Plasma Proteins Enzymes As Diagnostic Tools

Colloid osmotic pressure

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

Acute phase proteins

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

Where are most proteins synthesized

liver

Main anticoagulants

Heparin and EDTA

What do anticoagulants bind to

calcium, magnesium, iron

What type of protein are most plasma proteins

glycoproteins with the exception of albumin

Plasma proteins on an electrophoresis description

Highest is albumin,
Second highest is gamma
then A2

function of albumin

maintain osmotic pressure, transport drugs and big molecules like TAGs

What does a lack of albumin do to the osmotic presure

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

hypoalbuminemia

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

tied to renal disease

Hyperalbuminemia

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

Alpha 1 antitrypsin

inhibits trypsin and elastase

What carries alpha 1 antitrypsin?

Alpha 1 globulin

Haptoglobin

Binds free hemoglobin after RBC lysis to be destroyed by spleen

Alpha 2 macroglobulin

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

Ceruplasmin

Copper carrying protein in the body, also controls ferroxidase activity

Thyroxine binding globulin

T3 T4 transporter

Alpha 2 antiplasmin

This enzyme inhibits plasmin activity:

plasmin

an enzyme that dissolves the fibrin of blood clots

Protein C

inactivates factors Va and VIIIa

Angiotensin

a peptide hormone that constricts blood vessels and regulates Bp

Ferroxidase

oxidizes Fe2+ to Fe3+ for transport on ferritin

Beta 2 microglobin

recognition of self vs nonself in the MHC complex

-regulates transferin

Plasminogen

inactive form of plasmin

Sex hormone binding globulin

A protein that binds with the sex hormones testosterone and estrogen

Immunoglobins

Activated B2 antibodies

B2 usually are antibodies IgA, IgM

B IgA function

regulates inflammation and cell mediated cytotoxicity, also degranulation

IgM Beta function

Signals phagocytosis w bacteria aka opsonization
10 binding sites Pantameric

Gamma globulin IgG

pathogen recognition, Phagocytosis, fetal placenta crossing

Retinol binding protein

the specific protein responsible for transporting retinol

thyroxine binding globulin

Majority of the thyroid hormones in blood are bound to this

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.

Pre albumin function

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

Low levels of alpha fetoprotein

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

High levels of alpha fetoprotein

Indicate Neural tube defects

Low levels of ceruloplasmin

signify wilsons disease and kayser fleisher rings

wilsons disease

Disease of excess copper, which produces free radicals

Kayser-Fleischer rings

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

How to tell nephrotic syndrome?

increase B2 and A2 microglobulin

hemopexin

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

C reactive protein

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

What can cause increased red blood cell destruction

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

How to test for hemolytic anemia

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

function of alpha 1 antitrypsin

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

What is Lecithin cholesterol acyltransferase

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

what it Tissue derived enzymes

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

butyrylcholinesterase

Metabolizes SUCCINYLCHOLINE, and cocaine

Alkaline phosphatase function

Removes phosphate groups from organic molecules; regulated by vitamin D

Acid phosphatase use

Identify T-cell acute lymphocytic leukemia

Creatine kinase function

phosphorylate ATP as it leaves mitochondria

Gamma-Glutamyltransferase (GGT)

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

What raises GGT

liver damage via drinking, anticonvulsants, drugs

Amylase function

breaks down starches and sugars

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

During acute pancreatitis, and renal failure

- excreted through pee

Lipase fucntion

pancreatic enzyme necessary to digest fats

Acetylcholineesterase

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

organophosphates

irreversible inhbitor of ACHE

Atropine function

Sympathetic stimulation as it is an anticholinergic

increased levels of BuCHE signal for

Nephrotic syndrome

Alanine transaminase (ALT) increases result in

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

Aspartate transaminse (AST)

take aspartate and oxoglutarate and make oxaloacetate and glutamate

found in liver and cardia and skele muscle

Where can you see increases of AST

Viral hepatitis, MI, Circulatory failure

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

Alkaline and acid phosphatases main job it to?

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

When should you see change in ALP levels?

Bile duct diseases and Bine diseases.

Pregnancy - Childhood

What is the biggest factor for Acid phosphatase?

Prostate tumor marker (PSA)

When is there an increase in LDH 1 and 2

during MI

When is there an increase in LDH 5

During acute hepatitis

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

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

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

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