GENERAL BIOCHEMISTRY FOR NURSES
INTRODUCTION
Biochemistry can be defined as the science concerned with the chemical basis of life (Gk bios “life”). The cell is the structural unit of living systems. Thus, biochemistry can also be described as the science concerned with the chemical constituents of living cells and with the reactions and processes they undergo. By this definition, biochemistry encompasses large areas of cell biology, of molecular biology, and of molecular genetics.
The Aim of Biochemistry Is to Describe & Explain, in Molecular Terms, All Chemical Processes of Living Cells
The major objective of biochemistry is the complete understanding, at the molecular level, of all of the chemical processes associated with living cells. To achieve this objective, biochemists have sought to isolate the numerous molecules found in cells, determine their structures, and analyze how they function.
A Knowledge of Biochemistry Is Essential to All Life Sciences
The biochemistry of the nucleic acids lies at the heart of genetics; in turn, the use of genetic approaches has been critical for elucidating many areas of biochemistry. Physiology, the study of body function, overlaps with biochemistry almost completely. Immunology employs numerous biochemical techniques, and many immunologic approaches have found wide use by biochemists. Pharmacology and pharmacy rest on a sound knowledge of biochemistry and physiology; in particular, most drugs are metabolized by enzyme-catalyzed reactions. Poisons act on biochemical reactions or processes; this is the subject matter of toxicology. Biochemical approaches are being used increasingly to study basic aspects of pathology (the study of disease), such as inflammation, cell injury, and cancer. Many workers in microbiology, zoology, and botany employ biochemical approaches almost exclusively. These relationships are not surprising, because life as we know it depends on biochemical reactions and processes. In fact, the old barriers among the life sciences are breaking down, and biochemistry is increasingly becoming their common language.
Reciprocal Relationship between Biochemistry & Medicine has Stimulated Mutual Advances
The two major concerns for workers in the health sciences—and particularly physicians—are the understanding and maintenance of health and the understanding and effective treatment of diseases. Biochemistry impacts enormously on both of these fundamental concerns of medicine. In fact, the interrelationship of biochemistry and medicine is a wide, two-way street. Biochemical studies have illuminated many aspects of health and disease, and conversely, the study of various aspects of health and disease has opened up new areas of biochemistry.. For instance, knowledge of protein structure and function was necessary to elucidate the single biochemical difference between normal hemoglobin and sickle cell hemoglobin. On the other hand, analysis of sickle cell hemoglobin has contributed significantly to our understanding of the structure and function of both normal hemoglobin and other proteins.. Another example is the pioneering work of Archibald Garrod, a physician in England during the early 1900s. He studied patients with a number of relatively rare disorders (alkaptonuria, albinism, cystinuria, and pentosuria; these are described in later chapters) and established that these conditions were genetically determined. Garrod designated these conditions as inborn errors of metabolism. His insights provided a major foundation for the development of the field of human biochemical genetics. More recent efforts to understand the basis of the genetic disease known as familial hypercholesterolemia, which results in severe atherosclerosis at an early age, have led to dramatic progress in understanding of cell receptors and of mechanisms of uptake of cholesterol into cells. Studies of oncogenes in cancer cells have directed attention to the molecular mechanisms involved in the control of normal cell growth. These and many other examples emphasize how the study of disease can open up areas of cell function for basic biochemical research.
The relationship between medicine and biochemistry has important implications for the former. As long as medical treatment is firmly grounded in knowledge of biochemistry and other basic sciences, the practice of medicine will have a rational basis that can be adapted to accommodate new knowledge. This contrasts with unorthodox health cults and at least some “alternative medicine” practices, which are often founded on little more than myth and wishful thinking and generally lack any intellectual basis.
NORMAL BIOCHEMICAL PROCESSES ARE THE BASIS OF HEALTH
The World Health Organization (WHO) defines health as a state of “complete physical, mental and social well-being and not merely the absence of disease and infirmity.” From a strictly biochemical viewpoint, health may be considered that situation in which all of the many thousands of intra- and extracellular reactions that occur in the body are proceeding at rates commensurate with the organism’s maximal survival in the physiologic state. However, this is an extremely reductionist view, and it should be apparent that caring for the health of patients requires not only a wide knowledge of biologic principles but also of psychologic and social principles.
Impact Biochemical Research on Nutrition & Preventive Medicine
One major prerequisite for the maintenance of health is that there is optimal dietary intake of a number of chemicals; the chief of these are vitamins, certain amino acids, certain fatty acids, various minerals, and water. Because much of the subject matter of both biochemistry and nutrition is concerned with the study of various aspects of these chemicals, there is a close relationship between these two sciences. Moreover, more emphasis is being placed on systematic attempts to maintain health and forestall disease, ie, on preventive medicine. Thus, nutritional approaches to—for example—the prevention of atherosclerosis and cancer are receiving increased emphasis. Understanding nutrition depends to a great extent on a knowledge of biochemistry.
Most Disease Has a Biochemical Basis
We believe that most if not all diseases are manifestations of abnormalities of molecules, chemical reactions, or biochemical processes. All of them affect one or more critical chemical reactions or molecules in the body. In most of these conditions, biochemical studies contribute to both the diagnosis and treatment
The major causes of diseases. All of the causes listed act by influencing the various biochemical mechanisms in the cell or in the body.
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