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Biochemistry Branch |
About the Branch:
The branch biochemistry consists of the head of the branch and the laboratory of biochemistry, in which both first and second classes are studied, where the biochemical bases of the biological processes that occur within the human body are determined in normal and pathological cases, in addition to following the most advanced practical methods in conducting clinical biochemical analyzes, Which contribute to community service.
Vision:
Biochemistry forms the basis of all life sciences including clinical sciences. Physiological functions are indeed the manifestation of the underlying biochemical reactions. The
advances in the field of medical science are simply overwhelming and obviously, biochemistry occupies the central place in this endeavor. The profession of clinical
chemistry is rapidly merging with other disciplines in laboratory medicine. In the background of this rapid growth it has become essential that biochemistry is taught in the correct
perspective to the medical students. But in reality, biochemistry is taught with total contempt and quite naturally is learnt very casually.
Biochemistry by definition is the chemistry of life and life is a system of cooperative
enzyme catalyzed reactions. Of course, it is to the credit of a teacher to make the subject come alive and perhaps to inspire the student to devout they to an in depth study.
In the context of teaching biochemistry in medical colleges, the teacher needs to enlighten them with the molecular basis of life processes in normal health and in different disease
conditions. The relevance and importance of the subject in medicine should be clearly identified.
Teaching of biochemistry presently followed in medical colleges’ deals generally with:
- The chemical and structural details of biomolecules
- Their metabolic fate
- Discussion shortly on the physiological or pathological relevance.
Further, it has been a classroom teaching. The knowledge gained by this traditional method is hardly retained till the clinical teaching starts in the later years and at this stage there is very little scope for the student to understand the molecular basis of different clinical conditions.
Teaching biochemistry with poor clinical exposure does not do any justice to a medical student and in this way they neither learn the chemistry of life nor the chemical basis of
pathology. Exposing the student to less than the whole story is not fair. The beauty of the
subject lies not in the fact that something occurs but in why it occurs. Understanding why?, makes the subject lively.
Orientation of the medical students to understand the molecular basis of normal and/or
abnormal functioning of an organ system needs to be initiated aggressively. A good following of biochemistry helps a better learning of the other branches of medicine and vice versa.
Biochemistry in health science cannot be taught and learnt in isolation. A thoroughly integrated approach with an emphasis on the recent trends in clinical science and clinical
chemistry should be encouraged in medical colleges.
Biochemistry should be taught in all the three phases of the course in medicine.
Stage I deal with:
1. The chemical characteristics of biomolecules and how these characteristics can contribute to the physiological functions.
2. How these biomolecules are metabolized in the body and how a disturbed metabolic
profile can contribute to the onset and progress of a pathological condition.
Initially, the student should be encouraged to recognize that biochemistry is a continuum of organic chemistry and how scientists from varied backgrounds have
contributed to the understanding of life in molecular terms. Student should be oriented to appreciate some of the simple facts such as:
a. What unique properties of water have allowed life to originate and evolve in it.
b. During chemical reactions how the electron delocalization occur and result in simple organic reactions and how this very same factors play a role in the more complicated enzyme catalyzed reactions as well as how the structure of a biomolecule is related to its physiological function.
c. How nutritional status of a person is linked to his health and disease etc.
Stage II: Biochemistry should be to highlight: how a naturally occurring or a synthetic compound, generally an organic compound, comes to use as a drug. How does it act and how this compound, a prototype drug – the lead compound is chemically modified, in a number of cases, into a better drug. can be cited to convey the message clearly.
A little knowledge of basic biochemistry and chemistry such as the stereochemistry becomes very useful in identifying the compound with better efficacy. Remember, nearly half
of the commercially available drugs are stereoisomers and not all the stereoisomers of a
compound will have the same efficacy. (e.g. in the body only D-sugars, L-amino acids, cis- fatty acids) are generally physiologically active. Further understanding the mode of action of drugs or even the drug resistance needs to follow changes at the molecular level. Precisely, pharmacology is better followed with relevant aspects in biochemistry. Certainly, biochemistry is complimentary to pharmacology.
Stage III: When the student is amidst a variety of cases in almost all the clinical subjects, he is totally at a loss to understand the pathophysiology of the clinical condition that is before him. Let alone an understanding at the molecular level, he will not be in a position to identify a biochemical investigation that is needed for the clinical diagnosis of different cases. If at this stage, imagine, what a great advantage it would be, if the student were to have a discussion on the biochemical basis of the pathology in different cases that he would encounter. Without biochemistry, how would the student follow the metabolic disturbances and the ensuing complications that would develop in some of the common conditions such as diabetes, hypertension, coronary artery diseases, alcoholism, cancer, genetic disorders…..etc. Is it not an academic injustice? We have not given the student a complete story. It is now strongly felt and generally feasible that in addition to the clinics, regular case presentation by a clinician along with relevant discussions by a pathologist/microbiologist and a biochemist should become an essential component of the course. Such an integrated approach would not only be of immense value for a good understanding, it would also be a genuinely meaningful approach to therapy.
Syllabus of Biochemistry for Medical Colleges
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Academic Year
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2019 – 2020
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Course Title
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Principle of Medical Chemistry and Biochemistry
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Credit Hours
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3 Credit Hours Theory
2 Credit Hours Practical Work
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Duration Time
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15 weeks
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Credit Units
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4 Credit Units
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Topics
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Hours
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Week
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Biomolecules, water the universal solvent , solutions, acid-base properties and balance in the
body, buffers, pH , osmolality, stereochemistry.
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3
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First week
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Chemistry of Carbohydrates:
Nomenclature , monosaccharides, stereoisomers, reactions of monosaccharides
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3
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Second week
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Chemistry of Carbohydrates:
Disaccharides , polysaccharides, heteroglycans mucopolysaccharides , glycoproteins and mucoproteins
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3
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Third week
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Chemistry of Lipids
Classification of lipids, fatty acids , saturated and unsaturated fatty acids, trans fatty acids, neutral fats, phospholipids, sphingolipids, lipid bilayers and their properties.
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3
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Fourth week
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Chemistry of Lipids
Prostaglandins , thromboxanes and leukotrienes steroidal lipids, complex lipids, lipoproteins.
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3
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Fifth week
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Amino Acids: Structure and Properties
Structure of amino acids, stereoisomerism, classification, reactions and properties.
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3
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Sixth week
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Peptides and Proteins: Structure and Function
Peptide bond formation, polypeptides, structure of proteins, physical properties of proteins,
classification, simple and conjugate proteins.
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3
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Seventh week
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Chemistry of Nucleotides and Nucleic Acid Purine and pyrimidine nucleosides and nucleotides Nucleic acids, types, roles and their constituents.
Nucleic acids.
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3
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Eighth week
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Enzymology:
Enzyme specificity, mechanism of enzymatic action, classification of enzymes, co-enzymes, iso- enzymes, enzyme activities, active site or active
centre of enzyme.
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3
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Ninth week
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First Year – Course Titled (BIOC-101)
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Enzymology:
Factors influencing enzyme activity
Michaelis-Menten theory
Enzyme inhibition , Enzyme Regulation
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3
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Tenth week
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Vitamins and Nutrition
Nutrients, micronutrients and macronutrients, types and their roles in nutrition.
Vitamins, vitomers, nomenclature and classification
of vitamins.
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3
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Eleventh week
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Vitamins and Nutrition
Water-soluble vitamins, chemical constituents, activation and coenzymes biosynthesis and their
roles in metabolism. Vitamin deficiency diseases.
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3
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Twelfth week
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Vitamins and Nutrition
Fat – soluble vitamins, chemical structures and properties with their biochemical roles.
Vitamin antagonist, Hyper and hypovitaminosis.
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3
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Thirteenth week
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Bioenergetics
Energetic molecules , ATP and related compounds, mechanism of their production with biochemical roles with their regulation.
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3
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Fourteenth week
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Body Fluids
Blood, composition, plasma proteins, clotting factors.
Milk, composition and functions. CSF, composition and functions
Seminal fluids, composition and functions
Synovial fluid, saliva
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3
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Fifteenth week
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Experimental part
1. Case scenario for lab safety and security
2. Case scenario of fluids and solutions with PH.
3. Case scenario of buffer in blood .
4. Case scenario of carbohydrate (Two weeks)
5. Case scenario of Lipids (Two weeks)
6. Case scenario of Amino acids (Two weeks)
7. Case scenario of Proteins (Two weeks)
8. Case scenario of Enzymes (Two weeks)
9. Case scenario of Electrolyte importance
10. First – semester Practical Examination.
Second Year - First Semester (BIOC-201)
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Academic Year
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2020 – 2021
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Course Title
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Biochemistry and Metabolism
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Credit Hours
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3 Credit Hours Theory
2 Credit Hours Practical Work or Clinical Case Studies
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Duration Time
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15 Weeks
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Credit Units
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4 Credit Units
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Topics
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Hours
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Week
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Hormones
Classification of hormones, second messengers and G- proteins.
Mechanisms of hormonal action and signaling molecules
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3
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First week
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Hormones:
Steroid hormones
Thyroid hormones
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3
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Second week
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Hormones:
Hypothalamic and pituitary hormones
Gut hormones
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3
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Third week
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Mineral Metabolism and Toxic Metals
Calcium, PTH, calcitonin, hyper and hypocalcemia. phosphorous, magnesium, sodium, copper, lead, ……etc.
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3
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Fourth week
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Biological Membranes and Transport
Plasma Membrane, structure and functions, solute transport mechanisms across membranes, membrane dynamics, membrane channels.
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3
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Fifth week
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Clinical Enzymology
Enzymes in medicine, as reagents, as indices of diseases. Enzymes as a therapeutic agent.
Enzymes and isoenzymes in malignancies. Enzymes in myocardial infarction.
Enzymes and isoenzymes in liver diseases
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3
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Sixth week
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Digestion and Absorption of Carbohydrates
Digestion and absorption of carbohydrates.
Transport of monosaccharides. Glucose transporters. Insulin effect on different transporters.
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2
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Seventh week
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Overview of Metabolism
Metabolism, catabolism and anabolism. Metabolic pathways and control mechanisms Metabolic profile of organs
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1
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Carbohydrate Metabolism (Glycolysis)
Steps and key enzymes of glycolysis.
· Aerobic and anaerobic glycolysis, pyruvate and lactate as end products of glycolysis.
· Calculation of energy obtained by glycolytic pathway.
· Inhibitors of glycolysis.
· Comparison of hexokinase and glucokinase.
· Factors affecting glycolysis, regulation.
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3
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Eighth week
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Oxidation of Monosaccharides, Fructose
Intolerance, Galactosemia.
· Clinical correlation:
· Lactose intolerance.
· Fructose intolerance, fructosuria.
· Galactosemia
Oxidative Decarboxylation of Pyruvate
· Pyruvate dehydrogenase complex, enzymes and coenzymes.
· Fate of pyruvate , acetyl-CoA biosynthesis, regulation of pyruvate dehydrogenase complex.
· Citric acid cycle or tricarboxylic acid cycle (TCA).
· Regulation, energetic and inhibitors of TCA cycle.
· Clinical correlation:
Pyruvate dehydrogenase deficiency. Fumarase deficiency.
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3
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Ninth week
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Gluconeogenesis, Cori and Alanine cycle
· Definition and Importance.
· Reactions and irreversibility.
· Hormonal regulation.
· Factors affecting gluconeogenesis.
· Cori and alanine cycle.
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3
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Tenth week
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Pentose Phosphate Pathway, G6PD deficiency and
Favism.
· Two phases of pentose phosphate pathway or hexose mono-phosphate shunt (HMP-shunt), oxidative and interconversion phase.
· Biochemical significance of HMP-shunt in certain tissues.
· Biosynthesis of NADPH and ribose-5-phosphate.
Glucose-6-phosphate dehydrogenase (G6PD)
deficiency and hemolytic anemia, G6PD variants.
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3
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Eleventh week
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Glycogen Metabolism, Regulation, Glycogen Storage
Diseases.
· Glycogen biosynthesis (glycogenesis), steps, key enzymes.
· Glycogen degradation (glycogenolysis), steps, key enzymes.
· Regulation of each of glycogenesis and glycogenolysis.
· Hormonal and allosteric regulation of glycogenesis and glycogenolysis.
· Glycogen storage diseases.
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3
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Twelfth week
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Biological Oxidation and Electron Transport Chain
Structure and organization of complexes. Enzymes and coenzymes in oxidative phosphorylation, ATP synthase. Inhibitors of respiratory chain, Uncouplers, and inhibitors of oxidative phosphorylation.
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3
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Thirteenth week
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Metabolic interrelationship in well fed state and starvation.
· Biochemical roles of insulin and glucagon.
· Metabolic integration during well fed state.
· Hormonal balance : Insulin / glucagon.
· Early starvation : Duration and fuel utilization.
· Intermediate starvation : Duration and fuel utilization, glucose , alanine and fatty acid cycle.
· Stages of starvation and hormonal balance.
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3
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Fourteenth week
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Free Radicals and Antioxidants
Oxidants, Oxygen and nitrogen reactive species, Properties, Free radicals, Non-free radicals, Generation of oxidant molecules, Anti-oxidants, Enzymatic antioxidants, Non- enzymatic antioxidants, Oxidative stress
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3
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Fifteenth week
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Experimantal Part
1. Lab management
2. Principles of spectrophotometry
3. Case scenario on Lactose intolerance.
4. Case scenario on glucose tolerance test
5. Case scenario on glucose level estimation
6. Case scenario on G6PD
7. Case Scenario of NADPH roles
8. Case scenario on glycogen storage diseases
Second Year – Second Semester (BIOC-202)
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Academic Year
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2020 – 2021
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Course Title
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Biochemistry and Metabolism
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Credit Hours
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3 Credit Hours Theory
2 Credit Hours Practical Work or Clinical Case Studies
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Duration Time
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15 Weeks
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Credit Units
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4 Credit Units
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Topics
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Hours
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Week
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Digestion and Absorption, Storage and Mobilization of fats
· Digestion of lipid, lingual and gastric lipase.
· Pancreatic lipase and formation of micelle.
· Role of bile salts and bile acids, emulsification of fats.
· Absorption of lipid from intestinal cells and release as chylomicron into lymphatic system.
· Site and biosynthesis of TAG: liver and adipose tissues.
· Steps and regulation of storage of fats.
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3
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First week
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Lipid Metabolism
β-Oxidation of Fatty acids, Refsum’s disease.
· Transportation of fatty acids into mitochondria.
· β-Oxidation of fatty acid, steps, energetic, regulation.
· Saturated, unsaturated and odd carbon fatty acid oxidation.
· Lipolysis : steps and key enzyme.
· Hormone sensitive lipase, regulation of lipolysis.
· Clinical correlation: Refsum’s disease , genetic deficiency in carnitine transportation of fatty acids into mitochondria.
Ketone Body Metabolism.
· Ketogenesis, site, steps.
· Ketolysis, site, steps for utilization, ketonemia, ketonuria.
· Regulation of ketogenesis and ketolysis, Starvation and ketosis.
· Clinical correlation : Diabetic ketoacidosis.
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3
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Second week
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Fatty Acid Biosynthesis.
· Transportation of acetyl-CoA from mitochondria into the cytosol.
· Fatty acid synthase complex.
· Energetics, mechanism of regulation of fatty acid biosynthesis.
· Elongation reactions of palmitic acid, desaturation of fatty acids.
· Polyunsaturated fatty acids, prostaglandins , biochemical roles and their clinical correlations.
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2
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Third week
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Ethanol Metabolism
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1
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Cholesterol Metabolism, Regulation, Bile Acids
· Sources, distribution, and balance in tissues.
· Structure, cholesterol biosynthesis.
· Key enzyme, HMG-CoA reductase and regulation.
· Factors regulating cholesterol biosynthesis and degradation.
· Bile acid and bile salts, clinical correlations.
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3
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Forth Week
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Lipoprotein Metabolism, Hyperlipoproteinemia.
· Transport of lipids, lipoproteins.
· Classification and functions of lipoproteins and apoproteins.
· Metabolism and degradation of chylomicron and VLDL.
· Metabolism and uptake of LDL.
· HDL metabolism.
· Lipid profiles
· Hyperlipidemias and cardiovascular diseases
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3
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Fifth week
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Digestion and Absorption of Protein, Catabolism of
Tissue Protein, Protein Degradation
· Digestion of protein, absorption of amino acids.
· Gastric and intestinal peptidases, pancreatic peptidases.
· Amino acids transport across intestinal cells.
· Nitrogen balance, positive and negative nitrogen balance, causes.
· Degradation and transport of intracellular and tissue protein.
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3
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Sixth week
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Amino acid Metabolism
· Essential and non-essential amino acids.
· Amino acid biosynthesis.
Transamination reactions, role of pyridoxal-5- phosphate.
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3
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Seventh week
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· Amino acid catabolism.
· Ketogenic and glucogenic amino acids.
· Transport of ammonia to the liver and kidney, neurotoxicity associated with ammonia.
· Urea cycle, transport of urea and excretion, regulation.
· Clinical correlations:
- Metabolic disorders of urea biosynthesis.
- Deficiency of urea cycle enzymes
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3
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Eighth week
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· Metabolic fate of some amino acids, amino acids and
TCA cycle.
· Biosynthesis of some important of amino acids derivatives:
- Tyrosine - derived neurotransmitters.
- Tryptophan-derived neurotransmitters.
· Inborn error of metabolism : site of metabolic defects :
- Alkaptonuria.
- Albinism.
- Tyrosinosis.
- Parkinson’s disease.
- Maple syrup disease.
· Creatine, Glutathione, polyamines, biosynthesis and functions.
· Nitric oxide , biosynthesis and functions
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3
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Ninth week
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Nucleotides Metabolism
· Biosynthesis of purine nucleotides, de novo and salvage pathways.
· Regulation of purine biosynthesis, degradation of purines.
· Hyperuricaemia : primary and secondary
· Biochemistry of gout
Lesch-Nyhan syndrome
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3
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Tenth week
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· Biosynthesis of pyrimidine nucleotides, regulation, orotic aciduria.
· Degradation of pyrimidine nucleotides.
Deoxyribonucleotide biosynthesis.
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1
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Eleventh week
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Genetic code and translation
· Protein biosynthesis and genetic code
Inhibitors of protein biosynthesis
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2
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Hemoglobin, Porphyrins, Heme Biosynthesis and
Porphyrias
· Hemoglobin (structure, oxygen and carbon dioxide)
· Heme biosynthesis, porphyrias.
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3
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Twelfth week
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Liver Function Tests
· General liver functions
· Liver function tests
· Bilirubin metabolism, hyperbilirubinemia, clinical correlations.
· Jaundice, classification of jaundice
· Liver function test based on synthetic function
· Serum enzyme activity levels as markers of hepatobiliary diseases
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3
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Thirteenth week
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Biochemistry of Cancer and Tumor Markers
Etiology, chemical carcinogens, antimutagenes, oncogenes, proto-oncogene, onco-suppressor genes, growth factors,
tumor kinetics, tumor markers, anticancer drugs.
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3
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Fourteenth week
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Renal Function Tests
Renal function tests, functions of the tubules, renal threshold, protein urea, clearance tests, inulin clearance, creatinine clearance test, urea clearance test, tests for tubular function, osmolality, urinary acidification.
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3
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Fifteenth week
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Experimantal Part
Case scenario for each week related with the theoretical lecture.
1. Principle of ELIZA techniques
2. Lipid profile
3. Liver function tests
4. Case studies
5. Renal function test
6. Case studies
7. Bilirubin determination
8. Uric acid determination
9. Case studies
10. Tumor markers
11. Case studies
References:-
1. Lehninger Principle of Biochemistry, 4th ed. 2005.
2. Lippincott’s Reviews of Biochemistry, 3rd ed. , 2018.
3. Textbook of Biochemistry (For Medical Students) , 3rd ed. 2013, Vasudevan, DM
and Sreekumari, S.
4. Basic Medical Biochemistry: A Clinical Approach, 1996.
5. Harper’s Biochemistry, 27th ed. 20016.
6. General , Organic , and Biological Chemistry, 5th edition , H. Stephen Stoker,
2010.
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