Pope Janet E, Choy Ernest H
Janet E. Pope: Schulich School of Medicine, University of Western Ontario, St. Joseph's Health Care, London, ON, Canada.
Ernest H. Choy: Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom.
Semin Arthritis Rheum. 2021 Feb;51(1):219-229. doi: 10.1016/j.semarthrit.2020.11.005. Epub 2020 Dec 17.
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.
C反应蛋白（CRP）通常被用作类风湿关节炎（RA）全身炎症的标志物进行评估。然而，它也是一种免疫调节因子，在与RA相关的炎症途径中发挥重要作用，并促进动脉粥样硬化效应。与全身炎症相关的合并症在RA中很常见，CRP与心血管疾病、糖尿病、代谢综合征、肺部疾病和抑郁症的风险相关。RA中全身炎症、CRP与合并症之间的关系很复杂，确定CRP水平的变化如何影响这些合并症的风险或进展具有挑战性。我们综述了CRP在RA中的生物学作用及其对疾病活动和治疗反应的影响。我们还讨论了治疗对CRP水平的影响，以及降低全身炎症和抑制CRP介导的炎症途径是否可能对RA常见的合并症产生影响。
