The Clinical Significance and Potential Role of C-Reactive Protein in Chronic Inflammatory and Neurodegenerative Diseases

Abstract

C-reactive protein (CRP) is an acute-phase protein synthesized by hepatocytes in response to pro-inflammatory cytokines during inflammatory/infectious processes. CRP exists in conformationally distinct forms such as the native pentameric CRP and monomeric CRP (mCRP) and may bind to distinct receptors and lipid rafts and exhibit different functional properties. It is known as a biomarker of acute inflammation, but many large-scale prospective studies demonstrate that CRP is also known to be associated with chronic inflammation. This review is focused on discussing the clinical significance of CRP in chronic inflammatory and neurodegenerative diseases, such as cardiovascular disease, type 2 diabetes mellitus, age-related macular degeneration, hemorrhagic stroke, Alzheimer’s disease, and Parkinson’s disease, including recent advances on the implication of CRP and its forms specifically on the pathogenesis of these diseases. Overall, we highlight the advances in these areas that may be translated into promising measures for the diagnosis and treatment of inflammatory diseases.

Glycosylation deficiency of lipopolysaccharide-binding protein and corticosteroid-binding globulin associated with activity and response to treatment for rheumatoid arthritis

“…In the present study, inflammation level was also quantified by measuring the expression level of two acute-phase reactant proteins: CRP and SAA highly expressed in chronic inflammatory diseases, including RA [59][60][61][62]. In our analysis, ERA patients exhibited raised levels of CRP and SAA compared with HV.…”

Clinical usefulness of early serial measurements of C-reactive protein as outcome predictors in patients with subarachnoid hemorrhage

“…Brain magnetic resonance imaging was not used routinely to detect silent cerebral infarction after SAH, which may have limited the detection of vasospasm and DCI in this study. Fourth, the CRP levels might be increased in patients with chronic inflammatory diseases and neurodegenerative diseases [29]. Although we excluded patients with severely neurodegenerative diseases and chronic neurological abnormality, we could not exclude patients with mild or undiagnosed illness.…”

Thrombogenic and Inflammatory Reactions to Biomaterials in Medical Devices

“…Although drug-eluting stents limit early intimal hyperplasia, late-stent thrombosis, late catch-up phenomenon, and neo-atherosclerosis contribute to late failure (Park et al, 2012). Elevated hsCRP predicted increased risks of drug-eluting stent-related thrombosis, death, and myocardial infarction (Park et al, 2009); CRP had a high predictive value in atherosclerotic thrombotic events after drug-eluting stent implantation (Park et al, 2009;Luan and Yao, 2018), and statins only reduced the development of early stent thrombosis in patients with high hsCRP levels (Luan and Yao, 2018); and activated platelets, apoptotic macrophages, and microparticles generate mCRP in atherosclerosis and in stent restenosis; all these suggesting CRP participation in stent thrombosis and failure (Eisenhardt et al, 2009;Habersberger et al, 2012).…”