Temperature Regulation and the Pathogenesis of Fever
Temperature Regulation and the Pathogenesis of Fever
Temperature Regulation and the Pathogenesis of Fever
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From Gabay C, Kushner I. Acute-phase proteins <strong>and</strong> o<strong>the</strong>r systemic responses to inflammation. N Engl J<br />
Med. 1999;340:448–454. Copyright ? 1999 Massachusetts Medical Society. All rights reserved.<br />
Traditionally, <strong>the</strong> phrase acute-phase response has been used to denote changes in plasma<br />
concentrations <strong>of</strong> a number <strong>of</strong> secretory proteins derived from hepatocytes. Acute-phase proteins,<br />
<strong>of</strong> which <strong>the</strong>re are many ( Table 47–2 ), [108] exhibit ei<strong>the</strong>r increased syn<strong>the</strong>sis (positive<br />
acute-phase proteins) or decreased syn<strong>the</strong>sis (negative acute-phase proteins) during <strong>the</strong><br />
acute-phase response. IL-6 is <strong>the</strong> chief stimulator <strong>of</strong> <strong>the</strong> production <strong>of</strong> most acute-phase proteins.<br />
O<strong>the</strong>r pyrogenic cytokines, however, also influence <strong>the</strong> production <strong>of</strong> various subgroups <strong>of</strong> such<br />
proteins. [108]<br />
Table 47-2 -- Human Acute-Phase Proteins<br />
Proteins Whose Plasma Concentrations Increase<br />
Complement system<br />
C3<br />
C4<br />
C5<br />
C9<br />
MAC<br />
Factor B<br />
C1 inhibitor<br />
C4b-binding protein<br />
Mannose-binding lectin<br />
Coagulation <strong>and</strong> fibrinolytic system<br />
Fibrinogen<br />
Plasminogen<br />
Tissue plasminogen activator<br />
Urokinase<br />
Protein S<br />
Vitronectin<br />
Plasminogen-activator inhibitor I<br />
Kininogen<br />
Antiproteases
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