Serum protein electrophoresis is mainly used for the diagnosis and monitoring of patients with monoclonal gammopathies.
Total whey protein consists of albumin and globulins. Albumin (Albumin), which is synthesized in the liver, is essential for maintaining oncotic (osmotic) plasma pressure. It carries various molecules in the body, such as bilirubin, fatty acids, medicines and hormones, which bind to albumin while in the bloodstream.
There are three main types of globins: α-, β- and γ-globins. Α-globins are synthesized in the liver and include α1-globins, such as α1 antitrypsin, α-fetal globulin (aFP), and thyroxine-binding globulin and α2-globulins, including haptoglobulin, seroglobulin, (HDL) and α2 macroglobulin. B-globins are also synthesized in the liver and include transferrin, plasminogen, low-density cholesterol (LDL), and complement proteins. The γ-globins, also called immunoglobulins, are produced by B cells in response to antigen stimulation and include IgA, IgD, IgE, IgG, and IgM immunoglobulins.
Serum protein electrophoresis is a widely used method of measuring albumin and each of the types of globulins. It is used to detect diseases such as multiple myeloma and other disorders in serum proteins, inflammatory conditions, autoimmune diseases, infections and protein loss states. Serum protein electrophoresis is also used to investigate other abnormal laboratory results, such as when measuring total protein, albumin and urine protein, low calcium levels, and low white and / or red blood cells. It can also be used to monitor the progression of certain diseases and their response to treatment.
Electrophoresis separates proteins based on their physical properties. The serum is placed in a special medium and an electric current is applied, causing the various proteins to be separated according to their electrical charge, molecular size and shape. Albumin (Albumin) moves farther, followed by α-globins, β-globins and finally, γ-globins. These groups are then compared with different standard features of specific diseases.
A homogeneous peak in the gamma-globin region indicates monoclonal gammapathy. Monoclonal gammapathies are associated with malignant or potentially malignant conditions, including multiple myeloma, Waldenstrom's macroglobulinemia, leukemia, heavy chain disease, and amyloidosis. Polyclonal gammapathies can be the result of any reactive or inflammatory process. When a monoclonal gammopathy is found by electrophoresis of serum proteins, multiple myeloma must be excluded from other causes. This can be done by a process called immunofiltration or immunosuppression. In immuno-electrophoresis, the specific proteins of interest can be determined after first being fixed in the gel with antibodies, and by removing all other proteins by washing, prior to staining. This enhances the effect of serum protein electrophoresis.
Possible Interpretations of Pathological Values
- Increased total protein: Macroglobinemia, multiple myeloma, sarcoidosis
- Increased pralbumin band intensity: Alcoholism
- Increased albumin band intensity: Acute pancreatitis. Medications: Aspirin, penicillins
- Increased interstitial albumin a1-globulin intensity: Alcoholism (chronic), women during adolescence and pregnancy
- Increased α-globin band intensity: Acute phase response to inflammation (α1, α haptoglobin), acute rheumatic fever (α2), age (α2), albuminemia (α2), chronic glomerulonephritis (α2), cirrhosis (α2) normal or only slightly elevated α2), diabetes mellitus (α2), familial idiopathic dysproteinemia, glomerular protein loss (α2 macroglobulin), liver damage, liver metastases (elevated α1 with normal α2, hypoglycemic disease, A2), age (zone 2 is dominated by macroglobulin), acute infection, meningitis (α2), metastatic carcinoma (α1, α2), myocardial infarction, myxoedema, nephrosis (α2), nephrotic syndrome (α2), osteomyelitis (α2), peptic ulcer (α1, α2), α2, α2 (a2), pregnancy (increase in α1 with normal α2), enteropathy with loss of protein (α1, α2), rheumatoid arthritis (α2), sarcoidosis (α2), stress (α1, α2), systemic lupus erythematosus (α2), colitis (α1, α2). Medications: Estrogens (increase α1 with little change to α2)
- Increased interstitial intensity α2-β1: hypercholesterolemia (type II), nephrotic syndrome, pregnancy
- Increased beta-globin intensity: Acute phase response (β2), analbuminemia, diabetes mellitus (poorly controlled), familial idiopathic dysproteinemia, glomerular protein loss, viral hepatitis, viral hepatitis macroglobulinemia, nephrotic syndrome, pregnancy (β1), rheumatoid arthritis, sarcoidosis. Medications: Estrogens, oral contraceptives (increase beta1)
- Increased intensity of gamma globulin: Acute viral hepatitis (sometimes), amyloidosis, albuminemia, advanced carcinoma, chronic hepatitis (oligoclonal zones), chronic hepatic disease (IgM), chronic leukemia (IgM), chronic lymphoma infections (occurrence of oligoclonal bands), cirrhosis (IgA), cryoglobinemia, cystic fibrosis (IgG, IgA), Hashimoto's disease, liver disease, Hodgkin's disease, hypergammaglobulinemia, hypersensitivity reaction (Ig), severe IgM, severe Ig Laennec cirrhosis, leukemia (myeloma) generation, monocellular, lymphosarcoma (IgM paraprotein), macroglobulinemia, multiple myeloma, respiratory tract (IgA) infection, rheumatoid arthritis (IgA, IgM), sarcoidosis, scleroderma (S), scleroderma (partial) IgG), systemic lupus erythematosus (IgM), Waldenstrom's macroglobulinemia (IgM paraprotein)
- Decreased total protein: Analbuminemia, acute cholecystitis, chronic glomerulonephritis, Hodgkin's disease, hypertension (congestive heart failure), hypogammaglobulinemia, leukemia (myelogenous, monocytic, nephrotic, nephrotic)
- Pralbumin Zone Intensity Reduction: Acute Phase Response (Day 1), Cirrhosis
- Decrease in albumin band intensity: Acute rheumatic fever, analbuminemia, metastatic cancer, acute cholecystitis, diabetes mellitus, gastrointestinal protein loss (inflammatory or neoplasmatic disease, spleen hyperthyroidism, hypertension (congestive heart failure), Laennec cirrhosis, leukemia (lymphogenic, myelogenous, monocytic), lymphoma, macroglobulinemia, malnutrition, meningitis, multiple myeloma, kidney nephrotic syndrome, osteomyelitis, peptic ulcer, pneumonia, nodular polyarthritis, protein loss enteropathy, pyrexia, rheumatoid arthritis, sarcoidosis, stress, systemic lupus erythematosus. Medications: Corticosteroids
- Decreased interstitial albumin A1-globulin intensity: Cirrhosis, acute hepatitis, severe inflammation
- Decrease in the intensity of the α-globin: Acute viral hepatitis (α1, α2), congenital hypoglobulinemia (α2 haptoglobin), liver disease, intravascular hemolysis (haemolytic anemia, hepatic metastasis, hepatic metastasis, cirrhosis) emphysema (a1), scleroderma, hunger, stethorosis
- Decrease in interstitial α2-β1 intensity: Diabetes mellitus, inflammation, pancreatitis.
- Decreased beta-globin levels: Autoimmune disease, metastatic cancer, liver disease (β1), immune complex disease (β2), leukemia (lymphogenic, monocytic, myelogenous), lymphoma, malabsorption (beta), malabsorption, beta scleroderma, starvation, stearorrhea, systemic lupus erythematosus, ulcerative colitis
- Density of the gamma globulin: Acute viral hepatitis (sometimes), amamoglobinemia, glomerular protein loss, hypogammaglobulinemia, lymphatic leukemia, lymphoma, nephrosis, nephrotic syndrome, dysuropathy, stenorrhea, ulcerative colitis
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. Correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.