Acid phosphatase is an enzyme that accelerates the breakdown of molecules in the body. Determining its level in the blood is important for diagnosing a state of health. There are several types of acid phosphatases that have a common functional identity, but differ significantly from each other in relation to body tissues, chromosome origin, composition.
general information
The enzyme works in acidic environments, where the name comes from. Acid phosphatase is located in various tissues and cells, can be located in and outside of lysosomes. The greatest number is determined in the prostate gland, as well as in the cells of the following organs:
- liver
- the spleen;
- bone marrow;
- blood cells (red blood cells, platelets, macrophages).
In a healthy body, acid phosphatase activity is quite low. In males, its level is half composed of prostatic phosphatase and one that is in 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
It is found in most cells of the body. Its deficiency is manifested by an autosomal recessive disease, which is considered the result of pathology of metabolic processes. Symptoms of the disease are manifested as follows:
- periodic nausea and vomiting;
- weakness, decreased performance;
- lowering blood pressure;
- in childhood - opisthotonus (convulsive seizures, which are manifested by arching of the back by the arch, 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 white blood cells, patients often suffer from exacerbations of chronic infections.
Prostatic Acid Phosphatase
It is considered a marker of oncological processes of the prostate gland. This type of enzyme is also defined as a marker of seminal fluid in trials (cases of rape). Acid phosphatase is also increased several days after surgery on the prostate gland or against a biopsy.
The optimal acidity for the proper functioning of the enzyme is 4.6. Activity manifests itself exclusively after a man reaches puberty.
Currently, the determination of the level of prostatic phosphatase as a cancer marker is fading into the background due to the increased interest in the prostate-specific antigen, which is able to confirm the presence of the disease at earlier stages of development. Nevertheless, indicators of prostatic acid phosphatase are important in predicting the recurrence of the cancer after surgery for radical removal of the prostate.
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.
Acidic blood 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 on the background of eating legumes;
- anemia with 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 related to disorders that occur in childhood.
Macrophage type of acid phosphatase
The enzyme is important in the diagnosis of Gaucher disease. This is a hereditary disease, which is manifested by the accumulation in the tissues of the liver, spleen, kidneys, brain, lungs of 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.
Macrophagic acid phosphatase is also considered a specific marker of hairy cell leukemia. This disease is accompanied by the production of a significant amount of an enzyme that is detected in the blood.
Osteoclast Phosphatase
Osteoclasts are called bone cells responsible for its destruction. This stage is an important point in the growth and remodeling of the bone apparatus. The high rate of bone destruction accompanies the following diseases:
- Paget's disease (pathology of the normal synthesis of bone tissue and the formation of its elements);
- malignant hypercalcemia;
- hyperfunction of the thyroid and parathyroid glands ;
- postmenopause combined 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.
Preparation and conduct of diagnostics
Quantitative indicators are determined in laboratory conditions. The analysis should be carried out after 2 days from the date of other diagnostic procedures. If it is necessary to assess the level of prostatic acid phosphatase, then this should occur no earlier than 48 hours after the biopsy, palpation of the prostate gland, and catheterization of the bladder. Otherwise, the results may be false positive.
The material for research is taken 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 dishes, 1 hour before the analysis - from smoking. The last half hour before taking the material should be carried out in complete emotional calm.
For diagnosis, venous blood is used, namely its serum, avoiding hemolysis. The survey results are known the day after the study.
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 solution of hydrogen peroxide. To this is added 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.
Norm
The total acid phosphatase in the analyzes is indicated by U / L. Its acceptable values vary depending on age and gender.
| Age | Acid Phosphatase, U / L |
| Children under 14 years old | 0 to 5.5 |
| Women | from 14 to 40 | 0 to 5.5 |
| Men | Over 14 years old | 0 to 6.5 |
Normal rates of prostatic acid phosphatase are less than 2.1 ng / ml. All figures above indicate a positive diagnostic result.
When is the enzyme level elevated?
The most serious conditions in which quantitative indicators are higher than normal:
- thrombocytopenia - a reduced number of blood cells responsible for its coagulability;
- thromboembolism - clogging of the lumen of the main arteries with a thrombus detached from the vessel wall, or an embolus that has fallen into 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;
- myeloma - a malignant tumor process in which B-lymphocytes are responsible for the synthesis of protective cells;
- Nyman-Peak disease - a hereditary pathology characterized by impaired fat metabolism and lipid accumulation in large organs (liver, spleen, lungs, heart, kidneys);
- a few days after surgery on the prostate gland and biopsy of its tissue.
Acidic, alkaline phosphatase - groups of enzymes responsible for important processes in the body. It is with their help that vital, consistent reactions occur. Determining the level of enzymes allows you to timely determine the presence of pathology and carry out its correction to support the further high quality of life of the patient.