Macromolecular complex

Last revised by Daniel J Bell on 5 May 2020

Macromolecular complexes include both macrohormones and macroenzymes, which consist of hormones and enzymes respectively covalently bound to carrier molecules, e.g. immunoglobulins, or occasionally the molecule may self-polymerize. Their primary importance lies in their ability to produce an artifactually-high level of the particular hormone/enzyme in the blood as standard laboratory assays do not distinguish between the unbound and bound forms of the hormone/enzyme, e.g. in hyperamylasemia the serum amylase appears to be elevated but may actually be normal. This may lead to inappropriate investigations and therapy.

Macrohormones
  • macro-thyroid stimulating hormone (macro-TSH)
  • macroprolactin
Macroenzymes
Immunoglobulin-bound
Non-immunoglobulin-bound
  • macroamylase: amylase may bind to hydroxyethyl starch 2
  • macro-mitochondrial creatine kinase: mitochondrial CK self-polymerizes 2
  • macrotrypsin: proteases may bind to alpha-2-macroglobulin 2

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