section 29.2 
Heme Biosynthesis
685
C o A S H . C O 
2
\I . \ \ U ,.i 
e 
^ g
-A m inolevulinic acid (A L A )
Pyndoial phosphate
Succinyl-CoA
S1IT0CH0NDK10N
Protoporphyrinogen IX — Proto gen ^ 
protoporphynn IX 
»-«wthe^i^cHcmc
idasc^
(Proto gen)
CYTOSOL
A lA dehydratase
^ 
» 
Porphohlinogcn (PB(i )
H20 
4)SH 
PBG deamm
\1
\
4 CO
Spontaneous
Lro'gen I
Coproporphynnogen I
Hydrorymcihylniunc
H,<)>
Uro gen
Uro gen III
dccarbmviasc
tynUtaM
« ' I
Uroporphyrinogen III (Lro’gen III)
*—
( oproporphyrinogen III (Copro gen III)
FIGURE 29-4
Biosynthetic pathw ay of heme. The pathw ay consists o f eight irreversible reactions, four each in the m itochondrion and 
the cytosol. T he prim ary site o f regulation is the A LA synthase step.
octamer of the enzyme, and they are bound via the reduced 
thiol groups. Zinc is required for enzyme activity.
The reaction mechanism consists of Schiff base for-
mation by the keto group of one molecule of ALA with 
the e-amino group of a lysyl residue of the enzyme, fol-
lowed by nucleophilic attack by the enzyme-ALA an-
ion on the carbonyl group of a second ALA molecule 
with elimination of water. Then, a proton is transferred 
from the amino group of the second ALA molecule to the 
e-amino group of the lysyl residue with formation of PBG. 
Lead is a potent inhibitor of ALA dehydratase, presum-
ably by displacement of zinc by lead because the lead- 
inhibited enzyme can be reactivated by the addition of 
zinc. ALA dehydratase is inhibited competitively by suc- 
cinyl acetone 
(HOOC-CH2-CH2-CO-CH2-CO-CH3), 
which occurs in urine and blood in hereditary tyrosinemia 
(Chapter 17). Genetic deficiency of ALA dehydratase is 
known to occur.
Formation of Uroporphyrinogen III
Uroporphyrinogen III formation occurs in the cytosol and 
requires the successive action of porphobilinogen deam-
inase (or methylbilane synthase) and uroporphyrinogen 
III synthase. Porphobilinogen deaminase catalyzes con-
densation of four porphobilinogen molecules in a sym-
metrical head-to-tail arrangement to form a straight-chain 
tetrapyrrole, hydroxymethylbilane. Uroporphyrinogen III 
synthase catalyzes the rearrangement of one of the pyr-
role rings (ring D in Figure 29-5) to form an asymmetrical
tetrapyrrole, followed by its cyclization to form uropor-
phyrinogen III. In the absence of uroporphyrinogen III 
synthase (e.g., in congenital erythropoietic porphyria), the 
hydroxymethylbilane cyclizes spontaneously to the uro-
porphyrinogen I isomer, which is not a precursor of heme 
(Figure 29-5).
Formation of Coproporphyrinogen III
Cytosolic uroporphyrinogen decarboxylase catalyzes suc-
cessive decarboxylation of the four acetic groups to yield 
four methyl groups (Figure 29-6).
Formation o f Protoporphyrinogen IX
Mitochondrial coproporphyrinogen oxidase is localized 
in the intermembrane space and is probably loosely bound 
to the outer surface of the inner membrane. It catalyzes the 
successive conversion of propionic acid groups of ring A 
and ring B to vinyl groups (Figure 29-7).
Formation o f Protoporphyrin IX and Heme
Both of these steps occur in mitochondria (Figure 29-8). 
Porphyrinogen oxidase removes six hydrogen atoms (four 
from methane bridge carbons and two from pyrrole nitro-
gens) from protoporphyrinogen to yield protoporphyrin. 
The oxidase has an absolute requirement for oxygen. Pro-
toporphyrinogen can also be oxidized nonenzymatically 
to protoporphyrin at physiological pH, temperature, and 
aerobic conditions. Protoporphyrin oxidase is bound to the