View source for Alanine transaminase

{{protein
| Name = glutamic-pyruvate transaminase
| caption = 
| image = 
| width = 
| HGNCid = 4552
| Symbol = GPT
| AltSymbols = 
| EntrezGene = 2875
| OMIM = 138200
| RefSeq = NM_005309
| UniProt = P24298
| PDB = 
| ECnumber = 2.6.1.2
| Chromosome = 8
| Arm = q
| Band = 24.2
| LocusSupplementaryData = -qter
}}
{{SI}}
{{CMG}}



==Overview==

'''Alanine transaminase''' or '''ALT''' is a [[transaminase]] [[enzyme]] ({{EC number|2.6.1.2}}). It is also known as '''SGPT'''

'''ALT''' is found in [[blood plasma|serum]] and in various bodily tissues, but is most commonly associated with the [[liver]]; 

==Function==
It catalyzes the transfer of an [[amino]] group from [[alanine]] to [[Ketoglutaric acid|a-ketoglutarate]], the products of this reversible [[ transamination]] reaction being [[pyruvate]] and [[glutamate]].  

:[[glutamate]] + [[pyruvate]] {{unicode|&#8652;}}  [[alpha-ketoglutaric acid|α-ketoglutarate]] + [[alanine]]

[[Image:Alanine amino transférase.png|thumb|center|600px|Alanine transaminase]]

==Clinical significance==
It is commonly measured clinically as a part of a diagnostic [[liver function test]], to determine liver health.  It is also called '''serum glutamate pyruvate transaminase''' ('''SGPT''') or '''alanine aminotransferase''' ('''ALAT'''). Diagnostically, it is almost always measured in units/litre (U/L). 

===Elevated levels===
Elevated levels of '''ALT''' often suggest the existence of other medical problems such as alcoholic or viral [[hepatitis]], [[congestive heart failure]], [[liver]] damage, [[biliary duct]] problems, infectious [[mononucleosis]], or [[myopathy]].   For this reason, '''ALT''' is commonly used as a way of screening for liver problems.   However, elevated levels of '''ALT''' do not automatically mean that medical problems exist.  Fluctuation of '''ALT''' levels is normal over the course of the day, and '''ALT''' levels can also increase in response to strenuous physical exercise <ref>Paul T. Giboney M.D., [http://www.aafp.org/afp/20050315/1105.html Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient], ''American Family Physician''.</ref>. 

When elevated ALT levels are found in the blood, the possible underlying causes can be further narrowed down by measuring other enzymes.  For example, elevated ALT levels due to [[hepatocyte|liver-cell]] damage can be distinguished from [[biliary duct]] problems by measuring [[alkaline phosphatase]].  Also, [[myopathy]]-related ALT levels can be ruled out by measuring [[creatine kinase]] enzymes.

For years, the [[American Red Cross]] used '''ALT''' testing as part of the battery of tests to ensure the safety of its blood supply by deferring donors with elevated '''ALT''' levels.  The intent was to identify donors potentially infected with [[Hepatitis C]] ("non-A non-B [[Hepatitis]]") because there was no specific test for that disease at the time.  With the introduction of second generation [[ELISA]] antibody tests for [[Hepatitis C]], the Red Cross changed the '''ALT''' policy.  As of July 2003, donors previously disqualified for elevated '''ALT''' levels and no other reason may be reinstated as donors by contacting the donor counseling department of their regional Red Cross organization<ref>[http://www.tompkins-redcross.org/donor_req.htm Red Cross Donor Requirements]</ref>.

==Differential Diagnosis of Elevated ALT==
* Acute [[hepatitis]]
* [[Alcoholic]] hepatopathy
* [[Asenapine maleate]]
* [[Cholangitis]]
* [[Cholestasis]]
* [[Chronic active hepatitis]]
* [[Cirrhosis]]
* [[Dermatomyositis]]
* [[Drugs]]
**[[Amoxicillin]]
**[[Artemether and lumefantrin]]
**[[Asparaginase Erwinia Chrysanthemi]]
**[[Axitinib]]
**[[Aztreonam]]
**[[Bicalutamide]]
**[[Cefepime]]
**[[Cefprozil]]
**[[Ceftazidime]]
**[[Cefotaxime sodium]]
**[[Cladribine]]
**[[Crizotinib]]
**[[Doxorubicin Hydrochloride]]
**[[Eribulin]]
**[[Indinavir]]
**[[Interferon gamma]]
**[[Lacosamide]]
**[[Lamivudine]]
**[[Lincomycin Hydrochloride]]
**[[Meropenem]]
**[[Ritonavir]]
**[[Ruxolitinib]]
**[[Pertuzumab]]
**[[Pralidoxime]]
**[[Sorafenib]]
**[[Tigecycline]]
**[[Vedolizumab]]
* [[Epstein-Barr Virus]]
* [[Fatty liver]]
* [[Fulvestrant]]
* [[Hepatic tumor]]
* [[Hypothyroid]] myopathy
* [[Infliximab]]
* [[Malignant hyperthermia]]
* [[Malignancy]]
* [[Myocardial Infarction]]
* [[Myositis]]
* [[Open heart surgery]]
* [[Perimyocarditis]]
* [[Polymyositis]]
* [[Primary biliary cirrhosis]]
* Progressive myodystrophia
* [[Pulmonary Embolism]]
* [[Renal infarction]]
* [[Seizure]]
* Severe muscle [[trauma]]
* [[Spasm]]s, muscle injuries
* Strong physical work

==See also==
*[[Liver function tests]]

==References==
<references/>

==External links==
* {{MeshName|Alanine+transaminase}}


{{Transaminases}}
{{Glycolysis enzymes}}

[[Category:Chemical pathology]]
[[category:enzymes]]
[[Category:EC 2.6.1]]
[[Category:Hepatology]]
[[Category:Gastroenterology]]

[[de:Alanin-Aminotransferase]]
[[es:Alanina aminotransferasa]]
[[fr:Alanine amino transférase]]
[[nl:Alanineaminotransferase]]
[[ja:アラニンアミノ基転移酵素]]
[[pl:Aminotransferaza alaninowa]]
[[pt:Alanina aminotransferase]]
[[ru:Аланинаминотрансфераза]]
[[sv:Alaninaminotransferas]]
[[zh:谷丙转氨酶]]

{{WH}}
{{WS}}