Lecture Handout Enzymes Complete
Lecture Handout Enzymes Complete
Lectures handouts
Dr. Adnan Riaz
HISTORY OF ENZYMES
Around late 17th and early 18th centuries, the digestion of meat by stomach secretions and the conversion of starch to
sugars by plant extracts and saliva were known. However, the mechanism by which this occurred had not been identified.
In 1833, French chemist Anselme Payen discovered the first enzyme, diastase (amylase). In 1877, German physiologist
Wilhelm Kühne first used the term enzyme, which is Greek for "in leaven", to describe this process. It was later used to
refer to nonliving substances, such as pepsin.
* Ribozymes are not proteins but they act as Enzymes (Imp. Viva Q)
SUBSTRATE
These are the compounds or molecules which are acted upon by a specific enzyme Also called Reactant
PRODUCT
A product is something "manufactured" by an enzyme from its substrate.
CATALYST
A substance that lowers activation energy of a reaction so the reaction occurs more quickly but, in the end, is NOT used up
by the reaction is called a catalyst.
SPECIFIC ACTIVITY
It is the number of enzyme unit/ mg of total protein. The specific activity is a measure of enzyme purity.
ENERGY OF ACTIVATION
It is the minimal amount of energy required to start any given chemical reactions.In other words a reaction cannot take
place until unless the substrates gain this specific amount of Energy
SIMPLE ENZYMES
Enzymes composed wholly of protein are known as simple enzymes. They are the purely proteins in nature
HOLO-ENZYME
Complex enzymes are also known as Holo-Enzyme. They are made up of proteins plus any other non-protein (organic or
inorganic substance)
APO-ENZYME
The protein part of a Holo-enzyme is called Apo-Enzyme. They are purely proteins in nature
CO-FACTOR
Non-protein component is known as the Co-Factor. It is further subdivided on the basis of its chemical nature i.e. organic or
inorganic and its combination with apoenzyme i.e. covalent bonding or tightly bound and non-covalently or loosely bound.
CO-FACTORS include: coenzymes, Prosthetic Groups, Metals and their ions (See flow chart for classification of a co factor)
Important metals which acts as a cofactor
Metal Enzyme
Zn++ Carbonic anhydrase
Zn++ Alcohol dehydrogenase
Zn++ Carboxypeptidase
Fe+++ or Fe++ Cytochromes
Cu++ or Cu+ Cytochrome oxidase
K+ Propionyl CoA carboxylase
Mg++ Hexokinase
Mn++ Superoxide dismutase
Se Glutathione peroxidase
Mo Xanthine oxidase
Ni++ Urease
COENZYMES
Heat stable, low mol wt organic compounds non-covalently linked with enzymes can be separated.
If covalently Linked to apoenzymes = prosthetic group Coenzymes serve as recyclable shuttles—or group transfer agents—
that transport many substrates from their point of generation to their point of utilization. The water-soluble B vitamins
supply important components of numerous coenzymes
+
Nicitinamide Adenine Dinucleotide (NAD )
Its formula can be represented as Nicitinamide – Ribose – Phosphate – phosphate – Ribose – Adenine
Functional group of molecule is only Nicitinamide part where as rest of the molecule is represent as (R) The oxidized form
can be written as NAD+. The reduced form can be written as NADH+H+. NADH+H+ is primarily used in ATP generation
Where E represents the enzyme catalyzing the reaction, S the substrate, the substance being changed, and P the product of
the reaction.
Enzymes employ multiple mechanisms to facilitate catalysis. The mechanism of action of enzymes can be explained by
three perspectives-
2) Thermodynamic changes
1) The active site takes the form of a cleft or pocket which is formed by groups that come from different parts of the amino
acid sequences.
2) It takes up a relatively small part of the total volume of an enzyme. Most of the amino acid residues in an enzyme are not
in contact with the substrate. Nearly all enzymes are made up of more than 100 amino acid residues, some amino acids
serve as a scaffold to create the three-dimensional active site. The remaining amino acids also constitute regulatory sites,
sites of interaction with other proteins, or channels to bring the substrates to the active sites.
3) Substrates are bound to enzymes by multiple weak attractions. The noncovalent interactions in Enzyme Substrate (ES)
complex are much weaker than covalent bonds.The electrostatic interactions, hydrogen bonds, van der Waals forces, and
hydrophobic interactions mediate reversible interactions of biomolecules.
4) The specificity of binding depends on the precisely defined arrangement of atoms in an active site. Because the enzyme
and the substrate interact by means of short-range forces that require close contact, a substrate must have a matching
shape to fit into the site.
2) Induced-Fit Model of Enzyme-Substrate Binding In this model, the enzyme changes shape on substrate binding. The
active site forms a shape complementary to the substrate only after the substrate has been bound.When a substrate
approaches and binds to an enzyme they induce a conformational change, a change analogous to placing a hand (substrate)
into a glove (enzyme).
The induced fit model has been amply confirmed by biophysical studies of enzyme motion during substrate binding.
Besides explaining the specificity, it also explains the regulation of enzyme activity and the dynamic changes occurring at
the active site
2) Thermodynamic changes
2) Thermodynamic changes - All enzymes accelerate reaction rates by providing transition states with a lowered G for
formation of the transition states. However, they may differ in the way this is achieved.
Transition states: it is intermediate molecular event in which bond breakage, bond formation, and charge are not similar to
substrate or product
A chemical reaction of substrate S to form product P goes through a transition state S‡ that has a higher free energy than
does either S or P. (The double dagger denotes a thermodynamic property of the transition state).
The difference in free energy between the transition state and the substrate is called the Gibbs free energy of activation or
simply the activation energy, symbolized by ∆G‡
The activation energy barrier suggests how enzymes enhance reaction rate without altering ∆G of the reaction: enzymes
function to lower the activation energy, or, in other words, enzymes facilitate the formation of the transition state. The
combination of substrate and enzyme creates a new reaction pathway whose transition-state energy is lower than that of
the reaction in the absence of enzyme. The lower activation energy means that more molecules have the required energy
to reach the transition state. Decreasing the activation barrier is analogous to lowering the height of a high-jump bar; more
athletes will be able to clear the bar. The essence of catalysis is specific binding of the transition state.
3) Processes at the active site
2) Processes at the active site-Enzymes use various combinations of four general mechanisms to achieve dramatic catalytic
enhancement of the rates of chemical reactions. These are as follows-
a) Catalysis by Bond Strain: In this form of catalysis, the induced structural rearrangements that take place with the binding
of substrate and enzyme ultimately produce strained substrate bonds, which more easily attain the transition state.
Enzymes that catalyze lytic reactions that involve breaking a covalent bond typically bind their substrates in a conformation
slightly unfavorable for the bond that will undergo cleavage. The resulting strain stretches or distorts the targeted bond,
weakening it and making it more vulnerable to cleavage.
b) Catalysis by Proximity and Orientation: For molecules to react, they must come within bond-forming distance of one
another. The higher their concentration, the more frequently they will encounter one another and the greater will be the
rate of their reaction. When an enzyme binds substrate molecules at its active site, it creates a region of high local
substrate concentration. Enzyme-substrate interactions orient reactive groups and bring them into proximity with one
another.
c) Catalysis Involving Proton Donors (Acids) and Acceptors (Bases): Other mechanisms also contribute significantly to the
completion of catalytic event, for example, the use of glutamate as a general acid catalyst (proton donor). The ionizable
functional groups of aminoacyl side chains and (where present) of prosthetic groups contribute to catalysis by acting as
acids or bases. the rate of reaction is sensitive to changes in the concentrations of acids (proton donors) or bases (proton
acceptors) present at the active site
d) Covalent Catalysis: In catalysis that takes place by covalent mechanisms, the substrate is oriented to active sites on the
enzymes in such a way that a covalent intermediate forms between the enzyme or coenzyme and the substrate. One of the
best-known examples of this mechanism is serine proteases, which include both digestive enzymes (trypsin, chymotrypsin,
and elastase) and several enzymes of the blood clotting cascade. These proteases contain an active site serine whose R
group hydroxyl forms a covalent bond with a carbonyl carbon of a peptide bond. In Covalent catalysis activation energy is
lower and therefore reaction is faster. The chemical modification of the enzyme is, however, transient. On completion of
the reaction, the enzyme returns to its original unmodified state. Its role thus remains catalytic.
Classification of Enzymes
Classification of enzymes- More than 2000 different enzymes are currently known. The commonly used names for most
enzymes describe the type of reaction catalyzed, followed by the suffix -ase. For example, dehydrogenases remove
hydrogen atoms, proteases hydrolyze proteins, and isomerases catalyze rearrangements in configuration. Modifiers may
precede the name to indicate the substrate (xanthine oxidase), the source of the enzyme (pancreatic ribonuclease), its
regulation (hormone-sensitive lipase) etc.
To address ambiguities, the International Union of Biochemists (IUB) developed an unambiguous system of enzyme
nomenclature in which each enzyme has a unique name and code number that identify the type of reaction catalyzed and
the substrates involved. For instance, hexokinase has systemic name: ATP, D–Glucos –6–Phosphotransferases and
hexokinase has the classfication number EC 2.7.1.1.It is a transferase, so it is in subgroup 2;It transfers a phosphate group,
so it is in subgroup 7;It has an alcohol group as an acceptor, so it is in subsubgroup 1;It is the first such enzyme to be
classified. However, it is still called as hexokinase.
Dehydrogenases. Catalyzing oxidation of the substrate and coenzymes act as recipients of hydrogen e.g Lactate
Dehydrogenase with NAD and Glucose 6 phosphate dehydrogenase with NADP
Oxygenases . Catalyzing the reactions in which oxygen is added to the substrate e.g Homogentisate oxygenase,
L -Tryptophan dioxygenase, Phenylalanine Hydroxylase
TRANSFERASES
These enzymes transfer alkyl, acyl, aldehyde, amino, phosphate groups from one substrate to another.
Transaminases. Catalyzing transfer of amino group between an amino acid and a ketoacid e.g. Aspartate
transaminase (AST), Alanine transaminase (ALT)
Glutamic acid + Oxaloacetic acid Aspartate transaminase (AST) ketoglutaric acid + Aspartic acid
Glutamic acid + Pyruvic acid Alanine transaminase (ALT) ketoglutaric acid + Alanine
Transmethylases. Catalyzing transfer of methyl group between to substrates e.g. COMT
HYDROLASES
Catalyzing hydrolytic breakdown of different bonds e.g C-C,C-O, C-N and P-O. Most of the GIT enzymes belong to
this class
Enzymes hydrolyzing carbohydrates
Polysaccharidases
Starch Amylase Maltose, maltotrios, dextrins
Disacharidases
Maltose, Lactose, Sucrose Disacharidases monosaccharides
Enzymes Acting on Peptide Bonds
Exopeptidases
Exopeptidases amino acids
These are further subdivided into
1. Polypeptidases: 1) aminopeptidase
2) carboxypeptidase
2. Tripeptidases
3. Dipeptidases
Endopeptidase
Phosphatases
i. Phosphomonoesterases:
Glucose-6-P + H2O G-6-Phosphatase Glucose +Pi
ii. Phosphodiesterases:
Removal of one phosphate Group of diesters
LYASES
Catalysing reactions in which NH3, H2O, CO2 are removed without hydrolysis leaving a double bond or by adding
these groups to already existing double bonds
ISOMERASES
Thes enzymes catalyzes the structural changes within a single molecule by transfer of groups within it resulting in
the formation of an isomeric form of the substrate.
Glucose 6. P Phosphoglucomutase Glucose I.P
Chemical Nature
Enzymes are majorly made up proteins except Ribozymes which are made up of RNA molecule. As they are protein in
nature they have isoelectric PH, they are heat labile and can be denatured. They have special pockets or clefts which is
usually takes up a relatively small part of the total volume of an enzyme these clefts are known as Active Site which is the
site for substrate binding
Catalytic Efficiency
Enzymes are said to be efficient If they can speed up the reaction 103 to 108 times faster than uncatalyzed reaction.
In other words: One mol of an efficient enzyme can convert 100 to 1000 Molecule of substrate into the products Per
second
Enzyme Specificity
In general, there are two distinct types of specificity:
Absolute specificity - the enzyme will catalyze only one reaction.
Relative specificity - it can be subdivided into fallowing subgroups.
1. Group specificity - the enzyme will act only on molecules that have specific functional groups, such as amino,
phosphate and methyl groups
2. Linkage specificity - the enzyme will act on a particular type of chemical bond regardless of the rest of the
molecular structure
3. Stereo chemical specificity - the enzyme will act on a particular steric or optical isomer.
proenzymes or zymogens
Certain enzymes are synthesized and secreted as inactive precursor enzymes these enzymes are termed proenzymes or
zymogens. Selective proteolysis converts a proenzymes by one or more successive proteolytic "clips" to an active form that
exhibits the characteristic activity of the mature enzymes, e.g the digestive enzymes pepsin, trypsin, and chymotrypsin
(proenzymes = pepsinogen, trypsinogen, and chymotrypsinogen, respectively), several factors of the blood clotting and
blood clot dissolution cascades, complement and Kinin system are examples of Zymogen activation.
A+B C+D
H2O+CO2 H2CO3
In muscles: the active mass of H2O+CO2 is graeter than H2CO3 so reaction will continue to formH2CO3 while In lungs: the
active mass of H2O+CO2 is less than H2CO3 so reaction will start in reverse direction to form H2O+CO2
Expired Out
A+B C+D
It is due to number of reason other than these two main factors in these cases the product of the enzyme activity are
immediately acted upon by the next enzyme of the metabolic pathway. The rapid removal of these products does not allow
the reaction in the reverse direction.
CPK1 - BB - brain
CPK2 - MB - heart
For example: HMG – CoA reductase is the enzyme for rate limiting reaction in the cholesterol biosynthesis. Inhibition of this
enzyme by statin drugs decreases cholesterol synthesis and decreases level of cholesterol in blood.
Enzyme Kinetics
Enzyme kinetics is the field of biochemistry concerned with the quantitative measurement of the rates of enzyme-
catalyzed reactions and the systematic study of factors that affect these rates.
The rate of a chemical reaction is described by the number of molecules of reactant(s) that are converted into
product(s) in a specified time period.
Michaelis and Menten proposed a simple model for most of the features of enzyme-catalyzed reactions. In this
model, the enzyme reversibly combines with its substrate to form an ES complex that subsequently yields product,
regenerating the free enzyme.
Michaelis – Menten Equtaion describes the relationship between reaction velocity and the substrate Concentration
it is represented as:
Km reflects the affinity of the enzyme for that substrate. Km is numerically equal to the substrate concentration at
which the reaction velocity is equal to 1⁄2Vmax. Km does not vary with the concentration of enzyme.
a. Small Km:
A numerically small (low) Km reflects a high affinity of the enzyme for substrate, because a low concentration of
substrate is needed to half-saturate the enzyme—that is, to reach a velocity that is 1⁄2Vmax
b. Large Km:
A numerically large (high) Km reflects a low affinity of enzyme for substrate because a high concentration of
substrate is needed to half-saturate the enzyme.
It is observed that Most enzymes fallows the Michaelis-Menten kinetics but not all enzymes fallows these kinetics.
Those enzyme reactions which fallows these kinetics shows hyperbolic curve (similar to the oxygen-dissociation
curve of myoglobin) when initial reaction velocity (Vo) is plotted against substrate concentration (S)
While those which do not follow Michaelis-Menton kinetics (e.g allosteric enzymes) show a sigmoidal curve that
is similar in shape to the oxygen dissociation curve of hemoglobin
The following assumptions are made in the Michaelis-Menten equation:
1. Relative concentrations of E and S:
The concentration of substrate is much greater than the concentration of enzyme, so only small amount of substrate
is bound to the enzyme at any one time.
2. Steady-state assumption:
The [ES] is said to be in steady state when the rate of formation of ES is equal to that of the breakdown of ES, that
is, [ES] does not change with time.
3. Initial velocity:
Only initial reaction velocities (Vo) are used in the analysis of enzyme reactions. This means that the rate of the
reaction is measured as soon as enzyme and substrate are mixed. At that time, the concentration of product is very
small and, therefore, the rate of the back reaction from P to S can be ignored.
Lineweaver-Burk plot
When [Vo] is plotted against [S] it is not always possible to determine when Vmax has been achieved, because of
the gradual upward slope of the hyperbolic curve at high substrate concentrations. However, if 1/vo is plotted
versus 1/[S], a straight line is obtained.
This plot, the Lineweaver-Burk plot (also called a double-reciprocal plot) can be used to calculate Km and Vmax,
as well as to determine the mechanism of action of enzyme inhibitors.
where the intercept on the x-axis is equal to −1/Km, and the intercept on the y-axis is equal to 1/Vmax.
Factors affecting Enzyme activity
Numerous factors affect the reaction rate
The rate of an enzyme-catalyzed reaction increases with increase of substrate concentration until a maximal
velocity (Vmax) is reached. Increased substrate concentration after this point will not increase the rate of
reaction.(zero order reaction) This shows the active sites on most of the enzymes are now filled and saturation
occurred with substrate.
Order of reaction
1. First order reaction
When concentration of Substrate is less than Km, the velocity of the reaction is proportional to the substrate
concentration. This is the first order reaction.
When concentration of Substrate is greater than Km, the velocity of the reaction is constant and equal to Vmax.
And independent of substrate concentration. This is the zero order reaction.
Effect of Temperature
Initially the reaction rate increases with temperature to an optimum level, this increase is the result of the increased
number of molecules having sufficient energy to pass over the energy barrier.
Then Further elevation of the temperature results in a abrupt decline in reaction velocity as a result of temperature-
induced denaturation of the enzyme
The Q10, or temperature coefficient, is the factor by which the rate of a reaction increases for a 10 °C increase in
temperature. Majority of enzyme have Q10 value of 3 or lower which means that rise of 10 °C increases the
reaction rate 3 times
Effect of PH
The rate of almost all enzyme-catalyzed reactions exhibits a significant dependence on hydrogen ion concentration
There is also an optimum PH at which enzyme works at its maximum.
Most intracellular enzymes exhibit optimal activity at pH values between 3 and 9.
1. By denaturation of enzymes
2. By decreasing or increasing the ionized or unionized state of enzyme or substrates or both
Enzyme Inhibition
Inhibitors are chemicals that reduce the rate of enzymic reactions.They are usually specific and they work at
low concentrations.They block the enzyme but they do not usually destroy it. Many drugs and poisons are
inhibitors of enzymes in the nervous system
Inhibitors of the catalytic activities of enzymes provide both pharmacologic agents and research tools for study
of the mechanism of enzyme action.
1. Irreversible inhibition
2. Reversible inhibition
Irreversible inhibitors: Combine with the enzymes irreversibly. irreversible Inhibitors bind through
covalent interactions.
Reversible inhibitors: These can combine with the enzymes reversibly. Reversible Inhibitors bind through
non-covalent interactions.
1. Competitive Enzyme Inhibition
2. Non Competitive Enzyme Inhibition
3. Uncompetitive Enzyme Inhibition
4. Allosteric Enzyme Inhibition
Competitive Enzyme Inhibition
A competitive inhibitor
COO OOC H
CH2 succinate dehydrogenase
CH2
H COO
COO
Fumarate
Succinate
COO
CH2 succinate dehydrogenase
No reaction
COO
Malonate
Non Competitive Enzyme Inhibition
Noncompetitive inhibitors bind enzymes at sites distinct from the substrate-binding site
Generally bear little or no structural resemblance to the substrate
Binding of the inhibitor does not affect binding of substrate
Effect is not reversed by adding substrate.Formation of both EI and EIS complexes is therefore possible
The enzyme-inhibitor complex can still bind substrate, its efficiency at transforming substrate to product,
reflected by Vmax, is decreased.
1. Allosteric regulation
2. Regulation by Covalent modification
3. Regulation by Gene Expression
4. Regulation by Calcium
Allosteric regulation
Allosteric enzymes are those whose activity can be adjusted by reversible, non-covalent binding of a specific
modulator to the regulatory sites, specific sites on the surface of enzymes.
The presence of an allosteric effecter can alter the affinity of the enzyme for its substrate, or modify the maximal
catalytic activity of the enzyme.
Effectors that inhibit enzyme activity are termed negative effectors, whereas those that increase enzyme activity
are called positive effectors.
Allosteric enzymes are normally composed of multiple subunits which can be either identical or different.
The multiple subunits are
catalytic subunits
regulatory subunits
cAMP
R R
C
C cAMP
+ 4 cAMP +
C C cAMP
R R
cAMP
There are two conformational forms, T (tight)and R (relaxed), which are in equilibrium.
R form: if substrates is bind to the enzyme
T form: if inhibitors is bind to the enzyme
Homotropic effectors: When the substrate itself serves as an effector, the effect is said to be homotropic. Most
often, an allosteric substrate functions as a positive effecter. In such a case, the presence of a substrate molecule at
one site on the enzyme enhances the catalytic properties of the other substrate-binding sites—that is, their binding
sites exhibit cooperativity. These enzymes show a sigmoidal curve when reaction velocity (vo) is plotted against
substrate concentration ([S]),
Heterotropic effectors: The effector may be different from the substrate, in which case the effect is said to be
heterotropic.
Allosteric curve
Kinetic plot of [V] versus [S] is sigmoidal shape.Demonstrating either positive or negative cooperative effect.
Allosteric activation
Allosteric enzyme
Allosteric represion
[S]
Feed Back Inhibition of enzymes: in some cases an allosteric enzyme is inhibited by the product of its own
catalytic action. When the product is formed in excess it bring about inhibition of enzyme activity thus decreasing
its own production.
Covalent modification
Certain enzymes are synthesized and secreted as inactive precursor enzymes these enzymes are termed
proenzymes or zymogens.
Selective proteolysis converts a proenzymes by one or more successive proteolytic "clips" to a form that exhibits
the characteristic activity of the mature enzymes, e.g the digestive enzymes pepsin, trypsin, and chymotrypsin
(proenzymes = pepsinogen, trypsinogen, and chymotrypsinogen, respectively),
Activity of several enzymes are regulated by covalent attachment or detachment of specific groups such as
phosphate, methyl or nucleotide (most commonly phosphate) this attachment or detachment results in changed
shape of the enzyme and hence change its activity.
Common modifications
phosphorylation - dephosphorylation
adenylation - deadenylation
methylation - demethylation
acetylation - deacetylation
Phosphorylation and Dephosphorylation
Phosphorylation reactions are catalyzed by a family of enzymes called protein kinases that use adenosine
triphosphate (ATP) as a phosphate donor.
Dephosphorylation reactions are catalyzed by a family of enzymes called phosphoprotein phosphatases .
ATP ADP
2+
Mg
phosphorylation
protein
kinase
E-OH E-O-PO3H2
phosphatase
dephosphorylation
Pi H2O
Depending on the specific enzyme, the phosphorylated form may be more or less active than the unphosphorylated
enzyme. For example, phosphorylation of glycogen phosphorylase (an enzyme that degrades glycogen) increases
activity and dephosphorylation decreases its activity.
While on the other hand the addition of phosphate to glycogen synthase (an enzyme that synthesizes glycogen)
decreases activity and dephosphorylation increases its activity.
Regulation by Gene Expression
There are certain factors which either increase or decrease synthesis of a particular enzyme by effecting their
synthesis at gene level on DNA in nucleolus, according the requirements. The substances which causes the
increase of enzyme concentration are called inducers while the substances which causes the decrease of enzyme
concentration are called repressors.
Regulation By Calcium
Ca2+ is released into the cytoplasm in response to neural stimulation and binds to calmodulin which is calcium-
binding proteins.
The binding of four molecules of Ca2+ to calmodulin triggers a conformational change and activate Ca2+-
calmodulin complex which binds to and activates the enzymes—that are inactive in the absence of this complex.
Thus, calmodulin functions as an essential subunit of many enzyme. One such enzyme is phosphorylase kinase b ,
which is activated by the Ca2+-calmodulin complex.
Clinical significance of enzymes
1) Enzymes can act as diagnostic markers of underlying diseases .
2) Enzymes also used for the treatment of different diseases
1. Necrosis of cell
2. Increased permeability of cell without gross cellular damage
3. Increased production of enzyme within the cell resulting in increase in serum by overflow
4. Increase in tissue source of enzyme as in malignancy
1) Myocardial Infarction
2) Liver diseases
3) Muscle diseases
4) Bone diseases
5) GI Tract diseases
Diagnosis of AMI
• The diagnosis of AMI is usually predicated on the WHO criteria of chest pain, ECG changes, and
increases in biochemical markers of myocardial injury.
• Biochemical markers have excellent sensitivity for diagnosing AMI. By using these markers, diagnostic
accuracy can be enhanced.
Enzyme assays routinely carried out for the diagnosis of Acute Myocardial Infarction are-
Isoenzymes of creatine phosphokinase(CPK) or creatine kinase (CK) exists in 3 isoenzymes and has 2 subunits M
(muscle) , B (brain) or both
CPK1 - BB - brain
CPK2 - MB - heart
CPK3 - MM - skeletal muscle
2) Aspartate amino Transferase (AST)
4) Cardiac Troponins
• They are not enzymes; these are infect regulatory proteins involve in myocardial contractility however they
are accepted as markers of myocardial infarction.
• The Troponin complex consists of 3 components; Troponin C, Troponin I, and Troponin T.
• Troponin I is released in to the circulation within 4 hours of the onset of cardiac manifestations, peak is
observed at 14-24 hours and remains elevated for 3-5 days post infarction.
• Serum level of Troponin T increases within 6 hous of myocardial infarction, peaks at 72 hours and
then remains elevated up to 7-10 days. Cardiac troponin estimation is 100% sensitive index for
myocardial infarction.
Serum enzymes in liver diseases
Serum enzyme tests can be grouped into two categories:
(1) enzymes whose elevation in serum reflects damage to hepatocytes
(2) enzymes whose elevation in serum reflects cholestasis.
(1) Enzymes that Reflect Damage to Hepatocytes
The aminotransferases (transaminases) are sensitive indicators of liver cell injury and are most helpful in
recognizing acute hepatocellular diseases such as hepatitis. These include-
1) Aspartate aminotransferase (AST) and
2) Alanine aminotransferase (ALT).
• AST is found in the liver, cardiac muscle, skeletal muscle, kidneys, brain, pancreas, lungs, leukocytes, and
erythrocytes in decreasing order of concentration.
• Normal level- 0-41 IU/L
• ALT is found primarily in the liver.
• Normal level-0-45 IU/L
• The aminotransferases are normally present in the serum in low concentrations. These are released into the
blood in when there is damage to the liver cell membrane resulting in increased permeability.
Diagnostic significance of Aminotransferases
• Levels of up to 300 U/L are nonspecific and may be found in any type of liver disorder.
• Striking elevations—i.e., aminotransferases > 1000 U/L—occur almost exclusively in disorders
associated with extensive hepatocellular injury such as (1) viral hepatitis, (2) ischemic liver injury (3)
toxin- or drug-induced liver injury.
• In most acute hepatocellular disorders, the ALT is higher than or equal to the AST.
• An AST:ALT ratio > 3:1 is highly suggestive of alcoholic liver disease.
• In obstructive jaundice the aminotransferases are usually not greatly elevated.
Lipase-High Levels are seen in acute pancreatitis. Also reported high in perforated duodenal and peptic ulcers and
intestinal obstruction.
Enzymes as therapeutic agents
Enzyme Therapeutic Application
Aspirin and other NSAIDs Cyclo-oxygenase 1 and 2 Pain killer and Anti inflammatory