C-Reactive Protein in the Chronic Rheumatic Diseases

Hill, AlanG.S.

doi:10.1016/s0140-6736(51)91595-4

Cited by 36 publications

(9 citation statements)

References 8 publications

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“…They used a semiquantitative capillary precipitin technique to detect CRP, regarding as "positive" an amount of precipitate which they felt was equivalent to a concentration of at least 200 &ml. Similar findings had previously been reported in 4 patients by Hill (2).…”

supporting

confidence: 92%

Significance of serum c‐reactive protein elevation in patients with systemic lupus erythematosus

Zein

Ganuza

Kushner

1979

Arthritis & Rheumatism

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Serum C-reactive protein (CRP) concentration was determined by a radial immunodiffusion method in serum samples collected over a mean period of 19 months from a group of 17 patients with systemic lupus erythematosus (SLE). Thirty-two episodes of CRP elevation were detected. Twenty of these were associated with active SLE, and 9 with proven or possible infection or bone fracture. In 3 cases no explanation for CRP elevation was readily apparent. There were 8 instances of onset or exacerbation of lupus activity without accompanying CRP elevation. These data indicate that CRP elevation in the course of SLE is frequently associated with activation of lupus, and that detection of such elevation does not differentiate between lupus activity and infection.C-reactive protein (CRP) is an acute phase reactant whose serum concentration rises in a number of diseases associated with inflammation or tissue necrosis, including many infectious diseases, rheumatic fever,

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supporting

confidence: 92%

Significance of serum c‐reactive protein elevation in patients with systemic lupus erythematosus

Zein

Ganuza

Kushner

1979

Arthritis & Rheumatism

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“…The clinical significance of these biochemical effects of tenidap was evaluated by determining whether clinical treatment differences between tenidap and piroxicam were statistically related to acute-phase protein, ESR, and IL-6 treatment differences. Clinical disease activity has previously been correlated with CRP and ESR (41)(42)(43)(44). We also found clinical correlations with the CRP and ESR treatment differences, thus confirming the clinical relevance of these measures of the acute-phase response.…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis treated with tenidap and piroxicam clinical associations with cytokine modulation by tenidap

et al. 1995

Arthritis & Rheumatism

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Objective. To compare the effects of tenidap and piroxicam on acute-phase protein and cytokine levels in the blood of rheumatoid arthritis (RA) patients and to explore their associations with clinical disease activity.Methods. A double-blind, randomized, crossover trial in 49 patients with active RA compared 6 weeks of treatment with tenidap (120 mg/day) versus 6 weeks of treatment with piroxicam (20 mg/day).Results. Median values for C-reactive protein (CRP), Westergren erythrocyte sedimentation rate (ESR), serum amyloid A (SAA) protein, and interleukin-6 (IL-6) were significantly lower after tenidap treatment compared with piroxicam treatment, even in the presence of stable background treatment with prednisone, methotrexate, or prednisone plus methotrexate. The median within-patient treatment differences (after tenidap minus after piroxicam) in the CRP, ESR, SAA, and IL-6 values were -1.7 mg/dl, -10.0 mdhour, -22.0 pglml, and -3.7 pg/ml, respectively, and represent -60.4%, -17.7%, -35.5%, and -26.1% of the respective baseline levels. IL-6 levels were positively correlated with CRP and SAA. Plasma IL-lP was generally below the level of detection. Tumor necrosis factor a levels were similar after tenidap and after piroxicam. Treatment differences for 4 of 7 clinical parameters favored tenidap, but did not reach statistical significance. IL-6, CRP, and ESR were significantly correlated with clinical treatment differences. Tenidap and piroxicam toleration were similar, although tenidapBruce H. Littman, MD, Celena E. Drury, RN, MBA, Rupert 0. Zimmerer, PhD, Catharine B. Stack, MS, C. Gordon Law, PhD: Pfizer Incorporated, Groton, Connecticut. Address reprint requests to Bruce H. Littman, MD, Central Research Division, Pfizer Inc., Eastern Point Road, Groton, CT 06340.Submitted for publication November 16, 1994; accepted in revised form August 29, 1994 treated patients exhibited a reversible increase in urinary protein excretion.Conclusion. Tenidap was differentiated from piroxicam by lower levels of acute-phase proteins, ESR, and IL-6 after tenidap treatment. These treatment differences were significantly correlated with clincial parameters.Tenidap sodium is a new antiinflammatoryl antirheumatic drug that is chemically unrelated to nonsteroidal antiinflammatory drugs (NSAIDs). In clinical trials in patients with rheumatoid arthritis (RA), treatment with tenidap resulted in a rapid and sustained reduction of blood levels of acute-phase proteins such as C-reactive protein (CRP) and serum amyloid A (SAA) protein (1,2). Tenidap treatment also led to a reduction of the erythrocyte sedimentation rate (ESR) (1,2), which is determined primarily by plasma levels of fibrinogen, another acute-phase protein (3).Production of acute-phase proteins by the liver is regulated by cytokines, including interleukin-6 (IL-6), interleukin-1 (IL-l), and tumor necrosis factor (Y (TNFa) (4-6). These cytokines are produced by inflamed synovial tissues (7-10) and are present at higher levels in synovial fluid than in blood (11-15). IL-6 lev...

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“…Although serum levels of the acute‐phase reactant C‐reactive protein (CRP) usually parallel disease activity in inflammatory states, it is widely believed that systemic lupus erythematosus (SLE) is an exception. It has long been observed that many patients with active SLE display only modestly elevated or even normal CRP levels during periods of intense disease activity (1–3), particularly when compared with patients with rheumatoid arthritis (RA) (4). Indeed, this observation has led to the suggestion that marked CRP elevation in a patient with SLE indicates infection (3, 5, 6).…”

Section: Introductionmentioning

confidence: 99%