C-reactive protein as a diagnostic and prognostic factor in inflammatory bowel diseases

Mańkowska-Wierzbicka, Dorota; Karczewski, Jacek; Poniedziałek, Barbara; Grzymisławska, Małgorzata; Staszewski, Rafał; Królczyk, Aleksandra; Dobrowolska, Agnieszka; Grzymisławski, Marian

doi:10.5604/17322693.1223798

Cited by 8 publications

(5 citation statements)

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“…Significant up-regulation of CRP protein level was observed in the case of TNBS group and G-15-treated group. Some evidence points to a correlation between high-sensitivity CRP concentration at diagnosis and the risk of surgery in CD patients 22 . Our survival ratio analysis showed that G-1 and ICI 182.780 are able to reduce mortality of mice with TNBS-induced CD.…”

Section: Discussionmentioning

confidence: 99%

G protein-coupled estrogen receptor mediates anti-inflammatory action in Crohn’s disease

Jacenik

Zielińska

Mokrowiecka

et al. 2019

Sci Rep

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Estrogens exert immunomodulatory action in many autoimmune diseases. Accumulating evidence highlights the meaningful impact of estrogen receptors in physiology and pathophysiology of the colon. However, the significance of G protein-coupled estrogen receptor (GPER) on Crohn’s disease (CD), one of the inflammatory bowel disease (IBD) types, is still elusive. Our study revealed GPER overexpression at the mRNA and protein levels in patients with CD. To evaluate the effects of GPER activation/inhibition on colitis development, a murine 2, 4, 6-trinitrobenzene sulfonic acid (TNBS)-induced model of CD was used. We showed that activation of GPER reduces mortality, improves macroscopic and microscopic scores and lowers C-reactive protein (CRP) level. The impact of estrogen signaling on the suppression of the intestinal inflammation was proved by immunohistochemistry. It was demonstrated that GPER activation is accompanied by modulation of extracellular-signal regulated kinase (ERK) signaling pathway and expression level of genes involved in signal transmission and immune response as well as the expression of some microRNAs (miR-145, miR-148-5p and miR-592). Our study revealed that the membrane-bound estrogen receptor GPER mediates anti-inflammatory action and seems to be a potent therapeutic target in maintaining remission in CD.

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Section: Discussionmentioning

confidence: 99%

G protein-coupled estrogen receptor mediates anti-inflammatory action in Crohn’s disease

Jacenik

Zielińska

Mokrowiecka

et al. 2019

Sci Rep

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“…CRP levels are also associated with high-sensitivity CRP (hs-CRP) and prealbumin (pre-Alb) levels. The hs-CRP assay can measure values below the detection limit of CRP, and its results are correlated with disease activity in patients with UC [19,20]. Furthermore, pre-Alb levels are inversely correlated with disease activity in patients with IBD [21,22].…”

Section: Introductionmentioning

confidence: 99%

Biomarkers for Monitoring of Changes in Disease Activity in Ulcerative Colitis

Tatsumi,

Kakimoto,

Hara

et al. 2023

JCM

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Background: In recent years, various biomarkers of ulcerative colitis (UC) have emerged; however, few studies have simultaneously examined the utility of multiple biomarkers for monitoring disease activity. Additionally, serum leucine-rich alpha-2 glycoprotein (LRG), a new biomarker, may show a blunt response to anti-TNF antibody therapy. This prospective study explored effective biomarkers that could monitor disease activity changes in patients with UC. In addition, we examined the effect of anti-TNF antibody therapy on changes in LRG. Methods: Blood and stool samples were collected twice from patients with UC: at baseline and at least 8 weeks later. Changes in serum LRG, interleukin (IL)-6, prealbumin (pre-Alb), high-sensitivity C-reactive protein (hs-CRP), CRP, and fecal calprotectin (FC) were measured and correlated with changes in disease activity. The relationship between anti-TNF antibody therapy and LRG levels was also examined in patients with the same disease activity. Results: Forty-eight patients with UC (96 samples) were analyzed. ΔLRG and ΔIL-6 correlated strongly with the change in the partial Mayo (pMayo) score between the two time points (ΔpMayo) (r = 0.686, 0.635, respectively). In contrast, FC and IL-6 were particularly accurate predictors of clinical remission, and their area under the curves (AUCs) were significantly higher than that of CRP (AUC: 0.81, 0.76 vs. 0.50; p = 0.001, 0.005). No association was found between the administration of anti-TNF antibody preparations and the LRG values. Conclusions: Correlations were found between changes in UC disease activity and LRG, IL-6, pre-Alb, hs-CRP, CRP, and FC. LRG reflects disease activity during anti-TNF antibody therapy.

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“…CD patients generally have higher CRP production than patients with UC, along with a higher concentration of IL-6 [ 2 , 31 ]. Some possible explanatory mechanisms involve the accumulation of mesenteric fat, a major site of IL-6 and TNF-α synthesis in CD patients, as well as the association between disease flare-ups and significant bacterial migration during the extensive transmural inflammation in CD compared with mild to moderate mucosal inflammation in UC [ 2 , 31 ]. Regarding the risk of surgery, an increased level of high-sensitivity CRP (hsCRP) at diagnosis might be used as a predictive factor in evaluating the risk of surgery in CD [ 32 , 33 ].…”

Section: Reviewmentioning

confidence: 99%

C-reactive Protein: An Inflammatory Biomarker and a Predictor of Neurodegenerative Disease in Patients With Inflammatory Bowel Disease?

Muresan,

Slevin

2024

Cureus

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Inflammatory bowel disease (IBD) refers to two chronic conditions of the digestive tract: ulcerative colitis (UC) and Crohn’s disease (CD), representing a progressive inflammatory process that mainly occurs in the gut, with frequent extra-intestinal manifestations. Even if remission is periodically obtained for some patients, the histological activity and digestive symptoms may continue, maintaining a persistent systemic inflammation that could induce further extra-intestinal complications and contribute to the development of neurodegenerative disease. C-reactive protein (CRP) is an acute-phase reactant that is widely accepted as a dominant serum biomarker in IBD. CRP consequently activates the complement cascade, supports the release of pro-inflammatory cytokines, and the clearance of microbial pathogens. All these processes facilitate further processes, including atherosclerosis and hypercoagulability, alteration of the intestinal microbiota, and the increased permeability of the intestinal barrier for neurotoxic substances produced by gut microorganisms, due to the presence of a high level of lipopolysaccharides. For IBD, the connection between intestinal inflammation and central nervous system inflammation could be explained through the activity of the vagus nerve, a carrier of cytokines, CRP, and toxic materials to the brain, potentially inducing vascular lesions and damage of the glial vascular unit, with further risk for degeneration within the central nervous system. CRP is a key marker for IBD pathogenesis and is able to dissociate into its monomeric form, mCRP, on contact with activated cell and tissue components via the systemic circulation. We hypothesize that the chronic inflammatory process within IBD could initiate neuroinflammation and neurodegeneration, and therefore, further investigation of the significance of chronically raised plasma of CRP and mCRP in patients with IBD is warranted, as it may represent a critical predictive factor associated with a later neurodegenerative risk. Any future initiative aimed at pharmacologic modulation of CRP (e.g., blocking CRP-mCRP dissociation), could represent a new therapeutic approach protecting against intestinal inflammation and concomitantly reducing the risk of neuroinflammation, neurodegeneration, and cognitive decline.

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C-reactive protein as a diagnostic and prognostic factor in inflammatory bowel diseases

Abstract: HsCRP might be a useful diagnostic marker in differentiating active IBD from other diseases. Particularly important however seems to be the predictive value of hsCRP at diagnosis in prognosing the clinical outcome of the disease in CD patients.

Cited by 8 publications

References 1 publication

G protein-coupled estrogen receptor mediates anti-inflammatory action in Crohn’s disease

G protein-coupled estrogen receptor mediates anti-inflammatory action in Crohn’s disease

Biomarkers for Monitoring of Changes in Disease Activity in Ulcerative Colitis

C-reactive Protein: An Inflammatory Biomarker and a Predictor of Neurodegenerative Disease in Patients With Inflammatory Bowel Disease?

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