Mitochondria contain four acyl-CoA dehydrogenases,
with specificities for short- (C
4
to C
6
), medium- (C
6
to C
10
),
long- (between medium and very long), and very long-
chain (C
12
to C
18
) fatty acyl-CoAs. The reaction catalyzed
by these enzymes is thought to involve removal of a proton
at C
␣
and transfer of a hydride ion equivalent from C

to
FAD (Fig. 25-12, Reaction 1). The X-ray structure of the
medium-chain acyl-CoA dehydrogenase (MCAD) in com-
plex with octanoyl-CoA, determined by Jung-Ja Kim,
clearly shows how the enzyme orients the enzyme’s base
(Glu 376), the substrate C
␣
¬C

bond, and the FAD pros-
thetic group for reaction (Fig. 25-13).
a. Acyl-CoA Dehydrogenase Is Reoxidized
via the Electron-Transport Chain
The FADH
2
resulting from the oxidation of the fatty
acyl-CoA substrate is reoxidized by the mitochondrial
electron-transport chain through the intermediacy of a se-
ries of electron-transfer reactions. Electron-transfer flavo-
protein (ETF) transfers two electrons from FADH
2
to the
flavoiron–sulfur protein ETF:ubiquinone oxidoreductase,
which in turn transfers two electrons to the mitochondrial
electron-transport chain by reducing coenzyme Q (CoQ;
Fig. 25-12, Reactions 5–8). Reduction of O
2
to H
2
O by the
electron-transport chain beginning at the CoQ stage re-
sults in the synthesis of 1.5 ATPs per two electrons trans-
ferred (Section 22-2Bc).
b. Acyl-CoA Dehydrogenase Deficiency
Has Fatal Consequences
The unexpected death of an apparently healthy infant,
often overnight, has been, for lack of any real explanation,
termed sudden infant death syndrome (SIDS). MCAD has
been shown to be deficient in up to 10% of these infants,
making this genetic disease more prevalent than phenylke-
tonuria (PKU) (Section 26-3Hd), a genetic defect in
phenylalanine degradation for which babies born in the
United States are routinely tested. Glucose is the principal
energy metabolism substrate just after eating,but when the
glucose level later decreases, the rate of fatty acid oxida-
tion must correspondingly increase. The sudden death of
infants lacking MCAD may be caused by the imbalance
between glucose and fatty acid oxidation.
Lys 304, which becomes Glu in the most prevalent mu-
tation among individuals with MCAD deficiency, is ⬃20 Å
distant from the enzyme’s active site and hence cannot par-
ticipate in binding substrate or FAD. However, since the
side chains of Asp 300 and Asp 346 lie within 6 Å of Glu
304, near a subunit–subunit interface, it seems likely that
the high concentration of negative charges resulting from
the Lys 304 S Glu mutation structurally destabilizes the
enzyme.
Deficiency of acyl-CoA dehydrogenase has also been
implicated in Jamaican vomiting sickness, whose victims
suffer violent vomiting followed by convulsions, coma, and
death. Severe hypoglycemia is observed in most cases. This
condition results from eating unripe ackee fruit, which con-
tains hypoglycin A, an unusual amino acid, which is metab-
olized to methylenecyclopropylacetyl-CoA (MCPA-CoA;
Fig. 25-14). MCPA-CoA, a substrate for acyl-CoA dehy-
drogenase, is thought to undergo the first step of the reac-
tion that this enzyme catalyzes, removal of a proton from
C
␣
, to form a reactive intermediate that covalently modi-
fies the enzyme’s FAD prosthetic group (Fig. 25-14). Since
a normal step in the enzyme’s reaction mechanism gener-
ates the reactive intermediate, MCPA-CoA is said to be a
mechanism-based inhibitor.
c. Long-Chain Enoyl-CoAs Are Converted to
Acetyl-CoA and a Shorter Acyl-CoA by
Mitochondrial Trifunctional Protein
The products of acyl-CoA dehydrogenases are 2-enoyl-
CoAs. Depending on their chain lengths their processing is
continued by one of three systems (Fig. 25-12): the short-
chain, medium-chain, or long-chain 2-enoyl-CoA hydratases
(EHs), hydroxyacyl-CoA dehydrogenases (HADs), and
-ketoacyl-CoA thiolases (KTs). The long-chain (LC) ver-
sions of these enzymes are contained on one ␣
4

4
octameric
protein, mitochondrial trifunctional protein, located in the
inner mitochondrial membrane. LCEH and LCHAD are
contained on the ␣ subunits while LCKT is located on the
 subunits. The protein is therefore a combination multi-
functional protein (more than one enzyme activity on a sin-
948 Chapter 25. Lipid Metabolism
Figure 25-13 Ribbon diagram of the active site region in a
subunit of medium-chain acyl-CoA dehydrogenase from pig liver
mitochondria in complex with octanoyl-CoA. The enzyme is a
tetramer of identical 385-residue subunits, each of which binds an
FAD prosthetic group (green) and its octanoyl-CoA substrate
(whose octanoyl and CoA moieties are blue and white) in largely
extended conformations.The octanoyl-CoA binds such that its
C
␣
¬C

bond is sandwiched between the carboxylate group of
Glu 376 (red) and the flavin ring (green), consistent with the
proposal that Glu 376 is the general base that abstracts the ␣
proton in the ␣, dehydrogenation reaction catalyzed by the
enzyme. [Based on an X-ray structure by Jung-Ja Kim, Medical
College of Wisconsin. PDBid 3MDE.]
See Interactive
Exercise 23
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