Tsumura M, Ueno Y, Kinouchi T, Koyama I, Komoda T
R&D Center BML Inc. 1361-1, Matoba, Saitama 350-1101, Kawagoe, Japan.
Clin Chim Acta. 2001 Oct;312(1-2):169-78. doi: 10.1016/s0009-8981(01)00606-4.
Alkaline phosphatases (ALPs) originating from different organs are frequently detected in the serum and urine of patients with renal failure.
We investigated the characteristics of ALPs in the serum and urine of 108 patients with chronic renal failure (CRF) and of 106 healthy control subjects.
In polyacrylamide gel electrophoresis, three atypical ALP bands in serum of patients were designated as atypical-s1, -s2 and -s3, respectively. In contrast, five atypical bands (u1, u2, u3, u4 and u5) were detected in the urine of patients. The atypical ALPs were electrophoretically isolated and assayed to determine their biochemical properties, i.e., neuraminidase sensitivity, heat stability, reactivity to anti-intestinal or anti-tissue nonspecific ALP antibodies, molecular sizes and sugar chain heterogeneities. From these results, we found that atypical-s1 and -s2 were the intestinal-type ALP, while s3 was the tissue-unspecific type ALP. Atypical-u1, -u2 and -u3 were high-molecular type ALPs, which we suggested as the ones that originated from the intestine. Atypical-u4, a tissue-unspecific type ALP, was detected with considerable frequency in the urine of patients. In patients with CRF, the appearance of these atypical ALPs was accompanied by a deterioration of the creatinine clearance.
The appearance of atypical ALPs in the serum and urine of patients with CRF may be a useful marker for renal disease.
肾衰竭患者的血清和尿液中经常检测到源自不同器官的碱性磷酸酶（ALP）。
我们调查了108例慢性肾衰竭（CRF）患者和106例健康对照者血清和尿液中ALP的特征。
在聚丙烯酰胺凝胶电泳中，患者血清中的三条非典型ALP带分别被指定为非典型-s1、-s2和-s3。相比之下，在患者尿液中检测到五条非典型带（u1、u2、u3、u4和u5）。对非典型ALP进行电泳分离并测定其生化特性，即神经氨酸酶敏感性、热稳定性、对抗肠型或抗组织非特异性ALP抗体的反应性、分子大小和糖链异质性。从这些结果中，我们发现非典型-s1和-s2是肠型ALP，而s3是组织非特异性型ALP。非典型-u1、-u2和-u3是高分子型ALP，我们认为它们源自肠道。非典型-u4是一种组织非特异性型ALP，在患者尿液中检测频率较高。在CRF患者中，这些非典型ALP的出现伴随着肌酐清除率的下降。
CRF患者血清和尿液中非典型ALP的出现可能是肾脏疾病的一个有用标志物。
