Investigation Of Changes In Plasma Protein

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 Functions of plasma proteins
Function: Example
 Transport  thyroxine-binding globuline,
(and other hormon-binding
globulines)
 Apolipoproteins (cholesterol,
triglyceride)
 Transferrin (iron)
 Humoral  Immunoglobulins
Immunity
 Enzymes  Renin, Clotting Factors,
Complement Proteins
 Functions of plasma proteins
Function: Example
 Protease  α1-antitrypsin
Inhibitors

 Maintenance of  All Proteins, Particularly

Oncotic Pressure Albumin

 Buffering  All Proteins

 Causes of changes in total plasma protein
 Normal range: 60-80 g/l
 Increase
 Protein synthesis ↑
 hypergammaglobulinem
ia, paraproteinemia
 Volume of distribution↓ :
dehydration
 Artefactual:
hemoconcentration due
to stasis of blood during
venepuncture
concentration
 Decrease
 Protein synthesis ↓:
malnutrition,
malabsorption, liver
disease
 Volume of distribution ↑:
overhydration, increased
capillary permeability
 Excretion ↑, Catabolism ↑:
protein-losing states,
catabolic states
 Causes of changes in total plasma protein
concentration
• Dysproteinemia: total plasma protein
concentration is normal, but the normal ratio of
its components is changed example: acute
inflammation, chronic inflammation.
• Defectdysproteinemia: total absence of a
certain plasma protein example: lack of
albumin, lack of alfa-1 antitrypsin, lack of
ceruloplasmin
• Paraproteinemia: There is a protein in the
plasma, which can not be detected under
normal conditions example: monoclonal
gammopathy
 Principal plasma proteins Class

• α1-globulin
• prealbumin
• albumin
• α1-antitrypsin
• α1- acid glycoprotein
• α 2-globulin
• haptoglobins
• α2-macroglobulin
• ceruloplasmin
• transferrin
 Principal plasma proteins Class
• β-globulin
• low density lipoprotein
• Complement components
• γ-globulins
• IgG
• IgM
• IgD
• IgE
• IgA
 Albumin
• A globular protein with a molecular weight of
66-69,000 daltons (66-69 kDa).
• Synthesized in the liver and is catabolized in
various tissues where it is taken up by
pinocytosis.
• Uptake and degradation is facilitated if the
protein is structurally modified.
• The constituent amino acids are utilized by the
cells
 Albumin Functions
• Makes a large contribution to plasma colloid
osmotic pressure
• It also serves as a carrier protein for many
insoluble organic substances (e.G.,
Unconjugated bilirubin, long chain fatty acids)
and drugs.
• Also transports positively charged minerals,
such as calcium, zinc and copper
• Also thought to be an anti-oxidant protein by
scavenging reactive oxygen species, protecting
bound substances from oxidant injury, and
binding free copper, which acts as an oxidant
 Causes of Hypoalbuminemia

• Decreased synthesis:
• malnutrition
• malabsorption
• liver disease
• Increased volume of distribution:
• overhydration
• increased capillary permeability:
septicemia, hypoxemia
 Causes of Hypoalbuminemia

• Increased excretion /degradation:

• nephrotic syndrome
• protein-losing enteropathies
• burns
• hemorrhage
• catabolic states: severe sepsis, fever,
trauma, malignant disease
 Causes of Hyperalbuminemia

• Artifact
• Physiologic
• Volume Contraction secondary to fluid losses
globulins may also increase in this situation
resulting in hyperproteinemia with no change in
A:G ratio
• Drugs
• Examples Corticosteroid administration
 Causes of Hyperalbuminemia

• Pathological
• Adrenal dysfunction
• Hepatocellular carcinoma
 Laboratory Diagnosis of Inflammatory Diseases

• Changes of plasma proteins:

• Albumin ↓
• IgG, IgA, IgM: ↑ A/G ↓
• Acute phase proteins:
• Increase • Decrease
• α1-antitrypsin • Albumin
• fibrinogen • Transferrin
• haptoglobin
• ceruloplasmin
• CRP
 Laboratory findings in multiple myeloma
• Presence Of Paraprotein
• Normal Immunoglobulins ↓
• Β2-macroglobulin ↑
Thank You