Serum protein electrophoresis (SPEP) is an easy, inexpensive method of separating proteins based on their net charge, size, and shape. The 2 major types of protein present in the serum are albumin and the globulin proteins.

Albumin is the major protein component of serum and represents the largest peak that lies closest to the positive electrode. Albumin is the first peak on the electrophoretogram and is usually a tall thin peak. The albumin concentration by ELP is usually lower than that from the Modular P.

Globulins make up a much smaller fraction of the total serum protein but represent the primary focus of interpretation of serum protein electrophoresis.

The various proteins in body fluids are subjected to a controlled electric current, fractionating them into a typical pattern of bands or peaks that then can be measured. The proteins are divided into six groups, called prealbumin (rarely detected on serum or urine protein electrophoresis), albumin, alpha 1, alpha 2, beta, and gamma. The beta fraction may be further divided into beta 1 and beta 2 subgroups.

What is Albumin Excretion Rate?
The Albumin Excretion Rate (AER) measures the amount of albumin (a type of protein) excreted in the urine over a set period, usually in a 24-hour sample. It is a valuable marker for assessing kidney function, particularly in detecting early kidney damage or disease, such as diabetic nephropathy or hypertension-related kidney issues.

Why is it Important?
Albumin is normally present in very small amounts in urine, as the kidneys filter out waste but retain essential proteins. However, when the kidneys are damaged or stressed, they may leak albumin into the urine in higher amounts. Elevated levels of albumin in the urine can indicate kidney dysfunction, even before more noticeable symptoms arise. Monitoring AER is especially important in individuals with diabetes, hypertension, or other risk factors for kidney disease.

What is a serum Albumin test?

You need a proper balance of albumin to keep fluid from leaking out of blood vessels (= oncotic pressure). It also carries vital nutrients and hormones. Albumin also gives your body the proteins it needs to keep growing and repairing tissue.

A serum albumin test is a simple blood test that measures the amount of albumin in your blood. Having surgery, getting burned, or having an open wound raises your chances of having a low albumin level.

What Is Albumin?

Albumin is the most common protein found in the blood. It represents half (~50%) of the total protein content (reference range: 3.8 g/dL to 4.8 g/dL) of plasma in healthy human patients.

Albumin is synthesized (= produced) by liver hepatocytes (= the major cells in the liver). Very little albumin is stored in the liver, and most of it gets rapidly excreted into the bloodstream.

Albumin has two main functions:

1. Maintenance (modulation) of appropriate oncotic pressure in the vascular system.

Albumin is responsible for much of the colloidal osmotic pressure of the blood, and hence is a very important factor in regulating the exchange of water between the plasma and the interstitial compartment, which is the space between the cells. Due to the hydrostatic pressure, water is forced through the walls of the capillaries in the tissue space. This flow of water is continuous until the osmotic pull of protein, in this case albumin molecules, causes it to stop. An abnormal deficiency of albumin can lead to water passing from the bloodstream into the tissues (edema).

2. Transporter of endogenous and exogenous (i.e. drugs) ligands. 

Albumin serves as a transport protein carrying large organic anions, those such as fatty acids, hormones (cortisol and thyroxine when their specific binding globulins are saturated), bilirubin and many drugs. Severe liver disease can result in hypoalbuminemia (hypo = below, beneath), which leads to fewer available binding sites for exogenous drugs. This results in larger amounts of unbound exogenous drugs, which can lead to increased drug sensitivity. This sensitivity manifests when patients have serum albumin concentrations lower than 2.5 g/dL.

Albumin is one of the proteins found in your blood. If albumin shows up in your urine, it may be a sign of kidney damage.

This test is useful in the management of patients with relatively early diabetes mellitus to assist in avoiding or delaying the onset of diabetic renal disease.

Albumin/Creatinine Ratio is the first method of preference to detect elevated protein. The recommended method to evaluate albuminuria is to measure the Albumin/Creatinine Ratio in a spot urine sample.

The major proteins seen in the serum are albumin and globulin-the latter being primarily alpha 1 and alpha 2 globulin, beta globulin and gamma globulin. Albumin accounts for more than 50% of the total serum proteins. The albumin to globulin (A/G) ratio has been used as an index of disease state, however, it is not a specific marker for disease because it does not indicate which specific proteins are altered. The normal A/G ratio is 0.8-2.0. The albumin/globulin ratio is used to try to identify causes of change in total serum protein. It will go out of the normal range if one component increases or decreases relative to the other. Hence it is important to look at changes in the individual components (albumin and globulins) as well as the ratio.

The IBD Expanded Panel test offers three novel markers:

- antichitobioside IgA (ACCA),

- antilaminaribioside IgG (ALCA),

- antimannobioside IgG (AMCA),

together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.

Aldolase is an enzyme that participates in glycolysis, which is the pathway for metabolizing glucose into energy. Elevated levels of aldolase in the blood occur in diseases of muscle including Duchenne muscular dystrophy, dermatomyositis, and polymyositis.

The aldosterone to renin ratio blood test measures the amount of aldosterone divided by the amount of renin in the blood plasma. The test determines whether or not primary hyperaldosteronism is present and causing high blood pressure.

Aldosterone is a vital hormone for maintaining proper blood pressure and electrolyte balance. It regulates sodium and potassium levels in the body, ensuring that the correct amount of sodium is retained, and excess potassium is excreted through the kidneys. The synthesis of aldosterone is controlled by the renin-angiotensin system, which activates in response to low blood pressure or high potassium levels. Maintaining optimal aldosterone levels is crucial for overall cardiovascular health and preventing imbalances that can lead to conditions like hypertension, heart disease, or electrolyte disturbances.

Aldosterone is a mineralcoritcoid and a hormone. It allows the transport of sodium across the cell membrane. This is especially important in the kidney (distal tubule). Because of its function, aldosterone is important in blood pressure regulation and also for the volume of blood found in the blood vessels. Potassium is an antagonist to sodium. If potassium is high, sodium levels will be low. When potassium is found high in the plasma of the blood, the adrenals step in and synthesize aldosterone. The synthesis of aldosterone is taken care of in the body primarily by the renin-angiotensin system.

Aldosterone is a mineralcoritcoid and a hormone. It allows the transport of sodium across the cell membrane. Aldosterone is important in blood pressure regulation and also for the volume of blood found in the blood vessels.

The aldosterone-renin ratio (ARR), also known as the aldosterone plasma renin activity (PRA) ratio, is a critical diagnostic tool used in the evaluation of primary aldosteronism, a condition characterized by excessive production of the hormone aldosterone by the adrenal glands.

- Alistipes does not contribute significantly to short chain fatty acid production.

- A diet rich in animal protein and fat increases the abundance of Alistipes.

- High abundance of Alistipes was identified as a possible predictor of successful weight loss.

- Alistipes may positively correlate with depression.

Alistipes does not contribute significantly to short chain fatty acid production. A diet rich in animal protein and fat increases the abundance of Alistipes. High abundance of Alistipes was identified as a possible predictor of successful weight loss. Increased abundance of Alistipes has been correlated with a greater frequency of pain in pediatric irritable bowel syndrome patients.

What is Alkaline phosphatase (ALP)?

Alkaline phosphatase (ALP) is an enzyme (= enzymes are proteins that act as biological catalysts by accelerating chemical reactions) found in the blood that helps break down proteins and that plays a role in numerous processes in the human body. Any abnormalities in blood concentrations (either high or low) may be indicative of diseases ranging from gallstones and thyroid disease to hepatitis and cancer.

ALP is found in all tissues of the body but, not surprisingly, is found in its highest concentration in the liver, bones, kidneys, and intestines as well as the bile ducts (that drain bile from the liver) and gallbladder (that stores bile).

Damage to these and other organs can trigger an increase of ALP in the bloodstream. By contrast, certain diseases or conditions can impair ALP synthesis and lead to a drop in the blood concentration.

Allo-Tetrahydrocorticosterone (5α-THB) is a significant biomarker in dried urine panel analysis, offering vital insights into the body's hormonal balance and stress response. As a metabolite of cortisol, 5α-THB is crucial in understanding the body's glucocorticoid activity, a fundamental aspect of the stress response mechanism. Cortisol, produced by the adrenal glands, is known as the "stress hormone," playing a pivotal role in various physiological processes including metabolism regulation, immune response modulation, and stress adaptation. In the metabolic pathway, cortisol is reduced to tetrahydrocortisol (THF) and subsequently transformed into 5α-THB. This conversion is catalyzed by the enzyme 5α-reductase, which also participates in other critical physiological processes such as androgen metabolism.