PROTEIN & ANALISIS PROTEIN

Dr. Lucia Sincu Gunawan

AAK NASIONAL SURAKARTA
PROTEIN
 PROTEIN
 Protos : yang paling utama (bahasa
Yunani)
 Senyawa organik kompleks berbobot

molekul tinggi yang terdiri dari asam

amino yang diikat dengan ikatan
peptida
 Molekul protein mengandung karbon,

hidrogen, oksida, nitrogen, sulfur&

fosfor (kadang)
 Ditemukan oleh : Jons Jacob Berzelius

(1838)
Sintesa protein
 Dalam tubuh protein disintesa dari

◦ asam amino yang terdapat dalam makanan

◦ dari penguraian protein jaringan

◦ dari asam amino yang dibentuk oleh

aminasi fragmen carbon dari metabolisme
KH dan Lipid
Protein darah
 Disebut juga protein serum

 Protein
darah adalah protein yang
ditemukan dalam plasma darah.

 Total
protein serum dalam darah :
7g/dl, 7 % BB tubuh
 FUNGSI PROTEIN
◦ Transport / pembawa molekul seperti
lipids (lipoprotein), hormones, vitamins
and logam

◦ Enzymes, komponen komplemen,

protease inhibitors, and kinin precursors

◦ Mengatur aktivitas sel

◦ Berfungsi dalam sistem imun

PROTEIN DARAH
 Ratusan jenis protein beredar dalam darah

◦ Protein pembawa (seperti serum albumin,

transferrin, and haptoglobins
◦ Fibrinogen dan faktor koagulan lainnya
◦ Komponen komplemen
◦ Imunoglobulin
◦ Inhibitor enzim
◦ Prekusor zat seperti angiotensin dan
bradykinin
PROTEINS SYNTHESIS

 Semua protein
dalam plasma
diproduksi dari
hati / liver
kecuali gamma
globulin.
Separating serum proteins by electrophoresis is a valuable
diagnostic tool as well as a way to monitor clinical progress

Blood Normal
 % Function
protein level
3.5-5.0
Albumins
g/dl 60% create osmotic pressure a
nd transports other molec
I 1.0-1.5 ules
mmunoglo g/dl   participate in immune syst
bulins em
0.2-0.45
Fibrinogens
g/dl 4% blood coagulation
neutralize trypsin that has
alpha 1-antitry leaked from the
psin     digestive system
Regulatory pr   <1% Regulation of gene expres
oteins sion
Electrophoresis serum protein
INDIKASI SPE
 Suspek Multiple myeloma
 Suspek Primary amyloidosis
 Neuropathy yang tidak jelas
 Nyeri punggung yyang tidak jelas
 Hypercalcemia dengan kecurigaan

malignancy
 Insufisiensi renal dengan peningkatan serum

protein
 Adanya fraktur patologis
 Bence jones proteinuria
ALBUMIN SERUM
 Diproduksi oleh hati
 Memainkan peranan penting dalam

mengatur tekanan osmotik koloid

plasma
 Harga normal : 3,5 – 5 gr/ dL
 Penurunan kadar dalam serum dapat

dijumpai pada kegagalan hati dan

malnutrisi
FUNGSI ALBUMIN
 Memelihara tekanan osmotik
 Transport thyroid hormones

 Transports hormon lain yang larut dalam

lemak
 Transports asam lemak ("free" fatty acids)
ke liver
 Transports bilirubin tak terkonjugasi
 Transports obat
 Pengikat calsium secra kompetitif (Ca2+)

 Buffers pH
PENYEBAB HIPOALBUMINEMIA
 Sirosishepatis (paling sering)
 Penurunan produksi seperti pada
kelaparan
 Pengeluaran melalui urin (

nephrotic syndrome)
 Kehilangan melalui usus (protein
losing enteropathy)
 Luka bakar luas
 Mutasi  analbuminemia
 Penyakit akut (referred to as a

negative acute phase protein

 DRAINASE
ALBUMIN
ASCITES
 IMMUNOGLOBULINS
 Berfungsisebagai antibodi, dalam
bentuk glikoprotein .

 Terbagi dalam 5 kelas : Ig A, Ig D, Ig

E, Ig G, Ig M , berdasarkan struktur
dan aktivitas biologinya
IMUNODEFISIENSI
Increased Alpha-Globulins
 peningkatan bersama alpha 1 dan
alpha 2 biasanya signifikan
terjadi
 peningkatan sering terjadi pada
penyakit radang akut
 PERUBAHAN KADAR ALPHA GLOBULIN

KADAR ALPHA 1 GLOBULIN ALPHA 2 GLOBULIN

PENINGKATAN Kehamilan Adrenal insufficiency
Nephrotic syndrome
Adrenocorticosteroid therapy
Advanced DM
PENURUNAN Alpha 1 antytripsin Malnutrisi
defficiency Anemia megaloblastik
Penyakit liver berat
Increased Beta-Globulins
◦ Non -specific
◦ Active liver disease,
◦ Suppurative dermatopathy
◦ Nephrotic syndrome
◦ Cushing disease
◦ Hypotyroidism
◦ Anemia deff Fe
◦ Obstructive jaundice
◦ Kehamilan trimester III
High, sharp monoclonal spikes may be seen in
this region due to multiple myeloma, or
lymphosarcoma
PERUBAHAN KADAR GLOBULIN
 Beta-Gamma Bridging
Beta-gamma bridging is lack of clear
separation between the beta and gamma
fractions. (biasa terjadi pada penggunaan plasma yang
mengandung fibrinogen sebagai sampel menggantikan serum)

 Dalam serum beta-gamma bridging terjadi

pada
◦ Chronic active hepatitis berhubungan dengan
peningkatan IgM dan IgA
◦ Gammopathy
◦ Lymphosarcoma
Penurunan Gamma-Globulins
◦ Kadar rendah gamma globulins
diharapkan dari pemeriksaan serum
fetus dan precolostral neonates.

◦ Low level mungkin terlihat pada kasus

Severe Combined Immunodeficiency
(SCID) pada kelainan kongenital
Peningkatan Gamma
Globulins
◦ Ada 2 : polyclonal (broad) or monoclonal
(sharp) peaks.
◦
◦ Polyclonal gammopathies
 immune stimulation
 chronic infections, chronic hepatitis, immune-
mediated diseases or tumours.
◦ Monoclonal or oligoclonal (bi-phasic)
 multiple myeloma
 cutaneous lymphoma or lymphosarcoma
 Amyloidosis
 Immune -mediated disease.
 Sebuah
TRANSFERIN
protein yang membawa besi dalam
darah
 Merupakan beta globulin protein
 Adanya resetor transferin di permukaan
sel, untuk memasukkan besi ke dalam sel.
 Persentase pengikatan besi oleh transferin
akan meningkat pada overdosis Fe,
ataupun hemokromatosis.
 Serum transferin menurun pada
kekurangan protein
TERIMA KASIH
selanjutnya
 Multiple myeloma
 Sindroma nefrotik
 Anemia defisiensi besi
SELAMAT PAGI
Multiple myeloma
MULTIPLE MYELOMA
 Juga dikenal sebagai plasma cell myeloma/
Kahler's disease

 Adalah kanker dari sel plasma a type of white blood cell

normally responsible for the production of antibodies.

 Kumpulan abnormal sel terakumulasi di

tulang, yang menyebabkan lesi pada tulang
dan mempengaruhi sumsum tulang dalam
memproduksi sel darah yang normal 
anemia
MULTIPEL MYELOMA
 Memproduksi paraprotein (bence jones
protein) , sebuah antibodi yang abnormal
yang menyebabkan kerusakan ginjal

 Mengganggu produksi antibodi yang normal

sehingga timbul imunodefisiensi.

 Hypercalcemia (high calcium levels) sering

ditemukan
Angka kejadian & prognosis
 1–4 per 100,000 people per year.
 It is more common in men
 Twice as common in blacks as it is in whites.
 With conventional treatment, the prognosis is

3–4 years, which may be extended to 5–7

years with advanced treatments.
 Multiple myeloma is the second most

common hematological malignancy (13%) and

constitutes 1% of all cancers.[1]
FAKTOR RESIKO MM
 Age The risk of multiple myeloma goes up with age. Less than 1% of cases are diagnosed in people
younger than 35. Most people diagnosed with this cancer are over 65 years old.

 GenderMen are slightly more likely to develop multiple myeloma than women.
 RaceMultiple myeloma is almost twice as common among black Americans as white Americans. The
reason is not known.

 Radiation Exposure to radiation may increase the risk of multiple myeloma. At most, this
accounts for a very small number of cases.

 Family historyMultiple myeloma does seem to run in some families. Someone who has a
sibling or parent with myeloma is 4 times more likely to get it than would be expected. Still, most patients
have no affected relatives, so this accounts for only a small number of cases.

 Workplace exposuresSome studies have suggested that workers in certain

petroleum-related industries may be at a higher risk.

 ObesityA study by the American Cancer Society has found that being overweight or obese increases
a person's risk of developing myeloma.

 Other plasma cell diseasesMany people with MGUS or solitary

plasmacytoma will eventually develop multiple myeloma.
 Pathophysiology
 B lymphocytes start in the bone marrow
activated to secrete antibodies, they are known
as plasma cells.
 The proliferation of B cells and the secretion of
antibodies under tight control.
 Chromosomes and genes are damaged
stimulates an antibody gene to overproduction.
 IN dysregulation of the oncogene  Production
of cytokines osteoporosis, angiogenesis, ,
produced antibodies are deposited in various
organs,  renal failure, polyneuropathy
DIAGNOSA MULTIPEL MYELOMA
 Blood tests (protein electrophoresis)
 Microscopic examination of the bone marrow
 X-rays tulang yang sering terkena .
SPE – MULTIPEL MYELOMA
Gejala & tanda MM
 Nyeri tulang
 Patah tulang
 Anemia
 Infeksi berulang
 Lemah , bingung and lelah ( gejala

hypercalcemia)
 Sakit kepala, visual changes and

retinopathy (akibat hyperviskositas darah

karena adanya paraprotein)
TERAPI
KEMOTERAPI
Autologous stem cell
transplantation (ASCT), the
transplantation of a patient’s own stem cells after chemotherapy,
is the most common type of stem cell transplantation for multiple
myelomA
Selamat belajar