Review articleC-reactive protein: history and revival
Introduction
C-reactive protein (CRP) is an acute-phase constituent with a record of service for more than seven decades. In the last decade, the protein experienced a revival in attention due to the inflammatory pathogenesis of atherosclerosis. In particular, the role of CRP in the vulnerability and instability of atherosclerotic plaques, leading to rupture, thrombosis and thus to occlusive arterial disease, has been studied.
This review is divided into two sections. The first part covers the first six decades, starting with the discovery of CRP and reviewing the fundamental aspects of the protein. In the second part, the role of CRP in atherosclerotic disease is discussed.
Section snippets
Historical perspectives
C-reactive protein (CRP) is an acute-phase protein that was discovered in 1930 by William S. Tillet and Thomas Francis at the Rockefeller Institute for Medical Research [1]. Studying the immune response of patients with pneumococcal pneumonia, they found that sera of these patients precipitated with a soluble extract of the Pneumococcus pneumoniae. This soluble extract was called fraction C, later identified as a polysaccharide of the cell wall. After resolution of the pneumonia, no
Atherosclerosis and plaque formation
Atherosclerosis is a slowly progressive disease that begins in early childhood and smolders until it becomes manifest at middle age or later by a cardiac event, stroke, or peripheral vascular disease [35]. The first macroscopic stadium of atherosclerosis is the fatty streak, a slightly elevated yellow lesion within the intima, microscopically filled with foam cells (macrophages loaded with cholesterol esters and free cholesterol), smooth muscle cells, and a few T lymphocytes. In a later stage,
Conclusions
Measuring hsCRP in patients who are at risk for arterial occlusive disease may become a new risk assessment tool for the physician, whatever the role of CRP in the atherosclerotic process. The value of measuring CRP in asymptomatic, low-risk subjects, however, is unclear.
CRP levels may also be a useful marker for monitoring drug therapy. Of particular interest are the effects of statin therapy and anti-inflammatory drugs in high-risk patients (i.e. those with diabetes mellitus, obesity,
References (68)
Human C-reactive protein: expression, structure, and function
Mol Immunol.
(2001)- et al.
The physiological structure of human C-reactive protein and its complex with phosphocholine
Structure
(1999) - et al.
Human neurons generate C-reactive protein and amyloid P: upregulation in Alzheimer disease
Brain Res
(2000) - et al.
Generation of C-reactive protein an complement components in atherosclerotic plaques
Am J Pathol
(2001) - et al.
Structure and function of the pentraxins
Curr Opin Immunol.
(1995) The value of C-reactive protein measurement in rheumatoid arthritis
Semin Arthritis Rheum
(1994)Atherogenesis in children: implications for the prevention of atherosclerosis
Adv Pediatr
(2000)- et al.
Induction of inflammatory cytokine release from cultured human monocytes by C-reactive protein
Cytokine
(1992) - et al.
The effect of aspirin on C-reactive protein as a marker of risk in unstable angina
J Am Coll Cardiol
(2001) - et al.
Serological reactions in pneumonia with a non-protein somatic fraction of the Pneumococcus
J Exp Med
(1930)
C-Reactive protein. A historical overview
Ann. NY Acad. Sci.
Acute-phase proteins and other systemic responses to inflammation
New Engl J Med
Analysis of the binding of C-reactive protein to histones and chromatin
J Immunol
C-Reactive protein reacts with the U1 small nuclear ribonucleoprotein
J Immunol
Binding reactivity of C-reactive protein for polycations. II Modulatory effects of calcium and phosphocholine
J Immunol
Binding reactivity of C-reactive protein for polycations
J Immunol
Both human IL-1 and IL-6 induce synthesis of C-reactive protein (CRP) by the PLC/PRF/5 hepatoma cell line. II Modulatory effects of calcium and phosphocholine
J. Immunol
Regulation of the C-reactive protein gene, a major marker of inflammation and cancer
Mol Biol Med
Dual control of C-reactive protein gene expression by interleukin-1 and interleukin-6
EMBO J
The pentraxins, C-reactive protein and serum amyloid P component, are cleared and catabolized by hepatocytes in vivo
J Clin Ivest
Metabolic and scintigraphic studies of radioionated human C-reactive protein in health and disease
J Clin Invest
C-reactive protein is produced by a small number of normal human peripheral blood lymphocytes
J Exp Med
Expression of C-reactive protein in the human respiratory tract
Infect Immun
Topology and structure of the C1q-binding site on C-reactive protein
J Immunol.
CRP-mediated activation of complement in vivo. Assessment by measuring circulating complement–C-reactive protein complexes
J Immunol
C-reactive protein binds to apoptotic cells, protects the cells from assembly of the terminal complement components, and sustain an anti-inflammatory innate immune response: implications for systemic auto-immunity
J Exp Med
Loss of pentameric symmetry of C-reactive protein is associated with promotion of neutrophil–endothelial cell adhesion
J Immunol
Prevention of in vitro neutrophil adhesion to endothelial cells through shedding of L-selectin by C-reactive protein and peptides derived from C-reactive protein
J Clin Invest
C-reactive protein in acute viral infections
J Med Virol
Serum C-reactive protein cannot differentiate bacterial and viral etiology of community-acquired pneumonia in children in primary healthcare settings
Scand J Infect Dis
Clinical applications of C-reactive protein in pediatrics
Pediatr Infect Dis J
Serum C-reactive protein in primary Sjogren’s syndrome
Clin Exp Rheumatol
C-reactive protein levels during disease exacerbations and infections in systemic lupus erythematosus: a prospective longitudinal study
J Rheumatol
Cited by (131)
Biochemical evaluation of possible protective effect of purslane extract in experimentally induced arthritis associated with obesity
2024, Prostaglandins and Other Lipid MediatorsThe Effects of Vitamin D Supplementation on C-Reactive Protein and Systolic and Diastolic Blood Pressure in Postmenopausal Women: A Meta-Analysis and Systematic Review of Randomized Controlled Trials
2024, Journal of the Academy of Nutrition and DieteticsThe Association Between Prenatal Infection and Adolescent Behavior: Investigating Multiple Prenatal, Perinatal, and Childhood Second Hits
2023, Journal of the American Academy of Child and Adolescent PsychiatryThe long-term impact of elevated C-reactive protein levels during pregnancy on brain morphology in late childhood
2022, Brain, Behavior, and ImmunityInflammation and ischemic heart disease: The next therapeutic target?
2021, Revista Portuguesa de Cardiologia