From the Guidelines
Lactate dehydrogenase (LDH) is a crucial diagnostic marker used in various clinical settings, including the assessment of tissue damage, monitoring of malignant diseases, and evaluation of hemolysis. Elevated LDH levels are often observed in conditions such as myocardial infarction, liver disease, and certain types of cancer, including lymphoma and leukemia 1. The enzyme plays a significant role in cellular metabolism, and its levels can be measured to assess the extent of tissue damage or disease progression.
Key Applications of LDH
- Monitoring treatment efficacy: LDH levels are used to monitor the efficacy of treatments, such as chemotherapy, where LDH levels are measured at baseline and at regular intervals to assess treatment response 1.
- Prognosis: Elevated LDH levels are associated with a poor prognosis in certain types of cancer, such as melanoma and germ cell tumors 1.
- Diagnosis: LDH is used as a diagnostic marker for various conditions, including malignant diseases, tissue damage, and hemolysis 1.
Clinical Significance of LDH
The clinical significance of LDH lies in its ability to serve as a non-specific marker of tissue damage or disease. Elevated LDH levels can indicate the presence of various conditions, including cancer, liver disease, or myocardial infarction. However, the enzyme's lack of specificity requires careful interpretation of results in the context of clinical presentation and other diagnostic findings.
Measurement and Interpretation of LDH Levels
LDH levels can be measured using various assays, and the results are typically interpreted in conjunction with other clinical and laboratory findings. The enzyme's levels can be influenced by various factors, including the type of assay used, laboratory-specific reference ranges, and the presence of underlying conditions that affect LDH metabolism 1. In summary, LDH is a valuable diagnostic marker used in various clinical settings, including the assessment of tissue damage, monitoring of malignant diseases, and evaluation of hemolysis. Its levels can provide important information about disease prognosis, treatment efficacy, and diagnosis, but require careful interpretation in the context of clinical presentation and other diagnostic findings 1.
From the Research
Purpose of Lactate Dehydrogenase (LDH)
- Lactate dehydrogenase (LDH) is an enzyme that plays a crucial role in the metabolism of cells, catalyzing the conversion of pyruvate to lactate or lactate to pyruvate 2, 3, 4, 5, 6.
- LDH is involved in the glycolytic pathway and is a key enzyme in the metabolism of neoplastic cells, which are characterized by high glucose uptake and enhanced lactate production 5.
- Elevated LDH levels have been associated with various malignancies, including small cell lung cancer, breast cancer, and hematologic neoplasms, and are considered a negative prognostic biomarker 2, 3, 5, 6.
- LDH has been shown to promote immune suppression in the tumor microenvironment by altering the balance of immune cells, such as myeloid-derived suppressor cells, tumor-associated macrophages, and dendritic cells, and inhibiting cytolytic cells, such as natural killer cells and cytotoxic T-lymphocytes 5.
Clinical Applications of LDH
- LDH levels have been used as a diagnostic and prognostic marker in various diseases, including cancer, and have been shown to be associated with disease progression and survival 2, 3, 4, 6.
- LDH has been used to monitor treatment response in cancer patients, with changes in LDH levels reflecting the effectiveness of treatment 2, 6.
- Elevated LDH levels have been associated with a higher risk of disease progression and mortality, and have been used as a predictive marker for patient outcomes 3, 6.
Biomarker Potential of LDH
- LDH has been identified as a potential systems biomarker for various diseases, including hepatic encephalopathy and lung fibrosis, due to its high sensitivity and specificity 4.
- LDH has been shown to be a dynamic biomarker, with changes in LDH levels reflecting changes in disease activity and treatment response 6.
- The use of LDH as a biomarker has been proposed as a cost-effective and dynamic approach for monitoring disease progression and treatment response in cancer patients 6.