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Akyol O, Yang CY, Woodside DG, Chiang HH, Chen CH, Gotto AM. Comparative Analysis of Atherogenic Lipoproteins L5 and Lp(a) in Atherosclerotic Cardiovascular Disease. Curr Atheroscler Rep 2024; 26:317-329. [PMID: 38753254 PMCID: PMC11192678 DOI: 10.1007/s11883-024-01209-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE OF REVIEW Low-density lipoprotein (LDL) poses a risk for atherosclerotic cardiovascular disease (ASCVD). As LDL comprises various subtypes differing in charge, density, and size, understanding their specific impact on ASCVD is crucial. Two highly atherogenic LDL subtypes-electronegative LDL (L5) and Lp(a)-induce vascular cell apoptosis and atherosclerotic changes independent of plasma cholesterol levels, and their mechanisms warrant further investigation. Here, we have compared the roles of L5 and Lp(a) in the development of ASCVD. RECENT FINDINGS Lp(a) tends to accumulate in artery walls, promoting plaque formation and potentially triggering atherosclerosis progression through prothrombotic or antifibrinolytic effects. High Lp(a) levels correlate with calcific aortic stenosis and atherothrombosis risk. L5 can induce endothelial cell apoptosis and increase vascular permeability, inflammation, and atherogenesis, playing a key role in initiating atherosclerosis. Elevated L5 levels in certain high-risk populations may serve as a distinctive predictor of ASCVD. L5 and Lp(a) are both atherogenic lipoproteins contributing to ASCVD through distinct mechanisms. Lp(a) has garnered attention, but equal consideration should be given to L5.
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Affiliation(s)
- Omer Akyol
- Molecular Cardiology Research Laboratories, Vascular and Medicinal Research, The Texas Heart Institute, Houston, Texas, 77030, USA
| | - Chao-Yuh Yang
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, 77030, USA
| | - Darren G Woodside
- Molecular Cardiology Research Laboratories, The Texas Heart Institute, Houston, TX, 77030, USA
| | - Huan-Hsing Chiang
- Molecular Cardiology Research Laboratories, Vascular and Medicinal Research, The Texas Heart Institute, Houston, Texas, 77030, USA
| | - Chu-Huang Chen
- Molecular Cardiology Research Laboratories, Vascular and Medicinal Research, The Texas Heart Institute, Houston, Texas, 77030, USA.
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Nazemi P, SeyedAlinaghi S, Azarnoush A, Mabadi A, Khaneshan AS, Salehi M. Serum C-reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID-19: A systematic review. Immun Inflamm Dis 2023; 11:e1130. [PMID: 38156391 PMCID: PMC10753867 DOI: 10.1002/iid3.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 12/02/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023] Open
Abstract
INTRODUCTION Severe COVID-19 management is still challenging. Having a laboratory factor to predict the severity of a patient's condition can be very useful in how to approach each patient. There have been studies concentrating on the correlation between serum C-reactive protein (CRP) level and COVID-19 severity but we aim to reach a threshold for CRP in disease severity determination. METHODS We conducted a thorough search on PubMed, Web of Science and Google Scholar databases from early 2019 to October 2021, and 323 studies were assessed for eligibility in three phases. We used the Newcastle-Ottawa Scale to examine the validity of the studies. The t-test was applied for the CRP level cutoffs. RESULTS Eventually, 11 articles and 1615 patients were included in this systematic review. Our analysis evaluated combined mean, median, and standard deviation of severe patients' CRP to be respectively 73.37, 53.80, and 47.936. Based on the combined mean, 75 mg/dL was suggested as an initial threshold for baseline CRP in hospitalized patients for developing severe conditions. CONCLUSION This study recommends that COVID-19 patients with on-admission serum CRP levels of 75 mg/dL and more are likely associated with severe conditions. Thus, anti-inflammatory agents and further following may be helpful in these patients.
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Affiliation(s)
- Pershang Nazemi
- Department of Infectious Diseases, Imam Khomeini and Yas Hospital ComplexTehran University of Medical SciencesTehranIran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High‐Risk BehaviorsTehran University of Medical SciencesTehranIran
| | - Ayein Azarnoush
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High‐Risk BehaviorsTehran University of Medical SciencesTehranIran
- Medical SchoolAlborz University of Medical SciencesKarajIran
| | - Avin Mabadi
- Medical SchoolIran University of Medical SciencesTehranIran
| | - Arezoo Salami Khaneshan
- Department of Infectious Diseases, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Mohammadreza Salehi
- Department of Infectious Diseases, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
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Mouliou DS. C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians. Diseases 2023; 11:132. [PMID: 37873776 PMCID: PMC10594506 DOI: 10.3390/diseases11040132] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/25/2023] Open
Abstract
The current literature provides a body of evidence on C-Reactive Protein (CRP) and its potential role in inflammation. However, most pieces of evidence are sparse and controversial. This critical state-of-the-art monography provides all the crucial data on the potential biochemical properties of the protein, along with further evidence on its potential pathobiology, both for its pentameric and monomeric forms, including information for its ligands as well as the possible function of autoantibodies against the protein. Furthermore, the current evidence on its potential utility as a biomarker of various diseases is presented, of all cardiovascular, respiratory, hepatobiliary, gastrointestinal, pancreatic, renal, gynecological, andrological, dental, oral, otorhinolaryngological, ophthalmological, dermatological, musculoskeletal, neurological, mental, splenic, thyroid conditions, as well as infections, autoimmune-supposed conditions and neoplasms, including other possible factors that have been linked with elevated concentrations of that protein. Moreover, data on molecular diagnostics on CRP are discussed, and possible etiologies of false test results are highlighted. Additionally, this review evaluates all current pieces of evidence on CRP and systemic inflammation, and highlights future goals. Finally, a novel diagnostic algorithm to carefully assess the CRP level for a precise diagnosis of a medical condition is illustrated.
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Hackenberg RK, Schmitt-Sánchez F, Endler C, Tischler V, Surendar J, Welle K, Kabir K, Schildberg FA. Value of Diagnostic Tools in the Diagnosis of Osteomyelitis: Pilot Study to Establish an Osteomyelitis Score. J Clin Med 2023; 12:jcm12093057. [PMID: 37176498 PMCID: PMC10179525 DOI: 10.3390/jcm12093057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Osteomyelitis (OM) remains one of the most feared complications in bone surgery and trauma. Its diagnosis remains a major challenge due to lack of guidelines. The aim of this study was to prospectively analyze the value of the most common and available diagnostic tools and to establish an OM score to derive treatment recommendations. All patients with suspected OM were included in a prospective pilot study. All patients underwent blood sampling for C-reactive protein and white blood cell count analysis. Magnetic resonance imaging (MRI), and microbiologic and histopathologic samples, were taken from representative sites of initial debridement. All patients were treated according to their OM test results and followed for at least one year. Subsequently, the value of individual or combined diagnostic tools was analyzed in patients with confirmed OM and in patients in whom OM was ruled out. Based on these findings, an OM score was developed that included MRI, microbiology, and histopathology. The score identified all control patients and all but one OM patient, resulting in a correct diagnosis of 93.3%, which was validated in a second independent larger cohort. This was the first study to analyze the value of the most commonly used tools to diagnose OM. The proposed OM score provides a simple scoring system to safely interpret test results with high accuracy.
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Affiliation(s)
- Roslind K Hackenberg
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Fabio Schmitt-Sánchez
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Christoph Endler
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, Germany
| | - Verena Tischler
- Institute of Pathology, University Hospital Bonn, 53127 Bonn, Germany
| | - Jayagopi Surendar
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Kristian Welle
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Koroush Kabir
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Frank A Schildberg
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
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Karampoor S, Hesamizadeh K, Shams Z, Ghafari Novin A, Farahmand M, Zahednasab H, Mirzaei R, Zamani F, Hajibaba M, Bouzari B, Laali A, Tabibzadeh A, Hadi Karbalaie Niya M, Keyvani H. The role of lovastatin in the attenuation of COVID-19. Int Immunopharmacol 2021; 101:108192. [PMID: 34607230 PMCID: PMC8461262 DOI: 10.1016/j.intimp.2021.108192] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/05/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023]
Abstract
The mounting evidence regarding the pathogenesis of COVID-19 indicated that the cytokine storm has an axial role in the severity of this disease, which may lead to thrombotic complications, acute respiratory distress syndrome (ARDS), and myocardial damage, among other consequences. It has recently been demonstrated that statins are known to have anti-viral, anti-inflammatory, anti-thrombotic, and immunomodulatory features; however, their advantage has not been evaluated in COVID-19. This study aimed to investigate the protective effects of lovastatin in intensive care unit (ICU) patients with COVID-19. The case-control study consists of 284 ICU patients, which classified into three groups as follows: 1) the patients who no received lovastatin as a control (92 patients), 2) patients received 20 mg per day lovastatin (99 patients), and 3) patients received 40 mg per day lovastatin (93 patients). Each group's demographic and clinical parameters, along with CRP, interleukin (IL)-6, IL-8 levels, and mortality rate, were studied in three-time points. The results showed that there was no statistically significant difference between our study groups in terms of age and sex. (P > 0.05). Besides, in patients, receiving lovastatin the CRP, IL-6, IL-8 levels were significantly decreased from T1 to T3 than to the control group. Our results also showed that the use of lovastatin in COVID-19 patients significantly reduced the length of hospitalization in the ICU compared with the control group. In addition, our results showed that the mortality rate in patients receiving lovastatin was lower when compared to the control group; however, this difference was not statistically significant. Since the cytokine storm is a significant factor in the pathology of SARS-CoV-2, our findings highlighted the potential use of lovastatin to mitigate the inflammatory response induced by SARS-CoV-2 infection.
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Affiliation(s)
- Sajad Karampoor
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Khashayar Hesamizadeh
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Middle East Liver Diseases (MELD) Center, Tehran, Iran
| | - Zinat Shams
- Department of Biological Science, Kharazmi University, Tehran, Iran
| | - Arefeh Ghafari Novin
- Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Farahmand
- Department of Medical Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Zahednasab
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Rasoul Mirzaei
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Marzieh Hajibaba
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Bouzari
- Department of Pathology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Laali
- Department of Infectious Disease, School of Medicine, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Tabibzadeh
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Hossein Keyvani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Mosquera‐Sulbaran JA, Pedreañez A, Carrero Y, Callejas D. C-reactive protein as an effector molecule in Covid-19 pathogenesis. Rev Med Virol 2021; 31:e2221. [PMID: 34773448 PMCID: PMC7995022 DOI: 10.1002/rmv.2221] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 01/08/2023]
Abstract
The current pandemic caused by SARS-CoV-2 virus infection is known as Covid-19 (coronavirus disease 2019). This disease can be asymptomatic or can affect multiple organ systems. Damage induced by the virus is related to dysfunctional activity of the immune system, but the activity of molecules such as C-reactive protein (CRP) as a factor capable of inducing an inflammatory status that may be involved in the severe evolution of the disease, has not been extensively evaluated. A systematic review was performed using the NCBI-PubMed database to find articles related to Covid-19 immunity, inflammatory response, and CRP published from December 2019 to December 2020. High levels of CRP were found in patients with severe evolution of Covid-19 in which several organ systems were affected and in patients who died. CRP activates complement, induces the production of pro-inflammatory cytokines and induces apoptosis which, together with the inflammatory status during the disease, can lead to a severe outcome. Several drugs can decrease the level or block the effect of CRP and might be useful in the treatment of Covid-19. From this review it is reasonable to conclude that CRP is a factor that can contribute to severe evolution of Covid-19 and that the use of drugs able to lower CRP levels or block its activity should be evaluated in randomized controlled clinical trials.
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Affiliation(s)
- Jesús A. Mosquera‐Sulbaran
- Instituto de Investigaciones Clinicas “Dr. Americo Negrette”Facultad de MedicinaUniversidad del ZuliaMaracaiboVenezuela
| | - Adriana Pedreañez
- Catedra de InmunologiaEscuela de BioanalisisFacultad de MedicinaUniversidad del ZuliaMaracaiboVenezuela
| | - Yenddy Carrero
- Facultad de Ciencias de la SaludCarrera de MedicinaUniversidad Tecnica de AmbatoAmbatoEcuador
| | - Diana Callejas
- Facultad de Ciencias de la SaludDepartamento de Ciencias BiologicasUniversidad Tecnica de ManabiPortoviejoEcuador
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Retinal and Choroidal Thickness in relation to C-Reactive Protein on Swept-Source Optical Coherence Tomography. J Immunol Res 2021; 2021:6628224. [PMID: 33564690 PMCID: PMC7850851 DOI: 10.1155/2021/6628224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose To evaluate the relationships between C-reactive protein (CRP) and retinal and choroidal thickness by swept-source optical coherence tomography (SS-OCT). Methods The participants included in the prospective cross-sectional study underwent a comprehensive ophthalmic examination. Based on the CRP values, the subjects were divided into the CRP (+) group (CRP ≥ 8.2 mg/L) and the CRP (−) group (CRP < 8.2 mg/L). The retinal and choroidal thickness was compared between the two groups. Results This study enrolled 43 right eyes of 43 subjects from the CRP (+) group and 86 right eyes of 86 gender- and age-match subjects from the CRP (−) group. The choroidal thickness in the CRP (+) group was thinner than that in the CRP (−) group except for the outer nasal sector of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. However, the retinal thickness only in the inner temporal sector showed a significant difference. According to Pearson's correlation analysis, the CRP was significantly negatively correlated with the choroidal thickness in all sectors and the retinal thickness only in the inner temporal and outer nasal sectors of the ETDRS grid. Conclusion CRP levels are associated with retinal and choroidal thickness. The data related to the retinal and choroidal thickness changes may help understand the pathogenesis of specific ocular abnormalities in patients with systemic inflammation.
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Pope JE, Choy EH. C-reactive protein and implications in rheumatoid arthritis and associated comorbidities. Semin Arthritis Rheum 2020; 51:219-229. [PMID: 33385862 DOI: 10.1016/j.semarthrit.2020.11.005] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 02/07/2023]
Abstract
C-reactive protein (CRP) is routinely assessed as a marker of systemic inflammation in rheumatoid arthritis (RA). However, it is also an immune regulator that plays an important role in inflammatory pathways associated with RA and promotes atherogenic effects. Comorbidities linked to systemic inflammation are common in RA, and CRP has been associated with the risk for cardiovascular disease, diabetes, metabolic syndrome, pulmonary diseases, and depression. The relationship between systemic inflammation, CRP, and comorbidities in RA is complex, and it is challenging to determine how changing CRP levels may affect the risk or progression of these comorbidities. We review the biological role of CRP in RA and its implications for disease activity and treatment response. We also discuss the impact of treatment on CRP levels and whether reducing systemic inflammation and inhibiting CRP-mediated inflammatory pathways may have an impact on conditions commonly comorbid with RA.
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Affiliation(s)
- Janet E Pope
- Janet E. Pope: Schulich School of Medicine, University of Western Ontario, St. Joseph's Health Care, London, ON, Canada
| | - Ernest H Choy
- Ernest H. Choy: Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom.
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Chatterjee S, Caporale A, Tao JQ, Guo W, Johncola A, Strasser AA, Leone FT, Langham MC, Wehrli FW. Acute e-cig inhalation impacts vascular health: a study in smoking naïve subjects. Am J Physiol Heart Circ Physiol 2020; 320:H144-H158. [PMID: 33216614 DOI: 10.1152/ajpheart.00628.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study was designed to investigate the acute effects of nonnicotinized e-cigarette (e-cig) aerosol inhalation in nonsmokers both in terms of blood-based markers of inflammation and oxidative stress and evaluate their association with hemodynamic-metabolic MRI parameters quantifying peripheral vascular reactivity, cerebrovascular reactivity, and aortic stiffness. Thirty-one healthy nonsmokers were subjected to two blood draws and two identical MRI protocols, each one before and after a standardized e-cig vaping session. After vaping, the serum levels of C-reactive protein, soluble intercellular adhesion molecule, and the danger signal machinery high-mobility group box 1 (HMGB1) and its downstream effector and the NLR family pyrin domain containing 3 (NLRP3) inflammasome (as monitored by its adaptor protein ASC) increased significantly relative to the respective baseline (prevaping) values. Moreover, nitric oxide metabolites and reactive oxygen species production decreased and increased, respectively. These observations were paralleled by impaired peripheral vascular reactivity (with reduced flow-mediated dilation and attenuated hyperemic response after a cuff-occlusion test) and metabolic alterations expressed by decreased venous oxygen saturation, postvaping. The current results suggest propagation of inflammation signaling via activation of the danger signaling axis (HMGB1-NLRP3). The findings indicate that a single episode of vaping has adverse impacts on vascular inflammation and function.NEW & NOTWORTHY Endothelial cell signaling and blood biomarkers were found to correlate with functional vascular changes in a single episode e-cigarettes inhalation in healthy adults. This is indicative of the potential of e-cigarettes (even when inhaled acutely) to lead of vascular dysfunction.
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Affiliation(s)
- Shampa Chatterjee
- Institute for Environmental Medicine and Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Alessandra Caporale
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology
| | - Jian Qin Tao
- Institute for Environmental Medicine and Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Wensheng Guo
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Alyssa Johncola
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology
| | - Andrew A Strasser
- Department of Psychiatry and Center for Interdisciplinary Research on Nicotine Addiction, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Frank T Leone
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Michael C Langham
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology
| | - Felix W Wehrli
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology
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Azul L, Leandro A, Boroumand P, Klip A, Seiça R, Sena CM. Increased inflammation, oxidative stress and a reduction in antioxidant defense enzymes in perivascular adipose tissue contribute to vascular dysfunction in type 2 diabetes. Free Radic Biol Med 2020; 146:264-274. [PMID: 31698080 DOI: 10.1016/j.freeradbiomed.2019.11.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/19/2019] [Accepted: 11/03/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Perivascular adipose tissue (PVAT) surrounds most large blood vessels and plays an important role in vascular homeostasis. The present study was conducted to investigate the contribution of PVAT to vascular dysfunction in a rat model of type 2 diabetes. MATERIAL AND METHODS Several in vivo parameters such as lipid profile (total cholesterol and triglyceride systemic levels), fasting glucose levels, glucose tolerance and insulin sensitivity (through glucose and insulin tolerance tests, respectively) were determined in Goto-Kakizaki (GK) diabetic rats and compared with control Wistar rats. At the vascular level, endothelial dependent and independent relaxation and contraction studies were performed in aortic rings in the absence (PVAT-) or in the presence (PVAT+) of thoracic PVAT. We also evaluated vascular oxidative stress and performed western blots, PCR and immunohistochemistry analysis of cytokines and various enzymes in PVAT. RESULTS Endothelium-dependent relaxation to acetylcholine, assessed by wire myography, was impaired in GK rats and improved by the antioxidant TEMPOL and by the TLR4 inhibitor, CLI-095 suggesting an increase in oxidative stress and inflammation. In addition, vascular superoxide and peroxynitrite production was increased in the vascular wall of diabetic rats, accompanied by reduced nitric oxide bioavailability. The presence of PVAT had an anticontractile effect in response to phenylephrine in Wistar rats that was lost in GK rats. Western blot and immunohistochemistry analysis revealed that PVAT phenotype shifts, under diabetic conditions, towards a proinflammatory (with increment in CRP, CCL2, CD36), pro-oxidant (increased levels of aldose reductase, and reduced levels of antioxidant deference enzymes) and vasoconstriction state. CONCLUSION Our data suggest that this rat model of type 2 diabetes is associated with perivascular adipose dysfunction that contributes to oxidative stress, inflammation and endothelial dysfunction.
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Affiliation(s)
- Lara Azul
- Institute of Physiology, iCBR, Faculty of Medicine, University of Coimbra, Portugal
| | - Adriana Leandro
- Institute of Physiology, iCBR, Faculty of Medicine, University of Coimbra, Portugal
| | - Parastoo Boroumand
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, M5G 0A4, Canada; Department of Biochemistry, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
| | - Amira Klip
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, M5G 0A4, Canada; Department of Biochemistry, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
| | - Raquel Seiça
- Institute of Physiology, iCBR, Faculty of Medicine, University of Coimbra, Portugal
| | - Cristina M Sena
- Institute of Physiology, iCBR, Faculty of Medicine, University of Coimbra, Portugal.
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Sproston NR, El Mohtadi M, Slevin M, Gilmore W, Ashworth JJ. The Effect of C-Reactive Protein Isoforms on Nitric Oxide Production by U937 Monocytes/Macrophages. Front Immunol 2018; 9:1500. [PMID: 30013561 PMCID: PMC6036124 DOI: 10.3389/fimmu.2018.01500] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/15/2018] [Indexed: 12/22/2022] Open
Abstract
Inflammation is regulated by many endogenous factors including estrogen, a steroid hormone that declines with increasing age, leading to excessive inflammation in the elderly. C-reactive protein (CRP) is an acute phase inflammatory protein that exists in two forms, native CRP (nCRP) and monomeric CRP (mCRP), which mediate distinct biological activities. It is unclear how each CRP isoform mediates nitric oxide (NO), a signaling molecule generated by NO synthase (NOS). This study investigated whether CRP isoforms have distinct effects on NO production by unstimulated and lipopolysaccharide (LPS)-activated monocytes/macrophages and whether estrogen mediates CRP-induced NO production in an in vitro model of aging. NO and inducible NOS (iNOS) were measured (n = 12) by the Griess assay and an enzyme-linked immunosorbent assay, respectively following incubation (24 h) of human-derived U937 monocytes/macrophages with CRP isoforms [(nCRP) = 500 and 1,000 µg/ml; (mCRP) = 100 and 250 µg/ml] in the absence or presence of 17 beta-estradiol (1 × 10-7, 1 × 10-8, and 1 × 10-9 M). The response to each CRP isoform and estrogen was dependent on the differentiation and activation status of cells. Monocytes with or without prior LPS-activation significantly increased (P < 0.01) NO/iNOS production when treated with mCRP. The mCRP isoform had no effect (P > 0.05) on NO/iNOS production by unactivated or LPS-activated macrophages, whereas nCRP significantly (P < 0.05) reduced NO/iNOS production by macrophages, with or without prior LPS-activation. The nCRP isoform had opposing actions on monocytes, significantly (P < 0.01) increasing and reducing NO/iNOS by unactivated and LPS-activated monocytes, respectively. Estrogen significantly (P < 0.01) reversed nCRP-mediated NO inhibition by unactivated macrophages but decreased CRP-induced NO by unactivated monocytes treated with nCRP or mCRP and LPS-activated monocytes treated with mCRP. NO was differentially mediated by CRP isoforms in a cell-type/state-specific manner, with production corresponding to concomitant changes in iNOS levels. Collectively, the findings indicate nCRP and estrogen predominantly reduce NO production, whereas mCRP increases NO production. This supports growing evidence that mCRP exacerbates inflammation while nCRP and estrogen dampen the overall inflammatory response. Therapeutic strategies that restore estrogen levels to those found in youth and promote the stability of nCRP or/and prevent the formation of mCRP may reduce NO production in age-related inflammatory conditions.
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Affiliation(s)
| | | | | | | | - Jason J. Ashworth
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom
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12
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Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol 2018; 9:754. [PMID: 29706967 PMCID: PMC5908901 DOI: 10.3389/fimmu.2018.00754] [Citation(s) in RCA: 1423] [Impact Index Per Article: 237.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/26/2018] [Indexed: 01/08/2023] Open
Abstract
C-reactive protein (CRP) is an acute inflammatory protein that increases up to 1,000-fold at sites of infection or inflammation. CRP is produced as a homopentameric protein, termed native CRP (nCRP), which can irreversibly dissociate at sites of inflammation and infection into five separate monomers, termed monomeric CRP (mCRP). CRP is synthesized primarily in liver hepatocytes but also by smooth muscle cells, macrophages, endothelial cells, lymphocytes, and adipocytes. Evidence suggests that estrogen in the form of hormone replacement therapy influences CRP levels in the elderly. Having been traditionally utilized as a marker of infection and cardiovascular events, there is now growing evidence that CRP plays important roles in inflammatory processes and host responses to infection including the complement pathway, apoptosis, phagocytosis, nitric oxide (NO) release, and the production of cytokines, particularly interleukin-6 and tumor necrosis factor-α. Unlike more recent publications, the findings of early work on CRP can seem somewhat unclear and at times conflicting since it was often not specified which particular CRP isoform was measured or utilized in experiments and whether responses attributed to nCRP were in fact possibly due to dissociation into mCRP or lipopolysaccharide contamination. In addition, since antibodies for mCRP are not commercially available, few laboratories are able to conduct studies investigating the mCRP isoform. Despite these issues and the fact that most CRP research to date has focused on vascular disorders, there is mounting evidence that CRP isoforms have distinct biological properties, with nCRP often exhibiting more anti-inflammatory activities compared to mCRP. The nCRP isoform activates the classical complement pathway, induces phagocytosis, and promotes apoptosis. On the other hand, mCRP promotes the chemotaxis and recruitment of circulating leukocytes to areas of inflammation and can delay apoptosis. The nCRP and mCRP isoforms work in opposing directions to inhibit and induce NO production, respectively. In terms of pro-inflammatory cytokine production, mCRP increases interleukin-8 and monocyte chemoattractant protein-1 production, whereas nCRP has no detectable effect on their levels. Further studies are needed to expand on these emerging findings and to fully characterize the differential roles that each CRP isoform plays at sites of local inflammation and infection.
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Affiliation(s)
- Nicola R Sproston
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jason J Ashworth
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom
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Akyol S, Lu J, Akyol O, Akcay F, Armutcu F, Ke LY, Chen CH. The role of electronegative low-density lipoprotein in cardiovascular diseases and its therapeutic implications. Trends Cardiovasc Med 2016; 27:239-246. [PMID: 28040327 DOI: 10.1016/j.tcm.2016.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/01/2016] [Accepted: 11/15/2016] [Indexed: 11/30/2022]
Abstract
Cardiovascular disease (CVD) is a health problem of great concern to both the public and medical authorities. Low-density lipoprotein (LDL) has been reported to play an important role in both the development and progression of CVD, but studies are underway to determine how LDL exerts its effects. In recent years, it has been found that LDL has several subfractions, each of which affects endothelial function differently; L5, the most electronegative fraction, has been shown to be unique in that it induces an atherogenic response. This review examines the current knowledge concerning the relationships between L5 and CVD and highlights the role of L5 in the pathophysiology of CVD, especially with regards to atherosclerosis.
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Affiliation(s)
- Sumeyya Akyol
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA; Department of Medical Biology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey.
| | - Jonathan Lu
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA
| | - Omer Akyol
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA; Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatih Akcay
- Department of Medical Biochemistry, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ferah Armutcu
- Department of Medical Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Liang-Yin Ke
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chu-Huang Chen
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA; Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Nakamura K, Miyoshi T, Yunoki K, Ito H. Postprandial hyperlipidemia as a potential residual risk factor. J Cardiol 2015; 67:335-9. [PMID: 26744235 DOI: 10.1016/j.jjcc.2015.12.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 11/30/2015] [Indexed: 01/11/2023]
Abstract
Statin therapy targeting reduction of low-density lipoprotein cholesterol (LDL-C) decreases the risk of coronary heart disease (CHD) and all-cause mortality. However, a substantial number of cases of CHD are not prevented and residual risk factors remain unsettled. A high triglyceride (TG) level is considered to be an important and residual risk factor. Postprandial hyperlipidemia is a condition in which TG-rich chylomicron remnants are increased during the postprandial period and hypertriglycedemia is protracted. Postprandial hyperlipidemia evokes atherogenesis during the postprandial period. Several prospective studies have revealed that nonfasting serum TG levels predict the incidence of CHD. Values of TG, remnant lipoprotein cholesterol, and remnant lipoprotein TG after fat loading were significantly higher in diabetes patients with insulin resistance than in diabetes patients without insulin resistance. Endothelial dysfunction is an initial process of atherogenesis and it contributes to the pathogenesis of CHD. Postprandial hyperlipidemia (postprandial hypertriglyceridemia) is involved in the production of proinflammatory cytokines, recruitment of neutrophils, and generation of oxidative stress, resulting in endothelial dysfunction in healthy subjects, hypertriglyceridemic patients, or type 2 diabetic patients. Effective treatment has not been established till date. Ezetimibe or omega-3 fatty acids significantly decrease postprandial TG elevation and postprandial endothelial dysfunction. Ezetimibe or omega-3 fatty acids added to statin therapy reduce serum TG levels and result in good outcomes in patients with CHD. In conclusion, postprandial hyperlipidemia is an important and residual risk factor especially in patients with insulin resistance syndrome (metabolic syndrome) and diabetes mellitus. Further studies are needed to establish effective treatment.
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Affiliation(s)
- Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kei Yunoki
- Division of Cardiology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Asztalos BF, Horan MS, Horvath KV, McDermott AY, Chalasani NP, Schaefer EJ. Obesity associated molecular forms of C-reactive protein in human. PLoS One 2014; 9:e109238. [PMID: 25299074 PMCID: PMC4192316 DOI: 10.1371/journal.pone.0109238] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 09/03/2014] [Indexed: 01/12/2023] Open
Abstract
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.
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Affiliation(s)
- Bela F. Asztalos
- Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
- * E-mail:
| | - Michael S. Horan
- Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
| | - Katalin V. Horvath
- Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
| | - Ann Y. McDermott
- Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
| | - Naga P. Chalasani
- Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Ernst J. Schaefer
- Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
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Hein TW, Qamirani E, Ren Y, Xu X, Thengchaisri N, Kuo L. Selective Activation of Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Mediates C-Reactive Protein–Evoked Endothelial Vasodilator Dysfunction in Coronary Arterioles. Circ Res 2014; 114:92-100. [DOI: 10.1161/circresaha.114.301763] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rationale
:
Studies in cultured endothelium implicate that lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) or Fcγ receptor II (CD32) contributes to the proatherogenic effects of C-reactive protein (CRP). However, the identity of the receptors linking to deleterious actions of CRP in vasomotor regulation remains unknown.
Objective
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We tested the hypothesis that LOX-1 contributes to adverse effects of CRP on endothelium-dependent vasomotor function in resistance arterioles.
Methods and Results
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Porcine coronary arterioles were isolated for vasoreactivity study, dihydroethidium fluorescence staining of superoxide, immunohistochemical localization of receptors, immunoprecipitation of receptor/CRP interaction, and protein blot. Intraluminal treatment of pressurized arterioles with a pathophysiological level of CRP (7 µg/mL; 60 minutes) attenuated endothelium-dependent nitric oxide–mediated and prostacyclin-mediated dilations to serotonin and arachidonic acid, respectively. LOX-1 and CD32 were detected in the endothelium of arterioles. Blockade of LOX-1 with either pharmacological antagonist κ-carrageenan or anti–LOX-1 antibody prevented the detrimental effect of CRP on vasodilator function, whereas anti-CD32 antibody treatment was ineffective. Denudation of endothelium and blockade of LOX-1 but not CD32 prevented CRP-induced elevation of superoxide in the vessel wall. CRP was coimmunoprecipitated with LOX-1 and CD32 from CRP-treated arterioles. Similarly, LOX-1 and CD32 blockade prevented CRP-induced arteriolar expression of plasminogen activator inhibitor-1, a thrombogenic protein.
Conclusions
:
CRP elicits endothelium-dependent oxidative stress and compromises nitric oxide–mediated and prostacyclin-mediated vasomotor function via LOX-1 activation. In contrast, both LOX-1 and CD32 mediate plasminogen activator inhibitor-1 upregulation in arterioles by CRP. Thus, activation of LOX-1 and CD32 may contribute to vasomotor dysfunction and proatherogenic actions of CRP, respectively.
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Affiliation(s)
- Travis W. Hein
- From the Departments of Surgery (T.W.H., Y.R., L.K.) and Medical Physiology (E.Q., X.X., N.T., L.K.), College of Medicine, Texas A&M Health Science Center, Scott & White Healthcare, Temple; and Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand (N.T.)
| | - Erion Qamirani
- From the Departments of Surgery (T.W.H., Y.R., L.K.) and Medical Physiology (E.Q., X.X., N.T., L.K.), College of Medicine, Texas A&M Health Science Center, Scott & White Healthcare, Temple; and Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand (N.T.)
| | - Yi Ren
- From the Departments of Surgery (T.W.H., Y.R., L.K.) and Medical Physiology (E.Q., X.X., N.T., L.K.), College of Medicine, Texas A&M Health Science Center, Scott & White Healthcare, Temple; and Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand (N.T.)
| | - Xin Xu
- From the Departments of Surgery (T.W.H., Y.R., L.K.) and Medical Physiology (E.Q., X.X., N.T., L.K.), College of Medicine, Texas A&M Health Science Center, Scott & White Healthcare, Temple; and Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand (N.T.)
| | - Naris Thengchaisri
- From the Departments of Surgery (T.W.H., Y.R., L.K.) and Medical Physiology (E.Q., X.X., N.T., L.K.), College of Medicine, Texas A&M Health Science Center, Scott & White Healthcare, Temple; and Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand (N.T.)
| | - Lih Kuo
- From the Departments of Surgery (T.W.H., Y.R., L.K.) and Medical Physiology (E.Q., X.X., N.T., L.K.), College of Medicine, Texas A&M Health Science Center, Scott & White Healthcare, Temple; and Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand (N.T.)
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17
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Chu CS, Wang YC, Lu LS, Walton B, Yilmaz HR, Huang RY, Sawamura T, Dixon RAF, Lai WT, Chen CH, Lu J. Electronegative low-density lipoprotein increases C-reactive protein expression in vascular endothelial cells through the LOX-1 receptor. PLoS One 2013; 8:e70533. [PMID: 23950953 PMCID: PMC3738565 DOI: 10.1371/journal.pone.0070533] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 06/19/2013] [Indexed: 12/14/2022] Open
Abstract
Objectives Increased plasma C-reactive protein (CRP) levels are associated with the occurrence and severity of acute coronary syndrome. We investigated whether CRP can be generated in vascular endothelial cells (ECs) after exposure to the most electronegative subfraction of low-density lipoprotein (LDL), L5, which is atherogenic to ECs. Because L5 and CRP are both ligands for the lectin-like oxidized LDL receptor-1 (LOX-1), we also examined the role of LOX-1. Methods and Results Plasma LDL samples isolated from asymptomatic hypercholesterolemic (LDL cholesterol [LDL-C] levels, 154.6±20 mg/dL; n = 7) patients and normocholesterolemic (LDL-C levels, 86.1±21 mg/dL; P<0.001; n = 7) control individuals were chromatographically resolved into 5 subfractions, L1-L5. The L5 percentage (L5%) and the plasma L5 concentration ([L5] = L5% × LDL-C) in the patient and control groups were 8.1±2% vs. 2.3±1% (P<0.001) and 12.6±4 mg/dL vs. 1.9±1 mg/dL (P<0.001), respectively. In hypercholesterolemic patients treated with atorvastatin for 6 months (10 mg/day), [L5] decreased from 12.6±4 mg/dL to 4.5±1.1 mg/dL (P = 0.011; n = 5), whereas both [L5] and L5% returned to baseline levels in 2 noncompliant patients 3 months after discontinuation. In cultured human aortic ECs (HAECs), L5 upregulated CRP expression in a dose- and time-dependent manner up to 2.5-fold (P<0.01), whereas the least electronegative subfraction, L1, had no effect. DiI-labeled L1, internalized through the LDL receptor, became visible inside HAECs within 30 seconds. In contrast, DiI-labeled L5, internalized through LOX-1, became apparent after 5 minutes. L5-induced CRP expression manifested at 30 minutes and was attenuated by neutralizing LOX-1. After 30 minutes, L5 but not L1 induced reactive oxygen species (ROS) production. Both L5-induced ROS and CRP production were attenuated by ROS inhibitor N-acetyl cysteine. Conclusions Our results suggest that CRP, L5, and LOX-1 form a cyclic mechanism in atherogenesis and that reducing plasma L5 levels with atorvastatin disrupts the vascular toxicity of L5.
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Affiliation(s)
- Chih-Sheng Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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18
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C-reactive protein enhances the respiratory burst of neutrophils-induced by antineutrophil cytoplasmic antibody. Mol Immunol 2012; 52:148-54. [DOI: 10.1016/j.molimm.2012.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 04/14/2012] [Accepted: 05/15/2012] [Indexed: 12/30/2022]
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Yamamoto T, Nascimento MM, Hayashi SY, Qureshi AR, Waniewski J, Brodin LÅ, Anderstam B, Lind B, Riella MC, Seeberger A, Lindholm B. Changes in circulating biomarkers during a single hemodialysis session. Hemodial Int 2012; 17:59-66. [PMID: 22716238 DOI: 10.1111/j.1542-4758.2012.00720.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The hemodialysis (HD) procedure induces an inflammatory response potentially contributing to cardiovascular disease. Here we investigated the acute impact of HD on circulating biomarkers. Circulating biomarkers (small solutes, middle molecular-sized peptides, and proteins) related to inflammation, oxidative stress, and vascular calcification (VC) were measured before and after a single session of HD in 45 clinically stable patients. Concentrations were corrected for ultrafiltration-induced hemoconcentration. Among vascular calcification-related biomarkers, osteoprotegerin and fetuin-A remained unchanged while fibroblast growth factor-23 (FGF23) decreased by -19%. Changes of FGF23 and changes of phosphate correlated (ρ = 0.61, P < 0.001). While C-reactive protein did not change, interleukin-6 (IL-6) increased by 14% and pentraxin 3 (PTX3) increased by 45%. IL-6 and PTX3 appear to be valid biomarkers of the intradialytic inflammatory response. VC-related markers were in general not affected by the single HD session; however, the observed correlation between acute changes of FGF-23 and phosphate during HD warrants further studies.
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Affiliation(s)
- Tae Yamamoto
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden
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20
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Increased myocardial prevalence of C-reactive protein in human coronary heart disease: direct effects on microvessel density and endothelial cell survival. Cardiovasc Pathol 2012; 21:428-35. [PMID: 22285194 DOI: 10.1016/j.carpath.2011.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 11/24/2011] [Accepted: 12/16/2011] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Elevated plasma C-reactive protein (CRP) is a biomarker of cardiovascular diseases (CVDs), but its potential roles as a participant of the disease process are not well defined. Although early endothelial cell injury and dysfunction are recognized events in CVD, the initiating events are not well established. Here we investigated the local myocardial CRP levels and cardiac microvessel densities in control and CVD tissue samples. Using in vitro methodologies, we investigated the direct effects of CRP on human endothelial cells. METHODS Cardiac specimens were collected at autopsy within 4 h of death and were classified as normal controls or documented evidence of CVD. The regional prevalence of CRP and the cardiac microvessels (<40 μm) were investigated using immunohistochemistry. For in vitro experiments, human umbilical vein endothelial cells were incubated with CRP. Intracellular oxidant levels were assessed using 2',7'-dichlorofluorescein diacetate fluorescence microscopy, and cell survival was concurrently determined. Effects of chemical antioxidants on endothelial cell survival were also tested. RESULTS Myocardial CRP levels were elevated in CVD specimens. This was associated with reduced cardiac microvessels, and this rarefaction was inversely correlated to adjacent myocardial CRP prevalence. CRP caused concentration-dependent increases in oxidant production and cell apoptosis. CONCLUSIONS These findings provide evidence supporting myocardial CRP as a locally produced inflammatory marker and as a potential participant in endothelial toxicity and microvascular rarefaction.
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Wang M, Ji S, Bai C, Kebir IE, Li H, Shi J, Zhu W, Costantino S, Zhou H, Potempa LA, Zhao J, Filep JG, Wu Y. A redox switch in C‐reactive protein modulates activation of endothelial cells. FASEB J 2011; 25:3186-96. [DOI: 10.1096/fj.11-182741] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ming‐Yu Wang
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | - Shang‐Rong Ji
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | - Cai‐Juan Bai
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | - iss El Kebir
- Research CenterMaisonneuve‐Rosemont HospitalUniversity of MontréalMontréalQuébecCanada
| | - Hai‐Yun Li
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | - Jing‐Ming Shi
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | - Wei Zhu
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | - Santiago Costantino
- Research CenterMaisonneuve‐Rosemont HospitalUniversity of MontréalMontréalQuébecCanada
| | - Hai‐Hong Zhou
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | | | - Jing Zhao
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
| | - János G. Filep
- Research CenterMaisonneuve‐Rosemont HospitalUniversity of MontréalMontréalQuébecCanada
| | - Yi Wu
- Ministry of Education Key Laboratory of Arid and Grassland EcologyInstitute of BiophysicsLanzhou UniversityLanzhouChina
- Second HospitalLanzhou UniversityLanzhouChina
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Fay WP. Linking inflammation and thrombosis: Role of C-reactive protein. World J Cardiol 2010; 2:365-9. [PMID: 21179303 PMCID: PMC3006472 DOI: 10.4330/wjc.v2.i11.365] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 09/18/2010] [Accepted: 09/23/2010] [Indexed: 02/06/2023] Open
Abstract
C-reactive protein (CRP) is a biomarker of inflammation. Increased plasma levels of CRP are associated with an increased risk of myocardial infarction. However, the correlation between plasma CRP concentration and atherosclerotic plaque burden is poor. Based on these observations, it has been hypothesized that CRP increases the risk of myocardial infarction by promoting thrombosis. This article reviews available data that link enhanced CRP expression to increased risk of thrombosis, with a focus on the effects of CRP on hemostasis, platelet function, and fibrinolysis. Overall, the available data support the hypothesis that CRP is an important mechanistic link between inflammation and thrombosis.
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Affiliation(s)
- William P Fay
- William P Fay, Department of Internal Medicine and Medical Pharmacology and Physiology, University of Missouri, School of Medicine, and the Research Service, Harry S. Truman Memorial Veterans Affairs Hospital, Columbia, MO 65212, United States
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23
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Eisenhardt SU, Habersberger J, Murphy A, Chen YC, Woollard KJ, Bassler N, Qian H, von zur Muhlen C, Hagemeyer CE, Ahrens I, Chin-Dusting J, Bobik A, Peter K. Dissociation of Pentameric to Monomeric C-Reactive Protein on Activated Platelets Localizes Inflammation to Atherosclerotic Plaques. Circ Res 2009; 105:128-37. [DOI: 10.1161/circresaha.108.190611] [Citation(s) in RCA: 187] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
C-reactive protein (CRP) is a predictor of cardiovascular risk. It circulates as a pentamer (pentameric CRP) in plasma. The in vivo existence of monomeric (m)CRP has been postulated, but its function and source are not clear. We show that mCRP is deposited in human aortic and carotid atherosclerotic plaques but not in healthy vessels. pCRP is found neither in healthy nor in diseased vessels. As source of mCRP, we identify a mechanism of dissociation of pCRP to mCRP. We report that activated platelets, which play a central role in cardiovascular events, mediate this dissociation via lysophosphatidylcholine, which is present on activated but not resting platelets. Furthermore, the dissociation of pCRP to mCRP can also be mediated by apoptotic monocytic THP-1 and Jurkat T cells. The functional consequence is the unmasking of proinflammatory effects of CRP as demonstrated in experimental settings that are pathophysiologically relevant for atherogenesis: compared to pCRP, mCRP induces enhanced monocyte chemotaxis; monocyte activation, as determined by conformational change of integrin Mac-1; generation of reactive oxygen species; and monocyte adhesion under static and physiological flow conditions. In conclusion, we demonstrate mCRP generation via pCRP dissociation on activated platelets and H
2
O
2
-treated apoptotic THP-1 and Jurkat T cells, thereby identifying a mechanism of localized unmasking of the proinflammatory properties of CRP. This novel mechanism provides a potential link between the established cardiovascular risk marker, circulating pCRP, and localized platelet-mediated inflammatory and proatherogenic effects.
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Affiliation(s)
- Steffen U. Eisenhardt
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Jonathon Habersberger
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Andrew Murphy
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Yung-Chih Chen
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Kevin J. Woollard
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Nicole Bassler
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Hongwei Qian
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Constantin von zur Muhlen
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Christoph E. Hagemeyer
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Ingo Ahrens
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Jaye Chin-Dusting
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Alex Bobik
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
| | - Karlheinz Peter
- From the Baker Heart and Diabetes Institute (S.U.E., J.H., A.M., Y.-C.C., K.J.W., N.B., H.Q., C.E.H., I.A., J.C.-D., A.B., K.P.), Melbourne, Australia; and Department of Plastic and Hand Surgery (S.U.E.) and Department of Cardiology (C.v.z.M.), University of Freiburg Medical Center, Germany
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C-reactive protein, sodium azide, and endothelial connexin43 gap junctions. Cell Biol Toxicol 2009; 26:153-63. [PMID: 19415183 DOI: 10.1007/s10565-009-9125-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 04/17/2009] [Indexed: 10/20/2022]
Abstract
We investigated the effect of C-reactive protein (CRP) and sodium azide (NaN(3)) on endothelial Cx43 gap junctions. Human aortic endothelial cells (HAEC) were treated with (a) detoxified CRP, (b) detoxified dialyzed CRP, (c) detoxified dialyzed CRP plus NaN(3), (d) NaN(3), or (e) dialyzed NaN(3). The concentration of CRP in all preparations was fixed to 25 microg/ml and that of NaN(3) in the preparations of (c) to (e) was equivalent to that contained in the 25 microg/ml CRP purchased commercially. The results showed that both the expression of Cx43 protein and gap junctional communication function post-48-h incubation were reduced and inhibited by the detoxified CRP, NaN(3), or detoxified dialyzed CRP plus NaN(3), but not by the detoxified dialyzed CRP or dialyzed NaN(3). Reverse transcription-polymerase chain reaction analysis of cells treated for 72 h also showed a pattern of transcriptional regulation essentially the same as that for the proteins. We concluded that CRP does not have a significant effect on Cx43 gap junctions of HAEC, but NaN(3) inhibited the viability of cells and downregulate their junctions.
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Calabrò P, Golia E, Yeh ETH. CRP and the risk of atherosclerotic events. Semin Immunopathol 2009; 31:79-94. [PMID: 19415283 DOI: 10.1007/s00281-009-0149-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Accepted: 04/14/2009] [Indexed: 01/23/2023]
Abstract
A large body of literature supports the idea that inflammation plays a pivotal role in all phases of atherosclerosis, from the fatty streak lesion formation to the acute coronary event due to vulnerable plaque rupture. Indeed, vascular inflammation contributes to the pathogenesis of atherosclerosis, and later in the disease process, it is a major determinant for the acute coronary syndromes. There are various inflammatory markers that have been shown to predict cardiovascular events. These include high-sensitivity C-reactive protein (hs-CRP), a simple downstream marker of inflammation, recently emerged as a major cardiovascular risk factor. Elevated baseline concentrations of hs-CRP are associated with the risk of atherosclerotic events in general populations and show a predictive value even in terms of secondary prevention, both in patients with chronic stable angina and acute coronary syndromes. In recent year, a lot of concerns have emerged about the experimental models used to study the role of CRP in atherosclerosis; moreover, the results of trials evaluating the clinical association between this molecules and outcome are still controversial. In this paper, we attempt to review the pathophysiological evidences about the link between CRP and atherosclerosis and, most notably, about its utility as a marker and risk predictor in various clinical settings. The identification of specific triggers and mechanisms of underlying inflammation and a better understanding of each step involved in this complex process might lead to new ways to manage patients with atherosclerosis, both in terms of primary and secondary prevention, and CRP still appears to be a suitable candidate for this purpose.
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Affiliation(s)
- Paolo Calabrò
- Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Monaldi Hospital, Via L. Bianchi, 80131, Naples, Italy.
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Hein TW, Qamirani E, Ren Y, Kuo L. C-reactive protein impairs coronary arteriolar dilation to prostacyclin synthase activation: role of peroxynitrite. J Mol Cell Cardiol 2009; 47:196-202. [PMID: 19410579 DOI: 10.1016/j.yjmcc.2009.04.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Revised: 04/23/2009] [Accepted: 04/24/2009] [Indexed: 02/07/2023]
Abstract
Endothelium-derived vasodilators, i.e., nitric oxide (NO), prostacyclin (PGI(2)) and prostaglandin E(2) (PGE(2)), play important roles in maintaining cardiovascular homeostasis. C-reactive protein (CRP), a biomarker of inflammation and cardiovascular disease, has been shown to inhibit NO-mediated vasodilation. The goal of this study was to determine whether CRP also affects endothelial arachidonic acid (AA)-prostanoid pathways for vasomotor regulation. Porcine coronary arterioles were isolated and pressurized for vasomotor study, as well as for molecular and biochemical analysis. AA elicited endothelium-dependent vasodilation and PGI(2) release. PGI(2) synthase (PGI(2)-S) inhibitor trans-2-phenyl cyclopropylamine blocked vasodilation to AA but not to serotonin (endothelium-dependent NO-mediated vasodilator). Intraluminal administration of a pathophysiological level of CRP (7 microg/mL, 60 min) attenuated vasodilations to serotonin and AA but not to nitroprusside, exogenous PGI(2), or hydrogen peroxide (endothelium-dependent PGE(2) activator). CRP also reduced basal NO production, caused tyrosine nitration of endothelial PGI(2)-S, and inhibited AA-stimulated PGI(2) release from arterioles. Peroxynitrite scavenger urate failed to restore serotonin dilation, but preserved AA-stimulated PGI(2) release/dilation and prevented PGI(2)-S nitration. NO synthase inhibitor L-NAME and superoxide scavenger TEMPOL also protected AA-induced vasodilation. Collectively, our results suggest that CRP stimulates superoxide production and the subsequent formation of peroxynitrite from basal released NO compromises PGI(2) synthesis, and thus endothelium-dependent PGI(2)-mediated dilation, by inhibiting PGI(2)-S activity through tyrosine nitration. By impairing PGI(2)-S function, and thus PGI(2) release, CRP could promote endothelial dysfunction and participate in the development of coronary artery disease.
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Affiliation(s)
- Travis W Hein
- Scott and White Memorial Hospital, Department of Surgery, College of Medicine, Texas A&M Health Science Center, 702 Southwest H.K. Dodgen Loop, Temple, TX 76504, USA.
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Pessi T, Eklund C, Huhtala H, Raitakari OT, Juonala M, Kähönen M, Viikari JSA, Lehtimäki T, Hurme M. CRPand FCGR2Agenes have an epistatic effect on carotid artery intima-media thickness: the Cardiovascular Risk in Young Finns Study. Int J Immunogenet 2009; 36:39-45. [DOI: 10.1111/j.1744-313x.2008.00818.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Tan Y, Yu F, Yang H, Chen M, Fang Q, Zhao MH. Autoantibodies against monomeric C-reactive protein in sera from patients with lupus nephritis are associated with disease activity and renal tubulointerstitial lesions. Hum Immunol 2008; 69:840-4. [DOI: 10.1016/j.humimm.2008.09.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Revised: 08/29/2008] [Accepted: 09/15/2008] [Indexed: 11/17/2022]
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Devaraj S, Yun JM, Duncan-Staley C, Jialal I. C-reactive protein induces M-CSF release and macrophage proliferation. J Leukoc Biol 2008; 85:262-7. [PMID: 19008293 DOI: 10.1189/jlb.0808458] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Inflammation is pivotal in atherosclerosis. M-CSF regulates macrophage growth and differentiation and plays a role in atherogenesis. C-reactive protein (CRP), a cardiovascular risk marker, may promote atherogenesis. However, the effects of CRP on M-CSF release and subsequent macrophage proliferation have not been examined previously. Human aortic endothelial cells (HAEC) were incubated with boiled CRP or native CRP 12.5, 25, and 50 microg/mL for 12-15 h, and M-CSF release was examined by flow cytometry and ELISA. CRP resulted in a significant and dose-dependent increase in M-CSF mRNA and secretion from HAEC as well as human monocyte-derived macrophages (HMDM; P<0.01). Furthermore, conditioned medium (5%) from HAEC pretreated with CRP, when incubated with HMDM, increased macrophage proliferation significantly. This was blocked with M-CSF antibody but not irrelevant antibody. Inhibition of NF-kappaB resulted in significant abrogation of CRP-induced M-CSF release and subsequent macrophage proliferation. Antibodies to CD32 and CD64 but not CD16 abrogated CRP-induced M-CSF release. Thus, CRP up-regulates M-CSF release from HMDM and HAEC and increased macrophage proliferation. These effects appear to be mediated via activation of NF-kappaB via CD32 and CD64. These studies provide further evidence for a proatherogenic role for CRP.
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Affiliation(s)
- Sridevi Devaraj
- Laboratory for Atherosclerosis and Metabolic Research, Department of Medical Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA 95817, USA
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Turu MM, Slevin M, Matou S, West D, Rodríguez C, Luque A, Grau-Olivares M, Badimon L, Martinez-Gonzalez J, Krupinski J. C-reactive protein exerts angiogenic effects on vascular endothelial cells and modulates associated signalling pathways and gene expression. BMC Cell Biol 2008; 9:47. [PMID: 18764931 PMCID: PMC2551596 DOI: 10.1186/1471-2121-9-47] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Accepted: 09/02/2008] [Indexed: 12/22/2022] Open
Abstract
Background Formation of haemorrhagic neovessels in the intima of developing atherosclerotic plaques is thought to significantly contribute to plaque instability resulting in thrombosis. C-reactive protein (CRP) is an acute phase reactant whose expression in the vascular wall, in particular, in reactive plaque regions, and circulating levels increase in patients at high risk of cardiovascular events. Although CRP is known to induce a pro-inflammatory phenotype in endothelial cells (EC) a direct role on modulation of angiogenesis has not been established. Results Here, we show that CRP is a powerful inducer of angiogenesis in bovine aortic EC (BAEC) and human coronary artery EC (HCAEC). CRP, at concentrations corresponding to moderate/high risk (1–5 μg/ml), induced a significant increase in proliferation, migration and tube-like structure formation in vitro and stimulated blood vessel formation in the chick chorioallantoic membrane assay (CAM). CRP treated with detoxi-gel columns retained such effects. Western blotting showed that CRP increased activation of early response kinase-1/2 (ERK1/2), a key protein involved in EC mitogenesis. Furthermore, using TaqMan Low-density Arrays we identified key pro-angiogenic genes induced by CRP among them were vascular endothelial cell growth factor receptor-2 (VEGFR2/KDR), platelet-derived growth factor (PDGF-BB), notch family transcription factors (Notch1 and Notch3), cysteine-rich angiogenic inducer 61 (CYR61/CCN1) and inhibitor of DNA binding/differentiation-1 (ID1). Conclusion This data suggests a role for CRP in direct stimulation of angiogenesis and therefore may be a mediator of neovessel formation in the intima of vulnerable plaques.
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Affiliation(s)
- Marta M Turu
- Department of Neurology, University Hospital of Bellvitge, Fundació IDIBELL, Barcelona, Spain.
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Martin C, Cameron J, McGrath B. Mechanical and circulating biomarkers in isolated clinic hypertension. Clin Exp Pharmacol Physiol 2008; 35:402-8. [PMID: 18307729 DOI: 10.1111/j.1440-1681.2008.04886.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
1. This review examines the current evidence for altered mechanical and circulating biomarkers in isolated clinic hypertension and their potential significance. 2. Arterial stiffness, as assessed by central pulse wave velocity, is influenced by multiple cardiovascular risk factors; however, an independent association with isolated clinic hypertension (ICHT) has not been convincingly shown in four small studies. 3. Endothelial dysfunction, as assessed by brachial artery flow-mediated vasodilation, circulating levels of endothelial markers (e.g. nitrite/nitrate, von Willebrand factor, endothelin-1) and/or circulating levels of inhibitors of vascular nitric oxide (plasma asymmetric dimethylarginine, homocysteine), has been shown to be present in established hypertension and to a variable and inconsistent extent in subjects with ICHT. 4. Evidence of increased oxidative stress in ICHT versus normotensive subjects was found in two of three studies. 5. Circulating inflammatory markers C-reactive protein and plasminogen activator inhibitor-1 were significantly increased in two of three and two of two studies, respectively, in ICHT compared with normotensive subjects. 6. Urinary albumin excretion is a marker of both arterial and renal disease. The consensus from seven studies in patients with ICHT is that albuminuria is not an independent marker for ICHT. 7. Studies to date assessing biomarkers in ICHT have been small and cross-sectional. Larger, long-term longitudinal studies of arterial functional and circulating biomarkers are required to assess the potential vascular impact of ICHT.
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Affiliation(s)
- Catherine Martin
- Centre for Vascular Health, Monash University and Department of Vascular Sciences and Medicine, Dandenong Hospital, Southern Health, Melbourne, Victoria, Australia
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Teoh H, Quan A, Lovren F, Wang G, Tirgari S, Szmitko PE, Szalai AJ, Ward ME, Verma S. Impaired endothelial function in C-reactive protein overexpressing mice. Atherosclerosis 2008; 201:318-25. [PMID: 18433756 DOI: 10.1016/j.atherosclerosis.2008.02.034] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Revised: 01/09/2008] [Accepted: 02/27/2008] [Indexed: 10/22/2022]
Abstract
Increasing evidence suggests that the inflammatory biomarker, C-reactive protein (CRP), may play a causal role in the development and progression of atherothrombosis. Since endothelial dysfunction is an early and integral component of atherosclerosis, we hypothesized that endothelial homeostasis would be impaired in CRP-overexpressing CRP transgenic (CRPtg) mice. Male CRPtg and wild-type mice were injected thrice over 2 weeks with vehicle or turpentine to induce the inflammation-sensitive CRP transgene. Serum human CRP levels in turpentine-treated CRPtg mice was 276.28 +/- 95.7 microg/ml. Human CRP was undetectable in the sera of wild-type mice and present at only low levels (1.41 +/- 0.2 microg/ml) in vehicle-treated CRPtg mice (n=6-8 mice/group). Aortic segments from turpentine-induced CRP-overexpressing CRPtg mice demonstrated impaired endothelium-dependent responses to acetylcholine vs. those from vehicle-treated CRPtg controls (57.1 +/- 9.5% vs. 85.0 +/- 5.0%, P<0.05, n=6). Nitric oxide release as well as phosphorylated eNOS protein expression from isolated aortic segments of CRPtg mice overexpressing CRP were markedly reduced compared to that from vehicle-treated controls. Masson's trichrome staining revealed increased perivascular fibrosis in CRP-overexpressing CRPtg mice. CRP overexpression was also associated with augmented aortic endothelial staining for VCAM-1 and MCP-1 and enhanced macrophage infiltration. Mice overexpressing the human CRP gene exhibit endothelial dysfunction, possibly via reduced NO bioavailability, with resultant changes in vascular structure. These data further support a role for CRP in mediating endothelial dysfunction.
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Affiliation(s)
- Hwee Teoh
- Division of Cardiac Surgery, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
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O'Neill SG, Isenberg DA, Rahman A. Could antibodies to C-reactive protein link inflammation and cardiovascular disease in patients with systemic lupus erythematosus? Ann Rheum Dis 2007; 66:989-91. [PMID: 17626971 PMCID: PMC1954713 DOI: 10.1136/ard.2007.073312] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zheng XY, Liu L. Remnant-like lipoprotein particles impair endothelial function: direct and indirect effects on nitric oxide synthase. J Lipid Res 2007; 48:1673-80. [PMID: 17496332 DOI: 10.1194/jlr.r700001-jlr200] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Remnant-like lipoprotein particles (RLPs) have been implicated as potentially atherogenic lipoproteins. Endothelial dysfunction is known to be an early event in atherosclerosis and an important contributor to the pathogenesis of coronary artery disease. Moreover, there is considerable evidence linking increased RLP cholesterol levels with endothelial dysfunction, reflected by impaired endothelial vasodilatation and abnormal endothelial secretion. The underlying mechanisms by which RLPs may contribute to endothelial dysfunction are complex and have not been completely elucidated. Because the expression and activation of endothelial nitric oxide synthase (eNOS) are vital to endothelial function, and recent data have implied an association between RLPs and eNOS, this manuscript proposes the hypothesis that RLPs could impair endothelial function via direct and indirect effects on eNOS: RLPs may affect the autophosphorylation of focal adhesion kinase and its downstream phosphatidylinositol kinase/Akt (protein kinase B) signaling pathway, resulting in eNOS inactivation through induction of intracellular oxidative stress in endothelial cells; and RLPs could affect the expression or activation of eNOS indirectly by stimulating secretion of various inflammatory factors from multiple origins. The practical applications of this manuscript provide new insights for the future investigation of RLPs.
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Affiliation(s)
- Xiao-Yan Zheng
- Department of Cardiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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de Ferranti SD, Rifai N. C-reactive protein: a nontraditional serum marker of cardiovascular risk. Cardiovasc Pathol 2007; 16:14-21. [PMID: 17218210 DOI: 10.1016/j.carpath.2006.04.006] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Revised: 04/25/2006] [Accepted: 04/28/2006] [Indexed: 01/08/2023] Open
Abstract
Cardiovascular disease (CVD) is multifactorial in etiology. Traditional cardiovascular risk factors, such as increased cholesterol concentrations and blood pressure, are used to assess CVD risk. Recently, better understanding of the role of inflammation in atherosclerosis has prompted many to propose the measurement of various inflammatory markers to better identify those who are at increased risk. C-reactive protein (CRP) is found in endothelial atherosclerotic lesions, and evidence suggests that it may play a role in atherogenesis. Of candidate serum markers that might add information to clinical risk assessment, high-sensitivity C-reactive protein (hsCRP) measurement has the most potential for clinical use for multiple reasons: (a) high hsCRP is associated with a twofold to a threefold increase in the prevalence of myocardial infarction, stroke, and peripheral vascular disease, and it predicts incident cardiovascular events in those with and without preexisting CVD; (b) the increased risk associated with high hsCRP is independent of other established risk factors; (c) hsCRP augments the predictive capacity of the Framingham Risk Score; (d) hsCRP assays are standardized, and this analyte is biologically stable over time; (e) various risk-reducing interventions also reduce hsCRP, and research is underway to assess whether specifically targeting hsCRP reduces CVD risk. National guidelines regarding the clinical utility of hsCRP in primary and secondary prevention settings have been recently issued.
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Affiliation(s)
- Sarah D de Ferranti
- Department of Cardiology, Children's Hospital Boston and Harvard University School of Medicine, Boston, MA 02115, USA
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Taylor KE, van den Berg CW. Structural and functional comparison of native pentameric, denatured monomeric and biotinylated C-reactive protein. Immunology 2006; 120:404-11. [PMID: 17163961 PMCID: PMC2265887 DOI: 10.1111/j.1365-2567.2006.02516.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
There are many controversies surrounding the biological activities of native C-reactive protein (nCRP) and its various modified forms such as monomerized and biotinylated CRP (mCRP and bCRP). No simple methods have been described to distinguish among these forms. By adapting established electrophoresis methods, we have developed a useful quality control method with which we have investigated the structural and functional characteristics of these forms of CRP. Under all electrophoresis conditions, biotinylation altered the electrophoretic mobility of CRP. nCRP was sensitive to sodium dodecyl sulphate (SDS)-induced monomerization, and only mCRP was susceptible to digestion by trypsin or neutrophil-derived serine proteases. bCRP and mCRP but not nCRP bound to cells, suggesting that chemical modification by biotin and denaturation had altered the structural integrity of CRP. Neither nCRP nor mCRP had the ability to induce secretion of chemokines, nor did they increase intracellular adhesion molecule 1 (ICAM-1) expression in endothelial cells.
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Affiliation(s)
- Karolina E Taylor
- Department of Pharmacology, Therapeutics and Toxicology, Cardiff University, Wales College of Medicine, Cardiff, UK
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Zhong Y, Li SH, Liu SM, Szmitko PE, He XQ, Fedak PWM, Verma S. C-Reactive protein upregulates receptor for advanced glycation end products expression in human endothelial cells. Hypertension 2006; 48:504-11. [PMID: 16847147 DOI: 10.1161/01.hyp.0000234904.43861.f7] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The receptor for advanced glycation end products (RAGE) may play an important role in inflammatory processes and endothelial activation, likely to accelerate the processes of coronary atherosclerotic development, especially in diabetic patients. The factors that regulate arterial expression of RAGE are not completely clear. C-reactive protein (CRP) is identified as a key proinflammatory cytokine in patients with atherosclerosis. Therefore, we tested the hypothesis that RAGE expression in endothelial cells can be upregulated by CRP. Human saphenous vein endothelial cells were incubated with human recombinant CRP, free of sodium azide and endotoxin. RAGE protein expression was measured by flow-cytometric analysis and Western blotting. CRP caused a significant increase in RAGE protein expression at a dose as low as 5 mug/mL, with expression peaking at 24 to 48 hours after CRP incubation. The effects of modified monomeric CRP on RAGE protein expression were comparable with that of native pentameric CRP. At the mRNA level, CRP not only increased RAGE gene expression but also attenuated the degradation of RAGE mRNA. Furthermore, RNA interference of RAGE gene expression significantly decreased the level of macrophage chemoattractant protein 1, a key downstream mediator of CRP activity. Therefore, CRP at concentrations known to predict future vascular events upregulates RAGE expression in human endothelial cells at both the protein and mRNA level. Silencing of the RAGE gene prevents CRP-induced macrophage chemoattractant protein 1 activation. These data reinforce the mechanistic links among inflammation, endothelial dysfunction, and atherothrombosis.
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Affiliation(s)
- Yun Zhong
- Toronto General Research Institute, Toronto, Ontario, Canada
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Schwedler SB, Filep JG, Galle J, Wanner C, Potempa LA. C-Reactive Protein: A Family of Proteins to Regulate Cardiovascular Function. Am J Kidney Dis 2006; 47:212-22. [PMID: 16431250 DOI: 10.1053/j.ajkd.2005.10.028] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Accepted: 10/26/2005] [Indexed: 11/11/2022]
Abstract
Based on a multitude of clinical studies, C-reactive protein (CRP) has emerged as a risk marker for the development of cardiovascular disease, leading to recently published recommendations for screening the general population for plasma CRP level as a predictor for future cardiovascular events. However, uncertainties exist in how to apply these recommendations to populations with very high serum CRP levels and a high prevalence of cardiovascular disease, such as patients with end-stage renal disease. Furthermore, in vitro results are conflicting concerning the role of CRP in the vessel wall. Although many data are in favor of a proinflammatory effect of CRP, evidence is accumulating that CRP also exerts anti-inflammatory actions, mainly in neutrophils and platelets. Many of the apparently contradictory actions of CRP may be attributed to method issues, but, of interest, also may be explained by the existence of 2 distinct conformations of CRP, the native pentamer (nCRP) and modified CRP (mCRP) forms. nCRP is the classical acute-phase reactant detected in serum, whereas mCRP represents a predominantly tissue-bound form. It is detected immunohistochemically, mainly in and around endothelial and vascular smooth muscle cells. Although mCRP activates endothelial cells and neutrophils, induces neutrophil adhesion to the endothelium, and delays apoptosis of neutrophils in vitro, these effects were absent using nCRP. Clearly defined CRP conformers thus may provide a tool for how to reconcile the reported proinflammatory and anti-inflammatory properties of CRP. There is good evidence to believe that CRP is more than just a "bad guy," and further experiments are needed to determine how these 2 configurations contribute to atherogenesis, development of cardiovascular disease, and acute coronary events.
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Affiliation(s)
- Susanne B Schwedler
- Division of Nephrology, Department of Medicine, University of Würzburg, Germany.
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