Systemic effects local effects

(inflammation)

  reorganization of neuro-endicrine regulation, metabolism, functions of organs and systems (hypothalamus, hypothalamus - hypophysis - adrenals system, immune system, hemopoietic system, blood, liver, etc.)

IL - 1 – interleukin -1. Receptors to IL - 1 have all cells of an organism.

IL - 6 - interleukin - 6

TNF -α - Tumor necrosis factor - alpha

The scheme 2. The role of cytokines in pathogenesis of acute phase reactions.

  Effects Consequences
IL-1 Activation of T- lymphocytes, secretion IL-2 by T- lymphocytes, expression receptors for IL-2   Activation of immune response, inflammation, fever, stress, allergy, tissue damage
Maturation of B-lymphocytes
Production IL-6, IL-8
Adhesion of neutrophils
Expression molecules of adhesion on endothelium for neutrophils and macrophages
Chemotaxis of neutrophils. Increase of vascular permeability
Increase of NК-cells’ cytotoxic activity
Synthesis of acute phase proteins
Secretion of thromboplastin by macrophages and endothelial cells
Fever
Drowsiness
reticulocytosis
Synthesis of macrophagial coloniostimulating factor (М-CSF)
Increase secretion of adrenocorticotropic hormone (stress)
Proliferation of smooth muscle cells
Destruction of muscular tissue
Destruction of cartilage
Resorptoin of bone tissue by osteoclasts

The scheme 3. Effects of interleukin – 1 (by V.F.Kuznetsov, 2000)

Hypothalamus Elevation of body temperature (fever)
Hypothalamus-hypophysis -adrenals system Increase in secretion кортиколиберина → ↑АКТГ → ↑глюкокортикоидов (stress)
Metabolism Catabolism activation, negative nitrogen balance, loss of phosphates, sulfates, potassium and amino acids, kreatin, kreatinin and a uric acid with urine. Break down of lipids, glycogen, and activation of gluconeogenesis. Usage of endogenous energy sources.
Immune system Т-and B – lymphocytes activation
Blood · Activation of kallikrein-kinin, complement, blood coagulation and fibrinolytic systems · Dysproteinemia · Increase of syal acids (a component of glycoproteins) · Increase of erythrocyte sedimentation rate
Hemopoietic system (bone marrow) Increase neutrophils, reticulocytes
Neutrophils Output of lactoferrin → binding blood iron (from transferrin, bacteria) → hyposideremia (sideropenia)
Liver Activation of synthesis of acute phase globulins: fibrinogen, С-reactive protein (practically is absent in norm), amyloid A and Р, gaptoglobin, ceruloplasmin, ferritin, antihemophylic globulin, YII, IX factors of coagulation, anticoagolatory proteins C and S, antithrombin III, plasminogen, α2 - macroglobulin, etc. (all about 30). Functions of globulins of acute phase reactions: - antioxidant (ceruloplasmin, amyloid, gaptoglobin, - С-reactive protein, transcobalamin, α2-macroglobulin); - antimicrobic (С-reactive protein, lactoferrin, complement components). Reduce tissue intake of iron and zinc → ↓ bacteria reproduction - participation in hemostasis (factors of blood coagulation and anticoagulants)

The scheme 4. The main effects of acute phase reactions


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