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2.7. Enzymes in medicine

Enzymes are used as therapeutic agents:

- in their absence or deficiency (inherited or acquired);

- for the specific destruction of some metabolic products.

Enzyme

The use of the enzyme

Pepsin

Disorders in digestion of proteins in the stomach

Urease

Removal of urea from the organism in the apparatus of "artificial kidney"

Hyaluronidase

Resorption of scars

Streptokinase, urokinase

Preventing blood clots formation

during operations

Enzymes are used in the clinic as analytical reagents.

Immobilized enzymes are often used for the analysis, which are artificially connected with the water-insoluble carrier, which increases the stability of protein catalysts.

Enzyme

The use of enzyme

Glucose oxidase

Determination of glucose concentrations in blood

Lipase

Determination of triacylglycerols concentration in blood

Cholesterol oxidase

Determination of cholesterol in blood

Analysis of the kinetics of appearance and disappearance of enzymes in the serum is used in the diagnosis.

The composition of enzymes and their tissue distribution in an adult is mainly constant and can change in diseases. Almost all of the enzymes of the organism are functioning intracellularly. When tissue is damaged intracellular enzymes appear in the serum. Such enzymes are called indicator enzymes.

By the appearance of several tissue enzymes in plasma or serum in high amounts one can conclude on the functional status and lesions of various organs.

Disease

Enzyme

Myocardial infarction

Creatine kinase, aspartate transaminase, LDH-1

Viral hepatitis

Alanine transaminase, aspartate transaminase, glutamate dehydrogenase

Pancreatic diseases

-amylase

Liver diseases

Alanine transaminase, -glutamyltransferase

Enzimopathy (synonym fermentopathy) is the common name of diseases, developing as a result of the absence or decreased activity of certain enzymes. As a result of the interdependence of metabolic pathways defect of a single enzyme often leads to a number of disorders in the metabolism.

We distinguish hereditary and acquired enzymopathy.

1. Hereditary enzimopathys are associated with genetically determined deficiency of one or more enzymes. There are more than 150 hereditary enzymopathies, which are based on gene mutations.

2. Acquired enzimopathy.

Toxic enzymopathy is a consequence of toxic effects of xenobiotics and environmental mutagens. Lead, which is contained in the transport exhaust fumes, causes a inhibition of the enzyme aminolevulinatdehydrase involved in the synthesis of heme, which manifests the development of anemia of children in the city.

Nutritional enzymopathy may be due to prolonged lack of protein in the diet, vitamin deficiency, unbalanced nutrition.

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