Acute Inflammation Flashcards
1
Q
Acute phase protein (APP) defined as
A
- Protein whose concentration increases (pos. APP) or decreases (neg. APP) by 25% or more during inflammatory processes or disorder
2
Q
Acute phase proteins (APP) synthesized where
A
- Most synthesized in the liver (except gamma globulins; from plasma cells)
3
Q
APP regulated by
A
- Inflammatory cytokines *IL-6, IL-1Beta, TNF-alpha - Most regulated primarily at transcriptional level, but some post-transcriptional and transnational changes as well
4
Q
Clinical relevance of APP
A
- Reflect the presence and intensity of an inflammatory process - Useful as a diagnostic aid, helping to differentiate inflammatory from non-inflammatory conditions
5
Q
APP that rise the most after inflammatory stimulus
A
- C-reactive protein - Serum amyloid A
6
Q
Serum vs. Plasma
A
- Plasma still has active clotting factors *Inactivating them leaves you with serum
7
Q
Alpha 1 globulin
A
- alpha1- Antitrypsin
8
Q
Alpha 1/Alpha 2 globulins
A
- Ceruloplasmin
9
Q
Alpha 2 globulins
A
- Haptoglobin - alpha 2-macroglobulin
10
Q
Beta 1 globulin
A
- Transferrin
11
Q
Beta 2 globulin
A
- Fibrinogen
12
Q
Globulins increased during infection
A
- alpha 1 - alpha 2
13
Q
Alpha 1 antitrypsin deficiency
A
- Emphysema (adults) - cirrhosis (juvenile)
14
Q
C-reactive protein (CRP) elevated during
A
- Chronic inflammatory conditions - Cancer
15
Q
CRP regulation
A
- At the transcriptional level: IL-6 induces, other cytokines act synergistically to increase response
16
Q
CRP functions
A
- part of innate immune response - Ca++ dependent binding of phosphocholine (PCh) *PCh present on cell membranes of bacterial and fungal pathogens - Binds nuclear components of apoptotic or necrotic cells - Ligand-bound CRP is bound by C1q and activates the classical complement pathway - CRP may also help recruit phagocytes by binding Fc receptors
17
Q
Lower elevated levels of CRP are associated with
A
- Increase cardiovascular risk
18
Q
Serum amyloid A structure
A
- Family of apolipoproteins, some acute phase reactants, some constitutive - Contains alpha helix w/ beta pleated sheets
19
Q
SAA regulation
A
- Levels increase within hours of stimulus - Magnitude of increase may be larger than CRP - Induced by synergistic action of cytokines *IL-1, IL-6
20
Q
SAA function
A
- Precursor of amyloid A protein, major component of secondary amyloid plaques - Associates w/ HDL, replacing apolipoprotein A-1 *This is going to induce reverse cholesterol transport - Reduces storage of cholesterol esters in macrophages (decrease foam cells)
21
Q
Altered properties of acute phase HDL
A
- Cleared from the circulation more rapidly - 5x increased binding to macrophages - Enhanced uptake of HDL by macrophages
22
Q
Fibrinogen regulation
A
- Made in hepatocytes - Moderate APP - induced by IL-6, glucocorticoids, oncostatin-M Abundant in plasma, elongated shape, greatest effect on ESR - Allows the platelet to coagulate