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ATP synthase
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ATP Synthase
Molecular model of ATP synthase determined by X-ray crystallography. Stator is not shown here.
Identifiers
EC number
3.6.3.14
CAS number
9000-83-3
Databases
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IntEnz view
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BRENDA entry
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KEGG entry
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metabolic pathway
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proteins
ATP synthase is an enzyme that creates the energy storage molecule adenosine triphosphate (ATP). ATP is the most commonly used "energy currency" of cells for all organisms. It is formed from adenosine diphosphate (ADP) and inorganic phosphate (Pi). The overall reaction catalyzed by ATP synthase is:
ADP + Pi + H+out ⇌ ATP + H2O + H+in
The formation of ATP from ADP and Pi is energetically unfavorable and would normally proceed in the reverse direction. In order to drive this reaction forward, ATP synthase couples ATP synthesis during cellular respiration to an electrochemical gradient created by the difference in proton (H+) concentration across the mitochondrial membrane in eukaryotes or the plasma membrane in bacteria. During photosynthesis in plants, ATP is synthesized by ATP synthase using a proton gradient created in the thylakoid lumen through the thylakoid membrane and into the chloroplast stroma.
ATP synthase consists of two main subunits, FO and F1, which has a rotational motor mechanism allowing for ATP production.[1][2] Because of its rotating subunit ATP Synthase is a molecular machine.
Contents
[hide]
1 Nomenclature
2 Structure and function
2.1 F1 region
2.2 FO region
3 Binding model
4 Physiological role
5 Evolution
6 In different species
6.1 E. coli
6.2 Yeast
6.3 Plant
6.4 Bovine
6.5 Human
7 See also
8 References
9 Further reading
10 External links
Nomenclature[edit]
The F1 fraction derives its name from the term "Fraction 1" and FO (written as a subscript letter "o", not "zero") derives its name from being the binding fraction for oligomycin, a type of naturally-derived antibiotic that is able to inhibit the FO unit of ATP synthase.[3][4] These functional regions consist of different protein subunits — refer to tables. This enzyme is used in synthesis of ATP through aerobic respiration.
Structure and function[edit]
Bovine mitochondrial ATP synthase. The FO, F1, axle, and stator regions are color coded magenta, green, orange, and cyan respectively.[5][6]
Simplified model of FOF1-ATPase alias ATP synthase of E. coli. Subunits of the enzyme are labeled accordingly.
Rotation engine of ATP synthase.
Located within the thylakoid membrane and the inner mitochondrial membrane, ATP synthase consists of two regions FO and F1. FO causes rotation of F1 and is made of c-ring and subunits a, b, d, F6. F1 is made of α , β , γ , δ {\displaystyle \alpha ,\beta ,\gamma ,\delta } subunits. F1 has a water-soluble part that can hydrolyze ATP. FO on the other hand has mainly hydrophobic regions. FO F1 creates a pathway for protons movement across the membrane.[7]
F1 region[edit]
The F1 portion of ATP synthase is hydrophilic and responsible for hydrolyzing ATP. This portion is located through the intermembrane space between the inter membrane space of the mitochondria. Subunits α {\displaystyle \alpha } and β {\displaystyle \beta } make a hexamer with 6 binding sites. Three of them are catalytically inactive and they bind ADP.
Other three subunits catalyze the ATP synthesis. The other F1 subunits γ , δ , ϵ {\displaystyle \gamma ,\delta ,\epsilon } are a part of a rotational motor mechanism. γ {\displaystyle \gamma } subunit allows β {\displaystyle \beta } to go through conformational changes, i.e. closed, half open and open states allows for ATP to be bound and released once synthesized. The F1 particle is large and can be seen in the transmission electron microscope by negative staining.[8] These are particles of 9 nm diameter that pepper the inner mitochondrial membrane.
F1 - Subunits
Subunit
Human Gene
alpha ATP5A1, ATPAF2
beta ATP5B, ATPAF1, C16orf7
gamma ATP5C1
delta ATP5D
epsilon ATP5E
FO region[edit]
FO subunit F6 from the peripheral stalk region of ATP synthase.[9]
Fo is a water insoluble protein with eight subunits and a transmembrane ring. The ring has a tetramer shape with a helix loop helix protein that goes though conformational changes when protonated and deprotonated, pushing neighboring subunits to rotate, causing the spinning of FO which then also affects conformation of F1, resulting in switching of states of alpha and beta subunits. The FO region of ATP synthase is a proton pore that is embedded in the mitochondrial membrane. It consists of three main subunits a, b, and c, and (in humans) six additional subunits, d, e, f, g, F6, and 8 (or A6L). An atomic model for the dimeric yeast FO region was determined by cryo-EM at an overall resolution of 3.6 Å [10] This part of the enzyme is located inside the inter membrane space and is actually the portion that catalyzes the reaction between ADP and the inorganic phosphate.
FO-Main subunits
Subunit
Human Gene
a ATP6
b ATP5F1
c ATP5G1, ATP5G2, ATP5G3
Binding model[edit]
Mechanism of ATP synthase. ADP and Pi (pink) shown being combined into ATP (red), and the rotating γ (gamma) subunit in black causing conformation.
Depiction of ATP synthase using the chemiosmotic proton gradient to power ATP synthesis through oxidative phosphorylation.
In the 1960s through the 1970s, Paul Boyer, a UCLA Professor, developed the binding change, or flip-flop, mechanism theory, which postulated that ATP synthesis is dependent on a conformational change in ATP synthase generated by rotation of the gamma subunit. The research group of John E. Walker, then at the MRC Laboratory of Molecular Biology in Cambridge, crystallized the F1 catalytic-domain of ATP synthase. The structure, at the time the largest asymmetric protein structure known, indicated that Boyer's rotary-catalysis model was, in essence, correct. For elucidating this, Boyer and Walker shared half of the 1997 Nobel Prize in Chemistry.
The crystal structure of the F1 showed alternating alpha and beta subunits (3 of each), arranged like segments of an orange around a rotating asymmetrical gamma subunit. According to the current model of ATP synthesis (known as the alternating catalytic model), the transmembrane potential created by (H+) proton cations supplied by the electron transport chain, drives the (H+) proton cations from the intermembrane space through the membrane via the FO region of ATP synthase. A portion of the FO (the ring of c-subunits) rotates as the protons pass through the membrane. The c-ring is tightly attached to the asymmetric central stalk (consisting primarily of the gamma subunit), causing it to rotate within the alpha3beta3 of F1 causing the 3 catalytic nucleotide binding sites to go through a series of conformational changes that lead to ATP synthesis. The major F1 subunits are prevented from rotating in sympathy with the central stalk rotor by a peripheral stalk that joins the alpha3beta3 to the non-rotating portion of FO. The structure of the intact ATP synthase is currently known at low-resolution from electron cryo-microscopy (cryo-EM) studies of the complex. The cryo-EM model of ATP synthase suggests that the peripheral stalk is a flexible structure that wraps around the complex as it joins F1 to FO. Under the right conditions, the enzyme reaction can also be carried out in reverse, with ATP hydrolysis driving proton pumping across the membrane.
The binding change mechanism involves the active site of a β subunit's cycling between three states.[11] In the "loose" state, ADP and phosphate enter the active site; in the adjacent diagram, this is shown in pink. The enzyme then undergoes a change in shape and forces these molecules together, with the active site in the resulting "tight" state (shown in red) binding the newly produced ATP molecule with very high affinity. Finally, the active site cycles back to the open state (orange), releasing ATP and binding more ADP and phosphate, ready for the next cycle of ATP production.[12]
Physiological role[edit]
Like other enzymes, the activity of F1FO ATP synthase is reversible. Large-enough quantities of ATP cause it to create a transmembrane proton gradient, this is used by fermenting bacteria that do not have an electron transport chain, but rather hydrolyze ATP to make a proton gradient, which they use to drive flagella and the transport of nutrients into the cell.
In respiring bacteria under physiological conditions, ATP synthase, in general, runs in the opposite direction, creating ATP while using the proton motive force created by the electron transport chain as a source of energy. The overall process of creating energy in this fashion is termed oxidative phosphorylation. The same process takes place in the mitochondria, where ATP synthase is located in the inner mitochondrial membrane and the F1-part projects into mitochondrial matrix. The consumption of ATP by ATP-synthase pumps proton cations into the matrix.
Evolution[edit]
The evolution of ATP synthase is thought to have been modular whereby two functionally independent subunits became associated and gained new functionality.[13][14] This association appears to have occurred early in evolutionary history, because essentially the same structure and activity of ATP synthase enzymes are present in all kingdoms of life.[13] The F-ATP synthase displays high functional and mechanistic similarity to the V-ATPase.[15] However, whereas the F-ATP synthase generates ATP by utilising a proton gradient, the V-ATPase generates a proton gradient at the expense of ATP, generating pH values of as low as 1.[16]
The F1 region also shows significant similarity to hexameric DNA helicases, and the FO region shows some similarity to H+
-powered flagellar motor complexes.[15] The α3β3 hexamer of the F1 region shows significant structural similarity to hexameric DNA helicases; both form a ring with 3-fold rotational symmetry with a central pore. Both have roles dependent on the relative rotation of a macromolecule within the pore; the DNA helicases use the helical shape of DNA to drive their motion along the DNA molecule and to detect supercoiling, whereas the α3β3 hexamer uses the conformational changes through the rotation of the γ subunit to drive an enzymatic reaction.[17]
The H+
motor of the FO particle shows great functional similarity to the H+
motors that drive flagella.[15] Both feature a ring of many small alpha-helical proteins that rotate relative to nearby stationary proteins, using a H+
potential gradient as an energy source. This link is tenuous, however, as the overall structure of flagellar motors is far more complex than that of the FO particle and the ring with about 30 rotating proteins is far larger than the 10, 11, or 14 helical proteins in the FO complex.
The modular evolution theory for the origin of ATP synthase suggests that two subunits with independent function, a DNA helicase with ATPase activity and a H+
motor, were able to bind, and the rotation of the motor drove the ATPase activity of the helicase in reverse.[13][17] This complex then evolved greater efficiency and eventually developed into today's intricate ATP synthases. Alternatively, the DNA helicase/H+
motor complex may have had H+
pump activity with the ATPase activity of the helicase driving the H+
motor in reverse.[13] This may have evolved to carry out the reverse reaction and act as an ATP synthase.[14][18][19]
In different species[edit]
E. coli[edit]
E. coli ATP synthase is the simplest known form of ATP synthase, with 8 different subunit types.[20]
Yeast[edit]
Yeast ATP synthase is one of the best-studied eukaryotic ATP synthases; and five F1, eight FO subunits, and seven associated proteins have been identified.[7] Most of these proteins have homologues in other eukaryotes.[21][22][23]
Plant[edit]
In plants, ATP synthase is also present in chloroplasts (CF1FO-ATP synthase). The enzyme is integrated into thylakoid membrane; the CF1-part sticks into stroma, where dark reactions of photosynthesis (also called the light-independent reactions or the Calvin cycle) and ATP synthesis take place. The overall structure and the catalytic mechanism of the chloroplast ATP synthase are almost the same as those of the mitochondrial enzyme. However, in chloroplasts, the proton motive force is generated not by respiratory electron transport chain but by primary photosynthetic proteins.
Bovine[edit]
The ATP synthase isolated from bovine heart mitochondria (Bos taurus) is, in terms of biochemistry and structure, the best-characterized ATP synthase. Beef heart is used as a source for the enzyme because of the high concentration of mitochondria in cardiac muscle.[24][25][26]
Human[edit]
The following is a list of humans genes that encode components of ATP synthases:
ATP5A1, ATP5AL1
ATP5B, ATP5BL1
ATP5C2, ATP5D, ATP5E, ATP5F1, ATP5G1, ATP5G2, ATP5G3, ATP5H, ATP5HP1, ATP5I, ATP5J, ATP5J2, ATP5L, ATP5L2, ATP5O, ATP5S
ATP6, ATP6AP1, ATP6AP2
ATPSBL1, ATPSBL2
MT-ATP6, MT-ATP8
See also[edit]
ATP10 protein required for the assembly of the FO sector of the mitochondrial ATPase complex.
Chloroplast
Electron transfer chain
Flavoprotein
Mitochondrion
Oxidative phosphorylation
P-ATPase
Proton pump
Rotating locomotion in living systems
Transmembrane ATPase
V-ATPase
References[edit]
Jump up ^ Okuno D, Iino R, Noji H (April 2011). "Rotation and structure of FOF1-ATP synthase". Journal of Biochemistry. 149 (6): 655–64. doi:10.1093/jb/mvr049. PMID 21524994.
Jump up ^ Junge W, Nelson N (June 2015). "ATP synthase". Annual Review of Biochemistry. 84: 631–57. doi:10.1146/annurev-biochem-060614-034124. PMID 25839341.
Jump up ^ Kagawa Y, Racker E (May 1966). "Partial resolution of the enzymes catalyzing oxidative phosphorylation. 8. Properties of a factor conferring oligomycin sensitivity on mitochondrial adenosine triphosphatase". The Journal of Biological Chemistry. 241 (10): 2461–6. PMID 4223640.
Jump up ^ Mccarty RE (November 1992). "A plant biochemist's view of H+
-ATPases and ATP synthases". The Journal of Experimental Biology. 172 (Pt 1): 431–441. PMID 9874753.
Jump up ^ PDB: 5ARA; Zhou A, Rohou A, Schep DG, Bason JV, Montgomery MG, Walker JE, Grigorieff N, Rubinstein JL (October 2015). "Structure and conformational states of the bovine mitochondrial ATP synthase by cryo-EM". eLife. 4: e10180. doi:10.7554/eLife.10180. PMC 4718723  . PMID 26439008.
Jump up ^ Goodsell D (December 2005). "ATP Synthase". Molecule of the Month. RCSB PDB. doi:10.2210/rcsb_pdb/mom_2005_12.
^ Jump up to: a b Velours J, Paumard P, Soubannier V, Spannagel C, Vaillier J, Arselin G, Graves PV (May 2000). "Organisation of the yeast ATP synthase F(0):a study based on cysteine mutants, thiol modification and cross-linking reagents". Biochimica et Biophysica Acta. 1458 (2–3): 443–56. doi:10.1016/S0005-2728(00)00093-1. PMID 10838057.
Jump up ^ Fernandez Moran H, Oda T, Blair PV, Green DE (July 1964). "A macromolecular repeating unit of mitochondrial structure and function. Correlated electron microscopic and biochemical studies of isolated mitochondria and submitochondrial particles of beef heart muscle". The Journal of Cell Biology. 22 (1): 63–100. doi:10.1083/jcb.22.1.63. PMC 2106494  . PMID 14195622.
Jump up ^ PDB: 1VZS; Carbajo RJ, Silvester JA, Runswick MJ, Walker JE, Neuhaus D (2004). "Solution structure of subunit F(6) from the peripheral stalk region of ATP synthase from bovine heart mitochondria". Journal of Molecular Biology. 342 (2): 593–603. doi:10.1016/j.jmb.2004.07.013. PMID 15327958.
Jump up ^ Guo H, Bueler SA, Rubinstein JL (Nov 2017). "Atomic model for the dimeric FO region of mitochondrial ATP synthase". Science. 358 (6365): 936–40. Bibcode:2017Sci...358..936G. doi:10.1126/science.aao4815. PMID 29074581.
Jump up ^ Gresser MJ, Myers JA, Boyer PD (October 1982). "Catalytic site cooperativity of beef heart mitochondrial F1 adenosine triphosphatase. Correlations of initial velocity, bound intermediate, and oxygen exchange measurements with an alternating three-site model". The Journal of Biological Chemistry. 257 (20): 12030–8. PMID 6214554.
Jump up ^ Nakamoto RK, Baylis Scanlon JA, Al-Shawi MK (August 2008). "The rotary mechanism of the ATP synthase". Archives of Biochemistry and Biophysics. 476 (1): 43–50. doi:10.1016/j.abb.2008.05.004. PMC 2581510  . PMID 18515057.
^ Jump up to: a b c d Doering C, Ermentrout B, Oster G (December 1995). "Rotary DNA motors". Biophysical Journal. 69 (6): 2256–67. Bibcode:1995BpJ....69.2256D. doi:10.1016/S0006-3495(95)80096-2. PMC 1236464  . PMID 8599633.
^ Jump up to: a b Crofts A. "Lecture 10:ATP synthase". Life Sciences at the University of Illinois at Urbana-Champaign.
^ Jump up to: a b c "ATP Synthase". InterPro Database.
Jump up ^ Beyenbach, KW; Wieczorek, H (Feb 2006). "The V-type H+ ATPase: molecular structure and function, physiological roles and regulation". J Exp Biol. 209 (4): 577–89. PMID 16449553.
^ Jump up to: a b Martinez LO, Jacquet S, Esteve JP, Rolland C, Cabezón E, Champagne E, Pineau T, Georgeaud V, Walker JE, Tercé F, Collet X, Perret B, Barbaras R (January 2003). "Ectopic beta-chain of ATP synthase is an apolipoprotein A-I receptor in hepatic HDL endocytosis". Nature. 421 (6918): 75–9. Bibcode:2003Natur.421...75M. doi:10.1038/nature01250. PMID 12511957.
Jump up ^ Cross RL, Taiz L (January 1990). "Gene duplication as a means for altering H+/ATP ratios during the evolution of FOF1 ATPases and synthases". FEBS Letters. 259 (2): 227–9. doi:10.1016/0014-5793(90)80014-a. PMID 2136729.
Jump up ^ Cross RL, Müller V (October 2004). "The evolution of A-, F-, and V-type ATP synthases and ATPases: reversals in function and changes in the H+/ATP coupling ratio". FEBS Letters. 576 (1–2): 1–4. doi:10.1016/j.febslet.2004.08.065. PMID 15473999.
Jump up ^ Ahmad Z, Okafor F, Laughlin TF (2011). "Role of Charged Residues in the Catalytic Sites of Escherichia coli ATP Synthase". Journal of Amino Acids. 2011: 785741. doi:10.4061/2011/785741. PMC 3268026  . PMID 22312470.
Jump up ^ Devenish RJ, Prescott M, Roucou X, Nagley P (May 2000). "Insights into ATP synthase assembly and function through the molecular genetic manipulation of subunits of the yeast mitochondrial enzyme complex". Biochimica et Biophysica Acta. 1458 (2–3): 428–42. doi:10.1016/S0005-2728(00)00092-X. PMID 10838056.
Jump up ^ Kabaleeswaran V, Puri N, Walker JE, Leslie AG, Mueller DM (November 2006). "Novel features of the rotary catalytic mechanism revealed in the structure of yeast F1 ATPase". The EMBO Journal. 25 (22): 5433–42. doi:10.1038/sj.emboj.7601410. PMC 1636620  . PMID 17082766.
Jump up ^ Stock D, Leslie AG, Walker JE (November 1999). "Molecular architecture of the rotary motor in ATP synthase". Science. 286 (5445): 1700–5. doi:10.1126/science.286.5445.1700. PMID 10576729.
Jump up ^ Abrahams JP, Leslie AG, Lutter R, Walker JE (August 1994). "Structure at 2.8 A resolution of F1-ATPase from bovine heart mitochondria". Nature. 370 (6491): 621–8. Bibcode:1994Natur.370..621A. doi:10.1038/370621a0. PMID 8065448.
Jump up ^ Gibbons C, Montgomery MG, Leslie AG, Walker JE (November 2000). "The structure of the central stalk in bovine F(1)-ATPase at 2.4 A resolution". Nature Structural Biology. 7 (11): 1055–61. doi:10.1038/80981. PMID 11062563.
Jump up ^ Menz RI, Walker JE, Leslie AG (August 2001). "Structure of bovine mitochondrial F(1)-ATPase with nucleotide bound to all three catalytic sites: implications for the mechanism of rotary catalysis". Cell. 106 (3): 331–41. doi:10.1016/s0092-8674(01)00452-4. PMID 11509182.
Further reading[edit]
Nick Lane: The Vital Question - Energy, Evolution, and the Origins of Complex Life, Ww Norton, 2015-07-20, ISBN 978-0393088816 (Link points to Figure 10 showing model of ATP synthase)
External links[edit]
Boris A. Feniouk: "ATP synthase — a splendid molecular machine"
Well illustrated ATP synthase lecture by Antony Crofts of the University of Illinois at Urbana-Champaign.
Proton and Sodium translocating F-type, V-type and A-type ATPases in OPM database
The Nobel Prize in Chemistry 1997 to Paul D. Boyer and John E. Walker for the enzymatic mechanism of synthesis of ATP; and to Jens C. Skou, for discovery of an ion-transporting enzyme, Na+
, K+
-ATPase.
Harvard Multimedia Production Site — Videos — ATP synthesis animation
David Goodsell: "ATP Synthase- Molecule of the Month"
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Membrane transport protein: ion pumps, ATPases / ATP synthase (TC 3A2-3A3)
F-, V-, and A-type ATPase (3.A.2)
H+ (F-type)
H+ transporting, mitochondrial: ATP5A1
ATP5B
ATP5C1
ATP5C2
ATP5D
ATP5E
ATP5F1
ATP5G1
ATP5G2
ATP5G3
ATP5H
ATP5I
ATP5J
ATP5J2
ATP5L
ATP5L2
ATP5O
ATP5S
H+ (V-type)
H+ transporting, lysosomal: ATP6AP1
ATP6AP2
ATP6V1A
ATP6V1B1
ATP6V1B2
ATP6V1C1
ATP6V1C2
ATP6V1D
ATP6V1E1
ATP6V1E2
ATP6V1F
ATP6V1G1
ATP6V1G2
ATP6V1G3
ATP6V1H
ATP6V0A1
ATP6V0A2
ATP6V0A4
ATP6V0B
ATP6V0C
ATP6V0D1
ATP6V0D2
ATP6V0E
ATP6V0E1
TCIRG1
A-ATPase
found in Archea
P-type ATPase (3.A.3)
3.A.3.1.1: Na+/K+ transporting: ATP1A1
ATP1A2
ATP1A3
ATP1A4
ATP1B1
ATP1B2
ATP1B3
ATP1B4
ATP1G1
3.A.3.1.2: H+/K+
H+/K+ exchanging: ATP4A
ATP4B
3.A.3.1.4: H+/K+ transporting, nongastric: ATP12A
3.A.3.2: Ca2+ (SERCA, PMCA, SPCA) / Ca2+ transporting: ATP2A1
ATP2A2
ATP2A3
ATP2B1
ATP2B2
ATP2B3
ATP2B4
ATP2C1
3.A.3.5: Cu2+ transporting: ATP7A
ATP7B
3.A.3.8.8: flippase: ATP8A2
Other/ungrouped:
Na+/K+ – H+
Mg2+ transporting: ATP3
Class I, type 8: ATP8A1
ATP8B1
ATP8B2
ATP8B3
ATP8B4
Class II, type 9: ATP9A
ATP9B
Class V, type 10: ATP10A
ATP10B
ATP10D
Class VI, type 11: ATP11A
ATP11B
ATP11C
type 13: ATP13A1
ATP13A2
ATP13A3
ATP13A4
ATP13A5
see also ATPase disorders
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MT-CYB
Complex IV
MT-CO1
MT-CO2
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ATP synthase
MT-ATP6
MT-ATP8
tRNA
MT-TA
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MT-TK
MT-TL1
MT-TL2
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MT-TS1
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MT-TV
MT-TW
MT-TY
see also mitochondrial diseases
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Hydrolases: acid anhydride hydrolases (EC 3.6)
3.6.1
Pyrophosphatase
Inorganic
Thiamine
Apyrase
Thiamine-triphosphatase
3.6.2
Adenylylsulfatase
Phosphoadenylylsulfatase
3.6.3-4: ATPase
3.6.3
Cu++ (3.6.3.4)
Menkes/ATP7A
Wilson/ATP7B
Ca+ (3.6.3.8)
SERCA
ATP2A1
ATP2A2
ATP2A3
Plasma membrane
ATP2B1
ATP2B2
ATP2B3
ATP2B4
SPCA
ATP2C1
ATP2C2
Na+/K+ (3.6.3.9)
ATP1A1
ATP1A2
ATP1A3
ATP1A4
ATP1B1
ATP1B2
ATP1B3
ATP1B4
H+/K+ (3.6.3.10)
ATP4A
Other P-type ATPase
ATP8B1
ATP10A
ATP11B
ATP12A
ATP13A2
ATP13A3
3.6.4
Dynein
Kinesin
Myosin
Katanin
3.6.5: GTPase
3.6.5.1: Heterotrimeric G protein
Gαs
Gαi
GNAI1
GNAI2
GNAI3
Gαq/11
GNAQ
GNA11
Gα12/13
GNA12
GNA13
Transducin
GNAT1
GNAT2
Gustducin
GNAT3
3.6.5.2: Small GTPase > Ras superfamily
Rho family of GTPases: Cdc42
CDC42
TC10
TCL
RhoUV
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Rac
Rac1
2
3
RhoG
RhoBTB
1
2
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Rho
A
B
C
Rnd
1
2
3
RhoDF
RhoF
RhoD
other: Ras
HRAS
KRAS
NRAS
Rab
RAB23
RAB27
Arf
ARF6
SAR1B
ARL13B
ARL6
Ran
Rheb
Rap
RGK
3.6.5.3: Protein-synthesizing GTPase
Prokaryotic
IF-2
EF-Tu
EF-G
Eukaryotic
3.6.5.5-6: Polymerization motors
Dynamin
Tubulin
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Molecular and Cellular Biology portal
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text:
Health professional
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search
A health professional, health practitioner or healthcare provider (sometimes simply "provider") is an individual who provides preventive, curative, promotional or rehabilitative health care services in a systematic way to people, families or communities.
A health professional may operate within all branches of health care, including medicine, surgery, dentistry, midwifery, pharmacy, psychology, nursing or allied health professions. A health professional may also be a public/community health expert working for the common good of the society.
Contents
[hide]
1 Practitioners and professionals
1.1 Mental health practitioners
1.2 Maternal and newborn health practitioners
1.3 Geriatric care practitioners
1.4 Surgical practitioners
1.5 Rehabilitation care practitioners
1.6 Eye care practitioners
1.7 Medical diagnosis providers
1.8 Oral care practitioners
1.9 Foot care practitioners
1.10 Public health practitioners
1.11 Alternative medicine practitioners
2 Practice conditions and regulations
2.1 Shortages of health professionals
2.2 Occupational hazards
2.3 Regulation and registration of professionals
3 See also
4 References
5 External links
Practitioners and professionals[edit]
Health practitioners
and professionals
Athletic trainer
Audiologist
Chiropractor
Clinical coder
Clinical nurse specialist
Clinical officer
Community health worker
Dentist
Dietitian and nutritionist
Emergency medical technician
Feldsher
Health administrator
Medical assistant
Medical laboratory scientist
Medical transcriptionist
Nurse anesthetist
Nurse practitioner
Nurse midwives
Nurse
Occupational Therapist
Optometrist
Paramedic
Pharmacist
Pharmaconomist
Pharmacy technician
Phlebotomist
Physician
Physician assistant
Podiatrist
Psychologist
Psychotherapist
Physical therapist
Radiographer
Radiotherapist
Respiratory therapist
Speech-language pathologist
Surgeon
Surgeon's assistant
Surgical technologist
v
t
e
Healthcare practitioners include
physicians
dentists
dental hygienists
pharmacists
pharmacy technicians
physician assistants
nurses
advanced practice registered nurses
surgeons,
surgeon's assistant
athletic trainers
surgical technologist
midwives
dietitians
therapists
psychologists
chiropractors
clinical officers
social workers
phlebotomists
occupational therapists
optometrists
physical therapists
radiographers
radiotherapists
respiratory therapists
audiologists
speech pathologists
operating department practitioners
emergency medical technicians
paramedics
medical laboratory scientists
medical prosthetic technicians
naturopaths
and a wide variety of other human resources trained to provide some type of health care service.
They often work in hospitals, healthcare centres and other service delivery points, but also in academic training, research and administration. Some provide care and treatment services for patients in private homes. Many countries have a large number of community health workers who work outside formal healthcare institutions. Managers of healthcare services, health information technicians, and other assistive personnel and support workers are also considered a vital part of health care teams.[1]
Healthcare practitioners are commonly grouped into health professions. Within each field of expertise, practitioners are often classified according to skill level and skill specialization. “Health professionals” are highly skilled workers, in professions that usually require extensive knowledge including university-level study leading to the award of a first degree or higher qualification.[2] This category includes physicians, physician assistants, dentists, midwives, radiographers, registered nurses, pharmacists, physiotherapists, optometrists, operating department practitioners and others. Allied health professionals, also referred to as "health associate professionals" in the International Standard Classification of Occupations, support implementation of health care, treatment and referral plans usually established by medical, nursing, and other health professionals, and usually require formal qualifications to practice their profession. In addition, unlicensed assistive personnel assist with providing health care services as permitted.
Another way to categorize healthcare practitioners is according to the sub-field in which they practice, such as mental health care, pregnancy and childbirth care, surgical care, rehabilitation care, or public health.
Mental health practitioners[edit]
Main article: Mental health professional
A mental health practitioner is a health worker who offers services for the purpose of improving the mental health of individuals or treating mental illness. These include psychiatrists, clinical psychologists, clinical social workers, psychiatric-mental health nurse practitioners, marriage and family therapists, mental health counselors, as well as other health professionals and allied health professions. These health care providers often deal with the same illnesses, disorders, conditions, and issues; however their scope of practice often differs. The most significant difference across categories of mental health practitioners is education and training.[3]
Maternal and newborn health practitioners[edit]
Main articles: Obstetrics, Midwifery, and Birth attendant
A maternal and newborn health practitioner is a health worker who deals with the care of women and their children before, during and after pregnancy and childbirth. Such health practitioners include obstetricians, midwives, obstetrical nurses and many others. One of the main differences between these professions is in the training and authority to provide surgical services and other life-saving interventions.[4] In some developing countries, traditional birth attendants, or traditional midwives, are the primary source of pregnancy and childbirth care for many women and families, although they are not certified or licensed.
Geriatric care practitioners[edit]
Main articles: Geriatrics and Geriatric care management
A geriatric care practitioner plans and coordinates the care of the elderly and/or disabled to promote their health, improve their quality of life, and maintain their independence for as long as possible. They include geriatricians, adult-gerontology nurse practitioners, clinical nurse specialists, geriatric clinical pharmacists, geriatric nurses, geriatric care managers, geriatric aides, Nursing aides, Caregivers and others who focus on the health and psychological care needs of older adults.
Surgical practitioners[edit]
A surgical practitioner is a healthcare professional who specializes in the planning and delivery of a patient's perioperative care, including during the anaesthetic, surgical and recovery stages. They may include general and specialist surgeons, surgeon's assistant, assistant surgeon, surgical assistant, anesthesiologists, anesthesiologist assistant, nurse anesthetists, surgical nurses, clinical officers, operating department practitioners, anaesthetic technicians, perioperative nursing, surgical technologists, and others.
Rehabilitation care practitioners[edit]
A rehabilitation care practitioner is a health worker who provides care and treatment which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. These include physiatrists, rehabilitation nurses, clinical nurse specialists, nurse practitioners, physiotherapists, orthotists, prosthetists, occupational therapists, recreational therapists, audiologists, speech and language pathologists, respiratory therapists, rehabilitation counsellors, physical rehabilitation therapists, athletic trainers, physiotherapy technicians, orthotic technicians, prosthetic technicians, personal care assistants, and others.[5]
Eye care practitioners[edit]
Main articles: Ophthalmology and Optometry
Care and treatment for the eye and the adnexa may be delivered by ophthalmologists specializing in surgical/medical care, or optometrists specializing in refractive management and medical/therapeutic care.
Medical diagnosis providers[edit]
Main article: Medical diagnosis
Medical diagnosis providers are health workers responsible for the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. This usually involves a team of healthcare providers in various diagnostic units. These include radiographers, radiologists, medical laboratory scientists, pathologists, and related professionals.
Oral care practitioners[edit]
Main article: Dentistry
A dental care practitioner is a health worker who provides care and treatment to promote and restore oral health. These include dentists and dental surgeons, dental assistants, dental auxiliaries, dental hygienists, dental nurses, dental technicians, dental therapists, and related professionals.
Foot care practitioners[edit]
Care and treatment for the foot, ankle, and lower leg may be delivered by podiatrists, pedorthists, foot health practitioners, podiatric medical assistants, podiatric nurse and others.
Public health practitioners[edit]
A public health practitioner focuses on improving health among individuals, families and communities through the prevention and treatment of diseases and injuries, surveillance of cases, and promotion of healthy behaviors. This category includes community and preventive medicine specialists, public health nurses, clinical nurse specialists, dietitians, environmental health officers, paramedics, epidemiologists, health inspectors, and others.
Alternative medicine practitioners[edit]
In many societies, practitioners of alternative medicine have contact with a significant number of people, either as integrated within or remaining outside the formal health care system. These include practitioners in acupuncture, Ayurveda, herbalism, homeopathy, naturopathy, Siddha medicine, traditional Chinese medicine, traditional Korean medicine, and Unani. In some countries such as Canada, chiropractors and osteopaths (not to be confused with doctors of osteopathic medicine in the United States) are considered alternative medicine practitioners.
Practice conditions and regulations[edit]
Shortages of health professionals[edit]
See also: Health workforce, Doctor shortage, and Nursing shortage
Many jurisdictions report shortfalls in the number of trained health human resources to meet population health needs and/or service delivery targets, especially in medically underserved areas. For example, in the United States, the 2010 federal budget invested $330 million to increase the number of doctors, nurses, and dentists practicing in areas of the country experiencing shortages of trained health professionals. The Budget expands loan repayment programs for physicians, nurses, and dentists who agree to practice in medically underserved areas. This funding will enhance the capacity of nursing schools to increase the number of nurses. It will also allow states to increase access to oral health care through dental workforce development grants. The Budget’s new resources will sustain the expansion of the health care workforce funded in the Recovery Act.[6] There were 15.7 million health care professionals in the US as of 2011.[7]
In Canada, the 2011 federal budget announced a Canada Student Loan forgiveness program to encourage and support new family physicians, nurse practitioners and nurses to practice in underserved rural or remote communities of the country, including communities that provide health services to First Nations and Inuit populations.[8]
In Uganda, the Ministry of Health reports that as many as 50% of staffing positions for health workers in rural and underserved areas remain vacant. As of early 2011, the Ministry was conducting research and costing analyses to determine the most appropriate attraction and retention packages for medical officers, nursing officers, pharmacists, and laboratory technicians in the country’s rural areas.[9]
At the international level, the World Health Organization estimates a shortage of almost 4.3 million doctors, midwives, nurses, and support workers worldwide to meet target coverage levels of essential primary health care interventions.[10] The shortage is reported most severe in 57 of the poorest countries, especially in sub-Saharan Africa.
Occupational hazards[edit]
See also: Occupational hazards in dentistry
A healthcare professional wears an air sampling device to investigate exposure to airborne influenza
Play media
A video describing the Occupational Health and Safety Network, a tool for monitoring occupational hazards to health care workers
Occupational stress and occupational burnout are highly prevalent among health professionals.[11] Some studies suggest that workplace stress is pervasive in the health care industry because of inadequate staffing levels, long work hours, exposure to infectious diseases and hazardous substances leading to illness or death, and in some countries threat of malpractice litigation. Other stressors include the emotional labor of caring for ill people and high patient loads. The consequences of this stress can include substance abuse, suicide, major depressive disorder, and anxiety, all of which occur at higher rates in health professionals than the general working population. Elevated levels of stress are also linked to high rates of burnout, absenteeism and diagnostic errors, and to reduced rates of patient satisfaction.[12] In Canada, a national report (Canada's Health Care Providers) also indicated higher rates of absenteeism due to illness or disability among health care workers compared to the rest of the working population, although those working in health care reported similar levels of good health and fewer reports of being injured at work.[13] There is some evidence that cognitive-behavioral therapy, relaxation training and therapy (including meditation and massage), and modifying schedules can reduce stress and burnout among multiple sectors of health care providers. Research is ongoing in this area, especially with regards to physicians, whose occupational stress and burnout is less researched compared to other health professions.[14]
Exposure to respiratory infectious diseases like tuberculosis (caused by Mycobacterium tuberculosis) and influenza can be reduced with the use of respirators; this exposure is a significant occupational hazard for health care professionals.[15] Exposure to dangerous chemicals, including chemotherapy drugs, is another potential occupational risk. These drugs can cause cancer and other health conditions.[16] Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, including scabies.[17] Health professionals are also at risk for contracting blood-borne diseases like hepatitis B, hepatitis C, and HIV/AIDS through needlestick injuries or through contact with bodily fluids.[18][19] This risk can be mitigated with vaccination when there is a vaccine available, like with hepatitis B.[19] In epidemic situations, such as the 2014-2016 West African Ebola virus epidemic or the 2003 SARS outbreak, healthcare workers are at even greater risk, and were disproportionately affected in both the Ebola and SARS outbreaks. In general, appropriate personal protective equipment (PPE) is the first-line mode of protection for healthcare workers from infectious diseases. For it to be effective against highly contagious diseases, personal protective equipment must be watertight and prevent the skin and mucous membranes from contacting infectious material. Different levels of personal protective equipment created to unique standards are used in situations where the risk of infection is different. Practices such as triple gloving and multiple respirators do not provide a higher level of protection and present a burden to the worker, who is additionally at increased risk of exposure when removing the PPE. Compliance with appropriate personal protective equipment rules may be difficult in certain situations, such as tropical environment or low-resource settings. A 2016 Cochrane systematic review found low quality evidence that using more breathable fabric in PPE, double gloving, and active training reduce the risk of contamination.[20]
Female health care workers may face specific types of workplace-related health conditions and stress. According to the World Health Organization, women predominate in the formal health workforce in many countries, and are prone to musculoskeletal injury (caused by physically demanding job tasks such as lifting and moving patients) and burnout. Female health workers are exposed to hazardous drugs and chemicals in the workplace which may cause adverse reproductive outcomes such as spontaneous abortion and congenital malformations. In some contexts, female health workers are also subject to gender-based violence including from coworkers and patients.[21][22]
Healthcare workers are at higher risk of on-the-job injury due to violence. Drunk, confused, and hostile patients and visitors are a continual threat to providers attempting to treat patients. Frequently, assault and violence in a healthcare setting goes unreported and is wrongly assumed to be part of the job.[23] Violent incidents typically occur during one-on-one care; being alone with patients increases healthcare workers' risk of assault.[24] In the United States, healthcare workers suffer ⅔ of nonfatal workplace violence incidents.[23] Psychiatric units represent the highest proportion of violent incidents, at 40%; they are followed by geriatric units (20%) and the emergency department (10%). Workplace violence can also cause psychological trauma.[24]
The Occupational Health Safety Network is a system developed by the National Institute for Occupational Safety and Health (NIOSH) to address health and safety risks among health care providers. Hospitals and other healthcare facilities can upload the occupational injury data they already collect to the secure database for analysis and benchmarking with other de-identified facilities from throughout the U.S. NIOSH works with OHSN participants in identifying and implementing timely and targeted interventions. OHSN modules currently focus on three high risk and preventable events that can lead to injuries or musculoskeletal disorders among healthcare providers: musculoskeletal injuries from patient handling activities; slips, trips, and falls; and workplace violence.[23] Slips, trips, and falls are the second-most common cause of worker's compensation claims in the US, and cause 21% of work absences due to injury. These injuries most commonly result in strains and sprains; women, those older than 45, and those who have been working less than a year in a healthcare setting are at the highest risk.[7]
Health care professionals are also likely to experience sleep deprivation due to their jobs. Many health care professionals are on a shift work schedule, and therefore experience misalignment of their work schedule and their circadian rhythm. In 2007, 32% of healthcare workers were found to get fewer than 6 hours of sleep a night. Sleep deprivation also predisposes healthcare professionals to make mistakes that may potentially endanger a patient.[25]
Regulation and registration of professionals[edit]
Main article: Health professional requisites
Practicing without a license that is valid and current is typically illegal. In most jurisdictions, the provision of health care services is regulated by the government. Individuals found to be providing medical, nursing or other professional services without the appropriate certification or license may face sanctions and criminal charges leading to a prison term. The number of professions subject to regulation, requisites for individuals to receive professional licensure, and nature of sanctions that can be imposed for failure to comply vary across jurisdictions.
In the United States, under Michigan state laws, an individual is guilty of felony if identified as practicing in the health profession without a valid personal license or registration. Health professionals can also be imprisoned if found guilty of practicing beyond the limits allowed by their licences and registration. The state laws define the scope of practice for medicine, nursing, and a number of allied health professions.[26][unreliable source?] In Florida, practicing medicine without the appropriate license is a crime classified as a third degree felony,[27] which may give imprisonment up to five years. Practicing a health care profession without a license which results in serious bodily injury classifies as a second degree felony,[27] providing up to 15 years' imprisonment.
In the United Kingdom, healthcare professionals are regulated by the state; the UK Health and Care Professions Council (HCPC) protects the 'title' of each profession it regulates. For example, it is illegal for someone to call himself an Occupational Therapist or Radiographer if they are not on the register held by the HCPC.
See also[edit]
List of healthcare occupations
Community health center
Chronic care management
Electronic superbill
Geriatric care management
Health care
Health human resources
References[edit]
Jump up ^ World Health Organization, 2006. World Health Report 2006: working together for health. Geneva: WHO.
Jump up ^ World Health Organization, 2010. Classifying health workers. Geneva "Archived copy" (PDF). Archived (PDF) from the original on 2015-08-16. Retrieved 2016-02-13.
Jump up ^ "Difference Between Psychologists and Psychiatrists". Psychology.about.com. 2007. Archived from the original on April 3, 2007. Retrieved March 4, 2007.
Jump up ^ Gupta N et al. "Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes. Archived 2015-09-24 at the Wayback Machine. Human Resources for Health, 2011, 9(16). Retrieved 20 October 2011.
Jump up ^ Gupta N et al. "Health-related rehabilitation services: assessing the global supply of and need for human resources." Archived 2012-07-20 at the Wayback Machine. BMC Health Services Research, 2011, 11:276. Published 17 October 2011. Retrieved 20 October 2011.
Jump up ^ "Archived copy" (PDF). Archived (PDF) from the original on 2009-03-06. Retrieved 2009-03-06.
^ Jump up to: a b Collins, James W.; Bell, Jennifer L. (June 11, 2012). "Slipping, Tripping, and Falling at Work". NIOSH: Workplace Safety and Health. Medscape and NIOSH. Archived from the original on December 3, 2012.
Jump up ^ Government of Canada. 2011. Canada's Economic Action Plan: Forgiving Loans for New Doctors and Nurses in Under-Served Rural and Remote Areas. Ottawa, 22 March 2011. Retrieved 23 March 2011.
Jump up ^ Rockers P et al. Determining Priority Retention Packages to Attract and Retain Health Workers in Rural and Remote Areas in Uganda. Archived 2011-05-23 at the Wayback Machine. CapacityPlus Project. February 2011.
Jump up ^ "The World Health Report 2006 - Working together for health". Geneva: WHO: World Health Organization. 2006. Archived from the original on 2011-02-28.
Jump up ^ Ruotsalainen, Jani H.; Verbeek, Jos H.; Mariné, Albert; Serra, Consol (2015-04-07). "Preventing occupational stress in healthcare workers". The Cochrane Database of Systematic Reviews (4): CD002892. doi:10.1002/14651858.CD002892.pub5. ISSN 1469-493X. PMID 25847433. Archived from the original on 2016-12-27.
Jump up ^ "Exposure to Stress: Occupational Hazards in Hospitals". NIOSH Publication No. 2008–136. National Institute for Occupational Safety and Health (NIOSH). 2 December 2008. Archived from the original on 12 December 2008.
Jump up ^ Canadian Institute for Health Information. Canada's Health Care Providers, 2007 Archived 2011-09-27 at the Wayback Machine. Ottawa, 2007.
Jump up ^ Ruotsalainen, JH; Verbeek, JH; Mariné, A; Serra, C (7 April 2015). "Preventing occupational stress in healthcare workers". The Cochrane Database of Systematic Reviews (4): CD002892. doi:10.1002/14651858.CD002892.pub5. PMID 25847433.
Jump up ^ Bergman, Michael; Zhuang, Ziqing; Shaffer, Ronald E. (25 July 2013). "Advanced Headforms for Evaluating Respirator Fit". National Institute for Occupational Safety and Health. Archived from the original on 16 January 2015. Retrieved 18 January 2015.
Jump up ^ Connor, Thomas H. (March 7, 2011). "Hazardous Drugs in Healthcare". NIOSH: Workplace Safety and Health. Medscape and NIOSH. Archived from the original on March 7, 2012.
Jump up ^ FitzGerald, Deirdre; Grainger, Rachel J.; Reid, Alex (2014). "Interventions for preventing the spread of infestation in close contacts of people with scabies". The Cochrane Database of Systematic Reviews. 2 (2): CD009943. doi:10.1002/14651858.CD009943.pub2. ISSN 1469-493X. PMID 24566946.
Jump up ^ Cunningham, Thomas; Burnett, Garrett (17 May 2013). "Does your workplace culture help protect you from hepatitis?". National Institute for Occupational Safety and Health. Archived from the original on 18 January 2015. Retrieved 18 January 2015.
^ Jump up to: a b Lavoie, Marie-Claude; Verbeek, Jos H.; Pahwa, Manisha (2014). "Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel". The Cochrane Database of Systematic Reviews. 3 (3): CD009740. doi:10.1002/14651858.CD009740.pub2. ISSN 1469-493X. PMID 24610008.
Jump up ^ Verbeek JH, Ijaz S, Mischke C, Ruotsalainen JH, Mäkelä E, Neuvonen K, Edmond MB, Sauni R, Kilinc Balci FS, Mihalache RC. "Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff". Reviews. 4: CD011621. doi:10.1002/14651858.cd011621.pub2. ISSN 1465-1858. PMID 27093058. CS1 maint: Multiple names: authors list (link)
Jump up ^ World Health Organization. Women and health: today's evidence, tomorrow's agenda. Archived 2012-12-25 at the Wayback Machine. Geneva, 2009. Retrieved on March 9, 2011.
Jump up ^ Swanson, Naomi; Tisdale-Pardi, Julie; MacDonald, Leslie; Tiesman, Hope M. (13 May 2013). "Women's Health at Work". National Institute for Occupational Safety and Health. Archived from the original on 18 January 2015. Retrieved 21 January 2015.
^ Jump up to: a b c Hartley, Dan; Ridenour, Marilyn (12 August 2013). "Free On-line Violence Prevention Training for Nurses". National Institute for Occupational Safety and Health. Archived from the original on 16 January 2015. Retrieved 15 January 2015.
^ Jump up to: a b Hartley, Dan; Ridenour, Marilyn (September 13, 2011). "Workplace Violence in the Healthcare Setting". NIOSH: Workplace Safety and Health. Medscape and NIOSH. Archived from the original on February 8, 2014.
Jump up ^ Caruso, Claire C. (August 2, 2012). "Running on Empty: Fatigue and Healthcare Professionals". NIOSH: Workplace Safety and Health. Medscape and NIOSH. Archived from the original on May 11, 2013.
Jump up ^ wiki.bmezine.com --> Practicing Medicine. In turn citing Michigan laws
^ Jump up to: a b CHAPTER 2004-256 Committee Substitute for Senate Bill No. 1118 Archived 2011-07-23 at the Wayback Machine. State of Florida, Department of State.
External links[edit]
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