plasma protein, clinical significance, acute phase proteins, C-RP , multiple myeloma, Electrophoresis.

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PLASMA
PROTEINS
MEGHANA C
Dept Of Biochemistry
ESICMC & Hospital Gulbargha

2. Contents
FUNCTIONS OF PLASMA PROTEINS ( Albumin, α, β & γ Globulins)
CLINICAL SIGNIFICANCE OF PLASMA PROTEINS ( Albumin, α, β & γ Globulins)
ACUTE PHASE REACTANTS (+̶VE & ̶ VE ACUTE PHASE REACTANTS &
CLINICAL SIGNIFICANCE)
BIOLOGICAL REFERENCE RANGE OF SERUM TOTAL PROTEIN
MULTIPLE MYELOMA
SEPERATION & IDENTIFICATION OF PLASMA PROTEIN

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PLASMA PROTEINS
PLASMA consists of water, eectrolyte, metabolites, nutrients,
proteins, & hormones.
The concentration of total protein in human plasma is approximately
6.0-8.0g/Dl

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PLASMA PROTEIN
ALBUMIN (58%)
3.5 - 5.0 g/dL
FIBRINOGEN (4%)
200 – 400 mg/dL
GLOBULIN (38%)
2.5 – 3.5 g/dL
Alfa – 1 Globulin
(α1)- fetoprotein
(α1)-antitrypsin
Alfa – 2 Globulin
ceruloplasmin
Haptoglobin
Beta (β)-Globulin
Transferrin
C-RP
Gamma (γ) (Ig)
Antibodies

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ALBUMIN
• The name is derived from the latin word = Albus = white
• It constituents the major part of plasma proteins 58%
• It has one polypeptide chain with 585 amino acids with 17
disulphide bonds
• It has a molecular weight of 69000 D
• It is the simple globular protein with the pH around 4.7

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ALBUMIN (cont)..
Albumin is a low molecular weight protein, hence appears in urine
in kidney disorders (Neohrotic syndrome).
Three main sources of albumin are serum albumin, lactalbumin,
ovalbumin.

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ALBUMIN (cont)..
It is synthesized by hepatocyts; therefore estimation of albumin is
a LFT
Half-life of albumins is about 20 days
Liver produces 10 – 15 grams of albumin/ day, representing 25%
of total hepatic protein synthesis
Albumin can come out of vascular compartment, so albumin is
present in CSF & interstitial fluid also.

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FUNCTIONS OF ALBUMIN
1. OSMOTIC FUNCTION
2. TRANSPORT FUNCTION
3. NUTRITIVE FUNCTION
4. BUFFERING FUNCTION

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NORMAL LEVEL AND METHOD OF
ESTIMATION
Normal level of albumin is 3.5 – 5.0 g/dL .
Method for estimation of albumin in the blood is BCG
( Bromo Cresol Green).
Samples for albumin estimation is collected in plain
vacutainers /red tubes.

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CLINICAL SIGNIFICANCE OF ALBUMIN
Serum albumin measurement are used
to assess the various clinical condition ;
• Hypoalbuminemia
• Hyperalbuminemia
• Analbuminemia

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HYPOALBUMINEMIA
Normal level of albumin :- 3.5 – 5.0 g/dL .
When albumin level decreased to to less than 2g/d L It is
called HYPOALBUMINEMIA
Its seen in various disorders due to :-
• Physiological cause
• Pathological cause

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PATHOLOGICAL CAUSES OF HYPOALBUMINEMIA
1. Reduced or impaired synthesis
2. Abnormal distribution
3. Abnormal or excessive losses
4. Increased catabolism
5. Over hydration

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1. REDUCED SYNTHESIS (OR) IMPAIRED SYNTHESIS
1. Chronic liver disease
2. Severe or prolonged protein energy malnutrition (PEM)
3. Intestine malabsorption diseases.

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2. ABNORMAL DISTRIBUTION
Due to increased capillary permiablity which permits plasma to leak
into the extravascular compartments
Eg. Severe burn, ascites, & edema.
Edema & ascites are usually secondary cause to iincreased vascular
permeability rather than to hypoalbuminemia

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3. ABNORMAL (OR) EXCESSIVE LOSS
Nephrotic syndrome:- ( occurs in nephrotic syndrome there is a injury
to the glomerular membrane which results in the loss of albumin in the
urine resulting in albuminuria & hypoalbuminemia.
GIT Disease like protein losing enteropathy
Burns or certain skin diseases
Hemorrhage
Inflammations ( results from hemodilution, loss of protein into
extravascular space)

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4. INCREASED CATABOLISM
IT OCCURS AS A RESULT OF :-
• Injury eg; major surgery or trauma
• Infection
• Fever
• Malignant disease

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5. OVERHYDRATION
Due to hemodilution

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HYPERALBUMINAEMIA
When albumin level increase more than 5.0 g/d L, called
hyperalbuminemia
Increased level of albumin are present in acute dehydration
and have no clinical significance.

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ANALBUMINAEMIA
It’s a rare heriditary abormalities in which plasma albumin
concentration is less than 1.0 g/d L or completely devoid of
albumin (0.1- 1g/d L).
There may be no sign or symptoms, not even edema due to
compensatory increase in plasma globulin concentration.

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GLOBULIN (α, β & γ Globulins)
Can be seperated into different fractions on the basis of their electrophoretic mobility & sedimentation
coefficient;

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α1-globulins
α1-antitrypsin
α1-fetoprotein
prothrombin
Retinol binding proein and
High density lipoproteins HDL

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α1-globulins
α1-antitrypsin : gives elasticity to lungs
A genetic deficiency in α1-Antitrypsin can lead to emphysema
Excessive cigarette smokig lead to emphyema ( cigarette
smoking inhibit the activity of α1-AT

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α1-fetoprotein
Measurement of α1-fetoprotein (AFP) have two important applications:
In pregnancy : Helps in diagnosis of :-
1. Open Neural Tube Defects (ONTD) (Increase AFP)
Open neural tube is aa embrionic structure from which brain &
spinal cord develops.
2. Down’s syndrome (mental subnormality) (Decreased AFP)
In hepatic cancer: greatly increased in hepatoma ( Cancer of liver) and
used as tumer maarker.

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Prothrombin
It is synthesized by liver with the help of vitamin K & Involved
in blood clottiing.
Liver damage causes lengthening of prothrombin time.

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Alfa – 2 Globulin
1. Ceruloplasmin :
It’s a copper containing glycoprotein
Ceruloplasmin is reduced in :
Wilson’s Disease
Malnutrition
Nephrosis
Cirrhosis.
2. Haptoglobin:
plays important role in the conversion of iron by preventing its
loss in the urine
Patients suffering from hemolytic anemia exhibit low level of
haptoglobin

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Beta (β)-Globulin, (transferrin, C-RP)
1. Transferrin :
Increased level of transferrin is seen in
1. Iron deficiency anemia & in the last
2. Months of pregnancy.
Low level of transferrin is seen in
1. Chronic infection
2. Malnutrition

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Beta (β)-Globulin, (transferrin, C-RP)
C-RP
Involved in body response to foreign compound.
C-reactive protein named because it reacts with C-
Polysaccharides of the cell wall of pneumocci bacteria.
It is usefull in differentiating bacterial from viral infection
because level of C-RP is highly increased in bacterial infection.
Level of C-RP rises when there is an inflammation or an
infection.

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ACUTE PHASE RESPONSE
It is a non specific response to the stimulus of tissue following
trauma, infection inflammation, burns.
Following to trauma, infection inflammation, burns. The body
response by initiating a series mechanism that lead to rapid decrease
in the concentration of many proteins .
These protein are termed by negative acute phase proteins.
Examples are :
Albumin
Transferrin

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ACUTE PHASE PROTEIN
An increase in the concentration of several specific proteins occur
some hours after the injury. These proteins are termed as Acute
Phase Proteins
Examples are :-
C-Reactive Protein
Ceruloplasmin
Haptoglobin
Alfa 1 antitrypsin

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MULTIPLE MYELOMA
MULTIPLE MYELOMA (Plasma Cell Myeloma) is a cancer of
plasma cells.
Abnormal plasma cells produce abnormal antibodies which
cause kidney problems & overly thick bood .
Plasma cells also form mass in the bone marrow & soft
tissue.
When only one tumour is present itiscalled plasmacytoma,
more than one then it is called multiple myeloma.

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MULTIPLE MYELOMA ( clinical features)
Frequent infections
Weakness due to anemia
Bone pain
Kidney problems
A mnemonic to remember common symptoms of MULTIPLE
MYELOMA is CRAB
C- Elevated Calcium
R- Renal Failure
A- Anemia
B- Bone pain , Bone Lesions

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DIAGNOSIS OF MULTIPLE MYELMA
Protein electrophoresis of blood
and urine might shows the
presence of paraprotein ( M band)
Protein electrophoresis is a test
that measures specific proteins in
the blood. The test separates
proteins in the blood based on
their electrical charge. The protein
electrophoresis test is often used
to find abnormal substances called
M proteins.

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SERUM PROTEIN ELECTROPHORESIS

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