Serologic Examination of the Biochemical Mediators (P) Flashcards
Why does normal serum constituents increase rapidly?
Due to:
1) Infection
2) Injury or
3) Tissue trauma
What is the % of increase of normal serum constituents (due to infection, injury, or tissue trauma)?
These normal serum constituents increase rapidly by at least 25%
What type of cells produces acute-phase reactants?
Hepatocytes
What is the other term for hepatocytes?
Liver parenchymal cells
When does hepatocytes release acute phase reactants?
In response to an increased cytokines
What are the cytokines that are responded by acute phase reactants (being produced by hepatocytes)?
1) IL-6
2) IL-1B
3) TNF-a
4) Macrophage inhibitory protein
What are the functions of acute-phase reactants?
1) These enhances the phagocytosis of antigen
2) These serves as biomarkers for the diagnosis of inflammatory disease
3) These serves as indicators of successful organ transplant
4) These predicts the ameliorative effect of cancer therapy
Provide an example of acute-phase reactants
C-Reactive Protein (CRP)
How many are CRP?
< 10 mg/L
What are the functions of CRP?
1) It increases rapidly within 4 - 6 hrs following infection, surgery, or other trauma of the body, levels peak value within 48 hrs
2) It declines rapidly w/ cessation of stimulus
3) It serves as indicator of an acute inflammation
4) Functions for opsonization
5) It promotes phagocytosis
What is the principle of opsonization (for CRP)?
It binds to phosphocholine, phospholipids, peptidoglycan, ribonuclear proteins (bacteria, fungi, parasites)
What is the principle of phagocytosis (for CRP)?
It binds to specific receptors on monocytes, macrophages, and neutrophils
What are the diagnostic methods (or clinical significances) of acute-phase reactants (or CRP?)?
1) Agglutination
2) Precipitation
3) Activation of complement by classical pathway
4) Used to monitor the treatment of inflammation and infection
5) Used to follow the course of organ transplant
What serves (or principle) as indicator of organ rejection?
If the acute-phase reactants (or CRP?) is increased in lvl
What is the meaning of ESR?
Erythrocyte Sedimentation Rate
What is the main biological sign of inflammation?
Increased ESR
What is ESR?
It is the rate at w/c RBCs in anticoagulated whole blood descend or packed in a standardized tube over a period of 1 hr
What is the time period for ESR?
Over a period of 1 hr
Is ESR a specific measure of inflammation?
No, because ESR is a non-specific measure of inflammation
What is the normal range of ESR for males?
0 - 10 mm/hr
What is the normal range of ESR for females?
0 - 20 mm/hr
What is the relevance of plasma concentration (of ESR) of acute-phase reactants to inflammation?
In addition to ESR, measurement of the plasma concentration of acute-phase reactants is usually a good indicator of local inflammatory activity and tissue damage
What are the clinical significances of ESR?
1) Autoimmune diseases
- > Rheumatoid arthritis (RA)
- > Systemic Lupus Erythematosus (SLE)
2) Cancer
3) Infections
4) Muscular or connective tissue problem such as polymyalgia rheumatica
5) Chronic inflammatory disease
What is the principle of precipitation and agglutination?
These are the visible expression of the aggregation of AGs and ABs through the formation of a framework in w/c AG particles or molecules alternate w/ AB molecules
What is precipitation?
It is the term for agglutination of soluble test AGs
What is the principle of agglutination?
It is the combination of soluble AG w/ soluble AB to produce a visible insoluble complex
What is the principle of agglutination (in terms of rxn)?
It is the process whereby sp AGs aggregate to form larger visible clumps when the corresponding sp AB is present in the serum
What are the components present in precipitation test?
1) AGs (soluble)
2) Zone of equivalence (visible ppt)
3) ABs
What are the 2 types of agglutination rxn?
1) Direct agglutination rxn
2) Indirect agglutination rxn
What is the principle of CRP latex agglutination test?
1) It is based on the rxn between pt serum containing CRP as the AG and the corresponding antihuman (CRP) AB coated to the treated surface of latex particles
2) The coated particles enhance the detection of an agglutination rxn when AG is present in the serum being tested
3) Titer of the CRP lvl can be demonstrated by serial dilution method of the pt serum by distilled H2O
What are the clinical applications (or clinical significances) of CRP latex agglutination test (or CRP?)?
1) Detecting inflammatory diseases particularly infections
2) It is also used as a useful indicator in screening for organic disease
3) Inflammatory and malignant disease
4) Monitoring therapy in inflammatory diseases
5) Assays of CRP are the measurement of choice in suspected inflammatory conditions
What are the 2 types of rxns for CRP latex agglutination test?
1) Positive rxn
2) Negative rxn
What is the principle of (+) rxn (of CRP latex agglutination test)?
Agglutination of the latex suspension is a (+) result. A (+) rxn is reported when the undiluted sx or the 1:5 diluted sx demonstrates agglutination, or when both exhibit agglutination
What is the principle of (-) rxn (of CRP latex agglutination test)?
The absence of visible agglutination and the presence of opaque fluid constitute a (-) rxn. A (-) rxn is reported only when both the undiluted sx and the 1:5 diluted sx exhibit no visible agglutination
What is Serum Amyloid A?
1) It is an apolipoprotein synthesized in the liver
2) It is associated w/ HDL cholesterol
3) It cleans up the area of tissue injury by removing cholesterol from cholesterol-filled macrophages
4) It facilitates recycling of cell membrane cholesterol and phospholipids for reuse
5) It is significantly increased in bacterial infections than in viral infection
Is serum amyloid A an acute-phase reactant?
Yes
What is Mannose-Binding Protein / Mannose-Binding Lectin?
1) It is calcium-dependent opsonin
2) It recognizes mannose and other carbohydrates found primarily in bacteria, some yeasts, viruses, and several parasites
3) It is widely distributed to mucosal surfaces
4) It is similar to complement protein C1q, binding activates complement cascade and promote phagocytosis
Is mannose-binding protein / mannose-binding lectin an acute-phase reactant?
Yes
What is Alpha1 - Antitrypsin?
1) It is a plasma inhibitor of proteases released from WBC especially Elastase (elastin and collagen)
2) It counteracts the effects of neutrophil invasion during inflammation
3) It regulates expression of proinflammatory cytokines (TNF-a, IL B / IL 1B(?), IL 6)
4) It reacts w/ serine protease triggering of the complement cascade or fibrinolysis
What is elastase?
It is composed of elastin and collagen
