Enzyme Mechanism — Q-Bank
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Unit 5 Question Bank

Specificity · IUB classes · coenzymes · active site · induced fit · isozymes
25 MCQ · five options6 Definitions3 Written answersHarper's verified
Format note: the TMU Biochemistry paper gives five suggested answers (A–E), not four — these MCQs match that. Items tagged TMU 2019 or TMU 2020/21 come from the real papers. Answers are verified against Harper's Illustrated Biochemistry; the "marking schemes" in the source folder are other students' answer sheets, not official, so they are never used as the authority.
0 / 25 answered
1Which of the following statements about enzymes is FALSE?
A. They are mostly protein catalysts
B. Most of them are highly specific for their substrates
C. They do not change the equilibrium of the reaction
D. Enzymes do not alter themselves in an enzyme-catalysed reaction
E. Some of them have no active sites
Answer: E
All active enzymes have an active site — it is the three-dimensional catalytic centre where substrate binds and catalysis occurs, so an enzyme without one is a contradiction in terms. Every other statement is true, including the careful wording “mostly protein catalysts” (ribozymes are RNA) and “do not change the equilibrium” (enzymes lower activation energy, not ΔG). This question is printed on the TMU deck.TMU Lecture 5 Slide 31 · Harper's ch.7, pp.60–63
2The international (IUB) classification of enzymes does NOT include ( ).
A. Proteases
B. Transferases
C. Oxidoreductases
D. Lyases
E. Isomerases
Answer: A
“Protease” is a descriptive name based on the substrate, not an IUB class — proteases actually belong to the hydrolases, since they cleave peptide bonds using water. The six classes are oxidoreductases, transferases, hydrolases, lyases, isomerases and ligases. Printed on the TMU deck.TMU Lecture 5 Slide 31 · Harper's ch.7, p.61
3Which of the following statements about coenzymes is FALSE?
A. Coenzymes may be regarded as second substrates
B. All enzymes must require a coenzyme
C. Many coenzymes are derivatives of B vitamins
D. Coenzymes can transfer hydrogen or other groups
E. Coenzymes serve as recyclable shuttles within the cell
Answer: B
Many enzymes need no coenzyme at all, functioning with their amino acid side chains alone. Coenzymes exist to extend catalytic capability beyond the limited functional groups those side chains offer — an extension, not a requirement. Everything else listed is true. Printed on the TMU deck.TMU Lecture 5 Slide 32 · Harper's ch.7, p.62
4Which statement about the active site of an enzyme is NOT true?
A. Binding of the active site to substrate involves specific interactions
B. Active sites are often located in crevices or clefts in the enzyme
C. The active-site residues must be adjacent in the primary structure
D. It is the three-dimensional catalytic centre
E. All active enzymes possess an active site
Answer: C
The word that makes it false is primary. Catalytic residues are typically far apart in the linear sequence and are brought into proximity only by the three-dimensional fold — Unit 3 being tested inside an enzyme question. Printed on the TMU deck.TMU Lecture 5 Slide 32 · Harper's ch.7, pp.62–63
5The similarity between different isozymes of an enzyme is that ( ).
A. they have identical physical properties
B. they have identical chemical properties
C. their molecular structures are the same
D. they catalyse the same reaction
E. they are encoded by the same gene
Answer: D
Catalysing the same reaction is the whole definition and the only similarity. Isozymes differ in physical, chemical and immunological properties and in molecular structure — which is precisely what allows them to be separated by electrophoresis and used diagnostically. Printed on the TMU deck.TMU Lecture 5 Slide 33 · Harper's ch.7, p.66
6Enzymes typically enhance the rate of the corresponding non-catalysed reaction by a factor of at least ( ).
A. 10²
B. 10³
C. 10⁹
D. 10¹²
E. 10⁶
Answer: E
At least 10⁶ — a millionfold. Note the related but different figure: catalysis by proximity alone accounts for at least a thousandfold enhancement, one of the four mechanisms contributing to the total.Harper's ch.7, p.61 · TMU Lecture 5 Slide 10
7Enzymes accelerate reactions by ( ).
A. lowering the activation energy of the reaction
B. increasing the free energy change of the reaction
C. shifting the equilibrium towards the products
D. raising the temperature of the local environment
E. increasing the concentration of the products
Answer: A
An enzyme lowers activation energy (Ea), so a far larger proportion of molecules can reach the transition state. It does not alter ΔG or the position of equilibrium — the forward and reverse reactions are accelerated equally, so equilibrium is simply reached sooner.TMU Lecture 5 Slides 8–9
8Enzymes that catalyse the joining together of two molecules, coupled to the hydrolysis of a pyrophosphoryl group in ATP, belong to which IUB class?
A. Lyases
B. Ligases
C. Transferases
D. Hydrolases
E. Isomerases
Answer: B
Ligases — and the ATP requirement is the identifying feature. Do not confuse with lyases, which cleave bonds by elimination leaving a double bond (and can add groups to double bonds), without water and without ATP.Harper's ch.7, p.61 · TMU Lecture 5 Slide 13
9Enzymes that catalyse the cleavage of C–C, C–O or C–N bonds by ELIMINATION, leaving double bonds, are ( ).
A. Hydrolases
B. Oxidoreductases
C. Lyases
D. Ligases
E. Transferases
Answer: C
Lyases. The distinction from hydrolases is water: hydrolases cleave hydrolytically, lyases by elimination. Lyases also work in reverse, adding groups to double bonds.Harper's ch.7, p.61 · TMU Lecture 5 Slide 13
10A prosthetic group differs from a cofactor in that ( ).
A. it is always a metal ion, whereas a cofactor is always organic
B. it is consumed during the reaction, whereas a cofactor is not
C. it is derived from a B vitamin, whereas a cofactor is not
D. it is tightly and stably bound, whereas a cofactor associates reversibly
E. it binds the substrate, whereas a cofactor binds the product
Answer: D
The difference is entirely one of tightness of binding. A prosthetic group is tightly and stably incorporated by covalent or non-covalent forces; a cofactor binds transiently and dissociably, and must therefore be present in the surrounding medium for catalysis to occur. Metal ions can be either — as prosthetic groups in metalloenzymes, or as cofactors in metal-activated enzymes.Harper's ch.7, p.62
11Approximately what proportion of all enzymes contain tightly bound Fe, Co, Cu, Mg, Mn or Zn and are therefore termed metalloenzymes?
A. One-tenth
B. One-half
C. Three-quarters
D. Nine-tenths
E. One-third
Answer: E
About one-third. Metal ions constitute the most common type of prosthetic group. Metals may participate in redox reactions (usually complexed to haem or iron-sulfur clusters), facilitate substrate binding and orientation, form covalent bonds with intermediates, or act as Lewis acids or bases to make substrates more electrophilic or nucleophilic.Harper's ch.7, p.62
12The redox coenzymes NAD⁺ and NADP⁺ are derived from which vitamin?
A. Nicotinamide
B. Riboflavin
C. Pantothenic acid
D. Thiamin
E. Folic acid
Answer: A
Nicotinamide gives NAD and NADP. Riboflavin gives FMN and FAD; pantothenic acid gives coenzyme A; thiamin (as its pyrophosphate) participates in decarboxylation of α-keto acids; folic acid and cobamide coenzymes function in one-carbon metabolism.Harper's ch.7, p.62 · TMU Lecture 5 Slide 15
13Coenzyme A, the acyl group carrier, is a derivative of ( ).
A. Nicotinamide (vitamin B₃)
B. Pantothenic acid (vitamin B₅)
C. Riboflavin (vitamin B₂)
D. Pyridoxine (vitamin B₆)
E. Biotin (vitamin B₇)
Answer: B
Pantothenic acid. Remembering this pays off across the whole second half of the course — acetyl-CoA is the hub of Units 10, 11, 16 and 17, and it exists because a B vitamin acts as a handle that lets target enzymes recognise and bind acetate.Harper's ch.7, p.62
14NADP⁺ differs structurally from NAD⁺ by the presence of an additional ( ).
A. adenine ring
B. ribose sugar
C. phosphate group
D. nicotinamide ring
E. pyrophosphate bond
Answer: C
A single extra phosphate: in the standard structure R = H for NAD⁺ and R = PO₃²⁻ for NADP⁺. Both contain the adenine, ribose and phosphoryl moieties of AMP or ADP, a structural theme shared by many coenzymes.Harper's ch.7, p.62, Figure 7–2 · TMU Lecture 5 Slide 15
15Coenzymes are described as “substrate shuttles”. One of their two principal functions is to ( ).
A. provide the energy required to drive unfavourable reactions
B. determine the final equilibrium position of the reaction
C. permanently attach to the active site of their enzyme
D. stabilise species too reactive to persist freely in the cell
E. catalyse the reaction even without the enzyme present
Answer: D
Harper's gives the shuttle function as twofold: they stabilise reactive species such as hydride ions (NADH) or hydrogen atoms (FADH), and they act as an adaptor or handle that facilitates recognition and binding of small groups such as acetate (CoA) or glucose (UDP) by target enzymes.Harper's ch.7, p.62
16Enzyme stereospecificity is explained by ( ).
A. the enzyme adopting a mirror-image conformation for each isomer
B. covalent modification of the substrate before binding
C. the presence of only L-amino acids in the enzyme
D. the requirement for a divalent metal ion cofactor
E. binding at three or more points, which fixes its orientation
Answer: E
Three-point attachment. Once two of the substrate's groups are bound to their complementary sites, the orientation is fixed, so apparently identical atoms become distinguishable and only one can reach the remaining site. This also allows an enzyme to make a chiral product from a non-chiral substrate — pyruvate reduction yields exclusively L-lactate, not a racemic mixture.Harper's ch.7, p.61, Figure 7–1 · TMU Lecture 5 Slide 12
17The “lock and key” model of enzyme action was proposed by ( ), and was superseded because ( ).
A. Emil Fischer; it ignored the conformational changes in catalysis
B. Michaelis and Menten; it could not explain saturation kinetics
C. Daniel Koshland; it required the enzyme to be flexible
D. Linus Pauling; it ignored the transition state entirely
E. Pehr Edman; it applied only to the proteases
Answer: A
Emil Fischer proposed lock and key, reasoning from the observation that substrate binding makes enzymes more resistant to thermal denaturation — implying a stable ES complex. Its drawback was that a rigid site cannot explain the dynamic changes of catalysis, which Daniel Koshland's induced fit model addressed.Harper's ch.7, pp.62–64 · TMU Lecture 5 Slide 17
18The induced fit model states that ( ).
A. the active site is a rigid pocket exactly complementary to it
B. substrate binding changes the enzyme's shape, and vice versa
C. the substrate must be chemically modified before it can bind
D. the enzyme changes shape only after the product is released
E. catalysis requires the enzyme to dissociate into subunits
Answer: B
Koshland's analogy is a hand entering a glove. This matters mechanistically, not just descriptively: a rigid site could hold a substrate but never distort it, whereas a site that closes around its substrate can strain the bond targeted for cleavage — which is catalysis by strain.Harper's ch.7, p.64 · TMU Lecture 5 Slide 17
19Catalysis by strain works because the enzyme binds its substrate in a conformation that ( ).
A. raises the activation energy of the reverse reaction only
B. increases the substrate's free energy of formation
C. mimics the transition state, weakening the bond to be cleaved
D. prevents water from reaching the active site
E. covalently links the substrate to the enzyme
Answer: C
Enzymes catalysing lytic reactions bind substrate in a conformation unfavourable for the targeted bond, mimicking the transition state intermediate and thereby weakening the bond. Linus Pauling first proposed transition-state stabilisation as a general mechanism — and the idea is exploited clinically to design transition state analogues as drugs.Harper's ch.7, p.63
20A “ping-pong” mechanism is characteristic of which type of catalysis?
A. Catalysis by proximity
B. Acid-base catalysis
C. Catalysis by strain
D. Covalent catalysis
E. Metal-ion catalysis
Answer: D
Covalent catalysis — the formation of a covalent bond between enzyme and substrate — often follows a ping-pong mechanism, in which the first substrate binds and its product is released BEFORE the second substrate binds. Chymotrypsin and fructose-2,6-bisphosphatase are the examples used in the lecture.Harper's ch.7, p.63 · TMU Lecture 5 Slide 19
21In the mechanism of HIV protease, the first catalytic step is that ( ).
A. an aspartate forms a covalent bond with the peptide substrate
B. a serine residue attacks the carbonyl carbon of the peptide bond
C. a metal ion polarises the peptide bond
D. the substrate is strained into the transition state conformation
E. an aspartate acts as a base, abstracting a proton to activate a water molecule
Answer: E
HIV protease is an aspartic protease illustrating acid-base catalysis. Aspartate X acts as a base, activating a water molecule by abstracting a proton; the activated water attacks the peptide bond forming a tetrahedral intermediate; then Aspartate Y acts as an acid, donating a proton to the new amino group to break down the intermediate.Harper's ch.7, Figure 7–6 · TMU Lecture 5 Slide 18
22Lactate dehydrogenase exists as five isozymes because it is ( ).
A. a tetramer assembled from two different subunit types, H and M
B. a dimer assembled from five different subunit types
C. encoded by five separate genes with no shared subunits
D. a monomer that adopts five different conformations
E. glycosylated to five different extents in different tissues
Answer: A
LDH is a tetramer built from H (heart, gene LDHB) and M (muscle, gene LDHA) subunits, giving five possible tetramers: HHHH (LDH-1), HHHM, HHMM, HMMM and MMMM (LDH-5). Its tissue specificity is thus a direct consequence of its quaternary structure.Harper's ch.7, p.69 · TMU Lecture 5 Slide 24
23Myocardial infarction is characteristically associated with an elevated serum level of ( ).
A. LDH isozyme 5
B. LDH isozyme 1
C. LDH isozyme 3
D. amylase
E. ceruloplasmin
Answer: B
LDH-1 (HHHH) predominates in heart tissue, so it is the isozyme released in myocardial infarction; LDH-5 (MMMM) predominates in liver and rises in liver disease. Because the isozymes are separable by electrophoresis, the tissue of origin can be inferred from the pattern. Amylase indicates acute pancreatitis; ceruloplasmin, Wilson disease.Harper's ch.7, pp.68–69 · TMU Lecture 5 Slide 25
24NADH and NADPH are assayed spectrophotometrically at a wavelength of ( ).
A. 280 nm
B. 260 nm
C. 340 nm
D. 420 nm
E. 560 nm
Answer: C
340 nm — and crucially the oxidised forms NAD(P)⁺ do not absorb there, so the rate of change of absorbance is proportional to the amount of enzyme. Do not confuse with 280 nm, which measures protein via aromatic side chains (Unit 1), or 260 nm, which measures nucleic acid.Harper's ch.7, p.67 · TMU Lecture 5 Slide 27
25Which is today the preferred plasma marker for the diagnosis of myocardial infarction?
A. Lactate dehydrogenase
B. Aspartate aminotransferase
C. Alkaline phosphatase
D. Cardiac troponins I and T
E. γ-Glutamyl transferase
Answer: D
Troponin has replaced creatine kinase, which had itself replaced LDH and the aminotransferases. Cardiac troponins I and T rise 2–6 hours after infarction and remain elevated 4–10 days. Note the caveat: troponin marks all heart muscle damage, not only infarction. CK-MB appears at 4–6 h, peaks at 24 h and returns to baseline by 48–72 h.Harper's ch.7, p.69
1 Enzyme specificity — 3′ · TMU study question+
The property whereby an enzyme is specific both for the type of reaction it catalyses and for a single substrate or a small set of closely related substrates.

Enzymes are additionally stereospecific, typically catalysing the reaction of only one stereoisomer — D- but not L-sugars, L- but not D-amino acids. Stereospecificity arises from binding at at least three points of attachment, which fixes the substrate's orientation so that apparently identical groups become distinguishable.

Significance: specificity is what allows a cell to conduct and independently control a broad spectrum of biochemical processes simultaneously in the same small volume.Harper's ch.7, p.61 · TMU Lecture 5 Slides 10, 12
2 The active site — 3′ · TMU study question — describe the CHARACTERISTICS too+
The three-dimensional catalytic centre of an enzyme — a cleft or pocket formed by the residues that bind the substrate and carry out catalysis.

Characteristics:
• It comprises only a small part of the molecule.
• It is a three-dimensional entity: the residues are far apart in the primary structure and are brought together by folding.
• It is usually located in a cleft or crevice, shielding the substrate from water.
• It provides a distinct microenvironment, whose polarity, hydrophobicity, acidity or alkalinity may differ markedly from the surrounding cytoplasm.
• Substrate binding involves specific non-covalent interactions, bringing substrates into close proximity and optimal alignment with the cofactors, prosthetic groups and side chains that catalyse the change.Harper's ch.7, pp.62–63 · TMU Lecture 5 Slide 30
3 Prosthetic group, cofactor and coenzyme — 3′ · TMU study question+
All three are non-protein components that extend an enzyme's catalytic repertoire beyond the limited functional groups of amino acid side chains. They differ in how they associate.

Prosthetic grouptightly and stably incorporated into the protein's structure by covalent or non-covalent forces. Examples: pyridoxal phosphate, FMN, FAD, thiamin pyrophosphate, biotin. Metal ions are the commonest type; enzymes with tightly bound Fe, Co, Cu, Mg, Mn or Zn — about a third of all enzymes — are metalloenzymes.

Cofactor — associates reversibly and transiently with the enzyme or with the substrate, and therefore must be present in the surrounding medium for catalysis to occur. Most are metal ions; such enzymes are metal-activated enzymes.

Coenzyme — a recyclable shuttle transporting substrates from one point in the cell to another. Its role is twofold: to stabilise reactive species such as hydride ions (NADH) or hydrogen atoms (FADH), and to act as a handle facilitating recognition of small groups such as acetate (CoA). Many are derivatives of B vitamins.Harper's ch.7, p.62 · TMU Lecture 5 Slides 14–15, 30
4 Isozymes (isoenzymes) — 3′ · TMU study question+
Distinct enzyme forms that catalyse the SAME reaction, arising through gene duplication.

Although the reaction is identical, their physical, chemical and immunological properties differ significantly — which is what allows them to be separated by electrophoresis. Differences may include sensitivity to regulatory factors or substrate affinity (hexokinase and glucokinase), adapting them to particular tissues or circumstances; they also provide a “backup” copy of an essential enzyme.

Example: lactate dehydrogenase is a tetramer of H (heart) and M (muscle) subunits, giving five isozymes. LDH-1 predominates in heart and rises in myocardial infarction; LDH-5 predominates in liver and rises in liver disease.Harper's ch.7, pp.66, 69 · TMU Lecture 5 Slides 23–25
5 Induced fit — 2′+
Daniel Koshland's model of enzyme-substrate interaction, which states that when a substrate approaches and binds an enzyme it induces a conformational change — analogous to placing a hand (substrate) into a glove (enzyme).

Substrate and enzyme induce mutual conformational changes that facilitate both substrate recognition and catalysis. It replaced Emil Fischer's “lock and key” model, which pictured a rigid complementary site and failed to account for the dynamic changes that accompany catalysis.Harper's ch.7, pp.62–64
6 Conserved residues — 2′+
Specific amino acids present in the same relative position in every member of a protein family, from which the family's common ancestry can be inferred.

Proteins that diverged from a common ancestor and share a large number of conserved residues are said to be homologous. Among the most highly conserved residues are those that participate directly in catalysis — evolution tolerates change almost anywhere except the active site.Harper's ch.7, p.66 · TMU Lecture 5 Slide 22
1 What is the active site of an enzyme? Describe its characteristics. 5′ — TMU study question

Definition

The active site is the three-dimensional catalytic centre of an enzyme — a cleft or pocket, usually at the surface, formed by the aminoacyl residues that bind the substrate and carry out catalysis. It is where the enzyme-substrate (ES) complex forms and where the chemical transformation takes place.

Characteristics

CharacteristicExplanation
It occupies only a small part of the moleculeRelatively few residues form the site; the remainder of the protein positions them correctly and provides the structural scaffold
It is a three-dimensional entityThe catalytic residues are typically far apart in the primary structure and are brought into proximity only by the folding of the polypeptide. This is why tertiary structure is indispensable to function
It lies in a cleft or creviceThe substrate is bound in a pocket that shields it from water
It provides a distinct microenvironmentIts polarity, hydrophobicity, acidity or alkalinity may differ markedly from that of the surrounding cytoplasm, and this environment itself contributes to catalysis
Binding involves specific interactionsSubstrate is held non-covalently by hydrogen bonds, ionic and hydrophobic interactions, conferring the enzyme's specificity
It aligns the reactants optimallySubstrates are brought into close proximity to one another and into optimal alignment with the cofactors, prosthetic groups and side chains that catalyse the transformation

How the substrate is accommodated

Emil Fischer first likened the specificity of the site to a lock accepting only the proper key, having observed that bound substrate makes an enzyme more resistant to thermal denaturation. However, the rigid lock-and-key picture failed to account for the dynamic changes that accompany catalysis. Daniel Koshland's induced fit model corrected this: substrate binding induces a conformational change in the enzyme, and enzyme and substrate change each other's shape — a hand entering a glove. This flexibility is essential, because a site that closes around its substrate can strain the bond destined for cleavage.

Marking guide: definition as the three-dimensional catalytic centre 1 · residues far apart in primary structure, brought together by folding 1.5 · cleft/crevice shielding from water 0.5 · distinct microenvironment 1 · specific non-covalent binding interactions 0.5 · induced fit or the ES complex mentioned 0.5.
2 Outline briefly the mechanisms by which enzymes achieve catalysis. 5′ — 'outline briefly'

The general principle

Enzymes enhance reaction rates by factors of 10⁶ or more, and they do so by lowering the activation energy of the reaction — not by altering ΔG or the position of equilibrium. Harper's identifies four general mechanisms, used in combination.

1 · Catalysis by proximity

For molecules to interact they must come within bond-forming distance. By binding substrates at its active site, an enzyme creates a region of high local substrate concentration in which the molecules are held in the ideal orientation to react. This alone produces rate enhancements of at least a thousandfold.

2 · Acid-base catalysis

The ionisable functional groups of aminoacyl side chains — and of prosthetic groups where present — contribute to catalysis by acting as general acids (proton donors) or general bases (proton acceptors). Specific acid or base catalysis involves only protons or hydroxide ions; general acid or base catalysis responds to all the acids or bases present.

Example — HIV protease, an aspartic protease. Aspartate X acts as a base, abstracting a proton to activate a water molecule; the activated water attacks the peptide bond, forming a transient tetrahedral intermediate; Aspartate Y then acts as an acid, donating a proton to the newly formed amino group and facilitating breakdown of the intermediate. Shuttling the proton from Asp X to Asp Y restores the enzyme.

3 · Catalysis by strain

Enzymes that catalyse lytic reactions bind their substrate in a conformation that is unfavourable for the bond targeted for cleavage. This strained conformation mimics the transition state, selectively stretching and distorting the bond, weakening it and rendering it more vulnerable. Linus Pauling was the first to propose transition-state stabilisation as a general mechanism of enzyme catalysis; the idea is exploited to design transition state analogues as drugs.

4 · Covalent catalysis

The formation of a covalent bond between the enzyme and one or more substrates, generating a transient covalent intermediate. It often follows a “ping-pong” mechanism, in which the first substrate binds and its product is released before the second substrate binds. Chymotrypsin and fructose-2,6-bisphosphatase illustrate covalent catalysis.

A supporting point

The residues that participate directly in catalysis are among the most highly conserved in any enzyme family, and enzyme and substrate induce mutual conformational changes in one another that facilitate both recognition and catalysis.

Marking guide: statement that enzymes lower activation energy without changing equilibrium 0.5 · four mechanisms named 2 · proximity explained with local concentration and orientation 0.5 · acid-base with general acid/base or the HIV protease example 1 · strain linked to the transition state 0.5 · covalent catalysis with the ping-pong mechanism 0.5.
3 Elucidate what isozymes are and explain their clinical importance. 8′ — 'elucidate'

Definition

Isozymes are distinct enzyme forms that catalyse the same reaction. That is the only property they share: although the reaction is identical, their physical, chemical and immunological properties differ significantly.

Origin

Like other protein families, isozymes arise through gene duplication. A second copy of a gene is created, and the two copies then evolve independently. Unlike the divergent homologs described for the proteases — where chymotrypsin and trypsin acquired different substrate specificities — isozymes retain the same reaction but acquire subtle differences in properties such as sensitivity to regulatory factors or substrate affinity (hexokinase and glucokinase are the classic pair). These differences adapt them to specific tissues or circumstances. Isozymes may also enhance survival by providing a “backup” copy of an essential enzyme.

Lactate dehydrogenase — the worked example

LDH catalyses lactate + NAD⁺ → pyruvate + NADH + H⁺. It is a tetrameric enzyme assembled from two monomer types — H (for heart), encoded by LDHB, and M (for muscle), encoded by LDHA. Four subunits drawn from two types give five possible tetramers:

IsozymeCompositionPredominates in
LDH-1HHHHHeart
LDH-2HHHM
LDH-3HHMM
LDH-4HMMM
LDH-5MMMMLiver

The relative proportion of each subunit in a given organ is determined by tissue-specific patterns of expression of the H and M genes. LDH therefore acquires tissue specificity as a direct consequence of its quaternary structure.

Clinical importance

In health, LDH exists mainly within cells. In disease, damaged cells release their own characteristic isozyme pattern into the serum, so that the tissue of origin can be inferred from the pattern of LDH isozymes in plasma.

  • Myocardial infarction → elevated LDH-1.
  • Liver disease → elevated LDH-5.

Because their physical properties differ, individual isozymes are readily separated by electrophoresis and detected using a coupled assay. Detection is possible at all because of amplification: each enzyme molecule transforms thousands of substrate molecules, and under appropriate conditions the rate of reaction is proportional to the amount of enzyme present. For NAD(P)⁺-dependent dehydrogenases such as LDH the assay is spectrophotometric — NADH and NADPH absorb at 340 nm whereas the oxidised forms do not, so the rate of change of absorbance reports enzyme quantity.

The wider diagnostic picture

LDH is one of a family of non-functional plasma enzymes used diagnostically: AST and ALT (myocardial infarction and viral hepatitis), amylase and lipase (acute pancreatitis), creatine kinase (muscle disorders and MI), alkaline phosphatase (bone and obstructive liver disease), ceruloplasmin (Wilson disease). Many are not specific to the disease listed.

The history of cardiac markers illustrates the principle that an enzyme appearing in plasma only after 12 hours or more is of limited utility. LDH and the aminotransferases were superseded by creatine kinase — whose isozyme CK-MB appears 4–6 h after infarction, peaks at 24 h and returns to baseline by 48–72 h — and CK has in turn been replaced in most laboratories by cardiac troponins I and T, which rise within 2–6 h and remain elevated for 4–10 days.

Marking guide: definition as distinct forms catalysing the same reaction 1.5 · differing physical/chemical/immunological properties 1 · origin by gene duplication 0.5 · LDH as a tetramer of H and M giving five isozymes 2 · LDH-1 heart and LDH-5 liver 1.5 · separation by electrophoresis 0.5 · one further diagnostic enzyme or the 340 nm assay 1.