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Proteomics Clin Appl. 2016 Nov;10(11):1077-1092. doi: 10.1002/prca.201600028. Epub 2016 Jul 4.

Acute phase proteins as promising biomarkers: Perspectives and limitations for human and veterinary medicine.

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Institute of Bacteriology and Mycology, Veterinary Faculty, University Leipzig, Germany.
Institute of Biochemistry I, University Hospital Jena, Germany.
Institute of Molecular Pathogenesis at 'Friedrich Loeffler Institut', Federal Research Institute for Animal Health, Jena, Germany.
Clinic of Neurology, University Hospital Jena, Germany.


Acute phase proteins (APPs) are highly conserved plasma proteins that are increasingly secreted by the liver in response to a variety of injuries, independently of their location and cause. APPs favor the systemic regulation of defense, coagulation, proteolysis, and tissue repair. Various APPs have been applied as general diagnostic parameters for a long time. Through proteomic techniques, more and more APPs have been discovered to be differentially altered. Since they are not consistently explainable by a stereotypic hepatic expression of sets of APPs, most of these results have unfortunately been neglected or attributed to the nonspecificity of the acute phase reaction. Moreover, it appears that various extrahepatic tissues are also able to express APPs. These extrahepatic APPs show focally specific roles in tissue homeostasis and repair and are released primarily into interstitial and distal fluids. Since these focal proteins might leak into the circulatory system, mixtures of hepatic and extrahepatic APP species can be expected in blood. Hence, a selective alteration of parts of APPs might be expected. There are several hints on multiple molecular forms and fragments of tissue-derived APPs. These differences offer the chance for multiple selective determinations. Thus, specific proteoforms might indeed serve as tissue-specific disease indicators.


Acute phase proteins (APPs); Acute phase response (APR); Biomarkers; Extrahepatic proteoforms; Tissue-specific homologs

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