clinical importance of the enzymes lactate dehydrogenase and 5' neucleotidase . various assays used to treat disorders, basic knowledge about the enzymes used in clinical chemistry aspects and their saient features

1. ENZYMES OF BIOLOGICAL
IMPORTANCE
Shreya bhat
° Lactate dehydrogenase
° 5’ nucleotidase

2. COMPENDIUM

3. INTRODUCTION
• LDH, also known as lactic acid dehydrogenase, is a type of protein,
known as an enzyme. LDH plays an important role in making your
body's energy. It is found in almost all the body's tissues.

4. FORMS OF LACTATE
DEHYDROGENASE
• There are five types of LDH. They are known as isoenzymes. The five isoenzymes are
found in different amounts in tissues throughout the body.
• LDH-1: found in heart and red blood cells
• LDH-2: found in white blood cells. It is also found in heart and red blood cells, but in
lesser amounts than LDH-1.
• LDH-3: found in lung tissue
• LDH-4: found in white blood cells, kidney and pancreas cells, and lymph nodes
• LDH-5: found in the liver and muscles of skeleton

5. WHAT IT IS USED FOR ;
• An LDH isoenzymes test is used to find out the location, type, and severity of tissue
damage. It can help diagnose a number of different conditions including:
• Recent heart attack
• Anemia
• Kidney disease
• Liver disease, including hepatitis and cirrhosis
• Pulmonary embolism, a life-threatening blood clot in the lungs

6. CLINICAL SIGNIFICANCE OF LDH
• LDH may be used as a general Indicator for the severity of acute and chronic tissue
damage.
• LDH may he used to detect and monitor progressive conditions such As Anemia
Including Hemolytic Anemia, megaloblastic Anemia and severe infections.
• LDH determine prognosis or monitor treatment i.e chemotherapy of cancer such as
gem cell tumours e.g Testicular and ovarian cancer , Lymphom, a leukemia and
neuroblastoma.

7. CONDITIONS IN WHICH IT IS
ELEVATED
• Blood flow deficiency
• Hemolytic Anemia
• Infectious mononucleosis
• Low blood pressure
• Liver disease
• Muscle injury
• Cancer, stroke, tissue death
• Muscle weakness , loss of muscle tissue (muscular dystrophy)

8. LDH ASSAYS IN HEART DISEASES
The LDH activity in serum is measured by the rate of
NADH dissapearance.
When tissues are damaged or diseased, they release
LDH isoenzymes into the bloodstream. The type of
LDH isoenzyme released depends on which tissues
are damaged. This test can help your provider find
out the location a
If your results showed that levels of one or more
LDH isoenzymes were not normal, it probably
means you have some kind of tissue disease or
damage. The type of disease or damage will
depend on which LDH isoenzymes had abnormal
levels. Disorders that cause abnormal LDH levels
include:nd cause of your tissue damage.

9. 5’ NUCLEOTIDASE
• 5’ NT is present in liver as well as in various other tissues
• It is located mainly along the cell membrane , similar to ALP and GGT.
• Estimation of 5’- NT is helpful in deciding whether increased ALP is due to liver
disease or due to increased Osteoblastic activity In growing children.
The 5’nucleotidase enzyme catalyses the following
chemical reactions
a 5’-nucleotide + H2O ⇌ a nucleoside + phosphate
ribose 5-phosphate + H2O ⇌ ribose + phosphate

10. 5’ NUCLEOTIDASE IN MEDICAL
PURPOSES
• 5’ Nucleotidase blood test
• Relation to lead poisoning
• Lymphocyte 5’nucleotidase in immunological disorders

11. SALIENT ASPECTS OF 5’ NT IN
CLINICAL SIGNIFICANCE
• 1 )Serum 5’NT activity is generally elevated in hepatobiliary diseases, especially with
intrahepatic obstruction, but, unlike serum alkaline phosphatase, serum 5’NT activity
is not increased in infancy, childhood, pregnancy, or osteoblastic disorders.
• 2) In cancer patients, elevated serum 5’NT activity does not always indicate
hepatobiliary involvement; in some cases, 5’NT may be released into serum from the
primary tumor or local metastases.
• 3) Genetic deficiency of erythrocyte pyrimidine 5’NT activity is a common cause of
hereditary non-spherocytic hemolytic anemia

12. • 4) Acquired deficiency of erythrocyte pyrimidine 5’NT activity occurs in patients with
beta-thalassemia and lead poisoning.
• 5) 5’NT activity is low in circulating monocytes, increases markedly upon their
differentiation to tissue macrophages, and subsequently diminishes during
macrophage activation.

13. BROADBLAST💭
• What is the optimum range of LDH in blood
• LDH is used to diagnose cancers . ✅ or ❌

14. VERIFY
• 1: 140 units per liter (U/L) to 280 U/L
• 2: LDH is not used to diagnose cancer but can be used to see how well treatment is
working. LDH can be used to monitor treatment in testicular cancer, ovarian cancer,
lymphoma, leukemia, melanoma, and neuroblastoma. LDH levels can also be
elevated by many noncancerous conditions such as heart, lung, or kidney disease.

15. Thank y’ll For
listening..
Shreya bhat
Dept of biotechnology
Guide : prof preeti kumarmath