Factors regulating blood calcium level

(i) Vitamin D

(a) Vitamin D and absorption of calcium: Active form of calcium is calcitriol. Calcitriol enters intestinal wall and binds to cytoplasmic receptor and then binds with DNA causes depression and consequent transcription of gene code for calbindin. Due to increased availability of calbindin, absorption of calcium increases leading to increased blood calcium level.
(b) Vitamin D and Bone: Vitamin D activates osteoblast, bone forming cells & also stimulates secretion of alkaline phosphatase. Due to this enzyme, calcium and phosphorus increase.

(c) Vitamin D and Kidney: Calcitriol increase reabsorption of calcium and phosphorus by renal tubules.

(ii) Parathyroid  hormone (PTH)

Normal PTH level in serum is 10-60ng/l.

(a) PTH and bones: In bone, PTH causes demineralization. It also causes recreation of collagenase from osteoclast  leads to loss of matrix and bone resorption. As a result, mucopolysacharides and hydroxyproline are excreted in urine.

(b) PTH and Kidney: In kidney, PTH causes increased reabsorption of calcium but decreases reabsorption of phosphorus from kidney tubules.

(iii) Calcitonin Calcitonin decreases serum calcium level. It inhibits resorption of bone. It decreases the activity of osteoclasts and increases osteoblasts.

Hyper Calcemia When plasma Ca2+ level is more than 11mg/dl is called Hypercalcemia. It is due to parathyroid adenoma or ectopic PTH secreting tumor. calcium excreted in urine decreases excretion of chloride causing hyperchloremic acidosis.

Hypocalcemia Plasma calcium level less than 8mg/dl is called hypocalcemia. Tetany due to accidental surgical removal of parathyroid glands or by autoimmune disease. In tetany, neuromuscular irritability is increased. Increased Q-7 internal in ECG is seen. Main manifestation is carpopedal spasm. Laryngismus and stridor are also observed.

IONIZATION OF WATER, WEAK ACIDS AND WEAK BASES

The ionization of water can be described by an equilibrium constant. When weak acids or weak bases are dissolved in water, they can contribute H+ by ionizing (if acids) or consume H+ by being protonated (if bases). These processes are also governed by equilibrium constants

Water molecules have a slight tendency to undergo reversible ionization to yield a hydrogen ion and a hydroxide ion :

H₂O = H⁺ + OH⁻

The position of equilibrium of any chemical reaction is given by its equilibrium constant. For the general reaction,

A+B = C + D

Amino acids

Proteins are linear polymers of amino acids. Participate in virtually every biological process. Perform diverse functions:
       1. Enzymes: catalyze all reactions in living organisms
       2. Storage and transport
       3. Structural
       4. Mechanical work ( flagella, muscles, separation of chromosomes)
       5. Decoding information (translation, transcription, DNA replication)
       6. Cell-signalling (hormones and receptors)
       7. Defence (antibodies)

Biotin

 Biotin helps release energy from carbohydrates and aids in the metabolism of fats, proteins and carbohydrates from food.

RDA The Adequate Intake (AI) for Biotin is 30 mcg/day for adult males and females

Biotin Deficiency Biotin deficiency is uncommon under normal circumstances, but symptoms include fatigue, loss of appetite, nausea, vomiting, depression, muscle pains, heart abnormalities and anemia.

COPPER

The normal serum level of copper is 25 to 50 mg/dl.

Functions of copper

(a) Copper is necessary for iron absorption and incorporation of iron into hemoglobin.

(b) It is very essential for tyrosinase activity

(c) It is the co-factor for vitamin C requiring hydroxylation

(d) Copper increases the level of high density lipo protein and protects the heart.

Wilson’s disease

In case of Wilson’s disease ceruloplasmin level in blood is drastically reduced.

Wilson’s disease leads to

(i) Accumulation of copper in liver leads to hepatocellular degeneration and cirrhosis

(ii) Deposition of copper in brain basal ganglia leads to leticular degeneration

(iii) Copper deposits as green pigmented ring around cornea and the condition is called as Kayser-Kleischer ring

Over accumulation of copper can be treated by consumption of diet containg low copper and injection of D-penicillamine, which excretes copper through urine.

Menke’s kidney hair syndrome

 It is X-linked defect. In this condition copper is absorbed by GI tract, but cannot be transported to blood. The defect in transport of copper to blood is due to absence of an intracellular copper binding ATPase.

BIOLOGICAL BUFFER SYSTEMS 

Cells and organisms maintain a specific and constant cytosolic pH, keeping biomolecules in their optimal ionic state, usually near pH 7. In multicelled organisms, the pH of the extracellular fluids (blood, for example) is also tightly regulated. Constancy of pH is achieved primarily by biological buffers : mixtures of weak acids and their conjugate bases 

Body fluids and their principal buffers

Body fluids                     Principal buffers

Extracellular fluids        {Biocarbonate buffer Protein buffer } 

Intracellular fluids         {Phosphate buffer, Protein }

Erythrocytes                 {Hemoglobin buffer}