C-Reactive Protein Is an Indicator of the Immunosuppressive Microenvironment Fostered by Myeloid Cells in Hepatocellular Carcinoma

BackgroundC-reactive protein (CRP) is a widely used marker of systemic inflammation and predicts poor clinical outcomes in patients with hepatocellular carcinoma (HCC); however, its significance in the local immune response at the tumor site is not clear.MethodsSerum CRP levels of 329 HCC patients were detected before resection. Paired paraffin-embedded tumor samples were used to quantify immune cell populations, such as CD11b+ myeloid cells, CD68+ macrophages (Mφs), CD15+ neutrophils, CD8+ T cells, and CD206+, CD204+, CD163+ and CD169+ Mφs, by immunohistochemistry. Enrichment scores for 34 types of immune cells based on transcriptome data from 24 HCC samples were calculated by xCell. Overall survival of patients was analyzed using the Kaplan-Meier method.ResultsSerum CRP levels were correlated with liver functions and tumor stages in patients with HCC. The densities of CD68+ tumor-associated macrophages (TAMs) and CD15+ tumor-associated neutrophils (TANs) were significantly higher in patients with elevated serum CRP levels than in those with low CRP levels (both p < 0.0001). Further analysis of TAM subtypes revealed that serum CRP levels were associated with CD204+ and CD163+ Mφ densities (p < 0.0001 and p = 0.0003, respectively). Moreover, transcriptome data showed that CRP expression was associated with the expression of myeloid cell infiltration-related genes in HCC tumors. The combination of serum CRP with TAMs or TANs in both the nontumor and intratumor regions could represent a powerful criterion for predicting patient prognoses.ConclusionSerum CRP could serve as an indicator of an immunosuppressive TME in HCC, which could be of potential clinical application for treatment strategies targeting the TME.

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Prognostic and Predictive Value of Serum C-Reactive Protein Levels in Patients with Metastatic Or Locally Recurrent Gastric Cancer

The International Journal of Biological Markers ◽

10.5301/jbm.5000210 ◽

2016 ◽

Vol 31 (3) ◽

pp. 294-299 ◽

Cited By ~ 3

Author(s):

Zhigang Chen ◽

Yongchen Sun ◽

Ji Wang ◽

Xudong Shen ◽

Lei Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Malignant Tumors ◽

Elevated Serum ◽

Roc Curves ◽

Serum Levels ◽

C Reactive Protein ◽

Term Survival ◽

Reactive Protein ◽

Serum Crp

Background and Aims Increasing evidence suggests that elevated serum levels of C-reactive protein (CRP) are associated with poor survival in many malignant tumors. However, the prognostic value of CRP in advanced gastric cancer (AGC) remains uncertain. This study was undertaken to evaluate the significance of serum CRP as a biomarker of long-term survival in patients with AGC. Methods The serum CRP levels of AGC patients were analyzed for clinicopathological significance. Data were collected retrospectively for 244 patients treated between October 1, 2006 and September 30, 2013. The prognostic effect of serum CRP levels was evaluated. Results The baseline CRP level before chemotherapy was significantly associated with overall survival. The median survival was 351 days for patients with CRP ≥10 mg/L and 370 days for patients with CRP c10 mg/L (p = 0.033). Cox analysis revealed CRP to be an independent prognostic factor for overall survival. In the 93 patients whose baseline CRP was ≥10 mg/L, a cutoff point of 22% for the CRP declining rate provided optimum sensitivity and specificity for 1-year survival based on ROC curves. A CRP declining rate >22% was found to predict longer overall survival (410 days versus 299 days; p = 0.001). Conclusions Elevated serum CRP baseline levels before chemotherapy were associated with reduced overall survival in patients with AGC. The CRP declining rate was also associated with overall survival. The CRP baseline concentration before chemotherapy and CRP declining rate after chemotherapy may be used as novel, widely available and real-time independent prognostic and predictive markers of AGC.

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Antioxidant intake from diet and supplements and elevated serum C-reactive protein and plasma homocysteine concentrations in US adults: a cross-sectional study

Public Health Nutrition ◽

10.1017/s1368980011000395 ◽

2011 ◽

Vol 14 (11) ◽

pp. 2055-2064 ◽

Cited By ~ 19

Author(s):

Anna Floegel ◽

Sang-Jin Chung ◽

Anne von Ruesten ◽

Meng Yang ◽

Chin E Chung ◽

...

Keyword(s):

Elevated Serum ◽

Cross Sectional Study ◽

Elevated Blood ◽

Sectional Study ◽

C Reactive Protein ◽

Cross Sectional ◽

Reactive Protein ◽

Antioxidant Intake ◽

The Mean ◽

Serum Crp

AbstractObjectiveTo investigate the association of antioxidant intakes from diet and supplements with elevated blood C-reactive protein (CRP) and homocysteine (Hcy) concentrations.DesignA cross-sectional study. The main exposures were vitamins C and E, carotene, flavonoid and Se intakes from diet and supplements. Elevated blood CRP and Hcy concentrations were the outcome measures.SettingThe US population and its subgroups.SubjectsWe included 8335 US adults aged ≥19 years from the National Health and Nutrition Examination Survey 1999–2002.ResultsIn this US population, the mean serum CRP concentration was 4·14 (95 % CI 3·91, 4·37) mg/l. Intakes of vitamins C and E and carotene were inversely associated with the probability of having serum CRP concentrations >3 mg/l in multivariate logistic regression models. Flavonoid and Se intakes were not associated with the odds of elevated serum CRP concentrations. The mean plasma Hcy concentration was 8·61 (95 % CI 8·48, 8·74) μmol/l. Intakes of vitamins C, E, carotenes and Se were inversely associated with the odds of plasma Hcy concentrations >13 μmol/l after adjusting for covariates. Flavonoid intake was not associated with the chance of elevated plasma Hcy concentrations.ConclusionsThese results suggest that high antioxidant intake is associated with lower blood concentrations of CRP and Hcy. These inverse associations may be among the potential mechanisms for the beneficial effect of antioxidant intake on CVD risk mediators in observational studies.

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C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466620937175 ◽

2020 ◽

Vol 14 ◽

pp. 175346662093717 ◽

Cited By ~ 39

Author(s):

Ian Huang ◽

Raymond Pranata ◽

Michael Anthonius Lim ◽

Amaylia Oehadian ◽

Bachti Alisjahbana

Keyword(s):

Serum Ferritin ◽

Distress Syndrome ◽

Meta Analysis ◽

Elevated Serum ◽

Need For Care ◽

C Reactive Protein ◽

Reactive Protein ◽

Poor Outcome ◽

Serum Crp ◽

D Dimer

Background: Patients critically ill with coronavirus disease-2019 (COVID-19) feature hyperinflammation, and the associated biomarkers may be beneficial for risk stratification. We aimed to investigate the association between several biomarkers, including serum C-reactive protein (CRP), procalcitonin (PCT), D-dimer, and serum ferritin, and COVID-19 severity. Methods: We performed a comprehensive systematic literature search through electronic databases. The outcome of interest for this study was the composite poor outcome, which comprises mortality, acute respiratory distress syndrome, need for care in an intensive care unit, and severe COVID-19. Results: A total of 5350 patients were pooled from 25 studies. Elevated CRP was associated with an increased composite poor outcome [risk ratio (RR) 1.84 (1.45, 2.33), p < 0.001; I2: 96%] and its severe COVID-19 (RR 1.41; I2: 93%) subgroup. A CRP ⩾10 mg/L has a 51% sensitivity, 88% specificity, likelihood ratio (LR) + of 4.1, LR- of 0.5, and an area under curve (AUC) of 0.84. An elevated PCT was associated with an increased composite poor outcome [RR 3.92 (2.42, 6.35), p < 0.001; I2: 85%] and its mortality (RR 6.26; I2: 96%) and severe COVID-19 (RR 3.93; I2: 63%) subgroups. A PCT ⩾0.5 ng/ml has an 88% sensitivity, 68% specificity, LR+ of 2.7, LR- of 0.2, and an AUC of 0.88. An elevated D-dimer was associated with an increased composite poor outcome [RR 2.93 (2.14, 4.01), p < 0.001; I2: 77%], including its mortality (RR 4.15; I2: 83%) and severe COVID-19 (RR 2.42; I2: 58%) subgroups. A D-dimer >0.5 mg/L has a 58% sensitivity, 69% specificity, LR+ of 1.8, LR- of 0.6, and an AUC of 0.69. Patients with a composite poor outcome had a higher serum ferritin with a standardized mean difference of 0.90 (0.64, 1.15), p < 0.0001; I2: 76%. Conclusion: This meta-analysis showed that an elevated serum CRP, PCT, D-dimer, and ferritin were associated with a poor outcome in COVID-19. The reviews of this paper are available via the supplemental material section.

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C-reactive protein (CRP) rs3093059Cpredicts poor mizolastine response in chronic spontaneous urticaria patients with elevated serum CRP level

Experimental Dermatology ◽

10.1111/exd.13874 ◽

2019 ◽

Vol 28 (3) ◽

pp. 240-246 ◽

Cited By ~ 1

Author(s):

Siyu Yan ◽

Wangqing Chen ◽

Cong Peng ◽

Wu Zhu ◽

Mingliang Chen ◽

...

Keyword(s):

Elevated Serum ◽

Chronic Spontaneous Urticaria ◽

C Reactive Protein ◽

Reactive Protein ◽

Serum Crp

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Elevated Level of Serum C-reactive Protein Predicts Postoperative Delirium among Patients Receiving Cervical or Lumbar Surgery

BioMed Research International ◽

10.1155/2020/5480148 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Quan Ren ◽

Ya-zhou Wen ◽

Jin Wang ◽

Jing Yuan ◽

Xu-hui Chen ◽

...

Keyword(s):

Regression Model ◽

Postoperative Delirium ◽

Medical Center ◽

Elevated Serum ◽

Lumbar Vertebra ◽

Assessment Method ◽

C Reactive Protein ◽

Binary Logistic Regression Model ◽

Reactive Protein ◽

Serum Crp

Objective. To explore the relationship between elevated serum C-reactive protein (CRP) level and postoperative delirium (POD). Methods. 206 patients scheduled to receive cervical or lumbar vertebra surgery under general anesthesia for more than 2 hours in a single medical center were observed and analyzed. Patients’ serum CRP, delirious status (using the confusion assessment method (CAM)), and delirious score (using the memorial delirium assessment scale (MDAS)) were examined before surgery and 1-2 days after surgery. The association of a serum CRP elevation value from before to after surgery (D-CRP) with delirium occurrence within 2 days after surgery was assessed with a binary logistic regression model, while the association of D-CRP with the postoperative delirious score was assessed with a linear regression model. The effect of D-CRP on predicting delirium occurrence was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC). Results. D-CRP was significantly positively associated with postoperative delirium occurrence (OR=1.047, 95%CI=1.013, 1.082), and D-CRP was also significantly linearly associated with the postoperative delirious score (β=0.014, 95%CI=0.006, 0.023). AUC of ROC was 0.711 (P=0.014), suggesting that D-CRP had moderate efficacy on predicting postoperative delirium occurrence (P<0.05). Conclusions. Elevated serum CRP after surgery may be a risk factor for and a predictor of postoperative delirium.

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Septic and aseptic post-operative discitis in the lumbar spine — evaluation by MR imaging

Acta Radiologica ◽

10.1080/02841859809172162 ◽

1998 ◽

Vol 39 (2) ◽

pp. 108-115 ◽

Cited By ~ 56

Author(s):

P. Grane ◽

A. Josephsson ◽

A. Seferlis ◽

T. Tullberg

Keyword(s):

Lumbar Spine ◽

Mr Imaging ◽

Elevated Serum ◽

Low Back ◽

Retrospective Evaluation ◽

C Reactive Protein ◽

Surrounding Soft Tissue ◽

Reactive Protein ◽

Post Operative Period ◽

Serum Crp

Purpose: the aim of this study was to determine whether it was possible to differentiate septic from aseptic post-operative discitis in the lumbar spine by means of MR imaging Material and Methods: the study was a retrospective evaluation of 12 patients with prior lumbar discectomy and suspected post-operative discitis displaying low-back pain and typical MR findings. Six patients had elevated serum C-reactive protein (CRP) (septic) and 6 had normal CRP (aseptic). We used MR imaging to assess the distribution and degree of changes in the disc, in adjacent bone marrow, and in surrounding soft tissue Results: of the 6 patients with increased CRP levels, 3 had extensive MR changes typical of septic post-operative discitis: 1 found soon after surgery; 2 found later. the other 3 patients with septic discitis, who were examined in the early post-operative period, showed MR changes similar to those in the 6 patients with aseptic discitis Conclusion: Suspicion of septic post-operative discitis should be confirmed by MR imaging, serum CRP, and disc puncture. MR imaging is not reliable as the sole method for distinguishing septic from aseptic discitis in the early post-operative stage

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Elevated Serum C-Reactive Protein Relates to Increased Cerebral Myoinositol Levels in Middle-Aged Adults

Cardiovascular Psychiatry and Neurology ◽

10.1155/2012/120540 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 22

Author(s):

Danielle E. Eagan ◽

Mitzi M. Gonzales ◽

Takashi Tarumi ◽

Hirofumi Tanaka ◽

Sandra Stautberg ◽

...

Keyword(s):

Grey Matter ◽

Cerebral Metabolism ◽

Elevated Serum ◽

C Reactive Protein ◽

Middle Aged ◽

Blood Draw ◽

Reactive Protein ◽

Middle Aged Adults ◽

Serum Crp ◽

The Relationship

C-reactive protein (CRP), a systemic marker of inflammation, is a risk factor for late life cognitive impairment and dementia, yet the mechanisms that link elevated CRP to cognitive decline are not fully understood. In this study we examined the relationship between CRP and markers of neuronal integrity and cerebral metabolism in middle-aged adults with intact cognitive function, using proton magnetic resonance spectrocospy. We hypothesized that increased levels of circulating CRP would correlate with changes in brain metabolites indicative of early brain vulnerability. Thirty-six individuals, aged 40 to 60, underwent neuropsychological assessment, a blood draw for CRP quantification, and 1H MRS examining N-acetyl-aspartate, myo-inositol, creatine, choline, and glutamate concentrations in occipito-parietal grey matter. Independent of age, sex and education, serum CRP was significantly related to higher cerebral myo-inositol/creatine ratio (F(4,31)=4.74, P=0.004), a relationship which remained unchanged after adjustment for cardiovascular risk (F(5,30)=4.356, CRP β = 0.322, P=0.045). Because these biomarkers are detectable in midlife they may serve as useful indicators of brain vulnerability during the preclinical period when mitigating intervention is still possible.

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Effect of Periodontal Therapy on Serum C-Reactive Protein Levels in Patients with Gingivitis and Chronic Periodontitis: A Clinicobiochemical Study

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1305 ◽

2013 ◽

Vol 14 (2) ◽

pp. 233-237 ◽

Cited By ~ 10

Author(s):

Veena A Patil ◽

Manthan H Desai

Keyword(s):

Periodontal Disease ◽

Chronic Periodontitis ◽

Elevated Serum ◽

Periodontal Therapy ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Potential Biomarker ◽

Periodontal Index ◽

Serum Crp

ABSTRACT Aim The aim of the present study was to evaluate the effect of periodontal therapy on serum C-reactive protein (CRP) levels in patients with gingivitis and chronic periodontitis. Materials and methods A total of 60 subjects (30 males and 30 females) were included in the study with 20 subjects in each of the groups classified based on community periodontal index (CPI) scores: I: Healthy, II: Gingivitis, III: Mild periodontitis. Periodontal therapy was performed on groups II and III patients. Venous blood was collected from each subject at baseline and 3 months after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using immunoturbidimetric method. Results The present study demonstrated that the periodontitis group had a higher mean CRP levels (2.49 ± 0.47 ng/ml) as compared to the gingivitis group (1.40 ± 0.32 ng/ml) and healthy group (0.56 ± 0.20 ng/ml). The mean CRP values after periodontal therapy were found to be reduced to 0.44 ± 0.23 ng/ml in group II and 1.30 ± 0.36 ng/ml in group III patients. Conclusion Within the limitations of this study, it can be concluded that CRP level progressively increases from periodontal health to disease. A decrease in CRP levels with periodontal treatment was also observed. Clinical significance Due to its opsonizing abilities CRP plays an important role in the innate host defence. It can be hypothesized that CRP is a potential biomarker of periodontal disease. A number of studies have reported elevated serum CRP levels in periodontitis subjects. Long standing periodontal disease and raised CRP levels enhance the risk of cardiovascular disease, cerebrovascular accidents and preterm low birth weight infants. There is also evidence that effective periodontal therapy can lower serum CRP levels. However, the data of interventional studies on CRP in gingivitis and periodontitis is scarce. How to cite this article Patil VA, Desai MH. Effect of Periodontal Therapy on Serum C-Reactive Protein Levels in Patients with Gingivitis and Chronic Periodontitis: A Clinicobiochemical Study. J Contemp Dent Pract 2013;14(2):233-237.

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Immunohistochemical detection of procalcitonin in fibrolamellar hepatocellular carcinoma

Clinical Journal of Gastroenterology ◽

10.1007/s12328-021-01354-1 ◽

2021 ◽

Author(s):

Kotaro Matsumoto ◽

Kentaro Kikuchi ◽

Ayako Hara ◽

Hiromichi Tsunashima ◽

Koichi Tsuneyama ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Histopathological Examination ◽

Epigastric Pain ◽

Positive Staining ◽

C Reactive Protein ◽

Fibrolamellar Hepatocellular Carcinoma ◽

Tumor Biopsy ◽

Reactive Protein ◽

Right Lobe ◽

The Right

AbstractA 25-year-old woman with fever and epigastric pain was referred to our hospital. Blood examination showed significant liver dysfunction, markedly high C-reactive protein (CRP 19.1 mg/dL) and procalcitonin (48.3 ng/mL) levels. Dynamic computed tomography showed a tumor approximately 120 mm in size in the right lobe of the liver, but with no abscess formation. The patient was hospitalized and started on antibiotics; her CRP level improved, but the procalcitonin level did not decrease. Histopathological examination of the liver tumor biopsy revealed fibrolamellar hepatocellular carcinoma (FLC). Positive staining of the FLC with an anti-procalcitonin antibody suggested the production of procalcitonin.

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Serum C-Reactive Protein Is Negatively Associated With Olfactory Identification Ability in Older Adults

i-Perception ◽

10.1177/20416695211009928 ◽

2021 ◽

Vol 12 (2) ◽

pp. 204166952110099

Author(s):

Ingrid Ekström ◽

Davide Liborio Vetrano ◽

Goran Papenberg ◽

Erika J. Laukka

Keyword(s):

Statistical Significance ◽

Population Based ◽

Rate Of Change ◽

Odor Identification ◽

Sensitivity Analyses ◽

C Reactive Protein ◽

Reactive Protein ◽

Olfactory Identification ◽

Olfactory Ability ◽

Serum Crp

Importance Olfactory deficits are common in aging and associated with several conditions linked to inflammation. A few studies suggest that increased concentration of pro-inflammatory biomarkers may be related to olfactory deficits, but these associations are understudied in population-based samples. Objective To investigate the association between serum concentrations of C-reactive protein (CRP) and olfactory identification level as well as rate of change in aging. Methods We included 1,721 participants (mean age 70.5 years; 61.9% female) with at least two olfactory assessments across the 12-year follow-up. Baseline level and change in odor identification were estimated with linear mixed models as a function of CRP levels, derived from blood plasma at baseline. Results Results indicated a negative dose–response association between CRP level and odor identification scores at baseline, after adjustment for demographic, cognitive, health, and lifestyle factors. CRP levels ranging between 11 and 20 mg/L were significantly related to lower olfactory ability (β = −0.811, 95% confidence interval [CI] [−1.503 to −0.118]; p = .022). Likewise, CRP values above 20 mg/L were related to lower olfactory scores, an association that approached statistical significance (β = −0.996, 95% CI [−2.045 to 0.054]; p = .063). We found no associations between CRP and olfactory change ( ps > .368). Sensitivity analyses showed that associations between CRP and olfaction were confined to younger participants (age ≤72 years) and men ( ps < .034). Conclusions Our findings suggest a negative association between serum CRP levels and olfactory identification ability in aging that may be dependent on age and sex.

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