How does the serum protein electrophoresis change in response to inflammation?
The SPEP (Medicare cost $29.92) directly quantifies the acute-phase response. Inflammation is followed by characteristic protein alterations that are reflected on the high-resolution electrophoresis (which separates proteins in to five distinct regions: albumin peak, α-1, α-2, β I & II region, and gamma region). The typical pattern on SPEP for the inflammatory response includes increases in the α-2 zone most prominently (e.g., α-2 macroglobulin, haptoglobin), gamma zone (immunoglobulins), α-1 zone (e.g., α-1 antitrypsin, others) and the β-γ area (fibrinogen, CRP). Negative acute-phase reactants are seen on the SPEP as a diminished albumin peak and β region (transferrin).
Pearl: A rough rule of thumb for normal levels (% of the total protein) of the five regions on the SPEP is: α-1 (5%); α-2 (10%); β (15%); gamma (20%); albumin (50%)