Stec-Martyna Emilia, Wojtczak Karolina, Nowak Dariusz, Stawski Robert
Research Laboratory CoreLab, Medical University of Lodz, 6/8 Mazowiecka St., 92-215 Lodz, Poland.
Department of Clinical Physiology, Medical University of Lodz, 92-215 Lodz, Poland.
Biology (Basel). 2025 Apr 18;14(4):438. doi: 10.3390/biology14040438.
Systemic inflammation is monitored with various biomarkers; of these, C-reactive protein (CRP) is widely used due to its cost effectiveness and widespread implementation. However, its lack of specificity and delayed kinetics have directed interest in cell-free DNA (cfDNA), which offers rapid responses to cellular damage. Our review compares the use of CRP and cfDNA in myocardial infarction, sepsis, and physical exercise, focusing on their origins, kinetics, and clinical utility. cfDNA release from apoptotic or damaged cells increases within minutes to hours, providing an early marker of cellular stress. In myocardial infarction, cfDNA peaks early, indicating acute injury, while CRP rises later, reflecting prolonged inflammation. In sepsis, cfDNA correlates strongly with disease severity and prognosis, outperforming CRP in early diagnosis. During physical exercise, cfDNA offers an immediate picture of cellular stress, whereas CRP's delayed response limits its utility in this context. The interaction between CRP and cfDNA suggests their combined application could improve diagnostic accuracy and prognostic assessments. As cfDNA testing becomes more widely available, researchers will need to develop standardized protocols and determine how it can best complement CRP measurements in clinical practice. This approach offers promise for improving the management of systemic inflammation across diverse medical conditions.
全身炎症通过多种生物标志物进行监测；其中，C反应蛋白（CRP）因其成本效益高且应用广泛而被广泛使用。然而，其缺乏特异性和动力学延迟促使人们对游离DNA（cfDNA）产生兴趣，cfDNA对细胞损伤能做出快速反应。我们的综述比较了CRP和cfDNA在心肌梗死、脓毒症和体育锻炼中的应用，重点关注它们的来源、动力学和临床效用。凋亡或受损细胞释放的cfDNA在数分钟至数小时内增加，提供细胞应激的早期标志物。在心肌梗死中，cfDNA早期达到峰值，表明急性损伤，而CRP稍后升高，反映炎症持续时间延长。在脓毒症中，cfDNA与疾病严重程度和预后密切相关，在早期诊断方面优于CRP。在体育锻炼期间，cfDNA能即时反映细胞应激情况，而CRP的延迟反应限制了其在此情况下的效用。CRP与cfDNA之间的相互作用表明，它们联合应用可提高诊断准确性和预后评估。随着cfDNA检测的应用越来越广泛，研究人员需要制定标准化方案，并确定其在临床实践中如何能最好地补充CRP测量。这种方法有望改善各种医疗状况下全身炎症的管理。
