Advertisement

Pathobiological Role of CRP in Diseases: Clinical Medical Applications of CRP

  • Waliza Ansar
  • Shyamasree Ghosh
Chapter

Abstract

Although C-reactive protein has been designated as a marker for inflammation and recently as a marker in assessment of risk in cardiovascular disorders from a number of studies across the globe, the role of CRP in other diseases have also been studied. Some of the major diseases in which CRP levels have been correlated with disease states are detailed in this chapter. Bearing a hepatic origin, C-reactive protein is a protein found in the plasma and belongs to the pentraxin family participating in the inflammatory reaction. The CRP concentration in response to injury or infection becomes escalated about 1000-fold over and above normally expressed levels. CRP is known for its function as a mediator in the classical innate immunity pathway and constitutes a part of both humoral and cellular effector systems of inflammation. Although it is well known as a marker for acute-phase response in injury of the tissue, during the infection of the host by pathogenic agents like viruses, bacteria, parasites, and inflammations, it has recently gained the status of a disease marker in cardiovascular disorders and also has been reported for its clinical and pathological significance. In this chapter we highlight the status of C-reactive protein (CRP) in different disorders and pathological conditions.

Keywords

C-reactive protein Systemic Lupus Erythromatosus Thyroid diseases Ovarian diseases Rheumatoid arthritis 

References

  1. Allin KH, Nordestgaard BG, Flyger H, Bojesen SE (2011) Elevated pre-treatment levels of plasma C-reactive protein are associated with poor prognosis after breast cancer: a cohort study. Breast Cancer Res 13:R55CrossRefPubMedPubMedCentralGoogle Scholar
  2. Ansar W, Bandyopadhyay SM, Chowdhury S, Habib SH, Mandal C (2006) Role of C-reactive protein in complement mediated hemolysis in Malaria. Glycoconj J 23(3–4):233–240CrossRefPubMedGoogle Scholar
  3. Ansar W, Habib SK, Roy S, Mandal C, Mandal C (2009a) Unraveling the C-reactive protein complement-cascade in destruction of red blood cells: potential pathological implications in Plasmodium falciparum malaria. Cell Physiol Biochem 23(1–3):175–190. doi: 10.1159/000204106. Epub 2009 Feb 18CrossRefPubMedGoogle Scholar
  4. Asgari SA, Mokhtari G, Falahatkar S, Mansour-Ghanaei M, Roshani A, Zare A, Zamani M, Khosropanah I, Salehi M (2006) Diagnostic accuracy of C-reactive protein and erythrocyte sedimentation rate in patients with acute scrotum. Urol J 3(2):104–108PubMedGoogle Scholar
  5. Autelitano DJ, Raineri L, Knight K, Bannister K, Rice GE (2012) Performance of a multianalyte test as an aid for the diagnosis of ovarian cancer in symptomatic women. J Transl Med 10:45CrossRefPubMedPubMedCentralGoogle Scholar
  6. Bilgir O, Bilgir F, Topcuoglu T, Calan M, Calan O (2014) Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism. Endocrine 45(2):244–248CrossRefPubMedGoogle Scholar
  7. Cheng Q, Xia W, Yang S, Ye P, Mei M, Song Y, Luo M, Li Q (2013) Association of serum pigment epithelium-derived factor with high-sensitivity C-reactive protein in women with polycystic ovary syndrome. J Endocrinol Investig 36(8):632–635CrossRefGoogle Scholar
  8. Christ-Crain M, Meier C, Guglielmetti M, Huber PR, Riesen W, Staub JJ, Müller B (2003) Elevated C-reactive protein and homocysteine values: cardiovascular risk factors in hypothyroidism? A cross-sectional and a double-blind, placebo-controlled trial. Atherosclerosis 166(2):379–386CrossRefPubMedGoogle Scholar
  9. Clyne B, Olshaker JS (1999) The C-reactive protein. J Emerg Med 17:1019–1025CrossRefPubMedGoogle Scholar
  10. Czarnywojtek A, Owecki M, Zgorzalewicz-Stachowiak M, Woliński K, Szczepanek-Parulska E, Budny B, Florek E, Waligórska-Stachura J, Miechowicz I, Bączyk M, Sawicka N, Dhir S, Ruchała M (2014) The role of serum C-reactive protein measured by high-sensitive method in thyroid disease. Arch Immunol Ther Exp (Warsz) 62(6):501–509CrossRefGoogle Scholar
  11. Das UN (2001) Is obesity an inflammatory condition? Nutrition 17:953–966CrossRefPubMedGoogle Scholar
  12. Das T, Sen A, Kempf T, Pramanik SR, Mandal C, Mandal C (2003) Induction of glycosylation in human C-reactive protein under different pathological conditions. Biochem J 373(Pt 2):345–355CrossRefPubMedPubMedCentralGoogle Scholar
  13. De Beer FC, Shine B, Pepys MB (1982a) Radiometric ligand binding assay for C-reactive protein. Complexed C reactive protein is not detectable in acute-phase serum. Clin Exp Immunol 50:231–237PubMedPubMedCentralGoogle Scholar
  14. Deligeoroglou E, Vrachnis N, Athanasopoulos N, Iliodromiti Z, Sifakis S, Iliodromiti S, Siristatidis C, Creatsas G (2012) Mediators of chronic inflammation in polycystic ovarian syndrome. Gynecol Endocrinol 28(12):974–978CrossRefPubMedGoogle Scholar
  15. Dobrzycka B, Mackowiak-Matejczyk B, Terlikowska KM, Kulesza-Bronczyk B, Kinalski M, Terlikowski SJ (2013) Serum levels of IL-6, IL-8 and CRP as prognostic factors in epithelial ovarian cancer. Eur Cytokine Netw 24(3):106–113PubMedGoogle Scholar
  16. Doehn C, Fornara P, Kausch I, Büttner H, Friedrich HJ, Jocham D (2001) Value of acute-phase proteins in the differential diagnosis of acute scrotum. Eur Urol 39(2):215–221CrossRefPubMedGoogle Scholar
  17. El-Mesallamy HO, Abd El-Razek RS, El-Refaie TA (2013) Circulating high-sensitivity C-reactive protein and soluble CD40 ligand are inter-related in a cohort of women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 168(2):178–182CrossRefPubMedGoogle Scholar
  18. Esfahanian F, Zamani MM, Heshmat R, Moini nia F (2013) Effect of metformin compared with hypocaloric diet on serum C-reactive protein level and insulin resistance in obese and overweight women with polycystic ovary syndrome. J Obstet Gynaecol Res 39(4):806–813CrossRefPubMedGoogle Scholar
  19. Gaitonde S, Samols D, Kushner I (2008) C-reactive protein and systemic lupus erythematosus. Arthritis Rheum 59:1814–1820CrossRefPubMedGoogle Scholar
  20. Gasim S, Theander TG, ElHassan AM (2000) High levels of C-reactive protein in the peripheral blood during visceral leishmaniasis predict subsequent development of post kala-azar dermal leishmaniasis. Acta Trop 75(1):35–38CrossRefPubMedGoogle Scholar
  21. Haverkate F, Thompson SG, Pyke SDM, Gallimore JR, Pepys MB (1997) Production of C-reactive protein and risk of coronary events in stable and unstable angina. Lancet 349:462–466CrossRefPubMedGoogle Scholar
  22. Hirschfield GM, Pepys MB (2003) C-reactive protein and cardiovascular disease: new insights from an old molecule. QJM 96:793–807CrossRefPubMedGoogle Scholar
  23. Jublanc C, Bruckert E, Giral P, Chapman MJ, Leenhardt L, Carreau V, Turpin G (2004) Relationship of circulating C-reactive protein levels to thyroid status and cardiovascular risk in hyperlipidemic euthyroid subjects: low free thyroxine is associated with elevated hsCRP. Atherosclerosis 172(1):7–11CrossRefPubMedGoogle Scholar
  24. Kaya C, Akgül E, Pabuccu R (2010) C-reactive protein and homocysteine levels are associated with abnormal heart rate recovery in women with polycystic ovary syndrome. Fertil Steril 94(1):230–235CrossRefPubMedGoogle Scholar
  25. King DE, Mainous AG 3rd, Buchanan TA, Pearson WS (2003) C-reactive protein and glycemic control in adults with diabetes. Diabetes Care 26:1535–1539CrossRefPubMedGoogle Scholar
  26. Markt SC, Rider JR, Penney KL, Schumacher FR, Epstein MM, Fall K, Sesso HD, Stampfer MJ, Mucci LA (2014) Genetic variation across C-reactive protein and risk of prostate cancer. Prostate 74(10):1034–1042. doi: 10.1002/pros.22820, Epub 2014 May 20CrossRefPubMedPubMedCentralGoogle Scholar
  27. Martocchia A, Cola S, Frugoni P, Indiano I, D’Urso R, Falaschi P (2010) The burden of comorbidity and the C-reactive protein levels in nonthyroidal illness syndrome with metabolic syndrome and atherosclerosis-related cardiovascular complications. Ann N Y Acad Sci 1193:164–166CrossRefPubMedGoogle Scholar
  28. Mugabo Y, Li L, Renier G (2010) The connection between C-reactive protein (CRP) and diabetic vasculopathy. Focus on preclinical findings. Curr Diabetes Rev 6(1):27–34CrossRefPubMedGoogle Scholar
  29. Nagasaki T, Inaba M, Shirakawa K, Hiura Y, Tahara H, Kumeda Y, Ishikawa T, Ishimura E, Nishizawa Y (2007) Increased levels of C-reactive protein in hypothyroid patients and its correlation with arterial stiffness in the common carotid artery. Biomed Pharmacother 61(2–3):167–172, Epub 2007 Feb 21CrossRefPubMedGoogle Scholar
  30. Nebiker CA, Delko T, Zulewski H, Oertli D (2013) Acute thyroid swelling and elevated C reactive protein. BMJ Case Rep 2013. pii: bcr2013200427Google Scholar
  31. Niizuma T, Terada K, Kosaka Y, Daimon Y, Inoue M, Ogita S, Kataoka N, Tanaka K (2004) Elevated serum C-reactive protein in mumps orchitis. Pediatr Infect Dis J 23(10):971CrossRefPubMedGoogle Scholar
  32. Nowicka MA, Fritz-Rdzanek A, Grzybowski W, Walecka I, Niemiec KT, Jakimiuk AJ (2010) C-reactive protein as the indicator of severity in ovarian hyperstimulation syndrome. Gynecol Endocrinol 26(6):399–403CrossRefPubMedGoogle Scholar
  33. Oliveira EB, Gotschlich EC, Liu T-Y (1979) Primary structure of human C-reactive protein. J Biol Chem 254(2):489–502PubMedGoogle Scholar
  34. Orre IJ, Murison R, Dahl AA, Ueland T, Aukrust P, Fosså SD (2009) Levels of circulating interleukin-1 receptor antagonist and C-reactive protein in long-term survivors of testicular cancer with chronic cancer-related fatigue. Brain Behav Immun 23(6):868–874CrossRefPubMedGoogle Scholar
  35. Pepys MB, Hirschfield GM (2003) C-reactive protein: a critical update. J Clin Invest 111:1805–1812CrossRefPubMedPubMedCentralGoogle Scholar
  36. Pepys MB, Gallimore JR, Lloyd J, Li Z, Graham D, Taylor GW et al (2012) Isolation and characterization of pharmaceutical grade human pentraxins, serum amyloid P component and C-reactive protein, for clinical use. J Immunol Methods 384:92–102CrossRefPubMedPubMedCentralGoogle Scholar
  37. Piciu A, Piciu D, Marlowe RJ, Irimie A (2013) Highly-sensitive C-reactive protein, a biomarker of cardiovascular disease risk, in radically-treated differentiated thyroid carcinoma patients after repeated thyroid hormone withholding. Exp Clin Endocrinol Diabetes 121(2):102–108CrossRefPubMedGoogle Scholar
  38. Poole EM, Lee IM, Ridker PM, Buring JE, Hankinson SE, Tworoger SS (2013) A prospective study of circulating C-reactive protein, interleukin-6, and tumor necrosis factor α receptor 2 levels and risk of ovarian cancer. Am J Epidemiol 178(8):1256–1264CrossRefPubMedPubMedCentralGoogle Scholar
  39. Rezaieyazdi Z, Sahebari M, Hatef MR, Abbasi B, Rafatpanah H, Afshari JT, Esmaily H (2011) Is there any correlation between high sensitive CRP and disease activity in systemic lupus erythematosus? Lupus 20(14):1494–1500CrossRefPubMedGoogle Scholar
  40. Sasidevi A, Vellanki P, Kunselman AR, Raja-Khan N, Dunaif A, Legro RS (2013) Familial aggregation of circulating C-reactive protein in polycystic ovary syndrome. Hum Reprod 28(3):770–776. doi: 10.1093/humrep/des416. Epub 2012 DecCrossRefPubMedPubMedCentralGoogle Scholar
  41. Strati I, Copelovici Y, Selim G (1993) [C-reactive protein (Crp) in different clinical forms of mumps infection]. Rev Roum Virol 44(3–4):305–306PubMedGoogle Scholar
  42. Tanigaki K, Vongpatanasin W, Barrera JA, Atochin DN, Huang PL, Bonvini E, Shaul PW, Mineo C (2012) C-reactive protein causes insulin resistance in mice through Fcγ Receptor IIB-mediated inhibition of skeletal muscle glucose delivery. Diabetes 62:721–731CrossRefPubMedGoogle Scholar
  43. Tchernof A, Nolan A, Sites CK, Ades PA, Poehlman ET (2002) Weight loss reduces C-reactive protein levels in obese postmenopausal women. Circulation 105:564–569CrossRefPubMedGoogle Scholar
  44. Ter Borg EJ, Horst G, Limburg PC, van Rijswijk MH, Kallenberg CG (1990) C-reactive protein levels during disease exacerbations and infections in systemic lupus erythematosus: a prospective longitudinal study. J Rheumatol 17:1642–1648PubMedGoogle Scholar
  45. Thompson D, Pepys MB, Wood SP (1999) The physiological structure of human C-reactive protein and its complex with phosphocholine. Structure 7:169–177CrossRefPubMedGoogle Scholar
  46. Thurner EM, Krenn-Pilko S, Langsenlehner U, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T (2015) The elevated C-reactive protein level is associated with poor prognosis in prostate cancer patients treated with radiotherapy. Eur J Cancer 51(5):610–619. doi: 10.1016/j.ejca.2015.01.002. Epub 2015 Jan 21CrossRefPubMedGoogle Scholar
  47. Toriola AT, Grankvist K, Agborsangaya CB, Lukanova A, Lehtinen M, Surcel HM (2011) Changes in pre-diagnostic serum C-reactive protein concentrations and ovarian cancer risk: a longitudinal study. Ann Oncol 22(8):1916–1921CrossRefPubMedGoogle Scholar
  48. Trabert B, Pinto L, Hartge P, Kemp T, Black A, Sherman ME, Brinton LA, Pfeiffer RM, Shiels MS, Chaturvedi AK, Hildesheim A, Wentzensen N (2014) Pre-diagnostic serum levels of inflammation markers and risk of ovarian cancer in the prostate, lung, colorectal and ovarian cancer (PLCO) screening trial. Gynecol Oncol 135(2):297–304CrossRefPubMedPubMedCentralGoogle Scholar
  49. Tuzcu A, Bahceci M, Gokalp D, Tuzun Y, Gunes K (2005) Subclinical hypothyroidism may be associated with elevated high-sensitive c-reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocr J 52(1):89–94CrossRefPubMedGoogle Scholar
  50. Vogt B, Führnrohr B, Müller R, Sheriff A (2007) CRP and the disposal of dying cells: consequences for systemic lupus erythematosus and rheumatoid arthritis. Autoimmunity 40:295–298CrossRefPubMedGoogle Scholar
  51. Wethal T, Haugnes HS, Kjekshus J, Småstuen MC, Ueland T, Aukrust P, Fosså SD (2010) C-reactive protein; a potential marker of second cancer and cardiovascular disease in testicular cancer survivors? Eur J Cancer 46(18):3425–3433CrossRefPubMedGoogle Scholar
  52. Yu YT, Ho CT, Hsu HS, Li CI, Davidson LE, Liu CS, Li TC, Shih CM, Lin CC, Lin WY (2013) Subclinical hypothyroidism is associated with elevated high-sensitive C-reactive protein among adult Taiwanese. Endocrine 44(3):716–722CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  • Waliza Ansar
    • 1
  • Shyamasree Ghosh
    • 2
  1. 1.Department of ZoologyBehala CollegeKolkataIndia
  2. 2.National Institute of Science EducationSchool of Biological SciencesBhubaneswarIndia

Personalised recommendations