The proteinogram, A simple way of calling serum protein electrophoresis, it is a semi-quantitative method that analyzes blood proteins, a test frequently requested by physicians. Serum proteins are substances made up of chains of amino acids that perform different functions in the body..
The most important functions of these proteins are the transport of certain elements that are present in the blood and some defensive tasks. The proteinogram provides valuable information regarding the internal conditions of the organism.
Alterations in its results can be associated with different clinical entities and even guide the doctor towards the best available treatment.
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In the past, filters of paper, agarose or cellulose acetate were used to separate the proteins from the other elements of the serum.
They were then stained with different dyes and quantified through a densitometer. Today some of these methods are preserved but with substantial improvements.
Proteins have negative or positive electric charges and move in fluxes when placed in an electric field..
Capillary electrophoresis, the most widely used mechanism today, uses these fields to separate proteins and group them according to their electroosmotic charge, size and shape, allowing a faster, more precise and more comfortable study..
Protein electrophoresis is performed primarily to aid in the diagnosis and management of certain diseases. Among the large number of medical conditions that can modify the levels and characteristics of serum proteins, the following stand out:
- Some forms of cancer.
- Liver or kidney disorders.
- Immune system disorders.
- Malnutrition.
- Infections.
Serum protein levels may vary slightly depending on the laboratory where the studies are carried out, the type of equipment used and the reagents..
Despite this, there are ranges considered normal and the reference values are included in the printing of the results, which should only be interpreted by the doctor..
3.3 - 5.7 gr / dL
0.1 - 0.2 gr / dL
0.6 - 1 gr / dL
0.7 - 1.4 gr / dL
0.7 - 1.6 gr / dL
Some laboratories change the reporting units to grams per liter (gr / L) for which only the comma should be rolled one space to the right. For example, albumin: 33 - 57 gr / L. The same applies to the rest of the proteins and globulins.
Isolated alterations in serum protein levels are rare, with several changes being common at the same time.
However, each of the proteins is reported separately below with the possible causes of alteration and then an analysis by pathology.
Dehydration and some immune diseases.
Malnutrition, kidney or liver failure and inflammatory processes.
Infectious and inflammatory processes.
Severe inflammation and liver disease.
Inflammatory processes and kidney disease.
Thyroid and liver problems.
Severe hyperlipidemias and iron deficiency anemias.
Malnutrition and immune diseases.
Bacterial infections, sepsis, some cancers, and chronic liver disease.
Innate immune disorders.
As mentioned previously, there are many diseases that can modify the results of the proteinogram. Some of them are mentioned below, with the behavior of serum proteins in each of these.
It is characterized by the decrease in all serum proteins synthesized in the liver, especially albumin, whose level decreases alarmingly. There may also be a reactive elevation of immunoglobulins.
A striking fact is the virtual elevation of some globulins; These, as they are not metabolized due to liver disease, remain in the body for longer without this representing a true increase in their value.
It also causes significant hypoalbuminemia because the kidney does not adequately filter proteins. Lower molecular weight proteins are usually lost in the urine and higher molecular weight proteins rise in the blood as compensation.
There are different patterns for acute inflammation and for chronic inflammation. In acute inflammation, there is an elevation of alpha-globulins, both 1 and 2, which behave as acute phase reactants. A slight decrease in other globulins can also be found due to a compensatory effect.
In chronic inflammation, albumin is already compromised, so its level begins to decrease. This phenomenon can be accompanied by an elevation of gamma globulin as long as there are no immunological disorders..
Despite not being a disease itself, pregnancy produces important anatomical and physiological changes in women, and serum protein levels do not escape..
Albumin values are slightly low due to hemodilution (increased fluid in the blood vessels). Due to the action of the hormones of pregnancy, such as estrogens, globulins and transferrin rise.
Gamma globulinopathies are the most common innate immunological diseases among the group that affects serum proteins. They are characterized by the presence of recurrent infections and a deficit in weight-bearing development..
A significant decrease in gamma globulin is usually found in the proteinogram, accompanied by a compensatory elevation of beta and alpha globulins..
“Immature” forms of gamma globulin also appear, which helps a lot to make the diagnosis, since it is a pathognomonic phenomenon of this condition..
Serum protein electrophoresis is an extremely useful laboratory study for the detection and management of many chronic infectious, immunological, and oncological diseases, among others. It is a method with enough clinical sensitivity from the biochemical point of view but with low specificity..
It is important to understand that different clinical events produce different alterations in the pattern of the proteinogram and almost none of these modifications is specific for a disease, with the exception of some type of gamma globulinopathy, for which a detailed analysis by the specialist doctor is essential to the correct diagnosis.
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