Department of Internal Medicine "E", Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
Int J Mol Sci. 2022 Jul 22;23(15):8100. doi: 10.3390/ijms23158100.
C-reactive protein (CRP) is considered a biomarker of infection/inflammation. It is a commonly used tool for early detection of infection in the emergency room or as a point-of-care test and especially for differentiating between bacterial and viral infections, affecting decisions of admission and initiation of antibiotic treatments. As C-reactive protein is part of a dynamic and continuous inflammatory process, a single CRP measurement, especially at low concentrations, may erroneously lead to a wrong classification of an infection as viral over bacterial and delay appropriate antibiotic treatment. In the present review, we introduce the concept of C-reactive protein dynamics, measuring the velocity of C-reactive protein elevation, as a tool to increase this biomarker's diagnostic ability. We review the studies that helped define new metrics such as estimated C-reactive protein velocity (velocity of C-reactive protein elevation from symptoms' onset to first C-reactive protein measurement) and the measured C-reactive protein velocity (velocity between sequential C-reactive protein measurements) and the use of these metrics in different clinical scenarios. We also discuss future research directions for this novel metric.
C 反应蛋白（CRP）被认为是感染/炎症的生物标志物。它是急诊科早期检测感染的常用工具，也是一种即时检测工具，尤其可用于区分细菌感染和病毒感染，影响住院和开始抗生素治疗的决策。由于 C 反应蛋白是动态和连续炎症过程的一部分，因此单次 CRP 测量值，尤其是低值，可能会错误地将感染分类为病毒感染而非细菌感染，从而延迟了适当的抗生素治疗。在本综述中，我们介绍了 C 反应蛋白动力学的概念，即测量 C 反应蛋白升高的速度，以此作为提高该生物标志物诊断能力的工具。我们回顾了有助于定义新指标的研究，例如估计的 C 反应蛋白速度（从症状出现到首次 CRP 测量的 CRP 升高速度）和测量的 C 反应蛋白速度（连续 CRP 测量之间的速度），以及这些指标在不同临床情况下的应用。我们还讨论了这一新型指标的未来研究方向。
