CLINICAL CHEMISTRY

ENZYMES
Christiana lethe

 ENZYMES

as markers cellular damage

The

measurement of the enzyme activity is

an important function of clinical laboratories

ENZYMES

used in the investigation of

desease in several organs

NOT

ALL intracellular enzymes are equally

valuable as indicators of cellular damage

 The

result of elevation of enzyme

activity in blood has relation with
mass of the damaged or
malfunctioning of organ

The estimation if only one liver cell

in every 750 is damaged, elevation in
blood level of ALT is detectable

 Patological

damage to a tissue embraces

a wide spectrum of effect
:

To

increase only the permeability of the cell membrane

and----allow cytoplasmic enzymes to leak into the blood

To

disrups mitochondrial membrane, both cytoplasmic

and mitochonrial enzymes are detected in blood

A suitable enzymes are assayed in blood and the knowledge of the intracellular
location of enzymes can determine the nature and severity of a pahological process

Liver,

cardiac and skeletal enzymes :

Aminotransferases

: ASPARTATE and ALANINE

AMINOTRANSFERASE (ALT, AST)
kinase (ADENOSINE TRIPHOSPHATE :
CREATINE N-PHOSPHOTRANFERASE) CK

Creatine

phosphatase (ORTHOPHOSPHORICMONOESTER PHOSPHOHYDROLASE) ALP

Alkaline

Lactate

dehydrogenase
OXIDOREDUCTASE) LD

(L-lactate : NAD

i
LIVER ENZYME :
AST,ALT = aminotransferase
GLD = glutamate dehydrogenase
ALP = alkaline phosphatase
NTP = 5-nucleotidase
GGT = y glutamyl transferase
GST = glutathione S-transferase
CHE = serum cholinesterase

 catalyse AMINOTRANSFERASES

:
enzymes that the interconvertion of
amino acid to 2-oxo-acids by transfer of
amino groups

pair of donor and acceptor amino

groups, AST catalyzes, P-5-P as
coenzyme in amino- transfer reaction

 Coenzymes

in amino transferase
reaction are pyridoxal-5-phosphate
(P-5-P) and amino analogue
pyridoxamine-5-phosphate

The

P-5-P is bound to the

apoenzyme and serves as a true
prostetic group

AST is found primarily in the heart, liver, skeletal muscle

and kidney
.is found in cell

ALT is found primarily in liver and kidney,

Exclusively cytoplasmic, both mitochondria and

cytoplasmic

Both AST and ALT normaly are present in human

plasma,bile, CSF,

saliva, not is found in urine unless a kidney lession is

present
.

 Liver

desease is most important cause

of increased transaminase activity in
serum
ALT activity higher than that of AST
In

viral hepatitis and other form of liver

desease associate with acute hepatic
necrosis, ALT and AST,are elevated
before clinical sign, sympton appear

 Persistence

of increase ALT for more

than 6 mounth after an episode of
acut hepatitis is used to diagnose
chronic hepatis