With serum protein electrophoresis,
a quick word or two
about each one of the other
zones so that you’re familiar
and you don’t miss
I want you to go back and take a look at
the normal serum protein electrophoresis
and on the electrophoresis, I want
you to identify alpha-1 zone, okay?
Now, when you say alpha-1 zone,
you should automatically think
about alpha-1 antitrypsin, okay?
That should make your
life a little bit easier.
Now with alpha-1 antitrypsin,
what does this mean?
Well, a decreased band
is seen in deficiency.
It is decreased in
And nephrotic syndrome,
you’ll know that you’re losing
quite a bit of protein, right?
Quite a bit or albumin and perhaps even
quite a bit of alpha-1 antitrypsin.
So therefore, you expect there to
be a decrease in the alpha-1 zone.
if you lose enough, enough, enough of
your alpha-1 antitrypsin at some point,
well, emphysema, you
know about elastase.
If you find absolutely no alpha-1,
this to you should indicate, “Oh,
maybe” or, as far as you’re concerned,
should heighten the suspicion of –
Does my patient have alpha-1
the number one enzyme that should come
to mind is your alpha-1 antitrypsin.
We’ve talked about this
in greater detail.
I’m referring to my gene,
PI, protease inhibitor.
I want you to go back and take a look
at the serum protein electrophoresis.
And this time, we have
an alpha-2 zone, okay?
So little zones that you want to make sure
that you have an idea as to what they are.
The alpha-2 zone is the –
The abbreviation that I’ll be using
here is alpha-2 macroglobulin or AMG.
And more importantly, for you,
in the discussion that we’ve had
prior is haptoglobin, okay?
When did we have a
discussion of haptoglobin?
Yes, we had with hemolytic anemias.
And with hemolytic anemia,
what type of hemolysis of the RBC resulted
in influence or effect with a haptoglobin.
Was it intra or extravascular?
I’m pushing you here on purpose.
So intravascular hemolysis would then
cause a decrease in haptoglobin.
So haptoglobin is a suicide molecule,
which binds with free hemoglobin.
Therefore, if there was
you could then expect a
decrease in haptoglobin.
Haptoglobin is raised as part
of your acute phase reactant.
Remember haptoglobin is
one of those components
or acute phase reactant
that comes from the liver.
And haptoglobin here is responsible
for binding to hemoglobin
and intravascular hemolysis, you can
expect that haptoglobin to be decreased
and this is then represented by which
zone on serum protein electrophoresis?
A normal alpha-2 and elevated alpha-1 zone
is a typical pattern in hepatic
metastasis and cirrhosis.
Another very important clinical
aspect and application,
if you find normal alpha-2 and
an elevated alpha-1 zone,
Make sure that you know how to deal
with some of these other zones
of the serum protein electrophoresis
apart from our discussion here
focusing upon the gamma wave.
Students tend to forget
about these zones.
There’s one more zone left,
what is that called?