|alkaline phosphatase (ALP)||diagnosis for liver and bone disease, found in serum, high concentration in osteoblast, liver, placenta, and intestinal epithelium, tissue specific isoform|
physiological increase during pregnancy & childhood, pathological increase indicative of liver disease & certain bone diseases, decreased levels of associated with hypothyroidism
|lactate dehydrogenase 1 (LDH-1)||diagnosis for myocardial infarcation, found in serum from heart and RBC, peaks 40-50 hours post MI, four subunits- (alpha4) H4|
there is a significant rise in blood levels of this enzyme following heart attack, LDH-1 exceeding LDH-2 (1,2 flip or switch), indicative of heart attack. LDH-2 found in serum from reticuloendothelial system.
|phosphohexose isomerase||diagnosis for myocardial infarcation, found in serum|
|aspartate aminotransferase (AST)||diagnosis for myocardial infarction and hepatitis, found in serum and cerebrospinal fluid, not specific to the heart, also found in liver & muscle tissue, peaks at 30hours|
|alanine aminotransferase (ALT)||diagnosis for hepatitis, found in serum, from liver rather than muscle tissue, measured in addition to cardiac biomarkers to rule out liver disease as contributing factor to rise in AST|
|acid phosphatase||diagnosis for metastatic carcinoma of the prostate gland, found in serum|
|alpha-amylase lipase||diagnosis for pancreatitis and mumps, found in serum and urine|
|creatine kinase MB (CKMB) CK-2|| diagnosis for myocardial infarction, earliest indicators for MI, specific to the heart, peaks at 24 hours then rapidly falls, useful for detecting reinfarction, two subunits |
Two subforms: CKMB1, CKMB2
Myocardial damage is suspected if MB2 to MB1 ratio is > (1.5 : 1)
|total creatine kinase (CK)||diagnosis for myocardial infarction, measure for severity of myocardial infarction, indicative of size of infarction, peaks at 24 hours then rapidly falls, useful for detecting reinfarction|
|creatine kinase BB (CKBB) CK-1||diagnosis for damage to brain and lungs|
|creatine kinase MM (CKMM) CK-3||diagnosis for damage to myocardium and skeletal muscles|
|myoglobin||marker for muscle damage, earliest indicators for MI, released into serum after 1-3h post damage, peaks 4-12h, cleared 24-36h, sensitive indicator for MI but lacks specificity, if levels do not increase within first 3/6h it indicates no MI occurrence.|
level greater than 110ug/L indicative of MI.
when measured with carbonic anhydrase III (CAIII), found mostly in skeletal muscle, myoglobin:CAIII ratio >3.21 is indicative of MI
|cardiac troponin I (TnI)||marker for MI, long diagnosis window, detected 3/5h post MI, peaks 14/18h, can be detected 5/10 days post MI, assay is 100% sensitive up to 6h post MI|
|cardiac troponin T (TnT)|| marker for MI, long diagnosis window, less specific than cardiac TnI, rises 3/5h, remains elevated 14/21 days, assays 100% sensitive 6h post MI|
angina attacks also cause its release.
|gamma (y) glutamyl transferase (GGT)||marker for liver dysfunction and bile duct injury, found mainly in liver (small amount in pancreas and kidneys), also indicator for long term alcohol abuse, increased activity indicative of defensive mechanism against free radical production|
|alpha fetal protein (AFP)|| high levels indicative of hepatocellular carcinomas, cirrhosis & massive liver necrosis, pregnancy, testicular cancer.|
High levels in amniotic fluid (leaks from foetal blood) during the 2nd trimester can be indicative of neural tube defects eg. spina befida