Acute-phase reaction

Fever. Table 2 Some characteristic physiological responses to infectious pathogens or their products (the acute-phase reaction )... 

Zinc (Zn) deficiency is teratogenic in rats, and fetal skeletal defects are prominent. Embryofetal zinc deficiency secondary to changes induced by substances in maternal Zn metabolism is a well-established mechanism for developmental toxicity (29-31). Several substances, including urethane and alpha-hederin cause similar malformations as Zn deficiency in rodents. A number of mechanistic studies have shown that these substances act via an acute-phase reaction induction of metallothionein in the maternal liver which binds systemically available Zn in the pregnant animal. This results in a systemic redistribution of Zn. As a consequence the substances produce a transient but developmentally adverse Zn deficiency in the... 

Brogan et al. have studied CD62E+ and CD 105+ EMPs and PMPs in pediatric systemic vasculitis (PSV) [85]. An elevation in CD62E+ EMPs and, to a lesser extent, CD 105+ EMPs in patients with PSV over patients who underwent remission, control, or febrile controls was observed. EMPs correlated with vasculitis activity and the presence of acute phase reaction products in PSV however, there was no correlation between those parameters in febrile controls. The elevation in EMPs provides further evidence of the role of EC injury in acute PSV. Moreover, the presence of CD62E+ EMP indicates that EC activation may underlie the endotheliopathy in PSV. 

Patients with nephrotic syndrome often have markedly increased erythrocyte sedimentation rate (ESR) owing to high levels of fibrinogen. Thus, high ESR in nephrotic patients does not necessarily mean acute-phase reaction. 

TNF-a is a cytokine involved in systemic inflammation and is a member of a group of cytokines that stimulate the acute-phase reaction. 

Acute-phase proteins are a class of proteins whose plasma concentrations increase (positive acute-phase proteins) or decrease (negative acute-phase proteins) in response to inflammation. This response is called the acute-phase reaction (or acute-phase response). In response to injury, local inflammatory cells secrete a number of cytokines into the bloodstream, the most notable of which are the interleukins (IL-1, IL-6, IL-8) and TNF-a. The liver responds by producing a large number of acute-phase reactants or reducing the production of others. 

Moszczynski P, Bern S, Moszczynski P Jr, et al. 1990a. The indices of immunity and acute phase reaction according to duration of exposure to mercury vapors in men. Med Pr 41(3) 169-174. (Polish)... 

Rates of hepatic synthesis of many plasma proteins are affected by a patient s endocrine status. The effects of some steroid hormones on individual plasma protein levels are given in Table 20-5. The plasma protein levels characteristic of a specific disease may therefore be complicated by the steroid status of a patient and by an inflammatory acute phase reaction. The abnormal steroid status may be the result of an intrinsic hormonal disorder or of treatment with steroid hormones, as in inflammation. 

Presumably the APR aU play a part in the very complex defensive process of inflammation, particularly in complement activation and in control of enzyme activity. The acute phase reaction is a nonspecific reaction to inflammation, comparable with the increase in temperature or leukocyte count, and is not diagnostic for any given disease. Most of the changes are triggered by cytokines released from the site of injury (see Chapter 22). 

Urinary or Gastrointestinai Loss. Because of its small size, AAT diffuses into the glomerular urine and into the gastrointestinal tract however, AAT is not seen in the excreted urine unless there is damage to the proximal tubular cells or marked overflow proteinuria, as in the nephrotic syndrome. In the latter case, the serum level of AAT may be depressed, especially in the absence of an acute phase reaction. AAT is normally present in the excreted stool, mostly compiexed to pancreatic trypsin and elastase. In protein-losing enteropathies, the loss may be greatly increased. 

IL-lR knockout mice show a similar phenotype to that observed in IL-lj3 knockout mice (365, 366). Both mutations have revealed the role that IL-1 plays in IL-6 production and fever. In addition, IL-IR knockout mice had a reduced delayed-type hypersensitivity (DTK) response and acute-phase reaction to turpentine. These mice showed an impaired ability to fight infections by Listeria monocytogenes (365). In addition, IL-lR is required for the development of inflammatory lesions and clinical symptoms in a mouse model of EAE (367). 

The requirements for trace elements during nutritional support of ARF patients are not well established because trace element accumulation or losses during ARF have not been characterized. Additionally, many of the trace element alterations in ARF may in fact represent an acute phase reaction. " Zinc and chromium are excreted by the kidney and theoretically can accumulate due to reduced excretion and increased intake secondary to impurities in dialysate or intravenous fluids. In ARF patients undergoing CRRT, zinc intake via nutrition support has been shown to exceed patient losses. Selenium concentrations are... 

Serum caeruloplasmin. The normal adult levels are 2(M)-6(K) mg/1. Caeruloplasmin is increased greatly in the acute phase reaction, and in some cases may be so high as to raise the total copper concentration to 30-45 Jmol/l. Caeruloplasmin levels may be helpful in the interpretation of serum copper concentrations. 

Fulop, A. K. et al. 2001. Hepatic regeneration induces transient acute phase reaction Systemic elevation of acute phase reactants and soluble cytokine receptors. Cell Biology International 25 585-592. 

Scherer, R., M. Abd-El-Fattah, and G. Ruthenstroth-Bauer. 1977. Some applications of quantitative two-dimensional immunoelectrophoresis in the study of the systemic acute-phase reaction of the rat. In Perspectives in inflammation, future trends and developments, ed. 

The adverse side effects of bisphosphonates are renal toxicity, acute-phase reactions, gastrointestinal toxicity, hypocalcemia, ocular complications, asthma erythema, phlebitis, altered taste, and central nervous system side effects. The osteonecrosis of the jaw is the emerging one (Diel et ah, 2007 Tanvetyanon and Stiff, 2006). To overcome this kind of problem, researchers are now turning toward nature-based drugs. 

Steen H, Giannitsis E, Sommerer C, Bahner U, Brandi M, Merbach C, Merten C, Ritz E, Katus HA, Zeier M, Schwenger V. Acute phase reaction to gad-olinium-DTPA in dialysis patients. Nephrol Dial Transplant 2009 24 1274-7. 

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