The Relationship Between the Erythrocyte Sedimentation Rate and the Plasma Proteins 12

Abstract

From the time of the early Greek physicians many observers noted a relationship between the sedimentation rate of the red cells and the concentration of fibrinogen or " phlegma " in the blood. However, no detailed studies were made until 1918 when Fahraeus (5) studied the sedimentation rate in pregnancy and concluded that the increase in the rate was due to a lowering of the electric charge on the red cells. Since that time interest in the subject has been renewed. Numerous investigators have studied the variations in sedimentation rate that occur in disease and a few workers have attempted to determine also the factors underlying these variations. As a result of these investigations of the past twenty years, the sedimentation rate has become of definite clinical value, but there is no general agreement as to the factors involved in the aggregation and sedimentation of the red cells.The majority of investigators have corroborated the long-standing impression that there is a suggestive relationship between the concentration of fibrinogen and the sedimentation rate. In fact, despite occasional marked exceptions to an exact linear relationship between the fibrinogen and the sedimentation rate, the majority of recent workers have concluded that the concentration of fibrinogen determines the sedimentation rate (1,2,4,8,10,14,16). The occurrence of occasional marked inconsistencies, however, has led a few workers to conclude that the relationship between fibrinogen and sedimentation rate is not one of cause and effect (9,12,13 that blood samples with high concentrations of globulin have high sedimentation rates.In the course of our studies of the sedimentation rates and plasma protein fractions in arthritis, we occasionally obtained marked inconsistencies in the relationship between plasma proteins and sedimentation rates, in contrast with the majority of the findings reported in the literature. Because of these findings and the lack of agreement as to the correlation between the plasma proteins and the sedimentation rate, which is evident from a survey of the literature, we undertook a more detailed study of the relationship.The present investigation includes chiefly studies in various types of arthritis, but it also includes a few studies in other diseases which produce abnormal rates, such as myelomatosis, carcinoma of lung, malignant lymphoma of Hodgkin's type, acute lupus erythematosus disseminatus, poikiloderma atrophicans vasculare, lymphogranuloma inguinale, and nutritional edema. The results are of special significance since they cover both the sudden and marked changes in sedimentation rates and in concentration of proteins that occur in acute infections such as gonorrheal arthritis, and the more gradual changes in chronic infections such as rheumatoid arthritis. In conditions in which the type of reaction is so different, the chemical changes produced by the infection would be expected to be different. Whatever the stimulating agent may be which is produced by the infection and which leads to changes in the...

The Electrophoretic Distribution of Proteins in Plasma in Rheumatoid Arthritis12

“…A major role has been ascribed to elevations of fibrinogen or of the a,-, a2-, or 'y-globulin, respectively (4,33,(43)(44)(45). In the present study a correlation between the sedimentation rate and high concentrations of fibrinogen and y-globulin and low concentration of albumin is apparent with coefficients of .61, .60, and -.58, respectively.5…”

Association of aggressive periodontitis with reduced erythrocyte counts and reduced hemoglobin levels

“…It is one of the oldest nonspecific laboratory methods used to diagnose inflammatory disorders and monitor disease activity (60). It reflects the systemic response of the disease and results from a change in the colloidal state of plasma, which may be caused by variations in the concentrations of plasma proteins, such as fibrinogen and globulin (61). The mean ESR value of GAP patients in the present study was significantly higher than that of periodontally healthy individuals.…”

The effect of the plasma proteins upon the sedimentation rate of human blood

“…Thus it is quite possible to have a high fibrinogen content and low sedimentation rate due to increase of pseudoglobulin at the expense of the euglobulin, while the total globulin concentration remains stationary; or an increase of globoglycoid over crystalbumin can inhibit the action of the globulins without inducing any abnormality in the gross protein fractions. This concept probably explains why Alred-Brown & Monroe [1935] and Ropes et al [1939] found no relation between the concentration of any one protein fraction and sedimentation rate, while Frazer & Rennie [1941] found decrease of albumin and, to a lesser extent, increase of fibrinogen, associated with rise of sedimentation rate, while the globulins had no appreciable effect.…”