TCA cycle

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The TCA cycle (tricarboxylic acid cycle, also called the Krebs cycle or citric acid cycle) is a series of 8 enzymatic reactions in the mitochondrial matrix that oxidize acetyl-CoA to CO2, generating NADH, FADH2, and GTP. It is the central hub of aerobic metabolism, feeding electrons into the electron transport chain for ATP synthesis.
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TCA cycle steps enzymes NADH FADH2 regulation

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Here is a thorough breakdown of the TCA cycle, drawn from Harper's Illustrated Biochemistry and Guyton & Hall Medical Physiology.

The TCA Cycle (Citric Acid / Krebs Cycle)

TCA Cycle Diagram
Harper's Illustrated Biochemistry, Figure 16-3: The complete citric acid cycle with enzymes, cofactors, and inhibitor sites.

Location & Overview

  • Occurs in the mitochondrial matrix (enzymes are free or bound to the inner mitochondrial membrane/cristae)
  • Entry substrate: acetyl-CoA (2-carbon unit from carbohydrate, fat, and protein catabolism)
  • Acetyl-CoA condenses with oxaloacetate (OAA, 4C) to form citrate (6C), then two CO2 are released and OAA is regenerated
  • The cycle is amphibolic - serves both oxidative (energy) and biosynthetic (anabolic) functions

The 8 Reactions

StepSubstrate → ProductEnzymeCofactor/Product
1Acetyl-CoA + OAA → CitrateCitrate synthaseCoA-SH released
2Citrate → IsocitrateAconitase (via cis-aconitate)Fe²⁺; H₂O removed then added
3Isocitrate → α-Ketoglutarate + CO₂Isocitrate dehydrogenaseNADH produced; Mn²⁺
4α-Ketoglutarate → Succinyl-CoA + CO₂α-Ketoglutarate dehydrogenase complexNADH produced; thiamine (B1), lipoate, FAD, CoA
5Succinyl-CoA → SuccinateSuccinate thiokinaseGTP (substrate-level phosphorylation); Mg²⁺
6Succinate → FumarateSuccinate dehydrogenaseFADH₂ produced
7Fumarate → MalateFumaraseH₂O added
8Malate → OxaloacetateMalate dehydrogenaseNADH produced
Steps 3 and 4 are the two CO₂-releasing steps.

Energy Yield Per Acetyl-CoA (One Turn)

ProductQuantityATP equivalents
NADH3~2.5 ATP each = 7.5 ATP
FADH₂1~1.5 ATP each = 1.5 ATP
GTP/ATP11 ATP (substrate-level)
Total~10 ATP
Since one glucose yields 2 pyruvate → 2 acetyl-CoA, the TCA cycle contributes ~20 ATP per glucose (plus the 5 NADH from pyruvate dehydrogenase across two turns).

Vitamins Required

Four B vitamins are essential (Harper's, p. 171):
  • Thiamine (B1) - thiamine diphosphate; cofactor for α-ketoglutarate dehydrogenase
  • Riboflavin (B2) - FAD; cofactor for succinate dehydrogenase
  • Niacin (B3) - NAD⁺; electron acceptor for isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, and malate dehydrogenase
  • Pantothenic acid (B5) - component of coenzyme A; needed to form acetyl-CoA and succinyl-CoA
Deficiency in any of these impairs TCA cycle function and energy metabolism.

Regulation

The three key regulatory enzymes are all inhibited by NADH and activated by ADP/NAD⁺ (reflecting energy status):
EnzymeActivated byInhibited by
Citrate synthaseAcetyl-CoA, OAANADH, citrate, succinyl-CoA, ATP
Isocitrate dehydrogenaseADP, Ca²⁺, NAD⁺NADH, ATP
α-Ketoglutarate dehydrogenase complexCa²⁺, ADPNADH, succinyl-CoA, ATP
In high-energy states (high NADH, ATP), the cycle slows. In low-energy states (high ADP, NAD⁺), it accelerates.

Inhibitors (Toxicological/Experimental)

  • Fluoroacetate (rat poison) - converted to fluorocitrate, inhibits aconitase (step 2)
  • Malonate - competitive inhibitor of succinate dehydrogenase (step 6)
  • Arsenite - inhibits the α-ketoglutarate dehydrogenase complex (step 4) by reacting with lipoate cofactor

Amphibolic Role: Beyond Energy

The TCA cycle also serves as a hub for biosynthesis (Harper's, p. 171):
  • Gluconeogenesis - OAA → phosphoenolpyruvate via PEPCK
  • Amino acid synthesis - transamination of α-ketoglutarate → glutamate; OAA → aspartate
  • Fatty acid synthesis - citrate exported to cytoplasm → cleaved back to acetyl-CoA (by ATP-citrate lyase)
  • Heme synthesis - succinyl-CoA condenses with glycine to form δ-aminolevulinic acid (ALA)

Anaplerosis and Cataplerosis

To sustain the cycle, carbon entering (anaplerosis) must equal carbon exiting (cataplerosis):
  • Main anaplerotic reaction: pyruvate + CO₂ → OAA, catalyzed by pyruvate carboxylase (biotin-dependent; activated by acetyl-CoA)
  • Other sources: glutamine/glutamate → α-ketoglutarate; propionyl-CoA → succinyl-CoA
  • Cataplerosis: OAA → PEP (gluconeogenesis); citrate → cytoplasm (fatty acid synthesis)

Key Clinical Points

  • Thiamine deficiency (beriberi, Wernicke's encephalopathy) - impairs α-ketoglutarate dehydrogenase, leading to accumulation of α-ketoglutarate and neurological dysfunction
  • Pyruvate dehydrogenase deficiency - reduces acetyl-CoA supply to the cycle; lactic acidosis
  • IDH1/IDH2 mutations (gliomas, AML) - mutant enzyme produces 2-hydroxyglutarate (oncometabolite) instead of α-ketoglutarate, disrupting epigenetic regulation
  • Fumarate hydratase / succinate dehydrogenase mutations - tumor suppressors; loss causes accumulation of fumarate/succinate, inhibiting HIF prolyl hydroxylases → pseudo-hypoxia and tumor formation

Sources: Harper's Illustrated Biochemistry 32nd Ed, Chapter 16; Guyton & Hall Medical Physiology, Chapter 68
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