Acute phase response

from Wikipedia, the free encyclopedia

The acute phase response (APR) is a non-specific immune response of the body. It is an acute inflammatory reaction to tissue damage and serves to protect against tissue destruction or to maintain or restore homeostasis . It can occur with infections , tissue injuries, malignant diseases or disorders of the immune system and is the first phase of an inflammatory reaction.

In the Anglo-Saxon specialist literature, the term acute-phase response is used for the acute-phase response.

mechanism

The acute phase reaction can be triggered both locally and systemically . Cytokines such as interleukin-1 , interleukin-6 , TNF-α , TGF-β , interferon- γ, EGF and LIF , which are released by endothelial cells , fibroblasts , macrophages , granulocytes and lymphocytes , serve as messenger substances . These immunocompetent cells release the cytokines, for example after neighboring cells have been damaged or killed ( necrosis ). The cytokines reach the liver via the bloodstream , where, together with cortisol , they stimulate the organ to produce around 30 different acute phase proteins (APP). The APPs promote wound healing processes and counteract tissue damage. The acute phase proteins are important diagnostic markers . C-reactive protein, for example, is normally only found in traces in the blood plasma (<1 mg per liter, which corresponds to around 1 to 10 mg per day). In the event of inflammation, the value can increase up to a thousand times (> 1 gram per day).

The acute phase reaction can be triggered in all higher organisms and is evolutionarily highly conserved .

Effects of the acute phase response

The effects of the acute phase response are both local and systemic. The local effects should limit possible infections and eliminate xenobiotics . Dead or damaged cells are eliminated by phagocytosis and repair processes are initiated. In contrast, the systemic effects are defense reactions that are intended to ensure the survival of the entire organism, for example against endotoxins . The systemic effects include a number of "side effects", such as an increased body temperature, an increase in the white blood cell count, loss of appetite (anorexia) and depression . The levels of certain acute phase proteins go up while others go down. Furthermore, changes in fat metabolism , increased gluconeogenesis , hormonal changes, the activation of the complement and blood coagulation cascade , as well as an increased breakdown of muscle proteins - combined with an increased transfer of amino acids to the liver - can be observed.

history

The first surviving reports of the acute phase reaction come from ancient Greece . The ancient Greeks noted an accelerated sedimentation of erythrocytes in the blood of seriously ill patients. This effect is caused by increased plasma concentrations of fibrin and other acute phase proteins. The sedimentation reaction (erythrocyte sedimentation rate ) is still used as a non-specific laboratory test if there is a suspicion of inflammatory diseases or to assess the course of these diseases.

Theodore J. Abernethy and Oswald T. Avery coined the term “acute phase reaction” in 1941 when they discovered a protein in the serum of patients with febrile infections that they did not find in healthy patients. It was the C-reactive protein that Avery isolated and characterized together with Colin M. MacLeod .

literature

Reference books
Dissertations
Review article
  • NA Stephens et al .: Cachexia, survival and the acute phase response. In: Curr Opin Support Palliat Care 2, 2008, pp. 267-274. PMID 19060563
  • BJ Van Lenten et al .: Understanding changes in high density lipoproteins during the acute phase response. In: Arterioscler Thromb Vasc Biol 26, 2006, pp. 1687-1688. PMID 16857958
  • Z. Kmiec: Cooperation of liver cells in health and disease. In: Adv Anat Embryol Cell Biol 161, 2001, pp. 1-151. PMID 11729749
  • KL Streetz: Mediators of inflammation and acute phase response in the liver. In: Cell Mol Biol 47, 2001, pp. 661-673. PMID 11502073
  • AF Suffredini et al: New insights into the biology of the acute phase response. In: J Clin Immunol 19, 1999, pp. 203-214. PMID 10471974
  • BH Pannen and JL Robotham: The acute-phase response. In: New Horiz 3, 1995, pp. 183-197. PMID 7583160
  • H. Baumann and J. Gauldie: The acute phase response. In: Immunol Today 15, 1994, pp. 74-80. PMID 7512342
  • I. Kushner: The phenomenon of the acute phase response. In: Annals of the New York Academy of Sciences 389, 1982, pp. 39-48. PMID 7046585

Individual evidence

  1. ↑ a b H. HW Gabriel and others: The acute phase reaction. (PDF; 20 kB) In: German Journal for Sports Medicine 51, 2000, p. 31.
  2. ↑ a b P. C. Heinrich et al .: Interleukin-6 and the acute phase response. In: J Biochem 265, 1990, pp. 621-636. PMID 1689567 (Review)
  3. ↑ a b c A. Reinicke: Acute phase reaction after cardiopulmonary resuscitation. Dissertation, Medical Faculty of the Charité - Universitätsmedizin Berlin, 2004
  4. ^ Giuliano Ramadori and B. Christ: Cytokines and the hepatic acute-phase response. In: Semin Liver Dis 19, 1999, pp. 141-155. PMID 10422197 (Review)
  5. ↑ H. Baumann and J. Gauldie: The acute phase response. In: Immunology Today 15, 1994, pp. 74-80. PMID 7512342 (Review)
  6. ↑ A. Koj: Initiation of acute phase response and synthesis of cytokines. In: Biochimica et Biophysica Acta 1317, 1996, pp. 84-94. PMID 8950192 (Review)
  7. ^ JG Raynes: The acute phase response. In: Biochemical Society Transactions 22, 1994, pp. 69-74. PMID 7515833 (Review)
  8. ^ A. Bathen-Nöthen: Concentrations of Acute-Phase Proteins in Dogs with Steroid Responsive Meningitis-Arteritis. Dissertation, University of Veterinary Medicine Hannover, 2008
  9. ↑ H. Moshage: Cytokines and the hepatic acute phase response. In: J Pathol 181, 1997, pp. 257-266. PMID 9155709 (Review)
  10. ↑ R. Fahraeus: The suspension stability of blood. In: Acta Med Scand 55, 1921, p. 1.
  11. ↑ HC Sox and MH Liang: The erythrocyte sedimentation rate. Guidelines for rational use. In: Ann Intern Med 104, 1986, pp. 515-523. PMID 3954279
  12. ^ HE Paulus and E. Brahn: Is erythrocyte sedimentation rate the preferable measure of the acute phase response in rheumatoid arthritis? In: J Rheumatol 31, 2004, pp. 838-840. Review. PMID 15124238 (Review)
  13. ↑ TJ Abernethy and OT Avery: The occurrence during acute infections of a protein not normally present in the blood: I. distribution of the reactive protein in patients' sera and the effect of calcium flocculation reaction with c polysaccharide of pneumococcus. In: J Exp Med 73, 1941, pp. 173-182.
  14. ↑ CM MacLeod and OT Avery: The occurrence during acute infections of a protein not normally present in the blood: II. Isolation and properties of the reactive protein. In: J Exp Med 73, 1941, pp. 183-190.
  15. ↑ CM MacLeod and OT Avery: The occurrence during acute infections of a protein not normally present in the blood: III. immunological properties of the C-reactive protein and its differentiation from normal blood proteins. In: J Exp Med 73, 1941, pp. 191-200.