What are the uses of enzymes to diagnose a disease?
by coninxcgmailcom (student)
What are the uses of enzymes to diagnose a disease?
Enzymes are essential for living organisms to survive. They are made of amino acids, proteins and ribozymes and are present inside the cells. They are responsible for speeding up the chemical reactions in the body. If the enzymes are not working properly, it can lead to diseases in the body.
Enzymes can also be used to detect diseases in the human body. To detect diseases with the use of enzymes, a scientist will look for them in the plasma or serum. If the results are abnormal, for example if plasma levels are higher than normal, it means there may be a disorder in the body of the individual due to a damage to the tissue or cells. Because of the tissue damage, for example because of a heart attack, the enzymes that are normally found inside the muscle cells of the heart can now be found in the blood stream. Scientists need to examine which enzymes can be used to detect specific diseases and develop the tests that will help doctors to make the diagnosis.
To diagnose whether a patient has a disease, the doctor will take some blood in order to look for abnormal amounts of specific enzymes in the blood and then measure the plasma levels of the enzyme. Below is an image illustrating this.
(Figure 1 taken from “Clinical Enzymology”)
Higher levels intracellular enzymes indicate cell damage as enzymes are meant to be inside the cells. If you find them in the plasma that means the cell walls have been damaged. Although if someone has low levels, it could also simply be because of genetics or due to the fact that it is natural change with age.
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But measuring these enzymes is useful in estimating what could be wrong with someone and it helps making an early diagnosis of the disease. This is particularly important for heart and liver diseases.
In this article, I will discuss two plasma enzymes as an example: lactate dehydrogenase (LDH) and creatinine phosphokinase (CK).
Lactate dehydrogenase is an enzyme found in body tissues such as the blood cells and the heart muscle. If somebody has hepatitis, an infection of the liver, lactate dehydrogenase is also released from the damaged liver cells into the blood. The normal concentration of LDH should be between 55-140 IU/L (International Units per Litre) at 30°C (“Enzymes Used in Clinical Diagnosis”). However, when the level of enzymes increases in the serum, the chances of myocardial infarction (MI), commonly called heart attack or acute hepatitis (a liver disease) are higher. LDH is composed of two main protomers, LDH-M and LDH-H. The H signifies heart and M is named after muscle. These two protomers can form five possible forms namely LDH-1, LDH-2, LDH-3, LDH-4, and LDH-5. These five forms are similar but the concentration of each form is dependent on the parts of the body. The high level of one of the forms in the serum could suggest what problem a patient could have. For example, LDH-1 (HHHH) is mainly found in heart and red blood cells, and LDH-2 (HHHM) is found in the serum. If a LDH-1 level is higher than the LDH-2 level in the serum, it could suggest that there is a damage to heart tissue, as a result of myocardial infarction (MI), and LDH-1 is released into the bloodstream.
Creatine kinase (CK) is an enzyme that can be found in the heart but also in the brain and skeletal muscles. To test if someone has a problem, the CK levels will be increased along with the loss of muscle. Similarly to the lactate dehydrogenase, creatine kinase has as 2 protomers, B (named after brain) and M (for muscle). There are three possible combinations for creatine kinase, namely CK-MM, CK-BB, CK-MB. These combinations indicate what organs are damaged and will show if there are brain tumours, heart diseases or skeletal muscle disease.
It is important to look into using enzymes to diagnose a disease as it can help the decision what treatment needs to be used. This is done once an unusual presence of enzyme is found or there is a variation in enzyme concentration. For example, if the liver is damaged, some of its enzymes will leak into the bloodstream. Therefore a doctor can have an idea of the problem through a blood test, without doing too many tests and scans thus reducing the medical costs.
A problem that occurs is that the diagnosis is not always certain and further tests may be required to confirm the diagnosis. The doctor will always have to examine the patients for other signs of the disease. For diseases that affect multiple parts of the body, the enzymes can narrow it down. Therefore when making an assumption to what the disease is, one can sometimes make a false diagnosis, unnecessarily scaring the patient.
In conclusion, enzymes are used to diagnose patients who may have a disease. Their concentration is measured in the serum, plasma or intracellular. If the concentration of enzymes is higher than normal there is a chance you may have a disease. Doctors will then need to further look into this more in detail to give someone a diagnosis.
On the down side, the enzyme test alone may give a wrong diagnosis as there may be other reasons for the enzyme levels to be high. A doctor can misdiagnose you if he relies on the enzyme test alone. Fortunately, technology is so advanced and there are many ways of diagnosing a patient with a disease, so they can cross check the diagnosis with other tests. Using the enzymes however is a much easier and cheaper way to diagnose a disease therefore it is used commonly. With the advancing technology, the tests are also becoming more reliable. Eventually a link will be found between certain enzymes and specific diseases, which will make the diagnosis more certain.
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