SISTEM GASTROENTEROHEPATOLOGI

SEMESTER PENDEK TA. 2017/2018

BIOKIMIA SISTEM
GASTROENTEROHEPATOLOGI

Ika Yustisia
Departemen Biokimia FK UNHAS
Email: ikayustisia@gmail.com
 TIU dan TIK
TIU
Setelah mengikuti dan mempelajari kuliah ini
mahasiswa diharapkan mampu memahami dan
menjelaskan prinsip-prinsip dasar Biokimia pada
sistem pencernaan dan hepatobilier.
 TIU dan TIK
TIK
Setelah mengikuti dan mempelajari kuliah ini
mahasiswa diharapkan mampu memahami dan
menjelaskan:
1. Cairan dan enzim-enzim pencernaan
2. Pencernaan, absorpsi, dan transport karbohidrat,
lipid, protein, vitamin, air, dan mineral
3. Fungsi hati sebagai organ metabolik utama
 Tes fungsi hati
 Sintesis asam empedu dan garam empedu
 Metabolisme bilirubin
General Principles
of Digestion
 General Principles of Digestion
Major function of the gastrointestinal organs in
digestion and absorption
Organ Primary function

Production of fluid and digestive enzymes for homogenization, lubrication, and

Salivary glands
digestion of carbohydrate (amylase) and lipid (lingual lipase)

Stomach Secretion of HCl and proteases to initiate hydrolysis of proteins

Secretion of HCO3-, proteases, lipases, and amylase to continue digestion of

Pancrease
protein, lipid, and carbohydrate respectively

Liver Elaboration of bile acids

Gallblader Storage and concentration of bile

Final intraluminal digestion of foodstuffs, digestion of carbohydrate dimers and

Small intestine
specific absorptive pathway for digested material

Large intestine Absorption of fluid and electrolyte and products of bacterial action in colon
Cairan dan enzim-enzim pencernaan
Cairan dan enzim-
enzim pencernaan

Tidak diproduksi
oleh lambung
maniusia
Cairan dan enzim-enzim pencernaan
Cairan dan enzim-enzim pencernaan
Zimogen (=proenzim)
• Beberapa jenis enzim pencernaan berpotensi
menyebabkan kerusakan sel-sel yang
memproduksinya.
• Enzim-enzim ini disekresikan dalam bentuk
prekursor yang inaktif
• Enzim-enzim yang berpotensi merusak ini
terutama dari golongan protease dan
fosfolipase
Cairan dan enzim-enzim pencernaan
Cairan dan enzim-enzim pencernaan
Cairan dan enzim-enzim pencernaan
Cairan dan enzim-enzim pencernaan
Pencernaan, absorpsi, dan transport
karbohidrat, lipid, dan protein
Pencernaan, absorpsi, dan transport
karbohidrat

Overview of carbohydrate
digestion.

Digestion of the
carbohydrates occurs first,
followed by absorption of
monosaccharides.
Subsequent metabolic
reactions occur after the
sugars are absorbed
Pencernaan, absorpsi, dan transport
karbohidrat

Action of salivary and

pancreatic α-amylases
Pencernaan, absorpsi, dan transport
karbohidrat
 Pencernaan, absorpsi, dan transport
karbohidrat
Metabolism of Sugars by Colonic Bacteria

Some indigestible
carbohydrates.
These compounds are
components of dietary
fiber
Pencernaan, absorpsi, dan
transport lipid

Digestion of triacylglycerols in
the intestinal lumen
TG, triacylglycerol; bs, bile
salts; FA, fatty acid; 2-MG, 2-
monoacylglycerol.
1
Pencernaan, absorpsi, dan
transport lipid

1. Action of pancreatic lipase. Fatty acids (FA) are cleaved from

positions 1 and 3 of the triacylglycerol, and a monoacylglycerol
with a fatty acid at position 2 is produced
2. Action of pancreatic esterases (A) and phospholipase A2 (B)
Pencernaan, absorpsi, dan transport
lipid
Pencernaan, absorpsi, dan
transport protein

Digestion of proteins
The proteolytic enzymes,
pepsin, trypsin,
chymotrypsin, elastase, and
the carboxypeptidases, are
produced as zymogens that
are activated by cleavage
after they enter the
gastrointestinal lumen
Pencernaan, absorpsi, dan
transport protein
 Pencernaan,
absorpsi, dan
transport protein
Action of the digestive proteases
Pepsin, trypsin, chymotrypsin, and
elastase are endopeptidases; they
hydrolyze peptide bonds within
chains.
The others are exopeptidases;
aminopeptidases remove the amino
acid at the N-terminus and the
carboxypeptidases remove the
amino acid at the C-terminus.
 Pencernaan, absorpsi, dan
transport protein
Absorption of Peptides and Amino Acids
Fungsi hati sebagai organ metabolik utama
Fungsi hati sebagai organ metabolik utama

Biochemical function
Synthetic function

Excretory function
 Tes fungsi hati
A. Tests of the liver’s capacity to transport organic
anions and to metabolize drugs: serum bilirubin,
urine bilirubin, urobilinogen etc.
B. Tests that detect injury to hepatocytes (serum
enzyme tests): aminotransferases (ALT, AST),
alkaline phosphatase, γ-glutamyl transpeptidase, 5-
nucleotidase, leucine aminopeptidase etc.
C. Tests of the liver’s biosynthetic capacity: serum
proteins, albumin, prealbumin, serum
ceruloplasmin, procollagen III peptide, α1
antitrypsin, a feto protein, prothrombin time etc.
Fungsi hati sebagai organ metabolik utama
Bile acids, bile salts, and bile pigments
• Bile is an important product released by the
hepatocytes
• It promotes the digestion of fats from food by
emulsifying them in the small intestine
• The emulsifying components of bile, apart from
phospholipids, mainly consist of bile acids and
bile salts
• The bile also contains free cholesterol, which is
excreted in this way
Fungsi hati sebagai organ metabolik utama
Metabolisme bilirubin
Bilirubin metabolism
Bile pigments
 Pemeriksaan bilirubin
Total bilirubin:
Measured as the amount, which reacts in 30 minutes after
addition of alcohol. Normal range is 0.2-0.9 mg/dL (2-
15µmol/L).
Direct Bilirubin
Water-soluble fraction; measured by the reaction with
diazotized sulfanilic acid in 1 minute and this gives
estimation of conjugated bilirubin. Normal range
0.3mg/dL( 5.1µmol/ L)
Indirect bilirubin
This fraction is calculated by the difference of the total
and direct bilirubin and is a measure of unconjugated
fraction of bilirubin.
Tes fungsi hati contoh aplikasi
Tes fungsi hati contoh aplikasi
 REFERENCES
 Meisenberg, G., Simmons, WH. Principles of Medical
Biochemistry, 3 ed. Mosby Elsevier, 2012
 Lieberman, M., Marks, DA. Marks’ Basic Medical
Biochemistry a Clinical Approach 4 ed. Lippincott Williams
and Wilkins, 2013
 Koolman, J.; Roehm, KH. Color Atlas of Biochemistry, 2 ed.
Thieme, 2004; 266-273; 306-315
 Gaw A, Murphy MJ, Srivastava R, Cowan RA, O’Reilly DS.
Clinical Biochemistry 5 ed. Elsevier: Churchill Livingstone,
2013
 Hopfer, U. Digestion and Absorption of Basic Nutritional
Constituents in Textbook of Biochemistry with Clinical
Correlations, Devlin, TM (editor), 6th ed. Wiley Liss, 2006
 Bender, D.A., Mayes, P.A. Nutrition, Digestion, and
Absorption in Harper’s Ilustrated Biochemistry, Murray,
RK., Granner, DK., Rodwell, VW(editors), 30th ed., 2015