Humoral Innate Immunity and Acute-Phase Proteins

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Questions and Answers

Which of the following is NOT a condition that acute-phase proteins are used to diagnose?

  • Infection
  • Diabetes (correct)
  • Cardiovascular illness
  • Neurodegeneration

What is the primary function of the acute-phase response?

  • To suppress the immune system
  • To increase inflammation
  • To amplify antimicrobial resistance and tissue repair (correct)
  • To trigger the formation of antibodies

Which of the following is an example of an acute-phase protein?

  • Thyroid hormone
  • Insulin
  • Fibrinogen (correct)
  • Growth hormone

What is the role of the cellular arm of innate immunity?

<p>To recognize and destroy pathogens (C)</p> Signup and view all the answers

What are the molecular strategies used by the cellular arm of innate immunity to sense microbial moieties?

<p>Toll-like receptors, NOD-like receptors, RIG-I-like receptors, and STING (D)</p> Signup and view all the answers

Which of the following is NOT a type of receptor involved in innate immunity?

<p>G-protein coupled receptors (B)</p> Signup and view all the answers

How do acute-phase proteins contribute to humoral innate immunity?

<p>By acting as ante-antibodies (C)</p> Signup and view all the answers

What is the significance of the increasing use of molecular signatures in diagnosing and treating various conditions?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary function of Pentraxin 3 (PTX3) concerning urinary tract infections?

<p>It serves as a key component of innate immunity against the infection. (D)</p> Signup and view all the answers

In the context of sarcoidosis, what role does Pentraxin 3 (PTX3) play?

<p>It inhibits complement-driven macrophage activation, restraining granuloma formation. (C)</p> Signup and view all the answers

How does acute serum amyloid A (SAA) primarily contribute to the process of infection?

<p>By inducing the migration of cells during inflammation. (B)</p> Signup and view all the answers

What is the relationship between mannose-binding lectin (MBL) and community-acquired pneumonia?

<p>The acute-phase response of MBL is highly dependent on the patient's MBL2 genotype. (C)</p> Signup and view all the answers

In autoimmune vasculitis, how is the protective effect of α1-antitrypsin affected by methionine oxidation?

<p>Methionine oxidation compromises its protective effects. (D)</p> Signup and view all the answers

What is a significant role that lectins play in the context of SARS-CoV-2 infection?

<p>They enhance SARS-CoV-2 infection, facilitating viral entry and spread. (C)</p> Signup and view all the answers

How is increased levels of antiplasmin related to long COVID?

<p>Antiplasmin contributes to the persistent clotting protein pathology observed in Long COVID. (A)</p> Signup and view all the answers

What is the focus of study regarding multiple early factors in the context of post-acute COVID-19?

<p>To predict which patient will develop post-acute COVID-19 sequelae. (A)</p> Signup and view all the answers

What is the role of Interleukin 1 receptor antagonist (IL-1Ra) in the body?

<p>It acts as an acute-phase protein. (B)</p> Signup and view all the answers

What is the significance of serum amyloid A concentrations in COVID-19 patients?

<p>They are correlated with higher mortality rates. (C)</p> Signup and view all the answers

Which inflammatory markers were highlighted in relation to severe COVID-19 cases?

<p>Interleukin 6 and tumor necrosis factor. (A)</p> Signup and view all the answers

What was the aim of the meta-analysis regarding COVID-19 patients mentioned?

<p>To identify predictors of clinical deterioration. (B)</p> Signup and view all the answers

What feature of innate immune functions is emphasized in the context of the liver?

<p>Acute-phase protein synthesis. (A)</p> Signup and view all the answers

What does an 'acidic microenvironment' do to PTX3?

<p>Modulates its tissue repair functions. (D)</p> Signup and view all the answers

What was the reported outcome of long-term treatment with recombinant human pentraxin 2 protein?

<p>It leads to significant improvement in symptoms. (A)</p> Signup and view all the answers

Which aspect of intracellular complement activation is discussed?

<p>It is involved in the alerting mechanism of the immune system. (C)</p> Signup and view all the answers

What role does ferritin play in severe pathologic inflammatory conditions?

<p>It serves as a marker of severity and prognosis. (C)</p> Signup and view all the answers

Which acute-phase proteins act as soluble scavengers in the immune response?

<p>Haptoglobin and hemopexin (D)</p> Signup and view all the answers

Which cellular sensor does NOT recognize viral nucleic acids in the innate immune response to SARS-CoV-2?

<p>C-type lectins (A)</p> Signup and view all the answers

What mechanism does the SARS-CoV-2 ORF8 component use to inhibit interferon production?

<p>Epigenetic mechanisms (A)</p> Signup and view all the answers

Which of the following is involved in the recognition of SARS-CoV-2 components?

<p>C-type lectins and TLRs (B)</p> Signup and view all the answers

What is the consequence of free heme in the context of SARS-CoV-2 infection?

<p>It serves as a redox-active iron source. (D)</p> Signup and view all the answers

Which of the following is a function of the inflammasome in the immune response?

<p>Recognizing components of the virus (D)</p> Signup and view all the answers

MBL binds to which components as part of the immune response to SARS-CoV-2?

<p>Glycosylated spike protein (D)</p> Signup and view all the answers

What role does the long pentraxin PTX3 play in critically ill patients?

<p>It correlates with the severity of infection. (D)</p> Signup and view all the answers

What is the significance of PTX3 in predicting mortality outcomes?

<p>It serves as a biological marker for severity of illness. (B)</p> Signup and view all the answers

Which of the following diseases has been associated with genetic PTX3 deficiency?

<p>Aspergillosis (B)</p> Signup and view all the answers

According to the findings, which context is PTX3 suggested as a prognostic marker?

<p>SARS-CoV-2 patients admitted to the emergency department. (A)</p> Signup and view all the answers

In what manner is PTX3 hypothesized to function within the innate immune defense?

<p>As a complement system modulator. (A)</p> Signup and view all the answers

Which protein class is PTX3 categorized under?

<p>Acute-phase proteins. (B)</p> Signup and view all the answers

What type of clinical condition is primarily associated with the study of PTX3?

<p>Sepsis and severe infections. (B)</p> Signup and view all the answers

What is the potential clinical application of measuring PTX3 levels?

<p>As an early indicator of sepsis severity. (B)</p> Signup and view all the answers

What role does C-reactive protein play in Covid-19?

<p>Indicates association with ICU admission and need for interleukin-6 inhibition (B)</p> Signup and view all the answers

What is the significance of Serum amyloid A in Covid-19?

<p>Linked to severity of the disease (C)</p> Signup and view all the answers

How does PTX3 relate to Covid-19?

<p>Associated with lung lesions and responses to treatment (C)</p> Signup and view all the answers

What does the increase in Ferritin levels indicate in Covid-19 patients?

<p>Association with ICU admission and mechanical ventilation (B)</p> Signup and view all the answers

Which of the following proteins is known to decrease in patients with severe Covid-19?

<p>Antithrombin III (B)</p> Signup and view all the answers

How does the activation of the hypothalamus-pituitary-adrenal axis affect cytokine production?

<p>Promotes the production of inflammatory cytokines (C)</p> Signup and view all the answers

What role does alpha-1-antichymotrypsin have in Covid-19?

<p>Increases in response to severe inflammation (C)</p> Signup and view all the answers

What is the association of coagulation protein d-dimer in Covid-19?

<p>Indicates thromboembolic complications (B)</p> Signup and view all the answers

Which acute-phase protein is associated with a need for interleukin-6 inhibition in severe cases of Covid-19?

<p>C-reactive protein (B)</p> Signup and view all the answers

How does transferrin level change in Covid-19 patients?

<p>Decreases with disease severity (C)</p> Signup and view all the answers

Which protein’s levels remain unchanged or slightly increased during Covid-19?

<p>Ceruloplasmin (A)</p> Signup and view all the answers

Which of the following proteins plays a role in viral inhibition according to the outlined changes?

<p>Mannose-binding lectin (D)</p> Signup and view all the answers

What is the association of haptoglobin levels in Covid-19?

<p>Increases with disease severity (A)</p> Signup and view all the answers

What impact does interleukin-1Ra have in Covid-19?

<p>Associates with anti–interleukin-1Ra antibodies and severity (A)</p> Signup and view all the answers

What is the significance of the proteins C1q, C3, and C4 in Covid-19?

<p>Associated with pathogenesis (D)</p> Signup and view all the answers

Flashcards

Acute-phase proteins

Proteins that increase in concentration in the blood during inflammation, infection, or tissue injury.

C-reactive protein (CRP)

A key acute-phase protein that helps fight infection and can be used to diagnose inflammation.

Fibrinogen

A protein that helps form blood clots (fibrin) and plays a role in inflammation.

D-dimer

A breakdown product of fibrinogen that can indicate blood clotting issues.

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Ferritin

A protein that stores iron and can be elevated during inflammation and infection.

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Innate immunity

A type of immune system response that is the initial and rapid response to infection or tissue damage.

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Humoral immunity

A part of the immune system that involves proteins and other molecules in the blood.

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Cellular and humoral innate immunity

Protective mechanisms that the body uses to sense and respond to microbial invaders and tissue damage.

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Mannose-binding lectin (MBL)

A protein that binds to mannose sugars, a component of bacterial and fungal cell walls, helping to activate the immune system.

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Pentraxin 3 (PTX3)

A protein that plays a significant role in the activation of the complement system, a key part of the immune response.

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Complement system

A complex series of proteins that help clear pathogens and activate other immune cells.

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Antiplasmin

Proteins that help prevent the formation of blood clots in the blood.

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α1-antitrypsin

A protein that plays an important role in the immune system and can influence the development and progression of autoimmune diseases.

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Post-acute sequelae of COVID-19 (PASC)

Persistent symptoms that continue after the initial infection has cleared. This can happen after COVID-19, and it is a growing medical concern.

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Innate Immune Recognition

A molecule that plays a crucial role in the innate immune response against SARS-CoV-2, acting as a 'first responder' to the virus by recognizing its components.

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C-type Lectins

A type of cellular receptor involved in recognizing the spike protein of SARS-CoV-2. These receptors play a vital role in triggering the innate immune response.

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TLR3, TLR7, TLR8

Toll-like receptors (TLRs) are a type of receptor involved in recognizing viral nucleic acids (DNA and RNA) within the cell. This recognition triggers the activation of the immune system.

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cGAS-STING Pathway

A pathway involved in the immune response against SARS-CoV-2 that detects the presence of viral DNA within the cell, leading to the activation of immune signaling.

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Inflammasome

A complex of proteins within the cell that plays a role in recognizing certain viral components and triggering the release of inflammatory signals.

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ORF8

A protein encoded by the SARS-CoV-2 virus that has been shown to inhibit interferon production. Interferons are essential immune signaling molecules that help fight off viral infections.

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What is PTX3?

Pentraxin 3 (PTX3) is a protein produced by the immune system that helps fight infections and inflammation.

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How does PTX3 help with diagnosis?

PTX3 levels rise during infection or inflammation, acting as a biomarker to signal the presence of danger.

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What does high PTX3 level mean in patients?

High PTX3 levels in the blood can indicate a more severe infection and higher risk of complications in patients.

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Why is monitoring PTX3 important?

Studies have shown that PTX3 levels can be used to predict how severe an infection will be and which patients may need more intensive treatment.

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What is the role of PTX3 in the immune system?

PTX3 is a protein involved in innate immunity, the body's first line of defense against infections.

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How does PTX3 interact with other immune cells?

PTX3 interacts with other immune cells to signal and activate the immune response, helping to clear infections.

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How can PTX3 be used to identify patients with severe sepsis?

PTX3 can help identify patients with severe sepsis, a life-threatening condition characterized by a widespread infection.

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What's the future of PTX3 research?

PTX3 may be a potential therapeutic target in treating sepsis and other inflammatory diseases.

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What are acute-phase proteins (APPs)?

Acute-phase proteins (APPs) are proteins whose plasma concentration increases or decreases significantly during inflammation. They are produced mainly by the liver in response to inflammatory cytokines, like IL-6.

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What is C-reactive protein (CRP)?

C-reactive protein (CRP) is an APP that is produced by the liver and is a major component of the innate immune system. It binds to phosphocholine on the surface of microbes, activating the complement system and promoting phagocytosis by macrophages, thus triggering the immune response.

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What is Serum Amyloid A (SAA)?

Serum Amyloid A (SAA) is an APP produced by the liver primarily during inflammation. It plays a crucial role in the host defense by facilitating the recruitment of immune cells to the site of injury and by promoting tissue repair.

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What is Pentraxin 3 (PTX3)?

Pentraxin 3 (PTX3) is an APP that is produced by various cells, including macrophages, endothelial cells, and fibroblasts. It is known to play a role in both innate and adaptive immunity, and its levels are significantly elevated in various inflammatory conditions, including sepsis and viral infections.

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What is Mannose-binding lectin (MBL)?

Mannose-binding lectin (MBL) is an APP involved in innate immunity. It binds to mannose residues on the surface of pathogens and triggers complement activation, promoting phagocytosis and killing of pathogens.

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What is Interleukin-1Ra (IL-1Ra)?

Interleukin-1Ra (IL-1Ra) is a protein that naturally inhibits the activity of interleukin-1 (IL-1), a pro-inflammatory cytokine. Elevated IL-1Ra is associated with COVID-19 severity, as it can suppress the immune response.

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What is Fibrinogen?

Fibrinogen is an APP produced by the liver and is a key factor in blood clotting. Elevated fibrinogen levels are associated with several inflammatory conditions, including infection and trauma.

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What is Ferritin?

Ferritin is an APP that stores iron in the body. It is increased during inflammation to prevent iron from being used by pathogens, hindering their growth.

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What is Haptoglobin?

Haptoglobin is an APP that binds to free hemoglobin, preventing iron loss and oxidative damage. It is usually elevated in inflammatory conditions, including infection and trauma.

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What is Albumin?

Albumin is a major protein in blood plasma and is produced by the liver. Reduced albumin levels are observed in various conditions, including inflammation and malnutrition.

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What is Ceruloplasmin?

Ceruloplasmin is an APP produced by the liver that transports copper in the bloodstream and acts as a ferroxidase, helping to oxidize iron. It is elevated in inflammatory conditions.

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Acute-phase proteins (APPs)

Proteins whose levels increase or decrease significantly during inflammation, primarily produced by the liver in response to inflammatory signals.

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Serum Amyloid A (SAA)

An acute-phase protein produced by the liver during inflammation. It helps recruit immune cells and promotes tissue repair.

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Interleukin-1Ra (IL-1Ra)

A protein that inhibits interleukin-1 (IL-1), a pro-inflammatory cytokine. Its levels are associated with COVID-19 severity.

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Haptoglobin

An acute-phase protein that binds to free hemoglobin, preventing iron loss and oxidative damage. It is elevated in inflammatory conditions.

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Albumin

The major protein in blood plasma, produced by the liver. Reduced levels can indicate inflammation or malnutrition.

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Ceruloplasmin

A major acute-phase protein produced by the liver, transporting copper in the bloodstream and oxidizing iron.

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Immunology

The study of how the immune system functions to protect the body from disease and infection.

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Study Notes

Humoral Innate Immunity and Acute-Phase Proteins

  • Inflammation encompasses diverse tissue reactions, often triggered by microbial recognition or tissue damage. Dysmetabolic conditions (like diabetes and obesity) also elicit these reactions.
  • Inflammatory responses amplify innate resistance and aid tissue repair, restoring homeostasis.
  • Systemic inflammation manifests in fever, altered leukocyte counts, cardiovascular changes, endocrine responses, and metabolic reorientation.
  • Acute-phase proteins (APPs) are molecules produced during inflammation, particularly in the liver. C-reactive protein is a prototypic APP.
  • APPs appear in the blood and other fluids during inflammation (either local or systemic), indicating a response. This response decreases albumin production by hepatocytes and changes iron metabolism.
  • APPs serve as diagnostic tools for various conditions, including infection, cardiovascular disease, cancer, neurodegeneration, and dysmetabolism.
  • APPs, like C-reactive protein, fibrinogen, and D-dimer, were vital during the COVID-19 pandemic, for monitoring disease and prognosis.

The Context of Cellular and Humoral Innate Immunity

  • Innate immunity is the first line of defense against microbial pathogens.
  • It activates adaptive immune responses and fosters tissue repair.
  • Innate immunity includes a cellular and a humoral arm.
  • The cellular arm senses microbial moieties and tissue damage via receptor interactions.
  • The cellular arm results in cytokine production.
  • The humoral arm's role is to help activate complement, opsonize pathogens, and regulate inflammation.
  • Different types of molecules (pentraxins, collectins, and ficolins) are part of the humoral arm and function similar to antibodies (these are the ante-antibodies).

Upstream of the Acute-Phase Response: The Cytokine Cascade

  • Microbial moieties, tissue damage, or dysmetabolism initiate a cytokine cascade.
  • This cascade influences innate immunity and triggers the production of APPs. Interleukin-1, interleukin-6, and tumor necrosis factor (TNF) are primary inflammatory cytokines.
  • Secondary mediators amplify inflammation, recruit leukocytes, shape innate immunity, and influence adaptive immune responses.
  • Interleukin-6 plays a crucial role in directing the body's response to inflammation, including increasing APP production in the liver.

Main Acute-Phase Proteins and Their Role in Covid-19

  • Various acute phase proteins exhibit specific patterns of change during inflammatory responses, including COVID-19.
  • Some, like C-reactive protein, serum amyloid A, and pentraxin 3 (PTX3), show increased concentrations associated with disease severity in COVID-19.
  • Many proteins are involved in coagulation and tissue repair processes, and their levels adjust during inflammation.

Acute-Phase Proteins, Coagulation, and Tissue Repair

  • Various APPs are linked to coagulation and tissue repair.
  • Fibrinogen, a crucial clotting factor, and its degradation products (D-dimer), are significant diagnostic markers in inflammatory states. including COVID-19.
  • Acute phase proteins are also crucial elements to tissue repair

Hepatic and Non-Hepatic Sources of Acute-Phase Proteins

  • The liver has traditionally been considered the primary source of APPs. However, other cells (like macrophages, endothelial cells, hepatocytes, stellate cells) participate in APP production.
  • Production in peripheral tissues complements liver-derived APPs.
  • Adipose tissue is a significant producer of APPs in response to inflammatory cues

Pentraxins (C-Reactive Protein, SAP, and PTX3)

  • The pentraxins C-reactive protein (CRP), serum amyloid P component (SAP), and PTX3 are key molecules of the humoral arm of innate immunity
  • They have similar functions, like mediating complement activation, opsonizing microbes, and promoting phagocytosis.
  • Each pentraxin has unique properties and functions, e.g., CRP and SAP are generally produced by the liver, whereas PTX3 is produced by different tissues and cells, often in response to different stimuli.

Complement System and MBL

  • The complement system is crucial in humoral innate immunity.
  • It comprises ~50 molecules, largely produced by the liver to enhance the innate immune response to infection/damage.
  • Mannose-binding lectin (MBL) is a liver-derived C-type lectin involved in pattern recognition and initiation of complement activation pathways.

Acute-Phase Proteins and Iron Homeostasis

  • Iron metabolism plays a critical role in the host's response to pathogens because these microbes need iron to replicate/produce energy.
  • Several acute-phase proteins help in iron regulation, either maintaining higher iron stores or restricting iron availability to pathogens.
  • Hepcidin, ferritin, haptoglobin, hemopexin, and transferrin are key iron-metabolic regulators significantly influenced by the acute-phase reaction.

Acute-Phase Proteins and COVID-19

  • Acute-phase proteins are used to monitor disease stages, predict severity, and guide treatment decisions in COVID-19.
  • Levels of various acute-phase proteins might be helpful in detecting and following COVID-19.
  • These levels can influence clinical decisions to direct therapy.

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