Clinical pathology: BONE MARKER
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Transcript of Clinical pathology: BONE MARKER
GENERAL OBJECTIVE: After finishing lab activity of Bone Marker, the
student will be able to describe the Bone Marker in the DMS case problem
SPECIFIC OBJECTIVE: At the end of lab activity of Bone Marker , the
student will be able to interprete: - the normal of Bone Marker - the abnormal of Bone Marker
GENERAL OBJECTIVE:After finishing lab activity of bone
marker, the student will be able to describe the bone marker in the DMS
case problemSPECIFIC OBJECTIVE:
At the end of lab activity of bone marker, the student will be able to
interprete:- the normal and abnormal bone
marker
organic matrix(30% )
cells(2%) Matrix (98%)
collagen tipe 1 (95%) noncollagen protein (5%)-Osteonectin
-Osteocalcin- Bone Proteoglikan - Bone morfogenik protein
-Bone proteolipid -Bone phosfolipid
inorganic matrix(70% )
-Hidroksiapatit (95%)(Ca10(PO4)6(OH)2)
- Mg, Na, K, F, Cl, Sr, Pb (5%)
BONE PHYSIOLOGY:
BONE FORMATION AND RESORPTION
Bone turnover is characterized by twometabolic processes: Formation of new bone by osteoblast Degradation/resorption of old bone
by osteoclast
Bone mass depends on the balancedbetween bone formation and
resorption
Bone formation can be assessed by determination of: Total /Bone specific alkaline phosphatase and osteocalcin
Bone resorption can be assessed by determination of pyridinoline, cross linked N telopeptide and C terminal telopeptide (-crosslaps)
Osteocalcin
The most important non-collagen protein (Bone specific peptide)
Synthesize by osteoblast (marker bone turnover)
After release from osteoblast, assimilated into bone matrix and also secreted to the bloodstream
Specimen: serum or plasma Reference range: Male 18 - < 30 years: 24 – 70 ng/mL 30 - 50 years: 14 – 42 ng/mL >50 - 70 years: 14 – 46 ng/mL Female Premenopause> 20 years: 11 – 43
ng/mL Postmenopause : 15 – 46
ng/mL
Crosslaps
The specific degraded product of type 1 collagen (the C terminal telopeptides)
Increased bone resorption will cause the elevation of -crosslaps in serum
Specimen: serum Reference range: Male 30 - 70 years: 0.016 – 0.584 ng/mL >70years : 0.104 – 0.854
ng/mL Female Premenopause : 0.025 – 0.573 ng/mL Postmenopause : 0.104 – 1. 008 ng/mL
An enzyme located in osteoblast, liver , intestine, kidney and placenta
Function: activate the chemical reaction in in cells which the enzyme located
High concentration of ALP → specific organ has increased the production or release this enzyme ( bone or liver)
The causes of elevated ALP from bone disease → no elevation of ALT or AST
Specimen: serum Reference range: 370C Male < 129 U/L Female < 104 U/L Children higher (depends on age)