important enzymes in clinical practice

important enzymes in clinical practice

1. Alanine Amino Transferase (ALT)

   • Liver disease with liver cell damage

2. Aspartate transaminase (AST) AST is high in heart muscles and skeletal muscles

   • heart and skeletal muscle diseases
     • In myocardial and skeletal muscle cells damage

3. Creatine Kinase (CK) Composed of 2 subunits namely B (Brain) and M (muscle).

   • BB(CK-1)
     • in brain, prostate, gut, lungs, bladder, uterus, placenta and thyroid
   • MB(CK-2)
     • isoenzymes is present in moderate amount in heart muscle and in skeletal muscle
   • MM(CK-3)
     • predominates in skeletal muscle and heart muscles

4. Lactate dehydrogenase (LDH)

   • heart diseases
     • total LDH activity in serum is 3-4 times than of normal especially LDH 1 (H4 units ).
   • Skeletal Muscle diseases
     • Elevated LDH activity especially LDH5 ( M4 units )isoenzyme in the serum
   • Kidney diseases
     • LDH activity in the urine is found to be elevated 3 to 6 times the normal
   • Tumors
     • Increased LDH in serum or plasma used as a biomarker for patients with malignant disease as Leukemia , lymphomas and liver metastasis

5. lipase

   • pancreatic disorders

6. Amylase

   • In acute pancr and pancreatic cancer ,lesion to the salivary gland

7. Acid phophatase (ACP)

   • very high level in prostate cancer and mild in bone diseases

8. Glutamyltransferase(GGT)

   • liver disorder like liver cirrhosis , hepatic biliary obstruction , pancreatitis and in some cases of pancreatic malihnancies, prostate mlihnancy

9. Alkline phosphatase (ALP)

   • liver disease biliary obstruction ,bile duct carcinoma , bone cancer , pancreatic carcinoma, liver metastsis