MLS 422 Enzymes

Exam 3 part 2

Pyridoxal phosphate

coenzyme for AST and ALT

Magnesium

activator for ALP, ACP, CK

Calcium and chloride

activators for amylase

NAD

coenzyme for LD

Malate dehydrogenase coupled reaction

AST

Lactate dehydrogenase coupled reaction

ALT

p-Nitrophenyl phosphate at pH 10.2 (Bowers-McComb)

ALP

p-Nitrophenyl phosphate at pH 5.0

ACP

Tartrate inhibition

prostatic ACP

gamma-Glutamyl-p-nitroanilide

GGT

Oliver-Rosalki (reverse reaction)

CK

Amyloclastic, saccharogenic, chromogenic

amylase

Cherry-Crandall (olive oil substrate)

lipase

Heat inactivation at 56 C

ALP bone isoenzyme

Anti-M immunoinhibition

CK-MB and LD-1

More liver specific transaminase

ALT

Not found in cardiac or skeletal muscle

GGT

Not found in liver or RBCs

CK

Highest elevation in Paget’s disease

ALP

Highest elevations in pernicious anemia and hemolytic disorders

LD

Smallest enzyme, filtered into urine

amylase

More specific for acute pancreatitis

lipase

Historical prostate cancer marker (replaced by PSA)

ACP

Enzymes falsely increased by hemolysis

ALT, AST, ALP, ACP, CK, LD

LD storage

loss of activity occurs faster at lower temps

ACP stability

1-2 hrs at room temp

Effect of morphine/codeine on amylase and lipase

Increased levels

Specimen for G-6-PD deficiency

red cell hemolysate

LD-1 and LD-2

hemolytic anemia and acute renal infarction

LD-3

Lymphocytosis and acute pancreatitis

LD-4 and LD-5

Liver tissue and skeletal muscle

Normal pattern

LD-2 > LD-1>LD-3, minor amounts of LD-4 and LD-5

A flipped pattern (LD-1 > LD-2) means

Acute myocardial infarction

Most heat-labile ALP

bone

Most heat-stable ALP

liver, placental, and intestinal

Regan

carcinomas, especially ovarian

Nagao

carcinomas, pleural, pancreas, bile duct

ALP increased and GGT increased

liver disorder

ALP increased and GGT normal

not liver

Amylase increased and lipase normal

salivary gland

Enzyme used to monitor alcohol use during treatment

GGT

Prolonged apnea after anesthesia

Cholinesterase