11.6. Hemolytic Anemia
Pyruvate kinase deficiency causes hemolytic anemia, since red blood cells depend entirely on glycolysis for ATP synthesis. Pyruvate kinase deficiency causes accumulation of 1,3 BPG and PEP. The concentration of pyruvate and lactate are lower than normal in this disorder.
Acetyl CoA is an allosteric effector of both glycolysis and gluconeogenesis. Acetyl-CoA inhibits pyruvate kinase and reciprocally activates pyruvate carboxylase. Acetyl CoA also inactivates pyruvate dehydrogenase providing a regulatory link between glycolysis and the citric acid cycle. High concentrations of acetyl-CoA are indicative of high energy supplies. When the energy supply is high, metabolites are directed towards storage in the form of glycogen.