Several diseases can affect cellular respiration. Since cellular respiration is so vital to bodily functions, many of these diseases severely affect individuals.  The most common diseases affecting glycolysis are pyruvate kinase deficiency, erythrocyte hexokinase deficiency, and glucose phosphate isomerase deficiency. These diseases are typically inherited in an autosomal recessive manner and individuals who are homozygous (i.e., have two affected genes), for these diseases develop hemolytic anemia, jaundice, and splenomegaly.  Deficiencies in the pyruvate dehydrogenase enzyme can interfere with pyruvate oxidation. These can result in lactic acidosis characterized by a build-up of lactate and increased serum alanine due to pyruvate build-up that then undergoes fermentation to lactic acid. Children born with these deficiencies may have neurological defects, and management of the disease typically includes keto-diets or diets high in fats. There are several enzymes in the TCA cycle that may be affected and result in disease, including succinyl-CoA synthase and fumarase. Many individuals with these disorders have involuntary muscle spasms and posture, called dystonia, and are deaf. Mitochondrial myopathies are genetic disorders that may affect the production of enzymes involved in the electron transport chain or oxidative phosphorylation. These diseases are classically characterized by muscle weakness and fatigue and may include muscular paralysis. Additionally, exposure to high amounts of certain drugs or toxic chemicals can affect the electron transport chain or oxidative phosphorylation. Substances that can directly inhibit complexes in the electron transport chain include carbon monoxide and cyanide. Other substances may inhibit ATP synthase, such as oligomycin, or disrupt the connection between the electron transport chain and ATP synthase (i.e., an electron transport chain uncoupler), such as aspirin or 2,4-dinitrophenol.