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M.PRASAD NAIDU
Msc Medical Biochemistry,
Ph.D Research scholar.
Introduction
SERUM PROTEINS
 Composition
 Albumin: Conc. 60%, M.W. 69000, 585 AAs with 17 disulphide
bonds.
1. Synthesized from liver.
2. Maintains colloidal osmotic pressure.
3. Decreasing causes edema.
4. Serves as asource of AA
5. Decresed Alb –cirrhosis,nephrotic syndrome, malnutrition.
6. Increased alb - dehydration
Globulins
1. It’s a glycoprotein with m.w. 90000 – 130000.
2. Types.
3. The α & β helps to transport proteins, hormones, vitamins, minerals
and lipids.
4. γ globulins functions as immunoglobulins.
 Total proteins - 6-8 gm/dl (100%)
Alb - 3.5 – 5 gm/dl (60%)
Glob - 2.5 – 3 gm/dl (40%)
α1 - 3%
α2 - 11%
β - 11%
γ - 15%
METHODS FOR SEPARATION OF SERUM
PROTEINS
1. Precipitation by salts.
2. Cohn’s fractional precipitation method.
3. Sedimentation by ultracentrifugation.
4. Paper chromatography.
5. Electrophoresis.
ELECTROPHORESIS
 Definition: Electrophoresis is the migration of charged
molecules in an electric field. The negative charged particles
(anions) moves towards positive charged electrodes (anode).
Positively charged particles (cations) moves towards cathod
(negatively charged electrode).
 Types:
1. Depending upon the nature of supporting medium
a. Agar gel electrophoresis (AGE).
b. PAGE, SDS PAGE, QPNC PAGE (Quantitative preparative native
continuous PAGE).
c. Cellulose acetate electrophoresis.
d. Capillary electrophoresis.
2. Depending upon the mode of technique.
a. Slide gel electrophoresis.
b. Tube gel electrophoresis.
c. Disc electrophoresis.
d. Low and high voltage electrophoresis.
e. Two dimensional gel electrophoresis
Applications of Electrophoresis:
1. Separating serum proteins for diagnostic purpose.
2. Haemoglobin separation.
3. Lipoprotein separation and identification.
4. Isoenzyme separation and their analysis.
5. Nucleic acid studies.
6. Determination of molecular weight of the proteins.
FACTORS AFFECTING ELECTROPHORESIS
I. The electric field:
a. Voltage - V ∞ M
b. Current - C ∞ M
c. Resistance- R 1/∞ M
II. The sample:
a. Charge - C ∞ M
b. Size - S 1/∞ M
c. Shape - Molecules of similar size but different shape such as fibrus
and globular proteins exhibit diffeent migration
characteristics. Because of the differential effect of
frictional and electrophoretic force.
III. The buffers:
This determines and stabilizes the pH of the supporting medium and hence affects
the migration rate of compound in a number of ways.
a. Composition: The buffer should be such that it does not binds with the compounds
to be separated as this may alters the rate of migration. Therefore barbitone buffer
is always preferred for the separation of proteins or lipoproteins.
b. Concentration: As the ionic strength of the buffThe er increases the proportion of
current carried by the buffer will increase and the share of the current carried by the
sample will decrease thus slowing down the rate of migration.
c. pH: For organic compounds pH determines the extent of ionization and therefore
degree and direction of migration are pH dependent.
d. The supporting medium: The composition of supporting medium may cause
adsorption, electro osmosis and molecular sieving. Which may influence the rate of
migration of compounds. The commonly using supporting medium in the
laboratory are agarose, polyacrylamide and cellulose acetate membrane.
Types of buffers used in electrophoresis
1. Tris buffer.
2. Glycine buffer.
3. Sodium barbituric acid.
4. TAE buffer (Tris acidic acid EDTA).
Types of StainsFor serum proteins – Amido block
- Coomassie brilliant blue
For isoenzymes- Nitro tetra zolium blue
For lipoprotein zones- Fat red 7B
- Oil red O
- Sudan block B
For DNA fragments - Ethidium bromide
For CSA proteins - Silver nitrate
What is needed?
Agarose - a
polysaccharide made from
seaweed. Agarose is
dissolved in buffer and
heated, then cools to a
gelatinous solid with a
network of crosslinked
molecules
Some gels are made with
acrylamide if sharper
bands are required
 Buffer - in this case
TBE
 The buffer provides
ions in solution to
ensure electrical
conductivity.
 Not only is the agarose
dissolved in buffer, but
the gel slab is
submerged (submarine
gel) in buffer after
hardening
Also needed are a
power supply and a gel
chamber
Gel chambers come in
a variety of models,
from commercial
through home-made,
and a variety of sizes
A gel being run
Agarose block
Positive electrode
DNA loaded in
wells in the agarose
Black background
To make loading wells easier
Comb
Buffer
The comb is
removed, leaving
little ‘wells’ and
buffer is poured over
the gel to cover it
completely
The serum samples
are mixed with a
dense loading dye
so they sink into their
wells and can be
seen
The serum samples
are put in the wells
with a micropipette.
Micropipettes have
disposable tips and
can accurately
measure
1/1,000,000 of a litre
Pulsed field gel electrophoresis
Pulsed Field Gel Electrophoresis (commonly
abbreviated as PFGE) is a method for separating large
DNA molecules, which may be used for genotyping or
genetic fingerprinting.
Under normal electrophoresis, large nucleic acid
particles (above 30-50 kb) migrate at similar rates,
regardless of size. By changing the direction of the
electric field frequently, much greater size resolution
can be obtained
Pulsed field gel electrophoresis
SDS-PAGE
SDS-PAGE, officially sodium dodecyl sulfate
polyacrylamide gel electrophoresis, is a technique
used in biochemistry, genetics and molecular biology
to separate proteins according to their electrophoretic
mobility .
Quantitative preparative native continuous
polyacrylamide gel electrophoresis (QPNC-PAGE) is a
new method for separating native metalloproteins in
complex biological matrices.
Gel Electrophoresis
CAPILLARY ELECTROPHORESIS
MODES OF CAPILLARY
ELECTROPHORESIS
TABLE 1
Indications for Serum Protein Electrophoresis
Suspected multiple myeloma, Waldenström's macroglobulinemia, primary amyloidosis,
or related disorder
Unexplained peripheral neuropathy (not attributed to longstanding diabetes mellitus,
toxin exposure, chemotherapy, etc.)
New-onset anemia associated with renal failure or insufficiency and bone pain
Back pain in which multiple myeloma is suspected
Hypercalcemia attributed to possible malignancy (e.g., associated weight loss, fatigue,
bone pain, abnormal bleeding)
Rouleaux formations noted on peripheral blood smear
Renal insufficiency with associated serum protein elevation
Unexplained pathologic fracture or lytic lesion identified on radiograph
Bence Jones proteinuria
NORMAL PATTERN OF SERUM
ELECTROPHORESIS
1
i
γ-globulin
origin β2-globulin
β1-globulin
α2-globulin
α1-globulin
albumin
ABNORMAL PATTERN OF SERUM
ELECTROPHORESIS
MULTIPLE MYELOMAMULTIPLE MYELOMA
i
Extra M-Band is seen Albumin
NEPHROTIC SYNDROME
i
Β-globulin and α2-gloublin Albumin
AGAMMAGLOBULINEMIA
i
Absence or decrease of γ-globulin and others normal
LIVER DISEASES
i
γ β -globulin
origin α2-globulin
α1-globulin
albumin
Characteristic Patterns of Acute-Reaction Proteins Found on Serum Protein
Electrophoresis and Associated Conditions or Disorders
Increased albumin
Dehydration
Decreased albumin
Chronic cachectic or wasting diseases
Chronic infections
Hemorrhage, burns, or protein-losing enteropathies
Impaired liver function resulting from decreased synthesis of albumin
Malnutrition
Nephrotic syndrome
Pregnancy
Increased alpha1 globulins
Pregnancy
Decreased alpha1 globulins
Alpha1-antitrypsin deficiency
Increased alpha2 globulins
Adrenal insufficiency
Adrenocorticosteroid therapy
Advanced diabetes mellitus
Nephrotic syndrome
Decreased alpha2 globulins
Malnutrition
Megaloblastic anemia
Protein-losing enteropathies
Severe liver disease
Wilson's disease
Increased beta1 or beta2 globulins
Biliary cirrhosis
Carcinoma (sometimes)
Cushing's disease
Diabetes mellitus (some cases)
Hypothyroidism
Iron deficiency anemia
Malignant hypertension
Nephrosis
Polyarteritis nodosa
Obstructive jaundice
Third-trimester pregnancy
Decreased beta1 or beta2 globulins
Protein malnutrition
Increased gamma globulins
Amyloidosis
Chronic infections (granulomatous diseases)
Chronic lymphocytic leukemia
Cirrhosis
Hodgkin's disease
Malignant lymphoma
Multiple myeloma
Rheumatoid and collagen diseases (connective tissue disorders)
Waldenström's macroglobulinemia
Decreased gamma globulins
Agammaglobulinemia
Hypogammaglobulinemia
Differential Diagnosis of Polyclonal Gammopathy
Infections
Viral infections, especially hepatitis, human
immunodeficiency virus infection,
mononucleosis, and varicella
Focal or systemic bacterial infections,
including endocarditis, osteomyelitis, and
bacteremia
Tuberculosis
Connective tissue diseases
Systemic lupus erythematosus
Mixed connective tissue
Temporal arteritis
Rheumatoid arthritis
Sarcoid
Liver diseases
Cirrhosis
Ethanol abuse
Autoimmune hepatitis
Viral-induced hepatitis
Primary biliary cirrhosis
Primary sclerosing cholangitis
Malignancies
Solid tumors
Ovarian tumors
Lung cancer
Hepatocellular cancer
Renal tumors
Gastric tumors
Hematologic cancers (see below)
Hematologic and lymphoproliferative disorders
Lymphoma
Leukemia
Thalassemia
Sickle cell anemia
Other inflammatory conditions
Gastrointestinal conditions, including ulcerative
colitis and Crohn's disease
Pulmonary disorders, including bronchiectasis,
cystic fibrosis, chronic bronchitis, and
pneumonitis
Endocrine diseases, including Graves' disease
and Hashimoto's thyroiditis
Characteristic Features of Monoclonal Gammopathies
Disease Distinctive features
Multiple myeloma M protein appears as a narrow spike in the gamma, beta, or alpha2 regions.
M-protein level is usually greater than 3 g per dL.
Skeletal lesions (e.g., lytic lesions, diffuse osteopenia, vertebral compression fractures)
are present in 80 percent of patients.
Diagnosis requires 10 to 15 percent plasma cell involvement on bone marrow biopsy.
Anemia, pancytopenia, hypercalcemia, and renal disease may be present.
Monoclonal gammopathy of
undetermined significance
M-protein level is less than 3 g per dL.
There is less than 10 percent plasma cell involvement on bone marrow biopsy.
Affected patients have no M protein in their urine, no lytic bone lesions, no anemia, no
hypercalcemia, and no renal disease.
Smoldering multiple myeloma M-protein level is greater than 3 g per dL.
There is greater than 10 percent plasma cell involvement on bone marrow biopsy.
Affected patients have no lytic bone lesions, no anemia, no hypercalcemia, and no renal
disease.
Plasma cell leukemia Peripheral blood contains more than 20 percent plasma cells.
M-protein levels are low.
Affected patients have few bone lesions and few hematologic disturbances.
This monoclonal gammopathy occurs in younger patients.
Solitary plasmacytoma Affected patients have only one tumor, with no other bone lesions and no urine or serum
abnormalities.
Waldenström's macroglobulinemia IgM M protein is present.
Affected patients have hyperviscosity and hypercellular bone marrow with extensive
infiltration by lymphoplasma cells.
Heavy chain disease The M protein has an incomplete heavy chain and no light chain.
Serum protein electrophoresis & their clinical importance
Serum protein electrophoresis & their clinical importance

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Serum protein electrophoresis & their clinical importance

  • 1. M.PRASAD NAIDU Msc Medical Biochemistry, Ph.D Research scholar.
  • 3. SERUM PROTEINS  Composition  Albumin: Conc. 60%, M.W. 69000, 585 AAs with 17 disulphide bonds. 1. Synthesized from liver. 2. Maintains colloidal osmotic pressure. 3. Decreasing causes edema. 4. Serves as asource of AA 5. Decresed Alb –cirrhosis,nephrotic syndrome, malnutrition. 6. Increased alb - dehydration
  • 4. Globulins 1. It’s a glycoprotein with m.w. 90000 – 130000. 2. Types. 3. The α & β helps to transport proteins, hormones, vitamins, minerals and lipids. 4. γ globulins functions as immunoglobulins.  Total proteins - 6-8 gm/dl (100%) Alb - 3.5 – 5 gm/dl (60%) Glob - 2.5 – 3 gm/dl (40%) α1 - 3% α2 - 11% β - 11% γ - 15%
  • 5. METHODS FOR SEPARATION OF SERUM PROTEINS 1. Precipitation by salts. 2. Cohn’s fractional precipitation method. 3. Sedimentation by ultracentrifugation. 4. Paper chromatography. 5. Electrophoresis.
  • 6. ELECTROPHORESIS  Definition: Electrophoresis is the migration of charged molecules in an electric field. The negative charged particles (anions) moves towards positive charged electrodes (anode). Positively charged particles (cations) moves towards cathod (negatively charged electrode).  Types: 1. Depending upon the nature of supporting medium a. Agar gel electrophoresis (AGE). b. PAGE, SDS PAGE, QPNC PAGE (Quantitative preparative native continuous PAGE). c. Cellulose acetate electrophoresis. d. Capillary electrophoresis.
  • 7. 2. Depending upon the mode of technique. a. Slide gel electrophoresis. b. Tube gel electrophoresis. c. Disc electrophoresis. d. Low and high voltage electrophoresis. e. Two dimensional gel electrophoresis Applications of Electrophoresis: 1. Separating serum proteins for diagnostic purpose. 2. Haemoglobin separation. 3. Lipoprotein separation and identification. 4. Isoenzyme separation and their analysis. 5. Nucleic acid studies. 6. Determination of molecular weight of the proteins.
  • 8. FACTORS AFFECTING ELECTROPHORESIS I. The electric field: a. Voltage - V ∞ M b. Current - C ∞ M c. Resistance- R 1/∞ M II. The sample: a. Charge - C ∞ M b. Size - S 1/∞ M c. Shape - Molecules of similar size but different shape such as fibrus and globular proteins exhibit diffeent migration characteristics. Because of the differential effect of frictional and electrophoretic force.
  • 9. III. The buffers: This determines and stabilizes the pH of the supporting medium and hence affects the migration rate of compound in a number of ways. a. Composition: The buffer should be such that it does not binds with the compounds to be separated as this may alters the rate of migration. Therefore barbitone buffer is always preferred for the separation of proteins or lipoproteins. b. Concentration: As the ionic strength of the buffThe er increases the proportion of current carried by the buffer will increase and the share of the current carried by the sample will decrease thus slowing down the rate of migration. c. pH: For organic compounds pH determines the extent of ionization and therefore degree and direction of migration are pH dependent. d. The supporting medium: The composition of supporting medium may cause adsorption, electro osmosis and molecular sieving. Which may influence the rate of migration of compounds. The commonly using supporting medium in the laboratory are agarose, polyacrylamide and cellulose acetate membrane.
  • 10. Types of buffers used in electrophoresis 1. Tris buffer. 2. Glycine buffer. 3. Sodium barbituric acid. 4. TAE buffer (Tris acidic acid EDTA).
  • 11. Types of StainsFor serum proteins – Amido block - Coomassie brilliant blue For isoenzymes- Nitro tetra zolium blue For lipoprotein zones- Fat red 7B - Oil red O - Sudan block B For DNA fragments - Ethidium bromide For CSA proteins - Silver nitrate
  • 12.
  • 13. What is needed? Agarose - a polysaccharide made from seaweed. Agarose is dissolved in buffer and heated, then cools to a gelatinous solid with a network of crosslinked molecules Some gels are made with acrylamide if sharper bands are required
  • 14.  Buffer - in this case TBE  The buffer provides ions in solution to ensure electrical conductivity.  Not only is the agarose dissolved in buffer, but the gel slab is submerged (submarine gel) in buffer after hardening
  • 15. Also needed are a power supply and a gel chamber Gel chambers come in a variety of models, from commercial through home-made, and a variety of sizes
  • 16. A gel being run Agarose block Positive electrode DNA loaded in wells in the agarose Black background To make loading wells easier Comb Buffer
  • 17. The comb is removed, leaving little ‘wells’ and buffer is poured over the gel to cover it completely The serum samples are mixed with a dense loading dye so they sink into their wells and can be seen
  • 18. The serum samples are put in the wells with a micropipette. Micropipettes have disposable tips and can accurately measure 1/1,000,000 of a litre
  • 19.
  • 20.
  • 21.
  • 22. Pulsed field gel electrophoresis Pulsed Field Gel Electrophoresis (commonly abbreviated as PFGE) is a method for separating large DNA molecules, which may be used for genotyping or genetic fingerprinting. Under normal electrophoresis, large nucleic acid particles (above 30-50 kb) migrate at similar rates, regardless of size. By changing the direction of the electric field frequently, much greater size resolution can be obtained
  • 23. Pulsed field gel electrophoresis
  • 24.
  • 25. SDS-PAGE SDS-PAGE, officially sodium dodecyl sulfate polyacrylamide gel electrophoresis, is a technique used in biochemistry, genetics and molecular biology to separate proteins according to their electrophoretic mobility . Quantitative preparative native continuous polyacrylamide gel electrophoresis (QPNC-PAGE) is a new method for separating native metalloproteins in complex biological matrices.
  • 26.
  • 27.
  • 31. TABLE 1 Indications for Serum Protein Electrophoresis Suspected multiple myeloma, Waldenström's macroglobulinemia, primary amyloidosis, or related disorder Unexplained peripheral neuropathy (not attributed to longstanding diabetes mellitus, toxin exposure, chemotherapy, etc.) New-onset anemia associated with renal failure or insufficiency and bone pain Back pain in which multiple myeloma is suspected Hypercalcemia attributed to possible malignancy (e.g., associated weight loss, fatigue, bone pain, abnormal bleeding) Rouleaux formations noted on peripheral blood smear Renal insufficiency with associated serum protein elevation Unexplained pathologic fracture or lytic lesion identified on radiograph Bence Jones proteinuria
  • 32. NORMAL PATTERN OF SERUM ELECTROPHORESIS 1 i γ-globulin origin β2-globulin β1-globulin α2-globulin α1-globulin albumin
  • 33.
  • 34. ABNORMAL PATTERN OF SERUM ELECTROPHORESIS MULTIPLE MYELOMAMULTIPLE MYELOMA i Extra M-Band is seen Albumin
  • 35.
  • 36. NEPHROTIC SYNDROME i Β-globulin and α2-gloublin Albumin
  • 37. AGAMMAGLOBULINEMIA i Absence or decrease of γ-globulin and others normal
  • 38. LIVER DISEASES i γ β -globulin origin α2-globulin α1-globulin albumin
  • 39. Characteristic Patterns of Acute-Reaction Proteins Found on Serum Protein Electrophoresis and Associated Conditions or Disorders Increased albumin Dehydration Decreased albumin Chronic cachectic or wasting diseases Chronic infections Hemorrhage, burns, or protein-losing enteropathies Impaired liver function resulting from decreased synthesis of albumin Malnutrition Nephrotic syndrome Pregnancy Increased alpha1 globulins Pregnancy Decreased alpha1 globulins Alpha1-antitrypsin deficiency Increased alpha2 globulins Adrenal insufficiency Adrenocorticosteroid therapy Advanced diabetes mellitus Nephrotic syndrome Decreased alpha2 globulins Malnutrition Megaloblastic anemia Protein-losing enteropathies Severe liver disease Wilson's disease
  • 40. Increased beta1 or beta2 globulins Biliary cirrhosis Carcinoma (sometimes) Cushing's disease Diabetes mellitus (some cases) Hypothyroidism Iron deficiency anemia Malignant hypertension Nephrosis Polyarteritis nodosa Obstructive jaundice Third-trimester pregnancy Decreased beta1 or beta2 globulins Protein malnutrition Increased gamma globulins Amyloidosis Chronic infections (granulomatous diseases) Chronic lymphocytic leukemia Cirrhosis Hodgkin's disease Malignant lymphoma Multiple myeloma Rheumatoid and collagen diseases (connective tissue disorders) Waldenström's macroglobulinemia Decreased gamma globulins Agammaglobulinemia Hypogammaglobulinemia
  • 41. Differential Diagnosis of Polyclonal Gammopathy Infections Viral infections, especially hepatitis, human immunodeficiency virus infection, mononucleosis, and varicella Focal or systemic bacterial infections, including endocarditis, osteomyelitis, and bacteremia Tuberculosis Connective tissue diseases Systemic lupus erythematosus Mixed connective tissue Temporal arteritis Rheumatoid arthritis Sarcoid Liver diseases Cirrhosis Ethanol abuse Autoimmune hepatitis Viral-induced hepatitis Primary biliary cirrhosis Primary sclerosing cholangitis Malignancies Solid tumors Ovarian tumors Lung cancer Hepatocellular cancer Renal tumors Gastric tumors Hematologic cancers (see below) Hematologic and lymphoproliferative disorders Lymphoma Leukemia Thalassemia Sickle cell anemia Other inflammatory conditions Gastrointestinal conditions, including ulcerative colitis and Crohn's disease Pulmonary disorders, including bronchiectasis, cystic fibrosis, chronic bronchitis, and pneumonitis Endocrine diseases, including Graves' disease and Hashimoto's thyroiditis
  • 42. Characteristic Features of Monoclonal Gammopathies Disease Distinctive features Multiple myeloma M protein appears as a narrow spike in the gamma, beta, or alpha2 regions. M-protein level is usually greater than 3 g per dL. Skeletal lesions (e.g., lytic lesions, diffuse osteopenia, vertebral compression fractures) are present in 80 percent of patients. Diagnosis requires 10 to 15 percent plasma cell involvement on bone marrow biopsy. Anemia, pancytopenia, hypercalcemia, and renal disease may be present. Monoclonal gammopathy of undetermined significance M-protein level is less than 3 g per dL. There is less than 10 percent plasma cell involvement on bone marrow biopsy. Affected patients have no M protein in their urine, no lytic bone lesions, no anemia, no hypercalcemia, and no renal disease. Smoldering multiple myeloma M-protein level is greater than 3 g per dL. There is greater than 10 percent plasma cell involvement on bone marrow biopsy. Affected patients have no lytic bone lesions, no anemia, no hypercalcemia, and no renal disease. Plasma cell leukemia Peripheral blood contains more than 20 percent plasma cells. M-protein levels are low. Affected patients have few bone lesions and few hematologic disturbances. This monoclonal gammopathy occurs in younger patients. Solitary plasmacytoma Affected patients have only one tumor, with no other bone lesions and no urine or serum abnormalities. Waldenström's macroglobulinemia IgM M protein is present. Affected patients have hyperviscosity and hypercellular bone marrow with extensive infiltration by lymphoplasma cells. Heavy chain disease The M protein has an incomplete heavy chain and no light chain.