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An update on C-reactive protein for intensivists
1Department of Intensive Care, Royal Perth Hospital, Perth, Western Australia, Australia.
Anaesthesia and Intensive Care
|April 30, 2009
Summary
C-reactive protein (CRP) is a key inflammatory marker, but its levels alone don't diagnose infections. Interpreting CRP dynamics alongside clinical context is crucial for assessing disease and treatment response.
Area of Science:
- Biochemistry
- Immunology
- Clinical Medicine
Background:
- C-reactive protein (CRP) is a crucial acute-phase protein synthesized by the liver.
- Interleukin-6 (IL-6) is the primary regulator of CRP synthesis.
- CRP has a half-life of 19 hours, influencing its dynamic response compared to other markers like procalcitonin.
Purpose of the Study:
- To review the physiology, roles, and limitations of CRP as an inflammatory and infective marker in intensive care.
- To explore emerging roles of CRP in cardiovascular and autoimmune diseases.
- To highlight the importance of dynamic CRP response and clinical context in interpretation.
Main Methods:
- Literature review of observational and animal studies on CRP uses.
- Searched PubMed database without language restrictions.
- Did not pool quantitative data due to heterogeneity in studies.
Main Results:
- Elevated CRP is not specific to infections; absolute levels cannot differentiate between bacterial, fungal, or viral infections.
- CRP dynamics in response to therapy and patient's clinical context are vital for interpretation.
- CRP is a significant factor and prognostic indicator in various cardiovascular and chronic diseases.
Conclusions:
- CRP concentration is an important prognostic factor for many acute and chronic diseases.
- Serial CRP measurements can reflect a patient's response to therapies aimed at modifying inflammatory processes.
- Understanding CRP's limitations and dynamic behavior is essential for accurate clinical application.
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