Clinical Chemistry 2 - Laboratory - 4 - Alkaline Phosphatase - Complete

Hydrolase

ALP classification

3.1.3.1

ALP enzyme commission number

Various phosphomonoesters

What does ALP catalyze the hydrolysis of at an alkaline pH (pH 9-10)

Alcohol

ALP releases inorganic phosphates from organic phosphate esters to produce ___

Magnesium

ALP activator

Intestine, Liver (Sinusoidal and bile canalicular membrane), Bone (Osteoblasts), Spleen, Placenta, Kidneys

ALP highest concentrations in these organs

Paget's disease, Biliary tract obstruction

ALP increased in these conditions

Cirrhosis, Hepatitis

ALP slight elevation in these conditions

Non-specific

ALP is specific or non-specific?

Gamma-glutamyl transferase

Enzyme tested with ALP to know whether disease's origin is liver or bone

Liver

Increase in ALP and Gamma-glutamyl transferase means the origin of the disease is from what organ?

Obstructive jaundice

Increase in ALP and Gamma-glutamyl transferase is indicative of what condition?

Bone

Increase in ALP and and normal Gamma-glutamyl transferase means the origin of the disease is from what organ?

Osteomalacia, Rickets

Increase in ALP and and normal Gamma-glutamyl transferase indicates what conditions

Osteomalacia

Osteomalacia or Rickets

Bone disease for adults

Rickets

Osteomalacia or Rickets

Bone disease for children

Bowers-McComb method

ALP determination method used

Para-nitrophenylphosphate

Bowers-McComb substrate

Bowers-McComb method

ALP determination reference method

Phosphate-accepting buffer

Bowers-McComb buffer used

Classic colorimetric assay

Bowers-McComb principle

Biliary-Liver

Determine ALP isoenzyme

Heat/Urea inhibition: +

L-Phenylalanine: -

Anodal mobility: 1

Bone

Determine ALP isoenzyme

Heat/Urea inhibition: +++

L-Phenylalanine: -

Anodal mobility: 2

Placenta

Determine ALP isoenzyme

Heat/Urea inhibition: Heat-stable (-)

L-Phenylalanine: +++

Anodal mobility: 3

Intestinal

Determine ALP isoenzyme

Heat/Urea inhibition: +

L-Phenylalanine: +++

Anodal mobility: 4

Regan-Lung

Determine ALP isoenzyme

Heat/Urea inhibition: --

L-Phenylalanine: +++

Anodal mobility: 5

Biliary-Liver

ALP isoenzyme that moves fastest to anode

Major liver band

Liver band that migrates fastest to anode

Alpha-1 or Fast liver band

Liver band that is present in metastasis in presence of ectopic production by the metastatic tissue

Alpha-1 or Fast liver band

Liver band that migrates to the anode fast in cases if the patient has metastasis or metastatic carcinoma of the liver

Alpha-1 or Fast liver band

Liver band that is also an indicator of obstructive liver disorder

Placenta

ALP isoenzyme that is most heat-stable

60-65°C for 30 minutes

Placental ALP is not inhibited at this temperature and duration

Bone

ALP isoenzyme most inhibited and most-labile

B, O blood group

What blood groups can secrete intestinal ALP?

Raegen, Nagao

Carcinoplacental ALP

Nagao

Isoenzyme of Raegan

Raegan

Carcinoplacental ALP that comes from ectopic production by malignant tissues; Isoenzyme of Nagao

Liver, Bone, Intestine

ALP isoenzymes in normal people, not pregnant

Colorless

Para-nitrophenylphosphate color in alkaline medium

Para-nitrophenol

In Bowers-McComb method, Para-nitrophenylphosphate is converted into ___ with the help of ALP

Yellow

Para-nitrophenol color in alkaline medium

Bowers-McComb method

Most commonly used method for ALP

pH 10.15-10.2

Bowers-McComb method pH

pH 10.4

Bowers-McComb buffer, maintained using ERBA, pH

AMP Buffer, Magnesium acetate, Zinc sulfate, HEDTA

ALP Reagent 1 composition

Para-nitrophenylphosphate

ALP Reagent 2 composition

4:1

Monoreagent method R1:R2 ratio

Non-hemolytic serum

ALP preferred specimen

Heparinized plasma

ALP other accepted specimen

4 hours

ALP stable for how long at 20-25°C

3 days

ALP stable for how long at 4-8°C

2 months

ALP stable for how long at -20°C

<8%

ALP activity loss at 2-8°C within 3 days

<10%

ALP activity loss at 15-25°C within 3 days

54-369 U/L

ALP expected values (37°C) in females 4-15 years old

42-98 U/L

ALP expected values (37°C) in females 20-50 years old

53-141 U/L

ALP expected values (37°C) in females 60 years old or older

54-369 U/L

ALP expected values (37°C) in males 1-12 years old

53-128 U/L

ALP expected values (37°C) in males 20-50 years old

56-119 U/L

ALP expected values (37°C) in males 60 years old or older

4.5-1300 U/L

ALP measuring range

Bilirubin up to 40 mg/dL, Triglycerides up to 2000 mg/dL, Hemolysis up to 5 g/L

ALP interferences

2764

ALP kinetic factor

405 nm

ALP absorbance

20 uL

ALP sample volume

2000 uL

ALP reagent volume

60 seconds

ALP lag time

60 seconds

ALP kinetic interval

4

ALP number of readings

2764

ALP kinetic factor

Another reagent

ALP blank with?

Increasing

ALP reaction direction

3.1.3.1

ALP EC number