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. 2006;2006(1):47297.
doi: 10.1155/MI/2006/47297.

The acute-phase proteins serum amyloid A and C reactive protein in transudates and exudates

Alessandra M Okino  1 , Cristiani Bürger, Jefferson R Cardoso, Edson L Lavado, Paulo A Lotufo, Ana Campa
Affiliations

The acute-phase proteins serum amyloid A and C reactive protein in transudates and exudates

Alessandra M Okino et al. Mediators Inflamm. 2006.

Abstract

The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10 +/- 0.13. For comparison, the exudate/serum ratio for CRP and TP was 0.39 +/- 0.37 and 0.68 +/- 0.15, respectively. There was a strong positive correlation between serum and exudate SAA concentration (r = 0.764; p < 0.0001). The concentration of SAA in transudates was low and did not overlap with that found in exudates (0.02-0.21 versus 0.8-360.5 g/mL). SAA in pleural and ascitic exudates results mainly from leakage of the serum protein via the inflamed membrane. A comparison of the E/S ratio of SAA and CRP points SAA as a very good marker in discriminating between exudates and transudates.

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Figures

Figure 1
Figure 1
Correlation between effusion and serum for SAA (a), CRP (b), and TP (c). Exudates and transudates were from 36 and 12 patients, respectively. When shown the line represents the regression for exudates.
Figure 2
Figure 2
Correlation between CRP and SAA for (a) serum (r = 0.796; p < 0.0001) and (b) exudate (r = 0.449; p = 0.007) in 36 patients.
Figure 3
Figure 3
Correlation between CRP and SAA for (a) serum (r = 0.749; p = 0.005) and (b) transudate (r = 0.247; p = 0.438) in 12 patients.
Figure 4
Figure 4
Individual values of (a) SAA , (b) CRP, and (c) TP in serum and effusions (36 exudates and 12 transudates).
Figure 5
Figure 5
Factors affecting the concentration of a given protein in an exudate.
See this image and copyright information in PMC

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