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C-reactive protein, immunothrombosis and venous thromboembolism
Caroline Dix1,2, Johannes Zeller3,4, Hannah Stevens1,2,3
1Department of Haematology, Alfred Hospital, Melbourne, VIC, Australia.
Frontiers in Immunology
|September 30, 2022
Summary
C-reactive protein (CRP) can promote blood clots, especially in conditions with inflammation. Further research is needed to confirm CRP's role in venous thromboembolism (VTE) and develop new treatments.
Area of Science:
- Biochemistry
- Immunology
- Pathophysiology
Background:
- C-reactive protein (CRP) is a known marker for inflammation and infection.
- Emerging evidence suggests CRP isoforms actively contribute to inflammation and thrombosis.
- Venous thromboembolism (VTE) is increasingly understood as a thromboinflammatory condition.
Purpose of the Study:
- To explore the pro-inflammatory and pro-thrombotic roles of CRP isoforms.
- To investigate the potential link between CRP and the pathogenesis of VTE.
- To assess the clinical utility of CRP as a biomarker for VTE prediction.
Main Methods:
- Review of existing literature on CRP structure, function, and isoforms (pCRP, pCRP*, mCRP).
- Analysis of studies linking CRP levels to inflammatory conditions and VTE incidence.
- Examination of clinical data on CRP's predictive value for VTE, including recurrence and specific patient subsets.
Main Results:
- CRP exists as a pentamer (pCRP) and destabilized isoforms (pCRP*, mCRP) with pro-inflammatory properties.
- These isoforms activate platelets and the complement pathway, contributing to atherothrombosis and VTE.
- CRP elevation is observed in acute VTE and conditions like inflammatory bowel disease, COVID-19, and sepsis.
- CRP's predictive utility for VTE is modest but shows promise in specific populations (e.g., cancer-associated thrombosis, VTE recurrence, COVID-19).
Conclusions:
- Destabilized CRP isoforms (pCRP* and mCRP) possess pro-inflammatory and pro-thrombotic activities.
- CRP may play a role in promoting VTE, particularly in the context of inflammation.
- Further research is essential to elucidate CRP's direct role in VTE pathogenesis and develop targeted therapies for thromboinflammation.
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