Biology Chapter 16: Plasma Proteins and Enzymes

Thyroxine-binding globulin = Transport Immunoglobulins = Humoral immunity Albumin = Maintenance of oncotic pressure Renin = Enzymes

Malnutrition and malabsorption = Decrease Liver disease = Decrease Overhydration = Increase Catabolic states = Increase

Prealbumin = ↓ protein synthesis Albumin = ↑ protein synthesis Immunoglobulins (γ-globulins) = Humoral immunodeficiency α1-Antitrypsin = Protease inhibitors

<p>Albumin = 14.0 α1-globulin = 2.9 α2-macroglobulin = 2.6 β1-globulin = 3.0</p> Signup and view all the answers

<p>Albumin = Major contribution (∼80%) Transferrin = Minor contribution Haptoglobin = Negligible contribution Caeruloplasmin = Minimal contribution</p> Signup and view all the answers

<p>Decrease in normal immunoglobulins = Characteristically occurs Polyclonal increase in immunoglobulins = Does not occur Migration of paraproteins towards β region = Especially IgA class Typical migration of paraproteins in γ region = Paraproteins typically migrate</p> Signup and view all the answers

<p>α1-antitrypsin = Anti-protease activity Haptoglobin = Binds free hemoglobin Transferrin = Iron transport IgM immunoglobulin = Primary immune response</p> Signup and view all the answers

<p>IgM = Confined to the vascular spaces IgD = Present on the surface of B-lymphocytes IgE = Present on surface of mast cells and basophils IgG = Maternal IgG</p> Signup and view all the answers

<p>IgM = Major antibody of the primary immune response IgD = Involved in antigen recognition IgE = Probable role in immunity to helminths IgA = Contains either κ or γ light chains</p> Signup and view all the answers

<p>IgA = Slight variations in the structure of the constant regions of the heavy chains IgG = Different subclasses created by slight variations in structure IgM = Pentamer structure IgD = Surface presence on B-lymphocytes</p> Signup and view all the answers

<p>Infant's IgG = $20$ weeks of gestation Maternal IgG = $100$ adult values Total IgG = $50$ infant's IgG IgA = $30$ weeks of gestation</p> Signup and view all the answers

<p>Autoimmune diseases = Common cause for increased plasma immunoglobulin concentrations Chronic liver diseases = Some have an autoimmune basis and lead to increased immunoglobulin concentrations Infectious diseases = Widely used in diagnosis through measurement of specific autoantibodies Rheumatoid disease and SLE = Associated with autoimmune basis and increased immunoglobulin concentrations</p> Signup and view all the answers

<p>Polyclonal increase in γ-globulin region on electrophoresis = Result of production of many different immunoglobulins in autoimmune diseases Oligoclonal peaks on electrophoresis = 'Discrete peaks' sometimes seen in certain conditions Antigen recognition = Function associated with IgD Immediate hypersensitivity reactions = Associated with IgE presence on mast cells and basophils</p> Signup and view all the answers

<p>Sodium = 130 mmol/L Urea = 212 μmol/L Creatinine = 26 mL/min/1.73 m2 Calcium (adjusted) = 2.75 mmol/L</p> Signup and view all the answers

<p>Cholestasis = Alcoholic liver disease Polymyositis = Rhabdomyolysis Trauma or malignant hyperpyrexia = Duchenne muscular dystrophy Myocardial infarction = Hepatitis (acute and chronic)</p> Signup and view all the answers

<p>Phenotyping of plasma cells by flow cytometry and immunohistochemistry = Bone marrow trephine biopsy and aspirate Identification of myeloma-associated genetic changes = Examination of bone marrow Presence of monoclonal protein in serum or urine = Diagnosis of multiple myeloma Increased numbers of abnormal plasma cells in bone marrow = Prognostic information</p> Signup and view all the answers

<p>Acute or chronic kidney injury = Toxicity of excess light chains to renal tubules Anaemia = Replacement of normal bone marrow by malignant plasma cells Decreased synthesis of normal immunoglobulins = Malignant plasma cell infiltration in bone marrow End-organ damage = Typical radiological appearances</p> Signup and view all the answers

<p>Paraprotein = Immunoglobulin produced by a single clone of cells Electrophoresis = Technique used to separate proteins based on their electrical charge and size Anaphylactic shock = Severe and potentially life-threatening allergic reaction Dimerization = Process of forming a molecule consisting of two identical simpler molecules</p> Signup and view all the answers

<p>Urticaria = Skin rash characterized by red, raised, itchy welts Type 1 hypersensitivity reactions = Immediate allergic responses mediated by IgE antibodies Plasma cells = Cells that produce antibodies such as immunoglobulins IgA paraproteins = Immunoglobulins that can lead to complex formation with other proteins</p> Signup and view all the answers

<p>Tight peak in γ region = Characteristic appearance of paraproteins on electrophoresis Migrating peak = Occurs when protein is IgA or IgM, or when complex formation has happened Discrete peak = Representation of identical molecules in a paraprotein Multiple peaks = Possible due to dimerization or presence of complexes/fragments in addition to intact molecule</p> Signup and view all the answers

<p>Testing should only be done if it alters management = Guideline for interpreting results of specific antibody testing Consult immunology textbooks for detailed discussion = Encouragement for further learning beyond book content Paraprotein identified by identical molecules on electrophoresis = Characteristic feature of paraproteins in serum Color figures may print in black and white in final book = Note on potential discrepancy between color and black-and-white printing</p> Signup and view all the answers