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C反应蛋白:病理生理学、诊断、检测结果假阳性及面向临床医生的新型诊断算法

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians.

作者信息

Mouliou Dimitra S

机构信息

38500 Volos, Magnesia, Greece.

出版信息

Diseases. 2023 Sep 28;11(4):132. doi: 10.3390/diseases11040132.

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.

摘要

当前的文献提供了一系列关于C反应蛋白(CRP)及其在炎症中潜在作用的证据。然而,大多数证据都很稀少且存在争议。这本关键的前沿专著提供了关于该蛋白潜在生化特性的所有关键数据,以及关于其潜在病理生物学的进一步证据,包括其五聚体和单体形式,还包括其配体的信息以及针对该蛋白的自身抗体的可能功能。此外,还介绍了目前关于其作为各种疾病生物标志物潜在效用的证据,涵盖所有心血管、呼吸、肝胆、胃肠、胰腺、肾脏、妇科、男科、牙科、口腔、耳鼻喉科、眼科、皮肤科、肌肉骨骼、神经、精神、脾脏、甲状腺疾病,以及感染、疑似自身免疫性疾病和肿瘤,包括其他与该蛋白浓度升高相关的可能因素。此外,还讨论了关于CRP的分子诊断数据,并强调了假检测结果的可能病因。此外,本综述评估了目前所有关于CRP和全身炎症的证据,并突出了未来的目标。最后,阐述了一种用于仔细评估CRP水平以精确诊断疾病的新型诊断算法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ec/10594506/8ac304a20d07/diseases-11-00132-g001.jpg

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