Epinephrine inactivation

Glucagon and epinephrine inactivate the pathway by promoting phosphorylation of the enzyme in order to divert acetyl CoA toward energy generation under conditions of low glucose and ATP levels. 

Acetyl-CoA carboxylase is also regulated by covalent modification. Phosphorylation, triggered by the hormones glucagon and epinephrine, inactivates the enzyme and reduces its sensitivity to activation by citrate, thereby slowing fatty acid synthesis. In its active (dephosphorylated) form, acetyl-CoA carboxylase polymerizes into long filaments (Fig. 21-1 lb) phosphorylation is accompanied by dissociation into monomeric subunits and loss of activity. 

Fig. 7. Radioactivity profile in SDS-polyacrylamide gel of acetyl-CoA carboxylase isolated from control and epinephrine-treated rats. Each of three rats in the group was injected intraperitoneally with 0.41 mCi of carrier-free P, at 3 hours and 1 hour before killing. Epinephrine (1 mg/kg of body weight) or saline was administered 30 minutes before killing. The preparation of carboxylase from epididymal adipose tissue and all subsequent procedures were as described in Table II. In this experiment, carboxylase activity of epinephrine-treated animals was 76% of the control. O, Control carboxylase , epinephrine-inactivated carboxylase. Arrow indicates the location of carboxylase subunit band f shows the location of tracking dye front. From Lee and Kim (68).

Lee and Kim reported that carboxylase species from rat epididymal fat tissues which had been treated with epinephrine sedimented more slowly than enzyme from control tissues the sedimentation constants were identical to those of the protomers and the intermediate species (67). Halestrap and Denton (39) observed similar hormonal effects by measuring the amount of sedimentable carboxylase under different conditions. In further studies of the slow sedimenting carboxylase by immunochemical and kinetic methods, Lee and Kim showed that the enzyme species from hormone-treated tissues were not simply depolymerized, but were intrinsically inactive species of the carboxylase (67). Such studies, together with the demonstration that epinephrine inactivation of the carboxylase is due to phosphorylation (6S), establish that phosphorylation causes enzyme depolymerization and that depolymerized enzjmes are the phosphorylated forms and not protomers of unphosphorylated species. Thus the studies discussed above show the close relationship between covalent phosphorylation and the quaternary structure of the carboxylase and also the occurrence of such a relationship under both in vivo and, in vitro conditions. 

Smooth muscle contractions are subject to the actions of hormones and related agents. As shown in Figure 17.32, binding of the hormone epinephrine to smooth muscle receptors activates an intracellular adenylyl cyclase reaction that produces cyclic AMP (cAMP). The cAMP serves to activate a protein kinase that phosphorylates the myosin light chain kinase. The phosphorylated MLCK has a lower affinity for the Ca -calmodulin complex and thus is physiologically inactive. Reversal of this inactivation occurs via myosin light chain kinase phosphatase. 

Epinephrine is administered by a variety of different routes in anaphylaxis, except for the oral route, which is not feasible because of rapid inactivation of epinephrine in the gastrointestinal tract by catechol-O-methyltransferase and monoamine oxidase [9]. The initial intramuscular epinephrine doses of 0.3-0.5 mg currently recommended for adults with anaphylaxis are low compared with the doses required for resuscitation following cardiac arrest [1, 2,4,18]. 

Figure 21-6. Regulation of acetyl-CoA carboxylase by phosphorylation/dephosphorylation.The enzyme is inactivated by phosphorylation by AMP-activated protein kinase (AMPK), which in turn is phosphorylated and activated by AMP-activated protein kinase kinase (AMPKK). Glucagon (and epinephrine), after increasing cAMP, activate this latter enzyme via cAMP-dependent protein kinase. The kinase kinase enzyme is also believed to be activated by acyl-CoA. Insulin activates acetyl-CoA carboxylase, probably through an "activator" protein and an insulin-stimulated protein kinase.

The primary mechanism used by cholinergic synapses is enzymatic degradation. Acetylcholinesterase hydrolyzes acetylcholine to its components choline and acetate it is one of the fastest acting enzymes in the body and acetylcholine removal occurs in less than 1 msec. The most important mechanism for removal of norepinephrine from the neuroeffector junction is the reuptake of this neurotransmitter into the sympathetic neuron that released it. Norepinephrine may then be metabolized intraneuronally by monoamine oxidase (MAO). The circulating catecholamines — epinephrine and norepinephrine — are inactivated by catechol-O-methyltransferase (COMT) in the liver. 

The regulation of fat metabolism is relatively simple. During fasting, the rising glucagon levels inactivate fatty acid synthesis at the level of acetyl-CoA carboxylase and induce the lipolysis of triglycerides in the adipose tissue by stimulation of a hormone-sensitive lipase. This hormone-sensitive lipase is activated by glucagon and epinephrine (via a cAMP mechanism). This releases fatty acids into the blood. These are transported to the various tissues, where they are used. 

Phosphorylation of cardiac calcium-channel proteins increases the probability of channel opening during membrane depolarization. It should be noted that cAMP is inactivated by phosphodiesterase. Inhibitors of this enzyme elevate intracellular cAMP concentration and elicit effects resembling those of epinephrine. 

Inhibitors of monoamine oxi-dase-B (MAOb). This isoenzyme breaks down dopamine in the corpus striatum and can be selectively inhibited by selegiline. Inactivation of norepinephrine, epinephrine, and 5-HT via MAOa is unaffected. The antiparkinsonian effects of selegiUne may result from decreased dopamine inactivation (enhanced levodopa response) or from neuroprotective mechanisms (decreased oxyradical formation or blocked bioactivation of an unknown neurotoxin). 

The coenzyme tetrahydrofolate (THF) is the main agent by which Ci fragments are transferred in the metabolism. THF can bind this type of group in various oxidation states and pass it on (see p. 108). In addition, there is activated methyl, in the form of S-adenosyl methionine (SAM). SAM is involved in many methylation reactions—e. g., in creatine synthesis (see p. 336), the conversion of norepinephrine into epinephrine (see p. 352), the inactivation of norepinephrine by methylation of a phenolic OH group (see p. 316), and in the formation of the active form of the cytostatic drug 6-mercaptopurine (see p. 402). 

Monoaminooxidase is a complex enzymatic system that is present in practically every organ that catalyzes deamination or inactivation of various natural, biogenic amines, in particular norepinephrine (noradrenaline), epinephrine (adrenaline), and serotonin. Inhibition of MAO increases the quantity of these biogenic amines in nerve endings. MAO inhibitors increase the intercellular concentration of endogenous amines by inhibiting then-deamination, which seems to be the cause of their antidepressant action. 

Newer MAOI drugs are selective for the MAO-A subtype of the enzyme, and are less likely to interact with foods or other drugs. Monoamine oxidase (MAO) inactivates monoamine substances, many of which are, or are related to, neurotransmitters. The central nervous system mainly contains MAO-A, whose substrates are adrenaline (epinephrine), noradrenaline (norepinephrine), metanephrine, and 5-hydroxyti7ptamine (5-HT), whereas extra-neuronal tissues, such as the liver, lung, and kidney, contain mainly MAO-B which metabolises p-phenylethylamine, phenylethanolamine, o-tyramine, and benzylamine. 

Glucagon or epinephrine decreases [fructose 2,6-bisphosphate]. The hormones do this by raising [cAMP] and bringing about phosphorylation of the bifunctional enzyme that makes and breaks down fructose 2,6-bisphosphate. Phosphorylation inactivates PFK-2 and activates FBPase-2, leading to breakdown of fructose 2,6-bisphosphate. Insulin increases [fructose 2,6-bisphosphate] by activating a phosphoprotein phosphatase that dephosphorylates (activates) PFK-2. 

The regulated step in fatty acid synthesis (acetyl CoA - malonyl CoA) is catalyzed by acetyl CoA carboxylase, which requires biotin. Citrate is the allosteric activator, and long-chain fatty acyl CoA is the inhibitor. The enzyme can also be activated in the presence of insulin and inactivated in the presence of epinephrine or glucagon. 

Regulation of acetyl-CoA carboxylase by phosphorylation and dephosphorylation. Glucagon is known to activate cAMP-dependent protein kinase this kinase phosphorylates both serine 77 and serine 1200 of rat acetyl-CoA carboxylase, which inactivates the enzyme. However, there is also an AMP-dependent kinase that phosphorylates serine 79 and serine 1200 and inactivates the rat acetyl-CoA carboxylase. The relative importance of these two kinases in regulating the carboxylase in vivo is still unclear. Likewise, the phosphorylated enzyme is a substrate for several different protein phosphate phosphatases, and the physiologically relevant phosphatases are not known. Epinephrine may inhibit the carboxylase via a Ca2+-dependent protein kinase. 

Regardless of the untested merits of the above work, methylation as a first step in the deactivation of noradrenaline in the body is just as plausible as is the evidence that methylation is the final step in the synthesis of adrenaline. The evidence for and against this route of synthesis has been discussed previously in this review. Tainter etal. (155) reported that in dogs under phenobarbital anesthesia Z-arterenol had a pressor activity 1.7 times that of Z-epinephrine. In this sense then, methylation might be considered a process of inactivation. However, they found in contrast that the acute toxicity of Z-epinephrine (LDso) was about four times that of Z-norepinephrine (114) 155). 

Although no free epinephrine is excreted under the conditions of those experiments just described, it is permissible to question whether they are representative of the fate of epinephrine as it is secreted in the body, or whether conjugation is a mode of inactivation of catechol pressor amines administered as drugs. The relatively minute amounts of adrenaline or noradrenaline secreted normally and the limitations of present analytical methods definitely handicap a direct approach to the problem. However, it has been possible to study the fate of adrenaline secreted by the body in a more or less physiological type of experiment. 

Ephedrine is readily and completely absorbed after oral or parenteral administration. As it is less active than epinephrine, it does not produce enough local vasoconstriction to hinder absorption after subcutaneous or intramuscular injection. As has been indicated, ephedrine is resistant to amine oxidase, but it is deaminated to some extent in the liver, probably by the ascorbic-dehydroascorbic acid system. Conjugation also occurs. In addition, up to 40% of the ephedrine administered may be excreted unchanged in the urine. Inactivation and excretion are so slow that the action of ephedrine may persist for several hours. 

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