際際滷

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Metabolisme
piruvat kinase
GLIKOLISIS
 Enzim Kunci :
  1. Glukokinase / Heksokinase
  2. Fosfofruktokinase
  3. Piruvat Kinase
GLIKOLISIS
          REAKSI ENZIMATIK MENGOKSIDASI GLUKOSA
      SUASANA AEROB : GLUKOSA  PIRUVAT
      SUASANA AN AEROB :
              GLUKOSA  PIRUVAT  ASAM LAKTAT
TUJUAN :
1. MENGHASILKAN ENERGI
2. MENYEDIAKAN PIRUVAT  MENDORONG SIKLUS ASAM
    SITRAT ( SAS )  ENERSI >>
3. BERLANGSUNG DI SITOPLASMA ( EKSTRA MITOKONDRIA
    )


                  AS.PIRUVAT     ASETIL KoA    SA
1 MOL GLUKOSA                                   S
   ( AEROB )     AS.PIRUVAT      ASETIL KoA    SA
                                                S
                    AN AEROB    ASAM LAKTAT
JALUR REAKSI                                            GLIKOGEN
                             ATP   ADP

           DIET        Glc             Glc-6P         Fruk-6P
                          Heksokinase       Isomerase         ATP
                           Glukokinase
                                                           Fosfofruktokinase
   ENZIM KUNCI
                                                                            ADP
                                                                  Fruk-1,6P2
               ATP                                                    Aldolase
                       ADP
    3P-Glis                          Glis-3P dehidr
                            1,3P2-Glis              Glis-3P         (OH)2-ASETON-P
              P-Glis kinase                                Isomerase
      P-Glis. mutase                               NAD+
                                         NADH                              O2
   2P-Glis                                   H +
                                                     AEROB OKS -RESP-
                                                                H+ e H+ e
                                        H + , e-                              H2O
      Enolase


                                                        ANAEROB
   P.E.P
                                         H + , e-                                 3ADP
       ADP                                                           3ATP
      Piruvat kinase                        +
                                          H ,e      -

         ATP
                                    H+, e-
 ENOL-PIRUVAT            KETO-PIRUVAT                             LAKTAT
                                         L.D.H
ENERGI                                          GLIKOGEN
                             ATP   ADP

           DIET        Glc             Glc-6P         Fruk-6P
                          Heksokinase       Isomerase         ATP
                           Glukokinase
  AEROB                                                    Fosfofruktokinase
                                                                       ADP
   OKS. RESP. 2 X 3 = 6
  TK SUBSTRAT 2 X 2 = 4
                                   = 10   - 2 = 8ATP //Mol Glc
                                            1 =9 ATP Mol Glc
                                                           Fruk-1,6P   2

              ATP                                                Aldolase
                       ADP
    3P-Glis                          Glis-3P dehidr
                            1,3P2-Glis              Glis-3P        (OH)2-ASETON-P
              P-Glis kinase                                Isomerase
      P-Glis. mutase                               NAD+
                                         NADH                             O2
                                        1
   2P-Glis                                 H +
                                                     AEROB OKS RESP
                                                                             H2O
      Enolase


                                                ANAEROB
   P.E.P
                                                                             ADP
       ADP                                                       ATP
      Piruvat kinase                                         3
         ATP
 ENOL-PIRUVAT            KETO-PIRUVAT                       LAKTAT
                                               L.D.H
ENERGI                                      GLIKOGEN
                             ATP   ADP

           DIET        Glc            Glc-6P         Fruk-6P
                          Heksokinase      Isomerase         ATP
 ANAEROB                                                  Fosfofruktokinase
  OKS. RESP. 2 X 3 = 6                                            ADP
                         = 10 -
                       2 = 8 / Mol Glc
                              -
 TK SUBSTRAT 2 X 2 = 4 1 = 3 ATP //Mol Glc
                        2 = 2 ATP Mol Glc               Fruk-1,6P2
              ATP                                          Aldolase
                       ADP
    3P-Glis                          Glis-3P dehidr
                            1,3P2-Glis              Glis-3P        (OH)2-ASETON-P
              P-Glis kinase                                Isomerase
      P-Glis. mutase                               NAD+
                                       1 NADH
                                                                         XO2
                                           H
                                                               X
                                             +
   2P-Glis                                           AEROB OKS RESP
                                                                             H2O
      Enolase


                                             ANAEROB
   P.E.P
                                                                        ADP
       ADP                                               3 ATP
      Piruvat kinase
         ATP
 ENOL-PIRUVAT            KETO-PIRUVAT                    LAKTAT
                                           L.D.H
GLIKOLISIS DI SEL DARAH MERAH
                            SAAT BUTUH BPG
                                       ATP
                         ATP   ADP

         DARAH        Glc            Glc-6P         Fruk-6P
                         Heksokinase      Isomerase         ATP
                                                         Fosfofruktokinase
                 2,3-BIFOSFOGLISERAT                                 ADP
                          ( BPG )
 2,3 BPG-Fossfatase                                        Fruk-1,6P2
             ATP              BPG-mutase                        Aldolase
                      ADP
  3P-Glis                           Glis-3P dehidr
                           1,3P2-Glis              Glis-3P          (OH)2-ASETON-P
            P-Glis kinase                                 Isomerase
    P-Glis. mutase                                NAD+
                                         NADH
                                      H+, e-H
                                             +
 2P-Glis
    Enolase                          H + , e-
 P.E.P
                                     H + , e-
      ADP
     Piruvat kinase                H+, e-
        ATP
                                   H+, e-                LAKTAT
ENOL-PIRUVAT            KETO-PIRUVAT
                                                L.D.H
 Defisiensi piruvat kinase tidak sering ditemukan,
  tetapi merupakan defisiensi enzim enzim tersering
  kedua yang menyebabkan anemia hemolitik
 Mekanismenya diperkirakan disebabkan oleh
  gangguan glikolisis sehingga terjadi penurunan
  produksi ATP ( Defisienssi enzim piruvat kinase)
  akan mempengaruhi berbagai aspek integritas
  membran .
METABOLISME BILIRUBIN
PORFIRIN :
Porfirin adalah Senyawa siklik gabungan dari 4 cincin pirol
dan jembatan metenil ( -CH =)

SENYAWA INI DAPAT BERIKATAN DENGAN
LOGAM Fe ATAU Mg
  Fe           heme
                heme + protein  hemoprotein
             contoh : Hb
  Mg : Khloropil

Ikatan Porfirin + logam              Metalopofirin
HEMOGLOBIN. A
Heme                                                            Heme
   H   C   N    CH                            C
                                              H
                                                      N    CH
       N   Fe   N                                 N   Fe   N
   H   C   N    CH                            H   C   N    CH




                             硫
                         留       留   Globin
                             硫




       C
       H    N   CH                            C
                                              H
                                                      N    CH

       N   Fe N                                   N   Fe   N
       C
       H    N   CH                            C
                                              H       N    CH
                                                               Heme
Heme
KATABOLISME HEME
SETIAP 120 HARI ERITROSIT / Hb DIPECAH.
ERITROSIT  HEMOGLOBIN  HEME (Fe+++ + BIL ) + GLOBIN

    PEMECAHAN TERJADI DI SEL-SEL RES ( HEPAR, LIEN & SUMSUM
    TULANG ), OLEH SEL-SEL MAKROFAG.


PADA ORANG DEWASA, 70 Kg, SETIAP HARI 賊 6 GRAM Hb DIPECAH.
1 GRAM Hb MENGHASILKAN 35 MG BILIRUBIN  TIAP HARI DIHA-
SILKAN 250  350 MG BILIRUBIN.
DI R E S :
 ERI TUA / RUSAK                             DIMAKAN OLEH MAKROFAG

                             ERI         Hb              HEME + GLOBIN
                                         GLOBIN              ASAM AMINO
                                                               HAPTOGLOBIN

 HEM DI OKSIDASI OLEH SISTEM HEMOKSIGENASE, MENGHASILKAN :
                        > Fe++       Fe++ +    ( HEMIN )
                        > BILIVERDIN ( TETRA PIROL LINEAR / TERBUKA )

                             DARAH
     Fe   +++
                lepas                          TRANSFERIN                    HEPAR
     BILIVERDIN DI OKSIDASI                         BILIRUBIN             DARAH
     ( pigmen hijau )                         ( pigmen kuning merah )


DARAH :    BILIRUBIN + ALBUMIN                       BILIRUBIN ALBUMIN  HEPAR
DI HEPAR :
   ALBUMIN DILEPASKAN, DIGANTI DENGAN LIGANDIN.

BILIRUBIN-LIGANDIN MASUK KE SEL HAPATOSIT, KEMUDIAN DI KONJU-
 GASI-KAN DENGAN ASAM GLUKORONAT OLEH ENZIM URIDIN DIFOSFO-
 GLUKORONIL TRANSFERASE ( UDP-GLUKORONIL TRANSFERASE ).
 HASILNYA : BILIRUBIN DIGLUKORONIDA

                 UDP-GLUKOSA DEHIDROGENASE

   UDP-GLUKOSA                            UDP-GLUKORONAT
                 2 NAD            2 NADH + 2 H+


   UDP-GLUKORONAT     UDP-GLUK.TRANSFERASE   BILIRUBIN MONO GLUKORONIDA
      +                                           + UDP
   BILIRUBIN
                                                  UDP-GLUK.TRANSFERASE
   UDP-GLUKORONAT + BILI.MONOGLUKORONIDA
                                        BILI. DIGLUKORONIDA + UDP
   2 mol. BILI. MONOGLUKORONIDA          BILI. DIGLUKORONIDA + BILIRUBIN
BILIRUBIN DIGLUKORONIDA  DISEKRESI KE DALAM EMPEDU, SECARA
  AKTIF  DITERUSKAN KE USUS.


DI USUS :
   DI ILEUM & COLON, KONJUGASI DILEPASKAN.
   BILIRUBIN  DI REDUKSI OLEH BAKTERI USUS menjadi
                            UROBILINOGEN / STERKOBILINOGEN.

  UROBILINOGEN /           SEKRESI MELALUI FESES
   STERBILINOGEN
                         di REABSORPSI  MASUK KE HEPAR:


                                     sebagian di OKSIDASI MENJADI
                                    BILIRUBIN LAGI  KONJUGASI
                                    lagi  DAN SETERUSNYA.
                                       SIKLUS ENTEROHEPATIK

            Sebagian lagi PEREDARAN DARAH SISTEMIK 
            KE GINJAL  KE URINE.
KATABO              Fibroblas
LISME & OTAK                                          R E S
                                   SDM
EKSKRE                                                            Hb
SI HEME                                             GLOBULIN
                                                                  HEME
                                                  Heme-Oksigenase
                                                          Fe+++
             REOKSIDASI         BILIRUBIN                  BILIVERDIN
    HEPAR
                     LIGANDIN
                                 ALBUMIN                 BILIRUBIN
        UDP-Glukuronil
              BILIRUBIN
         BILI-GLUK
          BILI-GLUK
         Transferase2 2
                                            ALUR PIGMEN             GINJAL
    2-GLUKURONAT



           SIRKULASI
         ENTERO-HEPATIK
   Saluran
   Empedu    V. PORTA                                             UROBILIN
      STERKOBLNG
     STERKOBILIN
     STERKOBLNG
                 ENZ. FLORA USUS
       USUS                                 STERKOBILINMUSCLE
KATABOLISME Hb DAN EKSKRESI BILIRUBIN

 HEPA
 R                                                                          R E            Hb
      .      ASAM GLUKORONAT
   LI LU
         K                                                                  S
 BI I G
                                                                                      HEME +GLOBIN
                    BILIRUBIN
                                                                       BILIRUBIN




                                                       M IN
   D UDP Glukoronil




                                                    BU UB
                                                         IN
        Transferase




                                                  AL LIR
                                                                                            A.A




                                                   BI
                                                                        BILIVERDIN      HAPTOGLO
                                                          E                             BIN
                                                      G
  UROBILINOGEN                                    O
                                              N
                                           LI
                                      BI                              GINJAL
                                  O
                                  R                                  GINJAL
                              U
                                  N

                                                                           UROBILINOGEN

                                                                                 UROBILIN
USU                                             GEN                                  (URINE )
                    RED             STERKOBILINO
S     BILI.DIGLU
            BILI.         UROBILI /
      K
                          COLON                               STERKOBILIN ( FESES )
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Pyruvate kinase bilirubin

  • 2. GLIKOLISIS Enzim Kunci : 1. Glukokinase / Heksokinase 2. Fosfofruktokinase 3. Piruvat Kinase
  • 3. GLIKOLISIS REAKSI ENZIMATIK MENGOKSIDASI GLUKOSA SUASANA AEROB : GLUKOSA PIRUVAT SUASANA AN AEROB : GLUKOSA PIRUVAT ASAM LAKTAT TUJUAN : 1. MENGHASILKAN ENERGI 2. MENYEDIAKAN PIRUVAT MENDORONG SIKLUS ASAM SITRAT ( SAS ) ENERSI >> 3. BERLANGSUNG DI SITOPLASMA ( EKSTRA MITOKONDRIA ) AS.PIRUVAT ASETIL KoA SA 1 MOL GLUKOSA S ( AEROB ) AS.PIRUVAT ASETIL KoA SA S AN AEROB ASAM LAKTAT
  • 4. JALUR REAKSI GLIKOGEN ATP ADP DIET Glc Glc-6P Fruk-6P Heksokinase Isomerase ATP Glukokinase Fosfofruktokinase ENZIM KUNCI ADP Fruk-1,6P2 ATP Aldolase ADP 3P-Glis Glis-3P dehidr 1,3P2-Glis Glis-3P (OH)2-ASETON-P P-Glis kinase Isomerase P-Glis. mutase NAD+ NADH O2 2P-Glis H + AEROB OKS -RESP- H+ e H+ e H + , e- H2O Enolase ANAEROB P.E.P H + , e- 3ADP ADP 3ATP Piruvat kinase + H ,e - ATP H+, e- ENOL-PIRUVAT KETO-PIRUVAT LAKTAT L.D.H
  • 5. ENERGI GLIKOGEN ATP ADP DIET Glc Glc-6P Fruk-6P Heksokinase Isomerase ATP Glukokinase AEROB Fosfofruktokinase ADP OKS. RESP. 2 X 3 = 6 TK SUBSTRAT 2 X 2 = 4 = 10 - 2 = 8ATP //Mol Glc 1 =9 ATP Mol Glc Fruk-1,6P 2 ATP Aldolase ADP 3P-Glis Glis-3P dehidr 1,3P2-Glis Glis-3P (OH)2-ASETON-P P-Glis kinase Isomerase P-Glis. mutase NAD+ NADH O2 1 2P-Glis H + AEROB OKS RESP H2O Enolase ANAEROB P.E.P ADP ADP ATP Piruvat kinase 3 ATP ENOL-PIRUVAT KETO-PIRUVAT LAKTAT L.D.H
  • 6. ENERGI GLIKOGEN ATP ADP DIET Glc Glc-6P Fruk-6P Heksokinase Isomerase ATP ANAEROB Fosfofruktokinase OKS. RESP. 2 X 3 = 6 ADP = 10 - 2 = 8 / Mol Glc - TK SUBSTRAT 2 X 2 = 4 1 = 3 ATP //Mol Glc 2 = 2 ATP Mol Glc Fruk-1,6P2 ATP Aldolase ADP 3P-Glis Glis-3P dehidr 1,3P2-Glis Glis-3P (OH)2-ASETON-P P-Glis kinase Isomerase P-Glis. mutase NAD+ 1 NADH XO2 H X + 2P-Glis AEROB OKS RESP H2O Enolase ANAEROB P.E.P ADP ADP 3 ATP Piruvat kinase ATP ENOL-PIRUVAT KETO-PIRUVAT LAKTAT L.D.H
  • 7. GLIKOLISIS DI SEL DARAH MERAH SAAT BUTUH BPG ATP ATP ADP DARAH Glc Glc-6P Fruk-6P Heksokinase Isomerase ATP Fosfofruktokinase 2,3-BIFOSFOGLISERAT ADP ( BPG ) 2,3 BPG-Fossfatase Fruk-1,6P2 ATP BPG-mutase Aldolase ADP 3P-Glis Glis-3P dehidr 1,3P2-Glis Glis-3P (OH)2-ASETON-P P-Glis kinase Isomerase P-Glis. mutase NAD+ NADH H+, e-H + 2P-Glis Enolase H + , e- P.E.P H + , e- ADP Piruvat kinase H+, e- ATP H+, e- LAKTAT ENOL-PIRUVAT KETO-PIRUVAT L.D.H
  • 8. Defisiensi piruvat kinase tidak sering ditemukan, tetapi merupakan defisiensi enzim enzim tersering kedua yang menyebabkan anemia hemolitik Mekanismenya diperkirakan disebabkan oleh gangguan glikolisis sehingga terjadi penurunan produksi ATP ( Defisienssi enzim piruvat kinase) akan mempengaruhi berbagai aspek integritas membran .
  • 9. METABOLISME BILIRUBIN PORFIRIN : Porfirin adalah Senyawa siklik gabungan dari 4 cincin pirol dan jembatan metenil ( -CH =) SENYAWA INI DAPAT BERIKATAN DENGAN LOGAM Fe ATAU Mg Fe heme heme + protein hemoprotein contoh : Hb Mg : Khloropil Ikatan Porfirin + logam Metalopofirin
  • 10. HEMOGLOBIN. A Heme Heme H C N CH C H N CH N Fe N N Fe N H C N CH H C N CH 硫 留 留 Globin 硫 C H N CH C H N CH N Fe N N Fe N C H N CH C H N CH Heme Heme
  • 11. KATABOLISME HEME SETIAP 120 HARI ERITROSIT / Hb DIPECAH. ERITROSIT HEMOGLOBIN HEME (Fe+++ + BIL ) + GLOBIN PEMECAHAN TERJADI DI SEL-SEL RES ( HEPAR, LIEN & SUMSUM TULANG ), OLEH SEL-SEL MAKROFAG. PADA ORANG DEWASA, 70 Kg, SETIAP HARI 賊 6 GRAM Hb DIPECAH. 1 GRAM Hb MENGHASILKAN 35 MG BILIRUBIN TIAP HARI DIHA- SILKAN 250 350 MG BILIRUBIN.
  • 12. DI R E S : ERI TUA / RUSAK DIMAKAN OLEH MAKROFAG ERI Hb HEME + GLOBIN GLOBIN ASAM AMINO HAPTOGLOBIN HEM DI OKSIDASI OLEH SISTEM HEMOKSIGENASE, MENGHASILKAN : > Fe++ Fe++ + ( HEMIN ) > BILIVERDIN ( TETRA PIROL LINEAR / TERBUKA ) DARAH Fe +++ lepas TRANSFERIN HEPAR BILIVERDIN DI OKSIDASI BILIRUBIN DARAH ( pigmen hijau ) ( pigmen kuning merah ) DARAH : BILIRUBIN + ALBUMIN BILIRUBIN ALBUMIN HEPAR
  • 13. DI HEPAR : ALBUMIN DILEPASKAN, DIGANTI DENGAN LIGANDIN. BILIRUBIN-LIGANDIN MASUK KE SEL HAPATOSIT, KEMUDIAN DI KONJU- GASI-KAN DENGAN ASAM GLUKORONAT OLEH ENZIM URIDIN DIFOSFO- GLUKORONIL TRANSFERASE ( UDP-GLUKORONIL TRANSFERASE ). HASILNYA : BILIRUBIN DIGLUKORONIDA UDP-GLUKOSA DEHIDROGENASE UDP-GLUKOSA UDP-GLUKORONAT 2 NAD 2 NADH + 2 H+ UDP-GLUKORONAT UDP-GLUK.TRANSFERASE BILIRUBIN MONO GLUKORONIDA + + UDP BILIRUBIN UDP-GLUK.TRANSFERASE UDP-GLUKORONAT + BILI.MONOGLUKORONIDA BILI. DIGLUKORONIDA + UDP 2 mol. BILI. MONOGLUKORONIDA BILI. DIGLUKORONIDA + BILIRUBIN
  • 14. BILIRUBIN DIGLUKORONIDA DISEKRESI KE DALAM EMPEDU, SECARA AKTIF DITERUSKAN KE USUS. DI USUS : DI ILEUM & COLON, KONJUGASI DILEPASKAN. BILIRUBIN DI REDUKSI OLEH BAKTERI USUS menjadi UROBILINOGEN / STERKOBILINOGEN. UROBILINOGEN / SEKRESI MELALUI FESES STERBILINOGEN di REABSORPSI MASUK KE HEPAR: sebagian di OKSIDASI MENJADI BILIRUBIN LAGI KONJUGASI lagi DAN SETERUSNYA. SIKLUS ENTEROHEPATIK Sebagian lagi PEREDARAN DARAH SISTEMIK KE GINJAL KE URINE.
  • 15. KATABO Fibroblas LISME & OTAK R E S SDM EKSKRE Hb SI HEME GLOBULIN HEME Heme-Oksigenase Fe+++ REOKSIDASI BILIRUBIN BILIVERDIN HEPAR LIGANDIN ALBUMIN BILIRUBIN UDP-Glukuronil BILIRUBIN BILI-GLUK BILI-GLUK Transferase2 2 ALUR PIGMEN GINJAL 2-GLUKURONAT SIRKULASI ENTERO-HEPATIK Saluran Empedu V. PORTA UROBILIN STERKOBLNG STERKOBILIN STERKOBLNG ENZ. FLORA USUS USUS STERKOBILINMUSCLE
  • 16. KATABOLISME Hb DAN EKSKRESI BILIRUBIN HEPA R R E Hb . ASAM GLUKORONAT LI LU K S BI I G HEME +GLOBIN BILIRUBIN BILIRUBIN M IN D UDP Glukoronil BU UB IN Transferase AL LIR A.A BI BILIVERDIN HAPTOGLO E BIN G UROBILINOGEN O N LI BI GINJAL O R GINJAL U N UROBILINOGEN UROBILIN USU GEN (URINE ) RED STERKOBILINO S BILI.DIGLU BILI. UROBILI / K COLON STERKOBILIN ( FESES )