copper clinical importance for medical students

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Dr.M.Siva Kumar Reddy MD Department of Biochemistry Sri Venkateswara Medical College

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Page 1: Copper clinical importance for medical students

Dr.M.Siva Kumar Reddy MDDepartment of Biochemistry

Sri Venkateswara Medical College

Page 2: Copper clinical importance for medical students
Page 3: Copper clinical importance for medical students

Copper is an essential trace element (i.e., micronutrient) copper is essential to the proper functioning of organs

and metabolic processes. Body contains about 100 mg copper distributed in

different organ.  Copper is incorporated into a variety

of proteins and metalloenzymes which perform essential metabolic functions.

Copper deficiency and toxicity can be either of genetic or non-genetic origin.

Introduction

Page 4: Copper clinical importance for medical students

Biochemical functions

Biochemical functions of copper

Page 5: Copper clinical importance for medical students

Cu- constituent of several enzymes

Cytochrome

oxidase

catalase

tyrosinase

Super oxide

dismutase

Monoamine oxidase

Ascorbic acid

oxidase

Phenol oxidase

and uricase

ALA synthase

copper

Due to its presence in a wide variety ofenzymes, copper is involved in many metabolic reaction.

Page 6: Copper clinical importance for medical students

Copper - hemoglobin

Copper is necessary for the synthesis ofHemoglobin( Cu is a constituent of ALA synthase,needed for heme synthesis).

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Elastin &collagen - copper

Lysine Residues of collagen and elastin to allysin.

Lysyl oxidase( a copper-containing enzyme)

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Ceruloplasmin exhibits a copper-dependent oxidase activity.

oxidation of Fe2+ (ferrous iron) into Fe3+ (ferric iron)

Ceruloplasmin assist iron transport in the plasma in association with transferrin, which can carry iron only in the ferric state.

Ceruloplasmin and iron transport

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Melanin and phospholipids

Copper is necessary for the synthesis ofmelanin and phospholipids……..

Page 10: Copper clinical importance for medical students

HEMOCYANIN

Hemocyanin, a copper protein complex in invertebrates, functions like hemoglobin for 0xygen transport.

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COPPER-CONTAINING NON-ENZYMATIC PROTEINS

HEMOCUPREIN

CEREBROCUPREIN

HEPATOCUPREIN

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Development of bone and nervous system

Bone development

Nervous system development

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•Adults2-3mg/d

•children0.5-2mg/d

Daily requirements

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Sources of copper

Liver kidney

Meat

Egg yolk cereals Green veggies

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Milk is poor source of copper

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Copper absorption

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Copper absorption

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Facilitators vs Inhibitors

1. Phytate

2. Zinc

3. molybdenum

1. Metallothionein

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Demineralization of bones, Demyelination of neural tissue, Anemia, Fragility of arteries, Myocardial fibrosis, Hypopigmentation of skin, Greying of hair.

Copper deficiency

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Plasma copperPlasma copper

100-200mg/dl

95% tightly bound to

ceruloplasmin

5% loosely bound to Albumin

Normal concentration of serum ceruloplasmin is 25-50 mg/dl.

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The symptoms of Menke's disease include decreased copper in plasma and anemia and depigmentation of hair.

Defect in the intestinal absorption of copper

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Menke’s disease

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Wilson’s disease

Copper is deposited in abnormal amounts in liver and lenticular nucleus of brain. This may lead to hepatic cirrhosis and brain necrosis

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Kayser fleischer ring

KF ring

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Low levels of copper and ceruloplasmin in plasma with increased excretion of copper in urine.

Copper deposition in kidney causes renal damage. This leads to increased excretion of amino acids, glucose, peptides and hemoglobin in urine.

Intestinal absorption of copper is very high, about 4-6 times higher than normal.

Wilson’s disease

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Treatment of Wilson's disease

penicillamine treatment relies on its binding to accumulated copper and elimination through urine

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Thank you