Evaluation of serum bone alkaline phosphatase activity in patients with liver disease: Comparison between electrophoresis and chemiluminescent enzyme immunoassay

Abstract

When serum ALP3 (%) levels were high in patients with liver disease, the accuracy of electrophoresis was comparable to that of CLEIA. However, the accuracy of electrophoresis needs to be evaluated with further when patient samples under certain conditions.

Comparison between bone alkaline phosphatase immunoassay and electrophoresis technique in hemodialysis patients

“…The obtained data in our study, indicate a significant presence of intestinal isoforms and liver-2 isoenzymes, which most likely contribute to higher values of detected bALP by the immunochemical method compared to electrophoretic technique. This support findings of Zhan et al who pointed out that the accuracy of electrophoresis was comparable to that of immunochemistry assay when percent of serum bALP levels were high in patients with liver disease, but that accuracy of electrophoresis, further needs to be assessed, with patient samples under certain disease and conditions (14).…”

Retrospective evaluation of a local protocol used to enhance laboratory savings through minimizing the performance of alkaline phosphatase isoenzyme analysis

“…The use of this algorithm provided a clear differentiation between liver and bone-related cause of the increased total serum ALP in the majority of samples, which are the most frequent reasons for ALP isoenzyme requests. 2,4 A study carried out by Zhan et al 2 highlighted that when liver ALP isoenzyme predominated over Bone ALP isoenzyme in traditional ALP isoenzyme analysis via gel electrophoresis, there was an increase in errors associated with the measurement of Bone ALP isoenzyme, which required visual determination to differentiate the two ALP fractions. This error can compromise the accuracy of Bone ALP estimation in certain patient groups, for example patients with cholangitis or intrahepatic space-occupying lesions.…”

“…This error can compromise the accuracy of Bone ALP estimation in certain patient groups, for example patients with cholangitis or intrahepatic space-occupying lesions. 2 Measuring Bone ALP via an immunoassay diminishes the possibility of error associated with visual determination.…”

“…Due to both of these isoforms being the products of the same genetic loci with only a difference in posttranslational glycosylation, the differentiation between the two isoforms is difficult but can be vital for reaching an accurate diagnosis of liver and bone-related disorders. 1,2 ALP isoenzyme analysis is requested by clinicians to aid the differential diagnosis of some diseases, in particular, to differentiate between a liver and bone origin of an elevated total serum ALP. The current analytical technique that is used to separate ALP isoenzymes is electrophoresis.…”

“…Due to both of these isoforms being the products of the same genetic loci with only a difference in post-translational glycosylation, the differentiation between the two isoforms is difficult but can be vital for reaching an accurate diagnosis of liver and bone-related disorders. 1,2…”