The prototypic acute-phase reactant C-reactive protein (CRP) has long been recognized as a useful marker and gauge of inflammation. CRP also plays an important role in host defense against invading ...pathogens as well as in inflammation. CRP consists of five identical subunits arranged as a cyclic pentamer. CRP exists in at least two conformationally distinct forms, i.e. native pentameric CRP (pCRP) and modified/monomeric CRP (mCRP). These isoforms bind to distinct receptors and lipid rafts, and exhibit distinct functional properties. Dissociation of pCRP into its subunits occurs within the inflammatory microenvironment and newly formed mCRP may then contribute to localizing the inflammatory response. Accumulating evidence indicates that pCRP possesses both pro- and anti-inflammatory actions in a context-dependent manner, whereas mCRP exerts potent pro-inflammatory actions on endothelial cells, endothelial progenitor cells, leukocytes and platelets, and thus may amplify inflammation. Here, we review recent advances that may explain how conformational changes in CRP contribute to shaping the inflammatory response and discuss CRP isomers as potential therapeutic targets to dampen inflammation.
C-reactive protein (CRP) is expected to increase in response to a range of inflammatory stimuli such as infections or extensive tissue trauma.
We present a novel case of severely impaired CRP ...response following NSTEMI, influenza A infection and open-heart surgery in which serum CRP concentrations remained < 1 mg/L during an observational period of 28 days.
To our knowledge, no previous publications exists describing patients with a lack of CRP response following cardiothoracic surgery. We believe this to be a novel finding warranting further investigations regarding the etiology and prevalence of this phenomenon.
C-reactive protein (CRP) is well-recognized as a sensitive biomarker of inflammation. Association of elevations in plasma/serum CRP level with disease state has received considerable attention, even ...though CRP is not a specific indicator of a single disease state. Circulating CRP levels have been monitored with a varying degree of success to gauge disease severity or to predict disease progression and outcome. Elevations in CRP level have been implicated as a useful marker to identify patients at risk for cardiovascular disease and certain cancers, and to guide therapy in a context-dependent manner. Since even strong associations do not establish causality, the pathogenic role of CRP has often been over-interpreted. CRP functions as an important modulator of host defense against bacterial infection, tissue injury and autoimmunity. CRP exists in conformationally distinct forms, which exhibit distinct functional properties and help explaining the diverse, often contradictory effects attributed to CRP. In particular, dissociation of native pentameric CRP into its subunits, monomeric CRP, unmasks "hidden" pro-inflammatory activities in pentameric CRP. Here, we review recent advances in CRP targeting strategies, therapeutic lowering of circulating CRP level and development of CRP antagonists, and a conformation change inhibitor in particular. We will also discuss their therapeutic potential in mitigating the deleterious actions attributed to CRP under various pathologies, including cardiovascular, pulmonary and autoimmune diseases and cancer.
Background: Brucellosis is a major health and economic problem in many parts of the world, including the Middle East. Blood disorders such as anemia, leukopenia, and thrombocytopenia can be seen in ...brucellosis. However, laboratory findings of this disease are different. Therefore, this study aimed to investigate the changes in complete blood count (CBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in people with brucellosis in Gonabad community health centers.
Methods: During the 4 years from May 2016 to May 2019, a prospective study was performed on 221 patients with brucellosis. According to the national guidelines for brucellosis, titers greater than 1/80 for Wright and more than 1/40 for 2-ME were considered positive cases of brucellosis. Using the checklist, information related to CBC, CRP, and ESR test parameters was collected.
Results: The results showed that out of 221 patients studied, 58.4% were male and 41.6% were female. The mean age was 44.9±19.8 years for men and 49.3±17.3 years for females. High ESR was seen in 43.4% and positive CRP in 59.7% of patients. Leukopenia in 8.6%, leukocytosis in 9%, neutropenia in 6.8%, neutrophilia in 9.5%, lymphopenia in 3.6%, lymphocytosis in 10%, anemia in 17.2% and thrombocytopenia in 9.5% of patients were seen.
Conclusion: Brucellosis in endemic areas should be considered in the differential diagnosis of patients presenting with thrombocytopenia. Also in high Wright titers, CRP is a more valuable indicator than ESR.
Biosensors have become promising alternatives to the conventional methods in early identification of diseases. However, translation of biosensors from lab to commercial products have challenges such ...as complex sensor fabrications and complicated detection, and inadequate sensitivity and selectivity. Here, we introduce simple and low-cost fabricated conductometric sensors based on high resistivity silicon wafers (HR-Si) which can be adopted to functionalise with both natural and synthetic antibodies in detecting five biomarkers including interleukin-6, C reactive protein, cardiac troponin I, brain natriuretic peptide, and N terminal-probrain natriuretic peptide. All five biomarkers show selective and rapid (10 min sample incubation and <1 min of reading time) detection in both media of phosphate buffer saline and saliva with the detection limits lower than that of reported healthy levels in saliva. This work highlights the versatility of HR-Si sensors in functionalisation of both natural and synthetic antibodies in sensitive and selective biomarker detection. As these miniaturised conductometric biosensors can be easily modified with on-demand biomaterials to detect corresponding target biomarkers, they enable a new category of compact point-of-care medical devices.
Background
The objective of this study was to systematically evaluate the clinical value of procalcitonin and C‐reactive protein in the diagnosis of adult patients with sepsis.
Method
PubMed, ...Cochrane, Embase, Wanfang, China National Knowledge Infrastructure, and VIP database were searched by the index words to identify the qualified prospective studies, and relevant literature sources were also searched. The most recent research was done in the April 2017. The only languages included were English or Chinese. In the experiment group, patients were diagnosed with sepsis, severe sepsis, or septic shock; in the control group, the patients were of noninfectious origin or a systemic inflammatory response syndrome. The diagnostic accuracy was analyzed by heterogeneity, diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the summary receiver‐operating characteristic curve.
Results
At least nine studies were involved in the meta‐analysis with 495 patients in the sepsis group and 873 patients in the nonsepsis group. In terms of the diagnostic accuracy of C‐reactive protein (CRP) for sepsis, the overall area under the summary receiver operator characteristic (SROC) curve was 0.73 (95% confidence interval CI, 0.69‐0.77), with a sensitivity and specificity of 0.80 (95% CI, 0.63‐0.90) and 0.61 (95% CI, 0.50‐0.72) respectively, and the DOR was 6.89 (95% CI, 3.86‐12.31). In terms of the diagnostic accuracy of procalcitonin (PCT) for sepsis, the overall area under the SROC curve was 0.85 (95% CI, 0.82‐0.88), with a sensitivity and specificity of 0.80 (95% CI, 0.69‐0.87) and 0.77 (95% CI, 0.60‐0.88) respectively, and the DOR was 12.50 (95% CI, 3.65‐42.80).
Conclusion
In this meta‐analysis, our results together indicate a moderate degree of value of PCT and CRP for the diagnosis of sepsis in adult patients. The diagnosis accuracy and specificity of PCT are higher than those of CRP.
In this meta‐analysis, our results together indicate a moderate degree of value of PCT and CRP for diagnosis of sepsis in adult patients. The diagnosis accuracy and specificity of PCT are higher than those of CRP.
Cardiovascular disease is the most common cause of morbidity and mortality globally. Epidemiological studies using high‐sensitivity assays for serum C‐reactive protein have shown a consistent ...association between cardiovascular disease risk and serum C‐reactive protein concentrations. C‐reactive protein is a biomarker for inflammation, and has been established in clinical practice as an independent risk factor for cardiovascular disease events. There is evidence that serum C‐reactive protein is an excellent biomarker of cardiovascular disease and is also an independent and strong predictor of adverse cardiovascular events. Further characterization of the impact and influence of lifestyle exposures and genetic variation on the C‐reactive protein response to cardiovascular disease events may have implications for the therapeutic approaches to reduce cardiovascular disease events. This review summarizes the studies that have examined the association between serum C‐reactive protein and the risk of cardiovascular disease. We also discuss the impact of independent factors and C‐reactive protein genetic polymorphisms on baseline plasma C‐reactive protein levels.
This review summarizes some of the latest data, which have examined the association of C‐reactive protein (CRP) variation with the risk of cardiovascular events, to refute or support the role of CRP in cardiovascular disease as a marker or a causal factor. We also discuss the impact of independent factors and C‐reactive protein genetic polymorphisms on baseline plasma C‐reactive protein levels.
Mild, moderate, severe, and critical COVID-19 are associated with hyperinflammation. The CRP and ferritin are acute phase proteins that marks incidence of inflammation and used as the paramaters of ...hyperinflammation. This study aimed to determine the validity of CRP and ferritin level examination in moderate and severe COVID-19 since the time of admission. This was a cross-sectional analytical retrospective study with on moderate and severe COVID-19 patients admitted to Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of March 2020 to December 2020. The CRP and ferritin levels were obtained since the beginning of admission to the fourth day since admission on patients without any history of anemia. Subjects in this study were divided into moderate and severe COVID-19 groups based on the 3rd edition of COVID-19 Prevention and Control Guideline issued by the Ministry of Health Republic of Indonesia. Each group consisted of 30 subjects. The cut-off value was 7.65 mg/dL (AUC 0.698) for CRP and 963.1 mcg/L (AUC 0.938) for ferritin. The validity of ferritin vs CRP were reflected respectively as follows: 93.3% vs 76.7% sensitivity; 80.0% vs 63.3% specificity; 82.4% vs 67.6% PPV; and 92.3% vs 73.1% NPV. The validity of ferritin was proven to be superior as it significantly increases since day one, persisted longer and reaches its peak on the16th day. Meanwhile, CRP increases within 6-8 hours and reaches its peak within 48 hours after inflammation, then declines soon afterwards.
Cardiorespiratory fitness has been postulated to lower chronic inflammation in obesity. We assessed sex-specific associations of inflammation with cardiorespiratory fitness in overweight and obese ...persons.
Peak oxygen uptake (VO2max) was measured by treadmill in 566 participants (age 48 ± 9 years, 60% women) with body mass index >27.0 kg/m2 in the FAT associated CardiOvasculaR dysfunction (FATCOR) study. Fitness was identified from age- and sex specific reference levels of VO2max. The inflammatory markers C-reactive protein (CRP), serum amyloid A (SAA), kynurenine:tryptophan ratio (KTR) and pyriodoxic acid ratio (PAr) were measured by mass spectrometry. In the total study population 63% had obesity and 74% were cardiorespiratory unfit. Unfit women had the highest fat percentage and the highest serum levels of CRP and SAA (p < 0.05). In multivariable linear regression analyses in women, higher CRP (β −0.15, p = 0.001), SAA (β −0.10, p = 0.03) and PAr (β −0.09, p = 0.03) were associated with lower VO2max after adjusting for confounders. In multivariable analyses in men, higher PAr (β −0.14, p = 0.02) was associated with lower VO2max. In multivariable analyses in obese women, higher CRP and PAr remained associated with lower VO2max (p < 0.05), while in obese men there was no significant association. When normalizing VO2max for fat-free mass (VO2maxFFM) higher CRP, SAA and PAr index were associated with lower VO2maxFFM in women, while only higher PAr index was associated with lower VO2maxFFM in men.
The association of inflammation with lower cardiorespiratory fitness was more pronounced in women than men, in particular when obesity was present.
URL: http://www.clinicaltrials.gov NCT02805478.
•Inflammation is central in the development of atherosclerotic cardiovascular disease.•Fitness has been postulated to counter the negative effects of obesity-associated inflammation.•Sex-specific associations of inflammation andcardiorespiratory fitness is little studied in overweight and obese subjects.•Women with poor fitness had the highest levels of inflammatory markers, especially when obesity was present.
We conducted a meta‐analysis on the available randomized clinical trials (RCTs) to assess the role of resveratrol in lowering C‐reactive protein (CRP) and high‐sensitivity CRP (hs‐CRP) levels, as ...markers of inflammation, in various inflammatory disorders. Literature search through Medline/PubMed, Scopus, ISI Web of Science, and Cochrane Library yielded 35 RCTs (24 studies for hs‐CRP and 11 studies for CRP). Pooled results revealed that resveratrol supplementation significantly reduced the hs‐CRP (MWD = −0.40 mg/L; 95% CI: −0.70 to −0.09 mg/L; p = .01) and CRP (MWD = −0.31 mg/L; 95% CI: −0.47 to −0.15 mg/L; p < .001) levels in serum. Subgroup analysis revealed that resveratrol in group with ≥10 weeks significantly reduces hs‐CRP levels (MWD = −0.48 mg/L; 95% CI: −0.92 to −0.04 mg/L; p = .03) and CRP (WMD = −0.47 mg/L, 95% CI = −0.69 to −0.25, p < .001). A dose of ≥500 mg/day supplementation improves the levels of CRP, but not hs‐CRP. This meta‐analysis demonstrates that resveratrol consumption is effective in lowering the levels of CRP and hs‐CRP in inflammatory conditions, especially if supplementation takes place for ≥10 weeks with ≥500 mg/day.
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