Water electrolyte exchange biochemistry. Hormones regulating water-salt exchange

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.

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):

and. 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):

and. 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):

and. 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:

and. 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

Functional biochemistry

(Water-salt exchange. Biochemistry of kidneys and urine)

TUTORIAL

Reviewer: Professor N.V. Kozachenko

Approved at the meeting of the department No. _____ from _______________2004

Approved the head. Department ________________________________________

Approved on MK of the Medical and Pharmaceutical Faculties

pr.№ _____ from _______________2004

Chairman ________________________________________________

Water-salt exchange

One of the most frequently disturbed materials of metabolism is a water-salt. It is associated with the constant movement of water and mineral substances from the external environment of the body into the inner, and vice versa.

In the body of an adult, the water accounts for 2/3 (58-67%) body weight. About half of its volume is concentrated in the muscles. The need for water (a person daily receives up to 2.5-3 liters of liquid) is covered due to the receipt of it in the form of a drink (700-1700 ml), the proof of water, which is included in the composition of the food (800-1000 ml), and water generated in The body under the metabolism is 200-300 ml (during combustion of 100 g of fats, proteins and carbohydrates is formed, respectively, 107.41 and 55 g of water). Endogenous water in a relatively large quantity is synthesized when the process of fat oxidation process is activated, which is observed at different, primarily prolonged stressful states, the excitation of a sympathetic-adrenal system, unloading diet and therapy (often used for the treatment of obese patients).

Due to the constantly occurring mandatory water losses, the internal volume of fluid in the body is stored unchanged. Such losses include renal (1.5 liters) and extrarenal, associated fluid release through a gender-daughter-intestinal tract (50-300 ml), respiratory tract and skin (850-1200 ml). In general, the volume of mandatory water loss is 2.5-3 liters, largely depend on the number of slags derived from the body.

The participation of water in the processes of vital activity is very diverse. Water is a solvent of many compounds, a direct component of a number of physicochemical and biochemical transformations, conveyor of endo- and exogenous substances. In addition, it performs a mechanical function, weakening the friction of ligaments, muscles, the surface of the finishing joints (thereby facilitating their mobility), participates in thermoregulation. Water maintains homeostasis, depending on the magnitude of the osmotic pressure of the plasma (isosmium) and the volume of fluid (isoovolemia), the functioning of the mechanisms of regulating the acid-base state, flowing processes that ensure the constancy of the temperature (isothermia).

In the human body, water remains in three basic physicochemical states, in accordance with which it is distinguished: 1) free, or mobile, water (constitutes the main part of the intracellular liquid, as well as blood, lymphs, interstitial fluid); 2) water associated with hydrophilic colloids, and 3) a constitutional, part of protein, fats and carbohydrate molecules.

In an adult body, weighing 70 kg, the volume of free water and water bound by hydrophilic colloids is approximately 60% of body weight, i.e. 42 liters This liquid is represented by intracellular water (it accounts for 28 liters, or 40% of body weight) component intracellular sector and extracellular water (14 l, or 20% body weight) forming extracellular sector. The latter includes intravascular (intravascular) liquid. This intravascular sector is formed by plasma (2.8 l), which accounts for 4-5% of body weight, and lymph.

Interstitial water includes actually intercellular water (free intercellular fluid) and an organized extracellular liquid (component of 15-16% body weight, or 10.5 liters), i.e. Water ligaments, tendons, fascia, cartilage, etc. In addition, the extracellular sector includes water in some cavities (abdominal and pleural cavity, pericardia, joints, brain ventricles, eye chambers, etc.), as well as in the gastrointestinal tract. The liquid of these cavities does not take actively participating in metabolic processes.

The water of the human body is not stirred in the various departments, but constantly moving, continuously exchanged with other sectors of the liquid and with the external environment. The movement of water is largely carried out due to the allocation of digestive juices. Thus, with saliva, with a pancreatic juice in the intestinal tube, about 8 liters of water per day, noete water due to suction in lower sections of the digestive tract is practically not lost.

Vital elements are divided into macroelements (daily need\u003e 100 mg) and microelements (daily need<100 мг). К макроэлементам относятся натрий (Na), калий (К), кальций (Ca), магний (Мg), хлор (Cl), фосфор (Р), сера (S) и иод (I). К жизненно важным микроэлементам, необходимым лишь в следовых количествах, относятся железо (Fe), цинк (Zn), марганец (Μn), медь (Cu), кобальт (Со), хром (Сr), селен (Se) и молибден (Мо). Фтор (F) не принадлежит к этой группе, однако он необходим для поддержания в здоровом состоянии костной и зубной ткани. Вопрос относительно принадлежности к жизненно важным микроэлементам ванадия, никеля, олова, бора и кремния остается открытым. Такие элементы принято называть условно эссенциальными.

Table 1 (column 2) shows the average content minerals in an adult organism (based on a mass of 65 kg). Average daily The need for an adult in these elements is given in column 4. In children and women during the pregnancy and feeding of the child, as well as patients with the need for trace elements usually higher.

Since many elements can stock in the body, the deviation from the daily rate is compensated in time. Calcium in the form of apatite is inhibited in bone tissue, iodine - in the composition of thyroglobulin in the thyroid gland, iron - as part of ferritin and hemosiderin in the bone marrow, spleen and liver. The storage location of many trace elements serves the liver.

The exchange of minerals is controlled by hormones. This applies, for example, to consumption H 2 O, Ca 2+, PO 4 3-, binding Fe 2+, I -, excretion H 2 O, Na +, Ca 2+, PO 4 3-.

The amount of mineral substances absorbed from food, as a rule, depends on the metabolic needs of the organism and in some cases from the composition of food products. As an example of the effect of the composition of food, calcium can be considered. The absorption of Ca 2+ ions contributes to lactic and citric acid, while phosphate ion, oxalate-ion and phytic acid inhibit calcium suction due to complexation and formation of poorly soluble salts (fittings).

Mineral deficiency- The phenomenon is not as rare: it occurs for various reasons, for example due to monotonous nutrition, disruption of digestibility, with various diseases. Lack of calcium can occur during pregnancy, as well as with rickets or osteoporosis. Chloride comes due to the large loss of SL ions - with severe vomiting.

Due to the insufficient iodine content in food products in many areas of Central Europe, both the well-deficient states and a dicky disease became a common phenomenon. Magnesium deficiency may occur due to diarrhea or due to monotonous power during alcoholism. The disadvantage in the organism of trace elements is often manifested by a violation of blood formation, i.e. anemia.

The last column lists the functions performed in the body of these mineral substances. From the data table it is clear that almost all macroelements Function in the body as structural components and electrolytes. Signal functions are performed by iodine (as part of the iodhometronic) and calcium. Most of the trace elements are protein cofactors, mainly enzymes. In a quantitative attitude in the body, iron-containing hemoglobin, mioglobin and cytochrome proteins predominate, as well as more than 300 zinc-containing proteins.

Table 1

Similar information.

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 get a presentation:

On some pathological conditions, accompanied by a change in the biochemical parameters of urine (proteinuria, hematuria, glucosuria, Ketonuria, Bilirubinuria, Porphyrinuria) .

Information from the basic disciplines necessary to explore the topic:

1. Construction of the kidney, nephron.

2. Mechanisms of urine formation.

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. 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):

and. 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):

and. 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):

and. 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:

and. 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 glukegenesis 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.

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Karaganda State Media N. Skye Academy

Department of General and Biological Chemistry

Functional biochemistry

(Water-salt exchange. Biochemistry of kidneys and urine)

TUTORIAL

Karaganda 2004.

Authors: head. Department of Prof. L.E. Muravlev, Associate Professor TS Omarov, Associate Professor S.A. Iskakova, teachers D.A. Klyuev, O.A. Ponamareva, L.B. Aytishev

Reviewer: Professor N.V. Kozachenko

Approved at the meeting of the Department of Pr. No. __ from __2004

Approved the head. Department

Approved on MK of the Medical and Pharmaceutical Faculties

pr.№ _OT __2004

Chairman

1. Water-salt exchange

One of the most frequently disturbed materials of metabolism is a water-salt. It is associated with the constant movement of water and mineral substances from the external environment of the body into the inner, and vice versa.

In the body of an adult person, there are 2/3 (58-- 67%) body weight. About half of its volume is concentrated in the muscles. The need for water (a person receives every period of time to 2.5--3 l of liquid) is covered due to the receipt of it in the form of drinking (700--1700 ml), the informed water included in the composition of the food (800--1000 ml), and water generated in the body in the metabolism - 200--300 ml (during combustion of 100 g of fats, proteins and carbohydrates is formed, respectively, 107.41 and 55 g of water). Endogenous water in a relatively large quantity is synthesized when the process of fat oxidation process is activated, which is observed at different, primarily prolonged stressful states, the excitation of a sympathetic-adrenal system, unloading diet and therapy (often used for the treatment of obese patients).

Due to the constantly occurring mandatory water losses, the internal volume of fluid in the body is stored unchanged. Such losses include renal (1.5 liters) and extrarenal, associated fluid release through the daily-daisy tract (50--300 ml), respiratory tract and skin (850--1200 ml). In general, the volume of mandatory water loss is 2.5--3 liters, largely depend on the number of slags derived from the body.

The participation of water in the processes of vital activity is very diverse. Water is a solvent of many compounds, a direct component of a number of physicochemical and biochemical transformations, conveyor of endo- and exogenous substances. In addition, it performs a mechanical function, weakening the friction of ligaments, muscles, the surface of the finishing joints (thereby facilitating their mobility), participates in thermoregulation. Water maintains homeostasis, depending on the magnitude of the osmotic pressure of the plasma (isosmium) and the volume of fluid (isoovolemia), the functioning of the mechanisms of regulating the acid-base state, flowing processes that ensure the constancy of the temperature (isothermia).

In the human body, water remains in three basic physicochemical states, in accordance with which it is distinguished: 1) free, or mobile, water (constitutes the main part of the intracellular liquid, as well as blood, lymphs, interstitial fluid); 2) water associated with hydrophilic colloids, and 3) a constitutional, part of protein, fats and carbohydrate molecules.

In an adult body, weighing 70 kg, the volume of free water and water bound by hydrophilic colloids is approximately 60% of body weight, i.e. 42 liters This liquid is represented by intracellular water (it accounts for 28 liters, or 40% of body weight), which is an intracellular sector, and extracellular water (14 liters, or 20% body weight) forming the extracellular sector. The latter includes intravascular (intravascular) liquid. This intravascular sector is formed by plasma (2.8 l), which accounts for 4--5% of body weight, and lymph.

Interstitial water includes actually intercellular water (free intercellular fluid) and an organized extracellular liquid (component of 15--16% body weight, or 10.5 liters), i.e. Water ligaments, tendons, fascia, cartilage, etc. In addition, the extracellular sector includes water in some cavities (abdominal and pleural cavity, pericardia, joints, brain ventricles, eye chambers, etc.), as well as in the gastrointestinal tract. The liquid of these cavities does not take actively participating in metabolic processes.

The water of the human body is not stirred in the various departments, but constantly moving, continuously exchanged with other sectors of the liquid and with the external environment. The movement of water is largely carried out due to the allocation of digestive juices. Thus, with saliva, with a pancreatic juice in the intestinal tube, about 8 liters of water is directed per day, but this water due to suction in lower sections of the digestive tract is practically not lost.

Vital elements are divided into macroelements (daily need\u003e 100 mg) and trace elements (daily need<100 мг). К макроэлементам относятся натрий (Na), калий (К), кальций (Ca), магний (Мg), хлор (Cl), фосфор (Р), сера (S) и иод (I). К жизненно важным микроэлементам, необходимым лишь в следовых количествах, относятся железо (Fe), цинк (Zn), марганец (Мn), медь (Cu), кобальт (Со), хром (Сr), селен (Se) и молибден (Мо). Фтор (F) не принадлежит к этой группе, однако он необходим для поддержания в здоровом состоянии костной и зубной ткани. Вопрос относительно принадлежности к жизненно важным микроэлементам ванадия, никеля, олова, бора и кремния остается открытым. Такие элементы принято называть условно эссенциальными.

Table 1 (column 2) shows the average content of mineral substances in an adult organism (based on a mass of 65 kg). The average daily need for an adult in the specified elements is given in column 4. In children and women during pregnancy and feeding the child, as well as patients with the need for trace elements usually higher.

Since many elements can stock in the body, the deviation from the daily rate is compensated in time. Calcium in the form of apatite is inhibited in bone tissue, iodine - in the composition of thyroglobulin in the thyroid gland, iron - as part of ferritin and hemosiderin in the bone marrow, spleen and liver. The storage location of many trace elements serves the liver.

The exchange of minerals is controlled by hormones. This applies, for example, to consumption H 2 O, Ca 2+, PO 4 3-, binding Fe 2+, I -, excretion H 2 O, Na +, Ca 2+, PO 4 3-.

The amount of mineral substances absorbed from food, as a rule, depends on the metabolic needs of the organism and in some cases from the composition of food products. As an example of the effect of the composition of food, calcium can be considered. The absorption of Ca 2+ ions contributes to lactic and citric acid, while phosphate ion, oxalate-ion and phytic acid inhibit calcium suction due to complexation and formation of poorly soluble salts (fittings).

The deficiency of minerals - the phenomenon is not so rare: it occurs for various reasons, for example due to monotonous nutrition, disruption of digestibility, with various diseases. The lack of calcium may occur during pregnancy, as well as with rickets or osteoporosis. Chloride comes due to the large loss of SL ions - with severe vomiting. Due to the insufficient iodine content in food products in many areas of Central Europe, Iodo deficient states and a dicky disease became the widespread phenomenon. Magnesium deficiency may occur due to diarrhea or due to monotonous power during alcoholism. The disadvantage in the organism of trace elements is often manifested by a violation of blood formation, i.e. Anemia. In the last column lists the functions performed in the body of these mineral substances. From the data table, it can be seen that almost all macroelements operate in the body as structural components and electrolytes. Signal functions are performed by iodine (as part of the iodhometronic) and calcium. Most of the trace elements are protein cofactors, mainly enzymes. In a quantitative attitude in the body, iron-containing hemoglobin, mioglobin and cytochrome proteins predominate, as well as more than 300 zinc-containing proteins.

2. Regulation of water-salt metabolism. The role of vasopressin, aldosterone and a renin angiotensin system

The main parameters of 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 edema. The main hormones involved in the regulation of the water-salt balance are ADG, aldosterone and the atrial sodium-urethic factor (PNF).

ADG, or vasopressin, a peptide containing 9 amino acids connected by one disulfide bridge. It is synthesized in the form of a dermamon in the hypothalamus, then transferred to the nerve ending of the rear lobe of the pituitary gland, of which is secreted in the bloodstream at the corresponding stimulation. Axon Moving is associated with a specific protein-carrier (neurophysine)

The stimulus causing the secretion of ADG is an increase in sodium ions concentration and an increase in the osmotic pressure of extracellular fluid.

The most important target cells for ADG - cells of the distal tubules and collective tubes of the kidneys. The cells of these ducts are relatively impenetrable for water, and in the absence of ADG urine does not concentrate and can be released in quantities exceeding 20 liters per day (normal 1--1.5 l per day).

For ADG there are two types of receptors - V 1 and V 2. The receptor V 2 is detected only on the surface of the epithelial kidney cells. The binding of ADG with V 2 is associated with the adenylate cyclase system and stimulates the activation of protein kinase A (PKA). The PKA phosphorylates proteins that stimulate the expression of the gene of the membrane protein - Aquaporin-2. Aquaporin 2 moves to the apical membrane, is stirred into it and forms water channels. These provide selective permeability of the water cell membrane. Water molecules are freely diffused into the cells of the renal tubules, and then come into an interstitial space. As a result, there is reabsorption of water from the renal tubules. V 1 type receptors are localized in smooth muscle membranes. The interaction of the ADG with the receptor V 1 leads to the activation of phospholipase C, which hydrolyzys phosphatidylositol-4,5-biff patilation with the formation of IF-3. IF-3 causes the release of Ca 2+ from the endoplasmic reticulum. The result of the hormone action through the receptors V 1 is to reduce the smooth muscle layer of vessels.

The ADG deficiency caused by the dysfunction of the rear lobe of the pituitary gland, as well as a violation in the hormonal signal transmission system, can lead to the development of unacceptable diabetes. The main manifestation of unsax diabetes is polyuria, i.e. Allocation of a large amount of low density urine.

Aldosterone - the most active mineralocorticosteroid is synthesized in the adrenal cortex from cholesterol.

The synthesis and secretion of the aldosterone cells of the glomerular zone stimulate angiotensin II, ACTH, Prostaglandin E. These processes are also activated at a high concentration of K + and low Na + concentration.

The hormone penetrates the inside of the target cell and interacts with a specific receptor, located both in the cytosole, and in the core.

In the cells of the kidney channels, aldosterone stimulates the synthesis of proteins that perform different functions. These proteins can: a) increase the activity of sodium channels in the membrane of cells of distal renal tubules, thereby promoting the transport of sodium ions from urine into cells; b) be the enzymes of the TSK and, therefore, increase the ability of the Krex cycle to generate the ATP molecules necessary for the active transport of ions; c) Activate the operation of the pump to +, na + -atfase and stimulate the synthesis of new pumps. The total result of the action of proteins, which is induced by aldosterone is an increase in the reabsorption of sodium ions in ka-nalz nephrones, which causes NaCl delay in the body.

The main mechanism of adjusting the synthesis and secretion of aldosterone is a renin angiotensin system.

Renin is an enzyme produced by YuCstaglomelar cells of renal affective arterioles. Localization of these cells makes them particularly sensitive to the change in blood pressure. Reducing blood pressure, loss of liquid or blood, a decrease in the concentration of NACI stimulate the release of renin.

Angiotenzinogen - 2 - Globulin, formed in the liver. It serves as a substrate for renin. Renin hydrolyzes peptide bond in the angiotensinogen molecule and cleaves the N-terminal decapidide (angiotensin I).

Angiotensin I serves as a substrate for the anti-cycin-sparing enzyme carboxidpeptidylpeptidase, detected in endothelial cells and blood plasma. 2 terminal amino acids with octapeptide - angiotensin II are cleaved from angiotensin I.

Angiotensin II stimulates the production of aldosterone, causes a narrowing of the arteriole as a result of which blood pressure is increasing and causes thirst. Angiotensin II activates the synthesis and secretion of aldosterone through an inositol phosphate system.

The PNF is a peptide containing 28 amino acids with a single disulfide bridge. The PNF is synthesized and stored in the form of a prepgrade (consisting of 126 amino acid residues) in cardiocytes.

The main factor regulating the secretion of the PFF is an increase in blood pressure. Other incentives: an increase in plasma osmomolar, increasing heart rate, elevated level of catecholamines in blood and glucocorticoids.

The main targets of the PNF - kidneys, peripheral arteries.

The mechanism of action of the PNF has a number of features. The plasma membrane PNF receptor is a protein with a guanillaziclase activity. The receptor has a domain structure. The domain binding to the ligand is localized in the extracellular space. In the absence of the PNF, the intracellular domain of the PNF receptor is in phosphorylated state and inactive. As a result of the binding of the PNF with the receptor, the guanillatcyclase receptor activity increases and the formation of a cyclic GMP from GTP occurs. As a result of the action of the PNF, the formation and secretion of renin and aldosterone is inhibited. The total effect of the action of the PNF is an increase in the excretion of Na + and water and a decrease in blood pressure.

The PFF is usually considered as a physiological antagonist angiotensin II, since under its influence, it is not a narrowing of the lumen of vessels and (through the regulation of the aldosterone secretion), sodium delay, but, on the contrary, the expansion of vessels and salt loss.

3. Biochemistry of kidneys

The main kidney function is to eliminate water and water-soluble substances (finite metabolic waste) (1). The function of regulating the ionic and acid-base equilibrium of the internal environment of the body (homeostatic function) is closely connected with an excretory function. 2). Both functions are controlled by hormones. In addition, the kidneys perform an endocrine function, taking direct participation in the synthesis of many hormones (3). Finally, the kidneys are involved in the processes of intermediate metabolism (4), especially in glucongenesis and splitting of peptides and amino acids (Fig. 1).

A very large amount of blood passes through the kidneys: 1500 l per day. From this volume, 180 liters of primary urine is filtered. Then the volume of primary urine is significantly reduced due to the reabsorption of water, as a result, the daily yield yield is 0.5-2.0 liters.

Excretory kidney function. Urica process

The process of urica in nephrons is made up of three stages.

Ultrafiltration (glomerular or glomeric filtering). In the glomeruli of the renal calf from plasma of blood in the process of ultrafiltration, the primary urine is formed, isooosmotic with blood plasma. Pores through which plasma is filtered have an effective average diameter of 2.9 nm. With this amount of pores, all components of blood plasma with molecular weight (m) up to 5 kDa are free through the membrane. Substances with M.< 65 кДа частично проходят через поры, и только крупные молекулы (М > 65 kDa) held pores and do not fall into the primary urine. Since most blood plasma proteins have a sufficiently high molecular weight (M\u003e 54 kDa) and are negatively charged, they are held by the glomerular basal membrane and protein content in ultrafiltrate slightly.

Reabsorption. The primary urine is concentrated (approximately 100 times compared with the source volume) due to reverse filtration of water. At the same time, almost all low molecular weight substances, especially glucose, amino acids, as well as most electrolytes, and organic ions (Figure 2) are reabsorbed by the active transport mechanism in the tubules.

The reabsorption of amino acids is carried out using group-to-specific transport systems (carriers).

Calcium and phosphate ions. Calcium ions (Ca 2+) and phosphate ions are almost completely rebupported in renal tubules, and the process comes with considerable energy (in the form of ATP). The output of Ca 2+ is more than 99%, according to phosphate ions - 80-90%. The degree of reabsorption of these electrolytes is regulated by the parathgamon (paratyrine), calcitonin and calcitricol.

Peptide hormone Parathyrin (PTH), secreted by parachite gland, stimulates the reabsorption of calcium ions and at the same time inhibits the reabsorption of phosphate ions. In combination with the action of other bone tissue and intestines hormones, this leads to an increase in the level of calcium ions in the blood and a decrease in phosphate-ion levels.

Calcitonin, peptide hormone from the C-cells of the thyroid gland, inhibits the reabsorption of calcium and phosphate ions. This leads to a decrease in the level of both ions in the blood. Accordingly, in relation to the regulation of the level of calcium ions, calcitonin is a parasitis antagonist.

Steroid hormone Calcitrol, formed in the kidneys, stimulates the absorption of calcium ions and phosphate ions in the intestines, contributes to the mineralization of bones, is involved in the regulation of the reabsorption of calcium and phosphate ions in the renal tubules.

Sodium ions. The reabsorption of Na + ions from primary urine is a very important kidney function. This is a highly efficient process: about 97% Na + is absorbed. The steroid hormone aldosterone stimulates, and the atrirate sodium peptide [ANP (ANP)], synthesized in atrium, on the contrary, inhibits this process. Both hormones regulate the work of Na + / K + -atf-basin, localized on that side of the plasma membrane of the cells of the tubules (distal separal and collective tubes of nephron), which is washed by plasma. This sodium pump pumps Na + ions from the primary urine into the blood in exchange for ions to +.

Water. The reabsorption of water is passive process, in which the water is absorbed in an osmotically equivalent volume together with Na + ions. In the distal portion of nephron, water can only be absorbed in the presence of a peptide hormone vasopressin (antidiuretic hormone, ADG) secreted by the hypothalamus. ANP inhibits water reabsorption. i.e. enhances the removal of water from the body.

Due to passive transport, chlorine ions (2/3) and urea are absorbed. The degree of reabsorption determines the absolute amount of substances remaining in the urine and excreted from the body.

The reabsorption of glucose from the primary urine is an energy-dependent process, conjugate with hydrolysis of ATP. At the same time, it is accompanied by the concomitant transport of Na + ions (according to the gradient, since the concentration of Na + with primary urine is higher than in cells). Amino acids and ketone bodies are also absorbed by a similar mechanism.

The processes of reabsorption and secretion of electrolytes and non-electrolytees are localized in various deposits of renal tubules.

Secretion. Most of the substances to be removed from the body come to the urine due to active transport in the renal channels. These substances include H + and K + ions, uric acid and creatinine, medicinal substances, such as Penicillin.

Organic components of urine:

The main part of the organic urine fraction is nitrogen-containing substances, ultimate nitrogen exchange products. Urea formed in the liver. It is a nitrogen carrier contained in amino acids and pyrimidine bases. The amount of urea is directly related to the metabolism of the protein: 70 g of protein leads to the formation of ~ 30 g of urea. Uric acid serves as the final product of the exchange of purines. Creatine, which is formed by the spontaneous cyclization of creatine, is the final product of metabolism in muscle tissue. Since the daily discharge of creatinine is an individual characteristic (it is directly proportional to the muscle mass), creatinine can be used as an endogenous substance to determine the speed of glomerular filtering. The content in the urine of amino acids depends on the nature of the nutrition and efficiency of the liver. In the urine there are also derivatives of amino acids (for example, hypric acid). The content in the urine of derivatives of amino acids included in special proteins, for example, hydroxyproline present in collagen, or 3-methylgistidine, which is part of actin and myosin, can serve as an indicator of the intensity of splitting of these proteins.

Composite components of urine are conjugates with sulfur and glucuronic acids, glycine and other polar substances.

In the urine there may be products of metabolic transformation of many hormones (catecholamines, steroids, serotonin). According to the content of the final products, one can judge the biosynthesis of these hormones in the body. The protein hormone choriogonadotropin (xg, M 36 kDa), which is formed during the pregnancy, enters the blood and is found in the urine by immunological methods. The presence of a hormone serves as a pregnancy.

Yellow color of the urine give Urochrome - derivatives of bile pigments generated during hemoglobin degradation. Urine darkens when stored due to the oxidation of urochroms.

Inorganic components of urine (Figure 3)

The urine contains Na +, K +, Ca 2+, Mg 2+ and NH 4 + cations, CL -, SO 4 2- and NRA 4 2- and in trace amounts of other ions. The calcium and magnesium content in feces is significantly higher than in the urine. The number of inorganic substances largely depends on the nature of nutrition. With acidosis, ammonia excretion can greatly increase. The elimination of many ions is regulated by hormones.

Changes in the concentration of physiological components and the emergence of pathological components of urine are used to diagnose diseases. For example, with diabetes in the urine there are glucose and ketone bodies (application).

4. Hormonal regulation of urica

The amount of urine and the content of ions is regulated in it due to the combined action of hormones and the characteristics of the kidney structure. For the volume of daily urine, the hormones are influenced:

Aldosterone and Vasopressin (the mechanism of their action was discussed earlier).

Paranthgarmon - the hormone of the parachitoid gland of protein-peptide nature, (the membrane mechanism of action, through the CAMF) also affects the removal of salts from the body. In the kidneys, it enhances the channel reabsorption Ca +2 and Mg +2, increases the excretion of K +, phosphate, HCO 3 - and reduces the excretion of H + and NH 4 +. This is mainly due to a decrease in the tubing reabsorption of phosphate. Simultaneously in the blood plasma, calcium concentration increases. The hypoidsection of the pararathgamon leads to reverse phenomena - an increase in the content of phosphates in the blood plasma and to a decrease in the content of Ca +2 in plasma.

Estradiol - female sex hormone. Stimulates the synthesis of 1.25-dioxi-cyavitamined 3, enhances the reabsorption of calcium and phosphorus in the renal tubules.

Homeostatic kidney function

1) Water-salt homeostasis

The kidneys are involved in maintaining a constant amount of water by influencing the ionic composition of intra and extracellular liquids. About 75% sodium, chlorine and water ions are reabsorbated from the glomerular filtrate in the proximal tube thanks to the ATPAZ mechanism mentioned. In this case, only sodium ions are active, the anions are moved due to an electrochemical gradient, and the water is reabsorbed passively and isooosotically.

2) the participation of the kidneys in the regulation of acid-alkaline equilibrium

The concentration of H + ions in plasma and in the intercellular space is about 40 nm. This corresponds to the size of the pH of 7.40. The pH of the inner environment of the body should be maintained on constant, since significant changes in the concentration of runs are not compatible with life.

The constancy of the pH is maintained by plasma buffer systems that can compensate for short-term disorders of the acid-base balance. Prolonged pH equilibrium is maintained using the products and removal of protons. In case of disorders in buffer systems and in non-compliance with the acid-base balance, for example, as a result of a disease of the kidneys or failures in respiratory periodicity due to hypo-or hyperventilation, the pH of the plasma comes out for the permissible limits. Reducing the size of pH 7.40 more than 0.03 units is called acidosis, and an increase in alkalosis

The origin of protons. There are two sources of protons - free foods of food and sulfur-containing amino acids of proteins, obtained from food, for example, lemon, ascorbic and phosphorus, give protons in the intestinal tract (with an alkaline pH). To ensure the balance of protons, the memethionine and cysteine \u200b\u200bformed during the cleavage of proteins of amino acids is made. In the liver, the sulfur atoms of these amino acids are oxidized to sulfuric acid, which dissociates to sulfate ion and protons.

In anaerobic glycolisis in muscles and erythrocytes, glucose is converted into lactic acid, the dissociation of which leads to the formation of lactate and protons. The formation of ketone bodies - acetoxus and 3-hydroxyma salts - in the liver also leads to the release of protons, excess of ketone bodies leads to overload of the plasma buffer system and a decrease in pH (metabolic acidosis; lactic acid\u003e lactacidosis, ketone bodies\u003e ketoacidosis). Under normal conditions, these acids are usually metabolized to CO 2 and H 2 O and do not affect the balance of protons.

Since acidosis is particularly danger to the body, there are special mechanisms to combat it in the kidneys:

a) secretion H +

This mechanism includes the formation process CO 2 in metabolic reactions occurring in the cells of the distal tubule; The formation of H 2 CO 3 is then under the action of carbanecides; Further dissociation of it on H + and NSO 3 - and the exchange of ions H + on Na + ions. Then sodium and bicarbonate ions diffuse into the blood, providing her alkalization. This mechanism is tested in the experiment - the introduction of carbonic henhydrate inhibitors leads to an increase in sodium losses with secondary urine and urine acidification is stopped.

b) ammoniogenesis

The activity of ammonium enzymes in the kidneys is especially high in the conditions of acidosis.

Ammoniogenesis enzymes include glutamine and glutamate dehydrogenase:

c) glukegenesis

Leaks in the liver and in the kidneys. The key enzyme of the process is renal piruvatakarboxylase. The enzyme is most active in an acidic environment - it differs from the same hepatic enzyme. Therefore, with acidosis in the kidneys, carboxylase and oxygening substances (lactate, pyruvate) are activated, more intensively begin to turn into glucose, which does not have acid properties.

This mechanism is important with hodded acidosis (with a lack of carbohydrates or with a general lack of food). The accumulation of ketone bodies, which in their properties are acids - stimulates glukegenesis. And this contributes to the improvement of the acid-alkaline state and simultaneously supplies the body with glucose. With full fasting to 50% blood glucose is formed in the kidneys.

With alkalosis, glukegenesis is inhibited, (as a result, the PVC carboxylase is oppressed by the pH), the secretion of protons is inhibited, but glikoliz is at the same time increases and the formation of pyruvate and lactate increases.

Metabolic function of kidneys

1) formation of the active form of vitamin D 3 . In kidneys, as a result of the microsomal oxidation reaction, the final stage of the ripening of the active shape of vitamin D 3 is 1.25-dioxiforol occurs. The predecessor of this vitamin - vitamin d 3 is synthesized in the skin, under the action of ultraviolet rays from cholesterol, and then hydroxylates: first in the liver (in position 25), and then in the kidneys (in position 1). Thus, participating in the formation of the active form of vitamin D 3, the kidneys affect the phosphorus-calcium exchange in the body. Therefore, with kidney diseases, when vitamin d hydroxylation processes are violated, osteodistrophy may develop.

2) Regulation of erythropoese. Glycoprotein is produced in the kidneys called renal erythropoietic factor (PEF or erythropoietin). It is a hormone that is able to influence the stem cells of the red bone marrow, which are target cells for the PEF. The PEF sends the development of these cells along the sort of sritropoies, i.e. Stimulates the formation of red blood cells. The discharge rate of the PEF depends on the provision of kidney with oxygen. If the amount of incoming oxygen decreases, the production of PEF increases - this leads to an increase in the number of erythrocytes in the blood and the improvement of the supply of oxygen. Therefore, with kidney diseases, renal anemia is sometimes observed.

3) protein biosynthesis. In the kidneys, protein biosynthesis processes are actively going, which are necessary for other tissues. Some components are synthesized here:

- blood coagulation systems;

- Complement systems;

- fibrinolysis systems.

- In the kidneys in the cells of the YUKSTAGLOMARAILABUM (south), renin is synthesized

The renin angiotensin-aldosterone system works in close contact with another system of regulating the vascular tone: the kallicrein-kinin system, the action of which leads to a decrease in blood pressure.

Kindogenic protein is synthesized in the kidneys. Finding into the blood, KININOGEN under the action of serine proteinases - Callipers turns into vasoactive peptides - kinines: Bradykinin and Callidin. Bradykinin and Callidine have a vasodilatory effect - reduce blood pressure. Inactivation of kininov occurs with the participation of carboxyctepsin - this enzyme simultaneously affects both vascular tone regulation systems, which leads to an increase in blood pressure. Carboxytexin inhibitors are used for therapeutic purposes in the treatment of some forms of arterial hypertension (for example, Cloofellin preparation).

The participation of the kidneys in the regulation of blood pressure is also associated with the development of prostaglandins, which have a hypotensive effect, and are formed in kidneys from arachidonic acid as a result of lipid peroxidation reactions (floor).

4) Catabolism of proteins. The kidneys participate in the catabolism of some proteins having a low molecular weight (5-6 kDa) and peptides that are filtered into the primary urine. Among them are hormones and some other Bav. In the cells of the tubules, under the action of lysosomal proteolytic enzymes, these proteins and peptides are hydrolyzed to amino acids that enter the blood and reuterized by cells of other tissues.

Features of the metabolism of renal fabric

1. Great ATP costs. The main flow rate of ATP is associated with the processes of active transport during reabsorption, secretion, as well as with the biosynthesis of proteins.

The main way to obtain ATP is oxidative phosphorylation. Therefore, the kidney tissue needs significant amounts of oxygen. The kidney weight is only 0.5% of the total weight of the body, and the oxygen consumption by the kidneys is 10% of the total oxygen. Substrates for bio-oxidation reactions in renal cells are:

- fatty acid;

- ketone bodies;

- glucose, etc.

2. High speed biosynthesis proteins.

3. High activity of proteolytic enzymes.

4. The ability to ammoniogenesis and glucongenesis.

watering kidney watering

Medical meaning

pathological components of urine
COMPONENTS SYMPTOM Causes of appearance PROTEIN Proteinuria Damage to urinary tract (abandoned proteinuria) or nephron basal membranes (renal proteinuria). Toxicosis of pregnant women, anemia. The source of urine protein is mainly plasma proteins, as well as kidney tissue proteins. BLOOD Hematuria Hemoglobinuria Erythrocytes in the urine appear in acute jade, inflammatory processes and injury of urinary tract. Hemoglobin - with hemolysis and hemoglobinemia. GLUCOSE Glucosuria Sugar diabetes, steroid diabetes, thyrotoxicosis. FRUCTOSE Fructozuria An innate insufficiency of enzymes converting fructose in glucose (defect phosphophricinase). Galactose Galactosuria An innate lack of an enzyme converting galactose in glucose (galactose-1-phosphate uridyltransferase). Ketone bodies Ketonuria Diabetes, starvation, thyrotoxicosis, brain injuries, brain hemorrhages, infectious diseases. BILIRUBIN Bilirubinuria Jaundice. The level of bilirubin in the urine during mechanical jaundice is significantly elevated. Creatine Creatinuria Adults are connected with a violation of creatine conversion to creatinine. It is observed with muscle dystrophy, hypothermia, convulsive states (tetanus, tetania). PRECIPITATION: Phosphates Oxalates urata Phosphatia Oksalaturia Uratura The precipitate of some in the norm of hard-soluble urine components (salts of calcium, magnesium) leads to the formation of urinary stones. This is facilitated by the lashing of urine in the bladder and lobby of kidney in chronic bacterial infections: microorganisms are cleaved by urea, freeing ammonia, which leads to an increase in urine pH. When gougraning (urine is acidified), the stones are formed from uric acid, which is poorly soluble at a pH less than 7.0.

5. Physico-chemical properties of urine normally and with pathology

Polyuria is an increase in the daily volume of urine. It is observed in sugar and unacculent diabetes, chronic jade, pyelonephritis, with overweight fluid with food.

Oliguria is a decrease in the daily volume of urine (less than 0.5 liters). It is observed in a feverish condition, with acute diffuse nephrite, urolithiasis, poisoning with salts of heavy metals, the use of small amounts of liquid with food.

Anuria is the cessation of urine release. Observed when kidney damage due to poisoning, under stress (long Anuria can lead to death from Uremia (ammonia poisoning)

Urine color is as amber or straw yellow, due to the pigments of Urochrome, Urobilinogen, and DR

Red urine color - with hematuria, hemoglobinuria (kidney stones, jade, injury, hemolysis, consumption of some medicinal substances).

Brown color - at high concentration of urobinogen and bilirubin in the urine (for liver diseases), as well as homogenic acid (alkaptonuria, with violation of tyrosine metabolism).

Green color - with the use of certain drugs, with an increase in the concentration of indoxylserts, which decomposes with the formation of indigo (enhancing the processes of rotten rotting in the intestine)

The transparency of urine is completely complete. The turbidity may be due to the presence in the urine of protein, cell elements, bacteria, mucus, precipitation

The urine density is normal amounts to a fairly wide range - from 1.002 to 1.035 during the day (on average 1012-1020). This means that a day with urine is distinguished from 50 to 70 g of dense substances. Approximate calculation of the density of the residue: 35x2,6 \u003d 71 g, where 35 - two recent figures from a certain relative density, 2.6 - coefficient. Increased and decrease in urine density during the day, that is, its concentration and dilution are necessary to maintain the constancy of osmotic blood pressure.

Izostenuria - urine release with constantly low density equal to the density of primary urine (about 1010), which is observed in severe shortness of the kidneys, during non-car diabetes.

High density (more than 1035) is observed in diabetes mellitus due to the high glucose concentration in the urine, with acute jade (oliguria).

Normal urine residues are formed when it is standing

Flap-like - from proteins, mucoproteins, epithelial cells of urinary tract

Consisting of oxalate and urates (sowless and uric acid salts), which dissolve during acidification.

The pH of urine is normally within 5.5 - 6.5.

The acidic urine medium with a normal food diet can be due to: 1) with sulfuric acid, which is generated in catabolism of sulfur-containing amino acids; 2) phosphoric acid formed during the decay of nucleic acids, phosphoproproteins, phospholipids; 3) Anions adsorbed in the intestines from food.

Water exchange disorders (dishydriy).

Water exchange disorders include hyperhydrium (hyperhydration) and hypohydrium (hypo- and dehydration). And those and others may be common or cover mainly extracellular or intracellular space (i.e. extracellular or intracellular sector). Each of the forms of dizhydria is manifested as hyper-, iso- and hypotonic. In accordance with this, we can talk about intra and extracellular hyper-, iso- and hypotonic hyperhydrations, as well as on in-and extracellular hyper-, iso- and hypotonic hyphydrants. Changes caused by a violation of the distribution of water and electrolytes in one sector are invariably attained completely defined shifts in the other.

General dehydration (general dehydration) arises in cases where water into the body is entered less than it is lost in the same time (negative water balance). It is observed in the stenosis, obstruction of the esophagus (caused by burns, tumors or other reasons), peritonitis, operations on the digestive tract, polyuria, insufficient reimbursement of water loss in weakened patients, cholera, in patients in comatose state.

With aqueous shortage due to blood thickening, the concentration of dense substances in the plasma increases, which leads to an increase in osmotic pressure. The latter and determines the movement of water from cells through the intercellular space into the extracellular liquid. As a result, the volume of intracellular space is reduced.

Laboratory signs of general dehydration are the increase in hematocrit, blood viscosity, hyperproteinemia, hyperazotemia, polyuria.

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