Don’t let them do that to you.
Okay, so let’s take a look at our G6PD
and a couple of things
that are important for us.
I want you to move to the left and I
want you to identify glucose here.
And then this is the glycolytic pathway.
We’re going to branch off
the glycolytic pathway
and there’s my rate-limiting enzyme, G6PD,
What are you going to form?
Look, you took NADP and you formed NADPH.
Where do you actually
require that NADPH for?
You’re going to take oxidized
glutathione and you will reduce it.
Remember in biochemistry, if you reduce
something, what does that mean to you?
Oh, yeah, you create the active form.
So here’s my GSH,
that is the reduced
form of glutathione.
Ladies and gentlemen,
that is what protects us.
That is what protects the RBC.
What does a free radical mean to you?
Oxygen and company.
So for example, do you
Do you remember hydrogen peroxide?
Which one are we seeing here?
That’s hydrogen peroxide.
That’s a free radical.
But where did it come from?
Take a look at that box.
Infections most commonly.
Doesn’t that then produce free radicals?
Of course, drugs such as –
I told you if you’re about
to go to a tropical country
and you’re taking antimalarials
for months and months and months.
You’re introducing free radicals.
What was the name of that bean in the
Mediterranean that they consume in their diet?
The fava bean.
So all of these would then be
introducing a free radical,
that GSH, which is the glutathione.
We’ll take the free radical, hydrogen
peroxide and make it into water,
which is completely benign and
it’s a neutralizer, isn’t it?
So imagine, please, that your
patient doesn’t have G6PD.
You're not going
to produce NADPH.
You don’t activate glutathione.
Uh-oh, free radical damage.
What is it going to cause damage to?
What do you call that hemoglobin now?
Who are you going to attract?
What do you produce?
What was that other
thing that I told you?
Not only do we have hemolytic anemia, but
you also have susceptibility to infection.
What kind of organisms?
Everything that we just talked
about here is what you’re seeing.
It’s all lined up, X-linked recessive.
And then the last little part that I wish
to add is the part on the top, very right,
and you find that if you
don’t have G6PD deficiency,
you end up forming
your Heinz bodies.
In terms of its hemolysis,
it could either intravascular or it
could be extravascular, is that clear?
Take a look at that arrow, where it
says G6PD deficiency, that’s important.
Intra or extravascular,
both instances occur.
What we’re looking at here in
this picture is your Heinz body.
How does this occur?
Free radical exposure,
What are you going to find next?
You’re going to find bite cells.