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◉ What is α1 Acid Glycoprotein test?
Orosomucoid test is a blood test that measures the level of orosomucoid (also known as alpha-1-acid glycoprotein or AGP) in the plasma.
Orosomucoid is a protein that is produced by the liver and is involved in the transport of basic and neutral drugs, steroids, and protease inhibitors in the blood.
α1 Acid Glycoprotein is also an acute phase protein, which means that its level changes in response to inflammation, infection, tissue damage, or malignancy.
The test can be useful in diagnosing and monitoring various conditions, including infections, autoimmune disorders, inflammatory bowel disease, certain cancers, and chronic inflammatory conditions such as rheumatoid arthritis.
◉ What is the function of Orosomucoid ?
Its function in the body includes:
- Inflammation Response: Orosomucoid is an acute-phase protein, meaning its levels increase in response to inflammation or injury. It plays a role in modulating the immune response during some conditions.
- Drug Binding: Orosomucoid has binding sites for various drugs, influencing their distribution in the bloodstream.
- Transport of Molecules: It helps transport certain substances, including lipids and hormones in the blood.
◉ What is the Orosomucoid test used for?
The orosomucoid test may be used for several purposes, such as:
- To monitor the activity of inflammatory bowel disease (IBD), especially Crohn's disease, in its early stages.
- To adjust the dosage of certain drugs that bind to orosomucoid, such as propanolol, imipramine and quinidine, some HIV protease inhibitors. Changes in orosomucoid levels can affect the pharmacokinetics and efficacy of these drugs.
- Assists, along with haptoglobin, in diagnosing hemolytic anemia when it is associated with an inflammatory syndrome
◉ How can I prepare for the test?
The test has no restrictions or special preparations
◉ Normal levels of α1 Acid Glycoprotein
The normal vlaue of the orosomucoid test is 0.6-1.2 mg/mL for males and 0.4-1.0 mg/mL for females. However, this range may vary depending on age, pregnancy and other factors.
◉ High Orosomucoid
1. Causes
The causes of high values of the orosomucoid can be various, some possible causes are:
- Inflammatory Conditions: Orosomucoid levels can increase in response to acute or chronic inflammation. Conditions such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, and infections can lead to elevated orosomucoid levels.
- Infections: Bacterial, viral, or fungal infections can cause an increase in orosomucoid levels as part of the body's immune response.
- Cancer: Certain types of cancer, such as pancreatic cancer, liver cancer, and lung cancer, can be associated with elevated levels.
- Pregnancy: Increased urinary orosomucoid level early in pregnancy predicted preeclampsia in women with pregestational type 1 diabetes independently of albuminuria and other known risk factors. No association to preterm delivery was found.
2. Symptoms
The symptoms of high values of the orosomucoid test depend on the cause and severity of the condition. Some common symptoms are:
- Symptoms may vary depending on the site and type of infection but can include fever, malaise, localized pain or swelling, cough, and respiratory symptoms.
- Symptoms may vary depending on the specific cancer type and stage but can include weight loss, fatigue, pain and changes in bowel or bladder habits.
◉ Low Orosomucoid
1. Causes
The causes of low values of the orosomucoid can be various; depending on the underlying condition that affects the production or clearance of ORM. Some possible causes are:
- Liver Disease: Decreased orosomucoid levels can be observed in severe liver disease or liver dysfunction. Conditions such as cirrhosis, hepatitis, or liver failure can lead to reduced synthesis and release of orosomucoid by the liver.
- Malnutrition: It is inadequate intake of nutrients. Malnutrition can affect the liver function and the availability of amino acids for ORM synthesis.
- Excessive loss: urinary, digestive or skin leakage
- Women using oral contraceptives (estrogens).
2. Symptoms
The symptoms of low values of the orosomucoid test depend on the cause and severity of the condition. Some common symptoms are:
- Symptoms of liver disease can include jaundice (yellowing of the skin and eyes), fatigue, abdominal pain, nausea, and changes in appetite.
- Weight loss, muscle wasting, weakness, anemia, and increased susceptibility to infections in malnutrition.
◉ Orosomucoid-haptoglobin couple
Both orosomucoid and haptoglobin are acute-phase reactant proteins whose levels increase in response to inflammation or tissue injury. The relationship between haptoglobin and orosomucoid is approximately haptoglobin ≈ orosomucoid * 1.3.
Haptoglobin levels usually decrease in cases of hemolytic anemia. However, when hemolysis and an inflammatory syndrome coexist, interpreting haptoglobin levels becomes more nuanced. In these situations, the haptoglobin level may falsely appear normal, masking the underlying hemolysis due to the concurrent inflammatory response.
In such cases, the orosomucoid-haptoglobin difference, expressed as a percentage of variation, is increased, confirming hemolysis, even without specifying the mechanism.
◉ Additional tests
Some other related analytical tests to the orosomucoid test are:
- C-reactive protein (CRP) test: Like orosomucoid, CRP is an acute-phase reactant that increases during inflammation.
- Serum amyloid A (SAA) test: SAA is another acute-phase protein that increases in response to inflammation.
- Erythrocyte sedimentation rate (ESR) test: This measures the rate at which red blood cells settle in a tube, indicating inflammation.
- Fibrinogen test: Fibrinogen is involved in blood clotting and can increase during inflammatory processes.
- Complete blood count (CBC): Provides information about various blood components, including white blood cells, red blood cells, and platelets, which can be affected by inflammatory conditions.
- Haptoglobin test.
◉ Conclusion
In summary, the orosomucoid test is a valuable diagnostic tool for assessing inflammation and monitoring various health conditions. It provides healthcare professionals with important information to aid in the diagnosis, treatment, and management of inflammatory diseases.
By incorporating the orosomucoid test into clinical practice, healthcare providers can deliver personalized care and improve patient outcomes.