SERUM PROTEINS S.BY RV/06-09,17,23

SERUM PROTEINS Proteins are the most abundant compounds in your serum  (the rest of your blood when you remove all the cells).  Amino acids are the building blocks of all proteins.  turn proteins are the building blocks of all cells and body  tissues.They are the basic components of enzymes, many  hormones,antibodies and clotting agents. Proteins act as  transport substances for hormones, vitamins, minerals, lipids and other materials. In addition, proteins help balance the osmotic pressure of the blood and tissue. Osmotic  pressure is part of what keeps water inside a particular  compartment of your body. Proteins play a major role in  maintaining the delicate acid-alkaline balance of your  blood. Finally, serum proteins serve as a reserve source of  energy for your tissues and muscle when you are not  ingesting an adequate amount. The major measured serum proteins are divided into two  groups, albumin and globulins. There are four major types of globulins, each with specific properties and actions.  A typical blood panel will provide four different  measurements - the total protein, albumin, globulins,  and the albumin globulin ratio. Total Protein Because the total protein represents the sum of albumin  and globulins, it is more important to know which  protein fraction is high or low than what is the total  protein. Ideally, the total protein will be approximately7.5 g/dl. Optimal Range: 7.2-8.0 g/100ml Total protein may be elevated due to: Chronic infection (including tuberculosis) Adrenal cortical hypofunction Liver dysfunction Collagen Vascular Disease (Rheumatoid Arthritis, Systemic Lupus, Scleroderma) Hypersensitivity States Sarcoidosis Dehydration (diabetic acidosis, chronic diarrhea) Respiratory distress Hemolysis Cryoglobulinemia Alcoholism Leukemia Total protein may be decreased due to: Malnutrition and malabsorption (insufficient intake          and/or digestion of proteins) Liver disease (insufficient production of proteins) Diarrhea (loss of protein through the GI tract) Severe burns (loss of protein through the skin) Hormone Imbalances that favor breakdown of tissue Loss through the urine in severe kidney disease          (proteinuria) Low albumin (see "albumin") Low globulins (see "globulins") Pregnancy (dilution of protein due to extra fluid            held in the vascular system) Albumin Albumin is synthesized by the liver using dietary protein. Its presence in the plasma creates an osmotic force that  maintains fluid volume within the vascular space. A very  strong predictor of health; low albumin is a sign of  poor health and a predictor of a bad outcome. Optimal Range: 4.5-5.0 g/100ml Albumin levels may be elevated in: Dehydration - actual Congestive heart failure Poor protein utilization Glucocorticoid excess intake Congenital Albumin levels may be decreased in: Dehydration Hypothyroidism Chronic debilitating diseases (ex: RA) Malnutrition - Protein deficiency Dilution by excess H2O (drinking too much water,         or excess administration of IV fluids) Kidney losses (Nephrotic Syndrome) Protein losing-enteropathy (protein is lost from the        gastrointestinal tract during diarrhea) Skin losses (burns, exfoliative dermatitis) Liver dysfunction (the body is not synthesizing         enough albumin and indicates poor liver function) Insufficient anabolic hormones such as            Growth Hormone, DHEA, testosterone, etc. GLOBULINS, Total serum Globulins are proteins that include gamma globulins (antibodies) and a variety of enzymes and carrier proteins. The specific profile of the globulins is determined by protein electrophoresis (SPEP), which separates the  proteins according to size and charge. There are four  major groups that can be identified: gamma globulins, beta globulins, alpha-2 globulins, and alpha-1 globulins. Once the abnormal group has been identified, further studies can determine the specific protein excess or deficit. Since the gamma fraction usually makes up the largest portion of the globulins, antibody deficiency should always  come to mind when the globulin level is low. Antibodies are  produced by mature B lymphocytes called plasma cells, while  most of the other proteins in the alpha and beta fractions are  made in the liver. Optimal Range: 2.3-2.8 g/dL Optimal Range (Alpha Globulin): 0.2-0.3 g/L Optimal Range (Beta Globulin): 0.7-1.0 g/L The globulin level may be elevated in: Chronic infections (parasites, some cases of viral           and bacterial infection) Liver disease(biliary cirrhosis,obstructive jaundice) Carcinoid syndrome Rheumatoid arthritis Ulcerative colitis Multiple myelomas, leukemias, Waldenstrom's          macroglobulinemia Autoimmunity (Systemic lupus, collagen diseases Kidney dysfunction (Nephrosis) The serum globulin level may be decreased in: Nephrosis Alpha-1 Antitrypsin Deficiency (Emphysema) Acute hemolytic anemia Liver dysfunction Hypogammaglobulinemia/Agammaglobulinemia A/G (ALBUMIN/GLOBULIN) RATIO The liver can function adequately on 20% of liver  tissue, thus early diagnosis by lab methods is difficult.  A reversed A/G Ratio may be a helpful indicator.  With severe liver cell damage, the prolonged prothrombin  time will not change with ingestion of Vitamin K.  The proper albumin to globulin ratio is 2:1. When <1.7,  there is may be a need for increasing stomach acidity.  When >3.5 there may be a need for stomach acidity and pepsin. Optimal Range: 1.7-2.2 The AG ratio may be elevated in: Hypothyroidism High protein/high carbohydrate diet with poor                  nitrogen retention Hypogammaglobulinemia (low globulin) The AG ratio may be decreased in: Liver dysfunction

Blood proteins, also called serum proteins, are proteins found in blood plasma.
Serum total protein in blood is 7g/dl. They serve many different functions,
including

• circulatory transport molecules for lipids, hormones, vitamins and metals
• enzymes, complement components, protease inhibitors, and kinin precursors
• regulation of acellular activity and functioning and in the immune system.

Separating serum proteins by electrophoresis is a valuable diagnostic tool as well 
as a way to monitor clinical progress.

Often mentioned blood proteins:

Structure of hemoglobin

Blood protein	Normal level		Function
Albumins	3.5-5.0 g/dl	60%	create oncotic pressure and  transports other molecules
immunoglobulins	1.0-1.5 g/dl	18%	participate in immune system
Fibrinogens	0.2-0.45 g/dl	4%	blood coagulation
alpha 1-antitrypsin			neutralize trypsin that has leaked from the digestive system
Regulatory proteins		<1%	Regulation of gene expression

Other types of blood proteins include: Prealbumin Alpha 1 antitrypsin
Alpha 1 acid glycoprotein Alpha 1 fetoprotein Haptoglobin Alpha 2 macroglobulin
Ceruloplasmin Transferring C3/C4 Beta 2 microglobulin Beta lipoprotein 
Gamma globulin proteins C-reactive protein (CRP)

• alpha2-macroglobulin
• Other globulins, which are of three types- alpha, beta and gamma.
• Lipoproteins (chylomicrons, VLDL, LDL, HDL)
• Transferrin
• Prothrombin
• MBL or MBP

All the plasma proteins are synthesized in liver except gamma globulins.

60% of plasma proteins are made up of the protein albumin, which are 
major contributors to osmotic pressure of plasma which assists in the transport 
of lipids and steroid hormones. Globulins make up 35% of plasma proteins and 
are used in the transport of ions, hormones and lipids assisting in immune function.
4% is fibrinogen which is essential in the clotting of blood and can be converted
into insoluble fibrin. Regulatory proteins which make up less than 1% of plasma
proteins are proteins such as enzymes, proenzymes and hormones.
Current research regarding blood plasma proteins is centered on performing
proteomics analyses of serum/plasma in the search for biomarkers. 
These efforts started with two-dimensional gel electrophoresis^[1] 
efforts in the 1970s and in more recent times this research has been performed
using LC-tandem MS^[2][3] based proteomics.

SUBMITTED TO                                                     SUBMITTED BY

DR.VASILI ASHOK                                                      RV/06-09,

MVSc  DEPT.OF BIOCHEMISTRY                             RV/06-17

                                                                                          RV/06-23