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The Cahill cycle, also known as the alanine cycle or glucose-alanine cycle, [1] is the series of reactions in which amino groups and carbons from muscle are transported to the liver. [2] It is quite similar to the Cori cycle in the cycling of nutrients between skeletal muscle and the liver. [ 1 ]
It catalyzes the two parts of the alanine cycle. Serum ALT level, serum AST (aspartate transaminase) level, and their ratio (AST/ALT ratio) are routinely measured clinically as biomarkers for liver health. [2] The half-life of ALT in the circulation approximates 47 hours. [3] Aminotransferase is cleared by sinusoidal cells in the liver. [3]
Cori cycle. The Cori cycle (also known as the lactic acid cycle), named after its discoverers, Carl Ferdinand Cori and Gerty Cori, [1] is a metabolic pathway in which lactate, produced by anaerobic glycolysis in muscles, is transported to the liver and converted to glucose, which then returns to the muscles and is cyclically metabolized back to lactate.
In similar manner, in muscles the use of pyruvate for transamination gives alanine, which is carried by the bloodstream to the liver (the overall reaction being termed glucose-alanine cycle). Here other transaminases regenerate pyruvate, which provides a valuable precursor for gluconeogenesis.
Standard liver tests for assessing liver damage include alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Bilirubin may be used to estimate the excretory function of the liver and coagulation tests and albumin can be used to evaluate the metabolic activity of the liver.
Glyceroneogenesis is used when the concentrations of glucose in the cytosol are low, and typically uses pyruvate as the precursor, but can also use alanine, glutamine, or any substances from the TCA cycle. The main regulator enzyme for this pathway is an enzyme called phosphoenolpyruvate carboxykinase (PEPC-K), which catalyzes the ...
Glutamate in the liver enters mitochondria and is broken down by glutamate dehydrogenase into α-ketoglutarate and ammonium, which in turn participates in the urea cycle to form urea which is excreted through the kidneys. [23] The glucose–alanine cycle enables pyruvate and glutamate to be removed from muscle and safely transported to the liver.
Lactate is transported back to the liver where it is converted into pyruvate by the Cori cycle using the enzyme lactate dehydrogenase. Pyruvate, the first designated substrate of the gluconeogenic pathway, can then be used to generate glucose. [9]
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