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ENZYMOLOGY
Enzyme activity
Enzyme assays usually depend
on the measurement the catalytic
activity of the enzyme, rather than
the concentration of the enzyme
protein itself.
Disadvantages of enzyme
assays
A major disadvantage in the
use of enzymes for the
diagnosis of tissue damage is
their lack of specificity to a
particular tissue or cell type.
Many enzymes are common
to more than one tissue .
Alkaline phosphatase
(ALP)
Normal serum level of ALP is 40-125 U/L or 0.5-1.3
mmol/(hour L).
Aminotransferases
Two aminotransferases are
used in diagnosis and
management: aspartate
aminotransferase (AST)
and
alanine aminotransferase (ALT).
ASPARTATE AMINO
TRANSFERASE (AST)
It is also called as serum glutamateoxaloacetate transaminase (SGOT).
Normal serum level of AST is 8- 40 U/L or (0.10.45 mmol/(hour L))
It is significantly elevated in myocardial
infarction. It if moderately elevated in liver
diseases.
Measurement of cardiac
enzyme levels
Measure cardiac enzyme levels at regular
intervals, starting on admission and
continuing until the peak is reached or
until 3 sets of results are negative.
Biochemical biomarkers are useful for
both diagnosis and prognostication
Laboratory Diagnosis of
Myocardial Infarction
ALANINE AMINO
TRANSFERASE (ALT)
It is also called as serum
glutamate-pyruvate transaminase
(SGPT).
Normal serum level of ALT is 5-30
U/L or (0.1- 0.68 mmol/(hour L))
LACTATE DEHYDROGENASE
(LDH) (LD)
Normal value of LDH in serum is 100-200 U/L.
Values the upper range are generally seen in
children. Strenuous exercise will slightly
increase the value. LDH level is 100 times
more inside the RBC than in plasma, and
therefore minor amount of hemolysis will
result in a false-positive test.
NUCLEOTIDE
PHOSPHATASE (NTP)
It is a marker enzyme for plasma
membranes and is seen as an ectoenzyme (enzyme present on the cell
membrane).
Normal NTP level in serum is 2-10
U/L. It is moderately increased in
hepatitis and highly elevated in biliary
obstruction.
GAMMA GLUTAMYL
TRANSFERASE (GGT)
It is seen in liver, kidney, pancreas,
intestinal cells and prostate gland.
In the body it is used in the synthesis
of glutathione.
Normal serum value of GGT is 645 U/L in male and 5-30 U/L in
female.
PROSTATE SPECIFIC
ANTIGEN (PSA)
It is produced from the secretory
epithelium of prostal gland. It is
normally secreted into seminal fluid
Normal value is 1 -5 g/L. It is very
specific for prostate activity. Values
between 4-10 g/L is seen in benign
prostate enlargement; but values
above 10 g/L is indicative of prostate
cancer.
CHOLINESTERASE (ChE)
This enzyme is secreted by the liver
into the blood- stream and low plasma
activities occur in chronic hepatic
dysfunction. Low activities occur
physiologically during pregnancy.
CHOLINESTERASE (ChE)
Acetyl cholinesterase or true ChE or Type 1 ChE
can act mainly on acetyl choline.
Normal serum range is 2-12 U/ml
It is present in nerve endings and in RBCs.
Plasma cholinesterase activity also falls in
organophosphate poisoning.
Organophosphorus insecticides (Parathione)
irreversibly inhibit ChE in RBCs. Measurement of
ChE level in RBCs is useful to determine the
amount of exposure in persons working with these
insecticides.
Pseudocholinesterase or type II
ChE is non-specific and can
hydrolyse acyl esters. It is
produced mainly by liver cells.
Normal serum level is 8-18 U/ml.
GLUCOSE-6-PHOSPHATE
DEHYDROGENASE
This is an important enzyme in the
hexose monophosphate shunt pathway of
glucose.
Normal value of GPD in RBC is 125250 U/1012 cells.
It is mainly used for production of
NADPH. It has a special role in the RBC
metabolism.
AMYLASE
This splits starch to maltose. It is
activated by calcium, chloride and
fluoride ions.
It is produced by pancreas and
salivary glands
Normal serum value is 50-120 U/L,
(12-32 g/(hour L)).
LIPASE
It will hydrolyse triglyceride to monoglyceride and fatty acid.
The enzyme is present in pancreatic
secretion.
Normal serum range is 0.2-1.5
U/L.
Aldolase (ALD)
Enolase
It is a glycolytic enzyme. Neuronspecific enolase (NSE) is an iso-enzyme
seen in neural tissues and Apudomas.
NSE is a tumour marker for cancers
associated with neuro-endocrine origin,
small cell lung
cancer,neuroblastoma,pheochromocyto
m, medullary carcinoma of thyroid, etc.
Upper limit of NSE is 12 g/ml.