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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

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(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

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/11 21:42:53」(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 IL1, IL6 and IL8, and TNFα. 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.^[1]

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,^[2] 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^[3] (not an acute-phase reactant in mice)
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 activator inhibitor PAI-1	Prevents the degradation of blood clots by inhibiting Plasminogen ^[4]
Alpha 2-macroglobulin	Inhibitor of coagulation by inhibiting thrombin.^[5] Inhibitor of fibrinolysis by inhibiting plasmin
Ferritin	Binding iron, inhibiting microbe iron uptake ^[6]
Hepcidin^[7]	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,^[8] transferrin,^[8] transthyretin,^[8] 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.^[9]

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.^[10]

References

^ Abbas, A., Lichtman, A., & Pillai, S. (2012). Basic immunology Functions and Disorders of the Immune System (4th ed., p. 40). Philadelphia, PA: Saunders/Elsevier.
^ 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
^ 1. J. S. Inflammation and Acute Phase Proteins in Haemostasis. Acute Phase Proteins [Internet]. 2013 [cited 15 October 2015];. Available from: http://www.intechopen.com/books/acute-phase-proteins/inflammation-and-acute-phase-proteins-in-haemostasis
^ 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.
^ http://cdn.intechopen.com/pdfs/21451/InTech-Acute_phase_proteins_ferritin_and_ferritin_isoforms.pdf
^ 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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English Journal

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Wangkahart E1, Scott C2, Secombes CJ3, Wang T4.
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Matzner P1, Sorski L1, Shaashua L1, Elbaz E1, Lavon H1, Melamed R1, Rosenne E1, Gotlieb N2, Benbenishty A1,3, Reed SG4, Ben-Eliyahu S1,3.
International journal of cancer. Journal international du cancer.Int J Cancer.2016 Apr 1;138(7):1754-64. doi: 10.1002/ijc.29885. Epub 2015 Oct 26.
The use of TLR agonists as an anti-cancer treatment is gaining momentum given their capacity to activate various host cellular responses through the secretion of inflammatory cytokines and type-I interferons. It is now also recognized that the perioperative period is a window of opportunity for vari
PMID 26453448

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★リンクテーブル★

リンク元	「急性期」「acute stage」「acute period」
拡張検索	「acute-phase protein」「acute-phase response」
関連記事	「phase」「acute」「phased」