Glycogen phosphorylase is a key regulatory enzyme in glycogen metabolism that catalyzes the phosphorolytic cleavage of α-1,4-glycosidic bonds at the nonreducing ends of glycogen chains, releasing glucose-1-phosphate as the primary product while preserving the energy of the glycosidic bond.[1] This process, known as glycogenolysis, mobilizes stored glycogen into a form that can be rapidly converted to glucose-6-phosphate for energyproduction, particularly in tissues like muscle and liver during periods of high demand such as exercise or fasting.[1] The enzyme requires inorganic phosphate as a substrate and pyridoxal 5'-phosphate (PLP), a derivative of vitamin B6, as an essential cofactor that facilitates the reaction mechanism.[1]In humans, glycogen phosphorylase exists as three tissue-specific isozymes—muscle (PYGM), liver (PYGL), and brain (PYGB)—each encoded by distinct genes and sharing approximately 80% sequence identity, reflecting their evolutionary conservation.[2] The muscle isoform predominates in skeletal and cardiac muscle, where it supports rapid ATP generation for contraction, while the liver isoform regulates blood glucose homeostasis by enabling hepatic glucose release.[2] The brain isoform, expressed primarily in neurons and astrocytes, aids in maintaining cerebral energy supplies during hypoglycemia or cognitive stress, with lower glycogen stores compared to other tissues.[3] Structurally, each isozyme forms a homodimer with distinct catalytic and regulatory domains, allowing for precise control of activity.[2]Regulation of glycogen phosphorylase is multifaceted, involving covalent modification and allosteric mechanisms to fine-tune glycogen breakdown in response to physiological signals.[1] The enzyme interconverts between an active phosphorylated form (phosphorylase a) and an inactive dephosphorylated form (phosphorylase b) via phosphorylase kinase, which is activated by hormones like glucagon and epinephrine through cAMP-dependent protein kinase A, and protein phosphatase 1, which reverses this under fed conditions.[1] Allosteric effectors further modulate activity: AMP and inorganic phosphate activate the muscle isoform during energy depletion, while ATP and glucose-6-phosphate inhibit it; the liver isoform is uniquely sensitive to glucose inhibition, serving as a feedbackmechanism to prevent futile cycling.[2] Dysfunctions in glycogen phosphorylase lead to glycogen storage diseases, such as McArdle disease (muscle isoform deficiency) and Hers disease (liver isoform deficiency), underscoring its critical role in metabolic homeostasis.[1]
Biological Role
Glycogen Metabolism
Glycogen phosphorylase serves as the rate-limiting enzyme in glycogenolysis, catalyzing the phosphorolytic cleavage of α-1,4-glycosidic bonds at the non-reducing ends of glycogen chains to release glucose-1-phosphate (G1P).[4] This process requires inorganic phosphate (Pi) as a substrate and proceeds via the reversible reaction:(\text{glycogen})_n + \text{P}_\text{i} \rightleftharpoons (\text{glycogen})_{n-1} + \text{G1P}[5]The enzyme's activity accounts for approximately 90% of glucose units mobilized from glycogen in liver and muscle tissues, as branches occur every 8-12 residues, allowing phosphorylase to process the majority of linear chains before debranching enzymes handle the α-1,6 linkages.[1] The released G1P is subsequently converted to glucose-6-phosphate (G6P) by phosphoglucomutase, which can then enter glycolysis for ATP production or, in the liver, proceed to gluconeogenesis and glucose release into the bloodstream via glucose-6-phosphatase.[1] This integration positions glycogen phosphorylase as a central regulator in carbohydrate metabolism, ensuring rapid glucose availability.Evolutionarily, glycogen phosphorylase exhibits high conservation across prokaryotes and eukaryotes, with over 40% amino acid sequence identity from bacteria to mammals, underscoring its fundamental role in energy storage and mobilization.[6] In eukaryotes, it maintains energy homeostasis during physiological stresses such as fasting, where hepatic glycogenolysis supplies glucose to glucose-dependent tissues, or exercise, where muscle glycogen fuels anaerobicmetabolism.[7] Its activation, influenced by allosteric effectors like AMP and covalent modifications such as phosphorylation, fine-tunes this response to metabolic demands.[4]
Tissue-Specific Functions
Glycogen phosphorylase in the liver, encoded by the PYGL gene, plays a critical role in maintaining blood glucose homeostasis during fasting states by catalyzing the phosphorolytic cleavage of glycogen to glucose-1-phosphate (G1P), which is subsequently converted to glucose-6-phosphate (G6P) and then dephosphorylated to free glucose by glucose-6-phosphatase for export into the bloodstream.[8] This process ensures a steady supply of glucose to glucose-dependent tissues such as the brain and red blood cells when dietary intake is limited, preventing hypoglycemia.[4] In the post-absorptive state after an overnight fast, hepatic glycogenolysis mediated by this isoform contributes approximately 50-70% to total hepatic glucose production, underscoring its dominance in short-term glucose buffering.[9]In skeletal muscle, the PYGM-encoded isoform supports rapid energy mobilization during physical activity, particularly under anaerobic conditions, by breaking down glycogen to G1P and then G6P, which enters glycolysis locally to generate ATP without conversion to free glucose due to the absence of glucose-6-phosphatase.[10] This local utilization fuels muscle contraction and sustains high-intensity exercise, where glycogen phosphorylase activity can increase up to 10-fold from baseline levels to match the elevated energy demands.[11] Unlike the liver, muscle glycogen breakdown does not contribute to systemic glucose levels but instead prioritizes intramuscular ATP production during bursts of activity.[12]The brain isoform, PYGB, maintains a relatively low basal activity under normal conditions to provide a steady, albeit minor, supply of glucose for neuronal and glial functions, relying on astrocyte-stored glycogen as a backupenergy reserve during brief disruptions in blood glucose delivery.[13]Brainglycogen levels are small compared to those in liver or muscle, and phosphorylase-mediated breakdown supports cognitive processes like memory consolidation without significant flux variations in steady states.[14] This isoform's subdued activity reflects the brain's preference for continuous plasma glucose uptake over large glycogen reserves.[15]Hormonal regulation tailors these tissue-specific functions during stress responses; in the liver, glucagon binding to receptors triggers a phosphorylation cascade activating phosphorylase within minutes to ramp up glucose output, while in muscle, adrenaline stimulates similar activation within minutes via hormonal signaling, though contraction-induced activation can occur in seconds to enable immediate glycogen mobilization for exercise or fight-or-flight scenarios.[16] These timelines highlight the enzyme's role in acute energy adaptation across tissues.[17]
Molecular Structure
Quaternary Assembly
Glycogen phosphorylase in mammals exists primarily as a homodimer composed of two identical subunits, each with a molecular weight of approximately 97 kDa.[18] The inter-subunit contacts occur mainly through interactions involving the N-terminal cap domain helices (residues 36–48 and 262–278) and C-terminal domain helices (residues 571–597 and 727–745), which stabilize the dimer and bury approximately 1,400 Ų of solvent-accessible surface area per subunit, corresponding to about 14% of the total subunit surface.[19] These interfaces are critical for maintaining the structural integrity necessary for catalytic activity.Under certain conditions, such as high enzyme concentration or specific ionic environments, the enzyme can assemble into a tetramer by dimer-dimer association at the N-terminal interfaces.[20] Activation involves a shift from the inactive tetrameric T-state to the active dimeric R-state, often promoted by allosteric effectors or substrates like glycogen, which facilitate dissociation with equilibrium constants in the low μM range (e.g., K_d ≈ 1–10 μM depending on conditions).[21] This oligomeric transition enhances catalytic efficiency by exposing the active sites and optimizing substratebinding.The quaternary structure was first elucidated through X-ray crystallography in the late 1970s using rabbit muscle glycogen phosphorylase b, revealing a compact dimeric fold with dimensions of approximately 85 × 75 × 55 Å per subunit.[22] Subsequent structures, such as PDB entry 1GPA for the phosphorylated form, confirm the dimeric architecture and highlight conformational changes at subunit interfaces during state transitions.[23]Interspecies variations are notable; for instance, bacterial glycogen phosphorylases, such as that from Escherichia coli, form stable homodimers without the allosteric effector sites present in eukaryotic forms, reflecting simpler regulatory mechanisms.[24]
Key Domains and Sites
Glycogen phosphorylase subunits are structurally organized into two primary domains: an N-terminal regulatory domain spanning residues 1–482 and a C-terminal catalytic domain covering residues 483–842. The N-terminal regulatory domain houses sites for allosteric effectors and covalent modification, facilitating conformational shifts between inactive (T-state) and active (R-state) forms, while the catalytic domain contains the core machinery for substrate binding and reaction at the domain interface, and the C-terminal region contributes to subunit interactions and stability. This domain architecture allows for precise control of enzymatic activity in response to metabolic signals.[25]The active site is located at the interface between the catalytic domain and the C-terminal cap, featuring the essential cofactor pyridoxal 5'-phosphate (PLP) covalently bound via a Schiff base to Lys680. Key residues such as Asp339 and Arg309 play critical roles in coordinating inorganic phosphate (Pi) and the glycogensubstrate, positioning the nonreducing end of the α-1,4-glucosyl chain for phosphorolysis. Unlike its role in vitamin B6-dependent enzymes, PLP in glycogen phosphorylase functions as a general acid/base catalyst; its deprotonated pyridine nitrogen abstracts a proton from the substrate C1-OH, while the phosphate group assists in stabilizing the transition state and the released glucose 1-phosphate product.[26]Allosteric sites are primarily within the N-terminal regulatory domain, including the AMP-binding site formed by the purse-string loop (residues 40–50) and adjacent helices, which stabilizes the R-state upon AMP occupancy to enhance activity under energy-demanding conditions. The glucose inhibitor site, located at the subunit interface near the N- and C-terminal domains, binds glucose to lock the enzyme in the T-state, preventing activation and conserving glycogen stores when blood glucose is abundant. These sites enable fine-tuned regulation without direct interference with catalysis.[27]The glycogen-binding site consists of a surface groove on the catalytic domain, designed to accommodate approximately 8–10 glucose units from α-1,4-linked chains, facilitating processive degradation of glycogen particles. Residues in this groove, including those from β-sheets in the catalytic core, provide non-covalent interactions that anchor the substrate, positioning it for sequential phosphorolysis while the storage site nearby modulates overall affinity. This structural feature ensures efficient coupling of glycogen recruitment to catalytic turnover.[23]
Catalytic Mechanism
Phosphorolytic Reaction
Glycogen phosphorylase catalyzes the phosphorolytic cleavage of the α-1,4-glycosidic bonds at the non-reducing ends of glycogen chains, utilizing inorganic phosphate (Pi) as the nucleophile to yield α-D-glucose 1-phosphate (G1P) and a glycogen molecule shortened by one glucose unit. This reaction is represented as:(\text{[glycogen](/page/Glycogen)})_n + \text{P}_\text{i} \rightleftharpoons (\text{[glycogen](/page/Glycogen)})_{n-1} + \alpha\text{-D-glucose 1-phosphate}Unlike hydrolytic enzymes such as amylases, which use water to produce free glucose and expend energy to reform phosphate bonds downstream, phosphorolysis conserves metabolic energy by directly forming a high-energy phosphate ester in G1P, which can be readily converted to glucose 6-phosphate without ATP investment. This mechanism also mitigates osmotic pressure in cells by avoiding the release of free glucose molecules.[28]The catalytic process is facilitated by the essential cofactor pyridoxal 5'-phosphate (PLP), covalently bound via a Schiff base to Lys680 in the active site, which positions and activates substrates while stabilizing reaction intermediates. The key steps begin with the binding of glycogen oligosaccharide chains to a surface groove on the enzyme, inducing a conformational shift that aligns the terminal glucose residue with the catalytic site approximately four to five residues from the binding terminus. Inorganic phosphate then coordinates to residues such as Arg569, His571, and Lys574, positioning it for nucleophilic attack on the C1 anomeric carbon of the bound glucose.[28][29]Subsequently, PLP's protonated Schiff base donates a proton to the glycosidic oxygen (the leaving group oxygen linking to the glycogen chain), weakening the α-1,4 bond and promoting cleavage. This leads to the formation of a transient glucosyl carbanion-like intermediate (oxocarbenium iontransition state) at C1, stabilized by the electron-withdrawing pyridine ring of PLP and potentially by electrostatic interactions or a covalent link with nearby acidic residues in the active site. Phosphate then attacks the electrophilic C1, displacing the glycogen chain in a double-displacement manner that results in overall retention of the α-configuration from the substrate glycosidic bond to the α-G1P product. The transition state resembles an oxocarbenium ion, with the ring oxygen (O5) assisting in flattening the C1-C2-C5 plane for optimal orbital alignment. Finally, the products G1P and shortened glycogen are released, completing the cycle. Note that the precise nature of the intermediate stabilization remains under investigation, with proposals including non-covalent interactions or transient covalent bonds.[28][30][31]The reaction exhibits an optimal pH of 6.8, reflecting the physiological conditions in muscle and liver where the enzyme operates, with activity decreasing at higher pH due to deprotonation of key residues involved in phosphate binding. Kinetic parameters include a Km for Pi of approximately 5–10 mM for the active phosphorylase a form (higher for the less active b form), ensuring responsiveness to intracellular phosphate levels during energy demand, and a Km for glycogen of about 0.2 mM (or ~0.1–0.2 mg/mL), indicating high affinity for the substrate even at physiological concentrations. These values underscore the enzyme's efficiency in mobilizing glycogen stores without saturation under normal conditions.[32][33]
Enzyme Kinetics
Glycogen phosphorylase displays sigmoidal kinetics with respect to its substrates due to positive cooperativity, particularly evident in the binding of glycogen. For the rabbit skeletal muscle phosphorylase a isoform under saturating glycogen concentrations and no effectors, the maximum velocity (Vmax) is approximately 221 U/mg protein at 30°C and pH 7.0.[34] The Michaelis constant (Km) for inorganic phosphate (Pi) is 5.6 mM under these conditions, while literature values for glycogen range from 0.2 to 3 mM expressed as glucosyl units, reflecting low affinity relative to physiological concentrations.[34][33]The cooperative nature of substrate binding is quantified by the Hill coefficient (n), typically 2-3 for glycogen in the dimeric enzyme form, which enhances sensitivity to substrate levels near physiological ranges. This cooperativity leads to a velocity equation following the Hill model:v = \frac{V_{\max} [S]^n}{K_{0.5}^n + [S]^n}where [S] denotes substrate concentration, n is the Hill coefficient, and K0.5 represents the substrate concentration at half Vmax.[35]The phosphorolytic activity of glycogen phosphorylase is confined to the α-1,4-glycosidic linkages at the non-reducing ends of linear glycogen chains, halting four glucose residues from α-1,6 branch points due to steric hindrance, thereby requiring a debranching enzyme for complete glycogen mobilization.[36]Isotope exchange experiments have verified the phosphorolytic mechanism, showing incorporation of 18O from labeled inorganic phosphate into the phosphate group of glucose 1-phosphate during the forward reaction.[37]
Regulation
Allosteric Control
Glycogen phosphorylase exhibits allosteric regulation through non-covalent interactions with metabolites that induce conformational shifts between an inactive T-state (tense) and an active R-state (relaxed), enabling rapid responses to cellular energy demands. In the T-state, the enzyme predominantly exists as the dephosphorylated form (glycogen phosphorylase b), where the active site is obstructed by ordered regulatory loops, limiting substrate access. Binding of activators promotes a transition to the R-state, characterized by loop disordering and enhanced catalytic efficiency, while inhibitors stabilize the T-state to suppress activity. This mechanism is particularly prominent in the muscle isoform, where energy status directly modulates glycogen breakdown.[38]A key activator is adenosine monophosphate (AMP), which binds at an allosteric site located at the subunit-subunit interface near the N-terminus, with a dissociation constant (Kd) in the range of 10-50 μM under physiological conditions. AMP stabilizes the R-state by promoting subunit reorientation and facilitating access to the active site, thereby increasing the enzyme's affinity for phosphate and glycogen substrates. In muscle, ATP and ADP act as competitive inhibitors at this purine nucleotide site, with inhibition constants (Ki) around 0.5-1 mM for ATP, counteracting AMP activation during energy-replete states. These nucleotide interactions ensure that glycogenolysis accelerates only when AMP levels rise relative to ATP, reflecting falling energy charge.[39][40][12]In the liver isoform, glucose serves as a potent allosteric inhibitor, binding at the subunit interface with a Ki of approximately 5 mM, which specifically stabilizes the T-state and promotes enzyme dimerization into an inactive conformation.[41] This glucose-mediated inhibition is isoform-specific, absent or weak in muscle phosphorylase, allowing hepatic glucose sensing to curtail glycogen breakdown and maintain blood glucose homeostasis postprandially. Glucose-6-phosphate also contributes to T-state stabilization in both isoforms by binding near the AMP site, further modulating activity through competitive effects.[42][40]Allosteric activation involves significant conformational rearrangements, including a approximately 10-15° rotation of the tower helix and adjacent domains, which repositions regulatory loops and aligns the active site for catalysis. These changes have been quantified through structural studies showing domain shifts and helix repacking at the dimer interface, with fluorescence quenching assays confirming reduced solvent exposure in the R-state. Such transitions couple the nucleotide-binding site to the catalytic center over distances of up to 50 Å, exemplifying long-range allostery.[38][43][44]Physiologically, AMP concentrations in muscle can rise up to 10-fold or more during intense exercise due to increased ATP hydrolysis, crossing activation thresholds to shift phosphorylase toward the R-state and initiate glycogenolysis for ATP replenishment. This allosteric threshold ensures efficient energy mobilization without covalent modification under moderate stress, synergizing with phosphorylation for maximal activation during prolonged exertion.[12][45][46]
Phosphorylation Cascade
Glycogen phosphorylase is covalently activated through phosphorylation at serine 14 (Ser14) by phosphorylase kinase (PhK), which serves as the primary upstream kinase in the regulatory cascade.[47] This phosphorylation event is triggered by hormonal signals such as glucagon in the liver or epinephrine in muscle, which bind to G-protein-coupled receptors and stimulate adenylate cyclase to produce cyclic AMP (cAMP).[2] The elevated cAMP levels activate protein kinase A (PKA), which in turn phosphorylates PhK at multiple sites on its α and β subunits, including Ser1018 on α and Ser26, Ser700 on β (in rabbit; homologous sites in humans), enhancing PhK activity by 10- to 20-fold at physiological pH.[48] In muscle tissue, PhK activation is further modulated by Ca²⁺ ions binding to its δ subunit (calmodulin), which synergizes with PKA-mediated phosphorylation to fully expose the catalytic site of PhK's γ subunit, enabling efficient transfer of the phosphate group to glycogen phosphorylase.[48]The structural consequence of Ser14 phosphorylation involves a conformational shift in the N-terminal domain of glycogen phosphorylase, where the phosphorylated residue forms a 3₁₀-helix that stabilizes subunit interactions and exposes the active site, promoting a transition from the inactive T-state to the active R-state.[47] This covalent modification dramatically increases enzymatic activity, boosting the rate of glycogen breakdown by approximately 100-fold even in the absence of allosteric effectors like AMP.[49] All three isoforms—muscle (PYGM), liver (PYGL), and brain (PYGB)—undergo phosphorylation at homologous serine residues, ensuring conserved activation mechanisms across tissues, though the cascade integrates with tissue-specific signaling pathways.[2]Inactivation occurs via dephosphorylation at Ser14 by protein phosphatase-1 (PP1), which is recruited to glycogen particles through targeting subunits like PPP1R3A in muscle or PPP1R3B in liver.[2] The active, phosphorylated form of glycogen phosphorylase (phosphorylase a) inhibits PP1 activity by binding to these regulatory subunits, creating a feedback loop that sustains glycogenolysis until metabolite levels change.[50] Notably, the liver isoform (PYGL) exhibits heightened sensitivity to this feedback, as elevated glucose promotes PP1-mediated dephosphorylation and inactivation of PYGL, facilitating glycogen storage in response to high blood sugar.[50]
Isoforms and Genetics
Muscle Isoform (PYGM)
The PYGM gene, located on chromosome 11q13.1, encodes the muscle isoform of glycogen phosphorylase and spans approximately 14.2 kb of genomic DNA comprising 20 exons.[51][52] The primary transcript is a 3.4 kb mRNA uniquely expressed in skeletal muscle tissue, with a coding sequence of 2529 bp that produces a protein dedicated to glycogen breakdown in this tissue.[52] This muscle-specific expression pattern underscores PYGM's role in providing rapid glucose availability during anaerobic conditions, distinguishing it from the liver (PYGL) and brain (PYGB) isoforms.[51]The PYGM protein consists of 842 amino acids, forming a homodimer that catalyzes the phosphorolytic cleavage of glycogen to glucose-1-phosphate, the rate-limiting step in muscle glycogenolysis.[53][52] The human sequence shares high similarity with its rabbit muscle counterpart, exhibiting approximately 94% amino acid identity, which has facilitated early structural studies using rabbit models.[54] A distinctive feature of the muscle isoform is its enhanced sensitivity to allosteric activation by AMP at the C-terminal regulatory domain, enabling rapid response to energy demands during exercise; this contrasts with the glucose-inhibited liver isoform.[55]Expression of PYGM is tightly regulated and predominantly confined to skeletal muscle, where it is upregulated during myogenic differentiation in cultured myoblasts, reflecting its essential role in mature myofibers.[56] In cardiac tissue, PYGM levels are notably low, with the brain isoform PYGB predominating and colocalizing in cardiomyocytes to support distinct metabolic needs.[2] This tissue-specific pattern arises from evolutionary gene duplications of an ancestral phosphorylase gene, likely occurring early in vertebrate history, leading to isoform divergence; muscle-specific adaptations in PYGM, such as optimized AMP responsiveness, enhance anaerobic glycolytic capacity in fast-twitch fibers.[57]Functional studies using knock-in mouse models harboring the common human PYGM p.R50X mutation recapitulate McArdle disease, demonstrating severe exercise intolerance, reduced wire-grip endurance, and impaired treadmill performance, which confirms the non-redundancy of PYGM in skeletal muscle glycogen mobilization.[58] These models reveal compensatory increases in fatty acid oxidation but highlight the isoform's irreplaceable contribution to high-intensity anaerobic activity, as other phosphorylases fail to fully substitute in muscle.[59]
Liver and Brain Isoforms (PYGL, PYGB)
The PYGL gene, located on human chromosome 14q22.1, encodes the liver isoform of glycogen phosphorylase and spans 20 exons. This isoform is predominantly expressed in hepatic tissue, where it catalyzes the phosphorolytic breakdown of glycogen to glucose-1-phosphate, facilitating the release of glucose into the bloodstream to maintain systemic homeostasis. Unlike the muscle isoform, the PYGL protein exhibits heightened sensitivity to allosteric inhibition by glucose, which binds to a specific site and stabilizes the inactive T-state conformation, thereby preventing excessive glycogen degradation during periods of elevated blood glucose. This regulatory feature is enabled by sequence-specific residues in the N-terminal region that form the glucose-binding pocket, absent or altered in the muscle variant.[60][61]The PYGB gene resides on chromosome 20p11.21 and directs the expression of the brain isoform, primarily in neural tissues including the brain and heart, with notable presence in astrocytes and neurons. This isoform demonstrates lower basal enzymatic activity in the absence of activators and lower AMP affinity compared to PYGM, reflecting adaptations for energy demands in low-oxygen or stress conditions. Alternative transcripts may arise through splicing variations in neuronal contexts, though primary expression remains constitutive in glial cells to support steady-state glycogen turnover. Compared to other isoforms, PYGB shares approximately 80% amino acid sequence identity but features divergences in the allosteric domain.[62][63][2][64]Across isoforms, sequence conservation is high at around 80%, yet key divergences tailor function: PYGL includes extra residues (e.g., in the cap and tower helices) that enhance glucose site occupancy for feedback inhibition. Regulation of PYGL expression involves repression by insulin signaling in fed states. In contrast, PYGB maintains constitutive expression in glia, independent of acute hormonal fluctuations, ensuring baseline glycogen mobilization. Functionally, hepatic PYGL is indispensable during fasting, driving glycogenolysis to sustain euglycemia over extended periods without dietary intake. In the brain, PYGB provides critical support during hypoglycemia, mobilizing astrocytic glycogen reserves to supply lactate to neurons via the astrocyte-neuron lactate shuttle, thereby averting energy deficits and neuronal damage. These roles highlight non-redundant adaptations, with PYGL prioritizing systemic glucose export and PYGB focusing on local neuroprotection.[2][65][64][66][67]
Clinical Significance
Deficiency Disorders
Deficiencies in glycogen phosphorylase arise from pathogenic variants in the genes encoding its tissue-specific isoforms, leading to glycogen storage diseases characterized by impaired glycogen breakdown and metabolic disturbances. The muscle isoform deficiency, known as McArdle disease or glycogen storage disease type V (GSD V), results from biallelic mutations in PYGM and follows an autosomal recessive inheritance pattern.[68] This disorder has an estimated prevalence of approximately 1 in 100,000 individuals worldwide, with higher rates observed among populations of European descent, where it may be significantly more common than previously reported.[69] Clinical manifestations typically include exercise-induced muscle pain (myalgia), cramps, fatigue, and stiffness, often appearing in childhood or early adulthood; severe episodes can lead to rhabdomyolysis and myoglobinuria.[68] A hallmark feature is the "second wind" phenomenon, where patients experience an initial period of marked exercise intolerance followed by improved tolerance after 10-15 minutes, attributed to enhanced blood flow and fatty acid utilization compensating for blocked glycogenolysis.[70]Deficiency of the liver isoform, termed Hers disease or glycogen storage disease type VI (GSD VI), stems from biallelic variants in PYGL and is also inherited in an autosomal recessive manner.[71] Its prevalence is estimated at 1 in 65,000 to 85,000 live births, though many cases remain undiagnosed due to mild symptoms.[71] Symptoms primarily involve the liver, including hepatomegaly, mild hypoglycemia, hyperlipidemia, and growth retardation, presenting a milder phenotype compared to other hepatic glycogen storage diseases like GSD I, with rare progression to cirrhosis.[72]Diagnosis of glycogen phosphorylase deficiencies relies on a combination of clinical evaluation, biochemical assays, and genetic testing. Enzyme activity assays in affected tissues (e.g., muscle biopsy for PYGM or liver biopsy for PYGL) typically reveal less than 10% of normal activity, confirming functional deficiency.[68]Genetic sequencing identifies causative variants, such as the common R50X nonsense mutation in PYGM for McArdle disease, which predominates in European populations, or various PYGL mutations in Hers disease.[73] Molecular testing is increasingly preferred for its non-invasiveness and ability to detect carrier status, enabling prenatal or preconception counseling.[71]
Role in Disease Therapy
In type 2 diabetes and insulin resistance, overactivation of the liver isoform of glycogen phosphorylase (PYGL) promotes excessive hepatic glycogenolysis, contributing to postprandial hyperglycemia by increasing glucose output.[74] Small-molecule inhibitors targeting this enzyme, such as CP-316,819, have been developed to reduce glycogen breakdown and improve glycemic control; this compound demonstrated safety in phase I clinical trials and enhanced beta-cell function in preclinical models by preserving glycogen stores.[75]In cancer metabolism, glycogen phosphorylase isoforms, particularly PYGB, are upregulated in tumors like hepatocellular carcinoma (HCC) to support glycolytic flux and energy demands during rapid proliferation.[76] Allosteric inhibitors, such as CP-91149, target the enzyme to disrupt glycogen catabolism, inducing intrinsic apoptosis, mitochondrial dysfunction, and augmented response to multikinase inhibitors in HCC cells, highlighting its potential as a therapeutic target in glycogen-dependent malignancies.[77][78]Dysregulation of the brain isoform (PYGB) has been linked to neurodegenerative conditions, including Alzheimer's disease, where PYGB is overexpressed and may serve as a potential biomarker.[67] Experimental modulators, such as glycogen phosphorylase inhibitors, have shown promise in restoring brain metabolite balance; for instance, a single dose improved cognitive performance and altered brain concentrations of key metabolites in aged mouse models, suggesting a role in mitigating age-related cognitive decline relevant to Alzheimer's pathology.[79]Drug development efforts have focused on small molecules that bind the glucose-1-phosphate or allosteric sites of glycogen phosphorylase to modulate its activity, with several advancing to early clinical stages for conditions like type 2 diabetes, though challenges in isoform specificity persist.Gene therapy approaches using adeno-associated virus (AAV) vectors to deliver functional PYGM copies represent a promising intervention for McArdle disease, restoring muscle glycogen phosphorylase activity. In murine models, systemic AAV8-Pygm administration early postnatally restored enzyme activity, ameliorating exercise intolerance and histopathological features without toxicity.[80][81] As of 2025, these preclinical successes support continued efforts toward clinical translation for PYGM-related deficiencies, though no human trials have been initiated.
Historical Development
Discovery and Purification
Glycogen phosphorylase was first described in the late 1930s by Carl F. Cori and Gerty T. Cori, who identified it as the key "glycogenolytic enzyme" in muscle extracts responsible for catalyzing the phosphorolytic breakdown of glycogen into glucose 1-phosphate (G1P) and inorganic phosphate (Pi).[82] Their initial observations revealed that this enzymatic activity required the presence of Pi to drive the reaction, distinguishing it from hydrolytic degradation pathways.[82] This discovery built on their earlier formulation of the Cori cycle in 1929 and marked a pivotal step in elucidating glycogen metabolism.[82]Early assays for the enzyme's activity focused on measuring phosphorolysis through the formation of G1P, often employing coupled enzymatic reactions involving phosphoglucomutase to convert G1P to glucose 6-phosphate, followed by detection via reduction methods or dephosphorylation.[83] These assays confirmed the strict dependence on Pi, as omitting it abolished activity, and highlighted the enzyme's specificity for non-reducing ends of glycogen chains. The Coris' work demonstrated that the enzyme could operate reversibly, synthesizing glycogen from G1P under appropriate conditions, which laid the groundwork for understanding carbohydrate storage and mobilization.[82]Purification efforts advanced significantly in the 1940s, with Arda A. Green collaborating with Gerty T. Cori to achieve the first crystallization of the enzyme from rabbit muscle extracts in 1943, resulting in a preparation enriched approximately 100-fold in specific activity.[84] This milestone involved fractional ammonium sulfate precipitation, adsorption on calcium phosphate gel, and recrystallization in the presence of adenylic acid to stabilize the enzyme, yielding needle-like crystals suitable for biochemical characterization. The purified enzyme retained full catalytic potency, enabling detailed studies of its kinetics and prosthetic group. In the 1950s, enzyme instability during isolation was overcome with the identification of pyridoxal 5'-phosphate (PLP) as its essential prosthetic group, a vitamin B6 derivative required for structural integrity and catalytic function.[83]Key challenges in purification included separating glycogen phosphorylase from contaminating amylases, which hydrolyze glycogen non-specifically and interfere with activity measurements; this was addressed through repeated recrystallizations and selective precipitation steps that minimized amylase carryover. The Coris' foundational contributions to glycogen metabolism, including the isolation of phosphorylase, earned them the 1947 Nobel Prize in Physiology or Medicine.[85]
Major Milestones
In the 1970s, groundbreaking structural studies elucidated the molecular basis of glycogen phosphorylase's allosteric regulation. The X-raycrystal structure of rabbit muscle glycogen phosphorylase a was determined at 3.0 Åresolution, revealing the tense (T) and relaxed (R) conformational states central to its activity and the essential role of pyridoxal 5'-phosphate (PLP) as a cofactor in the active site.[86] This work by Johnson, Madsen, and colleagues provided the first atomic-level insights into how allosteric effectors like AMP and glucose-1-phosphate modulate the enzyme's function, laying the foundation for understanding its dimeric architecture and regulatory transitions. Subsequent refinements in the late 1970s, including comparisons between phosphorylase a and b forms, further clarified phosphorylation-induced shifts that activate the enzyme.The 1980s and 1990s marked advances in genetics and regulatory mechanisms, enabling links to clinical disorders. The human muscle isoform gene (PYGM) was cloned in 1987, revealing its nucleotide sequence and facilitating the identification of mutations causing glycogen storage disease type V (McArdle disease). By 1992, the liver isoform gene (PYGL) was cloned and sequenced, showing high homology to PYGM and allowing molecular diagnosis of type VI disease (Hers disease). These efforts coincided with deeper exploration of the phosphorylation cascade, building on Edmond Fischer's pioneering 1950s discoveries of reversible phosphorylation; the 1992 Nobel Prize in Physiology or Medicine was awarded to Fischer and Edwin G. Krebs for their work on this mechanism, and by the 1990s, elucidation of the multi-step kinase pathway involving phosphorylase kinase connected enzymeregulation to broader signaling networks.[87] This period also integrated genetic data with disease phenotypes, establishing PYGM and PYGL variants as key diagnostic markers for glycogen storage disorders.During the 2000s, research shifted toward therapeutic targeting, particularly for metabolic diseases. Allosteric inhibitors were designed to block hepatic glycogen phosphorylase activity and reduce glucose output in type 2 diabetes; structure-based design leveraging prior crystallographic data optimized binding at allosteric sites.[88]Advancements in the 2010s and 2020s incorporated cutting-edge imaging and gene-based therapies. In 2022, cryo-electron microscopy resolved the structure of human liver glycogen phosphorylase at 2.65 Å resolution within native microsomal complexes, illuminating dynamic interactions in its active state and interactions with cellular membranes.[89] This structure complemented earlier X-ray data, revealing subtle conformational nuances in the PLP-bound catalytic site under physiological conditions. Preclinical gene therapy studies for McArdle disease have explored AAV vectors to deliver functional PYGM in murine models, demonstrating improved muscle function and glycogen metabolism.[90]Recent studies in 2023 have explored bacterial homologs for biotechnological applications. Research on glycogen phosphorylase-like enzymes in gut commensals demonstrated their role in microbial glycogen storage as a niche adaptation trait.[91]