Sunday, September 27, 2015

Autoimmune and Inflammation

autoimmune and inflammation

Inflammation can be defined as a response to injury, infection, autoimmune, and indeed any tissue sites damage. Autoimmune diseases are when the white cells destroy self tissues rather than bacteria or exogenous material, often autoimmune diseases will present itself as inflammation and so both will be discussed in this review.

INFLAMMATION AND CRP ( C-Reactive Protein)
CRP is a key chemical in this process and is therefore a suitable marker for tissue injury. Generally, the more tissue injury that has occurred, the more CRP is released. Since CRP can be linked to vascular injury and is often raised by coronary vascular disease (CVD) it is increasingly being used as preventive marker for heart attack risk.

Plasma viscosity or PV is a measure of the pressure (Pascal) that plasma exerts on the vasculature. The lumen (diameter) of the blood vessels are a specific size to allow the correct amount of blood to be pumped around, like a domestic central heating system. It is therefore a general indicator what extra is in the plasma that would not normally be present; this will take up more space in the set diameter and increase the pressure. These extracts could be increased concentrations of antibodies, white blood cells, red cells (size and number) and plasma liquid volume. This makes PV a good global marker for various diseases. A general rule of is that the higher the PV the more extracts are in the plasma and more disease pathology is present.

Erythrocyte sedimentation rate or ESR can be written as "how fast do the red cells fall?"ESR is a measure of how fast do the red cells fall in a column of blood in 1 hour. ESR is there a surrogate marker of cancer, inflammation, anaemia, and soon after MI (plasma enzymes) because fibrinogen causes the red blood cells to stick together making them heavier, causing them to sink faster through the plasma. Generally, the higher the ESR the worst the disease pathology (usually inflammation).

The tissue injury causes an inflammation cellular response, which produces elevated CRP. The CRP will increase white cell count (particularly neotrophils and monocytes) which will raise PV, if the injury is caused by bacteria and the monocytes infiltrates cells then the CRP will be significantly raised. These extras will raise PV. The tissue injury will drive a rise in fibrinogen (needed to cause a clot), the fibrinogen will cause the red blood cells to stick together and thus ESR will raise, the final measure in the inflammation trilogy. A final word is that the original CRP response may drop but the PV and ESR will remain high until the extras and the fibrinogen stuck RBCs are removed.

An autoimmune disease occurs when the white blood cells either produces antibodies which are directed to the host or the directly release toxic chemicals to destroy the host tissue. Either of these events will result in the inflammation trilogy driven by tissue injury caused by the patient's own white blood cells.

So, to begin with most autoimmune disease, at one level, will have a raised WBC, increased  differential, CRP, PV and ESR.

This review discussed the key components of inflammation and autoimmune diseases. Disease pathologies of anaemias, autoimmune, leukaemia, cancers, heart disease risk, infections and inflammation and clotting ability would be at least partly addressed by these tests.



A Medical Microbiologist, Public health worker, blogger and artcle writer, and offcourse a fan of Manchester United football club