CRP Flashcards
What is the function of C-reactive protein (CRP)?
CRP is an acute-phase protein that binds to self and extrinsic ligands
What are some self-ligands that CRP can recognize?
• Plasma lipoproteins
• Damaged cell membranes
• Several phospholipids
• Small nuclear ribonucleoprotein components
• Apoptotic cells
What are some extrinsic ligands that CRP can bind to?
• Phospholipids
• Capsular/cell body components
What are positive and negative acute-phase proteins (APPs)?
Positive APPs: Increase during inflammation
Negative APPs: Decrease during inflammation
example of positive APPs
-C-reactive protein (CRP)
-Serum Amyloid A (SAA)
-Haptoglobin (Hp)
-Ceruloplasmin
-a2-Macroglobulin
-a1-Acid glycoprotein (AGP)
-Fibrinogen
-Complement (C3, C4)
what is an example of negative APPs
-Albumin
-Transferrin
-Transthyretin
-Retinol-binding protein
NV of CRP
<10 mg/L
What does an elevated CRP level indicate?
A higher CRP level suggests increased inflammation, which may be due to infection, autoimmune disease, or other inflammatory conditions.
Why is CRP not very specific?
CRP isn’t unique to one disease, so it cannot diagnose a specific condition but helps monitor inflammation and disease progression.
How is CRP useful in bacterial vs. viral infections?
An extremely elevated CRP suggests a bacterial infection, helping differentiate between bacterial and viral causes of illness.
How can CRP levels help in patient management?
• Monitor disease progression
• Assess response to treatment
• Detect postoperative complications or new infections
Which interleukins are related to CRP production?
IL-1, 1L-6
Stimulates acute-phase protein production, including CRP
IL-6
Primary inducer of the inflammatory response
IL-1
How do CRP and ESR compare?
CRP
- rapidly produced
- more sensitive
- more specific
ESR
- delayed response
- moderate sensitivity
- less specific
what are the functions of crp
- anti infective
- anti inflammatory actions
- scavenging action
anti infective functions of crp
- opsonization: makes particles for phagocytosis
- activates complement (via classical pathway)
anti inflammatory functions of crp
- prevents systemic inflammation
- release neutrophils while preventing white cell adhesion in non-inflamed tissue
scavenging function of crp
- does not bind to normal cell membrane
- binds to apoptopic & necrotic cells
- activates complement & attracts immune cells
Processes induced by CRP
- complement cascade activation
- RAAS activation
- prothrombotic state
- endothelial dysfunction
- opsonization of oxidized LDL
CRP & Vascular wall damage
- inflammatory cell infiltration
- smooth muscle proliferation
- increased sensitivity to proatherogenic factors
CRP & Prothrombotic State
- faster thrombin formation
- increased adhesion molecules
- decreased fibrolysis
CRP & Endothelial dysfunction
- decreased nitric oxide production
- decreased vasodilation
- glycocalyx damage
CRP & Oxidized LDL
- easier uptale by macrophages
- foam cell formation (atherosclerosis risk)
effects of body mass in CRP levels
weight loss - decrease crp
effect of gender in CRP levels
higher in women
factors affecting CRP levels
- gender
- body mass
- ethnicity
- exercise
- alcohol
effects of ethnicity in CRP levels
higher in blacks
effects of exercise in CRP levels
lowers CRP
effects of alcohol in CRP levels
lowers CRP
methods for CRP detection
-ELISA
-Immunoturbidimetry
-Rapid Immunodiffusion
-Visual Agglutination
clinical importance of CRP - elevated levels
- osteoarthritis
- coronary events (esp in stable angina)
- proinflammatory & prothrombotic effects
clinical importance of CRP - mild elevation
- SLE
- Sclerodema
- Sjogren’s Syndrome
- Dermatomyositis/Polymyositis
CRP & Antibiotic Therapy
CRP levels normalization = helpful tool in determining the response to antibiotic therapy and duration of treatment
elevated CRP levels can be seen in (transplants)
kidney & heart transplants
high CRP means possible?
GVHD
high CRP in cerebral vein thrombosis means
poor prognosis
thrombosis platelet count and CRP levels that have been found to be the strongest laboratory predictors of a positive temporal artery biopsy
CRP = >2.45 mg/dL
Platelets = >400,000 uL
when does pancreatitis levels increase
3 days after pain onset
CRP level for pancreatitis that distinguishes mild from severe disease
150MG/L
more sensitive than CRP for cardiovascular injury
high sensitivity CRP (hs-CRP)
normal range for hs-crp
<0.3 mg/dL
hs-CRP uses
- predicts cardiovascular risk (CVD, stroke, PVD)
- improves cholesterol based risk prediction
- associated with hypotension risk
hs-crp is taken as an independent risk factor for ___, ____, ____
CVD, Stroke, and Peripheral vascular disease
hs-crp has been reporyed as a risk factor for?
hypotension
