Observation on the Changes in Lactate Dehydrogenase Isoenzymes in Post-Burn Patients: Significance in Relation to Creatine Kinase

Abstract

Observation on the Changes in Lactate Dehydrogenase Isoenzymes in Post-Burn Patients: Significance in Relation to Creatine Kinase The present study deals with the quantitative assessment of lactate dehydrogenase isoenzymes in the sera of burn subjects. Efforts are also made here to show better predictive marker value of sera LDH, as a few other known protein markers like creatine kinase and myoglobin have limited analytical value in the management of thermal burns. Blood was initially collected at day-1 of admission from 29 burn and 10 healthy subjects. Further, the sampling was carried out at 2, 5, 10, 20 and 30 days of wound healing (recovery). Plasma and sera LDH isoenzymes were monitored on 7.5% polyacrylamide gel electrophoresis. Quantitative assessment of LDH isoenzymes was done from gelscans using GelPro and Scion Imaging softwares. Sera CK levels were estimated colorimetrically using reagent kits. Our results show that quantitative changes in LDH isoenzyme were more convincing and interpretable in the sera than plasma. Sera LDH-5 isoenzyme was detected as the major contributor of total sera LDH activity, which follows a change parallel to sera CK in burn subjects. Sera LDH-5 activity also remains significantly high for up to 10 days while sera CK levels were detected elevated up to 5 days (P<0.05) during the recovery of patients. Therefore, the present findings strongly recommended the use of sera to assess the LDH activity and indicate better stability of sera LDH-5 than sera CK during post burn wound healing.

Significance of Serum Lactate Dehydrogenase and its Isoenzymes During Post-Burn Follow-Up

“…Therefore, its use in labo ra to ries to screen the sera samples for enzymatic or protein activity in burn subjects is strongly recommended. Pla telets have been reported to interfere during the mea surement of LDH (4,29,30). Hence, du ring the pre sent investigations use of sera is preferred over plasma to evaluate the LDH activity in burn sub jects.…”

“…Extensive literature is available to suggest biochemical approaches as the most useful way to assess treatment strategy and management of the burn patients (4,(17)(18)(19)(20). A few reports on burn subjects sho wed deficiencies in total circulating hemoglobin (21) and demonstrated reduced levels of g-globulins by quantitative changes in serum electrophoretic profiles (22).…”

“…In this context, the present study was undertaken with the aim to propose the signi ficance of lactate dehydrogenase (LDH) enzyme data in thermal burn patients. As this is a very important enzyme of the last step of anaerobic glycolysis, its utility in terms of a metabolic indicator in a variety of animals cannot be ignored (4,6,8,9,13,25,26). Alte ra tions in the level of LDH tetramers in the damaged tissues have wide applications in the management of various diseases, including burns (4, 27-29).…”

“…Work on the relevance of LDH isoenzymes in burn subjects has also been carried out (1,4,14,15). However, reports that signify the importance of LDH during postburn follow-up and wound healing are still scarce.…”

“…These enzymes or their multiple forms together with other proteins have been shown as reliable markers to assess the type and extent of damage to many tissues under a variety of clinical conditions. Monitoring of these enzyme levels and their distribution in postburn subjects has valuable diagnostic and prognostic importance (1)(2)(3)(4). Various me tabolic and biological changes follow burn injury due to anomalies in a number of both serum and enzyme activities.…”