proteins are made by what (2)
- liver
- lymphatics
albumin is about what % of total proteins
- 50%
how are globulins calculated
- total proteins minus albumin %
why would total protein be higher in plasma than in serum
- because of fibrinogen -> fibrin
changes in [total protein] are usually due to changes in what
- albumin and 1 or more of the globulin concentrations
what plasma protein plays a major role in oncotic pressure
what is it’s trend
- albumin
- as albumin increases -> oncotic pressure increases
takes longer for hypoalbuminemia to develop when albumin production decreases in what species
- horses
- 1/2 life is 3 weeks
type of proteins that change in production soon after onset of inflammation
- acute-phase
plasma proteins that increase production within hours of onset of inflammation
- positive acute-phase proteins
examples of positive acute phase proteins (2)
- fibrinogen
- haptoglobin
plasma proteins that decrease production within hours to weeks of onset of inflammation
- negative acute-phase proteins
examples of negative acute phase proteins (2)
- transferrin
- albumin
delayed-response proteins
- immunoglobulins (produced by lymphocytes)
- changes in concentrations occurs 1-3 weeks after inflammation
interferences for [TP] of refractometry (5)
- increase [glucose]
- increase [urea]
- increase [Na and Cl]
- lipemia
- excess EDTA in blood (short samples)
what does not interfere with [TP] for refractometry
- bilirubin
Bromocresol green (BCG) for [albumin] will sometimes bind
- globulins
diseases and conditions of hyperfibrinogenemia (3)
- increased fibrinogen production
- inflammation
- hemoconcentration (dehydration)
disease and conditions of hypofibrinogenemia (7)
- increased fibrinogen consumption
- intravascular coagulation
- increased fibrinogenolysis
- decreased synthesis of fibrinogen
- hepatic insufficiency
- afibringoenemia
- DIC
dysproteinemia
- abnormal protein concentration
what proteins are affected in nonselective dysproteinemia
- all proteins
what proteins are affected in selective dysproteinemia
- some affected, some not
dehydration protein trend
- increase concentration of all proteins -> increase [TP]
hemodilution protein trend
- decrease concentration of all proteins -> decrease [TP]
chronic inflammation protein trend
- decrease [albumin]
- increase [globulins]
protein-losing nephropathy protein trend
- decrease [albumin]
- not all globulin concentrations decreased
hyperproteinemia caused by 3 things
- dehydration
- inflammation
- B-lymphocyte neoplasm
pathogenesis of dehydration causing hyperproteinemia
- decreased plasma water
- increase concentration of all plasma proteins
- hemoconcentration
inflammation acute phase response
- mild increase [TP]
- increase globulins (positive acute-phase proteins)
inflammation delayed phase response
- mild to marked increase [TP]
- increase [TP] with increase globulins and decreased albumin
- polyclonal gammopathy
b-lymphocyte neoplasm
- decreased albumin
- produce Ig
- monoclonal (narrow-based region)
hypoproteinemia caused by 2 basic mechanisms
- increase protein loss from vessels
- decreased protein production by liver
diseases and conditions that cause increase protein loss from vascular space (5)
- blood loss
- protein-losing nephropathy
- protein-losing enteropathy
- protein-losing dermatopathy (burn patient)
- extravasation of plasma proteins (2nd or 3rd space)
diseases and conditions that cause decreased protein synthesis (3)
- hepatic insufficiency
- malabsorption of maldigestion
- cachectic states (neoplasia, chronic disease)
pathogenesis of blood loss causing increased protein loss
- decrease blood volume
- > H2O shifts from extravascular to intravascular space
- > hemodilution -> hypoproteinemia & anemia
protein-losing nephropathy causing increased protein loss
- albumin and smaller globulins pass through porous glomeruli (larger remain in plasma)
- > proteinuria
- > hypoproteinemia, hypoalbuminemia (selective)
protein-losing enteropathy causing increased protein loss
- increase rate of proteins entering intestine & not resorbed (albumin & most globulins)
- > hypoproteinemia, hypoalbuminemia & decreased [globulins] (nonselective)
protein-losing dermatopathy (burn patient) causing increased protein loss
- plasma proteins oozing out of blood vessels (albumin & globulins)
- > hypoproteinemia, hypoalbuminemia & decreased [globulins] (nonselective)
later protein-losing dermatopathy (burn patient) will lead to
- increased globulins and inflammatory dysproteinemia
extravasation of plasma proteins (2nd or 3rd space) causing increased protein loss
- plasma oozes out of blood vessels (albumin & globulins)
- > H2O enters ECF to dilute proteins
- > hypoproteinemia, hypoalbuminemia & decreased [globulins] (nonselective)
hepatic insufficiency causing decreased production of protein production
- decrease production of albumin & most globulins
- hypoproteinemia, hypoalbuminemia (selective)
- gamma- globulins not decreased - but total may be
malabsorption of maldigestion decreased production of protein production
- decrease intake of nutrients (eating but starving)
- too few amino acids for protein production
- hypoproteinemia, hypoalbuminemia & decreased globulins (nonselective)
cachectic states (malignancies, chronic disease) decreased production of protein production
- decrease intake of nutrients (anorexia)
- decrease protein production
or - increased protein degradation exceeds production
- hypoproteinemia, hypoalbuminemia & decreased [globulins] (nonselective)