Abstract
The severity of inflammatory processes and the therapeutical approach today are mainly judged from the clinical status of a patient. Supplementary quantitative clinical and laboratory data mostly are related to the secondary reaction of the organism following the inflammatory stimulus. Typical measures are body temperature, white blood cell count, differential leukocytic hemogram, quantitative analysis of serum proteins, and quantification of acute phase proteins. The erythrocyte sedimentation rate also is a consequence of the altered serum protein pattern. The diagnostic usefulness of these parameters is limited for several reasons. The secondary reactions of the organism follow inflammatory stimuli with some delay, the data obtained in many cases are too late for initiation of an early therapy. On the other hand, the data obtained in many cases do not correlate quantitatively with the clinical severity of inflammatory processes. Therefore, the development of methodologies for quantitative measurement of parameters directly related to the inflammatory process ("Inflammation Markers") is a great challenge for pathobiochemical research. In the initiation, course, and termination of inflammatory processes humoral and cellular mechanisms are involved, which are interconnected to a complex network. Some important mechanisms involved are: Humoral mechanisms; coagulation and fibrinolysis; complement (classic and alternative pathway); kallikrein-kinin system. Cellular mechanisms; low molecular weight mediators; arachidonic acid metabolites; biogenic amines; oxygen metabolites. High molecular weight mediators; cytokins. Secretory proteins; lysosomal enzymes. In the preceding lectures the pathobiochemical significance of some of these mechanisms resp. products has been discussed. We present a review of the present and future repertoire of analytical procedures for parameters from these systems. The lecture will cover immunological, biochemical, chromatographic, as well as functional assays. Technical aspects and validity data regarding these assays are presented.
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