1 Clinical Enzymology

Abstract

This chapter discusses some aspects of clinical enzymology and several important enzymes individually and in detail. The chapter focuses on the analytical and clinical facets as well as to molecular forms of the enzyme. The estimation of groups of enzymes in specific clinical situations has also been discussed. The chapter covers the most important aspects of clinical enzymology from the standpoint of diagnostic enzyme assays and their impact upon patient care. Enzymatic assay techniques are being increasingly applied to the determination of commonly required constituents of serum. These techniques make use of the high specificity of enzymes for their substrates and the sensitivity of many of the spectral changes brought about by specific enzyme action, in particular, those involving changes in absorbance or fluorescence of oxidized and reduced pyridine nucleotides linked to dehydrogenases. The use of urease in the determination of urea was one of the earliest analytical applications of enzymes as reagents, but more recently, a coupled reaction with glutamate dehydrogenase has been gaining in popularity.