Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Proteins Structure n Primary structure Secondary structure Tertiary structure Quaternary structure Fibrous proteins: n n Globular Protein Structure fibrinogen, troponin, collagen, and myosin Globular proteins: n n most proteins of clinical interest hemoglobin, enzymes, and plasma proteins (soluble) Globular Protein Structure Properties of proteins can be used for their separation, identification, and assay. 2º n Molecular size. n 分子內 分子間 n Differential solubility. n Electrical charge. n 3º dialysis, ultrafiltration, gel filtration 4º n n electrophoresis, isoelectric focusing Adsorption on finely divided insert materials. n n affected by the pH, ionic strength, temperature silica, alumina, or hydroxyapatite Specific binding to antibodies, coenzymes, or hormone receptors. n high specificity 1 Biological function of proteins Plasma Protein: hundreds of different proteins n n n n n n n n General and local clinical symptoms of the acute phase reaction General symptoms Local symptoms fever Calor 熱 increased heart rate rubor 紅 hyperventilation dolor 痛 tiredness tumour 腫 Acute phase proteins Carriers Fibrinogen Other coagulation factors Complement components Immunoglobulins Enzymes inhibitors Many others Typical changes of CRP, fibrinogen, ESR and albumin during an acute phase reaction early loss of appetite ࢴ慾 2 C-reactive protein Structure and function Three properties can explain many functions of CRP: 1) Binding to phosphorylcholine 2) Activation of complement 3) Binding to cell receptors (Fc receptors or specific CRP receptors) Synthesis and turnover n Strong response in Induction and synthesis of CRP in hepatocytes Minor response in New Indications for C-Reactive Protein • From Acute Phase Protein to Cardiovascular Risk Marker n By Rolf D. Hinzman, M.D., Ph.D. 3 Relative risk for future cardiovascular events Table 19-1 Properties of Selective Plasma Proteins n Listed in the order of their electrophoretic mobilities in agarose gels at pH 8.6 P22 那一蛋白屬於那一電泳區? --> a high relative risk for a future cardiovascular events Table 19-2 Interim consensus reference intervals for 14 Plasma Proteins in human serum INDIVIDUAL PLASMA PROTEINS n Prealbumin n n n n n n retinol-binding protein & transthyretin Albumin a1-Acid Glycoprotein, a1-Antitrypsin, a1Fetoprotein, a2-Macroglobulin, Heptoglobin, Ceruloplasmin Transferrin, complement, b2-Microglobin Immunoglobulins, C-Reactive Protein 4 Albumin: 3.5 - 5.2 g/dL Albumin: 66.3 kD n n n The most abundant protein in human plasma n representing 40-60% of total protein n synthesized in liver. n n A marker of both glomerular and bloodbrain barrier function n pI lies between 4.0 and 5.8 n an anion at pH 7.4 n > 200 negative charges per molecule Hyperalbuminemia: >5.2 g/dL n n Acute dehydration No clinical significance n n Acute & chronic inflammation Hepatic disease: cirrhosis(肝硬化) Urinary loss n 是否脫水 實驗步驟是否正確 to transport and store a wide variety of ligands to maintain the plasma oncotic pressure to serve as a source of endogenous amino acids. Hypoalbuminemia: <3.5 g/dL n n The chief biological functions n n n n Nephrosis Renal disorders Gastrointestinal loss Protein energy malnutrition Edema & Ascites腹水 5 Alpha 1 n a1-Acid Glycoprotein (AAG, orosomucoid) n n n n n Serine proteinese inhibitor, an APR Deficiency: liver disease a1-Fetoprotein (AFP) n n antenatal diagnosis of neural tube defects hepatocellular carcinoma & germ cell tumor Alpha 2 n n low pI (2.7 - 3.5) An APR whose exact role is unknown a1-Antitrypsin (AAT) n Alpha 2 Ceruloplasmin (Cp) Contain ~95% serum copper; blue color n A late-reacting ARP n Wilson‘s disease a2-Macroglobulin (AMG, MW~725 kD) ⁄: effects of estrogen n ÿ: acute pancreatitis & prostate cancer n n Heptoglobin (HAP, Hp) An APR, binds free hemoglobin in serum n ⁄: effects of corticosteroid & NSAIDs n ÿ: hemolysis n ܧ類固醇抗免疫藥 普拿疼 Beta n n n Absent a intracellular ATPase to add Cu2+ to Cp n plasma Cp is typically reduced n dialyzable copper concentration is increased Transferrin (TRF, siderophilin) n Next slide b2-Microglobin (BMG, MW 1.8 kD) n n n Pass through the glomerular membrane => 99% reabsorbed ⁄: renal failure, inflammation, and neoplasma 6 Transferrin (TRF, siderophilin) n n n n Most of total iron binding capacity (TIBC) One molecule bind 2 ferric ion (Fe3+) A negative APR n Inflammation or malignancy ⁄: pregnancy & estogren administration n n n n Fe2+ ferric ion (Fe3+) n n n n n Overload proteinuria n n Mainly low-MW plasma proteins Defective tubular reabsorption n n Protein in amniotic fluid, saliva, and feces Specific quantitative assays of particular proteins by immunochemical methods n n n From plasma to urine of an abnormal low-MW protein Postrenal proteinuria Albumin, TRF, TTR Analysis of Proteins Most common & serious; mainly albumin Increased glomerular permeability Tubular proteinuria Only a small amount of protein Most is albumin Protein in cerebrospinal fluid (CSF) n Glomerular proteinuria n Urinary proteins n Proteinuria n Proteins in other body fluids n nephelometry, turbidimetry, RID, RIA, EIA Detection and identification of proteins by electrophoresis Quantitative measurements of total protein in serum, urine, and CSF Analysis by mass spectrometry Production of protein by the urinary tract 7 Serum Protein Electrophoresis-on cellulose acetate or agarose gel • pH 8.6 barbital buffer • Stains: • Amido black & Ponceau S in the past • CBB is more sensitive and more widely used. • Densitometry Serum Protein Electrophoresis-Polyclonal Gammopathy Polyclonal gammopathy usually occurs secondary to many chronic diseases avoids the complication of a fibrinogen band Serum Protein Electrophoresis-Nephrotic Pattern The long term loss of lower molecular weight proteins (albumin, IgG) and retention of higher molecular weight proteins (alpha-2macroglobulin.) Serum Protein Electrophoresis-Cirrhotic Pattern The "beta-gamma bridge" pattern: distinction between beta and gamma globulin is blurred 8 Serum Protein Electrophoresis-Acute inflammatory pattern The intensity of the alpha-2 fraction is greater that the gamma globulin fraction Serum Protein Electrophoresis-Monoclonal (M) Protein Present A large increase in serum IgG, but decreased IgA and IgM. Serum Protein Electrophoresis-Alpha 1 anti-trypsin deficiency Alpha-1-anti-trypsin deficiency can be congenital or acquired, typically secondary to liver or pulmonary diseases. Serum Protein Electrophoresis-Monoclonal (M) Protein Present IFE on this patient's serum showed the M protein was IgG kappa. A diagnosis of multiple myeloma was made. 9 Quantitative Measurements of Total Protein in Body Fluids n Specific methods n n n Bovine or human albumin is used routinely Cu2+ Reference intervals n n n An adult at rest: Ambulatory: Neonates: 6.0-7.8 g/dL 6.3-8.3 g/dL 4.6-7.0 g/dL Biuret Method n Biuret reaction Calibration of total protein methods n n Biuret, direct photometric, dye-binding, Lowry, Kjeldahl, refractometry, turbidimetric An analogous reaction occurs between cupric ion and the organic compound n n Amino acids & dipeptides: not react tri-, oligo-,& polypeptides: n give pink to reddish-violet products Biuret treated with Cu2+ ions in a moderately alkaline medium, a colored chelate is formed Direct photometric methods n UV 280 nm absorption n n n aromatic amino acids tyrosine, tryptophan, phenylalanine UV 220 nm n n 研究用 peptide bond Specific absorption at 220 nm is 10 to 30 times greater than at 280 nm 10 Dye-binding methods n Amido black 10B & Coomassie brilliant blue (CBB) n Simple, fast, and linear up to 150 mg/dL Folin-Ciocalteu (Lowry) method n Folin-Ciocalteu reagent n n 研究用 phosphotungstic-phosphomolybdic acid Tyrosine and tryptophan n produce a blue color ß More useful for assay n Urine: pyrogallol red, Ponceau S and CBB Kjeldahl’s method: reference method n of a pure prorein The Kjeldahl procedure used to determine protein content. Acid digestion n convert nitrogen in protein to ammonium ion The concentration of ammonia nitrogen was then evaluated by titration or nesslerization [Protein] = n Ammonia nitrogen value x 6.25 (100%/16%) n Well defined and reproducible; but timeconsuming and inconvenient 11 Auto Kjeldahl System B-339: Refractormetry: a fully automatic unit n A speedy and problem-free nitrogen determination n n The overall time for a complete determination is only 3-4 min. Formation of a fine precipitate of uniform, insoluble protein particles n n n n n performing distillation, digestion, titration, calculation and print-out of the results Turbidimetric or nephelometric methods n Refractormeter Sulfosalicylic acid alone Sulfosalicylic acid + sodium sulfate Sulfosalicylic acid + trichloroacetic acid (TCA) TCA alone If a solute is added to water, the refractive index of the solution increases n n proportion to concentration of solute quick Total Protein Methods Method Principle Comment Kjeldahl Digestion of protein; measurement of nitrogen content Reference method; assume average nitrogen content of 16% Measurement of refractive index Refractometry due to solutes in serum Rapid & simple; assume nonprotein solids are present in same concentration as in the calibrating serum 12 Total Protein Methods Method Biuret Dye-binding Principle Comment Formation of violetcolored chelate between Cu2+ ions & peptide bonds Protein binds to dye & causes a spectral shift in the absorbance maximum of the dye Routine method; requires at least two peptide bonds & an alkaline medium Research use Total Protein Abnormalities: Hypoproteinemia n Excessive loss n n n n n Excretion in urine & renal disease Loss of blood Decreased intake: malnutrition Decreased synthesis: liver disease Accelerated catabolism n Total Protein Methods Burns, trauma, other injuries Total Protein Abnormalities: Hyperproteinemia n n Is not seen as commonly as hypoproteinemia Dehydration n n Vomiting, diarrhea, excessive sweating, diabetic acidosis, & hypoaldosteronism Excessive production primarily of gglobulins 13 Determination of Albumin in Plasma n Most: automated dye-binding methods n n Albumin Methods Bromcresol green (BCG) or bromcresol purple (BCP) Serum is reommended BCG test is more sensitive dye Determination of Total Protein in Urine 14 Questions 1. What are five principal functions of plasma proteins? 2. What plasma protein is present in the highest concentration, and what are its functions? 3. Separation of serum proteins by electrophoresis depends on what principles? 4. In what circumstances is the concentration of urine protein elevated? Questions 5. What are the characteristic serum protein electrophoresis patterns in patients with (a) nephrotic syndrome, (b) acute infectious hepatitis, (c) multiple myeloma, & (d) hypogammaglobulinemia? 6. What principles are involved in the determination of total protein by the biuret reaction? Of albumin by the bromcresol gree method? Questions 7. What are the functions of (a) prealbumin & (b) acute phase reactants, & how may their concentrations in serum be measured? 8. What is the origin of cerebrospinal fluid proteins, & what is the rationale for measuring same? 15