HORMONES ENZYMES

FLUID EXCHANGE BINDING & TRANSPORT

DEFENCE OF BODY
BUFFER

FUNCTIONS

NUTRITIVE

VISCOSITY OF BLOOD

RESERVE PROTEINS

BLOOD COAGULATION

1. NUTRITIVE FUNCTION OF PLASMA PROTEINS

Simple proteins and a good source of proteins Macrophages split plasma proteins into amino acids for tissue protein synthesis

2. PLASMA PROTEINS AS RESERVE PROTEINS

Occurs in following conditions - malnutrition - starvation - fasting - hypoproteinaemia Amino acids released from broken plasma proteins distributed throughout body to form cellular protein molecules Used as a last source of energy

3. PLASMA PROTEINS FOR FLUID EXCHANGE

Exert colloid osmotic pressure Play an important role in distribution of water between blood and tissues
AT ARTERIAL END OF CAPILLARIES: Hydrostatic pressure > osmotic

pressure. Hence, fluid driven out of vessels into tissue spaces. Plasma proteins, however, do not leave capillaries because of their large size.
AT VENOUS END OF CAPILLARIES: Osmotic pressure > hydrostatic pressure

because of presence of plasma proteins in capillaries. Hence, fluid is drawn from tissue spaces into vessels.

This allows exchange of fluids and dissolved materials between blood and tissue spaces (STARLING HYPOTHESIS)

4. PLASMA PROTEINS AS BUFFERS

Amphoteric molecules In acidic pH. Amino group of plasma proteins combine with a proton and becomes positively charged In alkaline medium, carboxyl group of plasma proteins donate a proton and becomes negatively charged In this way, plasma proteins maintain a constant pH of the medium.

5. TRANSPORT FUNCTION OF PLASMA PROTEINS

Binds to and transport various substances throughout body Eg. 1) Albumin transport ions, drugs, penicillin, gases, pigments, ect 2) lipoproteins transport lipid fractions and fat-soluble vitamins 3) haptoglobin transport free haemoglobin 4) transferrin transport iron

7. ROLE OF PLASMA PROTEINS IN VISCOSITY OF BLOOD Makes blood viscous Albumin, globulins and fibrinogen mainly responsible Due to the large size and asymmetrical structure of plasma proteins

Viscosity provides resistance to blood flow in vessels

This maintains blood pressure in normal range

8. PLASMA PROTEINS FOR BODY DEFENCE

Gamma-globulins also known as immunoglobulin Act as antibodies against antigens to protect body against infections like diphtheria, thyroid, streptococcal infections, mumps, influenza, measles, hepatitis, rubella, poliomyelitis, ect.

9. PLASMA PROTEINS AS ENZYMES

Enzymes are proteins (except ribozymes) Eg. 1) Amylase 2) transaminase 3) dehydrogenase 4) lipase 5) phosphatase

10. PLASMA PROTEINS AS HORMONES

Certain hormones are proteins

Eg. 1) Oxytocin 2) Vasopressin 3) insulin 4) Parathormone 5) TSH 6) ACTH

11. ROLE OF PLASMA PROTEINS IN BLOOD COAGULATION

Plasma contains fibrinogen, enzymes and clotting factors These participate in coagulation of blood Prevent excessive loss of blood during injury

CLINICAL SIGNIFICANCE OF PLASMA PROTEINS

HYPERPROTEINAEMIA
Increase in plasma protein levels

Normal plasma protein level = 6-8 g%

Decrease in Plasma protein levels

HYPOPROTEINAEMIA

HYPERPROTEINAEMIA
Increase in total amount of plasma proteins in the body Occurs in following 2 situations: 1) Haemoconcentration - due to dehydration - both albumin and globulin are increased - A:G ratio remains unchanged

2) Diseases such as hypergammaglobulinaemia - high levels of plasma globulins - albumin level normal or reduced - A:G ratio reversed if albumin reduced

HYPERGAMMAGLOBULINAEMIA

POLYCLONAL GAMMOPATHIES

MONOCLONAL GAMMOPATHIES

POLYCLONAL GAMOPATHIES
Chronic infections like TB, leprosy, kalaazar, etc

Chronic liver disease like cirrhosis or chronic active hepatitis

Sarcoidosis Autoimmune diseases like rheumatoid arthritis

MONOCLONAL GAMMOPATHIES

MALIGNANT Multiple myeloma

Macroglobulinaemia

BENIGN

Secondary to diabetes mellitus, Chronic infections, etc Idiopathic

Lymphoreticular malignancies like lymphosarcoma, leukemia, hodgkins disease

HYPOPROTEINAEMIA

Haemodilution

Hypogammaglobulinaemia

Hypoalbuminaemia

HAEMODILUTION
Cause may be Water intoxication Both albumin and globulin are decreased A:G ratio remains unaltered Results in edema because of low plasma proteins in capillaries to exert colloid osmotic pressure

HYPOALBUMINAEMIA
1) LOSS OF ALBUMIN FROM THE BODY - RENAL: Nephrotic syndrome - GIT: Protein losing enteropathy - SKIN: Burns and other skin lesions 2) DECREASED SYNTHESIS OF ALBUMIN - SEVERE LIVER DISEASES: cirrhosis of liver , chronic hepatitis - NON-AVAILABILITY OF PRECURSORS: Malabsorption syndrome, protein calorie malnutrition - GENETIC DEFICIENCIES: Analbuminaemia 3) MISCELLANEOUS - Acute or chronic illnesses - infections - malignancy - pregnancy

HYPOGAMMAGLOBULINAEMIA
1) LOSS OF GAMMA-GLOBULINS FROM BODY - RENAL: Nephrotic syndrome - GIT: Protein losing enteropathy - SKIN: Burns and other skin lesions 2) DECREASED SYNTHESIS OF GAMMA-GLOBULINS - TRANSIENT: Neonates/infants - PRIMARY: Genetic deficiency - SECONDARY: AIDS, LEUKEMIA 3) MISCELLANEOUS - Pregnancies

Most abundant and fairly homogeneous protein of plasma. Half of the total plasma protein is made up of albumin.

Single polypeptide chain. Contain 585 amino acids. Have 17 interchain disulfide (s-s) bonds. Molecular weight : 69 000 Low isoelectric pH (pI = 4.7)

Precipitates last in salting out or alcohol precipitation method.

Normal value: 3.5 5.5 mg/dL

Normal values
Albumin globulin gobulin globulin

% of total proteins
50 - 70 7 - 17 7 - 16 11 - 22

Exclusively synthesised by the liver.

Liver produces approximately 12g albumin per day which represents 25% of the total hepatic protein synthesis.

Albumin has a half life of 20 days.

67 % helix

10 % turn

Amino Acid Aspartic Acid Asparagine Threonine Serine Glutamic Acid Glutamine Proline Glysine Alanine

Composition 36 17 28 24 62 20 24 12 62

Valine

41

Cystine
Methionine Isoleucine Leucine Tyrosine Phenyalanine Lysine Histidine Tryptophan Arginine

35
6 8 61 18 31 59 16 1 24

TOTAL

585

Osmotic Function Due to its high concentration and low molecular weight, albumin contributes to 75 80% of the total plasma osmotic pressure. Thus, albumin plays a predominant role in maintaining blood volume and body fluid distribution.

Transport Function Plasma albumin binds to several biochemically important compounds and transports them in the circulation. These include free fatty acids which is transported to the liver, bilirubin, steroid hormones, calcium and copper.

Nutritive Function Albumin serves as a source of amino acids for tissue protein synthesis to a limited extent, particularly in nutritional deprivation of amino acids.

Buffering Function Among the plasma proteins, albumin has the maximum buffering capacity. Exerts low viscocity Plays an important role in exchange of water between tissue fluid and blood.

Certain drugs also bind to albumin. e.g sulphonamides, aspirin, penicillin. These drugs are directly transported to the target organ.

Hypoalbuminemia

Hyperalbuminemia

Occurs due to a decrease in concentration of albumin, i.e

when it is less than 2.5 gm%

(2) Decreased synthesis of albumin (3) Others Severe liver diseases: chronic hepatitis, Chronic illness cirrhosis liver. Infections Non-availability of the precursor: Malignancy syndrome, protein calorie malabsorption (1) Loss from the body pregnancy malnutrition Loss of albumin in urine in nephrotic syndrome Genetic deficiency: Analbuminaemia In burns, albumin is loss through the unprotected skin surface.

Decrease in albumin concentration leads to oedema formation. Oedema is a situation where tissue swelling takes place.

increasing blood protein level in patient with a nutritional deficiency. Diuretic treatment kidney is made to excrete excess fluid from the body.

Occur when albumin level is high, i.e greater than 5.5 gm% Seen in the absence of dehydration. Frequent in obese men.

 Classification of plasma protein. Functions of plama protein. Albumin. Clinical significance.

 Wikipedia

Textbook of medical physiology MN Chatterjea, Rana Shinde

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