Medical Biochemistry
Course Director: Dr. Michael Lieberman
This course is designed for medical students having their first exposure to biochemistry, although it is assumed that everyone has a working knowledge of organic chemistry. Upon completion of this course the student should have an excellent grasp of the metabolic basis of disease. In order to understand the altered state, it is first necessary to study the normal pathways of metabolism, such as the biosynthesis of large molecules, the metabolism of small molecules involved in the generation and storage of energy, and the use of molecular genetics in diagnosis and treatment of disease. Once the normal pathways are understood, defective steps causing diseases will be introduced. By teaching biochemistry via a disease oriented approach the student should have a greater appreciation for the role of biochemistry in disease and the role of modern biochemistry in clinical treatments. Listed below are three major course objectives. For each pathway and disease discussed in class, a separate list of specific objectives will be provided.
- To understand how large molecules are made and function. Students should understand the mechanisms of DNA, RNA and protein biosynthesis. Many drugs act by inhibiting these basic processes, which are required for all cells and organisms to grow. The basic building blocks for these macromolecules should be known, as many drugs are structural analogs of the building blocks. Many proteins are modified either during or after their biosynthesis, and those modifications are important in the function of that protein. Drugs which alter these modifications are being developed in order to alter normal protein function. The shape of a protein determines its function, and variables altering protein structure should be remembered and understood. This objective is reached primarily through the lectures presented in the first month of the course.
- To understand how energy is generated, used, and stored by the various organs of the body. The major objective in the teaching of metabolism is to enable students to see how metabolic pathways communicate with each other and how altering the regulation of one pathway will affect many other pathways. Hence, regulation of the pathways will be emphasized. Many metabolic diseases, such as phenylketonuria (PKU), Tay-Sachs disease, and gout, are due to an alteration in a metabolic pathway. These diseases will be highlighted as the normal pathways are presented. Nutrition will also be featured, both in terms of how food is digested and how vitamins function. Students are expected to remember the pathways, to understand metabolic regulation, and to recognize which aspects of the pathways, when altered, lead to disease. This objective is met primarily by the lectures presented during the months of October through December.
- To understand modern diagnosis and treatment of metabolic diseases. The third major area discussed in Medical Biochemistry is molecular and human genetics. This section stresses modern techniques used to assist in the diagnosis and treatment of human diseases, such as muscular dystrophy, cancer, and cystic fibrosis. The techniques and concepts that the student will be exposed to are essential for understanding the concept of gene therapy and how it is accomplished. The student should be able to apply the techniques that are taught in this section of the course to other diseases which may not have been discussed in class. The relevance of the sequencing of the human genome to disease will also be made apparent during this series of lectures. This material will be presented in August, and again during the months of February and March, and will help to tie together all of the material presented earlier during the course.