Acid phosphatase is an enzyme that accelerates the breakdown of molecules in the body. Determining its level in the blood is essential for diagnosing a he alth condition. There are several types of acid phosphatases that have a common functional identity, but differ significantly from each other in relation to body tissues, chromosomal origin, and composition.
General data
The enzyme works in acidic environments, hence the name. Acid phosphatase is found in various tissues and cells; it can be located in lysosomes and outside them. The greatest amount is determined in the prostate gland, as well as in the cells of the following organs:
- liver;
- spleen;
- bone marrow;
- blood cells (erythrocytes, platelets, macrophages).
In a he althy body, the activity of acid phosphatase is quite low. In males, its level is half composed of prostatic phosphatase and the one that is locatedin the liver and destroyed blood cells. In the female body, enzymes are completely formed by the liver and destroyed red blood cells, platelets.
Lysosomal acid phosphatase
Found in most body cells. Its deficiency is manifested by an autosomal recessive disease, which is considered the result of the pathology of metabolic processes. Symptoms of the disease are manifested as follows:
- periodic nausea and vomiting;
- weakness, reduced efficiency;
- lower blood pressure;
- in childhood - opisthotonus (convulsive seizures, which are manifested by arching the back with an arc, patients lean on the surface of the bed only with the back of the head and feet);
- bleeding.
If the level of enzymes is insufficient only in leukocytes, patients often suffer from exacerbations of chronic infections.
Prostatic Acid Phosphatase
It is considered a marker of oncological processes in the prostate gland. This type of enzyme is also identified as a marker of seminal fluid in lawsuits (cases of rape). Acid phosphatase is elevated even a few days after surgery on the prostate gland or against the background of a biopsy.
The optimal acidity for the proper functioning of the enzyme is 4, 6. Activity appears only after the male reaches puberty.
Prostate phosphatase as a marker of cancer is currently receding bybackground due to the increased interest in the prostate-specific antigen, which is able to confirm the presence of the disease at an earlier stage of development. However, prostatic acid phosphatase levels are important in predicting cancer recurrence after radical prostate surgery.
The analysis allows you to determine the effectiveness of the treatment of benign prostatic hyperplasia and other prostatic pathologies.
Erythrocyte phosphatase
This is a polymorphic enzyme that is found not only in red blood cells, but also in other cells of the body. The optimal pH level for its functioning ranges from 5.2 to 6.2.
Blood acid phosphatase can be determined to clarify paternity. Certain forms of the enzyme are associated with the following conditions:
- hereditary predisposition to hemolytic anemia;
- pathology, which is characterized by the development of hemolytic anemia against the background of eating legumes;
- anemia due to the use of certain drugs or the development of infections of viral and bacterial origin.
There are forms of erythrocyte acid phosphatase that are directly associated with disorders that occur in childhood.
Macrophage type of acid phosphatase
Enzyme plays a role in the diagnosis of Gaucher disease. This is a hereditary disease that manifests itself in the accumulation in the tissues of the liver, spleen, kidneys,brain, lungs glucocerebroside (an organic substance from the group of fats). The disease is accompanied by a significant increase in the size of the above organs, a sharp decrease in the number of all blood cells, convulsions, spastic seizures, and mental retardation.
Macrophage acid phosphatase is also considered a specific marker for hairy cell leukemia. This disease is accompanied by the production of a significant amount of an enzyme that is determined in the blood.
Osteoclast Phosphatase
Osteoclasts are called bone tissue cells responsible for its destruction. This stage is an important point in the growth and remodeling of the bone apparatus. A high rate of bone destruction accompanies the following diseases:
- Paget's disease (pathology of normal bone synthesis and formation of its elements);
- malignant hypercalcemia;
- hyperfunction of the thyroid and parathyroid glands;
- postmenopause coupled with osteoporosis.
The result is frequent fractures and progressive thinning of bone structures. Determination of acid phosphatase of osteoclasts shows an increased level of enzymes against the background of the above pathologies.
Preparing and conducting diagnostics
Quantitative indicators are determined in the laboratory. The analysis should be carried out after 2 days from the moment of other diagnostic manipulations. If it is necessary to evaluate the level of prostatic acid phosphatase, then this should occur withoutearlier than 48 hours after the biopsy, prostate palpation, bladder catheterization. Otherwise, the results may be false positive.
Sampling of material for research is carried out on an empty stomach. You can drink only water, the use of tea, coffee, juices and other drinks is prohibited. For a day, you need to give up alcohol, fatty, smoked foods, 1 hour before the analysis - from smoking. The last half an hour before sampling should be spent in complete emotional calm.
Venous blood is used for diagnosis, namely its serum, avoiding hemolysis. The results of the examination are known the very next day after the examination.
Method used
To clarify the level of total acid phosphatase, an immunochemical method with chemiluminescent detection is used. Special substrates are used that interact with certain enzymes. Currently, systems use luminol derivatives with peroxidase in combination with a hydrogen peroxide solution. This adds the action of an initiator (for example, n-iodophenol), which can increase the luminescence of solutions up to several thousand times.
There are other systems that use alkaline phosphatase and AMPPD substrate, making the diagnostic method even more sensitive. The advantages of the research method are the stability of the reagents used, the absence of radiological risk. The disadvantages of the method are based on the complexity of the diagnostic process.
Norma
Total acid phosphatase in the analyzes is denoted U/L. Its acceptable levels vary by age and gender.
| Age | Acid phosphatase, U/L | |
| Children under 14 | 0 to 5, 5 | |
| Women | from 14 to 40 | 0 to 5, 5 |
| Men | Over 14 | 0 to 6, 5 |
Normal levels of prostatic acid phosphatase are less than 2.1 ng/mL. All numbers above indicate a positive diagnostic result.
When is an enzyme elevated?
Most serious conditions with higher than normal counts:
- thrombocytopenia - a reduced number of blood cells responsible for its clotting;
- thromboembolism - blockage of the lumen of the main arteries by a thrombus that has come off the vessel wall, or an embolus that has entered the bloodstream;
- hemolytic disease - a disease accompanied by massive destruction of red blood cells with the release of a significant amount of bilirubin into the bloodstream;
- progressive Paget's disease - a pathology of the bone apparatus, in which there is an imbalance between the formation of bone elements and their destruction in favor of the latter;
- multiple myeloma is a tumor process of a malignant nature, in which B-lymphocytes responsible for the synthesis of protective cells take part;
- Niemann-Pick disease is a hereditary pathology characterized byviolation of fat metabolism and accumulation of lipids in large organs (liver, spleen, lungs, heart, kidneys);
- a few days after prostate surgery and prostate biopsy.
Acid, alkaline phosphatase - a group of enzymes responsible for important processes in the body. It is with their help that vital successive reactions occur. Determining the level of enzymes allows you to clarify the presence of pathology in time and carry out its correction to support the patient's further high quality of life.
