An interpretation of the serum alkaline phosphatase isoenzyme patterns in patients with obstructive liver disease.

Abstract Early treatment of patients with malignant disease and liver or bone metastasis may increase their survival time. We have used the activity patterns of liver and bone isoenzymes of alkaline phosphatase (ALP), separated by agarose gel electrophoresis, to detect early metastasis. We studied ALP isoenzyme patterns in a background population of 101 patients with no evidence of any disease that might influence this pattern; a healthy reference population (n = 330); and the following three groups of patients: 143 with malignant disease, 47 with nonmalignant liver disease, and 22 with nonmalignant bone disease. Cutoff and predictive values of liver ALP, high-molecular-mass (high-M(r)) ALP, and bone ALP were established for detecting liver and bone metastasis. The positive predictive value of liver and high-M(r) ALP was higher than that of total ALP in detecting liver metastasis, but liver and high-M(r) ALP did not enable us to differentiate between malignant and nonmalignant liver disease. Total ALP activity was of slightly more value than liver and high-M(r) ALP in enabling us to rule out liver metastasis. From bone ALP activity we could not distinguish between nonmalignant bone disease and bone metastasis. The negative predictive value of bone ALP in the diagnosis of bone metastasis was low, but its positive predictive value was high and superior to that of total ALP.

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Reaction Rate Retardation as a Method for Serum Alkaline Phosphatase Isoenzyme Measurement

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456328001700407 ◽

1980 ◽

Vol 17 (4) ◽

pp. 192-198 ◽

Cited By ~ 5

Author(s):

Pamela B Brown ◽

K O Lewis

Keyword(s):

Alkaline Phosphatase ◽

Reaction Rate ◽

Serum Alkaline Phosphatase ◽

Enzyme Reaction ◽

Intestinal Alkaline Phosphatase ◽

Wide Range ◽

Alkaline Phosphatase Isoenzymes ◽

Sensitivity And Selectivity ◽

Rate Retardation ◽

Alkaline Phosphatase Isoenzyme

A method for serum alkaline phosphatase isoenzymes using an enzyme reaction rate analyser is described. The complete urea-induced degradation of enzyme activity is monitored, from which individual isoenzyme activities are obtained by calculating the constituent exponential components of the degradation curve. Activities have been measured with adequate sensitivity and selectivity for up to four isoenzyme components in normal and in pathological sera. The identity of each isoenzyme present is assigned from its characteristic degradation half-life, and by this method bone and liver alkaline phosphatase are clearly distinguished and quantitated, and a composite value for placental-intestinal alkaline phosphatase activity is obtained. The approach promises to be applicable to a wide range of isoenzymes, and in analogy with ‘reaction rate’ the term ‘reaction rate retardation’ is suggested for the procedure.

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Serum Gamma-Glutamyl Transpeptidase Activity as an Indicator of Disease of Liver, Pancreas, or Bone

Clinical Chemistry ◽

10.1093/clinchem/18.4.358 ◽

1972 ◽

Vol 18 (4) ◽

pp. 358-362 ◽

Cited By ~ 112

Author(s):

Gifford Lum ◽

S Raymond Gambino

Keyword(s):

Alkaline Phosphatase ◽

Liver Disease ◽

Viral Hepatitis ◽

Bone Disease ◽

Leucine Aminopeptidase ◽

Serum Alkaline Phosphatase ◽

Metastatic Carcinoma ◽

Gamma Glutamyl Transpeptidase ◽

Serum Alkaline Phosphatase Activity ◽

Glutamyl Transpeptidase

Abstract Serum γ-glutamyl transpeptidase (GGT), leucine aminopeptidase, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase activities were assayed in controls and in patients with liver, pancreatic, or bone disease. GGT activity was above normal in all forms of liver disease studied (viral hepatitis, cirrhosis, cholecystitis, metastatic carcinoma to liver, pancreatic carcinoma, liver granuloma, and acute pancreatitis). GGT more sensitively indicated hepatic disease than did alkaline phosphatase, much more so than did leucine aminopeptidase. GGT was disproportionately more active in relation to the transaminases in cases of intraor extrahepatic biliary obstruction; the reverse was true in cases of viral hepatitis. GGT activity was normal in children, adolescents, and pregnant women, and in cases of bone disease and renal failure. Kinetic measurement of GGT activity offers a simple, sensitive, and direct means for distinguishing whether bone or liver is the source of increased serum alkaline phosphatase activity. Activity was highest in obstructive liver disease.

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Serum alkaline phosphatase isoenzyme activities in canine malignant mammary neoplasms with and without osseous transformation

Veterinary Clinical Pathology ◽

10.1111/j.1939-165x.2006.tb00132.x ◽

2006 ◽

Vol 35 (3) ◽

pp. 287-290 ◽

Cited By ~ 8

Author(s):

M. Karayannopoulou ◽

Z. S. Polizopoulou ◽

A. F. Koutinas ◽

A. Fytianou ◽

N. Roubies ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Serum Alkaline Phosphatase ◽

Mammary Neoplasms ◽

Alkaline Phosphatase Isoenzyme

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Hypophosphatasia (adult form): quantitation of serum alkaline phosphatase isoenzyme activity in a large kindred.

Clinical Chemistry ◽

10.1093/clinchem/26.7.840 ◽

1980 ◽

Vol 26 (7) ◽

pp. 840-845 ◽

Cited By ~ 24

Author(s):

J L Millán ◽

M P Whyte ◽

L V Avioli ◽

W H Fishman

Keyword(s):

Alkaline Phosphatase ◽

Serum Alkaline Phosphatase ◽

Hepatic Metabolism ◽

Total Activity ◽

Heat Inactivation ◽

Mean Values ◽

Adult Form ◽

Cellulose Acetate Membranes ◽

Alkaline Phosphatase Isoenzymes ◽

Alkaline Phosphatase Isoenzyme

Abstract We used heat inactivation, L-phenylalanine inhibition, and electrophoresis on polyacrylamide gel and cellulose acetate membranes--with and without use of specific antisera against the liver-bone, intestinal, and placental isoenzymes--to distinguish and quantitate the different alkaline phosphatase isoenzymes in sera from 23 adult members of a kindred affected by the adult form of hypophosphatasia. Nine subjects had values for total activity more than two standard deviations below the mean values for age- and sex-matched normal persons. Bone isoenzyme was diminished in all nine, whereas liver isoenzyme was subnormal in only four. Phosphoethanolamine and phosphoserine in the urine of eight hypophosphatasemic individuals correlated inversely with both total and liver alkaline phosphatase activity in their serum, but not with the activity of the bone isoenzyme. Total activity in the serum of adult kindred members correlated best with the circulating liver isoenzyme activity. The findings suggest that altered hepatic metabolism is responsible for the increased urinary excretion of phosphoethanolamine, and perhaps phosphoserine, in hypophosphatasia.

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