Further characterization of serum amyloid A4 as a minor acute phase reactant and a possible nutritional marker

A constitutive isotype of human serum amyloid A, serum amyloid A4 (SAA4), is distributed into plasma lipoproteins, primarily in high density lipoproteins. Its physiological function is unknown; its serum concentration has no relationship with those of other major apolipoproteins. In this study, changes in SAA4 concentrations were further characterized. Variations in healthy individuals were negligible. In subjects undergoing renal allograft transplantation, SAA4 changed in parallel with acute phase SAA, although its magnitude was not larger than a three-fold increase. This confirmed that SAA4 is a minor acute phase reactant in humans. SAA4 concentrations showed a good agreement with serum pseudocholinesterase activity in healthy subjects and patients with lowered pseudocholinesterase when patients with elevated acute phase SAA were excluded. These results suggest that SAA4 can be an indicator of nutrition or of hepatic protein synthesis in the absence of inflammation.