Plasma Proteins Enzymes As Diagnostic Tools

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72 Terms

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Colloid osmotic pressure

pressure exerted by plasma proteins on permeable membranes in the body; synonym for oncotic pressure

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Acute phase proteins

Proteins that have plasma concentrations that increase and decrease depending on inflammation

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Where are most proteins synthesized

liver

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Main anticoagulants

Heparin and EDTA

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What do anticoagulants bind to

calcium, magnesium, iron

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What type of protein are most plasma proteins

glycoproteins with the exception of albumin

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Plasma proteins on an electrophoresis description

Highest is albumin,
Second highest is gamma
then A2

<p>Highest is albumin,<br>Second highest is gamma<br>then A2</p>
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function of albumin

maintain osmotic pressure, transport drugs and big molecules like TAGs

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What does a lack of albumin do to the osmotic presure

it decreases it and causes H20 to leave the vessel and cause EDEMAS

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hypoalbuminemia

low albumin levels in the blood leading to edema form increased capillary permeability

tied to renal disease

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Hyperalbuminemia

an increased level of albumin in the blood causes dehydration and stasis

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Alpha 1 antitrypsin

inhibits trypsin and elastase

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What carries alpha 1 antitrypsin?

Alpha 1 globulin

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Haptoglobin

Binds free hemoglobin after RBC lysis to be destroyed by spleen

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Alpha 2 macroglobulin

thrombin inhibitor, and also carries cytokines and growthfacotrs, copper as well

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Ceruplasmin

Copper carrying protein in the body, also controls ferroxidase activity

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Thyroxine binding globulin

T3 T4 transporter

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Alpha 2 antiplasmin

This enzyme inhibits plasmin activity:

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plasmin

an enzyme that dissolves the fibrin of blood clots

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Protein C

inactivates factors Va and VIIIa

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Angiotensin

a peptide hormone that constricts blood vessels and regulates Bp

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Ferroxidase

oxidizes Fe2+ to Fe3+ for transport on ferritin

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Beta 2 microglobin

recognition of self vs nonself in the MHC complex

-regulates transferin

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Plasminogen

inactive form of plasmin

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Sex hormone binding globulin

A protein that binds with the sex hormones testosterone and estrogen

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Immunoglobins

Activated B2 antibodies

B2 usually are antibodies IgA, IgM

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B IgA function

regulates inflammation and cell mediated cytotoxicity, also degranulation

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IgM Beta function

Signals phagocytosis w bacteria aka opsonization
10 binding sites Pantameric

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Gamma globulin IgG

pathogen recognition, Phagocytosis, fetal placenta crossing

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Retinol binding protein

the specific protein responsible for transporting retinol

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thyroxine binding globulin

Majority of the thyroid hormones in blood are bound to this

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Cortisol binding globulin

Also known as CBG or transcortin, this is the carrier protein for one molecule of cortisol in the blood. It helps to extend its half-life.

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Pre albumin function

-Carrier protein for thyroid hormones T4 and T3
-Transport vitamin A

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Low levels of alpha fetoprotein

May indicate fetal chromosome abnormalities such as Down's syndrome.

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High levels of alpha fetoprotein

Indicate Neural tube defects

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Low levels of ceruloplasmin

signify wilsons disease and kayser fleisher rings

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wilsons disease

Disease of excess copper, which produces free radicals

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Kayser-Fleischer rings

golden-brown bands in the limbus of the cornea seen on slit lamp exam (due to copper deposition)

<p>golden-brown bands in the limbus of the cornea seen on slit lamp exam (due to copper deposition)</p>
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How to tell nephrotic syndrome?

increase B2 and A2 microglobulin

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hemopexin

Binds free ferrous iron floating in system after RBC degredtation. tries to prevent ROS

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C reactive protein

first line of defense in injury/inflamation bind to pneumococcal bacteria cell walls

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What can cause increased red blood cell destruction

- Inheritied diseases (SCA, Spherocytosis)
-Spleen issues
-Cirrhosis
-Myelofibrosis

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How to test for hemolytic anemia

Haptoglobin test - looks to see if heme is being destroyed faster than being replaced

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function of alpha 1 antitrypsin

aids in cleaning out lungs
-Cometimes causes broncho constriction
- sometimes results in pulmonary emphysema

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What is Lecithin cholesterol acyltransferase

turns cholesterol to ester form. to make HDL. deficienct causes vision issues

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what it Tissue derived enzymes

certain enzymes are found in specific tissue tyes, and the level of enzyme activity depends on tissue damage extent

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butyrylcholinesterase

Metabolizes SUCCINYLCHOLINE, and cocaine

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Alkaline phosphatase function

Removes phosphate groups from organic molecules; regulated by vitamin D

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Acid phosphatase use

Identify T-cell acute lymphocytic leukemia

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Creatine kinase function

phosphorylate ATP as it leaves mitochondria

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Gamma-Glutamyltransferase (GGT)

Elevated levels indicate early liver disorders found in bile ducts and liver

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What raises GGT

liver damage via drinking, anticonvulsants, drugs

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Amylase function

breaks down starches and sugars

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When is amylase and lipase levels increased, how are they excreted?

During acute pancreatitis, and renal failure

- excreted through pee

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Lipase fucntion

pancreatic enzyme necessary to digest fats

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Acetylcholineesterase

-Breaks down acetylcholine in synaptic cleft
-Can be inhibited by ACE inhibitors

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organophosphates

irreversible inhbitor of ACHE

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Atropine function

Sympathetic stimulation as it is an anticholinergic

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increased levels of BuCHE signal for

Nephrotic syndrome

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Alanine transaminase (ALT) increases result in

High increase: Acute viral hepatitis
Moderate increase: Liver cirrhosis, Jaundice

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Aspartate transaminse (AST)

take aspartate and oxoglutarate and make oxaloacetate and glutamate

found in liver and cardia and skele muscle

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Where can you see increases of AST

Viral hepatitis, MI, Circulatory failure

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What is the importance of AST/ALT ratio

ratio should be 0.8
-if over 2.0 - alcohol liver disease
-1.0 or less = possible non alcohol fatty liver

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Alkaline and acid phosphatases main job it to?

facilitate membrane transport by droppping on phopho group and 5 or 10 PH

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When should you see change in ALP levels?

Bile duct diseases and Bine diseases.

Pregnancy - Childhood

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What is the biggest factor for Acid phosphatase?

Prostate tumor marker (PSA)

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When is there an increase in LDH 1 and 2

during MI

<p>during MI</p>
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When is there an increase in LDH 5

During acute hepatitis

<p>During acute hepatitis</p>
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When does CK and Troponin spike

usually happens after chest pain troponin spikes higher than CK but it is good to know to watch out for MI

<p>usually happens after chest pain troponin spikes higher than CK but it is good to know to watch out for MI</p>
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A 55-year old man reports to the physician complaining that his feet swell frequently. His history shows that he has been a heavy drinker for several years. His AST:ALT ratio is above 2 and his GGT is elevated. What is the most likely cause of the swelling?

increased LDH-5
Increased alpha 2 macroglobulin
Increase in gamma globulins
Decreased conjugation of bilirubin
Low plasma albumin

Low plasma albumin cause swelling due to water leaving blood vessels causing edemas

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A chronic smoker is found to have lost elasticity of his lungs resulting in emphysema from overactivity of elastase. Which protein was most likely decreased in this patient?

Trypsinogen
Alpha-2 macroglobulin
Fibrinogen
Alpha-1 antitrypsin
Lipase

Alpha 1 antitrypsin!!!

causes emphysema and also removes elastin causing bronchoconstriction

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A 42-year old woman is being treated for pneumococcal infection. Which protein would be useful to measure daily to determine whether she is recovering?

Albumin
C-Reactive protein
Protein C
alpha-2 macroglobulin
Gamma globulins

C reactive protein attaches to pneumonia to see if there is still inflammation you can use a test

- first line of inflammation and infection from bacteria prokaryotes