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      Acute phase reactant serum amyloid A in inflammation and other diseases.

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          Abstract

          Acute-phase reactant serum amyloid A (A-SAA) plays an important role in acute and chronic inflammation and is used in clinical laboratories as an indicator of inflammation. Although both A-SAA and C-reactive protein (CRP) are acute-phase proteins, the detection of A-SAA is more conclusive than the detection of CRP in patients with viral infections, severe acute pancreatitis, and rejection reactions to kidney transplants. A-SAA has greater clinical diagnostic value in patients who are immunosuppressed, patients with cystic fibrosis who are treated with corticoids, and preterm infants with late-onset sepsis. Nevertheless, for the assessment of the inflammation status and identification of viral infection in other pathologies, such as bacterial infections, the combinatorial use of A-SAA and other acute-phase proteins (APPs), such as CRP and procalcitonin (PCT), can provide more information and sensitivity than the use of any of these proteins alone, and the information generated is important in guiding antibiotic therapy. In addition, A-SAA-associated diseases and the diagnostic value of A-SAA are discussed. However, the relationship between different A-SAA isotypes and their human diseases are mostly derived from research laboratories with limited clinical samples. Thus, further clinical evaluations are necessary to confirm the clinical significance of each A-SAA isotype. Furthermore, the currently available A-SAA assays are based on polyclonal antibodies, which lack isotype specificity and are associated with many inflammatory diseases. Therefore, these assays are usually used in combination with other biomarkers in the clinic.

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          Author and article information

          Journal
          Adv Clin Chem
          Advances in clinical chemistry
          Elsevier BV
          2162-9471
          0065-2423
          2019
          : 90
          Affiliations
          [1 ] Shanghai R&D Center, DiaSys Diagnostic Systems (Shanghai) Co., Ltd., Shanghai, China.
          [2 ] Department of Laboratory Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
          [3 ] C.N. Maternity & Infant Health Hospital, Shanghai, China.
          [4 ] Shanghai R&D Center, DiaSys Diagnostic Systems (Shanghai) Co., Ltd., Shanghai, China. Electronic address: rwang@diasys.cn.
          Article
          S0065-2423(19)30002-2
          10.1016/bs.acc.2019.01.002
          31122611
          71e3539d-6f55-40d1-b731-a73621566a35
          History

          A-SAA assay,SAA isotype,Lipid metabolism,Diagnostic value,A-SAA,Acute-phase reactant

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