Lecture 3: Plasma Proteins and Dysproteinemia

plasma

liquid portion of UNCLOTTED blood

what is in plasma?

water, albumin, globulins, fibrinogen

serum

liquid remaining after blood is clotted

key difference of plasma vs serum

plasma has FIBRINOGEN, serum does not

function of albumin

osmotic pressure and transport

function of globulins

immune defense, transport

function of fibrinogen

coagulation and acute-phase response

function of transferrin

iron transport

function of ceruloplasmin

Cu transport and Fe mobilization

function of haptoglobin

binds free hemoglobin

function of immunoglobulins

antibody-mediated immunity

function of antithrombin

inhibits coagulation factors

function of lipoproteins

transport lipids

organ that makes most plasma proteins

LIVER

what produces immunoglobulins?

cells of lymphoid system

major function of all plasma proteins

transport, colloid osmotic effects, regulation, immune defenses, hemostasis

neonate total plasma protein amount

4-6 g/dL

adult total plasma protein amount

6-8 g/dL

why is neonate plasma protein amount lower?

no Ig before getting colostrum

what is failure of passive transfer?

inadequate transfer of maternal immunoglobulins, especially IgG

3 ways to meaasure plasma proteins

refractometry, spectrophotometry, protein electrophoresis

normal HCT, low TPP. what could it be?

GI protein loss, proteinuria, liver disease

normal HCT, high TPP. what could it be?

increased globulin synthesis, dehydration (masks anemia)

high HCT, low TPP. what could it be?

protein loss + erythrocytosis

high HCT, normal TPP. what could it be?

splenic contraction, erythrocytosis, dehydration (masks hypoprotinemia)

high HCT, high TPP. what could it be?

dehydration

low HCT, low TPP. what could it be?

substantial ongoing/recent blood loss; overhydration

low HCT, normal TPP. what could it be?

RBC destruction/production issues, chronic hemmorrhage

low HCT, high TPP. what could it be?

inflammation, multiple myeloma/other lymph disease

hemorrhage

loss of blood components

what happens if fluid is replace faster than cells/protein?

anemia and hypoproteinemia

dehydration

primary fluid loss

what does dehydration cause?

erythrocytosis and hyperproteinemia

formula for total globulins

total protein - albumin = total globulins

what happens with an error in albumin occurs?

error in globulins occurs

in electrophoresis, what protien migrates the farthest?

albumin

what does serum protein electrophoresis do?

separates proteins into albumin, a, b, y fractions

what is SPE best used for?

unexplained hyperglobulinemia or suspected immunoglobulin deficiency

albumin and osmotic pressure

major contributor

what does albumin transport?

Ca, metabolites, hormones, poorly soluble drugs, toxins

what can hypoalbuminemia cause?

edema and low total blood Ca

why does hypoalbuminemia cause low total blood Ca?

calcium is albumin-bound

is albumin positive or negative?

negative

how does hypoalbuminemia cause edema?

decrease albumin decreases pressure, fluid leaves vessels = edema

fibrinogen estimation

TP before heating - TP after heating = fibrinogen

hypoproteinemia

low total protein

hypoalbuminemia

albumin decreased

hypoglobulinemia

globulins decreased

panhypoproteinemia

both albumin and globulins decreased

what can cause hypoalbuminemia?

excess fluids, decreased albumin synthesis, loss of albumin, sequestration

what can decrease synthesis of albumin?

inflammation/liver failure

what can cause loss of albumin?

hemorrhage

what can cause albumin sequestration?

peritonitis

true or false: albumin is SMALL so is easily lost through the kidneys

TRUE

main cause of hyperalbuminemia

dehydration

what causes hypoglobulinemeia

hemorrhage, failure of passive transfer, overhydration, decreased Ig production

what causes hyperglobulinemia?

dehydration, increased Igs, inflammation

location of chylomicrons

intestine

function of chylomicrons

transport dietary triglycerides

location of VLDL

liver

function of VLDL

transports endogenous triglycerides

function of LDL

transports cholesterol from liver to tissues

function of HDL

transports cholesterol from tissues TO the liver

what forms "cream" on blood?

chylomicrons (dietary fat)

positive APP

goes UP with inflammation

negative APP

goes DOWN with inflammation