HIS 4/5 - Clinical Enzymology I/II Define and classify enzymes and isoenzymes.

Enzymes: A protein that catalyses a chemical reaction Measurement of enzyme activity or concentration to: o Diagnose disease, determine complications/extent of disease and monitor treatment. Enzymology: Application of the science of enzymes to the diagnosis and treatment of disease Isoenzymes: Multiple forms of an enzyme o Possess ability to catalyse enzyme's characteristic reaction o Differ structurally - encoded by distinct structural genes

Describe the general principles of enzyme measurement.

Measurement of enzyme activity in U/L where activity is dependant on: Substrate concentration, temperature of reaction, pH of buffer, the presence of cofactors and enzyme activators or inhibitors

Measurement of enzyme concentration in p or g/L where concentration is dependant on: Antibody specificity in assay

Explain the rationale for the appropriate selection of enzyme tests for diagnosis and monitoring disease progression.
Selection of enzymes for diagnostic or prognostic purposes dependant on: 1. Distribution of enzymes among various tissues a. Tissue/plasma concentration gradient (between interior and exterior) b. Intracellular localization c. Enzymes should be organ-specific for accurate diagnosis 2. Convenience of enzyme assay (knowledge of plasma enzyme characteristics a. Half life in blood b. Mode of clearance (Ex: if enzyme clearance is in glomerulus, renal failure might be diagnosed in high amounts.)

Interpret plasma enzyme test results.

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