Polyacrylamide gel disc electrophoresis of alkaline phosphatase isoenzymes in bone and liver disease.

Abstract

Royal Infirmary, Manchester M13 9WL SYNOPSiS Acrylamide gel disc electrophoresis provides a reliable and reasonably rapid method of differentiating the raised serum alkaline phosphatase (AP) of bone origin from that of liver origin. The technique has been placed for the first time on a semiquantitative basis. Measurement of both band width and band position effectively distinguishes the bone from the liver isoenzyme, but band width provides superior discrimination.An origin band was seen in none of the normal subjects and in only 7 % of patients with bone disease but was present in 78 % of patients with liver disease, a highly significant increase. Fifty percent of normal individuals had a small-intestinal band in serum taken two hours after a meal, as did 35 % of patients with liver disease, but the incidence of intestinal bands in bone disease was only 11 %, significantly less than in the other two groups. The genetic control of small-intestinal AP in serum has been confirmed, but it has been demonstrated that the decrease of intestinal AP in bone disorders is not genetically determined.

Intestinal alkaline phosphatase in the diagnosis of liver disease.

“…We have recently reported a decreased incidence of gut bands in osteoblastic bone disease, where we postulated that an increased serum contribution from one source may 'switch off' that from the small intestine (Warnes et al, 1976) but this explanation is not applicable to our present findings in liver disease, as the mean AP of the patients with extrahepatic lesions was not significantly higher than that of the patients in the intrahepatic group.…”

“…1) was seen in all 76 patients with liver disease, the vast majority of whom also had an origin band which is not present in normal subjects (Warnes et al, 1976).…”

“…On acrylamide gel disc electrophoresis main, origin, and intestinal bands may be seen. The origin band is fairly specific for liver disease, being found in 78 % of cases (Warnes et al, 1976). It has been shown that some patients with cirrhosis of the liver are characterised by increased amounts of intestinal AP in serum (Fishman et al, 1965).…”

Raised Liver Enzymes in Asymptomatic Patients: Investigation and Outcome

“…Only in the case of AP has this problem been overcome by separation and in some cases, partial quantitation of tis sue-specific isoenzymes. Polyacrylamide gel electrophoresis can reliably differentiate bone, liver and small intestinal bands [24]. AP isoenzyme separation may also reveal impor tant information concerning the nature of the liver pathology present.…”

Genetic Influences on Diagnostic Enzymes in Plasma

“…The first is that the overactivity of one gene may switch off the activity of another. There is some suggestion of this in that intestinal ALP is very infrequent in the plasma of patients with elevated ALP from bone dis ease [50,92].…”