Department of Biology
This case study describes a visit by "Naomi" to her physician, who upon seeing Naomi's bloodwork decides to prescribe her a cholesterol-lowering agent, a statin. The case discusses (1) the prevalence of non-communicable diseases such as atherosclerosis, which can lead to strokes and heart disease; (2) circulating lipoprotein particles including LDL and HDL, differentiating between which is a risk factor for heart disease and which is protective; (3) the pathway for cholesterol synthesis; (4) the evidence demonstrating that statins inhibit the enzyme HMG-CoA reductase, which is the committed step for cholesterol synthesis; and (5) the kinetic mechanism by which statins inhibit the enzyme. Students examine and interpret data from radioactive tracer and enzyme kinetics studies. The case ends with another visit by Naomi to her physician, who reexamines her bloodwork after she has been taking a statin for six months. Students are asked to determine whether the drug was effective for Naomi and, if not, what changes could be made to her regimen. The case was originally written for use in a survey of biochemistry course for upper level undergraduates.
- Recall the importance of non-covalent interactions in molecular complexes.
- Describe a mechanism for regulation of metabolic pathways.
- Interpret metabolic data.
- Compare relative drug efficacies.
- Determine mechanisms of enzyme inhibition.
Keywordsstatin; cholesterol; enzyme kinetics; committed step; enzyme inhibitors; enzyme inhibition; reductase; mevalonate; lipoprotein; HDL; LDL; atherosclerosis
Educational LevelUndergraduate upper division, Graduate, Clinical education
Type / MethodsDirected, Discussion
Subject HeadingsEpidemiology | Genetics / Heredity | Medicine (General) | Pharmacy / Pharmacology | Public Health | Biochemistry |