Topic value:Water and substances dissolved in it create an inner medium of the body. The most important parameters of the water-salt homeostasis are osmotic pressure, pH and the volume of intracellular and extracellular fluid. The change in these parameters can lead to a change in blood pressure, acidosis or alkalosis, dehydration and tissue edema. The main hormones involved in the fine regulation of the water-salt metabolism and acting on the distal tubules and collective kidney tubes: antidieretic hormone, aldosterone and a sodium factor; Renin-angiotensive kidney system. It is in the kidneys that the final formation of the composition and volume of urine, ensuring the regulation and constancy of the internal environment. The kidneys are distinguished by intensive energy exchange, which is associated with the need for active transmembrane transport of significant amounts of substances in the formation of urine.
Biochemical analysis of urine gives an idea of \u200b\u200bthe functional state of the kidneys, metabolism in various organs and the body as a whole, contributes to finding out the nature of the pathological process, allows to judge the effectiveness of the treatment.
Objective:examine the characteristics of the parameters of water-salt metabolism and the mechanisms of their regulation. Features of metabolism in the kidneys. Learn to conduct and evaluate urine biochemical analysis.
The student should know:
1. Mechanism of the formation of urine: glomeric filtering, reabsorption and secretion.
2. Characteristics of water compartments of the body.
3. The main parameters of the liquid medium of the body.
4. What is the constancy of intracellular fluid parameters?
5. Subjects (organs, substances) providing the constancy of extracellular fluid.
6.Factors (systems) providing osmotic pressure of extracellular fluid and its regulation.
7. Factors (systems) that ensure the constancy of the volume of extracellular fluid and its regulation.
8. Factors (systems) ensuring the constancy of the acid-alkaline state of the extracellular fluid. The role of the kidneys in this process.
9. Features of metabolism in the kidneys: high activity of metabolism, the initial stage of creatine synthesis, the role of intensive gluconeogenesis (isoenzymes), activation of vitamin D3.
10. General urine properties (number per day --Deurose, density, color, transparency), chemical composition of urine. Pathological components of urine.
The student must be able to:
1. The high-quality definition of the main components of urine.
2. Agreement of biochemical analysis of urine.
The student must own the information: about some pathological conditions accompanied by a change in the biochemical parameters of urine (proteinuria, hematuria, glucosuria, ketonuria, bilirubinuria, porphyrinuria); The principles of planning a laboratory study of urine and analyzing results for a preliminary conclusion on biochemical shifts based on the results of a laboratory survey.
1. Construction of the kidney, nephron.
2. Mechanisms of urine formation.
Tasks for self-preparation:
1. Contact the course of histology. Recall the building of the nephron. Mark the proximal channel, distal crawled channels, collecting tube, vascular tangle, YuCstaglomeler machine.
2. Refer to the course of normal physiology. Remember the urine formation mechanism: filtering in glomers, reabsorption in the tubules to form secondary urine and secretion.
3. The regulation of osmotic pressure and the volume of extracellular fluid is associated with the regulation, mainly the content of sodium ions and water in extracellular fluid.
Name the hormones involved in this regulation. Describe their effect according to the scheme: the reason for the secretion of the hormone; organ (cells) -misses; The mechanism of their action in these cells; The final effect of their action.
Check your knowledge:
A.Vazopressin (Everything is true, except one):
but. synthesized in the neurons of the hypothalamus; b. secreted with increasing osmotic pressure; in. increases the rate of reabsorption of water from the primary urine in the renal tubules; G. Increases reabsorption in the renal tubules of sodium ions; d. Reduces osmotic pressure E. Urine becomes more concentrated.
B. Aldosterone (Everything is true, except one):
but. synthesized in the adrenal cortex; b. secreted by reducing the concentration of sodium ions in the blood; in. In the renal channels increases the reabsorption of sodium ions; G. Water becomes more congenerated.
d. The main mechanism for regulating the secretion of an Arenin-angiotensive kidney system.
B. Sitrieval factor(Everything is true, except one):
but. It is synthesized in the foundations of atrium cells; b. Stimulus secretion - an increase in blood pressure; in. Enhances the filter ability of the glomeruli; G. Increases urine formation; D. urine becomes less concentrated.
4. Make a diagram illustrating the role of a renin angiotensive system in the regulation of the secretion of aldosterone and vasopressin.
5. The constancy of the acid-base equilibrium of the extracellular fluid is supported by buffer blood systems; By changing the pulmonary ventilation and the highness speed of the acids (H +).
Remember the buffer blood systems (basic bicarbonate)!
Check your knowledge:
Food of animal origin has an acidic character (preferably due to phosphates, in contrast to vegetable food). How will the pH of urine change in a person who uses mostly food of animal origin:
but. closer to pH 7.0; B.RN about 5.; in. pH about 8.0.
6. Answer questions:
A. than to explain the high proportion of oxygen consumed by the kidneys (10%);
B. High gluconeogenesis intensity; ??????????
B. The role of kidneys in the exchange of calcium.
7. One of the main tasks of nephrons reabsorb the useful substances from the blood in the desired amount and remove the ending products from the blood.
Make up the table Biochemical urine indicators:
Audit work.
Laboratory work:
Conduct a number of high-quality reactions in urine samples of different patients. Make a conclusion about the state of exchange processes based on the results of biochemical analysis.
Definition of pH.
Work move: 1-2 drops of urine are applied to the middle of the indicator paper and to change the color of one of the painted strips, which coincides with the painting of the control strip, is set to the pH of the urine under study. Normal pH 4.6 - 7.0
2. Quality reaction to protein. Normal urine does not contain protein (trace numbers are not opened by conventional reactions). In some pathological conditions, protein may appear in the urine - proteinuria.
Progress: 1-2 ml of urine Add 3-4 drops of freshly prepared 20% solution of sulfascylicylic acid. If there is a protein, a white precipitate appears or a torment.
3. High-quality glucose reaction (Feling Reaction).
Work move: 10 drops of urine add 10 drops of Feling reagent. Heat to boil. In the presence of glucose, red staining appears. Results Compare with the norm. Normally, in the urine, trace amounts of glucose are not detected with high-quality reactions. It is considered in the norm of glucose in the urine. In some pathological conditions, glucose appears in the urine glucosuria.
Definition can be carried out with a test strip (indicator paper) /
Detection of ketone tel
Working: on the slide glass of urine drop, a drop of 10% solution of caustic sodium and a drop of a freshly prepared 10% solution of sodium nitroprusside. Red painting appears. Pour 3 drops of concentrated acetic acid - Cherry staining appears.
Normally, the ketone bodies are missing in the urine. With some pathological conditions, ketton bodies appear in the urine - ketonuria.
Self solve problems, answer questions:
1. The osmotic pressure of extracellular fluid increased. Describe, in the form of a schema, the sequence of events that will lead to its reduction.
2. How to change the production of aldosterone if excess products of vasopressin will lead to a significant decrease in osmotic pressure.
3. Set out the sequence of events (as a scheme) aimed at restoring homeostasis when a decrease in sodium chloride concentration in tissues.
4. The patient has diabetes mellitus, which is accompanied by ketonemine. How is the main buffer system of blood - bicarbonate - will answer the change in the acid-base equilibrium? What is the role of kidneys in the restoration of the KOS? Will urine pH change in this patient.
5.Sportsman, preparing for competitions, undergoing enhanced training. How to change the speed of glukegenesis in the kidneys (answer to argue)? Is it possible to change the pH of urine at the athlete; answer argotten)?
6. The patient marked signs of metabolic disorders in bone tissue, which is reflected in the state of the teeth. The level of calcitonin and the parathgamon within the physiological norm. The patient receives vitamin D (cholecalciferol) in the required quantities. Make an assumption about the possible reason for metabolic disorders.
7. Consider the standard Urine Analysis Blanc (Multidisciplinary Tyugma Clinic) and be able to explain the physiological role and the diagnostic value of the biochemical components of the urine defined in biochemical laboratories. Remember the biochemical indicators of urine normally.
Lesson 27. Biochemistry saliva.
Topic value:In the oral cavity, various tissues are combined and microorganisms live. They are in relationships and a certain constancy. And in maintaining the homeostasis of the oral cavity, and the body as a whole, the most important role belongs to the oral fluid and, specifically, saliva. The oral cavity, as the initial digestive tract, is the place of the first contact of the body with food, medicinal substances and other xenobiotics, microorganisms . The formation, condition and functioning of the teeth and the mucous membrane of the oral cavity is also largely determined by the chemical composition of saliva.
Salus performs several functions defined by the physicochemical properties and saliva composition. Knowledge of the chemical composition of saliva, functions, the speed of salivation, the relationship of saliva with diseases of the oral cavity helps to identify the peculiarities of pathological processes and the search for new effective means of preventing dental diseases.
Some biochemical indicators of pure saliva are correlated with biochemical indicators of blood plasma, in connection with this, saliva analysis is a convenient non-invasive method used in recent years to diagnose dental and somatic diseases.
Objective:To study physico-chemical properties, composite saliva components that determine its main physiological functions. Leading factors leading to the development of caries, depositing of the dental stone.
The student should know:
1 . Glands secreting saliva.
2. Structure of saliva (micellar structure).
3. The mineralizing function of saliva and factors that determine and affecting this feature: Saliva's oversaturation; volume and speed of salvation; pH.
4. The protective function of the saliva and components of the system, which cause this function.
5. Buffer saliva systems. RN indicators are normal. Causes of disorders of the CB (acid-base state) in the oral cavity. The mechanisms of the regulation of the brass in the oral cavity.
6. Mineral composition of saliva and compared to the mineral composition of blood plasma. The value of the components.
7. Characteristics of organic saliva components, specific saliva components, their value.
8. Digestive function and factors that are determined.
9. Regulatory and excretory functions.
10. Leading factors leading to the development of caries, dental deposition.
The student must be able to:
1. Discern the concepts of "self-saliva or saliva", "gantry liquid", "mouth liquid".
2. To be able to explain the degree of change in caries resistance when changing the pH of saliva, the reasons for changing the pH of saliva.
3. Collect mixed saliva for analysis and analyze the chemical composition of saliva.
The student must own:information on modern ideas about saliva as an object of non-invasive biochemical studies in clinical practice.
Information from the basic disciplines necessary to explore the topic:
1. Anatomy and histology of the salivary glands; Slimming mechanisms and its regulation.
Tasks for self-preparation:
Examine the topic of the topic in accordance with the target issues ("the student should know") and write the following tasks in writing:
1. Write the factors that determine the regulation of salivation.
2. Eye schematically saliva micelle.
3. Make a table: Mineral composition of saliva and blood plasma in comparison.
Examine the meaning of the listed substances. Record other inorganic substances contained in saliva.
4. Make up the table: the main organic saliva components and their meaning.
6. Record factors leading to reduction and increase resistance
(respectively) to Caries.
Auditing work
Laboratory work:Qualitative analysis of the chemical composition of saliva
The water is the most important component of the living organism. No water organisms cannot exist. Without water, a person dies less than a week later, whereas without food, but he can give the water to live more than a month. Loss of 20% of water by the body leads to death. In the body, the water content is 2/3 by body weight and changes with age. The amount of water in different fabrics is different. The daily need of a person in water is approximately 2.5 liters. This need for water is covered by introducing liquids and food products into the body. This water is considered an exogenous. Water that is formed by the oxidative decay in the body of proteins, fats and carbohydrates is called endogenous.Water is a medium in which most exchange reactions occur. It takes direct participation in the metabolism. A determined role belongs to water in the processes of thermal regulation of the body. With the help of water, the fabrics and cells of nutrients and the removal of the final exchange products from them.
The separation of water from the body is carried out by the kidneys - 1.2-1.5 l, the skin is 0.5 l, light - 0.2-0.3 liters. Water exchange is regulated by a nervous hormonal system. Water delay in the body contribute to the hormones of adrenal cortex (cortisone, aldosterone) and hormone of the rear lobe of the pituitary gland of Vasopressin. Thyroxin thyroid hormone enhances water removal from the body.
^
Exchange of mineral substances
Mineral salts are among the food irreplaceable substances. Mineral elements do not have a nutritional value, but they need the body as substances involved in the regulation of metabolism in maintaining osmotic pressure to ensure the constancy of the pH of the intra-and extracellular fluid. Many mineral elements are structural components of enzymes and vitamins.
The organs and tissues of man and animals include macroelements and trace elements. The latter are contained in the body in very minor quantities. In various living organisms, as in the human body, the greatest quantities are oxygen, carbon, hydrogen, nitrogen. These elements, as well as phosphorus and sulfur, are part of the living cells in the form of various connections. Macroelements should also include sodium, potassium, calcium, chlorine and magnesium. The following are from trace elements in the body of animals: copper, manganese, iodine, molybdenum, zinc, fluorine, cobalt, etc. Iron occupies an intermediate position between macro and microelements.
Minerals in the body come only with food. Then through the intestinal mucous membrane and blood vessels - in the petrose vein and in the liver. In the liver there is a delay in some minerals: sodium, iron, phosphorus. The iron is part of the hemoglobin, participating in the transfer of oxygen, as well as in the composition of oxidative reducing enzymes. Calcium is included in the bone tissue and gives it strength. In addition, plays an important role in blood coagulation. Very much for the body phosphorus, which is found in addition to free (inorganic) in compounds with proteins, fats and carbohydrates. Magnesium regulates neuromuscular excitability, many enzymes activate. Cobalt is part of the vitamin B 12. Iodine is involved in the formation of thyroid hormones. Fluoride is found in teeth tissues. Sodium and potassium are of great importance in maintaining the osmotic blood pressure.
The exchange of mineral substances is closely associated with the exchange of organic substances (proteins, nucleic acids, carbohydrates, lipids). For example, cobalt, manganese, magnesium ions, iron are necessary for the normal excitation of amino acids. Chlorine ions are activated by amylase. Calcium ions have an activating effect on lipase. The oxidation of fatty acids is more vigorously in the presence of copper and iron ions.
^
Chapter 12. Vitamins
Vitamins are low molecular weight organic compounds that are a mandatory component of food. They are not synthesized in the animal organism. The main source for the human body and animal is vegetable food.
Vitamins are biologically active substances. Their absence or disadvantage of food is accompanied by a sharp violation of the processes of vital activity leading to severe diseases. The need for vitamins is due to the fact that many of them are integrated parts of enzymes and coenzymes.
In its chemical structure, vitamins are very diverse. They are divided into two groups: water-soluble and fat-soluble.
^ Water soluble vitamins
1. Vitamin B 1 (thiamine, aneuryne). Its chemical structure is characterized by the presence of an amine group and the sulfur atom. The presence of an alcohol group in vitamin B 1 makes it possible to form compound esters with acids. Connecting with two phosphoric acid molecules, thiamine forms a thiamineidiffosphate ester, which is a coenses of vitamin. Thiamiindiphosphate is a co-accummet of decarboxylase catalyzing decarboxylation -ketoxlot. In the absence of or insufficient admission to vitamin B 1, it becomes impossible to carry out carbohydrate metabolism. Violations occur at the stage of disposal of peer-grade and -ketoglutaric acids.
2. Vitamin B 2 (Riboflavin). This vitamin is a methyl and bathroom derivative of isoalloxacin associated with a 5-atomic alcohol by ribitol.
In the body of riboflavin in the form of ester with phosphoric acid, it is part of the prosthetic group of flavine enzymes (FMN, FAD), catalyzing the processes of biological oxidation, ensuring the transfer of hydrogen in the respiratory chain, as well as the reaction of the synthesis and decomposition of fatty acids.
3. Vitamin B 3 (pantothenic acid). Pantothenic acid is constructed from -alanine and dioxideimetheliac acid connected by peptide bond. The biological value of pantothenic acid is that it is part of the coenzyme A, which plays a huge role in the exchange of carbohydrates, fats and proteins.
4. Vitamin B 6 (pyridoxine). In the chemical nature, vitamin B 6 is a pyridine derivative. Phosphorylated production pyridoxine is a coenchander of enzymes catalyzing amino acid exchange reactions.
5. Vitamin B 12 (Kobalammin). The chemical structure of vitamin is highly complex. It includes four pyrrole rings. The center is a cobalt atom associated with nitrogen pyrrolean rings.
Vitamin B 12 belongs to a large role in the transfer of methyl groups, as well as the synthesis of nucleic acids.
6. Vitamin RR (nicotinic acid and its amide). Nicotinic acid is a pyridine derivative.
Amid nicotinic acid is an integral part of the coenzymes of OVI + and NADF +, which are part of dehydrogenase.
7. Folic acid (vitamin B C). Allocated from spinach leaves (Latin Folium -List). The composition of folic acid includes a para-aminobenzoic acid and glutamic acid. Folic acid belongs an important role in the exchange of nucleic acids and protein synthesis.
8. Para-aminobenzoic acid. It owns a large role in folic acid synthesis.
9. Biotin (vitamin H). Biotin is part of the enzyme catalyzing the carboxylation process (CO 2 addition to the carbon chain). Biotin is necessary for the synthesis of fatty acids and purines.
10. Vitamin C (ascorbic acid). In the chemical structure of ascorbic acid is close to hexos. A feature of this compound is its ability to reversible oxidation to form dehydroasorbinic acid. Both of these compounds possess vitamin activity. Ascorbic acid takes part in the oxidative and rehabilitation processes of the body, protects against the oxidation of the SH-group of enzymes, has the ability to dehydrate toxins.
^ Fat-soluble vitamins
This group includes vitamins of groups A, D, E, K-, etc.
1. Vitamins of Group A. Vitamin A 1 (Retinol, anti-mertophthalmic) in its chemical nature is close to Karoten. Is a cyclic monoatomy alcohol .
2. Vitamins of group D (anti-grachistic vitamin). By its chemical structure, the vitamins of the group D are close to the sterils. Vitamin D 2 is formed from yeast ergosterner, and d 3 from 7 de hydrocholesterol in animal fabrics under the influence of ultraviolet irradiation.
3. Vitamins of group E (, , -tocopherol). The main changes in avitaminosis E occur in the sexual system (loss of the ability to dry out the fetus, degenerative change of sperm). At the same time, the insufficiency of vitamin E causes the defeat of a wide variety of tissues.
4. Vitamins of group K. In their chemical structure, the vitamins of this group (K 1 and K 2) belong to naphto. The characteristic sign of avitaminosis K is the occurrence of subcutaneous, intramuscular and other hemorrhages and blood coagulation disorders. The reason for this is a violation of the synthesis protein protein-component of the blood coagulation system.
Antivitamins
Antivitamins are vitamin antagonists: often these substances are very close in structure to appropriate vitamins, and then the basis of their action is a "competitive" displacement of the corresponding vitamin from its complex in the enzyme system. As a result, the "negative" enzyme is formed, the exchange is violated and a severe disease occurs. For example, sulfonamides are antivitamins of para-aminobenzoic acid. Antivitamin vitamin B 1 is pyritiamine.It is also distinguished by structuralized antivitamins that are able to bind vitamins, damping their vitamin activity.
^
Chapter 13. Gormons
Hormones in the same way as vitamins belong to biologically active substances and are regulators of metabolism and physiological functions. Their regulatory role is reduced to activation or inhibiting enzyme systems, changes in the permeability of biological membranes and vehicles of substances through them, the excitation or strengthening of various biosynthetic processes, including the synthesis of enzymes.
The hormones are produced in the glands of internal secretion (endocrine glands), which do not have output ducts and their secrets are isolated directly into the bloodstream. The endocrine glands include the thyroid, parachitoid (near the thyroid), sex glands, adrenal glands, pituitary gland, pancreas, dormant (fork) glands.
Diseases arising from violation of functions of one or another endocrine gland are a consequence of either its hypofunction (reduced secretion of the hormone), or hyperfunction (excess hormone release).
Hormones in the chemical structure can be divided into three groups: protein hormones; Hormones, derivatives of Tyrosine amino acids, and hormones steroid structure.
^ Hormones of protein nature
These include pancreatic hormones, anterior to Lee pituitary and parachitoid glands.
Pancreatic insulin and glucagon hormones are in the regulation of carbohydrate metabolism. According to its action are antagonists among themselves. Insulin reduces, and glucagon increases blood sugar levels.
Hormones of pituitary glands regulate the activities of many other endocrine glands. These include:
Somatotropic hormone (STG) - growth hormone, stimulates cell growth, increases the level of biosynthetic processes;
Thyrotropic hormone (TSH) -stimulates the activity of the thyroid gland;
Adrenocorticotropic hormone (ACTH) - regulates the biosynthesis of corticosteroids of adrenal cortex;
Gonadotropic hormones are germinating the function of the sex glands.
^ Hormones of a series of tyrosine
These include thyroid hormones and hormones of brain layer of adrenal glands. The main hormones of the thyroid gland are thyroxine and triiodothyronine. These hormones are iodized derivatives of Tyrosine amino acids. With the pituitary gland hypofunction decreases metabolic processes. Hyperfunction of the thyroid gland leads to an increase in the main exchange.
Adrenal brainstuff produces two adrenaline hormones and norepinephrine. These substances increase blood pressure. Adrenaline has a significant impact on the exchange of carbohydrates - the level of glucose in the blood.
^ Steroid hormones
This class includes hormones produced by a cortical layer of adrenal glands and gender glands (ovaries and sementes). In chemical nature, they are steroids. The bark of adrenal glands produces corticosteroids, they contain with 21 -t. They are divided into mineralocorticoids, of which aldosterone and deoxyticosterone are most active. and glucocorticoids-cortisole (hydrocortisone), cortisone and corticosterone. Glucocorticoids have a big impact on the exchange of carbohydrates and proteins. Mineralocorticoids regulate basically the exchange of water and minerals.
Distinguish men (androgens) and female (estrogens) sex hormones. The first are from 19 -, and the second C 18-Steroids. Androgens include testosterone, androstendion, etc., to estrogen - estradiol, estrone and estriol. Testosterone and estradiol are most active. The sex hormones determine the normal sexual development, the formation of secondary sexual signs, affect the metabolism.
^ Chapter 14. Biochemical Basics of Rational Power
In the problem of nutrition, three interrelated sections can be distinguished: rational nutrition, therapeutic and medical and prophylactic. The basis is the so-called rational nutrition, as it is based on the needs of a healthy person, depending on the age, profession, climatic, etc. Conditions. The basis of rational food is balanced and the correct power mode. Rational nutrition is a means of normalizing the condition of the body and maintaining its high working capacity.
With food in the human body, carbohydrates, proteins, fats, amino acids, vitamins, minerals are coming. The need for these substances is different and is determined by the physiological state of the body. A growing organism needs more food. A person who is engaged in sports or physical labor consumes a large amount of energy, and therefore also needs more food than a small person.
In a person's nutrition, the number of proteins, fats and carbohydrates should be in the ratio of 1: 1: 4, i.e. it is necessary for 1 g of protein. Consistent 1 g of fat and 4 g of carbohydrates. Proteins should provide about 14% of the calorieness of the daily diet, fats are about 31%, and carbohydrates about 55%.
At the present stage, the development of nutrition science is not enough to proceed only from the total consumption of food substances. It is very important to establish the specific weight in the nutrition of the indispensable components of food (essential amino acids, unsaturated fatty acids, vitamins, mineral substances, etc.). Modern teaching about the needs of a person in food has received an expression in the concept of balanced nutrition. According to this concept, providing normal livelihoods is possible not only if the body is supplied with an adequate amount of energy and protein, but under compliance with sufficiently complex relationship between numerous indispensable power factors capable of exercising in the body maximum useful biological effects. The law of balanced nutrition is based on the quantitative and qualitative aspects of food assimilation processes in the body, i.e., the entire amount of exchange enzymatic reactions.
At the Institute of Nava, AMN USSR has developed average data on the values \u200b\u200bof the need for an adult in food substances. Mainly, in determining the optimal ratios of individual dietary substances, such a ratio of food substances is necessary on average to maintain normal vital activity of an adult. Therefore, in the preparation of common nutritional diet and evaluation of individual products, it is necessary to focus on these ratios. It is important to remember that not only the insufficiency of individual essential factors is harmful, but their excess is dangerous. The cause of the toxicity of an excess of essential food substances is likely to be associated with the unbalance of the diet, which in turn leads to a violation of the biochemical homeostasis (the constancy of the composition and properties of the inner medium) of the body, to the cellular nutrition.
The reduced balancing of nutrition can hardly be moved unchanged into the structure of the nutrition of people in various working conditions and life, people of different ages and gender, etc. Based on the fact that the differences in the needs of energy and food substances lie features The flow of metabolic processes and their hormone and nervous regulation is necessary for persons of different ages and gender, as well as for persons with significant deviations from the average indicators of the normal enzymatic status in the usual representation of the balanced nutrition formula, make certain adjustments.
Institute of Navigation of AMN USSR proposed standards for
calculation of optimal nutritional diet of our country.
These diet are differentiated relative to three climatic
zones: North, Central and South. However, the latest scientific evidence suggests that this division cannot be met today. Recent studies have shown that within our country the North must be divided into two zones: European and Asian. These zones are significantly different in climatic conditions. At the Institute of Clinical and Experimental Medicine with the AMN of the USSR (Novosibirsk), as a result of long research, it was shown that the exchange of proteins, fats, carbohydrates, vitamins, macro- and microelements is rebuilt in the conditions of the Asian North, and therefore the need to clarify human nutrition Taking into account shifts in metabolism. Currently, a wide scale study in the field of rationalizing the nutrition of the population of Siberia and the Far East. A primary role in the study of this issue is given to biochemical studies.
Regulation of water exchange is carried out by the neurohumoral path, in particular, by various departments of the central nervous system: the bark of large hemispheres, intermediate and oblong brain, sympathetic and parasympathetic gangs. Many glands of internal secretion are also involved. The effect of hormones in this case is reduced to the fact that they change the permeability of the cell membranes for water, providing its release or readsorption. The ability of the body in water is regulated by a feeling of thirst. Already at the first signs of blood thickening as a result of the reflex excitation of certain sections of the cortex of the brain, thirst arises. The water consumed is absorbed through the intestinal wall, and its excess does not cause blood dilution. . Of the blood is quickly moving into the intercellular spaces of loose connective tissue, liver, leather, etc. These fabrics serve as a depot of water in the body. Individual cations are provided from tissues from tissues. Na + ions contribute to the binding by colloidal particles of proteins, ions K + and Ca 2+ stimulate the release of water from the body.
Thus, vasopressin neurohypophysis (antidiuretic hormone) promotes readersbet from the primary urine of water, reducing the release of the latter from the body. Hormones of adrenal cortex - aldosterone, deoxykorticosterol - promotes sodium delay in the body, and since sodium cations increase tissue hydration, and water is delayed in them. Other hormones stimulate the selection of water by the kidneys: thyroxin - thyroid hormone, paratultgaron - a hormone of parachoid gland, androgens and estrogens - hormones of the genual gland. The thyroid gland hormones stimulate the release of water through sweat glands. The nature of water in the tissues, primarily free, increases with the disease Kidney, violation of the function of the cardiovascular system, with protein starvation, with violation of the liver function (cirrhosis). An increase in water content in intercellular spaces leads to edema. Insufficient formation of vasopressin leads to an increase in diuresis, to a disease of unsax diabetes. Dehydration of the body is also observed with insufficient education in the Aldosterone adrenal cortex.
Water and substances dissolved in it, including mineral salts, create an inner medium of the body, the properties of which are preserved constant or vary in a natural way when changing the functional state of organs and cells. The source parameters of the body's liquid medium are osmotic pressure,pHand volume.
The osmotic pressure of extracellular fluid largely depends on the salt (NaCl), which in this fluid is contained in the greatest concentration. Therefore, the main mechanism for regulating the osmotic pressure is associated with a change in the velocity of the release of either water, orNaCl, as a result of which the concentration of the tissue fluids changes, and therefore the osmotic pressure changes. The volume regulation occurs by simultaneously changing the release rate and water, andNaCl. In addition, the mechanism of thirst regulates water consumption. PH regulation is provided by selective acid separation or alkalis with urine; The pH of the urine depending on this may vary in the range from 4.6 to 8.0. Such pathological conditions, as dehydrutation of tissues or swelling, increase or decrease in blood pressure, shock, acidosis, alkalosis are associated with impaired water-salt homeostasis.
Regulation of osmotic pressure and volume of extracellular fluid.Water release and NaCl kidneys are regulated by antidiuretic hormone and aldosterone.
Antidiuretic hormone (Vasopressin).Vasopressin is synthesized in the neurons of the hypothalamus. Osioricceptors of the hypothalamus with an increase in the osmotic pressure of the tissue fluid stimulate the release of vasopressin from secretory granules. Vasopressin increases the rate of reabsorption of water from the primary urine and thereby reduces diuresis. Watering is becoming more concentrated. In this way, the antidiuretic hormone retains the required amount of fluid in the body without affecting the amount of NaCl allocated. The osmotic pressure of the extracellular fluid decreases, i.e., the incentive is eliminated, which caused the release of vasopressin. In some diseases, damaging hypothalamus or hypophies (tumors, injuries, infection), synthesis and secretion of vasopressin decreases and develops nonachar diabetes.
In addition to the decrease in the diurea, Vasopressin also causes the narrowing of arterioles and capillaries (hence and the name), and, consequently, the increase in blood pressure.
Aldosterone.This steroid hormone is produced in adrenal cortex. Secrecy increases with a decrease in the concentration of NaCl in the blood. In the kinding, aldosterone increases the rate of reabsorption Na + (and with it and C1) in the tubes of nephron, which causes the NaCl delay in the body. Thus, the stimulus is eliminated, which caused the secretion of aldosterone. The shapeless secretion of aldosterone leads, respectively, to excessive NaCl delay and an increase in the osmotic pressure of the extracellular fluid. And this serves as a wazopressin liberation signal, which speeds up the reabsorption of water in the kidneys. As a result, NaCl and water accumulates in the body; The volume of extracellular fluid increases while maintaining normal osmotic pressure.
Renin-angiotensin system.This system serves as the main mechanism for regulating the secretion of aldosterone; It also depends on the secretion of vasopressin. Lenin is a proteolytic enzyme that is synthesized in YuCstaglomelar cells surrounding the armor of the renal glove.
An renin angiotensin system plays an important role in the restoration of blood volume, which can decrease as a result of bleeding, abundant vomiting, diarrhea (diarrhea), sweating. The narrowing of the vessels under the action of angiotensin II plays the role of emergency measure to maintain blood pressure. Then flowing with drinking and food water and NaCl are delayed in the body to a greater extent than normal, which ensures the restoration of the volume and pressure of the blood. After that, Renin ceases to stand out, the substances already available in the blood are destroyed and the system comes to its original state.
A significant decrease in the circulating fluid volume can cause a dangerous violation of the blood supply to tissues before regulatory systems restore pressure and blood pressure. At the same time, the functions of all organs, and, above all, the brain; There is a condition that is called shock. In the development of shock (as well as edema), a significant role belongs to a change in the normal distribution of fluid and albumin between the bloodstream and the intercellular space. Vazopressin and aldosterone are involved in the regulation of the water-salt balance, acting at the nephron tubuing level - change the rate of reabsorption of primary urine components.
Water-salt metabolism and secretion of digestive juices.The volume of daily secretion of all digestive glands is quite large. Under normal conditions, the water of these liquids is again absorbed in the intestine; Abundant vomiting and diarrhea may cause a significant decrease in the volume of extracellular fluid and tissue dehydration. Significant loss of fluid with digestive juices entails an increase in the concentration of albumin in the blood plasma and the intercellular fluid, since albumin with secrets is not displayed; For this reason, the osmotic pressure of the intercellular fluid increases, water from the cells begins to move into the intercellular fluid and the cell functions are broken. The high osmotic pressure of extracellular fluid also leads to a decrease in or even cessation of urine formation , and if the water and salt do not come from the outside, the animal develops a comatose state.
GOVPO UGMA of the Federal Health and Social Development Agency
Department of Biochemistry
LECTURE COURSE
According to general biochemistry
Module 8. Biochemistry of water-salt metabolism and acid-base state
Yekaterinburg,
Lecture No. 24.
Topic: Water and Salt and Mineral Exchange
Faculties: Medical and prophylactic, medical and prophylactic, pediatric.
Water-salt exchange - Exchange of water and basic electrolytes of the body (Na +, K +, Ca 2+, Mg 2+, Cl -, HCO 3 -, H 3 PO 4).
Electrolytes - Substances that dissociate in the solution on anions and cations. They are measured in mol / l.
Neelectrics - Substances, non-missing in solution (glucose, creatinine, urea). They are measured in g / l.
Mineral exchange - exchange of any mineral components, including those that do not affect the basic parameters of the liquid medium in the body.
Water - the main component of all organism fluids.
Biological role of water
- Water is a universal solvent for most organic (except lipids) and inorganic compounds.
- Water and substances dissolved in it create an inner medium of the body.
- Water provides transport of substances and thermal energy by the body.
- A significant part of the chemical reactions of the organism flows in the aqueous phase.
- Water is involved in hydrolysis, hydration, dehydration reactions.
- Determines the spatial structure and properties of hydrophobic and hydrophilic molecules.
- In the complex with GAG, water performs a structural function.
General properties of body fluids
Volume. All terrestrial animal fluids are about 70% of the body weight. The distribution of water in the body depends on age, gender, muscle mass, ... With full deprivation of water, death occurs after 6-8 days, when the amount of water in the body decreases by 12%.Regulation of the body's water-salt balance
In the body, the water-salt balance of the intracellular medium is maintained by the constancy of the extracellular fluid. In turn, the water-salt balance of extracellular fluid is maintained through a blood plasma with the help of organs and is regulated by hormones.
Authorities regulating water-salt exchange
The flow of water and salts into the body occurs through the gastrointestinal tract, this process is controlled by a feeling of thirst and salt appetite. The removal of excess water and salts from the body carry out kidneys. In addition, water from the body remove the skin, lungs and gasts.
Balance of water in the body
Changes in the work of the kidneys, skin, lungs and the gastrointestinal tract can lead to a violation of water-salt homeostasis. For example, in a hot climate, to maintain ...Hormones regulating water-salt exchange
Antidiuretic hormone (ADG), or vasopressin - a peptide with a molecular weight of about 1100 D, containing 9 AK connected by one disulfide ... ADG is synthesized in the neurons of the hypothalamus, is transferred to the nerve endings ... The high osmotic pressure of the extracellular fluid activates the osimorceptors of the hypothalamus, as a result, arise ...Renin angiotensin-aldosterone system
Renin
Renin - a proteolytic enzyme produced by YUKSTAGLOMERAL cells located along the afferent (bringing) arterioles of renal calf. The secretion of renin stimulates the pressure drop in the arteriols of the Gulf, caused by a decrease in blood pressure and a decrease in the concentration of Na +. The secretion of renin also contributes to a decrease in impulse from the atrial baroreceptors and arteries as a result of decreasing blood pressure. Renin secretion inhibits angiotensin II, high blood pressure.
In the blood of Renin acts on angiotensinogen.
Angiotensinogen - α 2-Globulin, out of 400 AK. The formation of angiotensinogen occurs in the liver and is stimulated by glucocorticoids and estrogen. Renin hydrolyzes peptide bond in the angiotensinogen molecule, eliminating the N-terminal decaptide from it - angiotenzine I. without biological activity.
Under the action of an anti-bean-converting enzyme (ACE) (carboxidpeptidylpeptidase) of edothelial cells, light and blood plasma, from the C-terminus of angiotensin I are removed 2 ac and forms angiotenzine II. (octapeptide).
Angiotenzine II.
Angiotenzine II. Functions through the inositoltrim phosphate system of cells of the glomerular zone of adrenal cortex and MMC. Angiotensin II stimulates the synthesis and secretion of aldosterone cells of the glomerular zone of adrenal cortex. High concentrations of angiotensin II cause a strong narrowing of the vessels of peripheral arteries and increase hell. In addition, angiotensin II stimulates the center of thirst in the hypothalamus and inhibits the secretion of renin in the kidneys.
Angiotensin II under the action of aminoptidases is hydrolyzed in angiotensin III (heptapeptide, with angiotensin II activity, but having 4 times lower concentration), which is then hydrolyzed by angiotensinases (protease) to AK.
Aldosterone
Synthesis and aldosterone secretion stimulate angiotensin II, low concentration Na + and high concentration to + in blood plasma, ACTH, prostaglandins. NaCl delay in the body and increases ...Water-salt metabolism regulation scheme
The role of the RAAS system in the development of hypertensive disease
Hyperproduction of Raas hormones causes an increase in the volume of circulating fluid, osmotic and blood pressure, and leads to the development of hypertensive disease.
The increase in renin occurs, for example, in atherosclerosis of the renal arteries, which occurs in the elderly.
Hypersecretion of aldosterone - Hyperldosteronism , arises as a result of several reasons.
The cause of primary hyperaldosteroneism (conne syndrome ) Approximately 80% of patients are adrenal adenoma, in other cases - diffuse hypertrophy of the glomerular zone cells producing aldosterone.
With primary hyperaldosteroneism, excess aldosterone enhances the reabsorption of Na + in the renal tubules, which serves as an incentive for the secretion of ADG and the water delay. In addition, the removal of ions K +, Mg 2+ and H + increases.
As a result, it is developing: 1). hypernatremia causing hypertension, hypervolemia and edema; 2). hypokalemia leading to muscle weakness; 3). Magnesium deficiency and 4). Light metabolic alkalosis.
Secondary hyperaldosteronism It is much more common than primary. It may be associated with heart failure, chronic kidney diseases, as well as with tumors secreting renin. In patients, there is an elevated level of renin, angiotensin II and aldosterone. Clinical symptoms are less pronounced than in primary aldosteroneism.
Calcium, magnesium, phosphoric exchange
Calcium functions in the body:
- Intracellular mediator of a row of hormones (inositatrifosphate system);
- Participates in the generation of action potentials in nerves and muscles;
- Participates in blood clotting;
- Launches muscle contraction, phagocytosis, secretion of hormones, neurotransmitters, etc.;
- Participates in mitosis, apoptosis and necrobiasis;
- Increases the permeability of the cell membrane for potassium ions, affects sodium cell conductivity, to the operation of ion pumps;
- Coenzyme of some enzymes;
Magnesium functions in the body:
- It is the coenferment of many enzymes (transcetolaz (PFS), glucose-6f dehydrogenase, 6-phosphogluconate dehydrogenase, glucconolactant hydrolase, adenylate cyclase, etc.);
- The inorganic component of bones and teeth.
Functions of phosphate in the body:
- Inorganic component of bones and teeth (hydroxyappatitis);
- It is included in lipids (phospholipids, sphingolipids);
- It is included in the composition of nucleotides (DNA, RNA, ATP, GTF, FMN, OB, NADF, etc.);
- Provides energy exchange. forms macroeergic ties (ATP, creatine phosphate);
- Included in the composition of proteins (phosphoprotein);
- Is included in carbohydrates (glucose-6f, fructozo-6f, etc.);
- Regulates the activity of enzymes (the reaction of phosphorylation / dephosphorylation of enzymes, is included in the composition of the inositolitriphosphate - the component of the inositatriphosphate system);
- Participates in catabolism of substances (phosphoroid reaction);
- Regulates brand Forms phosphate buffer. Neutralizes and derives protons with urine.
Distribution of calcium, magnesium and phosphates in the body
In an adult body, it is contained in about 1 kg of phosphorus: bones and teeth contain 85% phosphorus; Extracellular liquid - 1% phosphorus. In serum ... Magnesium concentration in blood plasma 0.7-1.2 mmol / l.Exchange calcium, magnesium and phosphates in the body
With food per day, calcium should enter - 0.7-0.8g, magnesium - 0.22-0.26g, phosphorus - 0.7-0.8. Calcium is absorbed poor by 30-50%, phosphorus is good - by 90%.
In addition to the gastrointestinal tract, calcium, magnesium and phosphorus enter the blood plasma from bone tissue, in the process of its resorption. The exchange between blood plasma and calcium bone tissue is 0.25-0.5g / day, according to phosphorus - 0.15-0.3g / day.
Calcium, magnesium and phosphorus from the body are excreted through the kidneys with urine, through the trap with the feet and through the skin from then.
Regulation of exchange
The main regulators of calcium exchange, magnesium and phosphorus are parathglon, calcitriol and calcitonin.
Parathgormon
The secretion of the parathgamon stimulates the low concentration of Ca2 +, Mg2 + and the high concentration of phosphates, inhibits vitamin D3. The speed of the collar of the hormone decreases at a low concentration of Ca2 + and ... Parathgarmon acts on the bone and kidneys. It stimulates the secretion by Osteoblasts insulin-like growth factor 1 and ...Hyperparathyroidism
The hyperparathyroidism causes: 1. Destruction of bones, when mobilizing calcium and phosphates from them. ... 2. hypercalcemia, when strengthening the reabsorption of calcium in the kidneys. Hypercalcemia lead to a decrease in neuromuscular ...Hypoparatyosis
Hypoparatyosis is due to the insufficiency of parathyroid glands and is accompanied by hypocalcemia. Hypocalcemia causes an increase in neuromuscular conductivity, attacks of tonic seizures, respiratory muscles and diaphragms, laryngospasm.
Calcitrol
1. In the skin, under the influence of UV radiation from 7-dehydroholezterol, it is formed ... 2. In the liver of 25-hydroxylase, cholecalciferol is hydroxylates in calcidiol (25-hydroxycholecalciferol, 25 (OH) D3). ...Calcithonin
Calcitonine - polypeptide, consists of 32 AK with one disulfide bond, secreted by parapolycular n-cells of the thyroid gland or C-cells of parachitoid glasses.
The secretion of calcitonin stimulates the high concentration of Ca 2+ and glucagon, suppresses the low concentration of Ca 2+.
Calcitonin:
1. Sucts osteolysis (reducing the activity of osteoclasts) and inhibits the release of Ca 2+ from the bone;
2. In the kidney channels, the reabsorption of Ca 2+, Mg 2+ and phosphates;
3. Bashes digestion in the gastrointestinal tract,
Changes in the level of calcium, magnesium and phosphate with different pathologies
The increase in the concentration of Ca2 + in the blood plasma is observed at: the hyperfunctions of the parachitoid glands; bone fractures; polyarthritis; Multiple ... Reducing phosphate concentration in blood plasma is observed when: Rahit; ... an increase in the phosphate concentration in blood plasma is observed when: the hypofunction of the parachitoid glands; overdose…The role of trace elements: Mg2 +, Mn2 +, Co, Cu, Fe2 +, Fe3 +, Ni, Mo2 +, Fe3 +, Ni, Mo, SE, J. The value of ceruloplasmin, Konovalov-Wilson disease.
Manganese -aminoacil-TRNA synthetase cofactor.
The biological role of Na +, Cl-, K +, HCO3- - the main electrolytes, the value in the regulation of the COP. Exchange and biological role. Anionic difference and its correction.
Reducing the content of blood chlorides: alkalosis hypochlorinemic (after vomiting), acidosis respiratory, excessive sweating, nephritis with ... Increased selection of chlorides with urine: hypoaldosteroneism (Addison disease), ... Reducing chloride removal with urine: loss of chlorides during vomiting, diarrhea, disease Cushing, terminal phase renal ...Lecture number 25.
Topic: KS.
2 course. Acid-ground state (KS) - relative constancy of the reaction ...Biological meaning of regulation of pH, consequences of violations
The deflection of the pH from the norm by 0.1 causes noticeable disorders from the respiratory, cardiovascular, nervous and other organism systems. At the acdemia, it occurs: 1. Strengthening breathing to a sharp breath, disruption of breathing as a result of bronchospasm;Basic principles of regulation of braids
The basis of the regulation of KOS is 3 basic principles:
1. constancy of pH . The mechanisms of regulation of Kos support the constancy of the pH.
2. isosmolarity . When regulating the COP, the concentration of particles in the intercellular and extracellular fluid does not change.
3. electronterability . When regulating the KS, the number of positive and negative particles in the intercellular and extracellular fluid does not change.
SPE regulation mechanisms
We fundamentally exist 3 main mechanisms for the regulation of Kos:
- Physico-chemical mechanism , these are buffer blood and tissue systems;
- Physiological mechanism These are organs: lungs, kidneys, bone tissue, liver, leather, gastrointestinal tract.
- Metabolic (at the cellular level).
There are fundamental differences in these mechanisms:
Physical and chemical mechanisms regulation of braids
Buffer - This is a system consisting of weak acid and its salt with a strong base (conjugated acid-base pair).
The principle of operation of the buffer system is that it binds H + with their excess and allocates N + with their shortage: H + + A - ↔ AN. Thus, the buffer system strives to resist any changes in pH, while one of the components of the buffer system is spent and requires recovery.
Buffer systems are characterized by the ratio of the components of the acid-base pair, a capacity, sensitivity, localization and the size of the pH, which they support.
There are many buffers both inside and outside the cells of the body. The basic buffer systems of the body include bicarbonate, phosphate protein and variety of hemoglobine buffer. About 60% of acidic equivalents bind intracellular buffer systems and about 40%-vectors.
Bicarbonate (hydrocarbonate) buffer
It consists of H 2 CO 3 and NAnso 3 in the ratio of 1/20, is localized mainly in the intercellular fluid. In the serum at RSO 2 \u003d 40 mm.R.T., the concentrations of Na + 150 mmol / l It supports pH \u003d 7.4. The work of the bicarbonate buffer is provided by the fermented carboangeyndase and protein of the erythrocyte and kidney band.
Bicarbonate buffer is one of the most important buffers of the body, which is associated with its features:
- Despite low capacity - 10%, the bicarbonate buffer is very sensitive, it connects to 40% of all "unnecessary" H +;
- Bicarbonate buffer integrates the operation of the main buffer systems and physiological mechanisms for the regulation of Kos.
In this regard, the bicarbonate buffer is an indicator of the COP, the definition of its components is the basis for the diagnosis of the disorder of the Kos.
Phosphate buffer
It consists of acidic NAn 2 PO 4 and the main Na 2 NRA 4 phosphates, is localized mainly in cellular fluid (phosphates in a cell of 14%, in the intercellular liquid 1%). The ratio of acidic and basic phosphates in the blood plasma is ¼, in the urine - 25/1.
The phosphate buffer provides the regulation of the brass inside the cell, the regeneration of the bicarbonate buffer in the intercellular fluid and the removal of H + with the urine.
Protein buffer
The presence of amino proteins and carboxyl groups gives them amphoteric properties - they exhibit the properties of acids and bases, forming a buffer system.
The protein buffer consists of protein-n and protein-Na, it is localized mainly in cells. The most important protein buffer of blood - hemoglobine .
Hemoglobine buffer
Hemoglobine buffer is in red blood cells and has a number of features:
- he has the highest capacity (up to 75%);
- his work is directly related to gas exchange;
- it consists not from one, but from 2 pairs: HHB.↔H + + HB - and HHBO 2 ↔H + + HBO 2 -;
HBO 2 is a relatively strong acid, it is even stronger than coalic acid. The acidity of HBO 2 compared to HB is 70 times higher, therefore, oxymemoglobin is mainly present in the form of a potassium salt (KHBO 2), and deoxyhemoglobin in the form of unfinished acid (HHB).
The work of hemoglobin and bicarbonate buffer
Physiological mechanisms regulation of braids
The acids formed in the body can be volatile and non-volatile. Bat H2CO3 is formed from CO2, the final product of aerobic ... Lactate's non-volatile acids, ketone bodies and fatty acids accumulate in ... Falling acids are allocated from the body mainly light with exhaled air, non-volatile kidney with urine.The role of the lungs in the regulation of Kos
Regulation of gas exchange in the lungs and, accordingly, the release of H2CO3 from the body is carried out through the flow of pulses from chemoreceptors and ... Normally, the lungs are released 480l CO2, which is equivalent to 20 miles of H2CO3. ... The pulmonary mechanisms for maintaining Kos are highly efficient, they are able to level the brain 50-70. %. ...The role of the kidneys in the regulation of braids
The kidneys regulate Kos: 1. With the elimination of H + organism in the reactions of acidogenesis, ammoniogenesis and ... 2. The delay in the Na + body. Na +, K + -ATFase reabsorb Na + from urine, which is with carboangeyndase and acidogenesis ...The role of bones in the regulation of braids
1. CA3 (PO4) 2 + 2N2CO3 → 3 CA2 + + 2NRO42- + 2NSO3- 2. 2NRO42- + 2NSO3- + 4NO → 2N2O4- (in urine) + 2N2O + 2CO2 + 4A- 3. A- + CA2 + → CAA ( in urine)The role of the liver in the regulation of braids
The liver regulates Kos:
1. Transformation of amino acids, ketokyslot and lactate in neutral glucose;
2. The conversion of a strong base of ammonia into weakly main urea;
3. Synthesizing blood proteins that form protein buffer;
4. Synthesizes glutamine, which is used by kidneys for ammoniogenesis.
Hepatic insufficiency leads to the development of metabolic acidosis.
At the same time, the liver synthesizes the ketone bodies, which under conditions of hypoxia, starvation or diabetes are promoted by acidosis.
The effect of the gastrointestinal tract
The gastrointestinal tract affects the state of the COP, as it uses HCl and NSO 3 in the process of digestion. At first, HCl is secreted in the lumen of the stomach, while NSO 3 is accumulated in the blood - and alkalosis develops. Then NSO 3 - from the blood with pancreatic juice is entered into the intestinal lumen and the balance of Kos in the blood is restored. Since food that enters the body, and the feces, which is distinguished from the body mainly neutrally, the total effect on the brass turns out to be zero.
In the presence of acidosis, more HCl stands out in the clearance, which contributes to the development of ulcers. Vomiting is capable of compensating for acidosis, and diarrhea is aggravated. Long vomiting causes the development of alkalosis, in children it can have severe consequences, up to the lethal outcome.
Cellular mechanism
In addition to the physico-chemical and physiological mechanisms of Kos Regulation, there is still cellular mechanism Regulation of braids. The principle of its work is that excess amounts of H + can be placed in cells in exchange for K +.
SKU indicators
1. PH - (Power Hydrogene - hydrogen power) is a negative decimal logarithm (-lg) concentration of H +. The norm in the capillary blood is 7.37 - 7.45, ... 2. RSO2 is the partial pressure of carbon dioxide, which is in equilibrium with ... 3. PO2 is the partial pressure of oxygen in solid blood. The norm in the capillary blood is 83 - 108 mm.R.T., in venous - ...Violations of KG.
Correction of Kos is an adaptive reaction from the body that caused a violation of the Kos. There are two main types of violations of KK - acidosis and alkalosis.Acidosis
I. Gas (respiratory) . Characterized by accumulation in blood CO 2 ( rSO 2 \u003d, AB, SB, BB \u003d N,).
one). Difficultization of CO 2, with disorders of external respiratory (hypoventilation of the lungs with bronchial asthma, pneumonia, circulatory disorders with stagnation in a small circle, edema, emphysema, the atelectase of the lungs, the oppression of the respiratory center under the influence of a series of toxins and preparations such as morphine, etc. ) (RSO 2 \u003d, PO 2 \u003d ↓, AB, SB, BB \u003d N,).
2). High concentration of CO 2 in the environment (closed rooms) (RSO 2 \u003d, PO 2, AB, SB, BB \u003d N,).
3). Faults of anesthetically respiratory equipment.
Gas acidosis occurs in blood CO 2, H 2 CO 3 and lower pH. The acidosis stimulates reabsorption in the kidneys Na + and after some time in the blood there is an increase in AB, SB, BB and as compensation, an excretory alkalosis develops.
With acidosis in the blood plasma accumulates H 2 PO 4 - which is not capable of reabing in the kidneys. As a result, it stands out hard, causing phosphaturia .
To compensate for acidis of kidneys with urine, chlorides are highlighted, which leads to hypochroremia .
Excess H + enters the cells, in return from the cells it goes to + causing hepehercalemia .
Excess to + is stiffening with urine, which for 5-6 days leads to hypokalemia .
II. Negazova. Characterized by the accumulation of non-volatile acids (RSO 2 \u003d ↓, n, AB, SB, BB \u003d ↓).
one). Metabolic. Develops with disorders of tissue metabolism, which are accompanied by excessive formation and accumulation of non-volatile acids or loss of bases (RSO 2 \u003d ↓, N, AR \u003d, AB, SB, BB \u003d ↓).
but). Ketoacidosis. With diabetes mellitus, starvation, hypoxia, fever, etc.
b). Lactoacidosis. In hypoxia, impaired liver function, infections, etc.
in). Acidosis. It occurs as a result of accumulation of organic and inorganic acids with extensive inflammatory processes, burns, injuries, etc.
With metabolic acidosis, non-volatile acids and a decrease in pH occur. Buffer systems, neutralizing acids are consumed, concentration is reduced in the blood AB, SB, BBand rises AR.
H + non-volatile acids when interacting with NSO 3 are given H 2 C 3, which disintegrates on H 2 O and CO 2, the non-volatile acids are formed with Na + salt bicarbonates. Low pH and high RSO 2 stimulates breathing, as a result of RSO 2 in the blood normalizes or decreases with the development of gas alkalosis.
The excess H + blood plasma moves inside the cell, and in return from the cell goes to +, transient occurs in blood plasma hypercalemia , and cells - hypologicism . K + is intensively excreted with urine. Within 5-6 days, the content K + in the plasma is normalized and then becomes below the norm ( hypokalemia ).
In kidneys, the processes of acidida, ammoniogenesis and replenishment of plasma bicarbonate are enhanced. In exchange for NSO 3 - SL is actively excreted in the urine -, develops hypochloremia .
Clinical manifestations of metabolic acidosis:
- microcirculation disorders . There is a decrease in the inflow of blood and the development of the state under the action of catecholamines, the rheological properties of blood change, which contributes to the deepening of acidosis.
- damage and increase the permeability of the vascular wall Under the influence of hypoxia and acidosis. At acidosis, kinin levels increase in plasma and extracellular fluid. Kinina cause vasodilation and sharply increase permeability. Hypotension develops. The described changes in the vessels of the microcirculatory stream contribute to the process of thrombosis and bleeding.
At blood pH less than 7.2 arises reduced cardiac output .
- breath Kussmouul (The compensatory reaction is directed to the selection of excess CO 2).
2. Optional. It develops with violation of the processes of acidida and ammoniogenesis in the kidneys or with excessive loss of basic valences with carte masses.
but). Relief delay in renal failure (chronic diffuse glomerulonephritis, nephrosclerosis, diffuse jade, uremia). Urine neutral or alkaline.
b). Loss of alkalis: renal (renal tubular acidosis, hypoxia, intoxication with sulfanimamides), gastroenterny (diarrhea, hypersalization).
3. Exogenous.
Access of acidic food, drugs (ammonium chloride; transfusion of large quantities of bloodstream solutions and liquids for parenteral nutrition, whose pH is usually<7,0) и при отравлениях (салицилаты, этанол, метанол, этиленгликоль, толуол и др.).
4. Combined.
For example, ketoacidosis + lactoacidosis, metabolic + excretory, etc.
III. Mixed (gas + negotia).
Occurs during asphyxia, cardiovascular failure, etc.
Alkalosis
one). The enhanced decrease of CO2, when activating the external respiration (the hypervatolence of the lungs during compensatory shortness, accompanying a number of diseases, in that ... 2). O2 inhaled air deficiency causes the lungs hypervatolence and ... hyperventilation leads to a decrease in the blood of RSO2 and increase the pH. Alcalosis inhibits reabsorption in the kidney Na +, ...Negazine alkalosis
Literature
1. Serum or plasma bicarbonates / r. Marri, D. Grenner, P. Meys, V. Rodwell // Biochemistry of man: in 2 volumes. T.2. Per. From English: - M.: Mir, 1993. - p.370-371.
2. Blooming blood buffer systems and acid essential equilibrium / T.T. Berezov, B.F. KOROVKIN // Biological chemistry: textbook / ed. Akad. Ramne S.S. Debova. - 2nd ed. Pererab. and add. - M.: Medicine, 1990. - P.452-457.
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Concentration calciumin extracellular fluid, the norm is maintained on a strictly constant level, rarely increasing or decreased by several percent of relatively normal values \u200b\u200bconstituting 9.4 mg / dl, which is equivalent to 2.4 mmol calcium per liter. Such strict control is very important in connection with the main role of calcium in many physiological processes, including the reduction of skeletal, cardiac and smooth muscles, blood coagulation, the transfer of nerve impulses. Excitable fabrics, including nervous, are very sensitive to changes in calcium concentration, and an increase in the concentration of calcium ions compared with the norm (drylicemia) causes an increasing damage to the nervous system; On the contrary, a decrease in calcium concentration (hypocalcemia) increases the excitability of the nervous system.
An important feature of the regulation of the concentration of extracellular calcium is: only about 0.1% of the total calcium of the body is present in the extracellular fluid, about 1% is inside the cells, and the rest of the amount is stored in the bones, therefore bones can be considered as a large calcium storage that highlights it in Extracellular space if the calcium concentration is reduced there, and, on the contrary, the excess of calcium for storage.
Approximately 85% phosphate The organism is stored in the bones, from 14 to 15% - in cells, and only less than 1% is present in extracellular fluid. The concentration of phosphates in extracellular fluid is not so strictly adjustable as the calcium concentration, although they perform a variety of important functions by controlling many processes together with calcium.
The absorption of calcium and phosphates in the intestine and their excretion with the feces. The usual flow rate of calcium and phosphates is approximately 1000 mg / day, which corresponds to the amount derived from 1 l of milk. Usually bivalent cations, such as ionized calcium, are poorly absorbed in the intestines. However, as discussed below, Vitamin D contributes to the absorption of calcium in the intestine, and almost 35% (about 350 mg / day) consumed calcium is absorbed. The remaining calcium in the intestines enters the wheel masses and is removed from the body. Optionally, about 250 mg / day calcium enters the intestine in the composition of the digestive juices and the lunned cells. Thus, about 90% (900 mg / day) from the daily flow of calcium is derived from the feces.
Hypocalcemia Causes the excitation of the nervous system and totania. If the concentration of calcium ions in extracellular fluid falls below normal values, the nervous system is gradually becoming more excitable, because This change leads to an increase in the permeability for sodium ions, facilitating the generation of the action potential. In the event of a fall in the concentration of calcium ions to the level of 50% of the norm, the excitability of peripheral nerve fibers becomes so great that they start spontaneously discharged.
Hypercalcemia Lowings the excitability of the nervous system and muscle activity. If the calcium concentration in the liquid media of the body exceeds the norm, the excitability of the nervous system decreases, which is accompanied by a slowdown in reflex responses. An increase in calcium concentration leads to a decrease in the Qt interval on an electrocardiogram, a decrease in appetite and constipation, possibly due to a reduction in the contractile activity of the muscular wall of the gastrointestinal tract.
These depressive effects begin to appear when the calcium level rises above 12 mg / dl, and become noticeable when the calcium level exceeds 15 mg / dl.
Forming nerve impulses reach skeletal muscles, causing tetanic cuts. Consequently, hypocalcemia causes tenania, sometimes it provokes epileptiform attacks, since hypocalcemia increases brain excitability.
The absorption of phosphates in the intestine is easy. In addition to the amount of phosphates that are derived from the feces in the form of calcium salts, almost all phosphates contained in the daily diet are absorbed from the intestine to the blood and then excreted with urine.
The excretion of calcium and phosphates by the kidney. Approximately 10% (100 mg / day) of the calcium entered into the body is excreted with urine, about 41% of calcium in plasma is associated with proteins and therefore not filtered from glomerular capillaries. The remaining amount is combined with anions, for example, with phosphates (9%), or ionized (50%) and filtered with glomers to the renal tubules.
Normally, 99% of the filtered calcium is rebucing in the kidney channels, so almost 100 mg calcium are excreted per day. Approximately 90% of calcium contained in the glomerular filtrate is rebupping in proximal tubules, loop gene and at the beginning of the distal tubules. Then, at the end of the distal tubules and at the beginning of collective ducts, the remaining 10% of calcium are rebucing. Reabsorption becomes high and depends on the concentration of calcium in the blood.
If the concentration of calcium in the blood is low, reabsorption increases, as a result, calcium is almost not lost with urine. On the contrary, when calcium concentration in the blood slightly exceeds normal values, calcium excretion increases significantly. The most important factor controlling calcium reabsorption in the distal nephron departments and, therefore, regulating the level of calcium excretion, is pararatggumon.
The renal excretion of phosphates is regulated by the mechanism of abundant flow. This means that when the plasma phosphate concentration is reduced below the critical value (about 1 mmol / l), all phosphates from the glomerular filtrate are reabsorbed and ceased to be removed from the urine. But if the phosphate concentration exceeds the value of the norm, the loss of it with the urine is directly proportional to the additional increase in its concentration. The kidneys adjust the phosphate concentration in the extracellular space, changing the excretion rate of phosphates, respectively, their concentration in the plasma and the filtration rate of phosphates in the kidney.
However, as we will see further, parathgoromon can significantly increase the excretion of phosphates by the kidneys, so it plays an important role in regulating the phosphate concentration in plasma, along with the control of calcium concentration. Parathgormonit is a powerful regulator of calcium and phosphate concentrations, carrying out its influence, managing reabsorption processes in the intestines, excretion in the kidney and the exchange of these ions between extracellular liquid and bone.
The excessive activity of the parachitoid glands causes a rapid washing of calcium salts from bones, followed by the development of hypercalcemia in extracellular fluid; In contrast, the hypofunction of parathyroid glands leads to hypocalcemia, often with the development of Tetania.
Functional anatomy of parachitoid glands. Normally, a person has four parachitoid glands. They are located immediately after the thyroid gland, pairly at the top and lower poles. Each parathyroid gland is an formation of about 6 mm long, 3 mm wide and 2 mm high.
Macroscopically parathyroid glands look like dark brown fat, determine their location during the operation on the thyroid gland is difficult, because They often look like an additional fraction of the thyroid gland. That is why until the moment when the importance of these glands was established, total or subtotal thyroidectomy ended with the simultaneous removal of parachitoid glands.
The removal of half of the near-shaped glands does not cause serious physiological disorders, the removal of three or all four glands leads to transient hypoparathyroidism. But even a small amount of the remaining parachite gland fabric is capable of providing a normal function of the parachitoid glare due to hyperplasia.
Pararatoid glands of an adult consist mainly of the main cells and from a larger or less oxyphibal cells that are absent in many animals and young people. The main cells are allegedly secreted more, if not the entire number of parathgamon, and in oxyphibal cells - its purpose.
It is believed that they are modifications or exhausted their resource form of main cells that no longer synthesize hormone.
Chemical structure of the parathgamon. PTH is isolated in purified. Initially, it is synthesized on ribosomes in the form of a prepgrade, a polypeptide chain from the amino acid residues. It is then split to a turnman consisting of 90 amino acid residues, then to the hormone stage, which includes 84 amino acid residues. This process is carried out in the endoplasmic reticulum and the Golgi apparatus.
As a result, the hormone is packaged in secretory granules in cytoplasm cells. The final form of hormone has a molecular weight of 9500; Smaller compounds consisting of 34 amino acid residues, adjacent to the N-end of the pararathgamon molecule, also selected from the parathyroid glands, have the activity of PTH to the fullest. It has been established that the kidneys completely remove the shape of a hormone consisting of 84 amino acid residues, very quickly, within a few minutes, while the remaining numerous fragments provide a long time to maintain high degrees of hormonal activity.
Thyreocalcitonin- Hormone produced in mammals and in humans with paraphrolicular cells with thyroid gland, parachitoid gland and a fork iron. In many animals, for example, fish, a hormone, similar to functions, is made not in the thyroid gland (although it is in all vertebrate animals), but in ultimobranchial calves, and therefore is called just calcitonin. Thyreokalcitonin takes part in the regulation of phosphorous calcium exchange in the body, as well as the balance sheet of osteoclasts and osteoblasts, the functional antagonist of the parathgamon. Thyreocalcitonine lowers the content of calcium and phosphate in the blood plasma due to enhancing calcium capture and phosphate with osteoblasts. It also stimulates the reproduction and functional activity of Osteoblasts. At the same time, thyreocalcitonine slows down the reproduction and functional activity of osteoclasts and bone resorption processes. Thyreocalcitonin is a protein-peptide hormone, with molecular weight3600. Enhances the deposition of phosphorous calcium salts on a collagen bone matrix. Thyreocalcitonin, like paratggump, enhances phosphatine.
Calcitrol
Structure:It is a derivative of vitamin D and refers to steroids.
Synthesis:Formed in the skin under the action of ultraviolet and incoming with food cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2) are hydroxylized in the liver according to C25 and in kidneys according to C1. As a result, 1,25-dioxcalciferol (calcitriol) is formed.
Regulation of synthesis and secretion
Activate: hypocalcemia increases hydroxylation by C1 in the kidneys.
Reduce: Excess Calcitrile suppresses hydroxylation by C1 in the kidneys.
Mechanism of action:Cytosol.
Targets and effects: The calcitriol effect is to increase the concentration of calcium and phosphorus in the blood:
in the intestine induces the synthesis of proteins responsible for the absorption of calcium and phosphates, in the kidneys increases the reabsorption of calcium and phosphates, in bone tissue enhances calcium resorption. Pathology: Gypofunction corresponds to the painting of hypovitaminosis D. Role1.25-Dihydroxycaltsi-Farol in the exchange of Ca and P .: Enhances the absorption of Ca and P from the intestine, enhances the reabsorption of Ca and P by the kidneys, enhances the mineralization of the young bone, stimulates osteoclasts and the CA output from the old bone.
Vitamin D (calciferol, anti-oscillate)
Sources: There are two sources of vitamin D receipt:
liver, yeast, fatty facilities (butter, cream, sour cream), yolk eggs,
it is formed in the skin with ultraviolet irradiation from 7-dehydroholezterol in an amount of 0.5-1.0 μg / day.
Daily need:For children - 12-25 μg or 500-1000 me, in adults the need is much less.
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trojection:Vitamin is represented by two forms - Ergocalciferol and cholecalciferol. Chemically ergocalciferol differs from cholecalciferol by the presence in the double-bond molecule between C22 and C23 and the methyl group at C24.
After suction in the intestines or after synthesis in the skin, Vitamin falls into the liver. Here it is hydroxylated by C25 and calciferolitransport protein is transferred to the kidneys, where it is again hydroxylation, already according to C1. 1.25-dihydroxycholecalciferol or calcitriol is formed. The reaction of the hydroxylation in the kidneys is stimulated by the parathgamon, prolactin, somatotropic hormone and is suppressed by high concentrations of phosphates and calcium.
Biochemical functions:1. Increase the concentration of calcium and phosphates in the blood plasma. For this calcitriol: stimulates the absorption of CA2 + ions and phosphate ions in the small intestine (main function), stimulates the reabsorption of Ca2 + ions and phosphate ions in proximal renal tubules.
2. In bone tissue, the role of vitamin D double:
it stimulates the yona of Ca2 + ions from bone tissue, as it contributes to the differentiation of monocytes and macrophages in osteoclasts and a decrease in the synthesis of collagen I as osteoblasts,
increases the mineralization of the bone matrix, as it increases the production of citric acid, forming insoluble salts with calcium.
3. Participation in immunity reactions, in particular in stimulation of pulmonary macrophages and in the development of nitrogen-containing free radicals, destroying, including for mycobacterium tuberculosis.
4. Suppresses the secretion of the parathyroid hormone through an increase in the concentration of calcium in the blood, but enhances its effect on the calcium reabsorption in the kidneys.
Hyovitaminosis.Acquired hypovitaminosis.
It is often found in food deficiency in children, with insolation of insolation in people who do not go outside or under the national characteristics of clothing. Also, the cause of hypovitaminosis may be a decrease in hydroxylation of calciferol (liver and kidney disease) and impaired absorption and digestion of lipids (celiac disease, cholestasis).
Clinical picture:Children from 2 to 24 months are manifested in the form of rickets, in which, despite entering food, calcium does not digest in the intestines, and in the kidneys is lost. This leads to a decrease in the concentration of calcium in the blood plasma, violation of the mineralization of bone tissue and, as a result, to osteomalysis (softening of the bone). Osteomalacania is manifested by deformation of the bones of the skull (head of the head), chest (chicken breast), curvature of the leg, ricketical rosary on the ribs, an increase in the abdomen because of the muscle hypotension, slows down the teething and sinphorce.
In adults, osteomalaology is also observed, i.e. Osteoid continues to synthesize, but not mineralized. The development of osteoporosis is partially associated with vitamin D - deficiency.
Healthy hypovitaminosis
Vitamin D-dependent hereditary Rakhit type I, in which there is a recessive defect of renal α1-hydroxylase. Manifests a delay in development, rickettic characteristics of the skeleton, etc. Treatment - Calcitriogen preparations or large doses of vitamin D.
Vitamin D-dependent hereditary ricket II of type, in which the defect of the tissue receptors of calcitriol is observed. The clinically disease is similar to the I type, but the ALLELECTION, MILIA, epidermal cysts, muscular weakness are additionally marked. Treatment varies depending on the severity of the disease, the large doses of calciferol helps.
Hypervitaminosis.Cause
Redundant consumption with preparations (at least 1.5 million meters per day).
Clinical picture:Early signs of overdose of vitamin D are nausea, headache, loss of appetite and body weight, polyuria, thirst and polydipsy. There may be constipation, hypertension, muscle rigidity. Chronic excess vitamin D leads to hypervitaminosis, in which: demineralization of bones, leading to their fragility and fractures. Enlarging the concentration of calcium ions and phosphorus in the blood, leading to the calcification of vessels, light and kidney tissue.
Medicinal forms
Vitamin D - fish oil, Ergocalciferol, cholecalciferol.
1,25-Dioxiferol (active form) - osteotryol, oxidevit, rockaltrol, fused plus.
58. Hormones, fatty acid derivatives. Synthesis. Functions.
In the chemical nature, hormonal molecules refer to three groups of compounds:
1) proteins and peptides; 2) derivatives of amino acids; 3) steroids and derivatives of fatty acids.
Eykosanoids (ίίίίΣι, Greek-twenty) include oxidized derivatives of eikosanovy Kt: Eicosotrian (C20: 3), Arachidonova (C20: 4), TimnoDonova (C20: 5) G-K-T. Ekosanoid activity varies significantly from the number of double bonds in a molecule, which depends on the structure of the original John K-s. Eicosanoids are called hormone-like broadcasts, because They can only have a local action, persistent in the blood for several sec. Obr. in all organs and tissues with almost all types of CL. The eikosanoids cannot be deposited, they are destroyed for several seconds, and therefore the CL should synthesize them constantly from incoming fatty acids ω6- and ω3-row. Allocate three main groups:
Prostaglandins (PG) - It is synthesized in almost all cells, except erythrocytes and lymphocytes. The types of prostaglandins A, B, C, D, E, F. The functions of prostaglandins are reduced to the change in the tone of the smooth muscles of the bronchi, the urogen and vascular system, the gastrointestinal tract, and the direction of changes is different depending on the type of prostaglandins, the type of cell and conditions . They also affect body temperature. Can activate adenylate cyclase Prostacyclins They are a subspecies of prostaglandins (PG i), cause dilatation of small vessels, but also have a special function - inhibit platelet aggregation. Their activity increases with an increase in the number of double ties. Synthesized in the endothelium of myocardial vessels, uterus, stomach mucosa. Thromboxanes (TX) They are formed in platelets, stimulate their aggregation and cause narrowing of vessels. Their activity is reduced by increasing the number of double bonds. Increase the activity of phosphoinositid exchange Lakeotrienes (LT) synthesized in leukocytes, in the cells of the lungs, spleen, brain, hearts. 6 types of leukotrienes A, B, C, D, E, F. In leukocytes, they stimulate mobility, chemotaxis and cell migration to the focus of inflammation, in general they activate inflammation reactions, preventing it from chronizing. Also cause a reduction in the muscles of the bronchi (in doses of 100-1000 times smaller than histamine). Increase the permeability of membranes for S2 + ions. Since CAMF and Ca 2+ ions stimulate the synthesis of eikosanoids, a positive feedback is closed in the synthesis of these specific regulators.
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stochnik Free eicosanic acids are phospholipids of cell membrane. Under the influence of specific and nonspecific stimuli, phospholipase A 2 or the combination of phospholipase C and DAG-lipases are activated, which are cleaving fatty acid from phospholipid C2 position.
P 
olinatassed zhr K-Ta metabolizes mainly 2nd ways: cyclooxygenase and lipoxygenase, the activity of which in different cells is expressed in varying degrees. The cyclooxygenase path is responsible for the synthesis of prostaglandins and thromboxanes, lipoxygenous - for the synthesis of leukotrienes.
Biosynthesismost of the eikosanoids begins with the cleavage of arachidon to-you from membrane phospholipid or diacyl-glycerin in the plasma membrane. The synthetic complex is a polyenimen system, the function is predominantly on EPS membranes. Obr-smkosanoids easily penetrate the CL plasma membrane, and then a h / s intercellular prostley is transferred to the neighboring CL or go into blood and lymph. The rate of synthesis of eikosanoids was under the influence of hormones and neurotransmitters, the act of their adenylate cyclase or the concentration of Ca 2+ ions in CL. The most intense obrogen prostaglandins occurs in the seeds and ovaries. In many tissues, the cortisol inhibits the array of Arachidon K-you, which leads to the suppression of the Obrozanoids, and thereby has a counter-effect. Prostaglandin E1 is a powerful pyrogen. Suppression of the synthesis of this prostaglandin explains the therapeutic effect of aspirin. The half-life of Eicosanoids is 1-20 s. Enzymes inactivating them, there are pr-ki in all tissues, but their largest soda in the lungs. LE-I reg-I synthesis: Glucocorticoids, indirectly the synthesis of protein specificity, block the synthesis of eikosanoids, due to a decrease in the binding of phospholipid phospholipase A 2, which prevents the release of polyunsaturated to-you from phospholipid. Non-steroidal anti-ifs (aspirin, indomethacin, ibuprofen) irreversibly incoming cyclooxygenase and reduce the production of prostaglandins and thromboxanes.
60. Vitamins E. K and Ubiquinon, their participation in the metabolism.
Vitamins of group E (tocopherol). The name "Tocopherol" Vitamin E - from the Greek "Tokos" - "Birth" and "Ferro" - to wear. It was discovered in oil from sprouted wheat grains. Currently, a family of tocopherols and tokotrienols found in natural sources are known. All of them are the metallic derivatives of the initial connection of the tokol, in the structure are very close and denoted by the letters of the Greek alphabet. The greatest biological activity exhibits α-tocopherol.
Tocopherol insoluble in water; As well as vitamins A and D, it is soluble in fats, resistant to acids, alkalis and high temperatures. Normal boiling almost does not affect it. But light, oxygen, ultraviolet rays or chemical oxidizers are destructive.
IN 
itamin E contains ch. arr. In lipoprotein membranes of cells and subcellular organelles, where localized due to the intermol. Fortune. With nonsense. fatty fasteners. His biol. activitybased on the ability to form sustainable free. Radicals as a result of the cleavage of the H atom from the hydroxyl group. These radicals can enter into communities. with free radicals involved in the formation of the Org. peroxides. Thus, vitamin E prevents non-oxidation. lipids and protects from the destruction of biol. Membranes and other molecules, such as DNA.
The tocopherol increases the biological activity of vitamin A, protecting the unsaturated side chain from oxidation.
Sources: For a person - vegetable oils, salad, cabbage, seeds of cereals, butter, egg yolk.
Daily need Adult man in vitamin approximately 5 mg.
Clinical manifestations of insufficiency Human has not fully understood. The positive effect of vitamin E is known in the treatment of violation of the fertilization process, with repeated involuntary abortions, some forms of muscle weakness and dystrophy. The use of vitamin E is shown for premature children and children on artificial feeding, as in cow's milk 10 times less vitamin E than in feminine. The deficiency of vitamin E is manifested by the development of hemolytic anemia, possibly due to the destruction of the erythrocyte membranes as a result of the floor.
W. 
Bihanones (coenference q) - The widespread substance and was discovered in plants, mushrooms, animals and m / o. Related to the group of fat-soluble vitamin-like compounds, poorly dissolved in water, but is destroyed when exposed to oxygen and high temperatures. In a classical understanding, ubiquinone is not vitamin, since in sufficient quantity is synthesized in the body. But with some diseases, the natural synthesis of the Q COFER is reduced and it lacks it to meet the need, then it becomes an indispensable factor.
W. 
bihanones play an important role in the bioenergy of most priced cells and all eukaryotes. OSN. The ration of the ubiquinone is the transfer of electrons and protons from Split. substrates to cytochromas when breathing and oxidative phosphorylation. Ubiquins, ch. arr. In the reduced form (the ubiquinol, Q n h 2), perform antioxidants. There may be a protsure. Group of proteins. The Q-binding proteins of three classes acting in the breath are allocated. Chains in the field of functioning of the enzymes of succinate-bichinoneredoctase, Nadn-ubiquinned overcases and cytochromes in and from 1.
In the process of transferring electrons with NADH-dehydrogenase through FES to the ubiquinone, it is reversibly turning into hydroquinone. Ubiquinone performs a collector function, connecting electrons from NADH dehydrogenase and other flavine-dependent dehydrogenases, in particular, from succinate-dehydrogenase. Ubiquinon is involved in type reactions:
E (FMNH 2) + Q → E (FMN) + QH 2.
Symptoms of deficit: 1) anemia2) Changes in Skel Musculature 3) Heart Ladward 4) Changes in the Bone Mody
Symptoms of overdose: It is possible only during excessive administration and is usually manifested by nausea, stool impairment and stomach pain.
Sources:Vegetable - proprieties of wheat, vegetable oils, nuts, cabbage. Animals - Liver, Heart, Kidney, Beef, Pork, Fish, Eggs, Chicken. The intestine microflora is synthesized.
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weekly need: Under normal conditions, the body covers the need to completely, but there is an opinion that this required daily amount is 30-45 mg.
Structural formulas of the working part of FAD and FMN coenses. During the FAD and FMN reaction, 2 electrons attach 2 electrons and, unlike NAD +, both lost by the proton substrate.
63. Vitamins C and P, structure, role. Scurvy.
Vitamin R. (bioflavonoids; rutin, citrine; vitamin permeability)
Currently, it is known that the concept of "Vitamin R" unites the family of bioflavonoids (Catechins, Flavonons, flavones). This is a very diverse group of plant polyphenolic compounds that affect the permeability of the vessels in a similar way with vitamin C.
Under the term "vitamin P", which increases the resistance of capillaries (from lat. Permeability - permeability), a group of substances with similar biological activity are combined: catechins, Khalcon, Dihydrokhalkons, Flavins, Flavonons, Isoflavones, Flavonola, etc. All of them have p-vitamin activity And the basis of their structure is a diphenylpropane carbon "skeleton" chromone or flavon. This explains their common name "Bioflavonoids".
Vitamin P is absorbed better in the presence of ascorbic acid, and high temperatures easily destroys it.
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nurses: Lemons, buckwheat, black rowan, black currant, tea leaves, rosehip fruits.
Daily need For a person, constitutes a lifestyle, 35-50 mg per day.
Biological role Flavonoids is to stabilize the intercellular matrix of connective tissue and decrease the permeability of capillaries. Many representatives of the vitamin P group have a hypotensive effect.
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Vitamin R "protects" hyaluronic acid, which strengthens the walls of the vessels and is the main component of the biological lubrication of the joints, from the destructive actions of hyaluronidase enzymes. Bioflavonoids stabilize the main substance of the connective tissue by inhibiting hyaluronidase, which is confirmed by the data on the positive effect of p-vitamin preparations, as well as ascorbic acid, in the prevention and treatment of zinc, rheumatism, burns, etc. This data indicates the close functional bond of vitamins C and P in Redox processes of the body forming a unified system. This indirectly indicates the therapeutic effect provided by a complex of vitamin C and bioflavonoids called ascorutin. Vitamin R and vitamin C are closely related.
Rutin increases the activity of ascorbic acid. Protecting oxidation helps her better assimilation, he is rightfully considered to be the "main partner" ascorbic. Strengthening the walls of blood vessels and reducing their fragility, it thus reduces the risk of internal hemorrhages, prevents the formation of atherosclerotic plaques.
Normalizes elevated blood pressure, contributing to the extension of vessels. Promotes the formation of connective tissue, and hence the rapid healing of wounds and burns. Promotes the prevention of varicose veins.
Positive affects the work of the endocrine system. It is used for prevention and additional means in the treatment of arthritis - severe diseases of the joints and gout.
Enhances immunity, has antiviral activity.
Diseases: Clinical manifestation hypoavitaminosis Vitamin P is characterized by increased bleeding of disen and point subcutaneous hemorrhages, general weakness, rapid fatigue and pains in the limbs.
Hypervitaminosis: Flavonoids are not toxic and no overdose cases noticed from food excess easily derived from the body.
The reasons: The lack of bioflavonoids may occur against the background of long-term intake of antibiotics (or in large doses) and other potent drugs, with any adverse effect on the body, such as injury or surgical intervention.
