Role of Glucose in Rx of Acute Intermittent Porphyria

1. Note: CRE (c-AMP Response element) do not bind c-AMP. It is phosphorylated by cAMP activated kinase

1. PPAR-gamma causes lipid uptake and adipogenesis by fat cells
   1. Pyoglitazone is example of PP (Peroxisome activator)
   2. It bind and activate PPAR (PP activated Receptor)
   3. it activates PPAR-gamma (more tha PPAR-alpha)

1. PPAR-alpha cause fatty acid oxidation and ketogenesis and Heme sysnthesis and gluconeogenesis
   1. Insulin (via kinases activated by it) phosphorylates PGC-1α
   2. Phosphorylated PGC-1alpha is inactive
   3. inactivated PGC-1alpha can not co-activates PPAR-alpha
   4. So, FA oxidation, ketogenesis, gluconeogenesis and Heme synthesis is inhibited by Glucose→Insulin