Observation on the Changes in Lactate Dehydrogenase Isoenzymes in Post-Burn Patients: Significance in Relation to Creatine Kinase

Observation on the Changes in Lactate Dehydrogenase Isoenzymes in Post-Burn Patients: Significance in Relation to Creatine Kinase The present study deals with the quantitative assessment of lactate dehydrogenase isoenzymes in the sera of burn subjects. Efforts are also made here to show better predictive marker value of sera LDH, as a few other known protein markers like creatine kinase and myoglobin have limited analytical value in the management of thermal burns. Blood was initially collected at day-1 of admission from 29 burn and 10 healthy subjects. Further, the sampling was carried out at 2, 5, 10, 20 and 30 days of wound healing (recovery). Plasma and sera LDH isoenzymes were monitored on 7.5% polyacrylamide gel electrophoresis. Quantitative assessment of LDH isoenzymes was done from gelscans using GelPro and Scion Imaging softwares. Sera CK levels were estimated colorimetrically using reagent kits. Our results show that quantitative changes in LDH isoenzyme were more convincing and interpretable in the sera than plasma. Sera LDH-5 isoenzyme was detected as the major contributor of total sera LDH activity, which follows a change parallel to sera CK in burn subjects. Sera LDH-5 activity also remains significantly high for up to 10 days while sera CK levels were detected elevated up to 5 days (P<0.05) during the recovery of patients. Therefore, the present findings strongly recommended the use of sera to assess the LDH activity and indicate better stability of sera LDH-5 than sera CK during post burn wound healing. Opservacije O Promenama U Izoenzimima Laktat Dehidrogenaze Kod Pacijenata SA Opekotinama: Značaj U Odnosu NA Kreatin Kinazu Predmet studije je kvantitativna procena enzima laktat dehidrogenaze u serumu pacijenata sa opekotinama. Namera je bila da se prikaže bolja prediktivna vrednost markera LDH iz seruma, pošto nekoliko ostalih poznatih proteinskih markera poput kreatin kinaze i mioglobina imaju ograničenu analitičku vrednost u zbrinjavanju termičkih opekotina. Krv je uzeta prvog dana po prijemu od 29 pacijenata sa opekotinama i 10 zdravih subjekata. Zatim su uzimani uzorci posle 2, 5, 10, 20 i 30 dana zaceljivanja (oporavka). Izoenzimi LDH u plazmi i serumu praćeni su tokom elektroforeze na 7,5% poliakrilamidnom gelu. Kvantitativna procena izoenzima LDH izvršena je putem gel-skenova pomoću softvera GelPro i Scion Imaging. Nivoi CK u serumu određeni su kolorimetrijski korišćenjem komercijalnih reagenasa. Rezultati pokazuju da su kvantitativne promene u izoenzimima LDH bile ubedljivije i lakše za tumačenje u serumu nego u plazmi. Uočeno je da je izoenzim LDH-5 iz seruma glavni činilac ukupne aktivnosti LDH u serumu, koji prati paralelnu promenu CK u serumu pacijenata sa opekotinama. Takođe, aktivnost LDH-5 u serumu ostaje značajno povišena i do 10. dana, dok su nivoi CK u serumu povišeni do 5. dana (P<0,05) oporavka. Stoga naši rezultati ukazuju na bolju stabilnost LDH-5 u serumu nego CK u serumu tokom procesa zaceljivanja opekotina, te se preporučuje upotreba seruma za procenjivanje aktivnosti LDH.