OTHER LIVER ENZYMES Flashcards
Alkaline Phosphatase (ALP) is also known as
Alkaline orthophosphoric monoester phosphohydrolase
Alkaline Phosphatase (ALP) catalyze hydrolysis of various _______ at pH
phosphomonoesters, alkaline pH of 9-10
ALP liberate _______ from an ________ with production of _____
inorganic phosphate, organic phosphate ester, alcohol
ALP requires ____ activator
Mg2+ activator
Among healthy individuals, most of the ALP is derived from the _________
liver and the bone (osteoblast)
ALP major tissue sources
Liver, Bones (osteoblast), Intestine, Placenta, Kidneys
Elevated ALP can be used for evaluation of _________ and ________
hepatobiliary and bone disorders
Based on molar absorptivity of p-Nitrophenol
BOWERS & McCOMB
BOWERS & McCOMB absorbance is measured at
405 nm (yellow)
Methods that has β-glycero-phosphate as substrate and Inorganic PO4+ Glycerol as product
(1-4) Bodansky, Shinowara,
Jones, Reinhart
Methods that has p-nitrophenyl phosphate as substrate and p-nitrophenol (yellow) as end product
(5) Bessy, Lowry & Brock
(6) Bowers & McComb
King and Armstrong substrate and end product
Substrate: Phenyl phosphate
End Product: Phenol
ALP reference range
Adult: 30-90 u/L
0-3 Months: 70-220 u/L
3-10 Years: 50-260 u/L
10-Puberty: 60-295 u/L***
Tests for ALP isoenzymes
Electrophoresis, Chemical Inhibition, & Heating
suppresses the activity of certain enzyme so that specific isoenzyme is measured
Chemical Inhibitors
5 ALP isoenzymes
Liver ALP
Bone ALP
Placental ALP
Carcinoplacental ALP
INTESTINAL ALP
The most anodic/ fastest to migrate ALP isoenzyme
LIVER ALP
Liver ALP is increased in ____
hepatobiliary/ liver diseases
2 fraction of ALP isoenzyme
- Fast liver (a1) band
- Major liver band
Liver ALP fraction for fast migration to the anode
Fast liver (a1) band
liver ALP fraction that is contributing to the abundance of ALP in the circulation among healthy individual
Major liver band
Liver ALP inhibitor
Levamisole reagent
2nd most anodic/ fastest ALP isoenzyme
BONE ALP
Bone ALP is HEAT ______ fraction; readily denatured (significantly decreased in ____)
HEAT LABILE, 56degC
Bone ALP is increased in _______, _________-, and physiological _______
bone disease, healing of bone fractures, and physiological bone growth
Pathologic: Osteitis deformans/ Paget’s disease – ______deformity, the rate of bone resorption is _______; osteoclast activity is increased =
osteoclast, increased, Inc. ALP
Bone ALP inhibitors
Levamisole & 3M urea
3rd most anodic ALP isoenzyme
PLACENTAL ALP
PLACENTAL ALP most HEAT _____ fraction
HEAT STABLE
PLACENTAL ALP increased in pregnancy; _______ week of
gestation
16th-20th
Placental ALP is associated with _______
malignancy/ cancer (Carcinoplacental ALP)
Placental ALP inhibitor
Phenylalanine
1 - Regan ALP/ Bone ALP co-migrator is Most HEAT ______ ALP – when serum sample is heated at _______ , Regan ALP is still intact and functiona
HEAT STABLE ALP
65°C for 30 minutes
1- Regan ALP/ Bone ALP co-migrator is increased in
Lung, Breast, & Gynecological cancer
1- Regan ALP/ Bone ALP co-migrator inhibitor
Phenylalanine
1- Nagao ALP is increased in
Adenocarcinoma of the Pancreas and Bile Duct, & Pleural cancer
4th most anodic/ slowest moving fraction ALP isoenzyme
INTESTINAL ALP
1- Nagao ALP inhibitors
Phenylalanine & L-leucine
INTESTINAL ALP is increased in conditions:
Physiologic
Pathologic
Physiologic: px with blood type B or O, increased when fatty meal is consumed
Pathologic: GIT disorders
INTESTINAL ALP inhibitors
Phenylalanine
Heat Stability is used to differentiate ____ and ____ ALP isoenzymes
liver and bone
Total ALP elevations by Liver or Bone ALP is differentiated by heating of serum at ______
56°C for 10 minutes
From most heat stable to most heat labile/ unstable ALP isoenzyme
(1) Placental, (2) Intestinal, (3) Liver, (4) Bone
Heat Stability
Liver ALP: ALP residual activity is decreased to ______
Bone ALP: ALP residual activity is decreased to ______
> 20%
<20%
Acid Phosphatase (ACP) is also known as
Acid orthophosphoric monoester phosphohydrolase
Acid Phosphatase (ACP) catalyze hydrolysis of various phosphomonoesters at an _____
acid pH
ACP major sources
Nonspecific; Prostate gland (men), RBC, Platelets, Bones (osteoclast)
To differentiate the prostatic form from the non-specific form like RBC acid, ______ are added
inhibitors
inhibits specific prostatic ACP
L-tartrate Ions
inhibit red cell ACP
Formaldehyde & Cupric Ions
ACP diagnostic significance
evaluation of metastatic carcinoma of prostate and Forensic investigation of rape
ACP histological exam in cases of rape
lesions & forceful entry
The activity of ACP in the seminal fluid may persist for ____
4 days
Assay for ACP Activity
BOWERS & McCOMB
ACP reference range
Prostatic ACP: 0-3.5 ng/mL
ACP methods
1: Quantitative End Point
2: Continuous Monitoring
Continuous Monitoring substrate
a-naphthyl phosphate
Quantitative End Point substrate
Thymolphthalein monophosphate
Gutman & Gutman substrate and end product/s
Phenyl Phosphate
Inorganic Phosphate
Shinowara substrate and end product/s
PNPP
P-nitrophenol
Babson, Read &
Phillips substrate and end product/s
Alpha Naphthyl Phosphate
Alpha naphthol
Roy & Hillman substrate and end product/s
Thymolphthalein Monophosphate
Free thymolphthalein