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MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez. Plasma Proteins. Plasma Proteins. Two groups Albumin Globulins. Prealbumin. Synthesized mainly in the liver Migrates ahead of albumin on electrophoresis Transport protein for thyroid hormones and retinol(Vitamin A). Decreased Levels.

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MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

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  1. MLAB 2401: Clinical ChemistryKeri Brophy-Martinez Plasma Proteins

  2. Plasma Proteins • Two groups • Albumin • Globulins

  3. Prealbumin • Synthesized mainly in the liver • Migrates ahead of albumin on electrophoresis • Transport protein for thyroid hormones and retinol(Vitamin A)

  4. Decreased Levels Increased Levels • Hepatic damage • Acute-phase inflammatory responses • Tissue necrosis • Poor nutrition • Steroid therapy • Alcoholism • Chronic renal failure Prealbumin

  5. Albumin • Synthesized in the liver • Protein present in the highest concentration in the plasma • Functions • Maintenance of colloid osmotic pressure • Buffers pH • Negative acute phase reactant • Binds substances in the blood

  6. Decreased Levels Increased Levels • Malnutrition/Malabsorption • Inadequate intake of amino acids • Liver disease • GI loss • Loss of fluids • Renal disease • Excreted excessively • Dilution by excess • IV fluids, polydipsia • Dehydration • Excessive albumin infusion Albumin

  7. Globulins • Group consisting of α1, β, α2, and gamma fractions • Focus will be on globulins most often encountered in the lab

  8. α1- Globulins

  9. α2- Globulins

  10. β- Globulins

  11. ß- Globulins (con’t)

  12. γ- Globulins: Immunoglobulins

  13. Other Noteworthy Proteins • Myoglobin • Troponin • Heart marker for MI • BNP • Distinguishes between MI and CHF • Fibronectin • Glycoprotein used to predict the short term risk of premature delivery

  14. Do you feel like this? If the answer is “Yes” take a break!

  15. Protein Abnormalities • Total protein measures ALL of the proteins in plasma • Measurements reflect • Nutritional status • Kidney disease • Liver disease • Other

  16. Hypoproteinemia • Total protein level <6.4 g/dL • Due to a negative nitrogen balance • Causes • Excessive loss • renal disease, blood loss, burns • Decreased intake • Malnutrition, intestinal malabsorption • Decreased synthesis • Liver disease, inherited immunodeficiency • Acceleration of catabolism of proteins • Burns, trauma

  17. Hyperproteinemia • Total protein level > 8.3 g/dL • Causes • Dehydration • Excess water loss leads to the increased concentration of proteins • Examples: vomiting, diarrhea, diabetic acidosis, hypoaldosteronism • Excessive production of gamma globulins • Examples: Multiple myeloma, Waldenstrom’s macroglobulinemia

  18. Summary of Protein Levels N= normal I=increased D=decreased

  19. References • Bishop, M., Fody, E., & Schoeff, l. (2010). Clinical Chemistry: Techniques, principles, Correlations. Baltimore: Wolters Kluwer Lippincott Williams & Wilkins. • Sunheimer, R., & Graves, L. (2010). Clinical Laboratory Chemistry. Upper Saddle River: Pearson. • http://www.stoelrivesworldofemployment.com/tags/rest-break/

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