Th1L07 Clinical use of enzyme measurements

Th1L07 Clinical use of enzyme measurements

1. Appearance of creatine kinase and lactate dehydrogenase in plasma after myocardial infarction

   • Increase in CK2 activity 24 hours after
   • Increase in LDH activity 48 hours after
     • Isozymes of lactate dehydrogenase can be separated by chromatography
       • five different isozymes of lactate hydrogenase exist
         • H4, H3M, H2M2, HM3 and M4
       • During a myocardial infarction
         • Endothelial cells rupture, releasing their contents into the blood stream
           • This increases the serum levels for lactate hydrogenase isozyme 1 and 2 and cane be used as a diagnostic tool
     • composed of four monomers
       • heart or muscle type

2. Clinical uses of enzyme inhibitors

   • Control of angiotensin production
     • cleavage of Angiotensin I to Angiotensin II results in peripheral vasoconstriction and aldosterone secretion
       • Treatment of heart failure with ACE inhibitors prevents sodium/water retention > oedema

3. Enzyme inhibitors as toxins

   • Mustard gas, sarin (nerve gases)
     • Organophosphorus
       • Inhibits cholinesterase irreversibly; poisons the enzyme

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