Session 7 - Liver Detoxification Flashcards

1
Q

What are the functions of the liver?

A
  • bile production
  • filtration & storage of blood
  • 500 vital functions
  • stores iron & vitamin a
  • processes toxins like acetaldehyde in alcohol metabolism
  • metabolism & detoxification
  • regeneration
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2
Q

What are the role of kupffer cells?

A

Serve as a first line defense against immunoreactive material passing from GIT via portal circulation.

They are the resident macrophages in liver and account for 80-90 of total number of natural macrophages. They release cytokines, chemokines etc
Can regenerate.

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3
Q

What is the purpose of bile?

A
  • carrier of toxic substances
  • removes products of detoxification from liver
  • emulsifies dietary fats for digestion
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4
Q

What does the detoxification and biotransformation of exogenous substances involves?

A
  • hepatic filtering and phagocytosis
  • intestinal microbiota and gut-associated lymphoid tissue (GALT)
  • phase 1 liver detoxification pathway
  • phase 2 liver detoxification pathway
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5
Q

What are the purpose of the two detoxification pathways (3rd role)

A

to render endogenous and xenobiotic substances more water soluble and easier to excrete. Allows neutralization of unwanted chemical compounds (pesticides, drugs, medicines)

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6
Q

What happens in phase 1 pathway?

A

Small chemical changes making compounds more hydrophilic for elimination by kidneys or further acted upon by phase 2.

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7
Q

What is the important enzyme in pathway 1?

A

Heme Dependent enzymes (phase 1 reactions):

Cytochrome p450 (cyt) makes toxic compounds (fatty acids, steroids, xenobiotics) water soluble so they can be excreted.

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8
Q

What is a cofactor for Cytochrome P450?

A

Iron & NADH

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9
Q

What neutralises free radicals produced by phase 1 liver metabolism of chemical toxins?

A

Glutathione

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10
Q

What is glutathione (reduced from GSH) made up from and what is its function?

A

Amino acids: glutamine, glycine, and cysteine.
Acts as an antioxidant in phase 1
Conjugates heavy metals in phase 2

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11
Q

What nutrient replenishes glutathione?

A

Vitamin C

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12
Q

What are the cofactors for enzyme glutathione reductase?

A

Riboflavin/B2,
niacin/B3
vitamin c

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12
Q

What are the cofactors for Phase 1 detoxification?

A

Vitamin C, copper, magnesium, zinc, thiamin, riboflavin, niacin, b6, folate, b12, iron, branch chain amino acids.

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13
Q

What can an underactive Liver 1 pathway manifest an intolerance to?

A

Intolerance to perfume, caffeine, sugar cravings, bloating, constipation, abnormal fat metabolism. Environmental chemicals. An overactive Phase 1 can result in excess free radical production.

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14
Q

What are inducers of phase 1?

A

Drugs, environmental pollutants, pesticides, high protein diets, saturated fats, indoles from cruciferous vegetables

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15
Q

What are inhibitors?

A

phytochemicals in foods: grapefruit juice, curcumin from turmeric.

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16
Q

What foods assist in functioning of Liver Detox Phase 1?

A

Cuciferous vegetables, green tea, selenium, methionine.

17
Q

What does Liver detoxification Phase 2 involve?

A

The conjugation (change) of intermediate metabolites made in phase 1 with glucuronide, sulphate, or glutathione.

The biotransformed water soluble toxicants are excreted via the bile and faeces or kidneys & urine.

18
Q

What are the required nutrients for phase 2?

A

Amino acids, vitamins, minerals.

19
Q

What are the inducers and inhibitors of phase 2?

A

Inducers: cigarette smoking, birth control pills, Phenobarbital, limonene-containing foods

Inhibitors: Low protein diet, Non-steroidal anti-inflammatory drugs (e.g. aspirin), tartrazine (yellow food dye), Aspirin, probenecid (gout medication).

20
Q

What are the 3 main enzyme systems which metabolises alcohol?

A
  • Alcohol and acetaldehyde dehydrogenases
  • Microsomal ethanol oxidising system (MEOS) using cytochrome P450 enzymes.
    Catalase
21
Q

What cofactor is required for these enzyme systems?

A

Iron

22
Q

What nutrients are alcoholics deficient in?

A

Iron, zinc, vitamin a, b vitamins.

23
Q

What are the effects of alcohol on liver enzymes?

A

ALT - released when liver is damaged
ALP- an enzyme elevated during liver injury.
GGT - marker of liver injury (most sensitive biomarker of alcohol consumption)

24
Q

What nutrients can support alcohol detoxification?

A

Vitamin B3 (metabolise alcohol)
Glutamine (precursor to GABA - decreases cravings and relieves alcohol detoxification)
Phenylalanine

25
Q

List other nutrients to support alcohol detoxification.

A
Cruciferous vegetables
Glutathione
Vitamin B Complex
Selenium
Iron (cofactor for C450)
Zinc (cofactors for DNA damage repair enzyme)
Nuts
Vitamin A
Proteins
Carnitive
Antioxidants A, C
26
Q

What are the signs and symptoms of phase 1 liver pathway induction?

A

Bloating, tiredness, sweating at night, itchy skin, headaches, allergies, poor sleep, gut problems. Toxic metabolites travel in the blood rather than being excreted.

27
Q

What will be the nutritional impact of dysfunctional phase 1 in the body?

A
  • overburdening of phase 2
  • activation of kupffer cells leading to excess release of cytokines
  • depletion of nutrients (gutathione, niacin)
28
Q

What could be one of the biochemical reasoning pathways for bloating?

A

Toxic TMAO travel to gut (gut-liver axis) and harms microbiome and gut epithelium causing bloating.

29
Q

Which over the counter meds are detoxified via phase 1?

A

Salicylates and ibuprofen

30
Q

What are the largest macrophages with phagocytotic activity for the protection of liver cells called?

A

Kupffer cells

31
Q

Which group of enzymes are imperative for liver detox 1?

A

Cytochrome 450 (group of haem dependent enzyme)

32
Q

True or false? Curcumin and grapefruit cause an upregulation of phase 1 liver detoxification.

A

False they cause a lowering of phase 1

33
Q

True or false - Glutathione is required as a cofactor for detoxification pathway to support cytochromes.

A

False – it is required as an antioxidant in phase 1 and as a conjugant in phase 2.

34
Q

What is the form of glutathione that acts as an antioxidant?

A

Reduced Glutathione GSH

GSH is depleted by the oxidative by-products of phase 1, the GSH-dependent phase 2 activity is inhibited.

35
Q

T/F - Vitamin C is required as a cofactor for glutathione peroxidase enzyme

A

False

Selenium is required as cofactor for glutathione peroxidase enzyme (it’s a selenoprotein)

36
Q

Which primary nutrients ensure the optimal functioning of phase 1 liver detoxification?

A
Vitamin C
Magnesium
Zinc
Copper
Which all help with optimal functioning
37
Q

Which nutrients are required as cofactors for excretion of thyroxine, catecholamines and oestrogen via sulphation pathways?

A

Sulphation pathways require pyridoxine, methionine, cysteine, glutathione, taurine and molybdenum as cofactors.

38
Q

Which of the following induce the phase 2 liver detoxification pathway?

A

Cigarette smoke, birth control pills and limonene

NSAIDS, low protein diet and tartrazine inhibit this pathway

39
Q

T/F - Acetyldehyde dehydrogenase, MEOS and catalase are the enzymes involved in alcohol metabolism

A

True - The enzymes alcohol dehydrogenase (ADH), cytochrome (CYP2E1), and catalase all contribute to oxidative metabolism of alcohol. ADH, (in cytosol), converts alcohol (i.e., ethanol) to acetaldehyde (using NAD+). Catalase, (in peroxisomes), uses H2O2 to oxidize alcohol. At excessive levels of alcohol, CYP2E1, in the cell’s microsomes (MEOS), becomes active. Acetaldehyde is metabolized finally by aldehyde dehydrogenase (in mitochondria) to form acetate.