Inflammation

An inflammatory response may be the result of infection, massive cell death or a combination of both.  In addition, inflammation may lead to extra tissue damage and cell death, thereby perpetuating the inflammatory repsonse. Several inflammatory markers can be detected as measure for inflammation or cell death, such as cell free DNA (in the form of nucleosomes) which is released upon cell death. Neutrophils are the main innate immue cells that are attracted to infamed tissue. Elastase is excreted upon stimulation of neutrophils and can be used as a marker for in vivo neutrophil activation. In human plasma elastase is directly complexed with its inhibitor alpha 1-antitrypsin ( a1-AT), so in plasma samples elastase- a1-AT complexes should be measured. 



Assays inflammatory markers Context
CRP Acute phase protein, general inflammation marker
Elastase-a1-AT complexes Neutrophil activation
NETs Neutrophil extracellular traps
Nucleosomes Cell death/tissue damage
Granzyme A Activation NK cells and Cytotoxic T cells
Granzyme B Activation NK cells and Cytotoxic T cells
Monocyte activation test (MAT) Test whether a substance or vaccine elicits pro-inflammatory cytokine response


References

Solati S, Aarden L, Zeerleder S, Wouters D. An improved monocyte activation test using cryopreserved pooled human mononuclear cells. Innate Immun 2015; 21(7):677-84

Van Bijnen ST, Wouters D, van Mierlo GJ, Muus P, Zeerleder S. Neutrophil activation and nucleosomes as markers of systemic inflammation in paroxysmal nocturnal haemoglobinuria: effects of eculizumab. J Thromb Haemost. 2015 Aug 31.

Huson MA, Zeerleder SS, van Mierlo G, Wouters D, Grobusch MP, van der Poll T. HIV infection is associated with elevated nucleosomes in asymptomatic patients and during sepsis or malaria.J Infect 2015; 71(2):266-9.

Van Montfoort ML, Stephan F, Lauw MN, Hutten BA, Van Mierlo GJ, Solati S, Middeldorp S, Meijers JC, Zeerleder S. Circulating nucleosomes and neutrophil activation as risk factors for deep vein thrombosis. Arterioscler Thromb Vasc Biol 2013; 33(1):147-51.

Tschopp CM, Spiegl N, Didichenko S, Lutmann W, Julius P, Virchow JC, Hack CE, Dahinden CA. Granzyme B, a novel mediator of allergic inflammation: its induction and release in blood basophils and human asthma. Blood 2006;108(7):2290-9.

Van Woensel JB, Biezeveld MH, Hack CE, Bos AP, Kuijpers TW. Elastase and granzymes during meningococcal disease in children: correlation to disease severity.

Intensive Care Med 2005; 31(9):1239-47.

Zeerleder S, Zwart B, Wuillemin WA, Aarden LA, Groeneveld AB, Caliezi C, van Nieuwenhuijze AE, van Mierlo GJ, Eerenberg AJ, Lämmle B, Hack CE. Elevated nucleosome levels in systemic inflammation and sepsis. Crit Care Med 2003; 31(7):1947-51.

Last edited on: 4 November 2015