Plasma 1 ml collected in a greentop heparin tube is also acceptable. Alkaline phosphatase comes in many different forms, depending largely on the area of the body and organ in which they are produced. Alkaline phosphatase of cancerous larynx tissue in comparison. Corticosteroidinduced alkaline phosphatase isoenzyme in. Introduction alpalkaline phosphotaseis a hydrolase enzyme responsible for removing phosphate groups from many types of molecule including neucleotides,proteins and alkaloids. Spife 3000 alkaline phosphatase alp isoenzyme procedure. View details of cost of test, pretest information and report availability on. Specimen serum 1 ml collected in a gold, red, or redgraytop tube. The process of removing the phosphate group is called dephosphorylation. Alkaline phosphatase alp, alkp, alpase, alk phos ec 3. In serum, the specific activity of alkaline phosphatase decreased slightly after 10 days 18.
Grace fromthe departments ofclinicalbiochemistry andsurgery, university hospitaluniversity ofwestern ontario, 339 windermere road,london, ontario n6g2k3, canada. This isoenzyme is normally elevated in growing children and adults over the age of 50. Alkaline phosphatase, total and isoenzymes, serum billings. Alkaline phosphatase, total and isoenzymes, serum alomere.
Alkaline phosphatase, total and isoenzymes, serum national. Common use to assist in the diagnosis of liver cancer and cirrhosis, or bone cancer and bone fracture. Abstract alkaline phosphatases are found in different living species and play crucial roles in various significant functions, such as hydrolyzing a. Quantitative determination of the corticosteroidinduced isoenzyme of alkaline phosphatase cap was evaluated as a screening test for hyperadrenocorticism hac in dogs. L1 can be increased in some nonmalignant diseases such as cholestasis, cirrhosis, viral.
T h e three metal ions at each active center are shown as spheres an d the two active. Iap is partially heatstable isozyme present at high levels in intestinal tissue. Alkaline phosphatase, enzyme that is normally present in high concentrations in growing bone and in bile. Alkaline phosphatase serum, plasma 1 name and description of analyte 1. Results of apid were compared with actual patient diagnoses as determined by. Placental alkaline phosphatase is an isoenzyme of alkaline phosphatase, which can be distinguished from other alkaline phosphatases by biochemical means. There are three genes for alp intestinal, placental and the liverkidneybone gene. Alkaline phosphatase isoenzymes and leukocyte alkaline.
Alkaline phosphatase alp is present in a number of tissues including liver, bone, intestine, and placenta. Test classification this test has been cleared or approved by the u. Alkaline phosphatase forms a large family of dimeric enzymes, usually confined. Alkaline phosphatase, isoenzymes bone, liver and other fraction reported in ul and iul. The activity of alp found in serum is a composite of isoenzymes from those sites and, in some circumstances, placental or regan isoenzymes. Summary and explanation of test human alkaline phosphatase alkp, ec. Alkaline phosphatase total and isoenzymes northwell. Mayo medical laboratories web page december 2017 updates.
Food and drug administration and is used per manufacturers instructions. Alkaline phosphatase measurements are used in the diagnosis and treatment of liver, bone, and parathyroid disease. T h e non crystallographic twofold axis is vertical an d the maximum dimension of the dimer is hori zontal. Alkaline phosphatase total and isoenzymes northwell health. Alkaline phosphatase deficiency is a hereditary trait called hypophosphatasia, which results in bone deformities. These enzymes are widely distributed in nature, including prokaryotes and higher eukaryotes 36, with the exception of some higher plants. Pdf isoenzymes of alkaline phosphatase in epileptic. Alkaline phosphatase ap is a nonspecific phosphomonoester hydrolase that catalyzes the hydrolysis of a wide variety of organic monophosphates. Iliescu2, manole cojocaru3 and adela joanta4 1clinical laboratory, department of hematology, emergency county hospital targu jiu, gorj, romania. Alkaline phosphatase alp in human serum originates from several sources including bone. Alkaline phosphatase and isoenzymes synonymacronym. The relative position and colour intensity of the bands with and without lectin a migration retarding sugarbinding protein can provide a qualitative impression as to the organ.
The isoenzymes of alp differ in their physiochemical and electrophoretic properties and, by taking advantage of these differences, the individual isoenzymes can be identified. Because of the wide distribution, limited information can be obtained from a total alp activity assay. Laboratory procedure manual centers for disease control. Alkaline phosphatase isoenzymes and leukocyte alkaline phosphatase score in patients with acute and chronic disease. This test is most often used to test alp made in the tissues of the liver and bones. Pdf studies on alkaline phosphatase isoenzyme in the serum. In the presence of magnesium and zinc ions, pnitrophenyl phosphate is cleaved by phosphatases into phosphate and. Alkaline phosphatase, isoenzymes to intertinal, bone, liver, placental and macrohepatic. Alkaline phosphatase isoenzymes typing, serum clinical background. Significance of elevated liver alkaline phosphatase in serum. Useful for determining the tissue source of elevated total. Alkaline phosphatase alp in the circulation is a mixture of isoforms from the liver, kidney, bone and intestine. The wellknown marker of bone formation is bone alkaline phosphatase, which is produced by osteoblasts and is required for osteoid formation and matrix mineralization.
Alp is synthesized in a variety of tissues and has different. Serum alp is of interest in the diagnosis of 2 main groups of conditionshepatobiliary disease and bone disease associated with increased osteoblastic activity. Alkaline phosphatase isoenzymes medical laboratory tests. May 15, 2019 higherthannormal alkaline phosphatase alp levels for your age and sex may not necessarily mean you have a problem. Each monomer contains five cysteine residues, two zinc atoms and one magnesium atom crucial to its catalytic function, and it is optimally active at alkaline ph environments. An interpretation of the elevation of serum alkaline. Alkaline phosphatase is also present in the blood and is an important clinical diagnostic indicator for several illnesses, including chronic myelogenous leukemia. Alkaline phosphatase isoenzymes regional medical lab test. Helena biosciences europe alkaline phosphatase simple.
The helena biosciences europe alkaline phosphatase isoenzyme kit separates and quantifies alkaline phosphatase isoenzymes by agarose gel electrophoresis. Alkaline phosphatase isoenzyme determination apid is in common use despite evidence suggesting that the results correlate poorly with actual sites of disease. Alkalische phosphataseisoenzyme untersuchungsprogramm. A histochemical study of alkaline phosphatase alp was carried out using the simultaneous azo coupling method, and. Alkaline phosphatase isoenzymes typing, serum newcastle. Alkaline phosphatase alp isoenzymes apiso general information. The different molecular forms of this isoenzyme, which can be produced and separated by physical means, are referred as variants of placental alkaline phosphatase. We recommend the hepatitis b vaccination series for all analysts working with whole. Consider all plasma or serum specimens potentially positive for infectious agents including hiv and the hepatitis b virus. Alkaline phosphatase alp is an enzyme thats naturally present throughout your body. Each isoenzyme of alp is different, depending on where in. The spife alkaline phosphatase alp isoenzyme method is intended for the qualitative andor semiquantitative determination of serum alkaline phosphatase. Alkaline phosphatase and isoenzymes definition of alkaline.
Fishman wh, perspectives on alkaline phosphatase isoenzymes, the american journal of medicine, 1974. Diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases determining the tissue source of increased alkaline phosphatase alp. Human alkaline phosphatase enzyme is part of a group of enzymes phosphoric monoester hydrolases that catalyse the hydrolysis and transfer of a phosphate group at alkaline ph. Iliescu2, manole cojocaru3 and adela joanta4 1clinical laboratory, department of hematology, emergency. Monday through friday test classification this test has been cleared or approved by the u. Dr lal pathlabs offers test service for alkaline phosphatase alp isoenzymes test for checking disorders of bone and liver. Each monomer contains five cysteine residues, two zinc atoms and one magnesium atom crucial to its catalytic function, and it is optimally active at alkaline ph environments alp has the physiological role of dephosphorylating compounds. The tissue source of elevated alp in serum, however. Isoenzymes of human alkaline phosphatase sciencedirect. There are several different forms of alp called isoenzymes. Clinically significant elevated levels are seen in the presence of biliary tract obstruction and conditions involving increased bone turnover.
Recent advances with alkaline phosphatase isoenzymes and their. Bisher wurden funf gewebespezifische isoenzyme gefunden, deren. The structure of the enzyme depends on where in the body it is produced. Differentiating between a liver and bone source of alp. Alkaline phosphatase alp is an enzyme found in many body tissues such as liver, bile ducts, bone, and intestine. Isoenzymes of alkaline phosphatase in epileptic patients receiving carbamazepine monotherapy article pdf available in journal of clinical pathology 446. The ap isozyme constituted about 90% of the total alp activity, the iap isozyme less than 10% and the plap. Chromatographic patterns of human placental alkaline phosphatase separated on deaecellulose with a 0. Alkaline phosphatase is a broad term associated with nonspecific phosphomonesterases with activity optima at alkaline ph. It is essential for the deposition of minerals in the bones and teeth. Alkaline phosphatase isoenzymes liver 1% liver 1 06 years.
Diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases. Determination of alkaline phosphatase isoenzymes and. Bone isoenzyme is elevated as a result of increased osteoblastic activity. Alkaline phosphatase alp is a predominant enzyme which plays a significant role in the breakdown of organic substances. The latter isoforms undergo posttranslational modification with different carbohydrate sidechains being attached. Alkaline phosphatase isoenzyme tests will help measure the amounts of different types of alkaline phosphatase present in the blood.
The alkaline phosphatase isoenzymes are separated by electrophoresis into different bands. Evaluate contribution of liver, bone, and intestinal isoenzymes in relationship to total alkaline phosphatase. In contrast to the other alp isoenzymes, the carbohydrate side. Test code alkpiso alkaline phosphatase total and isoenzymes additional codes. Alp elevations tend to be more marked more than 3fold in extrahepatic biliary obstructions eg, by stone or cancer of the head of the pancreas than in intrahepatic obstructions, and the more complete the obstruction, the greater the elevation. Currently, regan, nagao and kasahara isoenzymes are. Of the 253 patients with elevation of band l, there were 166 with hepatic disorders usually associated. Alkaline phosphatase alp is an enzyme found in the liver. The widespread occurrence of ap in nature suggests its involvement in fundamental biochemical processes, however, there is no positive evidence regarding its physiological function, or the nature of. The accuracy of alkaline phosphatase isoenzyme determination. Kaslow, md, facp, facaai physician and surgeon board.
Pdf studies on alkaline phosphatase isoenzyme in the. Alkaline phosphatase intended use the alkaline phosphatase assay is used for the quantitation of alkaline phosphatase in human serum or plasma. Performance characteristics were verified by mayo clinic in a manner consistent with clia requirements. When uncertainty persists in determining the origin of increased total alkaline phosphatase alp, isoenzyme studies are performed to determine which of the predominant isoenzyme, either bone, liver, intestine or if pregnant, the placenta, is causing the total increase. In the serum, two types of alkaline phosphatase isozymes predominate. Alkaline phosphatase is divided into four isozymes depending upon the site of tissue expression. When the total alkaline phosphatase activity is increased, the isoenzymes are useful in determining the source of the increased activity. May 25, 2018 alkaline phosphatase alp is an enzyme thats naturally present throughout your body. Alkaline phosphatase alp isoenzymes test for disorders of. The enzyme requires zinc and is further activated by magnesium ions for activity. Additional sources of alp include the proximal tubules of the kidneys, pulmonary alveolar cells, germ cells, vascular bed, lactating mammary glands, and granulocytes of circulating blood. L1 can be increased in some nonmalignant diseases such as cholestasis, cirrhosis, viral hepatitis and in various biliary and hepatic pathologies. View details of cost of test, pretest information and report availability on dr lal pathlabs.
The highest total alp values have been attributed to an increased bone isoenzyme level due to paget disease or renal rickets. Alkaline phosphatase, total and isoenzymes, serum uchicago. Alkaline phosphatase alp testing is used to detecting liver diseases and bone disorders. Measurement of alkaline phosphatase isoenzymes may be useful in determining the source of increased total alkaline phosphatase activity and may assist in the diagnosis of hepatobiliary disorders and bone disease associated with increased osteoblastic activity. What do your alkaline phosphatase test results mean.