How Is Chemotherapy Used to Treat Cancer? Enzyme How Is Chemotherapy Used to Treat Cancer? Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemo can work throughout the whole body. This means chemo can kill cancer cells that have spread (metastasized) to parts of the body far away from the original tumor. The relation of Chemotherapy & Genetic diseases indicate that millions of peoples take a variety of drugs every day, but not every one benefit in cancer. Chemotherapy have a problems so only 30% of patients are response to chemotherapy, but 70% are not responsive, depend on:- -Complexity of Cancer -Inappropriate dosing if too high or too low -Time of dosing. The Step Of Chemotherapy Treatment : 1-Cells from some tumors use altered metabolic pattern compared with normal adult cells in the body, they consume much more Glucose so the Enzyme (Phosphokinase) activity increased during glycolysis and the product is the Lactate. The Lactate provides substrate for cell growth, and ATP activate the Enzyme(Pyruvate Kinase) its produced in all rapid cell division and its responsible for enabling cancer cells to consume glucose at an accelerated rate. This Enzyme form is not usually found in healthy tissues. As a key in cancer producing pathways is stopping carbohydrate consuming lead to blocking this metabolic pathway as a new approach in cancer treatments. 2-Stem cells are undifferentiated biological cells that can differentiate into specialized cells activate enzyme for divide and produce more stem cells. They are found (in mammals) in two broad types: embryonic stem cells, and adult stem cells, which are found in various tissues. محاضرة الانزيمات 6

Genetic Diseases :- 1- Galactosemia Its a rare inherited genetic metabolic disorder that are caused by defective gene which result in a loss of some enzyme activity, and cause a defect in galactose metabolism. German physician . The inherited gene structure Lactose in food (or lactation) is broken down by the enzyme lactase into glucose & galactose figure(1). Inheritance confers a deficiency in an enzyme responsible for adequate galactose degradation. lactase enzyme → + Figure(1): Lactose metabolism gives glucose & galactose. Any Deficiency Of These Enzyme Responsible For Galactose Degradation: 1-Galactokinase. 2-Galactose epimerase. 3-Galactose-1-phosphate uridylyl transferase. Diagnosis:- The diagnosis is start for an infant, if the family of the baby has a history of galactosemia, doctors can test prior to birth by taking a sample of fluid from the placenta. A galactosemia blood test is to check for enzymes above that are needed to change galactose in breast milk into glucose, to use for energy. The enzyme defect causes high levels of galactose in the blood or urine. The treatment for classic galactosemia is by eliminating lactose and galactose from the diet. Infants with classic galactosemia are usually fed a soy-based formula (is an infant food made using soy protein and other components.

Genetic Diseases :- 2- Wilson’s Disease It is a rare genetic disease, that require the patient to inherit the gene ATP7B, this genetic disorder prevent the body from expelling excess Copper, and causing marked increase of copper concentration in the liver, brain, kidneys, and eyes. So Wilson’s disease is biochemically characterized by reduced serum concentrations of copper and ceruloplasmin enzyme, and clinically by signs of hepatic and neurologic dysfunction. Treatment involves by using Penicillamine to remove of excess copper, It is readily absorbed by gastrointestinal tract and rapidly excreted in the urine. The chance of getting this disease is about 1 in 40,000 people over the world. Ceruloplasmin (ferroxidase) structure: Ceruloplasmin one of the blood plasma minor proteins which is responsible of Copper transfer in blood.)

Clinical significance of enzyme levels:- In clinical practice, the enzyme concentration monitoring is performed on patients These levels can be of great importance in diagnosis of many diseases & in monitoring of tissue damage. Table (1):Clinical significance of some enzyme Levels in human body:- Lactate dehydrogenase isoenzymes (LDH) Location Type Liver disease Heart muscle, RBC, kidney LDH1 1 LDH2 2 Brain and kidney LDH3 3 Heart attacks Liver and skeletal muscle LDH4 4 LDH5 5 Creatinine Phosphokinase (CPK) isoenzymes Myocardial infarction Location Composition Type Brain and skeletal muscle BB CK1 1 Myocardial muscle MB CK2 2 Skeletal muscle and myocardial muscle MM CK3 3

Clinical significance of enzyme levels:- In clinical practice, the enzyme concentration monitoring is performed on patients These levels can be of great importance in diagnosis of many diseases & in monitoring of tissue damage. Table (2):Clinical significance of some enzyme Levels in human body:- Enzyme Location Enzyme Levels increased in Enzyme Its function in basic media, present in Liver& Bone. Liver Cancer, Jaundice Alkaline phosphatase (ALP) 1 Salivary gland& Pancreatic secretion. Liver and pancreatic disease. Amylase 2 Intravenous. Hypertension Angiotensin II 3 Heart & Liver. Infectious hepatitis, myocardial infarction. Glutamic oxalocetic transamiase (GOT) 4 Liver. Infectious hepatitis. Glutamic pyruvic transamiase (GPT) 5 Myocardial infarction, leukemia Lactate dehydrogenase (LDH) 6