Enzymes and isoenzymes have various therapeutic and diagnostic applications. Therapeutically, enzymes are used as thrombolytic agents to lyse blood clots, in enzyme replacement therapy for genetic deficiencies, to control cancer growth, as antidotes for toxins, and to reduce inflammation. Diagnostically, elevated specific enzymes indicate tissue damage and are markers for conditions like heart attack, liver disease, and pancreatitis. Isoenzymes further aid diagnosis by distinguishing between tissue types like liver and bone lesions. Lactate dehydrogenase isozymes specifically can monitor tissue breakdown and cancer treatment effectiveness.

1. ENZYMES AND ISOENZYMES
APPLICATIONS
BY,
N.N.ARTHIKASREE

2. THERAPEUTIC APPLICATIONS OF ENZYMES
 The principal therapeutic applications of enzymes are as thrombolytic agents capable of
rapidly lysing the clots which cause, or contribute to, myocardial infarction, phlebitis,
pulmonary embolisms, occluded catheters, and allied conditions.
 They are used in oral or parenteral replacement therapy for genetic diseases attributable
to a deficiency of a specific enzyme or family of enzymes.
 Used in in oncology, for the control of the growth of select neoplasms or leukemias.
 Used as as antidotes to poisons or as counteragents capable of mitigating the delirious
effects of toxins, etc.
 Administration of some enzymes is shown to be effective in the reduction of various
inflammatory responses.
Eg: Bromelains and chymotrypsin .
 Debriding agents effectively clean open wounds by removal of foreign matter and any
surrounding dead tissue.Eg:Trypsin, papain and collagenase.

3. DIAGNOSTIC APPLICATION OF ENZYMES
 Enzymes are the preferred markers in various disease states such as myocardial infarction,
jaundice, pancreatitis, cancer, neurodegenerative disorders, etc.
 Aminotransferases: Aspartate arminotransferase- Myocardial infarction (AST, or
SGOT).Alanine aminotransferase Viral hepatitis (ALT, or SGPT).
 Amylase -Acute pancreatitis
 Ceruloplasmin-Hepatolenticular degeneration(Wilson•s disease)
 Creatine kinase- Muscle disorders and royocardial infarction.
 Alfa Glutamyl transpeptidase -Various liver diseases
 Lactate dehydrogenase -Myocardial infarction
 Lipase-Acute pancreatitis.
 Phosphatase, acid -Metastatic carcinorna of the prostate.
 Phosphatase, alkaline -Various bone disorders, obstructive liver diseases.

4. THERAPEUTIC APPLICATION OF ISOENZYMES
 LDH may be used as a general indicator for the severity of acute and chronic tissue
damage.
 Alkaline phosphatase is used to distinguish liver lesions from bone lesions in
metastatic carcinoma.
 In medicine, LDH is often used as a marker of tissue breakdown as LDH is abundant in
red blood cells and can function as a marker for hemolysis.
 LDH expression can act as a general marker in the prognosis of cancers.
 Expression of LDH5 and VEGF in tumors and the stroma has been found to be a strong
prognostic factor for diffuse or mixed-type gastric cancers.
 LDH determine prognosis or monitor treatment i.e chemotherapy of cancer such as
germ cell tumors e.g testicular and ovarian cancer,lymphom,a,leukemia and
neuroblastoma.

5. DIAGNOSTIC APPLICATION OF ISOENZYMES
 LDH ( lactate dehydrogenase) is often used as a marker of tissue breakdown, therefore it can be
used in detection of myocardial infarction, hemolysis.
 Variation in LDH isozymes profile might have a role in studying muscle response to training so
its used in sports medicine.
 A series of CK(creative kinase) tests may be used to monitor muscle damage to see if it resolves
or continues.
 LDH may be used to detect and monitor progressive conditions such as anemia including
hemolytic anemia,megaloblastic anemia and severe infections.
 The CK test was once one of the primary tests ordered to help diagnose a heart attack .

6. DIAGNOSTIC APPLICATION OF ISOENZYMES
 The analysis of the isoenzymes of alkaline phosphatase is an aid in
diagnosing liver and/or bone disease, especially the high molecular weight
isoenzymes that appear in cholestatic liverdisease.
 Creatine kinase is assayed In blood tests as a marker of damage of CK-rich
tissue such as in myocardial infarction (heart attack), rhabdomyolysis (severe
muscie breakdown), muscular dystrophy, autoimmune myositides, and acute
kidney injury.