Acute Phase Protein – Part 2 – Ceruloplasmin
Acute-phase protein (Acute Phase Reactants)
- Acute-phase protein is raised in inflammatory conditions.
- When there is an increase in a protein called positive acute-phase protein.
- In the case of a decrease in the acute phase protein, is called negative phase protein.
- The acute phase proteins (positive) are protein whose concentration increases in the plasma and after the disease episode is over then it decreases and may become normal.
- This test is done in the serum.
- The test is done with a fresh sample.
- Can store the sample for 3 days at 4 °C.
- For 4 weeks can store at -20 °C.
- Avoid hemolyzed or lipemic serum.
- Ceruloplasmin is affected by infection and liver function.
- Birth control pills increase ceruloplasmin and pregnancy.
- This is done to diagnose Willson’s disease.
- To diagnose an accumulation of copper in the liver, eye, and other organs.
- This is a major copper-carrying protein in the blood.
- Ceruloplasmin is α2- globulin, and glycoprotein (7.5% carbohydrate) which is made by the liver.
- Ceruloplasmin which contains 95%of the total copper and gives it a blue color.
- 95% of the copper is bound to Ceruloplasmin.
- Its molecular mass is 134,000.
- This is an acute-phase protein and it has enzymatic activity (peroxidase activity).
Ceruloplasmin can leads to:
- Ceruloplasmin reduces the number of WBCs attachment to the endothelium.
- In one of the experiments, it was found that ceruloplasmin may act as an anti-inflammatory agent by reducing the number of PMNs attaching to endothelium and by acting as an extracellular scavenger of superoxide.
- This is a decrease in Wilson’s disease.
- There is decreased ceruloplasmin and blood copper concentration, with increased urine copper level, indicate Wilson’s disease.
- This is an increase in acute and chronic inflammation.
- One day to 3 months = 5 to 18 mg/dL
- > 7 years = 20 to 54 mg/dL
- Adult = 18 to 45 mg/dL
- Critical value = <20mg/dL is abnormal.
- Another source gives this normal value:
- Male = 36.0 ± 5.6 mg/dL (2.38 ± 0.37 µmol/L).
- Female = 40.9 ± 6.8 mg/dL (2.71 ± o.45 µmol/L).
- Source 4
- 25 to 63 mg/dL (250 to 630 mg/L) by nephelometry.
Increased level of ceruloplasmin is seen in:
- The latter half of the pregnancy.
- Acute and chronic infection.
- In myocardial infarction.
- Leukemia and cancers.
- In liver cirrhosis.
- This is rarely inherited autosomal recessive abnormality.
- Age: This is seen in young adults, adolescents, and both sexes.
- Sign and symptom:
- There is increasing rigidity.
- The patient will have spasticity.
- This patient develops difficulty in swallowing and speaking.
- Pathophysiology: All the tissues will have a high content of the copper.
- There is especially more copper in the liver and brain.
- In the liver copper concentration is 5 to 30 times more than normal tissues.
- The plasma ceruloplasmin level is low because of the copper deposition in the liver.
- Most of the patients develop cirrhosis.
- Diagnosis: There is decreased ceruloplasmin.
- Increased urine copper.