Which of the following acute-phase protein levels are increased in human plasma following acute inflammation?

a. C-reactive protein

b. Serum amyloid

c. a -Proteinase inhibitor

e. Albumin

The acute-phase response is a series of homeostatic responses of the organism to tissue injury in infection and inflammation. After an inflammatory stimulus occurs, a number of events occur within hours. These reflect altered set-points for various physiologic parameters including thermoregulation (fever), nitrogen balance (negative), and levels of various plasma proteins (increased or decreased). The erythrocyte sedimentation rate, which increases with inflammatory states, is an example of this phenomenon. The increased sedimentation rate is due to increased levels of fibrinogen and some of the other acute-phase reactants in plasma. Some proteins show a large increase (about 1000-fold), some a 4-to 5-fold increase, and others about a 50% increase over resting nonstressed levels. Note that albumin is an acute-phase reactant. Levels of albumin drop after an inflammatory stimulus, usually 30% to 50% of the level before injury. The reason for the decrease in production is poorly understood.