title: Tartrate-resistant acid phosphatase isoform 5b as serum marker for osteoclastic activity.
abstract: BACKGROUND
  Tartrate-resistant acid phosphatase (AcP) 5b is a marker of osteoclastic activity and bone resorption. Immunoassays for serum TRAcP may lack sensitivity and specificity because of the presence of non-bone isoform 5a. The purpose of this study was to isolate the serum isoforms, quantify their disease-related expressions, and test an improved immunoassay for TRAcP 5b.
  
  
  METHODS
  We separated TRAcP isoforms chromatographically from pooled sera of healthy, rheumatoid arthritis (RA) and endstage renal disease (ESRD) subjects. TRAcP isoforms were identified by electrophoresis and quantified by biochemical and immunochemical assays. Serum TRAcP activity in healthy, RA, and ESRD cohorts was assessed at pH 5.5 and 6.1, and compared with bone alkaline phosphatase (BAP) and N-telopeptides of type I collagen (NTx).
  
  
  RESULTS
  TRAcP isoforms 5a and 5b were present in all sera; 5b was identical to osteoclastic TRAcP. In serum from healthy subjects, 5a accounted for 87% of the enzyme protein but only 55% of the activity. In RA, both isoforms were increased two- to threefold in protein, but their specific activities were subnormal. In ESRD, only 5b was abnormal, being increased fivefold in protein and threefold in activity. In RA sera, TRAcP activity did not correlate with either BAP or NTx. In ESRD sera, TRAcP activity correlated with BAP and NTx only when measured at pH 6.1.
  
  
  CONCLUSIONS
  All sera contained both TRAcP isoforms 5a and 5b, but only 5b was present in bone. TRAcP isoform expression was variable in different diseases. Measurement of TRAcP activity at pH 6.1 improves the specificity of immunoassay for isoform 5b.
authors.affiliation: Special Hematology Laboratory, Veterans Affairs Medical Center, Louisville, KY 40206, USA. pat.streipts@med.va.gov
authors.forename: A J
authors.initials: AJ
authors.lastname: Janckila
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.forename: S Z
authors.initials: SZ
authors.lastname: Sun
authors.forename: L T
authors.initials: LT
authors.lastname: Yam
mesh_terms: D000135:Acid Phosphatase / Q000378:metabolism*; D001172:Arthritis, Rheumatoid / Q000201:enzymology; D015415:Biomarkers / Q000097:blood; D006801:Humans; D007118:Immunoassay; D007527:Isoenzymes / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000201:enzymology; D010010:Osteoclasts / Q000201:enzymology*; D012016:Reference Values; D012680:Sensitivity and Specificity; D000071681:Tartrate-Resistant Acid Phosphatase
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; C000605510:ACP5 protein, human; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase