ACTH Acutephas specific receptors on different target cells leading to a Corsol proteins systemic reaction characterized by fever, leukocytosis, increase in erythrocyte sedimentation rate, increases in Leucocytosis secretion of ACTH and glucocorticoids, activation of Complement activat complement and clotting cascades, decreases in serum levels of iron and zinc, a negative nitrogen balance, and by dramatic changes in the concentration of some plasma ,l' proteins. These proteins are named acute phase proteins. i Acute phase proteins The acute phase protein patterns vary from one species to another. C-reactive protein and serum amyloid A, for example, show the highest increases during an acute phase response in man, whereas in the rat, a2-macroglobulin and al-acid glycoprotein are the acute phase proteins with the most spectacular changes (Table 1). In many species plasma levels of fibrinogen, haptoglobin, al-antichymotrypsin and a1-antitrypsin increase during an acute phase response [1-9]; simultaneously, albumin and transferrin concentrations decrease. These changes in plasma levels of acute phase proteins are preceded by corresponding alterations in mRNA concentrations. In addition, increases in the rates of secretion of some acute phase proteins have been observed. The earliest description of the acute phase response came from the ancient Greeks [10]. They already observed an increased sedimentation rate of erythrocytes in blood of severely ill patients. As we know today, this increase is due to elevated plasma concentrations of fibrinogen and other acute phase proteins [11]. The term 'acute
The three monokines interleukin-lg (IL-IS), tumor necrosis factor a (TNFa), and interleukind (IL-6) modulate acute phase plasma protein synthesis in adult human hepatocytes. Only IL-6 stimulates the synthesis of the full spectrum of acute phase proteins as seen in inflammatory states in humans, i.e. synthesis and secretion of C-reactive protein, serum amyloid A, fibrinogen, ar-antitrypsin, q-antichymotrypsin and haptoglobin are increased while albumin, transferrin and fibronectin are decreased. IL-lb as well as TNFa, although having a moderate effect on the positive acute phase proteins and inhibiting the synthesis of fibrinogen, albumin and transferrin, fail to induce serum amyloid A and C-reactive protein.These data suggest that IL-6 plays the key role in the regulation of acute phase protein synthesis in human hepatocytes.Acute phase protein; Interleukind; Interleukin-l/I; Tumor necrosis factor a; (Human hepatocyte)
Cytokines play a central role in the modulation of the intestinal immune system. They are produced by lymphocytes (especially T cells of the Th1 and Th2 phenotypes), monocytes, intestinal macrophages, granulocytes, epithelial cells, endothelial cells, and fibroblasts. They have proinflammatory functions [interleukin-1 (IL-1), tumor necrosis factor (TNF), IL-6, IL-8, IL-12] or antiinflammatory functions [interleukin-1 receptor antagonist (IL-1ra), IL-4, IL-10, IL-11, transforming growth factor beta (TGF beta)]. Mucosal and systemic concentrations of many pro- and antiinflammatory cytokines are elevated in inflammatory bowel disease (IBD). An imbalance between proinflammatory and antiinflammatory cytokines was found for the IL-1/IL-1ra ratio in the inflamed mucosa of patients with Crohn's disease, ulcerative colitis, diverticulitis, and infectious colitis. Furthermore, the inhibition of proinflammatory cytokines and the supplementations with antiinflammatory cytokines reduced inflammation in animal models, such as the dextran sulfate colitis (DSS) model, the trinitrobenzene sulfonic acid (TNBS) model, or the genetically engineered model of IL-10 knockout mice. Based on these findings a rationale for cytokine treatment was defined. The first clinical trials using neutralizing monoclonal antibodies against TNF alpha (cA2) or the antiinflammatory cytokine IL-10 have shown promising results. However, many questions must be answered before cytokines can be considered standard therapy for IBD.
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