CRP tissue concentration
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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C-reactive protein (CRP)is an acute phase protein, normally present in the plasma at a concentration of less than 5 mg/l.
CRP is synthesized by liver cells and it increases in plasma concentration during infection and inflammation. Cytokines (protein messengers that aggravate inflammation), particularly IL-6, stimulate CRP synthesis in the liver.
The plasma levels of CRP in most healthy subjects is usually 1 mg/L with normal being defined as <1.2 mg/L. Plasma levels begin increasing within 4-6 hours after initial tissue injury and continue to increase several hundred fold within 24-48 hours.
CRP increases in virtually all conditions associated with tissue damage and injury. CRP remains elevated during the acute-phase response, and returns to normal rapidly with restoration of tissue structure and function. CRP is better than ESR for monitoring fast changes as it is not affected by red blood cell numbers and shape.
Serial CRP measurements can be used as a diagnostic tool for infection, monitoring effect of treatment, or early detection of relapse.
Most clinical trials in rheumatoid arthritis use CRP as opposed to the ESR because of its sensitivity as well as rapid response to inflammatory states.
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