Protein electrophoresis (SPE) Methodology and interpretation of results

Serum Protein Electrophoresis (SPE) is an important blood test that helps doctors detect changes in protein levels in the body and understand the causes of many medical conditions, such as immune system disorders, liver disease, kidney disease, and anemia. Through this test, physicians can determine the proportions of different blood proteins—such as albumin and globulins—and identify any abnormal increases or decreases that may indicate health conditions requiring treatment or follow-up.If you are looking for a clear interpretation of test results, the causes of high or low protein levels, or the precise medical uses of this test, this Daleely Medical article serves as a comprehensive guide that explains everything you need to know.

What Is Protein Electrophoresis (SPE)?

Serum Protein Electrophoresis (SPE) is a blood test that identifies and separates different types of proteins in the blood serum into the following fractions:

Albumin
Alpha-1 Globulins
Alpha-2 Globulins
Beta Globulins
Gamma Globulins

This test helps physicians diagnose blood disorders, immune system abnormalities, liver and kidney diseases, as well as conditions involving abnormal increases or decreases in blood proteins.

When Is SPE Requested?

SPE is commonly used to detect or evaluate:

Autoimmune diseases such as lupus or rheumatoid arthritis
Plasma cell disorders, including Multiple Myeloma
Chronic liver or kidney diseases
Immune deficiency or abnormal protein loss due to certain conditions

Does SPE Require Fasting?

❌ Fasting is usually not required, unless SPE is performed alongside other tests such as lipid profile or liver function tests that require fasting.

How Is Protein Electrophoresis Performed?

A venous blood sample is drawn.
Serum is separated from blood cells.
The sample is placed on a special gel or slide.
An electric current is applied to separate proteins based on size and electrical charge.
Results are analyzed to determine the percentage of each protein fraction.

Is SPE Dangerous?

❌ SPE is completely safe. Possible minor side effects include:

Mild pain or needle prick during blood draw
Small bruise or slight bleeding at the puncture site
Temporary dizziness in some individuals

What Do SPE Results Mean?

Elevated Gamma Globulins: May indicate chronic immune disorders or plasma cell abnormalities
Low Albumin: Can suggest liver disease, kidney disease, or malnutrition
M-protein (Monoclonal) spike: May indicate multiple myeloma or other monoclonal gammopathies

???? Results help the physician decide whether further tests are needed for confirmation and treatment planning.

Difference Between Total Protein Test and SPE

Total Protein Test: Measures the overall amount of protein in the blood
SPE: Identifies individual protein types and their proportions, detecting subtle disease-related changes

Can Children Undergo SPE?

✔️ Yes. The test can be performed in children using a smaller blood sample, and results are interpreted based on age and health status.

Do Medications Affect SPE Results?

✔️ Yes. Certain medications and supplements may affect results, including:

Immunosuppressive drugs (e.g., corticosteroids, azathioprine)
Nutritional supplements (e.g., vitamin B12, zinc)

⚠️ Always inform your doctor about all medications and supplements before testing.

How Long Do Results Take?

⏱️ Usually 1–3 days, depending on the laboratory. Some labs offer faster results if urgently needed.

Does SPE Detect All Protein Disorders?

❌ No. SPE provides an overview of protein changes but may not diagnose all conditions definitively. Additional tests may be required.

Can Results Be Normal Despite Disease?

✔️ Yes. Early stages of immune disorders or plasma cell tumors may show partially normal results, which is why periodic follow-up may be recommended.

Difference Between SPE and Antibody Tests

SPE: Measures overall protein fractions
Antibody tests: Focus on specific immune proteins

⚠️ Both tests are often used together for comprehensive immune evaluation.

Can SPE Be Repeated?

✔️ Yes, especially for monitoring disease progression or treatment response in immune disorders or chronic liver disease.

Does SPE Diagnose Anemia?

✔️ SPE may suggest abnormalities in proteins related to iron transport or immunity, but it does not directly diagnose anemia. Additional blood tests are required.

Does Pregnancy Affect SPE Results?

✔️ Yes. Pregnancy may temporarily increase Alpha-1 and Alpha-2 Globulins, so results must be interpreted in the context of pregnancy.

Should Certain Medications Be Stopped Before the Test?

✔️ Some drugs may influence results, such as:

Corticosteroids and immunosuppressants
Thyroid medications or certain antibiotics

⚠️ Always consult your doctor before stopping any medication.

Does SPE Detect Cancer?

❌ SPE does not directly diagnose cancer, but abnormal increases in Gamma Globulins or M-protein may suggest plasma cell tumors like multiple myeloma and warrant further testing.

Is SPE Painful?

❌ Most people experience only a brief needle prick, with discomfort resolving immediately.

Can SPE Be Done in Infants?

✔️ Yes. The test can be performed in infants using minimal blood volume, and results are interpreted according to age and development.

Types of Proteins Identified in SPE

Albumin

Makes up more than half of blood proteins
Maintains oncotic pressure and prevents fluid leakage from blood vessels

Alpha-1 Globulins

Produced in the liver and lungs
Increase during inflammatory conditions

Alpha-2 Globulins

Play roles in inflammation and immune response

Beta Globulins

Support immunity and infection control
Elevated in:
- Atherosclerosis
- High cholesterol
- Multiple myeloma

Gamma Globulins

Essential for immune defense
Elevated in:
- Multiple myeloma
- Autoimmune diseases such as lupus and rheumatoid arthritis

???? SPE helps detect abnormal protein patterns and enables early diagnosis of immune, liver, kidney, and blood disorders.

Major Uses of Serum Protein Electrophoresis (SPE)

1. Diagnosis of Blood and Immune Disorders

Multiple Myeloma: Characteristic M-protein spike
MGUS: Limited monoclonal protein requiring monitoring
Chronic autoimmune diseases: Abnormally elevated gamma globulins

2. Detection of Liver Disease

Low albumin indicates impaired liver function
Elevated globulins may indicate chronic hepatitis or cirrhosis

3. Evaluation of Kidney Disease

Albumin loss or abnormal protein excretion may indicate renal disease
Helps identify the type of protein loss

4. Assessment of Chronic Inflammation

Elevated Alpha-1 and Alpha-2 globulins suggest chronic inflammation

5. Monitoring Treatment Response

Used to track immune disorders and protein-producing tumors

6. Detection of Protein Deficiency or Imbalance

Low albumin: malnutrition, liver or kidney disease
Low globulins: immune deficiency

7. Differential Diagnosis

Helps distinguish between immune disorders, tumors, and chronic protein abnormalities in patients with:

Fatigue
Weight loss
Swelling
Recurrent infections

Requirements Before SPE Testing

1. Inform the Doctor About Medications

Drugs that may affect results include:

Immunosuppressants (corticosteroids, azathioprine, cyclosporine)
Thyroid medications
Nutritional supplements (vitamin B12, zinc, protein supplements)

2. General Health Status

Patient should be clinically stable
Inform the doctor about:
- Acute infections
- Active bleeding
- Chronic liver or kidney disease

3. Fasting

Usually not required unless combined with other tests

4. Psychological Preparation

Relaxation and deep breathing may help reduce anxiety during blood draw

Sample Collection Conditions

Use sterile equipment
Collect blood in the appropriate tube
Maintain proper temperature during transport

After SPE Testing

Resume normal activities immediately
Monitor the puncture site for redness, swelling, or bleeding
Inform the doctor of any new medications

If results are abnormal, the doctor may recommend:

Additional protein tests
Liver or kidney function tests
Antibody tests or bone marrow examination if needed

Steps of Serum Protein Electrophoresis (SPE)

1. Sample Collection

A venous blood sample is drawn using a small sterile needle
In children, a finger-prick sample may be used
Strict sterile techniques are followed to prevent infection

2️⃣ Sample Preparation

Blood serum is separated from blood cells using a centrifuge.
The serum is stored in a sterile tube until it is transferred to the laboratory.
If transport takes a long time, the sample is kept in a cool place or refrigerated.

3️⃣ Protein Electrophoresis

The sample is placed on a special gel or an electrophoresis slide.
An electric current is applied, causing proteins to move according to their electrical charge and size.
Proteins are separated into five main groups:
- Albumin
- Alpha-1 Globulins
- Alpha-2 Globulins
- Beta Globulins
- Gamma Globulins

4️⃣ Result Analysis

The analyzer generates a graph showing the proportion of each protein fraction.
Results provide information about:
- The presence or deficiency of proteins
- Sometimes the concentration level of each protein group
The test helps physicians diagnose blood disorders, immune diseases, liver and kidney conditions, and monitor treatment response.

5️⃣ Turnaround Time

Results usually appear within 1–3 days, depending on the laboratory.
Some labs provide faster results if the test is urgent.

6️⃣ After the Test

No special precautions are usually required.
The patient can resume normal activities immediately.
If unusual symptoms such as redness or swelling at the blood draw site occur, the doctor should be informed promptly.

Risks of Serum Protein Electrophoresis (SPE)

1️⃣ Mild pain or needle prick

Most people feel slight pain or a prick during needle insertion.
The discomfort resolves immediately after the needle is removed.

2️⃣ Bruising or minor bleeding

A small bruise or mild bleeding may appear at the puncture site.
This usually disappears within 2–3 days.

3️⃣ Dizziness or fainting

Some individuals may feel dizzy or briefly faint during or after blood collection.
Resting and drinking water usually help relieve symptoms.

4️⃣ Minor infection (very rare)

Infection may occur if non-sterile equipment is used.
In modern laboratories, this risk is extremely low since sterile, single-use tools are applied.

5️⃣ Effect of medications or medical conditions on results

The test itself is safe, but certain medications or chronic diseases may affect result accuracy, such as:
- Immunosuppressive drugs or dietary supplements
- Chronic liver or kidney diseases

Causes of Low Protein Levels in SPE

1️⃣ Low Albumin
Causes include:

Chronic liver diseases (cirrhosis, chronic hepatitis)
Kidney diseases causing protein loss in urine
Malnutrition or low protein intake
Protein loss from the gastrointestinal tract (inflammatory bowel diseases)

2️⃣ Low Alpha-1 Globulins

Rare genetic disorders or chronic liver disease

3️⃣ Low Alpha-2 Globulins

Hemolytic anemia, severe liver disease, or severe malnutrition

4️⃣ Low Beta Globulins

Protein loss due to liver or kidney disease, or immune deficiency

5️⃣ Low Gamma Globulins (Immunoglobulins)

Indicates weakened immunity or reduced antibody production
Causes include congenital or acquired immunodeficiency, protein loss via kidneys or gastrointestinal tract

6️⃣ Low Total Protein
Occurs when most protein fractions are decreased, due to:

Chronic liver disease
Kidney disease
Malnutrition
Severe infections or acute inflammation

SPE Result Interpretation

1️⃣ Albumin

Function: Maintains blood pressure and transports substances
Normal: 50–60% of total proteins
Low: Liver disease, kidney failure, malnutrition
High: Rare; usually due to dehydration

2️⃣ Alpha-1 Globulins

Function: Inflammatory proteins and enzymes
High: Acute or chronic inflammation
Low: Rare genetic disorders

3️⃣ Alpha-2 Globulins

Function: Protective proteins such as haptoglobin
High: Chronic inflammation or liver disease
Low: Hemolytic anemia or liver dysfunction

4️⃣ Beta Globulins

Function: Iron transport proteins and part of antibodies
High: Liver disease, chronic inflammation, iron overload
Low: Malnutrition or protein loss

5️⃣ Gamma Globulins (Immunoglobulins)

Function: Antibodies of the immune system
High: Chronic immune diseases or plasma cell disorders (e.g., multiple myeloma)
Low: Immunodeficiency or reduced antibody production

6️⃣ Abnormal Patterns

M-protein peak: Sharp spike in gamma region → may indicate multiple myeloma or other plasma cell disorders
General protein deficiency: Low albumin and globulins → liver disease, malnutrition, or protein loss
Diffuse globulin increase: Chronic inflammation or autoimmune diseases

Causes of High Protein Levels in SPE

1️⃣ High Albumin

Very rare and usually temporary
Caused by dehydration, severe blood loss, or prolonged diarrhea

2️⃣ High Alpha-1 Globulins

Acute or chronic inflammation
Liver disease
Sometimes elevated during pregnancy

3️⃣ High Alpha-2 Globulins

Chronic inflammation
Chronic hepatitis
Autoimmune diseases
Hemolytic anemia

4️⃣ High Beta Globulins

Chronic liver disease
Chronic inflammation
Iron overload (hemochromatosis)

5️⃣ High Gamma Globulins

One of the most common SPE abnormalities
Seen in chronic immune diseases (e.g., lupus, rheumatoid arthritis)
Chronic infections (lung or liver infections)
Plasma cell disorders (multiple myeloma, MGUS)
Note: Often appears as a sharp M-protein peak, indicating a monoclonal abnormal protein.