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Macroamylases: differences in activity against various-sized substrates

J L Rosenblum1, G L Hortin, C H Smith

  • 1Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, MO 63110.

Clinical Chemistry
|September 1, 1992
PubMed

Insights

Macroamylase can cause false acute pancreatitis diagnoses. Assays using high-molecular-mass substrates show less interference, aiding in accurate macroamylase detection and preventing misdiagnosis.

Area of Science:

  • Clinical Chemistry
  • Biochemistry

Background:

  • Macroamylasemia, characterized by the presence of macroamylase in blood, can lead to elevated amylase levels (hyperamylasemia).
  • This condition may result in the misdiagnosis of acute pancreatitis, a serious medical condition.

Purpose of the Study:

  • To investigate whether using high-molecular-mass (high-M(r)) substrates reduces interference in amylase assays compared to oligosaccharide substrates.
  • To determine if this difference in substrate reactivity can aid in identifying macroamylasemia.

Main Methods:

  • Assayed eighteen macroamylasemic samples using both high-M(r) polysaccharide substrates (amylopectin, starch) and oligosaccharide substrates (maltoheptaose, maltotetraose).
  • Compared amylase activities obtained from different substrate types in both macroamylasemic and non-macroamylasemic samples.
  • Investigated the mechanism by adding amylase antibodies to assess their differential impact on substrate hydrolysis.

Main Results:

  • High-M(r) polysaccharide substrates showed consistently lower amylase activities in macroamylasemic samples compared to oligosaccharide substrates.
  • No significant bias was observed when analyzing non-macroamylasemic specimens.
  • Antibody addition demonstrated a greater reduction in amylase activity with complex polysaccharides than with oligosaccharides.

Conclusions:

  • High-M(r) substrates diminish interference from macroamylase in amylase assays.
  • Comparing results from automated methods employing different substrates may enable the detection of suspected macroamylasemia.

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