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The acute phase reaction

Authors:
Anne Husebekk, MD, Ph.D., Department of Immunology and Transfusion Medicine, University Hospital of Tromsų, Norway
and
Lars-Olof Hansson, MD, Ph.D., Department of Medical Sciences, University Hospital, Uppsala, Sweden


(Ref. 3)

In the acute phase reaction, several biochemical, metabolic, hormonal and cellular changes take place in order to fight the stimulus and re-establish a normal functional state in the body. Examples of these changes are shown in Table I. An increase in the number of granulocytes will increase the phagocytotic capacity, an increase in scavengers will potentiate the capability to neutralise free oxygen radicals, and an increase in metabolic rate will increase the energy available for cellular activities, despite a reduced food intake. Some of these changes can explain the symptoms of an acute phase reaction, which are typically fever, tiredness, loss of appetite and general sickness, in addition to local symptoms from the inducer of the acute phase (Table II).

Table I Cellular, metabolic and endocronological changes in the acute phase response to inflammation.

Changes compared with normal stateIncreaseDecrease
Cellularphagocytotic cells (in circulation and at the site of inflammation)erythrocytes
Metabolicacute phase proteins
serum Cu
protein catabolism
gluconeogenesis
serum Fe
serum Zn
albumin synthesis
transthyretin
transferrin
Endocrinologicalglucagon
insulin
ACTH
GH
T4
cortisol
aldosterone
vasopressin
T3
TSH

Table II General and local clinical symptoms of the acute phase reaction.

General symptomsLocal symptoms
fevercalor
increased heart raterubor
hyperventilationdolor
tirednesstumour
loss of apptetitefunctio laesa

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