{"id":9392,"date":"2020-04-23T03:36:40","date_gmt":"2020-04-23T01:36:40","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/alfa2-macroglobulina\/"},"modified":"2025-01-31T12:42:44","modified_gmt":"2025-01-31T10:42:44","slug":"alfa2-macroglobulina","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/alfa2-macroglobulina\/","title":{"rendered":"A\u043b\u044c\u0444\u0430-2 \u043c\u0430\u043a\u0440\u043e\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d"},"content":{"rendered":"

\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f<\/em><\/strong><\/p>\n

Alfa-2-macroglobulina (A2M) este cea mai mare protein\u0103 plasmatic\u0103 nonimunoglobulinic\u0103 (greutate molecular\u0103 de 725 kDa), fiind alc\u0103tuita din 4 lan\u0163uri polipeptidice ce con\u0163in o secven\u0163\u0103 specific\u0103 de aproximativ 35 aminoacizi (regiunea \u201cmomeal\u0103\u201d) \u015fi un domeniu tioester similar cu cel din structura frac\u0163iunilor C3 \u015fi C4 ale complementului. Este un inhibitor endoproteazic cu spectru larg, put\u00e2nd inactiva aproape toate tipurile de serin, tiol, metal \u015fi carboxil proteaze. Enzimele se leag\u0103 \u015fi cliveaz\u0103 regiunea \u201cmomeal\u0103\u201d form\u00e2ndu-se astfel un complex covalent \u00een care A2M sufer\u0103 o modificare conforma\u0163ional\u0103 form\u00e2nd A2M activat\u0103 care se leag\u0103 de receptorii specifici de pe macrofage. S-au descris mai multe forme de A2M, care difer\u0103 \u00eentre ele prin compozi\u0163ia\u00a0\u00een acid sialic, manoza \u015fi galactoza, care pot fi separate prin focusare izoelectric\u01037<\/sup>.<\/p>\n

\u00cen condi\u0163ii normale, nivelul seric de A2M este mai crescut la femei dec\u00e2t la b\u0103rba\u0163i, ca r\u0103spuns la secre\u0163ia de estrogeni7<\/sup>.<\/p>\n

A2M este una din proteinele de faz\u0103 acut\u0103. Multe citokine, incluz\u00e2nd TGF-beta, IL1, IL2, IL6, PDGF, FGF, VEGF,\u00a0 se leag\u0103 de A2M, \u00een unele cazuri aceasta reprezent\u00e2nd o cale de transport \u015fi posibil o modalitate de prelungire a duratei vie\u0163ii biologice, iar\u00a0\u00een alte cazuri legarea de A2M determin\u0103 inhibarea unora din activit\u0103\u0163ile biologice ale liganzilor. Interac\u0163iunea dintre A2M \u015fi citokine se crede c\u0103 moduleaz\u0103 expresia proteinelor de faz\u0103 acut\u0103\u00a0\u00een hepatocite. De asemenea, A2M a fost raportat ca un important factor antiapoptotic pentru celulele musculare netede vasculare2<\/sup>.<\/p>\n

A2M func\u0163ioneaz\u0103, de asemenea, ca un inhibitor al coagul\u0103rii prin inactivarea trombinei \u015fi FXa \u015fi ca inhibitor al fibrinolizei prin inactivarea plasminei \u015fi kalikreinei.<\/p>\n

A2M a fost implicat\u0103 \u00een boala Alzheimer pe baza abilit\u0103\u0163ii sale de a media clearance-ul \u015fi degradarea A\u03b2, componentul major al depozitelor de \u03b2-amiloid, mo\u015ftenirea unei dele\u0163ii la nivelul exonului 18 a genei A2M \u00a0de pe cromozomul 12 conferind risc crescut de boala Alzheimer. De asemenea Saunders et al. (2003) au g\u0103sit o asociere genetic\u0103 semnificativ\u0103 a dele\u0163iei respective \u015fi a 2 polimorfisme cu boala Alzheimer, dar alte studii efectuate nu au confirmat aceast\u0103 asociere6<\/sup>.<\/p>\n

\u00cen sindromul nefrotic majoritatea proteinelor str\u0103bat membrana de ultrafiltrare \u015fi ajung \u00een urin\u0103, lucru ce nu se \u00eent\u00e2mpl\u0103 cu A2M datorit\u0103 dimensiunilor sale \u015fi, ca urmare, proteina este re\u0163inut\u0103\u00a0\u00een fluxul sanguin \u015fi men\u0163ine \u00eempreun\u0103 cu albumina presiunea oncotic\u0103. \u00cen aceste condi\u0163ii, concentra\u0163ia seric\u0103 poate atinge nivele p\u00e2n\u0103 la de 10 ori mai mari dec\u00e2t valorile de referin\u0163\u01035;7<\/sup>.<\/p>\n

Pacien\u0163ii cu boli proteolitice, cum ar fi pancreatita acut\u0103, prezint\u0103 concentra\u0163ii serice sc\u0103zute care se coreleaz\u0103 cu severitatea bolii3:5<\/sup>. Concentra\u0163iile sc\u0103zute de A2M nu determin\u0103 o stare patologic\u0103 \u015fi nu se cunoa\u015fte nici o deficien\u0163\u0103 specific\u0103 a A2M7<\/sup>.\u00a0A2M constituie unul din testele care fac parte din profilele de investiga\u0163ii non-invazive ale func\u0163iei hepatice denumite Fibrotest-Actitest \u015fi Fibromax4<\/sup>.<\/p>\n

Recomand\u0103ri pentru determinarea alfa2-macroglobulinei <\/em><\/strong>\u2013 evaluarea pacien\u0163ilor cu pancreatit\u0103, sindrom nefrotic, diabet \u015fi ciroz\u0103 hepatic\u01033,5<\/sup>.\u00a0<\/em><\/strong><\/p>\n

Preg\u0103tire pacient<\/em><\/strong> - \u00e0<\/em> jeun (pe nem\u00e2ncate)4<\/sup>.<\/p>\n

Specimen recoltat<\/em><\/strong> - <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c4<\/sup>.<\/p>\n

Recipient de recoltare <\/em><\/strong>-<\/em> vacutainer f\u0103r\u0103 anticoagulant cu\/f\u0103r\u0103 gel separator4<\/sup>.<\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare<\/em><\/strong> - <\/em>se separ\u0103 serul prin centrifugare \u00een aceea\u015fi zi4<\/sup>.<\/p>\n

Volum prob\u0103<\/em><\/strong> - <\/em>minim 0.5 mL ser4<\/sup>.<\/p>\n

Cauze\u00a0 de respingere a probei<\/em><\/strong> - <\/em>specimen lipemic4<\/sup>.<\/p>\n

Stabilitate prob\u0103<\/em><\/strong> - <\/em>serul separat este stabil 3 zile<\/em> la 2-8\u00baC; timp \u00eendelungat <\/em>\u00a0la -20\u00baC4<\/sup>.<\/p>\n

Metod\u0103 <\/em><\/strong>- <\/em>imunoturbidimetric\u0103<\/span>4<\/sup>.<\/p>\n

Valori de referin\u0163\u0103 <\/em><\/strong>\u2013 1.3-3 g\/L4<\/sup>.<\/p>\n

Interpretarea rezultatelor<\/em><\/strong><\/p>\n

Valorile \u03b12-macroglobulinei sunt crescute \u00een sindrom nefrotic propor\u0163ional cu severitatea pierderii de proteine5<\/sup>.<\/div>\n
Cre\u015fteri moderate ale valorilor plasmatice de \u03b12-macroglobulina pot fi observate la pacien\u0163ii cu ciroz\u0103 hepatic\u0103 \u015fi \u00een fazele incipiente ale nefropatiei diabetice5;7<\/sup>.<\/div>\n
\u00cen st\u0103rile hiperfibrinolitice, dup\u0103 interven\u0163ii chirurgicale majore, insuficien\u0163a hepatic\u0103 sever\u0103 \u015fi pancreatita acut\u0103 se \u00eenregistreaz\u0103 concentra\u0163ii reduse de \u03b12-macroglobulina3;5<\/sup>. Nivelurile de A2M sunt sc\u0103zute \u00een sepsis \u015fi au fost asociate cu evolu\u0163ie letal\u0103\u00a0\u00een unele studii2<\/sup>.<\/div>\n
Bolnavii care au suferit un infarct miocardic acut \u015fi au valori plasmatice sc\u0103zute de \u03b12-macroglobulin\u0103 au un prognostic mult mai bun, cu perioada de supravie\u0163uire mai mare de un an3;5<\/sup>.<\/div>\n
Cre\u015fterile sau sc\u0103derile A2M pot fi observate din modific\u0103rile frac\u0163iunii alfa2-globulinelor din electroforeza proteinelor serice5<\/sup>.<\/div>\n

\u00a0<\/span><\/p>\n

\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n

1. Blacker D et col. \u201cAlpha-2 Macroglobulin is genetically associated with Alzheimer Disease\u201d, Nature Genetics 19, 357 \u2013 360 (1998)<\/span><\/div>\n
2. Cytokines & Cells Encyclopedia \u2013 COPE, \u201cAlpha-2-Macroglobulin\u201d. Ref Type: Internet Communication.<\/span><\/div>\n
3. Laboratory Corporation of America. Directory of Services and Interpretive Guide. \u03b12-Macroglobulin, Quantitative. www.labcorp.com. 2010. Ref Type: Internet Communication<\/span><\/div>\n
4. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog<\/span><\/div>\n
5. Mayo Clinic\/Mayo Medical Laboratories.Test Catalogs and Guides. Alpha-2-Macroglobulin, Serum. www.mayomedicallaboratories.com. Ref Type: Internet Communication.<\/span><\/div>\n
6. Online Mendelian Inheritance in Man, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine. \u201cAlpha-2-Macroglobulin\u201d. Ref Type: Internet Communication.<\/span><\/div>\n
7. Richard A. McPetersen, Matthew R. Pincus. Alfa2 macroglobulin. In Henry\u2019s Clinical Diagnosis and Management by Laboratory Methods \u2013 Sauders Elsevier 21-Ed 2007, 237.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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<\/td>\n<\/td>\n<\/tr>\n
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\u042d\u0441\u0442\u0440\u043e\u0433\u0435\u043d\u044b<\/td>\n\u0414\u0435\u043a\u0441\u0442\u0440\u0430\u043d,\u00a0\u0441\u0442\u0440\u0435\u043f\u0442\u043e\u043a\u0438\u043d\u0430\u0437\u0430<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n
\u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f\u00a0\u043a\u00a0\u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044e<\/b><\/td>\n<\/tr>\n
\u0410\u043b\u044c\u0444\u0430-2-\u043c\u0430\u043a\u0440\u043e\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d\u00a0—\u00a0\u043e\u0434\u0438\u043d\u00a0\u0438\u0437\u00a0\u043d\u0435\u043f\u0440\u044f\u043c\u044b\u0445\u00a0\u043c\u0430\u0440\u043a\u0435\u0440\u043e\u0432\u00a0\u0444\u0438\u0431\u0440\u043e\u0437\u0430\u00a0\u043f\u0435\u0447\u0435\u043d\u0438<\/b><\/p>\n

\u00b7\u00a0\u0411\u0438\u043e\u0445\u0438\u043c\u0438\u0447\u0435\u0441\u043a\u0430\u044f\u00a0\u043e\u0446\u0435\u043d\u043a\u0430\u00a0\u0440\u0438\u0441\u043a\u0430\u00a0\u0444\u0438\u0431\u0440\u043e\u0437\u0430\u00a0\u043f\u0435\u0447\u0435\u043d\u0438\u00a0\u0443\u00a0\u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432\u00a0\u0441\u00a0\u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438\u00a0\u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u043c\u0438\u00a0\u043f\u0435\u0447\u0435\u043d\u0438;<\/p>\n

\u00b7\u00a0\u043d\u0435\u0444\u0440\u043e\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439\u00a0\u0441\u0438\u043d\u0434\u0440\u043e\u043c,\u00a0\u043f\u0430\u043d\u043a\u0440\u0435\u0430\u0442\u0438\u0442,\u00a0\u0441\u0430\u0445\u0430\u0440\u043d\u044b\u0439\u00a0\u0434\u0438\u0430\u0431\u0435\u0442<\/td>\n<\/tr>\n

\u0418\u043d\u0442\u0435\u0440\u043f\u0440\u0435\u0442\u0430\u0446\u0438\u044f\u00a0\u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u043e\u0432<\/b><\/td>\n<\/tr>\n
\u041f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435\u00a0\u0443\u0440\u043e\u0432\u043d\u044f<\/b><\/td>\n\u0421\u043d\u0438\u0436\u0435\u043d\u0438\u0435\u00a0\u0443\u0440\u043e\u0432\u043d\u044f<\/b><\/td>\n<\/tr>\n
\u00b7\u00a0\u0417\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u00a0\u043f\u0435\u0447\u0435\u043d\u0438\u00a0(\u0446\u0438\u0440\u0440\u043e\u0437,\u00a0\u0433\u0435\u043f\u0430\u0442\u0438\u0442\u044b);<\/p>\n

\u00b7\u00a0\u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c\u00a0\u0430\u043b\u044c\u0444\u0430-1-\u0430\u043d\u0442\u0438\u0442\u0440\u0438\u043f\u0441\u0438\u043d\u0430;<\/p>\n

\u00b7\u00a0\u043d\u0435\u0444\u0440\u043e\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439\u00a0\u0441\u0438\u043d\u0434\u0440\u043e\u043c;<\/p>\n

\u00b7\u00a0\u0441\u0430\u0445\u0430\u0440\u043d\u044b\u0439\u00a0\u0434\u0438\u0430\u0431\u0435\u0442\u00a0(\u0447\u0430\u0449\u0435\u00a0\u043f\u0440\u0438\u00a0\u043d\u0430\u043b\u0438\u0447\u0438\u0438\u00a0\u043e\u0441\u043b\u043e\u0436\u043d\u0435\u043d\u0438\u0439);<\/p>\n

\u00b7\u00a0\u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u0430\u044f\u00a0\u043d\u0430\u0433\u0440\u0443\u0437\u043a\u0430;<\/p>\n

\u00b7\u00a0\u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c<\/td>\n

\u00b7\u00a0\u0417\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f\u00a0\u043b\u0435\u0433\u043a\u0438\u0445;<\/p>\n

\u00b7\u00a0\u043c\u043d\u043e\u0436\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0430\u044f\u00a0\u043c\u0438\u0435\u043b\u043e\u043c\u0430;<\/p>\n

\u00b7\u00a0\u042e\u0420\u0410;<\/p>\n

\u00b7\u00a0\u0438\u043d\u0444\u0430\u0440\u043a\u0442\u00a0\u043c\u0438\u043e\u043a\u0430\u0440\u0434\u0430;<\/p>\n

\u00b7\u00a0\u043f\u0430\u043d\u043a\u0440\u0435\u0430\u0442\u0438\u0442;<\/p>\n

\u00b7\u00a0\u043f\u0440\u0435\u044d\u043a\u043b\u0430\u043c\u043f\u0441\u0438\u044f<\/td>\n<\/tr>\n<\/tbody>\n<\/table>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[954,953],"product_tag":[],"class_list":{"0":"post-9392","1":"product","2":"type-product","3":"status-publish","5":"product_cat-proteine-specifice-in-ser-si-urina","6":"product_cat-teste-de-biochimie","8":"first","9":"instock","10":"sold-individually","11":"shipping-taxable","12":"purchasable","13":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/9392","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=9392"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9392"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9392"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9392"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9392"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}