Elevated CRP values in inflammation and in tumors

CRP or C-reactive protein is one of the inflammatory phase proteins and can be measured in routine blood collection . In addition to inflammation, CRP is also elevated in tumors, infarctions, or some chronic diseases.

What is C-reactive protein (CRP)?

C-reactive protein is a protein that is created in the liver in response to the inflammation in the body. The messengers of inflammation are cytokines that tell the liver to boost CRP.

In addition to CRP, there are other inflammatory proteins in the blood such as fibrinogen , amyloid A and interleukin 6.

CRP has many roles, primarily in the human immune system, such as attachment to dead or damaged cells and their labeling, attachment to pathogens in the body, and activation of the complement system (which destroys infected cells).

Because of these actions, the C-reactive protein is called the acute phase protein of inflammation . Inflammation is a normal reaction of the immune system to foreign microorganisms or tissue necrosis (tissue death) and is coordinated by the multiplicity of inflammatory cells and messengers between them (cytokines).

The stronger the inflammation, the more cytokines are produced, and the liver also releases more CRP into the blood.

CRP is an indicator of inflammation, trauma or necrosis of tissue that is determined from peripheral venous blood by routine blood sampling.

Recently, CRP findings have almost replaced erythrocyte sedimentation .

CRP has high sensitivity and low specificity , which means that it certainly tells us exactly what is happening in the body, but it does not tell us anything about where it is going and why.

In addition to acute inflammation and infection, CRP in the blood also tells us conditions such as myocardial infarction , vein thrombosis , chronic inflammation, various malignant tumors, or rheumatic diseases.

In order to make a correct diagnosis, we must first of all know the patient’s problems and symptoms, perform a clinical examination and complete blood count, and, if necessary, other examinations.

The scientific journal Journal of Biological Chemistry brings a study that more closely explains the action of C-reactive protein (CRP). Namely, it is a plasma protein that participates in the systemic response to inflammation of the organism, and its plasma concentration increases during inflammatory conditions.

The group of scientists who conducted this study also points out the following: “The rapid elevation of CRP in the body within hours of tissue injury or infection suggests that it contributes to the body’s defense and is part of the innate immune response. The association between CRP values and the onset of major cardiovascular disease has recently been recognized, leading to numerous medical recommendations to all heart disease control centers so that at-risk groups of patients suffering from coronary heart disease can reap the many benefits of measuring CRP. “

Increased CRP and temperature

If CRP and fever are elevated , it is almost certainly an acute inflammation / infection.

In acute inflammation, CRP rises rapidly , in 6-9 hours, and reaches a maximum in one to three days.

CRP is much higher in bacterial than in viral infection and can be used to differentiate these inflammations. The level of CRP can be monitored as an indicator of cure, ie the action of antibiotics.

Increased CRP together with elevated leukocytes is sufficient to detect infection and sepsis in the newborn (as there are no visible signs of inflammation) as in patients who have recently undergone surgery. In these situations, a laboratory examination alone is sufficient to diagnose and empirically treat antibiotics .

If the CRP is elevated and the leukocytes normal, it may be the very beginning of the inflammation before the leukocytes have been able to multiply.

A study published in the scientific journal Immunologic research highlights C-reactive protein as one of the most important indicators of inflammatory infections in the body. Current knowledge of the functions of CRP has greatly increased its appreciation in inflammation and disease, and many more studies in this field are being encouraged to reduce inflammation more effectively and protect against certain autoimmune diseases.

CRP values in children – infections

Since infections are most common in childhood , and by the symptoms themselves, it can sometimes be difficult to conclude whether the virus is a virus or a bacterium, CRP can tell us more about the etiology of the disease.

In bacterial infections, CRP values are usually extremely high, with viral infections just above the upper limit.

The value of CRP thus becomes a good indication of whether or not your child needs an antibiotic.

We can also monitor the effect of antibiotics on the value of CRP and, if it does not go down, adjust therapy with more effective antibiotics.

A scientific study published in the New England Journal of Medicine examined the role of CRP values in the pathogenesis of cardiovascular disease in women. The results showed that measuring C-reactive protein based on lipid levels can effectively identify the risk of cardiovascular disease, especially in women.

CRP benchmarks

Normal blood CRP value is up to 5 mg / l .

There is no difference between the benchmarks for men and women.

In the elderly, normal CRP in the blood is higher, up to 10 mg / l.

Elevated CRP values in the blood

Elevated blood CRP is associated with many conditions such as:

obesity ,
smoking ,
hypertension ,
increased physical exertion and stress,
pregnancy ,
diabetes,
oral contraceptives,
infections – much higher in bacterial than viral infections,
rheumatic diseases (eg rheumatoid arthritis ),
autoimmune diseases (eg lupus ),
vasculitis ,
inflammatory bowel disease ,
myocardial infarction ,
malignancy.

CRP values in tumors

The value of CRP is elevated in some patients with malignancies, but scientists do not yet fully understand why. Some possible mechanisms are:

Tumor growth causes inflammation of the tissue around it. Inflammation is the cause of CRP growth.
Elevated CRP could be a response of the immune system to tumor cells.
Some tumor cells can cause increased production of inflammatory proteins, including CRP.
Some tumor cells produce interleukin 6 which increases CRP formation.

These mechanisms suggest that an increase in CRP is a result of the process of tumor cell formation and that by measuring CRP, tumors may be easier to detect at an earlier stage of the disease.

Also, patients suffering from a malignancy due to reduced immunity are more likely to get another infection such as pneumonia.

Because of all of the above, it is necessary to monitor CRP values in patients with malignant diseases. A single blood test is not sufficient, but it is necessary to monitor the increase or decrease of CRP.

Given that patients with malignant disease are more susceptible to infection and are a vulnerable group , an increased CRP and leukocyte count is sufficient for a physician to decide on antibiotic therapy.

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