Re: Intestinal alkaline phosphatase Question for Dave

[Guest guest]

Dave,

I have a question that maybe you could help me with. My Dr.

conducted a ALP fractionalization on me which showed that my

Macrohepatic Isoenzyme was at 18% with a normal of 0. My Dr said

that that of the two liver isoenzymes, this one being significantly

elevated was more significant because it indicated more advanced

disease and that I might be at higher risk for liver cancer. CAn you

tell me anything more about what this could possibly mean? I have

been able to find very little information about this on the

internet.

Also if you have informatioin on Renin levels could you please let me

know what that means. My level can in very low at 0,3 with a norm of

0.65 - 5.0. My doctor said that this explains my problem with

extremely low blood pressure, but I do not understand what it exactly

means and how they relate.

Thank you for any information that you could provide.

Dawn

>

> Lipopolysaccharide is a very toxic product produced by gut

bacteria.

> Intestinal alkaline phosphatase plays an important role in

> detoxifying lipopolysaccharide in the intestines. It's been the

> subject of a number of recent papers:

>

> Bates JM, Akerlund J, Mittge E, Guillemin K. Intestinal alkaline

> phosphatase detoxifies lipopolysaccharide and prevents inflammation

> in zebrafish in response to the gut microbiota. Cell Host Microbe.

> 2007 Dec 13;2(6):371-82.

> http://www.ncbi.nlm.nih.gov/pubmed/18078689

>

> Vaishnava S, Hooper LV. Alkaline phosphatase: keeping the peace at

> the gut epithelial surface. Cell Host Microbe. 2007 Dec 13;2(6):365-

7.

> http://www.ncbi.nlm.nih.gov/pubmed/18078687

>

> Strauss E. Microbiology. Detoxifying enzyme helps animals stomach

> bacteria. Science. 2007 Dec 21;318(5858):1853-4.

> http://www.ncbi.nlm.nih.gov/pubmed/18096780

>

> Goldberg RF, Austen WG Jr, Zhang X, Munene G, Mostafa G, Biswas S,

> McCormack M, Eberlin KR, Nguyen JT, Tatlidede HS, Warren HS,

Narisawa

> S, Millán JL, Hodin RA. Intestinal alkaline phosphatase is a gut

> mucosal defense factor maintained by enteral nutrition. Proc Natl

> Acad Sci U S A. 2008 Mar 4;105(9):3551-6.

> http://www.ncbi.nlm.nih.gov/pubmed/18292227

>

> Geddes K, Philpott DJ. A new role for intestinal alkaline

phosphatase

> in gut barrier maintenance. Gastroenterology. 2008 Jul;135(1):8-12.

> http://www.ncbi.nlm.nih.gov/pubmed/18549817

>

> It has now been shown that intestinal alkaline phosphatase (iAP) is

> markedly down-regulated in inflammed tissue of Crohn's and

ulcerative

> colitis patients, and that feeding iAP-tablets to colitic rats

> resulted in a significant attenuation of colonic inflammation:

>

> Tuin A, Poelstra K, Jager-Krikken AD, Bok L, Raaben W, Velders MP,

> Dijkstra G. Role of alkaline phosphatase in colitis in man and rats.

> Gut. 2008 Oct 13. [Epub ahead of print].

> http://www.ncbi.nlm.nih.gov/pubmed/18852260

>

> The authors suggest that iAP-tablets be considered as a novel

> treatment approach for IBD.

>

> Best regards,

>

> Dave

> (father of (23); PSC 07/03; UC 08/03)

>

[Guest guest]

Hi Dawn;

The alkaline phosphatase isozyme fractionation test allows

distinguishing between the various types of alkaline phosphatase.

There are 2 liver forms, L1 and L2. The macrohepatic isoenzyme is

referred to as L2. According to this article, the normal amount of L2

is anywhere from 2 - 15% of the total. Since yours is at 18%, this

would indicate (if I am interpreting it correctly) a slight

elevation.

http://www.sbmflab.org/tech_notices/200404ALKALINE.pdf

The follwing article notes that " Macrohepatic ALP has been isolated in

cases of metastatic carcinoma to the liver and has been suggested as a

diagnostic tool in identifying such cases. It has also been isolated

in patients with viral hepatitis, alcoholic cirrhosis and other liver

diseases. Data generated in a study by Viot and his associates (11)

suggest that hepatic ALP is highly correlated with the presence of

liver metastases and that the presence of this isoenzyme could be

predictive of the appearance of liver metastases. Viot also reports

that macrohepatic ALP is seen occasionally in patients free of any

disease state. (11) "

http://www.helena.com/Procedures/Pro034Rev6.pdf

So an elevated macrohepatic ALP does not always mean advanced disease

and higher risk for liver cancer!

But it's hard to tell what's going on from the percentages alone ...

you also need to know the absolute level of alkaline phosphatase in

IU/L. L2 is " normally " 2-19 IU/L.

Sorry, but I don't know much about causes of low renin levels, but

this article might give you some clues:

http://www.nlm.nih.gov/medlineplus/ency/article/003698.htm

Best regards,

Dave

(father of (23); PSC 07/03; UC 08/03)

>

> Dave,

>

> I have a question that maybe you could help me with. My Dr.

> conducted a ALP fractionalization on me which showed that my

> Macrohepatic Isoenzyme was at 18% with a normal of 0. My Dr said

> that that of the two liver isoenzymes, this one being significantly

> elevated was more significant because it indicated more advanced

> disease and that I might be at higher risk for liver cancer. CAn

you

> tell me anything more about what this could possibly mean? I have

> been able to find very little information about this on the

> internet.

>

> Also if you have informatioin on Renin levels could you please let

me

> know what that means. My level can in very low at 0,3 with a norm

of

> 0.65 - 5.0. My doctor said that this explains my problem with

> extremely low blood pressure, but I do not understand what it

exactly

> means and how they relate.

>

> Thank you for any information that you could provide.

>

> Dawn