TISSUE ISOZYMES

• Isozymes are fractions of one enzyme having the same catalytic activity
but differ in chemical and immunological structure.
•
• The human body is composed of a number of different cell types that
perform specific functions unique to that cell type and synthesize only
the proteins consistent with their functions.

• Because regulation matches function, regulatory enzymes of pathways

usually exist as tissue-specific isozymes with somewhat different
regulatory properties unique to their function in different cell types.
• For example, hexokinase and glucokinase are tissue-specific isozymes
with different kinetic properties. Also LDH has 5 isoenzymes.
 ENZYMES in CLINICAL DIAGNOSIS

• Plasma enzymes can be classified into two major groups.

• First, a relatively small group of enzymes are actively secreted into the
blood by certain cell types. For example, the liver secretes zymogens
(inactive precursors) of the enzymes involved in blood coagulation.
• Second, a large number of enzyme species are released from cells
during normal cell turnover. These enzymes almost always function
interacellularly and have no physiologic use in the plasma but the
presence of elevated enzyme activity in the plasma may indicate tissue
damage that is accompanied by increased release of intracellular
enzymes.
• Important examples
• GPT , GOT, CPK, LDH, Amylase, lipase, ALP,
• Diagnosis of myocardial infarction: Myocardial muscle is the only
tissue that contains more than five percent of the total CK activity as the
CK2 (MB) isoenzyme.
• Appearance of this isoenzyme in plasma is virtually specific for
infarction of the myocardium.
• Following an acute myocardial infarction, this isoenzyme appears
approximately four to eight hours following onset of chest pain, and
reaches a peak of activity at approximately 24 hours .

• [Note: Lactate dehydrogenase activity is also elevated in plasma

following an infarction, peaking 36 to 40 hours after the onset of
symptoms. LDH activity is, thus, of diagnostic value in patients admitted
more than 48 hours after the infarction
List of enzymes used in the clinical laboratory as reagents for assays

Alcohol dehydrogenase >>>>Ethanol

Lactate dehydrogenase >>>>Lactate

Glucose oxidase and peroxidase >>>>Glucose

Hexokinase and glucose-6- phosphate dehydrogenase>>>>creatine kinase

Uricase>>>>>>> Uric acid

Urease >>>>>>Urea

Cholesterol oxidase and peroxidase >>>>>>Cholesterol

Lipase, glycerol kinase, glycerol phosphate dehydrogenase>>>Triacylglycerol