[Alkaline phosphatase isoenzymes in serum and bronchoalveolar lavage from patients with bronchopulmonary disease]. / Isoenzimas de fosfatasa alcalina en el suero y lavado broncoalveolar de pacientes con patología broncopulmonar.

OBJECTIVE: In this study, we are looking at the principal isoenzymes of alkaline phosphatase (ALP), as injury markers of cellular membranes from bronchial epithelium, in 80 patients diagnosed with bronchopulmonary pathology from different ethology, using serum samples and bronchoalveolar lavage fluid (BAL). METHOD: Patients were grouped according to age as following: 26 preterm neonates suffering respiratory distress syndrome requiring mechanical ventilation; 32 children ranging from 2 to 12 years old, and 22 adults (30-65 years old) examined by bronchoscopy for the purpose of diagnosis. Results obtained from all pathological groups were compared with a control group showing similar characteristics. Isoenzymes were separated by electrophoresis on agarose gel and were quantified by desitometry. Total protein was measured in BAL; ALP activity was expressed in UI/mg x 10-3 of protein. RESULTS: We found that macromolecular ALP fraction was significantly increased in the serum of neonates with distress (p < 0.01), in the patients 2-12 years and adults affected by pulmonary pathology (p < 0.001). The electrophoresis of ALP isoenzymes showed a unique isoenzymatic band corresponding with its macromolecular fraction in the BAL fluid. CONCLUSIONS: We conclude that increased macromolecular fraction of alkaline phosphatase found in the serum of patients diagnosed with respiratory problems could have its origin in damaged pulmonary tissue.

Isoenzimas de fosfatasa alcalina en el suero y lavado broncoalveolar de pacientes con patología broncopulmonar / Alkaline phosphatase isoenzymes in serum and bronchoalveolar lavage from patients with bronchopulmonary disease

Objetivo: Se estudiaron las principales isoenzimas de la fosfatasa alcalina (ALP) como marcadores de lesión de las membranas celulares del epitelio bronquial, utilizando suero y líquido procedente del lavado broncoalveolar (LBA), en 80 enfermos con patología broncopulmonar de etiología diversa. Método: Los enfermos se clasificaron, atendiendo a su edad, en tres grupos, comparándose los resultados de cada grupo patológico con un grupo control de características similares: 26 recién nacidos prematuros, con distress respiratorio grave, que precisaron ventilación mecánica; 32 niños entre 2-12 años con broncopatía obstructiva y 22 adultos (30-65 años) sometidos a broncoscopia y LBA con fines diagnósticos. Las isoenzimas se separaron por electroforesis sobre gel de agarosa y se cuantificaron por densitometría. En el LBA se midieron proteínas totales, expresándose la actividad de ALP en UI/mg de proteína ¥ 10-3. Resultado: Encontramos la fracción macromolecular de ALP significativamente aumentada en el suero de los neonatos con distress (p<0,01), en los enfermos de 2-12 años y en los adultos patológicos estudiados (p<0,001). La electroforesis de isoenzimas de ALP en el LBA mostró una única banda isoenzimática, correspondiente a su fracción macromolecular. Conclusiones: El aumento de la fracción macromolecular de la ALP en el suero de los enfermos con problemas respiratorios podría tener su origen en el tejido pulmonar dañado. Fosfatasa Alcalina. Isoenzimas. Enfermedad Broncopulmonar. Lavado Broncoalveolar (AU)

[Creatine kinase BB activity in the serum and bronchial aspirate of preterm newborns with respiratory distress syndrome]. / Actividad de la isoenzima CKBB en suero y broncoaspirado de recién nacidos pretérmino con síndrome de distrés respiratorio.

OBJECTIVE: The aim of this study was to test the utility of serum creatine kinase (CK) isoenzyme determinations as a marker of tissue injury in preterm newborns with respiratory distress syndrome (RDS). PATIENTS AND METHODS: Two groups of neonates were studied, 26 suffering from RDS who required mechanical ventilation and 20 healthy newborns with gestational ages, hours of life and birth weights similar to the first group. The activity of CK and its isoenzymes was determined in the bronchial aspirate and serum samples that were obtained before and 24 hours after exogenous surfactant therapy. The isoenzymes were separated by electrophoresis on agarose gel and their activity expressed as a percentage of the total CK. Total proteins were quantified in the bronchial aspirate and CK enzymatic activity expressed in U/mg of protein x 10-3. RESULTS: The CK-BB isoenzyme was significantly increased (p < 0.001) in the serum of infants with RDS compared with the control group. In the bronchial aspirate, the isoenzymatic study showed that the CK-BB isoenzyme represented 98-100% of the total enzymatic CK activity. CONCLUSIONS: The study shows significant differences in the CK isoenzyme patterns of neonates with RDS compared to controls. An increase in serum levels of the CK-BB isoenzyme could be an effective marker of tissue injury in lung disease in the newborn.

[Serum creatine kinase MM isoforms and lactate dehydrogenase isoenzymes in patients with non-traumatic acute rhabdomyolysis]. / Isoformas de creatin quinasa-MM e isoenzimas de lactico deshidrogenasa en el suero de pacientes con rabdomiolisis aguda no traumática.

We studied lactate-dehydrogenase (LD) isoenzymes and creatinekinase MM (CKMM) isoforms MM1, MM2 and MM3, in the serum of 18 patients with nontraumatic acute rhabdomyolysis, to test the utility of these markers in the diagnosis and disease evolution. The isoenzymes were separated by electrophoresis on agarose gel and were quantified with a densitometer. We studied the correlation between CKMM isoforms calculating the MM3/MM1 ratio, establishing the reference values from control group of 36 healthy adults. MM3 and MM3/MM1 ratio values were significantly increased in patients with rhabdomyolysis (p < 0.001) and progressively decreased coinciding with signs of getting better, showing 10 days after similar values of control group. LD4 and LD5 isoenzymes were significantly increased (p < 0.001) keeping elevated until 8-10 days when they showed a significant decrease compared with admission values (p < 0.05) but keeping elevated respect to control (p < 0.01).

[Lactate dehydrogenase isoenzymes in the serum and bronchial aspirate of newborn infants with respiratory difficulty of different etiologies]. / Isoenzimas de lactato deshidrogenasa en el suero y aspirado bronquial de recién nacidos con dificultad respiratoria de etiología diversa.

OBJECTIVE: To study the usefulness of lactate dehydrogenase isoenzymes serum determination as tissue injury markers in newborns with respiratory distress. DESIGN AND METHODS: Ninety four neonates were studied and classified in two groups: 64 suffering various types of respiratory problems, and 30 healthy newborns of a similar birth weight and gestational age. LDH activity and its isoenzymes was determined in the serum of all the infants and in 23 samples of the bronchial aspirate of infants who required ventilation support. The isoenzymes were separated by electrophoresis on agarose gel and their activity was expressed as percentage of the total LDH. RESULTS: LDH1 and LDH2 isoenzymes were decreased, and LDH4 and LDH5 isoenzymes were significantly increased (p > 0.001) in infants serum with respiratory distress, compared with controls. We compared LDH isoenzymes values found in bronchial aspirate with their values found in serum of ventilate infants, and we found a significant levels of LDH2 and LDH3 were lower, and those of LDH5 were higher (p < 0.001) in bronchial aspirate than in serum and a positive correlation (r = 0.47, p < 0.01) between LDH5 values in both samples. CONCLUSIONS: The study shows significantly differences in the LDH isoenzyme profiles of neonates with respiratory distress compared with controls. The increase in serum of LDH4 and particularly of LDH5 isoenzymes could be an effective marker of tissue damage in lung disease in the newborn.