When our body is confronted with infection, inflammation, or trauma, there is a series of changes in acute temporal reactions. These changes involve changes in the concentration of some serum proteins, including serum amyloid A, fibrinogen, haptoglobin,1 acid glycoprotein, ceruloplasmin, 1 antitrypsin, etc., in addition to the well-known C-reactive protein (CRP). CRP was first discovered in patients with pneumonia as a protein that binds to the capsular C polysaccharide of Streptococcus pneumoniae. Synthesized mainly in the liver, this amazing protein is made up of five identical subunits, has a molecular weight of 115 kd, a half-life of 20 hours, and is shaped like a cyclic pentadic protein. CRP is a substance that responds to inflammatory cytokines, specifically interleukins IL-1, IL-6, and tumor necrosis factor (TNF-). When stimulated by lipopolysaccharide and TNF-, mature adipocytes and leukocytes also secrete CRP. CRP has the ability to enhance the production of endothelial chemokines and adhesion molecules, such as increasing the yield of monocyte chemoattractant protein 1 (MCP-I) and adhesion molecule 1 in soluble cells. In addition, studies have also found that non-liver cells such as atheromas, neurons, monocytes, lymphocytes, and even Kopför's cells can also produce small amounts of CRP. As one of the acute phase-reactive proteins, CRP is involved in injury and infection responses, which can promote the release of more lysosomes from phagocytic cells and neutrophils, enhance the body's immune function and improve anti-inflammatory ability. Under normal circumstances, only trace amounts of CRP are present in our bodies. However, when our body is infected, it stimulates the body to release a large number of inflammatory factors, resulting in a rapid increase in CRP in a short period of time. Therefore, the degree of infection in the body can be assessed clinically by the level of CRP. (Geriatric Clinical Medicine).
CRP is considered to be the most valuable because it has a very low concentration (5 mg L) in the serum of healthy people and a significant increase in bacterial infection or tissue damage.
01Diagnosis and differentiation of infection
C-reactive protein (CRP) plays an important role in clinical practice, helping us to identify different types of infections. When we are confronted with a bacterial infection, the concentration of CRP rises rapidly, while in the case of a viral infection, the level of CRP usually remains normal. What's more, the increase in CRP is directly proportional to the severity of the infection and can be used as a metric. CRP has a half-life of about 20 hours and can rise rapidly within just 6 hours of infection, peaking within 24 hours. CRP promotes apoptosis and necrosis, activates complement, and removes pathogens in and out of the body and in vivo by binding to the cell wall phosphocholine or membrane phospholipids of pathogens. According to the National Clinical Laboratory Practice (4th Edition), when CRP is greater than or equal to 100 mg L, bacterial infection is likely to be present. When the CRP is less than 50 mg L, a comprehensive judgment of other test indicators and signs is required to determine the possibility of a mild bacterial or viral infection, or other diseases. Within 6-8 hours of the onset of bacterial infection, CRP begins to rise and peaks within 24-48 hours. Once the infection is under control, the level of CRP decreases rapidly and returns to normal levels within a week. Gram-negative infections usually cause a spike in CRP levels, sometimes as high as 500 mg L; Gram-positive infections and parasitic infections usually cause moderate reactions, typically around 100 mg L; In viral infection, the increase in CRP is not significant, generally not exceeding 50 mg L, and rarely exceeding 100 mg L. When the bacterial infection is in the acute phase, CRP is markedly elevated, while oligoadenosine synthase levels are normal; In viral infection, CRP levels are normal or slightly elevated, and oligoadenosine synthase levels are elevated.
02**Risk of myocardial infarction and stroke in the future
Cardiovascular disease (CVD) is a range of diseases including coronary artery disease (CAD), stroke, heart failure, and arterial disease. CVD is associated with acute coronary syndrome (ACS) or rupture of atherosclerotic plaques, and may also be associated with arterial thrombosis. In many developed countries, cardiovascular disease is the leading cause of death, disability and healthcare costs. Clinical studies have confirmed that C-reactive protein (CRP) levels are strongly correlated with the severity of coronary heart disease, and that this association is not affected by gender. Several case-control studies have found that CRP is associated with an increased risk of myocardial infarction, stroke, sudden cardiac death, and peripheral arterial disease. Some scholars believe that in the process of atherosclerotic plaque formation, CRP and foam cells are deposited in the arterial wall, in which CRP can bind to lipoproteins, activate the complement system, release inflammatory mediators and oxygen free radicals, resulting in vasospasm and plaque instability, thereby causing myocardial infarction. Therefore, CRP is an important marker of acute myocardial infarction. Serum CRP levels can be used to assess patients at moderate risk of coronary artery disease by 10% to 20% of coronary artery disease risk over 10 years compared to other indicators. High serum HS-CRP levels also contribute to poor cardiovascular outcomes and clinical outcomes of ACS, and are used to distinguish between statin and antiplatelet drug use in high-risk patients. In addition, high serum CRP concentrations were positively correlated with the risk of peripheral arterial disease, independent of body mass index (BMI), waist circumference, smoking, serum total cholesterol levels, blood pressure, and other concomitant factors. C-reactive protein is the strongest risk indicator for cardiovascular disease, and high CRP levels are associated with a higher risk of future myocardial infarction and stroke. CRP levels greater than 2 compared to CRP levels less than 1 mg LPeople with 1 mg l have an increased risk of myocardial infarction in the future9 times, the risk of ischemic stroke increases by 19 times, the risk of peripheral arterial vascular disease increases by 41 times. Within a few hours of the onset of pain, CRP levels rise, peaking in 3-4 days and returning to normal levels in 7-10 days after the creatine kinase isoenzyme (CK-MB) returns to normal.
03C-reactive protein concentration assesses the prognosis of malignancy
After rewriting: Your body has a natural line of defense, which is called CRP, which is the first moat of the body's immune system. It is responsible for monitoring necrotic cells and viruses and regulating them. There are many studies that show that when a patient has a tumor or **, the associated acute protein increases significantly. The combination of serum CRP and tumor markers is very effective in the detection of gastrointestinal malignancies. When CRP levels are abnormal, it usually means the presence of a bacterial infection. Therefore, in combination with other tumor markers, CRP can improve the detection rate of malignant tumors and play an early warning role. It has also been shown that in patients who have undergone gastric cancer** resection, the preoperative CRP-albumin ratio is 0025 is considered an important ** indicator. For liver cancer progression and decreased liver reserve**, the CRP albumin ratio is 0037 is closely related to it. These indicators can help us to better prognosis of liver cancer. Focus on geriatric clinical medicine and serve the future of geriatrics.