WordNet

arrange in phases or stages; "phase a withdrawal"
(physical chemistry) a distinct state of matter in a system; matter that is identical in chemical composition and physical state and separated from other material by the phase boundary; "the reaction occurs in the liquid phase of the system" (同)form
a particular point in the time of a cycle; measured from some arbitrary zero and expressed as an angle (同)phase_angle
any distinct time period in a sequence of events; "we are in a transitional stage in which many former ideas must be revised or rejected" (同)stage
adjust so as to be in a synchronized condition; "he phased the intake with the output of the machine"
(astronomy) the particular appearance of a bodys state of illumination (especially one of the recurring shapes of the part of Earths moon that is illuminated by the sun); "the full phase of the moon"
of critical importance and consequence; "an acute (or critical) lack of research funds"
having or demonstrating ability to recognize or draw fine distinctions; "an acute observer of politics and politicians"; "incisive comments"; "icy knifelike reasoning"; "as sharp and incisive as the stroke of a fang"; "penetrating insight"; "frequent penetrative observations" (同)discriminating, incisive, keen, knifelike, penetrating, penetrative, piercing, sharp
extremely sharp or intense; "acute pain"; "felt acute annoyance"; "intense itching and burning" (同)intense
having or experiencing a rapid onset and short but severe course; "acute appendicitis"; "the acute phase of the illness"; "acute patients"
of an angle; less than 90 degrees
a chemical substance that is present at the start of a chemical reaction

PrepTutorEJDIC

(変化・発達の)『段階』,『局面』 / (物事の)『面』,様相《+『of』+『名』》 / (月・惑星などの)相 / …‘を'段階的に調整(整理)する
(先の)『鋭い』,とがった / (痛み・感情などが)『激しい』,強い / (知力・感覚などが)『鋭い』,鋭敏な / (事態が)重大な / (病気が)急性の / (音が)高い,鋭い / 鋭角の
反応物(化学反応を受ける物質)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/06/28 13:14:47」(JST)

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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 (also called acute-phase response).

Inflammatory cells and red blood cells

In response to injury, local inflammatory cells (neutrophil granulocytes and macrophages) secrete a number of cytokines into the bloodstream, most notable of which are the interleukins IL-1, IL-6 and IL-8, and TNF-α. The liver responds by producing a large number of acute-phase reactants. At the same time, the production of a number of other proteins is reduced; these are, therefore, referred to as "negative" acute-phase reactants. Increased acute phase proteins from the liver may also contribute to the promotion of sepsis.^{[citation needed]}

Positive

Positive acute-phase proteins serve (part of the innate immune system) different physiological functions for the immune system. Some act to destroy or inhibit growth of microbes, e.g., C-reactive protein, mannose-binding protein,^[1] complement factors, ferritin, ceruloplasmin, Serum amyloid A and haptoglobin. Others give negative feedback on the inflammatory response, e.g. serpins. Alpha 2-macroglobulin and coagulation factors affect coagulation, mainly stimulating it. This pro-coagulant effect may limit infection by trapping pathogens in local blood clots.^{[citation needed]} Also, some products of the coagulation system can contribute to the innate immune system by their ability to increase vascular permeability and act as chemotactic agents for phagocytic cells.

"Positive" acute-phase proteins:
Protein	Immune system function
C-reactive protein	Opsonin on microbes ^[2]
Serum amyloid P component	Opsonin
Serum amyloid A	Recruitment of immune cells to inflammatory sites Induction of enzymes that degrade extracellular matrix
Complement factors	Opsonization, lysis and clumping of target cells. Chemotaxis
Mannan-binding lectin	Mannan-binding lectin pathway of complement activation
Fibrinogen, prothrombin, factor VIII, von Willebrand factor	Coagulation factors, trapping invading microbes in blood clots. Some cause chemotaxis
Plasminogen	Degradation of blood clots
Alpha 2-macroglobulin	Inhibitor of coagulation by inhibiting thrombin.^[3] Inhibitor of fibrinolysis by inhibiting plasmin
Ferritin	Binding iron, inhibiting microbe iron uptake
Hepcidin^[4]	Stimulates the internalization of ferroportin, preventing release of iron bound by ferritin within intestinal enterocytes and macrophages
Ceruloplasmin	Oxidizes iron, facilitating for ferritin, inhibiting microbe iron uptake
Haptoglobin	Binds hemoglobin, inhibiting microbe iron uptake
Orosomucoid (Alpha-1-acid glycoprotein, AGP)	Steroid carrier
Alpha 1-antitrypsin	Serpin, downregulates inflammation
Alpha 1-antichymotrypsin	Serpin, downregulates inflammation

Negative

"Negative" acute-phase proteins decrease in inflammation. Examples include albumin,^[5] transferrin,^[5] transthyretin,^[5] retinol-binding protein, antithrombin, transcortin. The decrease of such proteins may be used as markers of inflammation. The physiological role of decreased synthesis of such proteins is generally to save amino acids for producing "positive" acute-phase proteins more efficiently. Theoretically, a decrease in transferrin could additionally be decreased by an upregulation of transferrin receptors, but the latter does not appear to change with inflammation.^[6]

Clinical significance

Measurement of acute-phase proteins, especially C-reactive protein, is a useful marker of inflammation in both medical and veterinary clinical pathology. It correlates with the erythrocyte sedimentation rate (ESR), however not always directly. This is due to the ESR being largely dependent on elevation of fibrinogen, an acute phase reactant with a half-life of approximately one week. This protein will therefore remain higher for longer despite removal of the inflammatory stimuli. In contrast, C-reactive protein (with a half-life of 6-8 hours) rises rapidly and can quickly return to within the normal range if treatment is employed. For example, in active systemic lupus erythematosus, one may find a raised ESR but normal C-reactive protein.

They may also indicate liver failure.^[7]

References

^ B L Herpers, H Endeman, B A W de Jong, B M de Jongh, J C Grutters, D H Biesma, and H van Velzen-Blad. Acute-phase responsiveness of mannose-binding lectin in community-acquired pneumonia is highly dependent upon MBL2 genotypes. Clin Exp Immunol. 2009 Jun;156(3):488-94. PMID 19438602
^ Lippincott's Illustrated Reviews: Immunology. Paperback: 384 pages. Publisher: Lippincott Williams & Wilkins; (July 1, 2007). Language: English. ISBN 0-7817-9543-5. ISBN 978-0-7817-9543-2. Page 182
^ Boer, JP, Creasey, AA, Chang, A, Abbink, JJ et al. (1993). "Alpha-2-macroglobulin functions as an inhibitor of fibrinolytic, clotting, and neutrophilic proteinases in sepsis: studies using a baboon model". Infect Immun 61 (12): 5035–5043.
^ Vecchi C, Montosi G, Zhang K, et al. (August 2009). "ER stress controls iron metabolism through induction of hepcidin". Science 325 (5942): 877–80. doi:10.1126/science.1176639. PMC 2923557. PMID 19679815.
^ ^a ^b ^c Ritchie RF, Palomaki GE, Neveux LM, Navolotskaia O, Ledue TB, Craig WY (1999). "Reference distributions for the negative acute-phase serum proteins, albumin, transferrin, and transthyretin: a practical, simple and clinically relevant approach in a large cohort". J. Clin. Lab. Anal. 13 (6): 273–9. doi:10.1002/(SICI)1098-2825(1999)13:6<273::AID-JCLA4>3.0.CO;2-X. PMID 10633294.
^ Chua E, Clague JE, Sharma AK, Horan MA, Lombard M (October 1999). "Serum transferrin receptor assay in iron deficiency anaemia and anaemia of chronic disease in the elderly". QJM 92 (10): 587–94. doi:10.1093/qjmed/92.10.587. PMID 10627880.
^ Ananian P, Hardwigsen J, Bernard D, Le Treut YP (2005). "Serum acute-phase protein level as indicator for liver failure after liver resection". Hepatogastroenterology 52 (63): 857–61. PMID 15966220.

External links

Acute-Phase Proteins at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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Ganguly A1, Malabadi RB1, Bhatnagar PK1, Tang X1, Das D1, Loebenberg R1, Suresh MR1, Sunwoo HH2.
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Inflammatory cytokines and acute-phase proteins concentrations in the peripheral blood and uterus of cows that developed endometritis during early postpartum.

Brodzki P1, Kostro K2, Brodzki A3, Wawron W4, Marczuk J5, Kurek Ł5.
Theriogenology.Theriogenology.2015 Jul 1;84(1):11-8. doi: 10.1016/j.theriogenology.2015.02.006. Epub 2015 Feb 12.
The aim of the study was to evaluate the level of proinflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6]), anti-inflammatory cytokine (interleukin-10 [IL-10]), and acute-phase proteins (haptoglobin [Hp] and serum amyloid A [SAA]) in serum and uterine washings in cows that
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Comparative proteomic analysis of lung tissue from guinea pigs with leptospiral pulmonary haemorrhage syndrome (LPHS) reveals a decrease in abundance of host proteins involved in cytoskeletal and cellular organization.

Schuller S1, Sergeant K2, Renaut J2, Callanan JJ3, Scaife C4, Nally JE5.
Journal of proteomics.J Proteomics.2015 Jun 3;122:55-72. doi: 10.1016/j.jprot.2015.03.021. Epub 2015 Mar 27.
Leptospiral pulmonary haemorrhage syndrome (LPHS) is a particularly severe form of leptospirosis. LPHS is increasingly recognized in both humans and animals and is characterized by rapidly progressive intra-alveolar haemorrhage leading to high mortality. The pathogenic mechanisms of LPHS are poorly
PMID 25818725

Japanese Journal

Comparison of C-reactive Protein Levels between Serum and Plasma Samples on Long-term Frozen Storage after a 13.8 Year Interval : The JMS Cohort Study

ISHIKAWA Shizukiyo,KAYABA Kazunori,GOTOH Tadao,NAKAMURA Yosikazu,KARIO Kazuomi,ITO Yoshihisa,KAJII Eiji
Journal of epidemiology 17(4), 120-124, 2007-07-01
… BACKGROUND: C-reactive protein (CRP) is an acute phase reactant, and has been reported as a predictor of cardiovascular diseases. …
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Hyperglycemia Promotes Microinflammation as Evaluated by C-Reactive Protein in the Very Elderly

Fukuhara Masayo,Matsumura Kiyoshi,Wakisaka Masanori,Takata Yutaka,Sonoki Kazuo,Fujisawa Kiyoshi,Ansai Toshihiro,Akifusa Sumio,Fujii Koji,Iida Mitsuo,Takehara Tadamichi
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NAID 130000078552