle damage, gastritis, pancreatitis, impaired intestinal absorption, testicular atrophy, liver damage
Term
what types of liver damage occur from ethanol toxicity?
Definition
fatty change (reversible), hepatitis (reversible), cirrhosis (irreversible)
Term
hepatitis (5)
Definition
liver cell necrosis, inflammation, fatty change in zone 1 (cell periphery). liver tenderness, jaundice.
Term
cirrhosis causes / clinical signs (5 all together)
Definition
collagen deposition, scar tissue / decreased albumin and clotting factors, jaundice
Term
cytosolic ethanol metabolism pathway
Definition
90% of normal alcohol metabolism: alcohol dehydrogenase>acetaldehyde (which causes hangovers)
Term
microsomal ethanol metabolism pathway
Definition
used when drinking in excess: CYP2E1>acetaldehyde. leads to increased TOLERANCE.
Term
peroxisomal ethanol metabolism pathway
Definition
10% of normal ethanol metabolism: catalase>acetaldehyde
Term
acetaldehyde>
Definition
acetic acid, via acetaldehyde dehydrogenase
Term
t/f fatty liver has no clinical symptoms
Definition
true
Term
biochemical mechanisms of fatty liver synthesis (3)
Definition
1. metabolism via ADH converts NAD to NADH. excess reducing equivalents favors lipid biosynthesis. 2. increased catabolism of fat by peripheral tissues = more FA's delivered to liver. 3. transport problem (duh) - ethanol impairs microtubular function
Term
t/f fatty liver doesn't look like cloudy swelling
Definition
true - fatty liver has well-defined vacuoles, unlike cloudy swelling (which is hydropic change = water accumulation)
Term
alcoholic hyaline
Definition
=Mallory bodies; build up in hepatitis
Term
neutrophils and hepatitis?
Definition
neutrophils around foci of necrosis
Term
biochemical mechanisms of alcoholic hepatitis (4)
Definition
1. mitochondrial injury, 2. depletion of glutathione, 3. excess generation of ROS by P450 metabolism of ethanol/xenobiotics, 4. protein cross-links induced by acetaldehyde = formation of intracellular mallory bodies
Term
other than increasing alcohol tolerance, induction of CYP2E1 does what? (4)
Definition
increases metabolism of CCl4, cocaine, acetaminophen, anesthetics
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