1. Determination of plasma enzymes (Determination of ALT in Serum)

2. Objectives
To evaluate the presence of tissue damage, by estimating the level of ALT in serum.

3. - Most clinical enzyme measurements using serum or plasma, occasionally other fluids, such as urine and gut secretions, are investigated.

4. Functional Plasma Enzymes (plasma derived enzymes)
Nonfunctional Plasma Enzymes
(Cell derived enzymes)
They perform no physiological function in the  plasma and mostly arise from destruction  of RBCs, Tissue damage caused by injury or  disease can cause marked increase in their  level, so measurement of these enzymes  level can help in diagnosis and prognosis of  diseases, depending on their tissue origin.
Enzymes that are always present in the circulation and preform a physiological function in the blood.

5. 1- Functional Plasma Enzymes (plasma derived enzymes):
Enzymes that are always present in the circulation and preform physiological function in the blood.
2- Nonfunctional Plasma Enzymes (Cell derived enzymes):
they perform no physiological function in the plasma and mostly arise from destruction of RBCs, Tissue damage caused by injury or disease.
- can cause marked increase in their level, so measurement of these enzymes level can help in diagnosis and prognosis of diseases, depending on their tissue origin.

6. Differences of Functional and Nonfunctional plasma enzymes
Their substrate
Always present in the blood
Absent from the blood
Site of synthesis
synthesized and secreted by  liver. 
Different organs
e.g. liver, heart, muscles, and brain
Effect of diseases
Decrease in liver diseases
Different enzymes increase in different organ diseases
Examples
Clotting factors lipoprotein lipase
ALT
AST LDH
Acid Phosphatase Amylase
Alkaline Phosphatas

7. Sources of Nonfunctional Plasma Enzyme
Cell damage with the release of its content of enzymes into blood e.g. Myocardial infarction and viral hepatitis

8. Obstruction of normal pathways e. g
Obstruction of normal pathways e.g. Obstruction of bile duct increases alkaline phosphatase
Increase of the enzyme synthesis e.g. bilirubin increases the rate of synthesis of alkaline phosphatase in obstructive liver disease
Increased permeability of cell membrane as in hypoxia

9. Medical Importance of Non Functional Plasma Enzymes
Measurement of non functional enzymes is important for:
Diagnosis of diseases.
Prognosis of the disease: following up of the treatment by measuring plasma enzymes before and after treatment.

10. Alanine transaminase
ALT is an enzyme that catalyzes a type of reaction (transamination) between an amino acid and α-keto acid.
It is important in the production of various amino acids.

12. ALT diagnostic importance
ALT is found in serum (at low level) but is most commonly associated with the liver.
thus , an elevated level ALT is a sensitive index of acute hepatocellular injury.
Elevated serum ALT (SGPT) level are found in hepatitis, cirrhosis , and obstructive jaundice. Levels of ALT are only slightly elevated in patient following a myocardial infraction.
•NORMAL RANGE OF ALT: ( up to 42 ) U/L males
( up to 32 ) U/L females

13. Principle

14. Pipette into clean and dry test tubes:
Method
Pipette into clean and dry test tubes:
ALT Reagent
3ml
Pre-warm at 37°C for 3 minutes and add
Serum Sample
0.2 ml = ( µl) ??
Mix and incubated at 37 °C for 1 minute, then read absorbance ( at 340 nm against distilled water ) every minute for 3 minutes) and determine ΔA/min
Choose the following on the spectrophotometer:
2) Applications → 2) Simple Kinetics → wave length (340 nm) → Seconds → Duration (180 sec = 3 min) → Intervals (60 sec= 1 min) → Print Data Table (off) → Press start (2 times)

15. ∆A/min=((A1-A2)+(A2-A3))/2
Results
Time
Absorbance 340nm
∆A/min=((A1-A2)+(A2-A3))/2
1 min A1
2 min A2
3 min A3
Calculations:
ALT Activity ( U/L) = ΔA/min x 1768
ALT Activity (U/L) = Calculations
Ignore A0 (first absorbance)