Minimal Inflammation, Acute Phase Response and Avoidance of Misclassification of Vitamin A and Iron Status in Infants – Importance of a High-Sensitivity C-Reactive Protein (CRP) Assay

2003 ◽  
Vol 73 (6) ◽  
pp. 423-430 ◽  
Author(s):  
Abraham ◽  
Müller ◽  
Grüters ◽  
Wahn ◽  
Schweigert
Keyword(s):  
Vitamin A ◽  
Acute Phase ◽  
Acute Phase Response ◽  
Clinical Chemistry ◽  
High Sensitivity ◽  
Phase Response ◽  
Healthy Children ◽  
C Reactive Protein ◽  
Blood Draw ◽  
Reactive Protein

The acute phase response is known to affect many biological parameters used to assess the iron and vitamin A status. Usually, C-reactive protein (CRP) values higher than 5 to 10 mg/L are taken as indicative of this response. Here we report changes occurring at much lower CRP values. A range of parameters (clinical chemistry, retinol, vitamin E, carotenoids, thyroid status, blood count, immunology) were measured in 101 healthy one-year-old children with no or only minimal symptoms of airway infection and CRP values below 6 mg/L on routine testing. Additionally, CRP values were measured by a high-sensitivity assay (detection limit 0.2 mg/L). When determined by a more sensitive assay, CRP values (median, 0.26 mg/L) revealed highly significant associations with parameters known to be influenced by the acute phase response. Using a limit of 0.6 mg/L (75th percentile), significantly lower levels were observed for transthyretin, iron, retinol, and beta-carotene in the group with the higher CRP levels. This relationship was confirmed intra-individually in a subgroup of 21 children who underwent a second blood draw about four weeks after the first one. The acute phase response is triggered at very low inflammatory levels with CRP values considerably lower than 5 to 10 mg/L, and can occur in apparently healthy children. A high-sensitivity CRP assay is necessary to detect this low level, and in the case of iron or vitamin A, it can help to avoid misclassification of the nutritional status.

Acute phase response after myocardial infarction: Correlation between serum levels of cytokines and C-reactive protein

1990 ◽  
Vol 68 (21) ◽  
pp. 1083-1083 ◽  
Author(s):  
H. Tilg ◽  
J. Mair ◽  
M. Herold ◽  
W. E. Aulitzky ◽  
P. Lechleitner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Phase ◽  
Acute Phase Response ◽  
Serum Levels ◽  
Phase Response ◽  
C Reactive Protein ◽  
Reactive Protein

The acute phase response and C-reactive protein

2020 ◽  
pp. 2199-2207
Author(s):  
Mark B. Pepys
Keyword(s):  
Acute Phase ◽  
Acute Phase Response ◽  
Serum Amyloid A ◽  
Acute Phase Proteins ◽  
Phase Response ◽  
Serum Amyloid ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Amyloid A ◽  
Serum Amyloid A Protein

The acute phase response—trauma, tissue necrosis, infection, inflammation, and malignant neoplasia induce a complex series of nonspecific systemic, physiological, and metabolic responses including fever, leucocytosis, catabolism of muscle proteins, greatly increased de novo synthesis and secretion of a number of ‘acute phase’ plasma proteins, and decreased synthesis of albumin, transthyretin, and high- and low-density lipoproteins. The altered plasma protein concentration profile is called the acute phase response. Acute phase proteins—these are mostly synthesized by hepatocytes, in which transcription is controlled by cytokines including interleukin 1, interleukin 6, and tumour necrosis factor. The circulating concentrations of complement proteins and clotting factors increase by up to 50 to 100%; some of the proteinase inhibitors and α‎1-acid glycoprotein can increase three- to fivefold; but C-reactive protein (CRP) and serum amyloid A protein (an apolipoprotein of high-density lipoprotein particles) are unique in that their concentrations can change by more than 1000-fold. C-reactive protein—this consists of five identical, nonglycosylated, noncovalently associated polypeptide subunits. It binds to autologous and extrinsic materials which contain phosphocholine, including bacteria and their products. Ligand-bound CRP activates the classical complement pathway and triggers the inflammatory and opsonizing activities of the complement system, thereby contributing to innate host resistance to pneumococci and probably to recognition and safe ‘scavenging’ of cellular debris. Clinical features—(1) determination of CRP in serum or plasma is the most useful marker of the acute phase response in most inflammatory and tissue damaging conditions. (2) Acute phase proteins may be harmful in some circumstances. Sustained increased production of serum amyloid A protein can lead to the deposition of AA-type, reactive systemic amyloid.

scholarly journals Studies of translatable mRNA for rabbit C-reactive protein

1985 ◽  
Vol 227 (3) ◽  
pp. 759-765 ◽  
Author(s):  
D Samols ◽  
S S MacIntyre ◽  
I Kushner
Keyword(s):  
Acute Phase ◽  
Acute Phase Response ◽  
Phase Response ◽  
Translation Product ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Primary Translation Product ◽  
Free Translation ◽  
Translatable Mrna

C-reactive protein (CRP) mRNA was assayed by cell-free translation of poly(A)-containing liver RNA isolated both from rabbits stimulated to undergo the acute-phase response and from unstimulated control rabbits. No CRP-related translation products were identified until the denaturant methylmercury hydroxide (CH3HgOH) was added to the RNA before cell-free translation. In the presence of the denaturant, a 24000-Da translation product was synthesized which was immunochemically identifiable as the CRP primary translation product. It is likely that rabbit CRP mRNA can form a stable intramolecular duplex which interferes with its translatability in vitro. The 24000-Da CH3HgOH-facilitated cell-free translation product was not detected in poly(A)-containing liver RNA from unstimulated animals, indicating that the concentration of translatable CRP mRNA was dramatically induced during the acute-phase response. On the basis of absorption experiments, the 24000-Da CRP primary translation product was immunochemically more closely related to denatured CRP than to native CRP.

Strenuous exercise: analogous to the acute-phase response?

1991 ◽  
Vol 81 (5) ◽  
pp. 677-683 ◽  
Author(s):  
Lindsay M. Weight ◽  
Donald Alexander ◽  
Peter Jacobs
Keyword(s):  
Acute Phase ◽  
Total Protein ◽  
Protein Level ◽  
Acute Phase Response ◽  
Interleukin 1 ◽  
Phase Response ◽  
Strenuous Exercise ◽  
Iron Level ◽  
C Reactive Protein ◽  
Reactive Protein

1. It has been suggested that the physiological consequences of strenuous exercise are analogous to those of the acute-phase response. 2. In 70 male and 20 female competitive distance runners, a marked, but transient, neutrophil leucocytosis occurred immediately after these athletes completed a standard (42 km) marathon race. Concomitant significant increases were noted in the plasma cortisol levels, creatine kinase activity, C-reactive protein level, total protein level and albumin level (P <0.01). 3. The plasma fibrinogen, C-reactive protein and total protein concentrations were markedly increased both 24 h and 48 h after exercise (P <0.01). The serum haptoglobin level was significantly decreased after exercise (P <0.01), and increased 48 h later (P <0.05). There was no change in the serum iron level, total iron-binding capacity, per cent saturation of transferrin and serum ferritin level. 4. A significant increase in interleukin-1-type activity was demonstrated immediately and 24 h after exercise (P <0.01). 5. It is concluded that the metabolic sequelae of sustained exercise are similar, but not analogous, to the acute-phase response, and interleukin-1 probably plays a significant role in linking the haematological and immunological changes observed after sustained strenuous exercise.

scholarly journals Acute Phase Response in Patients With Uncomplicated and Complicated Endoscopic Retrogradic Cholangiopancreaticography

HPB Surgery ◽  
1994 ◽  
Vol 8 (2) ◽  
pp. 129-131 ◽  
Author(s):  
Heikki Kiviniemi ◽  
Tatu Juvonen ◽  
Jyrki Mäkelä
Keyword(s):  
Prospective Study ◽  
Acute Phase ◽  
Acute Phase Response ◽  
Response Curve ◽  
Serum Amylase ◽  
Phase Response ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Biliary Diseases

Acute phase response after endoscopic retrogradic cholangiopancreaticography (ERCP) was studied in 42 patients with suspected pancreatic or biliary diseases. In uncomplicated cases acute phase response determined by serum C-reactive protein levels was rare and did not parallel the serum amylase or lipase levels. In three of the these 42 patients, post-ERCP pancreatitis developed and CRP levels elevated sharply and paralleled the degree of pancreatitis. Six additional patients outside of this prospective study with post-ERCP-pancreatitis and daily CRP determinations were used to determine the CRP-response curve in post-ERCP pancreatitis.

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