Agar-Gel Precipitin-Inhibition Technique for C-Reactive Protein Determinations: II. Degree of Sensitivity and Reproducibility

The agar-gel precipitin-inhibition test (AGPI) for C-reactive protein determinations proved more sensitive than the capillary tube-precipitin procedure. Furthermore, titers of positive CRP sera were obtained by this AGPI technique. This technique was compared with other indices of infectivity, namely, the white blood cell count and the erythrocyte sedimentation rate. The ease and reproducibility of this recommended test procedure were demonstrated by technicians unfamiliar with this procedure.     

Agar-Gel Precipitin-Inhibition Technique for C-Reactive Protein Determinations

An application of the agargel precipitin-inhibition technique of Ray and Kadull detects the C-reactive protein present in the acute-phase human sera. The sensitivity of this procedure is compared with the capillary tube-precipitin method of Selman and Halpern.     

Lifetime Trauma,Praying for Others,and C-Reactive Protein

Research indicates that praying for others may offset the effects of stress on self-rated health and psychological well-being. The purpose of the current study is to extend this literature by seeing whether praying for others moderates the effects of exposure to lifetime trauma on a key marker of inflammation: C-reactive protein. The data come from a recent nationwide survey of adults of all ages (N = 1,589). Levels of C-reactive protein were obtained from assays of blood spots drawn from a capillary fingerstick. The findings suggest that the magnitude of the relationship between lifetime trauma and C-reactive protein is completely offset for study participants who frequently pray for others. The theoretical implications of this research are discussed.     

Pentameric Two-Dimensional Crystallization of Rabbit C-Reactive Protein on Lipid Monolayers

As a member of the pentraxin family, C-reactive protein plays various roles in the nonspecific immunity of animals. Though soluble, C-reactive protein always functions on membranes. In order to study the structure of the membrane-bound protein and the reaction between protein and membranes, two-dimensional (2D) crystallization of rabbit C-reactive protein on lipid monolayers was performed. The 2D crystals composed of pentameric proteins were obtained on lipid monolayers by specific adsorption for the first time. The projection map at 26-A resolution is presented, which exhibits P2 symmetry with lattice parameters a = 158(+/-3) A, b = 92(+/-1) A, and gamma = 107(+/-1) degrees. The current work may give a basis for the further study on the structure of complexes made up of C-reactive protein with its functional binding molecules on membranes.     

血清C-反应蛋白(CRP)测定报告

通过２８４９例患者血清Ｃ－反应蛋白（ＣＲＰ）检测证实,ＣＲＰ是细菌性感染的重要指标,败血症增高率达９１．６％,肺炎为４８％,其它细菌感染性疾病也均有不同程度的增高,而病毒性心肌炎则不增高。ＣＲＰ是诊断恶性肿瘤的重要指标之一,在恶网、肝癌、膀胱癌中均为１００％增高,而肺癌增高率为６６．６％。ＣＲＰ在风湿病活动期很敏感,故用于诊断活动性ＲＡ、ＳＬＥ极有意义,ＣＲＰ也可作为白血病继发感染的诊断及急性组织损伤的可靠证据     

Genetic Variants in C-Reactive Protein and Ischemic Stroke Susceptibility

Considerable discrepancies in the previously reported associations of the C-reactive protein (CRP) gene variants and ischemic stroke (IS) risk prompted us to perform this meta-analysis. We selected the fixed effects Mantel–Haenszel method to estimate the risk of IS [OR (odds ratio) along with its 95 % CI (confidence interval)] in relation to the CRP variants (?717 A > G, 1444 C > T). Heterogeneity test, influence analysis and publication bias test were appropriately performed using respective methods. We analyzed 1,926 IS patients and 2,678 controls and found the ?717 A > G variant was not significantly associated with overall IS risk. Subsequent analysis of the 1444 C > T variant involving 3,278 samples similarly revealed no significant association with IS. There was no substantial heterogeneity or publication bias in this analysis. Our meta-analysis may provide first evidence showing that genetic variants within the CRP locus are unlikely to modulate risk of IS.     

Effect of Calcium Ions on Hydrodynamic Properties of Pentameric and Decameric C-Reactive Protein in Solution

The molecular mass and sedimentation coefficient of native C-reactive protein in solution were determined by analytical ultracentrifugation in the presence and absence of calcium ions. Pentameric C-reactive protein was shown to be the major macroscopic form of this protein in solution. The removal of calcium ions from solution caused decompaction of the protein accompanied by changes in its hydrodynamic parameters. The sedimentation coefficient s ⁰ _20,w of pentameric C-reactive protein in solution containing 2 mM Ca²⁺ (6.6S) exceeded that for C-reactive protein in solution containing 2 mM EDTA (6.4S). Analysis of average molecular masses M _w and M _z obtained from sedimentation data demonstrated that the solution of highly purified protein was not homogeneous. As shown by intermolecular crosslinking, the solution also contained the 241-kDa decamer of C-reactive protein (9.5S) as a separate macroscopic form, whose share hardly reached 10% in the presence of 2 mM Ca²⁺ and increased after removal of calcium ions. The decamers were shown to result from intermolecular association of the pentamers.     

猪-C反应蛋白的分离纯化及其性质的研究

以猪血清为材料,通过磷酸乙醇胺—琼脂糖亲和层析,Sepharose 4B柱层析和Sephacryl—S300凝胶过滤,获得了猪C—反应蛋白的结晶。猪C—反应蛋白可与肺炎球菌壁C多糖发生特异的沉淀反应,这种结合是依赖钙离子的。EDTA和一些磷脂代谢产物如磷酸胆碱,磷酸乙醇胺等,能抑制猪C—反应蛋白与C多糖的结合。在SDS—聚丙烯酰胺凝胶电泳及梯度聚丙烯酰胺凝胶电泳中,猪C—反应蛋白表现出与人C—反应蛋白相同的行为,亚基是一条分子量为23.5kD的肽链,全分子的表观分子量为150kD。猪C—反应蛋白与兔抗人C—反应的蛋白的抗血清能发生免疫交叉反应。     

High-Sensitivity C-Reactive Protein and Risk of Sepsis

Background

Conventional C-reactive protein assays have been used to detect or guide the treatment of acute sepsis. The objective of this study was to determine the association between elevated baseline high-sensitivity C-reactive protein (hsCRP) and the risk of future sepsis events.

Methods

We studied data from 30,239 community dwelling, black and white individuals, age ≥45 years old enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Baseline hsCRP and participant characteristics were determined at the start of the study. We identified sepsis events through review of hospital records. Elevated hsCRP was defined as values >3.0 mg/L. Using Cox regression, we determined the association between elevated hsCRP and first sepsis event, adjusting for sociodemographic factors (age, sex, race, region, education, income), health behaviors (tobacco and alcohol use), chronic medical conditions (coronary artery disease, diabetes, dyslipidemia, hypertension, chronic kidney disease, chronic lung disease) and statin use.

Results

Over the mean observation time of 5.7 years (IQR 4.5–7.1), 974 individuals experienced a sepsis event, and 11,447 (37.9%) had elevated baseline hsCRP (>3.0 mg/L). Elevated baseline hsCRP was independently associated with subsequent sepsis (adjusted HR 1.56; 95% CI 1.36–1.79), adjusted for sociodemographics, health behaviors, chronic medical conditions and statin use.

Conclusion

Elevated baseline hsCRP was associated with increased risk of future sepsis events. hsCRP may help to identify individuals at increased risk for sepsis.     

Obesity Associated Molecular Forms of C-Reactive Protein in Human

Objective

To describe novel C-reactive protein (CRP) molecular forms (mf) in human plasma.

Design and Methods

Five novel CRP-mfs, disctinct from the previously described native (nCRP) and modified (mCRP) C-reactive proteins, were separated from human plasma by polyacrylamide gel electrophoresis and immunodetected by western blot in subjects with or without increased BMI, cardiovascular disease (CVD), and diabetes (n = 1800).

Results

Three of the five CRP-mfs were present in all samples. One, CRPmf-4, was present in a subgroup of subjects and its presence was associated with elevated body mass index (BMI). CRP-mf-5 was present in about 2% of the subjects and was not associated with any other parameters. The presence or distribution of the 5 CRP-mfs were not Ca²⁺-dependent. Crossed immuno-localization experiments indicated that none of the CRP-mfs were complexed with any of the lipoprotein classes or with signature proteins of the complement-factor. Moreover, the distribution of CRP-mfs were not significantly correlated with plasma CRP levels. CRP-mf-4 was significantly associated with increased BMI, but not with other parameters of the metabolic syndrome (HDL-C and triglyceride levels, and diabetes).

Conclusions

We have identified five new CRP-mfs out of which CRP-mf-4 was significantly associated with obesity. We have shown that oligomerization of CRP was not calcium dependent. We hypothesize that adipose tissue produces a factor which influences the formation of CRP mf-4. CRP-mfs might be used as an obesity-associated inflammatory marker.     

Serum Copeptin and Cortisol Do Not Accurately Predict Sickle Cell Anaemia Vaso-Occlusive Crisis as C-Reactive Protein

Objective

This study assessed the diagnostic performance and prognostic properties of C-reactive protein (CRP), copeptin and cortisol in individuals with sickle cell anaemia (SCA).

Design

Prospective case-control study

Methods

Sixty consecutive SCA subjects (18–40 years) comprising 30 subjects in the steady state and 30 subjects in vaso-occlusive crisis (VOC) were recruited into this study. Thirty (30) apparently healthy individuals with HbAA genotype served as controls. ELISA was used for the determination of serum levels of copeptin, CRP and cortisol. Data obtained were statistically analyzed using the Student’s t-test and Mann Whitney U as appropriate and P<0.05 was considered significant.

Results

SCA subjects in VOC had significantly lower copeptin level and significantly higher CRP level compared with controls. However, serum levels of copeptin, cortisol and CRP were significantly higher in SCA subjects in VOC compared with SCA subjects in steady state. Furthermore, CRP had the widest Area under the ROC curve (AUROC) than copeptin and cortisol. No significant difference was observed in the levels of copeptin, CRP and cortisol when SCA subjects in VOC who were hospitalized for less ≤5 days were compared with subjects who had longer stays.

Conclusion

It could be concluded that C-reactive protein has a superior diagnostic performance for vaso-occlusive crisis in individuals with sickle cell anaemia and that C-reactive protein, cortisol and copeptin are not good prognostic markers in SCA subjects in vaso-occlusive crisis.     

急性肺炎支原体肺炎儿童CRP和D-二聚体检测的临床意义

探讨急性肺炎支原体肺炎患儿CRP和D-二聚体水平的变化及临床意义。采用速率散射比浊法和Liatest免疫法,分别检测急性肺炎支原体肺炎患儿96例、细菌性肺炎患儿123例及对照组60例血清CRP水平和血浆D-二聚体水平。实验结果显示,急性肺炎支原体肺炎患儿、细菌性肺炎患儿血清CRP水平和血浆D-二聚体水平均明显高于对照组。CRP和D-二聚体可以作为急性肺炎支原体肺炎患儿体内炎症反应和血液高凝状态的检测指标。     

Computational Analysis of C-Reactive Protein for Assessment of Molecular Dynamics and Interaction Properties

Serum C-reactive protein (CRP) is used as a marker of inflammation in several diseases including autoimmune disease and cardiovascular disease. CRP, a member of the pentraxin family, is comprised of five identical subunits. CRP has diverse ligand-binding properties which depend upon different structural states of CRP. However, little is known about the molecular dynamics and interaction properties of CRP. In this study, we used SAPS, SCRATCH protein predictor, PDBsum, ConSurf, ProtScale, Drawhca, ASAView, SCide and SRide server and performed comprehensive analyses of molecular dynamics, protein–protein and residue–residue interactions of CRP. We used 1GNH.pdb file for the crystal structure of human CRP which generated two pentamers (ABCDE and FGHIJ). The number of residues involved in residue–residue interactions between A–B, B–C, C–D, D–E, F–G, G–H, H–I, I–J, A–E and F–J subunits were 12, 11, 10, 11, 12, 11, 10, 11, 10 and 10, respectively. Fifteen antiparallel β sheets were involved in β-sheet topology, and five β hairpins were involved in forming the secondary structure. Analysis of hydrophobic segment distribution revealed deviations in surface hydrophobicity at different cavities present in CRP. Approximately 33 % of all residues were involved in the stabilization centers. We show that the bioinformatics tools can provide a rapid method to predict molecular dynamics and interaction properties of CRP. Our prediction of molecular dynamics and interaction properties of CRP combined with the modeling data based on the known 3D structure of CRP is helpful in designing stable forms of CRP mutants for structure–function studies of CRP and may facilitate in silico drug design for therapeutic targeting of CRP.     

Comparative study of C-Reactive Protein and other biochemical parameters in patients with hepatitis B and malaria in Calabar, Nigeria

Serum levels of C-reactive proteins (CRP), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), total protein, albumin and globulins were investigated using high sensitivity Immunoturbidometric and colorimetric techniques in individuals with hepatitis (n=50), Malaria (n=50) and 40 control subjects in age range of 30 to 65 years. The hepatitis patients had a significantly higher (P < 0.01) level of aminotransferases when compared to malaria patients and control subjects. The mean value of ALT was 103.50 ± 71.4 IU/L and 46.72 ±17.48 IU/L for hepatitis and malaria respectively. The values for AST were 116.76 ± 63.27 IU/L and 57.74 IU/L ± 15.18 IU/L for hepatitis and malaria respectively while the values for control were 34.75 ± 14.64 and 35.25 ± 15.56 IU/L for AST and ALT respectively. The malaria patients showed a significantly higher level (P < 0.01) of aminotransferases when compared to the control. The mean serum CRP levels were 0.71 ± 0.11 mg/dL and 0.78 ± 0.13 mg/dL for hepatitis and malaria respectively. These values were significantly higher (P < 0.01) than those of the controls which was 0.32 ± 0.12 mg/dL. The values of CRP in malaria were significantly higher (P< 0.05) when compared with hepatitis. In malaria, AST correlated with CRP (r = 0.58). The mean serum proteins of hepatitis patients were significantly lower (P < 0.05) than those of the control and malaria while there were no significant differences between the total protein in malaria when compared with control. Albumin levels in both patients were significantly lower (P > 0.05) than those of the controls. The mean values were 33.40 ± 3.40g/L and 34.47 ± 3.56g/L for hepatitis and malaria respectively and 37.00 ± 3.43 g/L for the control. C-reactive protein correlated negatively with albumin in malaria (r = -0.26) while albumin had a negative correlation with globulin(r = -0.36). Also albumin-globulin ratio were significantly (P < 0.05) decreased in both patients when compared with controls. This result suggests that a systemic acute phase response is present in hepatitis and malaria patients hence measurement of C-reactive proteins may be helpful in the diagnosis and management of hepatitis and malaria; especially in the malaria endemic region such as Nigeria. Keywords: Hepatitis B, Malaria, C-reactive protein, Liver function tests.     

Paradoxical Association of C-Reactive Protein with Endothelial Function in Rheumatoid Arthritis

Background

Within the general population, levels of C-reactive protein (CRP) are positively associated with atherosclerotic cardiovascular disease (CVD). Whether CRP is causally implicated in atherogenesis or is the results of atherosclerosis is disputed. A role of CRP to protect endothelium-derived nitric oxide (EDNO) has been suggested. We examined the association of CRP with EDNO-dependent vasomotor function and subclinical measures of atherosclerosis and arteriosclerosis in patients with raised CRP resulting from rheumatoid arthritis (RA).

Methodology/Principal Findings

Patients with RA (n = 59) and healthy control subjects (n = 123), underwent measures of high sensitivity CRP, flow-mediated dilation (FMD, dependent on EDNO), intima-media thickness (IMT, a measure of subclinical atherosclerosis) and aortic pulse wave velocity (PWV, a measure of arteriosclerosis). IMT and PWV were elevated in patients with RA compared to controls but FMD was similar in the two groups. In patients with RA, IMT and PWV were not correlated with CRP but FMD was positively independently correlated with CRP (P<0.01).

Conclusions/Significance

These findings argue against a causal role of CRP in atherogenesis and are consistent with a protective effect of CRP on EDNO bioavailability.     

Inverse Association of Plasma IgG Antibody to Aggregatibacter actinomycetemcomitans and High C-Reactive Protein Levels in Patients with Metabolic Syndrome and Periodontitis

The association between clinically diagnosed periodontitis, a common chronic oral infection, and metabolic syndrome has been previously reported. The aim of this study was to investigate the association of plasma IgG levels against Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia, C-reactive protein, and periodontal status with metabolic syndrome. Plasma IgG levels and C-reactive protein were measured by enzyme-linked immunosorbent assay, and salivary levels of A. actinomycetemcomitans and P. gingivalis were determined by quantitative real-time polymerase chain reaction. Among 127 individuals aged 35–76 years, 57 participants had metabolic syndrome and severe periodontitis, 25 had metabolic syndrome and an absence of severe periodontitis, 17 healthy individuals had severe periodontitis, and 28 healthy individuals were without severe periodontitis. Patients with metabolic syndrome had reduced humoral immune response to A. actinomycetemcomitans (p = 0.008), regardless of their salivary levels or periodontitis status compared with healthy participants. The IgG antibody response to P. gingivalis, regardless of their salivary levels or participants’ health condition, was significantly higher in severe periodontitis patients (p<0.001). Plasma IgG titers for P. intermedia were inconsistent among metabolic syndrome or periodontal participants. Our results indicate that the presence of lower levels of IgG antibodies to A. actinomycetemcomitans (OR = 0.1; 95%CI 0.0–0.7), but not P. gingivalis, a severe periodontitis status (OR = 7.8; 95%CI 1.1–57.0), high C-reactive protein levels (OR = 9.4; 95%CI 1.0–88.2) and body mass index (OR = 3.0; 95%CI 1.7–5.2), are associated with the presence of metabolic syndrome. The role of the decreased IgG antibody response to A. actinomycetemcomitans, increased C-reactive protein levels on the association between periodontal disease and metabolic syndrome in a group of Thai patients is suggested.     

C 反应蛋白、白细胞计数与脑梗死体积及近期预后的关系

目的:研究血清C反应蛋白水平、白细胞计数与急性脑梗死患者的梗死灶体积大小以及预后的关系。方法:检测70例急性脑梗死患者(CI组)、64例腔隙性脑梗死患者(LCI组)和80例健康人(对照组)的血浆CRP水平,并进行白细胞计数。在CI及LCI组人院当天和4周时进行临床神经功能缺损程度评分(NDS)评定以判断预后。结果:CI组血浆CRP水平高于LCI组及对照组(P<0.01),LCI组高于对照组(P<0.01);CI组白细胞计数高于LCI组及对照组(P<0.01),LCI组高于对照组(P<0.05);血浆CRP水平及白细胞计数正常组患者住院4周时显著进步和进步的比率明显高于血浆CRP水平及白细胞计数异常组(均P<0.01),而无变化和死亡的比率明显低于异常组(均P<0.01)。结论:ACI患者血浆CRP水平和白细胞计数均明显升高;脑梗死急性期血清CRP水平、白细胞计数可能与脑梗死患者梗死体积大小以及近期预后有密切的关系。     

Cross-Sectional and Prospective Associations between Physical Activity and C-Reactive Protein in Males

BackgroundThere is conflicting evidence about the association between physical activity and inflammatory markers. Few prospective studies are available, particularly from low and middle-income countries. This study was aimed at assessing the cross-sectional and prospective associations between physical activity and C-reactive protein (CRP) levels in males belonging to the 1982 Pelotas (Brazil) Birth Cohort Study.MethodsThe sample comprised 2,213 males followed up at the ages of 18 and 23 years. We performed high sensitivity CRP assays; we used a cut-off of 3 mg/L in categorical analyses. We measured physical activity by self-report at ages 18 and 23 years. Body mass index and waist circumference were studies as possible mediators.ResultsCRP levels above the 3mg/L cut-off were found in 13.3% (95%CI: 11.7; 14.8) of the individuals. We found no evidence for an association between physical activity (leisure-time or all-domains) and either continuous (geometrical mean) or categorical CRP. We confirmed these null findings in (a) prospective and cross-sectional analyses; (b) trajectories analyses.ConclusionsThere was no association between CRP levels and physical activity levels in early adulthood in a large birth cohort. Little variability in CRP at this early age is the likely explanation for these null findings.     

The Impact of Baseline Serum C-Reactive Protein and C-Reactive Protein Kinetics on the Prognosis of Metastatic Nasopharyngeal Carcinoma Patients Treated with Palliative Chemotherapy

Background

The aim of this study was to determine whether baseline C-reactive protein (CRP) levels and CRP kinetics predict the overall survival in metastatic nasopharyngeal carcinoma (mNPC) patients.

Methods

A total of 116 mNPC patients from January 2006 to July 2011 were retrospectively reviewed. Serum CRP level was measured at baseline and thereafter at the start of each palliative chemotherapy cycle for all patients.

Results

Patients with higher values of baseline CRP (≥ 3.4 mg/L) had significantly worse survival than those with lower baseline CRP values (< 3.4 mg/L). Patients were divided into four groups according to baseline CRP and CRP kinetics: (1) patients whose CRP < 3.4 mg/L and never elevated during treatment; (2) patients whose CRP < 3.4 mg/L and elevated at least one time during treatment; (3) patients whose CRP ≥ 3.4 mg/L and normalized at least one time during treatment; and (4) patients whose CRP ≥ 3.4 mg/L and never normalized during treatment. The patients were further assigned to non-elevated, elevated, normalized, and non-normalized CRP groups. Overall survival rates were significantly different among the four groups, with three-year survival rates of 68%, 41%, 33%, and 0.03% for non-elevated, elevated, normalized, and non-normalized CRP groups respectively. When compared with the non-elevated group, hazard ratios of death were 1.69, 2.57, and 10.34 in the normalized, elevated, and non-normalized groups (P < 0.001).

Conclusions

Baseline CRP and CRP kinetics may be useful to predict the prognosis of metastatic NPC patients treated with palliative chemotherapy and facilitate individualized treatment. A prospective study to validate this prognostic model is still needed however.