Therefore, these epidemiological data indicate a significant interaction between both genetic and environmental factors and increased CRP levels that predict a greater risk of CVD events. Some basic research shows that the inflammatory response plays a central role in various phases of atherosclerosis, i. CRP may be critically involved in each of these stages by directly influencing processes, including complement activation, apoptosis, endothelial nitric oxide NO synthase inhibition, vascular cell activation, monocyte recruitment, lipid accumulation and thrombosis, and pro-inflammatory cytokine formation It binds to phosphocholine of oxidized LDL.
NO, an important signaling molecule, is closely associated with the regulation of vasodilatation, blood rheology, platelet aggregation, and other physiological as well as pathological processes. Figure 1. CRP may be involved in various stages through its direct influence on pathophysiological processes such as the activation of endothelial cells and macrophages, inhibition of apoptosis of neutrophils and expression of endothelial NO synthase, stimulation of the complement cascade, enhancement of PAI-1 activity and LDL uptake, accumulation of lipid and thrombosis, and upregulation of pro-inflammatory cytokine expression.
Type 2 diabetes mellitus is a serious disease associated with high morbidity and mortality. CRP, tumor necrosis factor-alpha, and IL-6 may be triggered by the excessive adipose tissue to activate insulin signaling pathways, resulting in insulin resistance that eventually progresses into T2DM Cross-sectional and prospective studies have demonstrated a relationship between elevated CRP levels and increased risk for T2DM Based on the multitude of clinical observations, CRP appears to be not only a marker of chronic inflammation but also a mediator of kidney diseases in basic research.
Age-related macular degeneration, an acquired disease of the macula, is characterized by progressive visual impairment, owing to the late-onset neurodegeneration of the photoreceptor-retinal pigment epithelial complex 53 — Chronic inflammation is thought to be critically involved in the pathophysiology of AMD.
In comparison with pCRP, pro-inflammatory mCRP strongly influenced endothelial cell phenotypes, indicative of its potential role in choroidal vascular dysfunction in AMD A recent observational study of elderly European patients by Cipriani et al. However, complement activation may be involved in the development of AMD. It was found that mCRP played a role in choroidal vascular dysfunction in AMD by influencing endothelial cell phenotypes in vitro and ex vivo During the initial stages of hemorrhagic stroke, including intracerebral hemorrhage and subarachnoid hemorrhage, the reflex mechanisms are activated to protect cerebral perfusion.
The inflammatory process and hyperglycemia are involved in the spontaneous intracerebral hemorrhage sICH as well as the progression of sICH-induced brain injury 65 , Several prospective studies have reported the association between higher CRP levels and increased disability risk of ischemic stroke CRP elevation displays negative prognostic implications for many conditions, while elevations in CRP as a consequence of the major acute-phase response following ischemic or hemorrhagic stroke are associated with death and vascular complications In a cross-sectional study, an increase in hs-CRP level was observed in patients with ischemic infarction but not in those with hemorrhagic stroke, suggestive of the role of hs-CRP in the initial diagnosis of the stroke type Moreover, CRP was an independent predictor of mortality and its expression was significantly correlated with poor clinical outcomes in sICH 70 — Although several studies have shown the higher level of CRP in patients with ischemic stroke, its potential role in various stroke types, particularly in ischemic and hemorrhagic stroke, needs to be investigated.
Neuroinflammation may play a potential role in AD pathogenesis 73 , However, the precise mechanism related to AD phenotype remains unclear. A meta-analysis included 10 cross-sectional studies and showed no significant difference in the serum CRP level between AD patients and normal controls, whereas patients with mild and moderate AD had lower serum CRP levels as compared with the healthy controls by Mini-Mental State Examination scores 15 , indicating that the diagnostic value of CRP for mild and moderate AD may be useful in clinical practice.
Most studies support the reduced plasma CRP levels in mild and moderate AD patients and indicate its potential role as a representative systemic inflammatory marker for the diagnosis of AD.
In addition, lower CRP levels are associated with more rapid cognitive and functional decline The elevated CRP level was associated with an increased risk of AD 77 , while such elevation appeared to diminish and fall below the level observed in nondemented controls after the clinical manifestation of the disease.
Strang et al. Taken together, a direct functional effect elicited by CRP may, at least in part, explain the pathogenesis of AD. Previous studies have highlighted the key role of neuroinflammatory reactions in the pathogenesis of PD and patients with PD were shown to exhibit higher levels of serum hs-CRP. Baseline CRP concentrations were recently shown to be associated with the risk of death and predicted life prognosis of patients with PD A retrospective analysis further supported the association between baseline plasma CRP levels and motor deterioration and predicted motor prognosis in patients with PD; these associations were independent of sex, age, PD severity, dementia, and use of antiparkinsonian agents Although formal demonstration of the mechanism of action of CRP in the pathogenesis of PD is currently lacking, there is a continuous increase in the experimental data, which is in line with the aforementioned concept.
As a nonspecific marker of inflammation, CRP plays a vital role in the monitoring of bacterial infection, inflammation, neurodegeneration, tissue injury, and recovery. Chronic inflammation may be a continuation of an acute or a prolonged low-grade form, which is increasingly recognized as an important issue with social and economic implications.
CRP levels are observed to be increased during acute-phase inflammation as well as chronic inflammatory diseases. Moreover, CRP is not only an excellent biomarker of chronic inflammation but also acts as a direct participant in the pathological process The differentiation between the physiological and pathophysiological CRP levels may allow better management of inflammation-related diseases.
Although the clinical significance and underlying mechanisms of CRP in chronic inflammatory and neurodegenerative diseases are incompletely elucidated, further research is required in order to differentially characterize the roles of CRP isoforms pCRP, facilitator, versus mCRP, effector in chronic inflammation onset and progression.
A better understanding of CRP activation and dissociation is essential to develop therapeutic strategies to minimize tissue injury, which may further improve the outcome of chronic inflammatory diseases.
We affirm that all authors have contributed to, seen, and approved the final, submitted version of the manuscript and are willing to convey copy right to Frontiers in Immunology. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
C-reactive protein and inflammation: conformational changes affect function. Biol Chem — C-reactive protein at 24 hours after hospital admission may have relevant prognostic accuracy in acute pancreatitis: a retrospective cohort study. GE Port J Gastroenterol — Diagnostic value of PCT and CRP for detecting serious bacterial infections in patients with fever of unknown origin: a systematic review and meta-analysis.
Appl Immunohistochem Mol Morphol e61—9. Immunologic biomarkers for diagnostic of early-onset neonatal sepsis. J Matern Fetal Neonatal Med — C-reactive protein: a critical update. J Clin Invest — Nathan C, Ding A. There are other factors that can raise your CRP levels. These include cigarette smoking , obesity , and lack of exercise. Learn more about laboratory tests, reference ranges, and understanding results. Although they both measure CRP, they are used to diagnose different conditions.
It is used to check for risk of heart disease. The information on this site should not be used as a substitute for professional medical care or advice.
Contact a health care provider if you have questions about your health. What is a c-reactive protein CRP test? Other names: c-reactive protein, serum. What is it used for? A CRP test may be used to find or monitor conditions that cause inflammation. These include: Bacterial infections , such as sepsis , a severe and sometimes life-threatening condition A fungal infection Inflammatory bowel disease, a disorder that causes swelling and bleeding in the intestines An autoimmune disorder such as lupus or rheumatoid arthritis An infection of the bone called osteomyelitis.
This was among men who had no previous history of heart disease. High cholesterol is a more commonly cited risk factor. There is also new research that suggests CRP may be used as a predictor in health outcomes related to chronic obstructive pulmonary disease COPD. Doctors may also order a CRP test to diagnose inflammatory autoimmune diseases, including:.
Elevated levels of CRP may have an important role in identifying those who might need closer follow-up or more intensive treatment after heart attacks or heart procedures.
CRP levels may also be useful in uncovering those at risk of heart disease where cholesterol levels alone may not be helpful. The Centers for Disease Control and Prevention considers these conditions significant risk factors for developing heart disease:. A nurse or other health practitioner draws blood from a vein, usually on the inside of your elbow or the back of your hand:.
First, they clean the skin over the vein with antiseptic. Next, they wrap an elastic band around your arm, causing your veins to bulge out slightly. The practitioner then inserts a small needle into the vein and collects your blood in a sterile vial. After the nurse or health practitioner collects your blood sample, they remove the elastic band around your arm and ask you to apply pressure to the puncture site with gauze.
They may use tape or a bandage to hold the gauze in place. The benefits of this test outweigh potential complications, especially for those at risk of heart disease or stroke and those recovering from recent heart procedures.
But it's easy to do and gives more information. So many healthcare providers will order it at the same time. Antinuclear antibody ANA test. The ANA test measures autoantibodies that attack your cells. This is important in diagnosing some autoimmune diseases.
Rheumatoid factor RF. This test is done to help diagnose and monitor rheumatoid arthritis. Anticyclic citrullinated peptide anti-CCP antibodies. Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you. The normal range for this test depends on the lab and the procedure used in the lab. If the level of CRP in your blood is higher than that, it may mean your body is having an inflammatory reaction to something.
More tests will be needed to figure out what's causing the inflammation. The test is done with a blood sample.
0コメント