CASE FILES: BIOCHEMISTRY
G lu c o s e
U D P -g lu c o s e
2 NADH + 2H
Figure 40-1. Formation of UDP-glucuronate and acetaminophen glucuronide.
is the oxidation of the sixth carbon of glucose in UDP-glucose to the acid level
forming UDP-glucuronic acid. This reaction is catalyzed by UDP-glucose dehy-
drogenase, which also produces
mol of nicotinamide adenine dinucleotide
(NADH) as an additional product. UDP-glucuronyl transferase, in the next phase
of the reaction, catalyzes the transfer of the glucuronide group to the hydroxyl
group of acetaminophen forming acetaminophen glucuronide, which is elimi-
nated without toxic effects to the organism.
Alternatively, acetaminophen can be conjugated with organic sulfate for
elimination. This alternative pathway shown in Figure 40-2 also consists of