To help diagnose or monitor conditions that result in abnormal protein production or loss of protein
To help diagnose or monitor conditions that result in abnormal protein production or loss of protein
When you have an abnormal result on a total protein, albumin, or immunoglobulins blood test; when you have symptoms of a disease that is associated with abnormal protein production such as multiple myeloma, Waldenstrom macroglobulinemia, amyloidosis, monoclonal gammopathy of underdetermined significance (MGUS), lymphoma, chronic lymphocytic leukemia or multiple sclerosis
Protein electrophoresis is typically performed on serum (the fluid portion of blood), urine samples or, in certain circumstances, cerebrospinal fluid (CSF). Serum is obtained by collecting a blood sample by inserting a needle into a vein. Urine samples may either be collected as a random sample (not timed) or a 24-hour urine sample. CSF is collected by a spinal tap (also known as lumbar puncture, which is inserting a needle into the spinal canal to withdraw spinal fluid).
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Proteins are important building blocks of all cells and tissues. They form the structural part of most organs and make up enzymes and some hormones that regulate bodily functions. Protein electrophoresis is a lab method that separates proteins based on their size and electrical charge. Knowing which proteins are present, absent, elevated, or decreased in body fluids such as blood can help diagnose and/or monitor various diseases and conditions.
Body fluids, such as blood, urine, and cerebrospinal fluid (CSF) contain many different proteins that have various roles, such as transporting nutrients, removing toxins, and controlling body functions.
The two major types of proteins are:
The various proteins in body fluids are subjected to a controlled electric current, fractionating them into a typical pattern of bands or peaks that then can be measured. The proteins are divided into six groups, called prealbumin (rarely detected on serum or urine protein electrophoresis), albumin, alpha 1, alpha 2, beta, and gamma. The beta fraction may be further divided into beta 1 and beta 2 subgroups.
Each of these protein groups (electrophoresis fractions) is distinct and at specific concentrations. The patterns typically seen in certain conditions and diseases can help with diagnosis. The major serum proteins and their functions are listed according to their electrophoretic region or fraction (the visible band that they are part of) in the table titled Protein Groups.
Various conditions and diseases can affect protein production and/or protein loss, thus changing the pattern of bands seen on a protein electrophoresis. The most important example is the appearance of a distinct, monoclonal band in the gamma region. For example, uncontrolled growth and division of a malignant plasma cell as seen in multiple myeloma leads to the production of large amounts of a single type of immunoglobulin (monoclonal immunoglobulin).
When an abnormal protein (band or peak) is detected, additional tests are done to identify the type of protein (immunotyping). Immunofixation electrophoresis or immunosubtraction electrophoresis can be used to identify abnormal bands seen on protein electrophoresis, typically in the gamma region, in order to determine whether a type of antibody (immunoglobulin) is abnormally produced (e.g., IgG, IgA, IgM).
In most cases of multiple myeloma, a single type of intact (whole) immunoglobulin is produced in excess. In a minority of cases, only one section of an immunoglobulin called a “free light chain” is produced in large amounts. These excess free light chains are released into the bloodstream and since they are relatively small molecules, they are filtered by the kidneys and released into the urine. Another term for these excess free light chains in the urine is Bence Jones proteins.
| GROUP | PROTEIN | FUNCTION |
|---|---|---|
| Albumin | Albumin | Main plasma protein; involved in the control of tissue water accumulation, transports many substances (ions, hormones) in circulation |
| Alpha1-globulin | Alpha1-Antitrypsin | Inactivates trypsin and other proteolytic enzymes, reduces damage from inflammation |
| Orosomucoid (Alpha-1-acidic glycoprotein) | Immune response modifier, binds acidic drugs such as lidocaine | |
| High Density Lipoprotein (HDL) | Reverse transport of cholesterol (“good cholesterol”) | |
| Alpha2-globulin | Alpha2-Macroglobulin | Binds to and inactivates proteolytic enzymes, preventing tissue damage |
| Haptoglobin | Hemoglobin-binding protein | |
| Ceruloplasmin | Copper-containing enzyme and copper carrier, also involved in normal iron metabolism | |
| Beta-globulin | Transferrin | Iron transport and delivery to cells |
| Low Density Lipoprotein (LDL) | Cholesterol delivery to tissue | |
| Complement component 3 | Helps regulate inflammatory response to foreign substances and immunity | |
| Gamma-globulin | IgA | Immunoglobulin involved in secretions (e.g., maternal milk) |
| IgG | Major immunoglobulin; long-term immunity | |
| IgM | Initial response immunoglobulin | |
| C-reactive protein | Inflammatory response mediator | |
| Fibrinogen | Coagulation factor (found only in plasma, not serum) |
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