Biochemistry

The main task and aim of the “Human” Polyclinic biochemical laboratory is laboratory diagnostics which is to enable timely establishing of diagnosis and monitoring treatment and course of diseases.

The fact that we are determined to apply and implement sensitive and specific methods of testing leads us towards that goal. The constant development resulted in a large number of various analyses of biological material which are possible at our biochemical laboratory.

The basic biochemical parameters provide insight into the functioning of some organs and the organism as a whole. If a parameter deviates from the reference values, this usually points to a pathological condition of a certain organ; in case there is a deviation of a larger number of parameters, this points to a serious clinical picture of a disease.

Enzymes are biologically active proteins which accelerate biochemical processes in our organisms. They control: digestion, absorption and breaking down of food, energy metabolism, physiological functions, muscle contraction, growth, hormone functions, detoxication etc. Enzymes are very important for diagnostics because they are often determined in the serum/plasm or urine. They are the principal markers of heart, haematological and malignant diseases, liver diseases, pancreas, gastrointestinal tract, kidneys, skeletal muscle and bones.

Diabetes (Diabetes mellitus) is nowadays one of the most common diseases in the world and in our country. This disease is characterized by a permanent increase of the level of glucose in blood which can be a consequence of insulin deficiency or the inability of the insulin to play its part. The laboratory tests are very important in establishing a diagnosis, monitoring the effectiveness of a treatment, as well as monitoring acute and chronical complications of this disease. Not regulated sugar level in blood leaves permanent consequences on many organs.

Vitamins are organic substances which a person cannot synthetize enough on its own; some of the vitamins cannot be synthetized at all, therefore, they must be taken with food (food of plant and animal origin). The way in which food is produced and processed nowadays, together with the industrial pollution of the environment and the stressful lives we lead require that we need larger amounts of vitamins. Hypovitaminosis is a condition caused by an insufficient intake of vitamins or an insufficient absorption and is characterized by common symptoms such as: fatigue, irritability, loss of appetite and often infections.

The significance of the laboratory tests is seen in the monitoring of the efficiency of certain groups of drugs too. Nowadays, a concentration of those drugs that are restricted to a small number of diseases are determined in the laboratories, such as anticonvulsants (Eftil®, Tegretol®, Keppra® etc.), lithium, digoxin etc. It is very important to monitor the concentration of these drugs in the blood because the dosage is determined according to that. If the concentration of a drug is below the expected, the drug will not be efficient, and vice versa, it can cause a series of side-effects.

The coagulation stage is a stage in which a large number of blood plasm proteins participate and which are marked as coagulation factors. Testing the coagulation parameters is necessary for all surgical procedures, monitoring oral anticoagulant treatment and thrombolytic treatment, diagnosing thrombosis, as well as for assessing liver capacity since most of the coagulation factors are synthetized in the liver.

According to the definition, tumor markers are substances that are synthetized by a tumor cell or a non-tumor cell responding to a benign or malignant condition in the organism. They are used to reach and establish a diagnosis and monitoring all types of malignancies. Some of them are related to one type of cancer (specific tumor markers), whereas some of them could be high in more types of malignancies (general tumor markers). There are limitations when it comes to using these parameters for diagnosing because it does not mean that every increase in the level of tumor markers is a malignancy, since there are some other physiological conditions that are characterized by that (CEA and AFP in pregnant women).

An allergy is a reaction of the body to some substances (allergens) and it sees them as foreign or harmful. Some of the allergens that cause an allergic reaction are food, spores, animal body parts, insect poison, pollen etc. In most of the allergic reactions, the immune system sees the allergen as a harmful agent. Allergens are classified into those sensitive to inhalation (allergens we breathe in), digestion (allergens we take in the body as food or drinks) and medication. Symptoms of an allergy reaction could be mild, moderate and severe that cause an anaphylactic (allergic) shock. Nowadays, the most commonly used tests are blood tests that determine the total amount of IgE antibodies which increase due to allergic, parasitic or malignant diseases or determine the concentration of specific IgE antibodies to certain allergens.

Hormones are biologically active substances that are produced by the endocrine glands. The function of the endocrine system is closely related to the functioning of the nervous, cardiovascular, digestive and respiratory systems. They travel through the blood and reach specific tissues where they regulate growth, development, reproduction, metabolic processes, homeostasis (the state of steady internal conditions).

Electrolytes participate in the maintaining balance and distribution of water in the human body, as well as in maintaining the acid/base ratio. They are crucial for a normal functioning of nervous and muscle cells, they facilitate the operation of enzymes, and some of them have a structural role. Our bodies secure electrolytes via food and water only, and lose them most during some illnesses which are accompanied by diarrhea and vomiting. Electrolyte metabolism imbalance could lead to serious health problems. The body is the most sensitive to small changes in the concentration of potassium in blood, and the fact that the pH value of our blood varies within a very narrow range 7.35–7.45 clearly shows the importance of electrolytes for our bodies. Microelements or trace elements are found in our tissues and bodily fluids, however, in small amounts. A large part of them are metals such as chromium, copper, cobalt, manganese, zinc, selenium, etc. On the other hand, lead and mercury are heavy metals which could be found in our body only in cases the person had been exposed to these metals through food, water, air, etc.

A complete blood count (CBC) is the basic laboratory test which is used to evaluate one’s overall health and detect a wide range of disorders including anemia, infections, nutritional status of a body and exposure to hazardous materials. The CBC includes the number of erythrocytes (red blood cells), leukocytes (white blood cells) and thrombocytes (platelets), erythrocyte constants (MCV, MCH, MCHC, RDW), thrombocyte constants (MPV, PDW), leukocyte formula (types of leukocytes: neutrophils, eosinophils, basophils, monocytes, lymphocytes), hemoglobin and hematocrit. This blood test gives insight into the number and quality of the blood cells. Inflammation is a reaction of our tissue to an injury or an infection. Regardless of the cause (mechanical injury, radiation, heat, chemical agents, various infections), every damage of the tissue starts a myriad of biochemical processes in the body whose goal is to create and release certain substances which are identified as inflammatory markers (mediators of inflammation). Some of the most important inflammatory markers are the so-called acute-phase proteins such as C-reactive protein (CRP) and fibrinogen.

A clinical urine test is one of the most useful screening methods the results of which give information about the body metabolism and the condition of the urinary system. It can help detect kidney and prostate disorders, diabetes and urinary infections. The most suitable urine for the test is the first one in the morning, whereby handling it properly and hygienically, the second stream is taken into a sterile cup. Analysis of urinary calculi. The existence of stones in the kidneys is called a nephrolithiasis and this can cause the obstruction of normal urine flow, facilitate the occurrence of urinary infections and cause severe pain. The main signs/symptoms of urinary calculi are pain and blood in the urine. By examining stool (feces), one evaluates the functions of the liver, pancreas and the entire digestive system. Within a biochemical analysis, it is possible to test the stool for absorption of fat, proteins and carbohydrates, and for the presence of the protein calprotectin as well as for examining the presence of blood in the stool.

Our body has a defense, that is, an immune system which protects us from different infections. It has a complex activity; it is responsible for the production of antibodies (immunoglobulin). The synthesis of the antibodies is harmonized in healthy people, whereas, on the other hand, some individuals can have different types of immunoregulation disorders and that is often the case with people who have a genetic predisposition after some repeated viral infections or stressful situations. In cases such as these, there is a synthesis of the antibodies, called autoantibodies, which is directed against its own tissues/organs. There are different types of autoantibodies. They are sometimes classified according to the organ they attack, and called organ-specific autoantibodies (anti TPO, anti TG, anti TSHR). The autoantibodies could also be systemic, for example, antinuclear antibodies (ANA) which can appear with systemic lupus, rheumatoid arthritis, scleroderma. The existence of autoantibodies in a person’s serum does not mean that he/she has an autoimmune disease.

Food intolerance or a non-allergic hypersensitivity to food is a late reaction of the body to food, drinks or food additives. It causes several symptoms in one or more organs or in the entire system. It arises as a consequence of a deficiency of specific chemical substances or enzymes necessary for digestion of food, but also due to a pathological reaction to some of the usually present substances in the food. Food intolerance symptom manifestation is the following:

Skin (rash, itch, hives, angioedema, dermatitis, eczema, psoriasis, acne)
Respiratory system (olfactory epithelium inflammation, rhinitis, sinusitis, pharyngitis, asthma, dry cough)
Digestive tract (abdominal pain, nausea, bloating, diarrhea, constipation and irritable bowel syndrome)
Neurological (headache, migraine, dizziness, lightheadedness);
Psychological (loss of motivation, lethargy, depression, fatigue, hyperactivity with kids)
Others (arthritis, fibromyalgia, swollen joints, obesity)

Thrombophilia is a tendency of the blood to produce blood clots or thrombosis due to the existence of congenital and/or acquired blood coagulation abnormality. Deep vein thrombosis in the lower extremities (swelling, pain, red skin) is the most common type of thrombophilia manifestation. Additional risk factors for developing thrombosis, besides congenital and acquired thrombophilia, might be old age, smoking, obesity, surgeries, malignities and diabetes, higher fat values and the level of estrogen in blood, pregnancy and others. The PCR technology that is applied in the “Human” Polyclinic laboratory has led to the discovery of gene polymorphism for coagulation factors and their inhibitors which are also responsible for deep vein thrombosis primarily. Patients should be tested for thrombophilia after the acute phase of thrombosis has passed and when the acquired conditions that cause such abnormalities (pregnancy, liver and kidney diseases, contraceptive pills, inflammatory processes) are over.

Cytogenetics studies the chromosomes. Chromosomes are long threads of DNA which are located in all cells of a body. The changes in number, size and structure of the chromosomes can cause disorders that affect growth, development and health. Chromosomal disorders can be inherited from parents, but can occur when an egg cell or a sperm cell is formed. Chromosomal disorders can occur due to a sufficiency or deficiency of copies of a chromosome (Down syndrome, Edwards syndrome, Klinefleter syndrome, Turner syndrome, etc.) and due to structural abnormalities of chromosomes. A cytogenetic testing can be done on adults, from a blood sample; married couples with infertility problems or consecutive early-pregnancy