Week 2 Flashcards

(57 cards)

1
Q

Major lipids of the plasma membrane

1) PE
2) PS
3) PI
4) PC
5) SM
6) Cholesterol
7) Glycolipids

A

1) Phosphatidyl ethanolamine- inner leaflet, neutral
2) Phosphatidyl serine- net negative charge, inner leaflet
3) Phosphatidyl Inositol- net negative charge, inner leaflet, can be phosphorylated in cell signaling
4) Phosphatidyl Choline- Neutral, outer leaflet
5) SPhingomyelin-outer leaflet, non-glycerol back bone
6) rigid planar structure that fits between kinks in phospholipid. Adds stiffness to membrane and lowers permeability
7) component of outer membrane, heavily involved in cell recognition and signaling. (ABO antigens)

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2
Q

Proteoglycans

A

Separate class of glycolipids that have longer unbranched glycosylation. Important in ECM formation, glycocaalyx formation and cell-cel signaling/recognition.

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3
Q

What is the site of the cytochrome p450 enzymes?

What is the main function of them?

A

Membrane proteins found in the SER membrane in the liver.

Detoxify many drugs and toxins, particularly lipid soluble ones in two phases.

First phase is oxidation, reduction, or hydrolysis.

Second phase tags the molecule with a polar group to make it water soluble and excretable through kidneys.

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4
Q

What affect does acetylcholine have on the following cells?

Skeletal muscle, cardiac muscle, salivary glands.

A

Contraction of skeletal muscle

Secretion from salivary glands

Decreased contractility in cardiac muscle

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5
Q

Myasthenia Gravis

Cause, symptoms, and treatment

A

Autoimmune disorder that creates antibodies for acetylcholine receptors on skeletal muscle.

Fatigue, weakness, droopy mouth, and single droopy eyelid, double vision, unsteady walking, difficulty swallowing

Steroids to inhibit immune system, acetylcholinesterase inhibitor to up Ach in synapse.

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6
Q

G-proteins Gs Gi Gq

A

Gs=stimulates Adenylyl cyclase

Gi= inhibits adenylyl cyclase

Gq activates phospholipase C

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7
Q

What is the most numerous type of enzyme linked receptors, how does it work, and what processes is it typically involved in?

A

Tyrosine kinases, dimerized upon ligand (growth factor) binding with cross phosphorylation. Phosphorylated intracellular domains activate other proteins.

Typically involved in growth, survival

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8
Q

Ion channel linked receptors are typically found where?

A

Receptors in synapse on neuron dendrites

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9
Q

How does NO result in vasodilation?

A

Made by NO synthase from, diffuses easily across membranes where it binds and activates guanylyl cyclase to upregulate cGMP production to then signal relaxation of smooth muscle.

Good for angina, and high BP.

Very powerful and unstable. Short lived paracrine

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10
Q

What two hormones activate the cAMP/PKA system?

A

Epinephrine and norepinephrine both bind GPCRs to activate cAMP system.

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11
Q

Explain the PI phospholipase C pathway.

A

Phospholipase C breaks down phosphorylated PI (PIP2) to then form IP3 and DAG. IP3 goes in to trigger Ca2+ release from ER. DAG and Ca2+ then activate protein kinase C.

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12
Q

RAS

A

Monomeric G-protein activated by nearly all tyrosine kinase receptors.

Activate RAS-MAPK cascade (3 successive kinases that result in altered gene expression and protein activity)

RAS mutations are present in 30% of all cancers (oncogene, typically stimulate overactive cell proliferation)

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13
Q

PI-3 Kinase pathway

A

PI is phosphorylated at position 3 to make PI3P.

PI3P stays attached to lipid membrane. Stimulates cell growth and survival

This pathway is stimulated by RAS as well

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14
Q

JAK STAT pathway

A

Short pathway important in immunity and inflammation.

No intrinsic tyrosine kinase

Receptor is phosphorylated by JAK after binding cytokines(protein signals), attracts and activates STAT proteins that go on to nucleus to affect gene expression.

JAK inhibitors used to treat arthritis and othe inflammatory diseases

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15
Q

TGF-Beta Pathway

A

Short pathway involved in development.

Receptor is a serine threonine kinase.

Ligand binding leads to phosphorylation TGF-beta receptors. SMADS is then activated which travels to nucleus to affect expression of genes.

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16
Q

Desensitization

A

COnstant activation of receptors leads to decreased activation of proteins.

Best studied in GPCRs where GPCR kinases can come in to cause arrestin to bind to GPCR and blockchain activity.

Other mechanisms are down regulation of receptor synth, increased receptor turnover, endocytosis of receptor.

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17
Q

Beta adrenergic receptors

A

Bind epi and norepi to regulate contractility in heart. Associate Gs to stimulate cAMP pathway.

Damage to heart can cause activation of sympathetic nervous system leading to constant epi/norepi levels leading to desensitization of GPCR receptors. Vicious cycle.
Ironically beta blockers can ease this problem.

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18
Q

INsulin receptor

A

Pre-dimerized tyrosine kinase receptor. Activates MAPK and PI-3K pathways for cell growth/proliferation. and upregulation of insulin receptors

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19
Q

AKT

A

Downstream in PI-3K pathway. Has many effects. Don’t know why we have to know this.

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20
Q

Name the proteins and steps involved in vesicle formation

A

Cargo receptors bind adaptin and then clathrin protein molecules as invagination occurs. Dynamin pinches off the vesicle and then the clathrin and adaptin fall off to be recycled to the membrane.

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21
Q

Enzyme and amino acid residue typically associated with glycosylation

A

Asn, oligosaccharyl transverse

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22
Q

How are acid hydrolases tagged for transport to lysosomes?

Diseases associated with this?

A

Acid hydrolases are tagged with a mannose 6 phosphate that docks them into a receptor in the Golgi apparatus that then buds off. Resulting vesicles go on to fuse with an early endosome.

Lysosomal storage diseases typically result in death before 15 years. Child is born normal but accumulation of substrates results in cell death.

Inclusion cell disease= mannose is never phosphorylated and hydrolases are not properly marked for transport to endosome. Excreted from cell.

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23
Q

Familial Hypercholesteremia

A

Mutations in LDL receptor result in excessive cholesterol levels in blood.

Systemic deposits and atherosclerosis result

24
Q

Inert binding site

A

Endogenous binding site of a drug that does not result in any relevant chemical response.

Blood albumin is a common site of this.

25
Agonist levels
Full, partial, inverse. Based on target activity father binding. Based on enzyme activity after introduction.
26
Antagonist classifications 1) chemical/physical 2) non-competitive allosteric 3) competitive 4) non-competitive active site
1) do not react with receptor at all, change chemical/physical environment 2) bind at allosteric site to decrease efficiency of receptor/enzyme 3) reversible binding of receptor. Can be overcome by increased agonist 4) suicide inhibition, irreversible binding of receptor
27
Beta adrenergic receptors
react with epi/norepi Beta1 on heart increase rate and blood pressure Beta 2 result in bronchoconstriction Selective beta blockers metoprolol, esmolol, atenolol
28
GRaded and quantal dose response
Graded= Effect vs. concentration. Can get ED50 and Emax. Quantal=%individual response vs concentration. Keeps track of therapeutic, toxic, and lethal effectsTD50/ED50. The bigger the better. Want large therapeutic window. Small therapeutic window (warfarin) means patients must be monitored for toxicity.
29
Ubiquitin proteasome pathway What is it? Associated diseases?
Proteins are marked for degradation by a ubiquitin tag added by ubiquitin ligases. Proteasome consists of three domains. A central core where Degradation occurs, two domains on ends that recognize ubiquitin tags, and thread protein through to core. Disorders in this pathway typically lead to immune disorders, cancer, neurodegenerative, muscle wasting, diabetes.
30
Autophagy
Lysosome associated degradation of cellular components. Typically triggered by cell stress/damage Macro= isolation membrane forms around organelle or complex. Fuse with lysosome Micro= autophagic tube forms as result of direct invagination of lysosome Chaperone mediated= longlived proteins have KFERQ motif. Heat stress chaperone binds and shuttles to lysosome Rapamycin targets MTOR to inhibit expression of autophagy genes.
31
Cystic fibrosis symptoms
Dehydration (salty sweat) Meconium ileus from sticky feces (poor ion transport) Loose foul smelling feces from malabsorption (PancIns) Digestive problems and poor growth (PancIns) Prone to infection and respiratory distress (poor ion transport/mucus in lungs) Infertility, sinus, liver issues (PIT, Mucus build up) Long term issues include cirrhosis, diabetes, rectal prolapse, bronchiectasis, chronic infection, portal hypertension, respiratory failure
32
Structure of CFTR protein
2 Transmembraane domains that form channel two nuclear binding domains that bind and hydrolyze ATP. Gating area (Site of phe508del) One regulator domain that can be phosphorylted and activate the NBD. (Phosphorylated by PKA/cAMP pathway)
33
CFTR Classes and common mutations
Type 1-3 are more sever while type 4-6 are typically asymptomatic Type 1: nonsense mutation, no protein synth. Severe Type 2: p.phe508del. Issue in folding/processing. No functional protein makes it to membrane. Most common form of CF. Protein ubiquinated and degraded. Type 3: p.gly551asp missense. Causes gating issues. No ion transport. Type 4: p.Arg117His gating issues, some ion transport Type 5: splicing defect (5T) less functional protein made. Type 6: less stability of protein, increased turnover.
34
CF genetic correlation
Lung obstruction=poor correlation Infertility= moderate correlation Pancreatic insufficiency= best correlation
35
How does diabetes result from CF?
thickened pancreatic juice does not move out into intestine causing a back up and damage to both acinar(exocrine) and islet(endocrine) cells.
36
why are CF mutations so prevalent (4-5%) in European populations?
It is believed that CF produces less severe reactions to cholera toxin. Cholera constitutively activates cAMP/PKA system and produces ion/water transport out into intestines. Cholera binds GM receptor to enter cell. Alpha toxin separates in ER and leaves to bind to a g-protein that activates adenylyl cyclase.
37
ADME
Pharmacokinetics mnemonic. Absorption, distribution, metabolism, excretion
38
Therapeutic window
The amount of drug that sits between the minimum effective doses for therapeutic and toxic effects.
39
Drug hydrophobicity.
Typically drugs are hydrophobic, allowing them to enter cell via passive diffusion which is non-saturable first order kinetics.
40
Bioavailability
F= available drug from oral dose/available drug from IV Fraction of oral administered drug that makes it past liver, gut, etc. into systemic circulation.
41
Drug absorption in liver vs brain.
Liver has capillaries with large fenestrations to allow drugs to pass. Brain has tight junctions in capillaries (blood brain barrier) much more difficult to get drugs in.
42
Two compartment model of drug distribution
Rapid initial drop in plasma concentration while tissue concentration equalizes. (Alpha phase) Beta phase= slower drop in concentration that is due to metabolism of drug.
43
Distribution volume Clearance
Vd=dose/plasma concentration. Not always accurate representation. Very high numbers can tell you things like localization of drug in certain tissue. Clearance= .693*Vd/T-half
44
First and zero order metabolism (elimination) kinetics
First: V=Vmax *[c]/Km Displays half life behavior C=C0*e^-kt Zero order: V=Vmax Saturation, variable half life C=C0-kt T-half=ln(2)/ Km
45
Steady state drug concentration
IV administration: ~5 half lives to steady state. Css directly proportional to infusion rate, inversely proportional to elimination rate. Oral administration: Css is proportional to dose and bioavailability, inversely proportional to dose interval and elimination. Loading dose can be used to reduce time to Css
46
Cytochrome p450 enzymes
Membrane enzymes in SER membrane. Typically involved in phase 1 of drug metabolism. Reduction, oxidation, hydrolysis, deamination, etc. of drugs. Most common is CYP3A4. CYP2C9(16% including warfarin/Coumadin) and CYP2D6(20-25%, including antipsychotics, antidepressants, metoprolol, activation of tamoxifen) Both 2C9 and 2D6 have high genetic variability and people may be classified as poor, intermediate, efficient and ultra maetabolizers.
47
Warfarin
Anticoagulant used for orthopedic surgeries, heart valve replacements, embolisms. Narrow therapeutic window, may lead to bleeding issues. Processed by CYP2C9, targets VKORC1 VKORC1 and CYP2C9 both have a high genetic variability and may affect necessary dose.
48
Tamoxifen
Estrogen modulator used to treat and prevent breast cancer. Activated to Endoxifen in part by CYP2D6
49
Thiopurine S-methyl transferase
Enzyme that modifies thiopurines. Thiopurines are immunosuppressants used to treat a number of inflammation, leukemia, and autoimmune diseases. TPMT deficiency can lead to dangerous leukopenia when using thiopurines. FDA recommends genetic testing before use of thiopurines.
50
QALY
Quality adjusted life year. Measure used in determining cost-utility assessment along with 10 year survival and rehospitalization rates.
51
HLA-B(MHC I) mutants
Associated with increased risk of taking drugs such as abacavir and carbamazepine.
52
Diagnostics and Genetic Testing in cystic fibrosis
NBS tests for IRT levels. Top 4%ile get sent to genetic panel test with 23 of most common CF mutations (Over 2000 known mutations) More extensive genetic testing may be required if mutation is not initially found. Extended panel tests, sequencing, and del/dup tests are all available. False negatives still possible. Targeted sequencing available if known carriers in family. Sweat test (pilocarpine intophoresis) is gold standard for positive diagnosis (30-60 mmol/L = grey area, >60 mmol/L = positive diagnosis)
53
CF drugs
Ivacaftor- potentiator, helps with gating issues (Type II and III) Lumacaftor and tezacaftor- correctors help with folding and processing Ivacaftor can treat type III alone (p.gly551asp) Pairing a corrector and potentiator can treat type II. Iva/teza pair is more successful due to reduced side effects (two p.phe508del)
54
CF and 5T
There is a polyT track before exon 9 in the CFTR gene. Reducing number of T’s to 5 causes defective splicing and a reduced amount of functional CFTR made. Other risk factors play into this such as en expanding poly TG track (>12) and the type IV p.Arg117HIs. So long as they are on the same chromosome. Parental testing often necessary to determine cis/trans
55
Death of CF patients
used to be meconium ileus, but is now respiratory distress. Above 10% CFTR function = no symptoms.
56
CF treatment
Hydration, pancreas enzymes, vibratory vests and inhalers, antibiotics, ADEK vitamin supplementation, improved nutrition, clearing of sinuses, pancreatic enzymes, liver/lung transplants, treatment of cirrhosis and diabetes after long term, surgical removal of meconium ileus
57
Prevalence of CF
General population chance of being a carrier = 1/25