C reactive protein is increased during pregnancy consequences. SRP analysis is normal for pregnant women. C-reactive protein in the blood: normal in tests, why it increases, role in diagnosis

C-reactive protein (CRP) is a large pentamer with a mol. weighing from 1100 to 1400 kD, promotes the activation of natural killer cells, T-lymphocytes and polymorphonuclear neutrophils, participates in the reactions of precipitation, agglutination, swelling of the bactericidal capsule, phagocytosis and complement fixation. Normally, PSA levels in blood serum range from 0 to 10 mg/l. Inflammation or acute tissue damage leads to a thousandfold increase in the concentration of CRP. The content of CRP in the blood serum of women with pregnancy complicated by late toxicosis is 3–10 times higher than in the control group of women with a normally developing pregnancy, 70–220 and 20 mg/l, respectively. The ability of CRP to bind acetylcholine may contribute to the development of hypertension in eclampsia, and blocking platelet aggregation factor suggests that this acute phase protein has an anticoagulant function. The review provides data on other properties of PSA.

C-reactive protein

pregnancy

preeclampsia

1. Antoshina N.L., Mikhalevich S.I., Modern ideas about the etiology and pathogenesis of gestosis // Medical news. – 2005. – No. 3. – P. 23–28.

2. Gudinskaya N.I., Nikolaev A.A., Boyko O.V., Kondrashova Yu.V., Zhurikhin A.V. Immunochemical markers of pathological conditions // Russian Immunological Journal. –2008. – volume 2. No. 2. – P. 287–289.

3. Leiderman I.N. Multiple organ failure syndrome // Bulletin of intensive care. – 1999. – No. 2. – P. 8–13.

4. Nazarov P.G. Reactants of the acute phase of inflammation. – St. Petersburg: Nauka, 2001. – 423 p.

5. Nikolaev A.A., Akhushkova L.M. Study of alkaline phosphatase in placental tissue during gestosis // Fundamental Research. – 2013. – No. 12. – P. 167–171.

6. Petrunina Yu.A., Tumenova S.K. Comparison of two immunochemical methods for determining C-reactive protein in an obstetric clinic // Laboratory work. – 1983. – No. 7. – P. 51–57.

7. Sukharev A.E., Vaichulis Yu.V., Asfandiyarov R.I., Panchenko L.F. and others // Placental alkaline phosphatase and acute phase proteins in clinical and laboratory assessment of factors of increased thrombohemorrhagic risk in obstetrics. – M.-Astrakhan, 2006. – pp. 53–58.

8. Akiibinu M.O., Kolawole T.O., Ekun O.A., Akiibinu S.O. Metabolic dysfunctions in Nigerian pre-eclamptics // Arch Gynecol Obstet. – 2013. – Vol. 288. – No. 5. – R. 1021–1026.

9. Baum L.L., Johnson B., Berman S., et al. C-reactive protein is involved in natural killer cell-mediated lysis but does not mediate effector-target cell recognition // Immunology. – 1987. – Vol. 189. – No. 5. – R. 6193–6199.

10. Best L.G., Saxena R., Anderson C.M., Barnes M.R., Hakonarson H., Falcon G., Martin C., Castillo B.A., Karumanchi A., Keplin K., Pearson N., Lamb F., Bercier S., Keating B.J. Two variants of the C-reactive protein gene are associated with the risk of pre-eclampsia in an American Indian population // PLoS One. – 2013. – Vol. 8. – No. 9. – R. 71231–71238.

11. Blasco L.M., C-Reactive Protein Levels in Pregnancy // Environ Health Perspect. – 2012 – Vol. 120. – No. 9. – R. 342–346.

12. Borzychowski A.M., Sargent I.L., Redman C.W.G. Inflammation and pre-eclampsia.// Seminars in Fetal and Neonatal Medicine. – 2006. – Vol. 11. – No. 5. – R. 309–316.

13. Brown A.S., Sourander A., Hinkka-Yli-Salomäki S., McKeague I.W., Sundvall J., Surcel H.M. Elevated maternal C-reactive protein and autism in a national birth cohort // Mol Psychiatry. – 2013 – Vol. 19. – No. 2. – R. 259–264.

14. Bullen B.L., Jones N.M., Holzman C.B., Tian Y., Senagore P.K., Thorsen P., Skogstrand K., Hougaard D.M., Sikorskii A. C-reactive protein and preterm delivery: clues from placental findings and maternal weight // Reprod Sci. – 2013. – Vol. 20. – No. 6. – R. 715–722.

15. Danielsen I., Granström C., Rytter D., Halldorsson T.I., Bech B.H., Henriksen T.B., Stehouwer C.D., Schalkwijk C.G., Vaag A.A., Olsen S.F. Subclinical inflammation during the third trimester of pregnancy was not associated with markers of the metabolic syndrome in young adult offspring. Obesity (Silver Spring). – 2013. – Vol. 25. – No. 4. – R. 1715–1721.

16. Dekker G.A., Sibai B.M. Etiology and pathogenesis of preeclampsia: current concepts // Am J Obstet Gynecol. – 2008. – Vol. 179. – No. 5. – R. 1359–1275.

17. Deveci K., Sogut E., Evliyaoglu O., Duras N. Pregnancy-associated plasma protein-A and C-reactive protein levels in pre-eclamptic and normotensive pregnant women in the third trimester J. Obstetrics Gynaecology Research. – 2009. – Vol. 35. – No. 1. – R. 94–98.

18. Du Clos T., W., Mold C Pentraxins (CRP, SAP) in the process of complement activation and clearance of apoptotic bodies through Fcγ receptors // Curr Opin Organ Transplant. – 2011 – Vol. 16. – No. 1. – R. 15–20.

19. Engin-Ustun Y., Tonguç E., Var T., Deveer R., Yilmaz N., Danisman N., Besli M., Mollamahmutoglu L. Vaspin and C-reactive protein levels in hyperemesis gravidarum // Eur Rev Med Pharmacol Sci. – 2013. – Vol. 17. – No. 1. – R. 138–140.

20. Ernst L.M., Grobman W.A., Wolfe K., Huang M.H., McDade T.W., Holl J.L., Borders A.E. Biological markers of stress in pregnancy: associations with chronic placental inflammation at delivery. Am J Perinatol. – 2013. – Vol. 30. – No. 7. – R. 557–564.

21. Farzadnia M., Ayatollahi H., Hasan-zade M., Reza Rahimi H. A Comparative Study of Serum Level of Vascular Cell Adhesion Molecule-1 (sVCAM-1), Intercellular Adhesion Molecule-1(ICAM-1) and High Sensitive C – reactive protein (hs-CRP) in Normal and Pre-eclamptic Pregnancies // Iran J Basic Med Sci. – 2013. – Vol. 16. – No. 5. – R. 689–693

22. Goldberger G., Bing D.H., Sipe J.D. et al. Transcriptional regulation of genes encoding the acute-phase proteins CRP, SAA and C3// The J. of Immunol.Copyright. – 1987. – Vol. 138. – No. 11. – R. 3967–3971.

23. Gould Jane M., Weiser Jeffrey N. The Inhibitory Effect of C-Reactive Protein on Bacterial Phosphorylcholine Platelet-Activating Factor Receptor–Mediated Adherence Is Blocked by Surfactant // J. of Infectious Diseases. – 2002. – Vol. 186. – No. 3. – R. 361–371.

24. Grgic G., Skokic F., Bogdanovic G. C-reactive protein as a biochemical marker of idiopathic preterm delivery // Med Arh. – 2010. – Vol. 64. – No. 3. – R. 132. – 134.

25. Imhof A., Fröhlich M., Loewel H., Helbecque N., Woodward M., Amouyel P., et al: Distributions of C-reactive protein measured by high-sensitivity assays in apparently healthy men and women from different populations in Europe // Clin Chem. – 2003. – Vol. 49. – No. 3. – R. 669–672.

26. Irgens H.U., Reisaeter L., Irgens L.M., Lie R.T. Long term mortality of mothers and fathers after preeclampsia population based cohort study //Br Med J. – 2001. – Vol. 323. – No. 7. – R. 1213–1217.

27. Kashanian M., Aghbali F., Mahali N. Evaluation of the diagnostic value of the first-trimester maternal serum high-sensitivity C-reactive protein level for prediction of pre-eclampsia // J Obstet Gynaecol Res. – 2013 – Vol. 39. – No. 12. – R. 1549–1554.

28. Khan K.S., Wojdyla D., Say L., Gu¨lmezoglu A.M., Van Look P.F. WHO analysis of causes of maternal death: a systematic review // Lancet. – 2006. – Vol. 367. – No. 5. – R. 1066–1074.

29. Kristensen K., Wide-Swensson D., Lindstrom V., Schmidt C., Grubb A., Strevens H. Serum amyloid a protein and C-reactive protein in normal pregnancy and preeclampsia // Gynecol Obstet Invest. – 2009. – Vol. 67. – No. 3. – R. 275–280.

30. Kumru S., Godekmerdan A., Kutlu S., Ozcan Z. Correlation of maternal serum high-sensitive C-reactive protein levels with biochemical and clinical parameters in preeclampsia. // European Journal of Obstetrics & Gynecology and Reproductive Biology. – 2011. – Vol. 127. – No. 2. – R. 164–167.

31. Martinez J.A., Coll J.M. Preliminari clinical studies of C-reactive protein quantified by enzyme-linked immunoassay // Clin. Chem. – 1987. – Vol. 33. – No. 12. – R. 2185–2190.

32. Nazarov P.G., Krylova I.B., Evdokimova N.R., Nezhinskaya G.I., Butyugov A.A. C-reactive protein: a factor of inflammation binding and inactivating acetylcholine // Cytokines and Inflammation. – 2006. – Vol. 5. – No. 4. – R. 32–35.

33. Nielsen F. R., Bek K. M., Rasmussen P. E., et al. C-reactive protein during normal pregnancy // Europ. J. Obstetr. & Gynec. and Reproductive Biol. – 1990. – Vol. 35. – No. 1. – R. 23–27.

34. Park Y.S., Owen A.M., Adno A.M., Marry J. Pyogenic Sacroiliitis due to Group A Streptococcus following Uncomplicated Pregnancy and Vaginal Delivery // Case Rep Obstet Gynecol. – 2013. – Vol. 2013. – Article ID 981474, 2 pageshttp://dx.doi.org/10.1155/2013/981474.

35. Rebelo F., Schlüssel M.M., Vaz J.S., Franco-Sena A.B., Pinto T.J., Bastos F.I., Adegboye A.R., Kac G. C-reactive protein and later preeclampsia: systematic review and meta-analysis taking into account the weight status / / J Hypertens. – 2013. – Vol. 31. – No. 1. – R. 16–26.

36. Roberts J.M., Gammill H.S. Preeclampsia: Recent Insights // Hypertension. – 2005. – Vol. 46. – No. 6. – R. 1243–1249.

37. Shephard E., Van Helden P., Strauss M., et al. Functional effects of CRP binding to nuclei // Immunology. – 1986. – Vol. 58. – No. 2. – R. 489–494.

38. Smertka M., Wroblewska J., Suchojad A., Majcherczyk M., Jadamus-Niebroj D., Owsianka-Podlesny T., Brzozowska A., Maruniak-Chudek I. Serum and Urinary NGAL in Septic Newborns // BioMed Res. . Int. – 2014. – Vol. 2014. – R. 717318–717325.

39. Smith E.J., Muller C.L., Sartorius J.A., White D.R., Maslow A.S. C-reactive protein as a predictor of chorioamnionitis // J Am Osteopath Assoc. – 2012. – Vol. 112. – No. 10. – R. 660–664.

40. Sonnenschein-van der Voort A.M., Jaddoe V.W., Moll H.A., Hofman A., van der Valk R.J., de Jongste J.C., Duijts L. Influence of maternal and cord blood C-reactive protein on childhood respiratory symptoms and eczema // Pediatr Allergy Immunol. – 2013. – Vol. 24. – No. 5. – R. 469–475.

41. Van den Hooven E.H., de Kluizenaar Y., Pierik F.H., Hofman A., van Ratingen S.W., Zandveld P.Y., et al. Chronic air pollution exposure during pregnancy and maternal and fetal C-reactive protein levels: the Generation R Study. //Environ Health Perspective. – 2012. – Vol. 120. – No. 3. – R. 746–751.

42. Van Rijn B.B., Veerbeek J.H., Scholtens L.C., Post Uiterweer E.D., Koster M.P., Peeters L.L., Koenen S.V., Bruinse H.W., Franx A. C-reactive protein and fibrinogen levels as determinants of recurrent preeclampsia: a prospective cohort study. J Hypertens. – 2014. – Vol. 32. – No. 2. – R. 408–414.

43. Volanakis J.E. Human C-reactive protein: expression, structure, and function // Mol Immunol. – 2001. – Vol. 38. – No. 1. – R. 189–197.

44. Wei S.Q., Fraser W., Luo Z.C. Inflammatory cytokines and spontaneous preterm birth in asymptomatic women: a systematic review // Obstet Gynecol. – 2012. – Vol. 116. – No. 2. – R. 393–401.

45. Zai-Chun Deng, Peng Zhao, Chao Cao, Shi-Fang Sun, Feng Zhao, Hong-Ying Ma C‑reactive protein as a prognostic marker in chronic obstructive pulmonary disease // Exp. Ther. Med – 2014. – Vol. 7. – No. 2. – R. 443–446.

C-reactive protein (CRP) is an acute phase protein found in many animals, including invertebrates. Tillet et Francis first described its presence in the sera of patients with pneumonia when they discovered a precipitation reaction of the pneumococcal cell wall C-polysaccharide with this protein, reminiscent of a precipitation reaction. SRP is a large pentamer with a mol. weighing from 1,100,000 to 1,400,000 d, composed of five subunits of 215,000 d according to the type of radial symmetry and having the electrophoretic mobility of beta-gamma globulins. SRP is part of the family of so-called pentraxins. Pentraxins are a family of homologous human and animal proteins consisting of five subunits that bind specific ligands. Pentraxins, such as C-reactive protein (CRP) and serum amyloid P component (SAP), are markers of acute phase inflammation and play a protective role in innate immune responses. The previously studied properties of SRP indicate its multifunctional role in the body. One of the functions of SRP is to bind damaged and harmful products - components of cellular detritus (phosphorylcholine, liposomes, phosphate monoesters, polysaccharides), nucleoproteins, bacterial toxins, modified lipoproteins. PSA promotes their elimination from the body, like a “garbage cleaner”. It is known that SRP promotes the activation of natural killer cells, T-lymphocytes and polymorphonuclear neutrophils through special receptors on their cell membranes, and is involved in the reactions of precipitation, agglutination, swelling of the bactericidal capsule, phagocytosis and complement fixation. The structural gene for this protein is located on chromosome 1, and synthesis occurs in the liver.

Interacting with antimicrobial and antitumor immunological mechanisms, SRP activates macrophages, neutrophils and C1-C4 complement components, which can lead to the inclusion of kallikrein, fibrinolytic hemostasis systems, and the release of activators of the coagulation and anticoagulation systems. Along with this, the ability of SRP to inhibit platelet aggregation and stabilize platelet membranes by blocking platelet aggregation factor suggests that this acute phase protein has an anticoagulant function.

Normally, only trace amounts of it are detected in blood serum ranging from 0 to 10 mg/l. Inflammation or acute tissue damage leads to a thousand-fold increase in serum concentrations of CRP. Thus, an increase in the level of CRP above 20 to 53 ± 6 mg/l is observed with chorioamnionitis and prenatal rupture of the membranes, with bilateral pyogenic sacroiliitis in a woman during and after pregnancy. At the same time, the test specificity and positive predictive value increase to 100% if the threshold value is increased to 35-40 mg/l.

Ernst L.M., Grobman W.A., Wolfe K. et al examined the relationship between biomarkers of chronic pregnancy stress and chronic inflammation in the placenta in 112 African-American and Caucasian women. Women with chronic villitis had significantly increased levels of Epstein-Barr virus antibodies and CRP in the second and third trimesters.

Although CRP is considered a good marker of acute inflammation, Smith E.J. and co-authors, based on a statistical meta-analysis, showed that SRP is still not a sufficiently effective prognostic marker of chorioamnionitis and rupture of the membranes, which somewhat contradicts the above studies.

In pregnant women, the normal concentration of PSA does not exceed 20 mg/l. According to Farzadnia M. et al. , an increase in the amount of CRP in the blood serum during normal childbirth is observed in 16.6% of cases. The content of CRP in the blood serum of women with pregnancy complicated by late toxicosis is 3-10 times higher than in the control group of women with a normally developing pregnancy, respectively, 70-220 and 20 mg/l. More sensitive methods have also shown that CRP levels above 7 mg/l are significantly more common in pregnant women with preeclampsia compared to normal pregnancies, in 73.9 and 6.2%, respectively. .

Preeclampsia is one of the most common complications after 20 weeks of pregnancy and is characterized by high blood pressure and proteinuria. This accounts for 2-8% of obstetric pathologies worldwide and is responsible for high maternal mortality, as well as maternal and neonatal morbidity. The cause of preeclampsia remains unknown, but many factors appear to be associated with its development. Inflammation has been shown to be an important contributor to the pathogenesis of this disease.

Clinical and biochemical evidence suggests that endothelial dysfunction may be the underlying cause of this condition and that this dysfunction is accompanied by increased levels of inflammatory markers that have been investigated as possible predictors of preeclampsia, especially C-reactive protein (CRP).

It is believed that preeclampsia may be caused by changes in the maternal immune system, and CRP, as an important component of the innate immune system, may play a role in the occurrence of preeclampsia.

Research into the mechanisms of preeclampsia has led to the recognition of the concept of a “systemic inflammatory response” (SIR). SVR is characterized by activation of phagocytes, endothelial cells, mast cells and platelets. As a result, the production of free radicals, cytokines, and arachidonic acid derivatives increases, which can contribute to the generalization of the pathological process. Signs of the latter include changes in the hemostatic system (predominant damage to the platelet component), immune status, slowdown in the growth of circulating plasma volume, etc.

According to the latest data, gestosis or preeclampsia (according to the international classification) is accompanied by an increase in serum levels of CRP and soluble vascular cell adhesion factor-1. Along with various inflammatory reactions, hypothyroidism, hypercholesterolemia and oxidative stress are also potential signs of preeclampsia. Thus, in women with uncontrollable vomiting of pregnancy, the blood serum levels of CRP, vaspin, total cholesterol, triglycerides and low-density lipoproteins are significantly higher compared to normal pregnancy.

Bullen B.L., et al. found that the level of CRP (5.5 μg/ml) was significantly higher in spontaneous preterm labor compared to term birth (4.8 μg/ml), especially in the presence of chorioamnionitis (6.3 μg/ml ). They also found a direct correlation between an increase in CRP to 8.9 μg/ml and preterm birth in women with a high body mass index compared with low weight pregnant women. According to other data, increased levels of CRP also correlate with the likelihood of preterm birth. However, Wei S.Q. et all believe that it is more informative to examine amniotic fluid for the content of PSA. Spontaneous preterm birth was strongly correlated with elevated amniotic fluid C-reactive protein levels in the middle trimester of pregnancy, but not with plasma levels of this protein. There is an observation that increased levels of CRP in obese women may serve as a marker of the risk of preterm birth. Based on a statistical meta-analysis of 23 publications (727 women with preeclampsia and 3538 controls), Rebelo F. et al concluded that an increase in the concentration of CRP more than 2.30 mg/l (normal range 1.27-3. 34 in their studies) increases the risk of eclampsia in pregnant women with high body weight.

Other researchers have found no association between preeclampsia or preterm birth and CRP levels, since CRP, serum amyloid-A protein, and ceruloplasmin are increased in both pregnant women with and without preeclampsia. It is believed that the concept of preeclampsia as a systemic inflammatory condition may not be reflected in the content of these proteins.

According to some data, SRP can serve as a prognostic criterion in the postpartum period. Thus, an increase in the level of CRP and fibrinogen in the blood serum of first-time mothers is associated with the risk of preeclampsia during repeated births. When studying inflammatory pathology of the respiratory tract in pregnant women, van den Hooven et al. found increased levels of both maternal and fetal PRP associated with the severity of air pollution. It is believed that an increase in CRP in maternal serum creates a risk for pathology in children in the first 4 years. Brown A.S., et al. examined the association between CRP levels, a recognized biomarker of inflammation, in early pregnancy and subsequent autism in children. In their opinion, inflammatory processes and increased maternal CRP are associated with autism and other neurological disorders in children later. At the same time, Danielsen I., Granström C., Rytte D. do not find that such markers of subclinical inflammation as CRP, tumor necrosis factor-α, interleukin-1β and interleukin-6 in the third trimester of pregnancy are associated with metabolic syndrome in the offspring .

Returning to the connection between PSA and preeclampsia, it should be noted not only the diagnostic and prognostic potential of determining PSA, but also its pathogenetic role. Mentioned above was the ability of SRP to bind to various biologically active molecules. In particular, CRP forms strong complexes with acetylcholine. This property is even used to clean PSA. In turn, the role of endothelial factors in the development of preeclampsia is recognized, and it is known that acetylcholine is actively produced by edothelial cells during inflammation. Nazarov et all showed that PSA, actively binding to acetylcholine, reduces its biological activity (neutralizes the hypotensive effect and reduces bradycardia caused by acetylcholine). Thus, it can be considered that SRP in preeclampsia may contribute to an increase in blood pressure by inhibiting the protective response of the endothelium to the inflammatory process.

Reviewers:

Moldavskaya A.A., Doctor of Medical Sciences, Professor of the Department of Human Anatomy, Astrakhan State Medical Academy, Astrakhan;

Feldman B.V., Doctor of Biological Sciences, Associate Professor, Head of the Department of Botany, Pharmacognosy and Pharmaceutical Technology, Pharmaceutical Faculty, Astrakhan State Medical Academy, Astrakhan.

The work was received by the editor on April 4, 2014.

Bibliographic link

Akhushkova L.M., Bulakh N.A., Moskalenko N.P., Sukharev A.E., Nikolaev A.A. STUDY OF C-REACTIVE PROTEIN IN PREGNANCY // Fundamental Research. – 2014. – No. 4-3. – P. 619-623;
URL: http://fundamental-research.ru/ru/article/view?id=33972 (access date: 02/22/2020). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"

The doctor ordered this test. The results arrived today. Everything is normal except for C-reactive protein. When the laboratory norm is up to 5, I have 7.5. The therapist said that this is very bad for a pregnant woman because... this indicates probable preeclampsia in later stages (I'm currently 13 weeks) and the risk of preterm birth. It’s only March 10th to see the gynecologist, but somehow I’m a little worried. Is the therapist right and can such a C-reactive protein level indicate pregnancy complications?

Yulia Titova

Comments on this post

Only group members can comment.

Elena Berezovskaya Doctor

There is a slight association between increased CRP ((≥25.0 mg/L) in early pregnancy and pregnancy complications only in relation to fetal growth retardation. However, such an association was noted more often in the group of women with bad habits (smoking, drinking alcohol), obesity and the presence of other diseases.

The following levels of C-reactive protein are considered normal: second trimester - 0.4 -20.3 mg/L, third trimester - 0.4 - 8.1 mg/L. You have entered the second trimester.

C-reactive protein during pregnancy: reasons to panic

During pregnancy, monitoring the well-being, health of the woman and the proper development of the fetus, the doctor prescribes a series of tests. These are very important studies, they help to identify diseases at the stage of development. C-reactive protein during pregnancy informs about the presence of inflammation. This is an important indicator: its value increases sharply in the first four hours after the onset of the disease.

The value and norm of c-reactive protein

Damage to the cells of any organ is accompanied by increased production of c-reactive protein by the liver. Binding of c-polysaccharide is one of the main functions of c-reactive protein; in addition, it is a stimulator of leukocyte production. C-reactive protein is detected from the onset of the disease and during its acute phase.

A biochemical blood test determines the level of CRP (c-reactive protein) in the blood plasma. It should normally be less than five mg/l. However, there are a number of factors that contribute to its increased concentration. C-reactive protein C-reactive protein: what is it? in pregnant women it can increase to 20 mg/liter. If other indicators in the tests are normal and you feel good, then there is no reason to worry. But with significantly elevated levels of c-reactive protein, you need to look for the source of the disease.

Test for C-reactive protein or ESR?

During pregnancy, a woman regularly undergoes blood tests. The test results always reflect the erythrocyte sedimentation rate, or ESR. Relying on an increased ESR value, the doctor can make a conclusion about possible inflammation in the pregnant woman’s body. However, this is not always the case. For a reliable result, you need to donate blood for a biochemical analysis to find out the CRP value. The result of such a study is more informative compared to conventional analysis:

C-reactive protein increases after four hours from the onset of the disease, and the ESR rate increases a few days after the onset of the disease;
The growth of c-reactive protein levels is influenced by the actual disease and, unlike the ESR result, is not affected by factors such as gender, age, temperature, plasma protein levels, and the number of red blood cells;
Analysis for c-reactive protein makes it possible to detect even minor inflammatory processes.

Based on the values of c-reactive protein, as well as the ESR indicator, conclusions can be drawn about possible inflammation. The analysis also helps to evaluate the effectiveness of therapy when monitoring patients who have undergone surgery. However, it must be taken into account that the state of pregnancy itself can also cause an increase in these indicators.

Reasons for high C-reactive protein levels during pregnancy

During inflammatory processes, the concentration of C-reactive protein indicates the severity of the disease. If the value is more than two hundred mg/l, a possible cause may be an exacerbation of chronic diseases.

Analysis for c-reactive protein allows you to assess the correctness of therapy, since the values change quickly in the case of positive dynamics, and normalize on average within a week after the start of treatment. If this does not happen, the doctor concludes that the chosen treatment method was ineffective and, without wasting time, prescribes another therapy.

Various tissue damages - surgical interventions, injuries - increase the result of c-reactive protein. Also, the cause may be myocardial infarction. Myocardial infarction is the most dangerous diagnosis or cardiovascular disease. High levels of C-reactive protein from the fifth to the nineteenth week of pregnancy may indicate a risk of spontaneous abortion. With a CRP value above eight mg/l, the likelihood of premature birth doubles.

The presence of toxicosis can cause an increase in CRP to twenty mg/l. Also, an increase in the level of protein in the blood serum can be provoked by heavy physical activity, taking hormonal drugs. Hormonal drugs are not only contraceptives, smoking and other factors.

To make a reliable diagnosis, the results of several studies are compared, which may indicate a possible inflammatory process in the body. If C-reactive protein is high, you need to take a repeat test after five to seven days. All recommendations and prescriptions of medications are made by the attending physician, based on the results of a set of tests.

Preparing for analysis

A biochemical blood test determines the level of c-reactive protein. Venous blood is taken for analysis. Incorrect preparation for the analysis can affect the meaning of the result, so lead the right lifestyle before taking it:

The last food intake is allowed twelve hours before the analysis. Since the test is usually scheduled for the morning, this means that you will need to donate blood on an empty stomach;
On the eve of the study, fatty, fried, spicy or salty foods are contraindicated;
The presence of alcohol in the blood distorts the test result;
You should not drink juices, coffee, or tea the day before the test. You can only drink clean still water;
You should not smoke for at least half an hour before donating blood;
Severe physical and emotional stress shortly before donating blood will distort the data.

Scientists have established the relationship between breastfeeding Breastfeeding: feed - and no nails! girls in infancy and their C-reactive protein levels in adulthood. Thus, those girls who grew up on breast milk had an average CRP of about 2.2 milligrams per liter of plasma at the age of 26, and cholesterol of 4.6. In the remaining girls, at the age of 26, c-reactive protein averaged about four mg/l, and total cholesterol was more than five. This pattern was not found in men.

This is another argument for breastfeeding. The study of the phenomenon continues, but today we can say that breastfeeding will have a positive effect on the child’s health, including in the long term.

Norm C reactive protein during pregnancy

C - reactive protein during pregnancy is a diagnostic marker that may indicate the presence of inflammatory processes in the body. Pregnancy is an important period in a woman’s life, which is monitored by a gynecologist, and a number of tests are performed according to his orders. Thanks to regular examinations, you can get a high-quality picture of the progress of pregnancy.

During pregnancy, it is important to pay attention to the results of this analysis. Thanks to timely diagnostics, you can find out all the subtleties of the process.

Norm of C-reactive protein

The human body is a mechanism in which all vital systems work harmoniously. Its performance is influenced by many factors. During pregnancy, the performance of the female body increases, due to the development of the fetus, many systems work in a special way.

C - reactive protein, this is the main indicator of any changes at the cellular level. The presence of protein may indicate a number of diseases that occur in the body. The C-reactive protein level should not exceed 0.5 mg/l. This protein reacts sharply to the presence of the causative agent of the disease and after 2–4 hours, its indicators may change. During pregnancy, protein levels have their own characteristics; its level can increase to 3 mg/l, and this will be considered normal.

A certain degree of increase in protein indicates various diseases:

up to 10 mg/l is a sign of atherosclerosis;
from 10 to 30 mg/l indicates rheumatic diseases and viral complications;
from 40 to 200 mg/l, such a high indicator indicates the presence of serious pathologies in the body.

In order to find out the amount of C-reactive protein in the blood, it is necessary to undergo a biochemical analysis.

In pregnant women, many indicators may deviate from the norm, and only a doctor can talk about the presence of normality or pathology in the body.

Causes of high C-reactive protein levels

A biochemical blood test is a reliable indicator of ongoing changes in the human body.

Variations in the level of c-reactive protein are influenced by many factors, the most common:

The level of C-reactive proteins may also increase in the postoperative period. Bacterial, fungal, and infectious diseases also leave a mark on the result. With timely and high-quality treatment, the indicator quickly returns to a stable state. Otherwise, if C-reactive protein remains high, this may indicate exacerbations of the disease.

C-reactive protein is very sensitive to various neoplasms; when cancer cells appear, the amount of protein increases sharply. Biochemical analysis is an additional diagnostic marker for identifying oncology.

How to influence C-reactive protein levels

The normal level of C-reactive protein is an indicator of health. This enzyme reacts acutely already in the initial stages of any disease. But it also depends on secondary factors that can be adjusted independently. In order to bring the protein level back to normal, the root cause, that is, the pathogen, must be eliminated.

Compliance with basic nutrition rules. Pregnant women have a deficiency of potassium and magnesium; to replenish it, they need to eat more fruits and vegetables. Also, in many cases, the doctor prescribes a vitamin complex that contains the required daily dose of all elements.
Cholesterol level is an important indicator that needs constant monitoring. During pregnancy, you should avoid fatty foods to avoid unpleasant consequences.
Controlling your weight is always important, but during pregnancy this topic becomes especially relevant. Excess weight can negatively affect your well-being and health.

Pay attention to your blood sugar levels. Sharp surges in sugar levels in pregnant women are possible throughout the entire period of pregnancy. This is an important indicator for identifying many diseases and abnormalities.
Monitor blood pressure. Blood pressure changes quite often in pregnant women, which is why it is so important to regularly visit a doctor for examination and examination.
To refuse from bad habits. During such an important period, you should stop smoking and drinking alcohol, as such habits can cause irreparable harm to the child’s body.

Purpose and preparation for analysis

Biochemical analysis to detect C-reactive protein is a reliable method for determining any changes in the body. Using this method, it is possible to identify not only inflammatory foci, but also to distinguish a viral pathogen from a bacterial one.

This analysis is prescribed for the following conditions:

people over 50 years old;
the presence of chronic diseases such as diabetes mellitus, atherosclerosis;
diseases of the cardiovascular system, surges in blood pressure;
as control over the intake of certain medications;
the presence of any neoplasms;
infectious diseases.

For reliable readings, the preparatory stage is important and cannot be ignored. Improper preparation can lead to distorted results.

In order for the C-reactive protein level to be accurate, the following rules should be followed:

Eating food at least 12 hours ago, it is important to calculate this time with your doctor.
The day before the test, you must avoid fried and fatty foods, alcoholic beverages, coffee and juices. One day before the test, you can drink only plain water.
Strong physical activity and emotional instability can also distort the result.

The optimal time to take the test is in the morning. By following these simple recommendations, you can get reliable results with maximum accuracy.

Causes of elevated C-reactive protein

When C-reactive protein is elevated, you need to look for reasons. This name refers to a glycoprotein, the production of which is responsible for the liver. CRP in the blood above normal indicates that some system is severely inflamed.

general information

Already six hours after the start of the inflammatory process, an increase in the synthesis of C-reactive protein occurs. At the same time, after one or two days, CRP in the blood will immediately exceed the normal concentration. Most often, a high level of CRP can be noted during a bacterial infection, especially in a child. If we are talking about a viral infection, then the blood test will usually not go beyond 20 mg/l in terms of protein. A positive test result will also be obtained in the case of tissue necrosis, which manifests itself during myocardial infarction or necrosis as a result of a tumor.

Most often, a blood test for CRP is prescribed when necessary to diagnose:

various infectious inflammations, autoimmune processes;
bacterial and viral infection;
activity of the inflammatory process;
complications after surgery or infection;
hidden infections;
How effective is the treatment?

In addition, such a blood test is prescribed for fairly serious indications. For example, when with pancreatic necrosis it is necessary to assess a possible fatal outcome. It can also be used to track the progression of malignant tumors. Of course, an increase in CRP is a consequence, so treatment should be based on finding the cause.

Why is protein elevated?

If a blood test shows an elevated level of CRP, the reasons for this phenomenon may be different. Quite often, such a positive test is observed after an acute infection, especially in the case of a child. If you have any chronic disease, including allergies, then such an elevated blood test may be a signal for the onset of its acute form.

Tissue damage cannot be ruled out. Treatment is not always required here. After all, we are even talking about primitive injuries, burns, as well as the postoperative period.

The reasons for the increase are often problems with blood pressure, and in particular, with its increase. If endocrine pathologies are present in the body, such as diabetes, obesity or an excessive amount of female hormones, then the analysis will also demonstrate increased CRP.

The reasons for the increase also often lie in an unhealthy lifestyle. In particular, smoking has this effect. An increase in CRP occurs in women during pregnancy. Treatment, of course, is not required in this case. During pregnancy, this increase is due to physiological reasons.

There may be other harmless reasons. For example, significant physical activity or taking hormonal contraceptives also lead to increased CRP. A reduced level of CRP is also noted. It is associated with the use of certain drugs, including non-steroidal anti-inflammatory drugs. Speaking specifically about testing, most doctors prefer a quantitative analysis of CRP. Within its framework, changes in indicators will be presented, and in qualitative terms, an increase is indicated using a system of pluses.

Testing Features

Many people believe that any disturbance in the body manifests itself in the form of specific symptoms. Unfortunately, it is not. This also applies to increasing CRP. The absence of any specific symptoms is primarily due to the fact that, by and large, an increase in CRP is only a consequence, and not a separate disease. Therefore, it is possible to determine that you have an increase in CRP only after passing the test.

However, doctors traditionally refer representatives of the older age group for such a study, even as part of a routine examination, of patients undergoing hemodialysis. The risk group for increased CRP includes people suffering from hypertension and coronary heart disease.

Coronary bypass surgery is also an indication for testing, since there may be complications after it. Analysis is necessary when treating cardiovascular complications in patients with cardiac problems.

Analysis for CRP allows you to evaluate the effectiveness of treatment of bacterial infections and chronic diseases. Neoplasms and acute infections are also reasons to check CRP levels.

It is worth noting that during pregnancy, women diagnosed with preeclampsia have higher CRP levels than healthy women during pregnancy. However, it will be impossible to establish this in the first days of pregnancy. At 16 weeks, the normal level for women is 2.9 mg/l.

Treatment methods

Deviation of CRP from the norm, when there are no physiological prerequisites for this, requires treatment. This is because elevated CRP can be a sign of risk for cardiovascular disease.

Of course, the prescription of a specific treatment is carried out only by a specialist after passing all the tests and studies. The level of such a protein can only be reduced if the root cause of the increase has been established. Treatment is prescribed individually for each patient.

To enhance the effectiveness of treatment, it is advisable to include a diet in addition to medications. It is necessary to choose products that will further strengthen the cardiovascular system. In addition, you will need to reduce blood cholesterol. To keep your body in good shape, you will need to exercise regularly and also monitor your weight, especially if you have problems with it.

For those suffering from diabetes, checking your sugar levels and blood pressure is mandatory. It is necessary to stop smoking and completely eliminate alcoholic beverages. Only all these measures taken together will quickly and effectively reduce the level of DRR.

C-reactive protein in the blood: normal in tests, why it increases, role in diagnosis

C-reactive protein (CRP, C-Reactives protein - CRP) is a fairly old laboratory test, which, like ESR, shows that an acute inflammatory process is going on in the body. CRP cannot be detected by conventional methods; in a biochemical blood test, an increase in its concentration is manifested by an increase in α-globulins, which it, along with other acute-phase proteins, represents.

The main reason for the appearance and increase in the concentration of C-reactive protein is acute inflammatory diseases, which give a multiple (up to 100 times) increase in this acute-phase protein within hours of the start of the process.

CRP in the blood and a separate protein molecule

In addition to the high sensitivity of CRP to various events occurring in the body, changes for the better or worse, it responds well to therapeutic measures, and therefore can be used to control the course and treatment of various pathological conditions accompanied by an increase in this indicator. All this explains the high interest of clinicians, who called this acute-phase protein a “golden marker” and designated it as a central component of the acute phase of the inflammatory process. At the same time, the detection of CRP in a patient’s blood was associated with certain difficulties at the end of the last century.

Problems of the last century

The detection of C-reactive protein until almost the end of the last century was problematic, due to the fact that CRP was not amenable to traditional laboratory tests that make up a biochemical blood test. The semi-quantitative method of ring precipitation in capillaries using antiserum was rather qualitative, since it was expressed in “pluses” depending on the number (in millimeters) of flakes (precipitates) that fell out. The biggest drawback of the analysis was the time spent on obtaining the results - the answer was ready only after a day and could have the following values:

No sediment – the result is negative;
1mm sediment - + (slightly positive reaction);
2 mm - ++ (positive reaction);
3mm - +++ (pronounced positive);
4 mm - ++++ (strongly positive reaction).

Of course, waiting 24 hours for such an important analysis was extremely inconvenient, because in a day a lot could change in the patient’s condition and often not for the better, so doctors most often had to rely primarily on ESR. The erythrocyte sedimentation rate, which is also a nonspecific indicator of inflammation, unlike CRP, was determined within an hour.

Currently, the described laboratory criterion is valued higher than both ESR and leukocytes - indicators of a general blood test. C-reactive protein, which appears before the increase in ESR, disappears as soon as the process subsides or the treatment has its effect (after 1 - 1.5 weeks), while the erythrocyte sedimentation rate will be above normal values for up to a month.

How is CRP determined in the laboratory and what do cardiologists need?

C-reactive protein is one of the very important diagnostic criteria, so the development of new methods for its determination has never faded into the background, and nowadays tests to detect CRP have ceased to be a problem.

C-reactive protein, which is not included in the biochemical blood test, can be easily determined using latex test kits, which are based on latex agglutination (qualitative and semi-quantitative analysis). Thanks to this technique, in less than half an hour the answer, which is so important to the doctor, will be ready. Such a rapid study has proven itself to be the very initial stage of the diagnostic search for acute conditions; the technique correlates well with turbidimetric and nephelometric methods, therefore it is suitable not only for screening, but also for the final decision regarding diagnosis and choice of treatment tactics.

The concentration of this laboratory indicator is determined using highly sensitive latex-enhanced turbidimetry, enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay methods.

It should be noted that very often the described criterion is used to diagnose pathological conditions of the cardiovascular system, where CRP helps to identify possible risks of complications, monitor the progress of the process and the effectiveness of measures taken. It is known that CRP itself is involved in the formation of atherosclerosis, even at relatively low values of the indicator (we will return to the question of how this happens). To solve such problems, traditional methods of laboratory diagnostics do not satisfy cardiologists, so in these cases, high-precision hsCRP measurement is used in combination with the lipid spectrum.

In addition, this analysis is used to calculate the risk of developing cardiovascular pathology in diabetes mellitus, diseases of the excretory system, and unfavorable course of pregnancy.

Norm SRB? One for all, but...

In the blood of a healthy person, the level of CRP is very low or this protein is completely absent (in a laboratory test, but this does not mean that it is not there at all - the test simply does not detect tiny amounts).

The following limits of values are accepted as the norm, and they do not depend on age and gender: for children, men and women it is one - up to 5 mg/l, the only exception is newborn children - they are allowed to have up to 15 mg/l of this acute-phase protein (as evidenced by reference literature). However, the situation changes if sepsis is suspected: neonatologists begin urgent measures (antibiotic therapy) when the child’s CRP increases to 12 mg/l, while doctors note that a bacterial infection in the first days of life may not cause a sharp increase in this protein.

A laboratory test is prescribed to detect C-Reactives protein in the case of many pathological conditions accompanied by inflammation, the cause of which is infection or destruction of the normal structure (destruction) of tissues:

Acute period of various inflammatory processes;
Activation of chronic inflammatory diseases;
Infections of viral and bacterial origin;
Allergic reactions of the body;
Active phase of rheumatism;
Myocardial infarction.

In order to better understand the diagnostic value of this analysis, it is necessary to understand what acute phase proteins are, learn about the reasons for their appearance in the patient’s blood, and consider in more detail the mechanism of immunological reactions during an acute inflammatory process. Which is what we will try to do in the next section.

How and why does C-reactive protein appear during inflammation?

CRP and its binding to the cell membrane in case of damage (for example, during inflammation)

SRP, participating in acute immunological processes, promotes phagocytosis at the first stage of the body's response (cellular immunity) and is one of the key components of the second phase of the immune response - humoral immunity. It happens like this:

The destruction of cell membranes by a pathogen or other factor leads to the destruction of the cells themselves, which does not go unnoticed by the body. Signals sent from the pathogen or from leukocytes located near the site of the “accident” attract phagocytic elements to the affected area, capable of absorbing and digesting particles foreign to the body (bacteria and the remains of dead cells).
The local response to remove dead cells causes an inflammatory response. Neutrophils, which have the highest phagocytic ability, rush to the scene of the incident from the peripheral blood. A little later, monocytes (macrophages) arrive there to help with the formation of mediators that stimulate the production of acute phase proteins (CRP), if necessary, and to act as a kind of “janitors” when it is necessary to “clean up” the source of inflammation (macrophages are able to absorb particles , exceeding themselves in size).
To carry out the processes of absorption and digestion of foreign factors at the site of inflammation, the production of its own proteins (C-reactive protein and other acute phase proteins) is stimulated, capable of resisting an invisible enemy, enhancing by its appearance the phagocytic activity of leukocyte cells and attracting new components of the immune system to fight infection . The role of inducers of this stimulation is taken on by substances (mediators) synthesized by macrophages “ready for battle” located in the lesion and arriving in the zone of inflammation. In addition, other regulators of the synthesis of acute-phase proteins (cytokines, glucocorticoids, anaphylotoxins, mediators formed by activated lymphocytes) are also involved in the formation of CRP. CRP is produced primarily by liver cells (hepatocytes).
Macrophages, after performing their main tasks in the area of inflammation, leaving, capture the foreign antigen and are sent to the lymph nodes to present it there (antigen presentation) to immunocompetent cells - T-lymphocytes (helpers), which recognize it and give the command to B-cells to begin antibody formation (humoral immunity). In the presence of C-reactive protein, the activity of lymphocytes with cytotoxic abilities increases markedly. From the beginning of the process and at all its stages, CRP itself is actively involved in the recognition and presentation of the antigen, which is possible thanks to other immunity factors with which it is in close relationship.
Within half a day (approximately 12 hours) from the start of cell destruction, the concentration of serum C-reactive protein will increase many times. This gives grounds to consider it one of the two main acute phase proteins (the second is serum amyloid protein A), which carry the main anti-inflammatory and protective functions (other acute phase proteins perform primarily regulatory tasks during inflammation).

Thus, an increased level of CRP indicates the onset of an infectious process at a very early stage of its development, and the use of antibacterial and anti-inflammatory drugs, on the contrary, reduces its concentration, which makes it possible to give this laboratory indicator special diagnostic significance, calling it the “golden marker” of clinical laboratory diagnostics.

Cause and investigation

For its qualities that ensure the performance of numerous functions, C-reactive protein was nicknamed “two-faced Janus” by a witty researcher. The nickname turned out to be apt for a protein that performs many tasks in the body. Its versatility lies in the roles it plays in the development of inflammatory, autoimmune, necrotic processes: the ability to bind to many ligands, recognize foreign agents, and promptly attract the body’s defenses to destroy the “enemy.”

Probably, each of us has at some point experienced the acute phase of an inflammatory disease, where C-reactive protein plays a central role. Even without knowing all the mechanisms of SRP formation, you can independently suspect that the whole body is involved in the process: the heart, blood vessels, head, endocrine system (the temperature rises, the body “aches”, the head hurts, the heartbeat quickens). Indeed, the fever itself already indicates that the process has begun, and changes in metabolic processes in various organs and entire systems have begun in the body, caused by an increase in the concentration of acute-phase markers, activation of the immune system, and a decrease in the permeability of vascular walls. These events are not visible to the eye, but are determined using laboratory indicators (CRP, ESR).

C-reactive protein will be elevated within the first 6-8 hours from the onset of the disease, and its values will correspond to the severity of the process (the more severe the course, the higher the CRP). Such properties of CRP allow it to be used as an indicator at the onset or course of various inflammatory and necrotic processes, which will be the reasons for the increase in the indicator:

Bacterial and viral infections;
Acute cardiac pathology (myocardial infarction);
Oncological diseases (including tumor metastasis);
Chronic inflammatory processes localized in various organs;
Surgical interventions (violation of tissue integrity);
Injuries and burns;
Complications of the postoperative period;
Gynecological pathology;
Generalized infection, sepsis.

Elevated CRP often occurs with:

It should be noted that the indicator values for different groups of diseases may differ significantly, for example:

Viral infection, tumor metastases, rheumatic diseases, which proceed sluggishly, without severe symptoms, give a moderate increase in the concentration of CRP - up to 30 mg/l;
Exacerbation of chronic inflammatory processes, infections caused by bacterial flora, surgical interventions, acute myocardial infarction can increase the level of the acute phase marker by 20 or even 40 times, but in most cases from such conditions an increase in concentration can be expected to 40 - 100 mg/l ;
Severe generalized infections, extensive burns, septic conditions can very unpleasantly surprise clinicians with numbers indicating the content of C-reactive protein; they can reach prohibitive values (300 mg/l and much higher).

And one more thing: without wanting to scare anyone, I would like to raise a very important issue regarding the increased amount of CRP in healthy people. A high concentration of C-reactive protein with complete external well-being and the absence of signs of any pathology suggests the development of an oncological process. Such patients should undergo a thorough examination!

but on the other hand

In general, in its properties and abilities, SRP is very similar to immunoglobulins: it “can distinguish between self and foe, bind to the components of the bacterial cell, ligands of the complement system, and nuclear antigens. But today two types of C-reactive protein are known and how they differ from each other, thereby adding new functions to C-Reactives protein, can be shown by a clear example:

The native (pentameric) acute phase protein, discovered in 1930 and consisting of 5 interconnected ring subunits located on the same surface (therefore it was called pentameric and attributed to the pentraxin family) is the CRP that we know and are talking about. Pentraxins consist of two sections responsible for specific tasks: one recognizes a “stranger”, for example, an antigen of a bacterial cell, the other “calls for help” those substances that have the ability to destroy the “enemy”, since the SRB itself does not have such abilities;
“New” (neoCRP), represented by free monomers (monomeric CRP, which is called mCRP), which has other properties that are not characteristic of the native version (fast mobility, low solubility, acceleration of platelet aggregation, stimulation of production and synthesis of biologically active substances). A new form of C-reactive protein was discovered in 1983.

A detailed study of the new acute-phase protein revealed that its antigens are present on the surface of lymphocytes circulating in the blood, killer cells and plasma cells, and it is obtained (mCRP) from the transition of a pentameric protein into a monomeric protein during the rapid development of the inflammatory process. However, the most important thing that scientists have learned about the monomeric variant is that the “new” C-reactive protein contributes to the formation of cardiovascular pathology. How does this happen?

Elevated CRP is involved in the formation of atherosclerosis

The body's response to the inflammatory process sharply increases the concentration of CRP, which is accompanied by an increased transition of the pentameric form of C-reactive protein to the monomeric one - this is necessary to induce the reverse (anti-inflammatory) process. An increased level of mCRP leads to the production of inflammatory mediators (cytokines), adhesion of neutrophils to the vascular wall, activation of the endothelium with the release of factors that cause spasm, the formation of microthrombi and impaired circulation in the microvasculature, that is, the formation of atherosclerosis of arterial vessels.

This should be taken into account in the latent course of chronic diseases with a slight increase in the level of CRP (domg/l). A person continues to consider himself healthy, but the process slowly develops, which can lead first to atherosclerosis, and then to myocardial infarction (the first) or other thromboembolic complications. Can you imagine how much risk a patient has if he has elevated concentrations of C-reactive protein in a blood test, a predominance of the low-density lipoprotein fraction in the lipid spectrum, and high values of the atherogenic coefficient (AA)?

In order to prevent sad consequences, patients at risk must remember to take the tests necessary for themselves, moreover, their CRP is measured by highly sensitive methods, and LDL is examined in the lipid spectrum with the calculation of the atherogenicity coefficient.

The main tasks of the DRR are determined by its “many faces”

The reader may not have had all of his questions answered regarding the central acute phase component, C reactive protein. Considering that complex immunological reactions of stimulation, regulation of CRP synthesis and its interaction with other immune factors are unlikely to be of interest to a person far from these scientific and incomprehensible terms, the article focused on the properties and important role of this acute-phase protein in practical medicine.

And the importance of SRP is truly difficult to overestimate: it is indispensable in monitoring the course of the disease and the effectiveness of therapeutic measures, as well as in diagnosing acute inflammatory conditions and necrotic processes, where it exhibits high specificity. At the same time, it, like other acute-phase proteins, is also characterized by nonspecificity (a variety of causes for increased CRP, the multifunctionality of C-reactive protein due to the ability to bind to many ligands), which does not allow using this indicator to differentiate various conditions and establish an accurate diagnosis ( No wonder they called him “two-faced Janus”?). And then, it turns out, it takes part in the formation of atherosclerosis...

On the other hand, the diagnostic search involves many laboratory tests and instrumental diagnostic methods that will help CRP and the disease will be established.

The value and norm of c-reactive protein

Damage to the cells of any organ is accompanied by increased production of c-reactive protein by the liver. Binding of c-polysaccharide is one of the main functions of c-reactive protein; in addition, it is a stimulator of leukocyte production. C-reactive protein detected from the onset of the disease and during its acute phase.

A biochemical blood test determines the level of CRP (c-reactive protein) in the blood plasma. It should normally be less than five mg/l. However, there are a number of factors that contribute to its increased concentration. C-reactive protein in pregnant women can increase to 20 mg/liter. If other indicators in the tests are normal and you feel good, then there is no reason to worry. But with significantly elevated levels of c-reactive protein, you need to look for the source of the disease.

Test for C-reactive protein or ESR?

C-reactive protein increases after four hours from the onset of the disease, and the ESR rate increases a few days after the onset of the disease;
The growth of c-reactive protein levels is influenced by the actual disease and, unlike the ESR result, is not affected by factors such as gender, age, temperature, plasma protein levels, and the number of red blood cells;
Analysis for c-reactive protein makes it possible to detect even minor inflammatory processes.

Reasons for high C-reactive protein levels during pregnancy

Often the cause of a large increase in CRP is an infection. With a bacterial infection, its level can increase from 80 to 100 mg/l. With a viral infection, there is a slight increase in CRP, up to approximately twenty mg/l.
During inflammatory processes, the concentration of C-reactive protein indicates the severity of the disease. If the value is more than two hundred mg/l, a possible cause may be an exacerbation of chronic diseases.

Various tissue damages - surgical interventions, injuries - increase the result of c-reactive protein. Myocardial infarction may also be the cause. Myocardial infarction is the most dangerous diagnosis or cardiovascular diseases. High levels of C-reactive protein from the fifth to the nineteenth week of pregnancy may indicate a risk of spontaneous abortion. With a CRP value above eight mg/l, the likelihood of premature birth doubles.

The presence of toxicosis can cause an increase in CRP to twenty mg/l. Also, an increase in protein levels in the blood serum can be provoked by heavy physical activity and taking hormonal drugs. Hormonal drugs are not only contraceptives, smoking and other factors.

Preparing for analysis

The last food intake is allowed twelve hours before the analysis. Since the test is usually scheduled for the morning, this means that you will need to donate blood on an empty stomach;
On the eve of the study, fatty, fried, spicy or salty foods are contraindicated;
The presence of alcohol in the blood distorts the test result;
You should not drink juices, coffee, or tea the day before the test. You can only drink clean still water;
You should not smoke for at least half an hour before donating blood;
Severe physical and emotional stress shortly before donating blood will distort the data.

Despite the fact that this substance was discovered at the beginning of the last century, to this day the analysis of reactive protein is widely used in any medical practice. If C-reactive protein is elevated, it means there is inflammation in the body, the activity of which helps determine this indicator. And although it is impossible to make any specific diagnosis using this analysis, it can be indispensable when first examining a person or when monitoring the activity of a chronic disease.

You can learn how to interpret the results of the examination, determine the risk of cardiovascular complications and even predict the course of pregnancy using reactive blood protein from this article.

What is SRB

C-reactive protein (abbreviated as CRP) is a complex mixture of carbohydrates and proteins that is produced in liver cells. In the blood of a healthy person, its content is so low that most devices can even show a zero result. The production of this substance is stimulated by any factors that pose a threat to the body. These include:

Harmful bacteria;
Any viruses;
Pathogenic fungi;
Trauma, including surgery;
Damage to internal organs (heart attacks, strokes, tissue rupture, etc.);
Tumors and growth of metastases;
Autoimmune reactions are immune disorders in which blood cells begin to produce substances that damage healthy tissue.

High C-reactive protein activates the body's defense systems. It is an important part of the immune system, which activates the release of antimicrobial and antiviral substances, and also stimulates the work of protective cells.

A side effect of protein is its effect on fat metabolism. In high concentrations, this compound promotes the deposition of “bad cholesterol” (low-density lipoprotein - LDL) in the artery wall. That is why the measurement of this indicator is used to assess the risk of vascular complications.

Norm

Unlike most indicators, the C-reactive protein norm is universal for all groups of the population, regardless of age and gender.

Exceeding this value, in most cases, allows one to suspect an inflammatory or oncological disease, depending on the presence of certain changes in the person’s body.

With the development of knowledge about this substance and the advent of new high-precision equipment, scientists began to talk about another indicator - it is called the basic value of CRP. This value allows us to estimate in a person, which does not suffer from any inflammatory reaction, the risk of damage to the heart and arterial vessels. The norm for the basic level of reactive protein differs significantly from traditional data - it is less than 1 mg/l.

It is better to take tests in the same laboratory, because... CRP is determined by different methods, using:

radial immunodiffusion;
nephelometry,

therefore, repeated results may differ, which will prevent the dynamics from being interpreted correctly.

Comparison with ESR

In addition to C-reactive protein, ESR () is also a marker of acute inflammation in the body. What they have in common is that both indicators increase in a number of diseases. What is their difference:

CRP increases much earlier and decreases faster. Therefore, in the early stages of diagnosis, it is more informative than ESR.
If the treatment is effective, then the c-reaction. protein decreases on days 7-10, and ESR decreases only after 14-28 days.
The results of ESR are influenced by the time of day, plasma composition, number of red blood cells, gender (higher in women), but the results of CRP do not depend on these factors.

It becomes clear that the C reactive protein test is a more sensitive method for assessing inflammation than ESR. If you suspect any disease, to establish the cause, determine whether the process is acute or chronic, assess the activity of inflammation and the effectiveness of the therapy, it is more informative and convenient.

Reasons for the increase

There are 3 main groups of reasons that can lead to an increase in the content of CRP in the blood - the inflammatory process and pathology of arterial vessels. They include a huge number of diseases, between which it is necessary to conduct a diagnostic search. The degree of protein increase helps to roughly navigate the pathologies:

More than 100 mg/l– such a strong immune reaction is most often observed with bacterial infections (microbial pneumonia, salmonellosis, shigellosis, pyelonephritis, etc.);
20-50 mg/l– this level is more typical for human viral diseases, such as mononucleosis, adenovirus or rotavirus infection, herpes and others;
Less than 19 mg/l– a slight excess of the normal value can occur due to any significant factor affecting the body. However, with constantly elevated CRP, autoimmune and oncological pathologies should be excluded.

But, the level of CRP is a very approximate indicator, and even the boundaries indicated above are quite arbitrary. It happens that a patient with rheumatoid arthritis has a CRP above 100 during an exacerbation. Or in a septic patient 5-6 mg/l.

When the inflammatory process begins, literally in the first hours the protein concentration will increase, and may be more than 100 mg/l; after 24 hours there will be a maximum concentration.

Under what conditions and diseases does it increase:

After major surgery
After injuries, burns
After transplantation, if CRP increases, this indicates graft rejection
For tuberculosis
For peritonitis
For rheumatism
Endocarditis, myocardial infarction
Oncological diseases with metastases
Acute infections - fungal, viral, bacterial
For helminthiases
Multiple melanoma
For various autoimmune diseases
Severe allergic reactions

How informative is it for chronic diseases?

For diagnosing chronic diseases, this analysis is not very informative. In diseases such as rheumatoid arthritis, systemic vasculitis, sponylarthropathy, myopathies, the result of the analysis depends on the activity of the process, and it is used to assess the effectiveness of therapy. The prognosis is unfavorable if the amount of protein does not decrease, but increases.

Examples of analysis evaluation for specific diseases:

Myocardial infarction- in this condition, CRP increases after 20-30 hours. Then from the 20th day it begins to decrease, and after 1.5 months it returns to normal. High protein levels mean an unfavorable prognosis and the likelihood of death. Repeated growth indicates relapse.
Rheumatoid arthritis- protein is determined both for diagnosis and for monitoring treatment, but it is impossible to distinguish rheumatoid polyarthritis from arthritis.
For systemic lupus erythematosus the level of analysis will be within normal limits if there is no serositis. An increase in its concentration may indicate the occurrence of arterial thrombosis.
Malignant tumors- not specific for oncology, also increases with relapse after treatment. Used in combination with other methods for assessing the effectiveness of treatment (tumor markers).
Bacterial infections- here CRP levels are much higher than with viral infections.
Angina pectoris - with stable angina the levels are most often normal, but with unstable angina the levels increase.
— the amount of protein depends on the activity of the process.
Even a slight increase of up to 10 mg/l C-reactive protein indicates the risk of thromboembolism, atherosclerosis and myocardial infarction.

The patient’s condition, age and gender can make the doctor’s task easier. For example, young women have an extremely low risk of having atherosclerosis, and men 50-60 years old have a low chance of contracting a childhood infection. The most typical causes of elevated C-reactive protein for different population groups are discussed below.

Reasons for the increase in children

Infections are the most dangerous conditions for young patients, especially those less than 7-10 years of age. Since most children do not have time to develop chronic organ damage (ischemic heart disease, chronic kidney disease, cholecystitis, etc.), with elevated C-reactive protein, an infectious process should first be excluded.

There are a large number of diseases caused by microorganisms, but in children, lesions of the digestive tract and respiratory tract are most common. They can occur acutely with the appearance of pronounced symptoms (dysentery, salmonellosis, pneumonia, ARVI and others) or develop slowly in the body, causing a chronic disease. Bronchitis, tonsillitis, sinusitis, gastritis, etc. can occur in this way.

Only after excluding the listed pathologies should one look for other factors in the child’s body that can increase the concentration of CRP. Of course, this stage can be skipped if there are characteristic symptoms or test results confirming a different diagnosis.

Indicator for women

In the absence of obvious symptoms and an increase in c-reactive protein in women, it is necessary to conduct a thorough diagnostic search. This is especially true for the age group of 30-60 years. It was at this time that there was a significant increase in incidence among the fair sex. First of all, the presence of the following pathologies should be excluded:

Gynecological diseases(endomentriosis, endometritis, true cervical erosion, cervicitis and others);
Oncology– it is women aged 40-60 who often experience the debut of tumor growth, for example breast cancer or cervical cancer. In order to detect them promptly and treat them at an early stage, it is strongly recommended to undergo an annual examination by a gynecologist, starting from the age of 35;
Foci of chronic infection. CRP is an excellent indicator of prolonged inflammatory reactions. Despite the fact that they may not bother a person (up to a certain time) and may not reduce his quality of life, their presence is still reflected in the analysis of reactive protein in women.

What infections should be excluded? In the first place among girls are lesions of the genitourinary tract: chronic pyelonephritis, cystitis, urethritis, sexually transmitted infections (chlamydia, mycoplasmosis, gardnerellosis, etc.). The next most common diseases are pathologies of the digestive system - pancreatitis, chronic cholecystitis, intestinal dysbiosis and others.

The absence of these diseases against the background of increased CRP is a reason to continue the diagnosis in order to detect the pathology of other tissues/organs.

Increased rate in men

Despite the fact that men are considered the stronger sex, their morbidity and mortality rates significantly exceed those of women. However, acute infections are not the leading pathology in adults. A more serious problem is chronic diseases, which gradually damage various tissues and lead to depletion of the body's resources. Their diagnosis can be quite difficult, and often the first sign is an increase in C-reactive protein.

To facilitate the diagnostic search, you should remember which pathologies are most common in middle-aged and older men. In the absence of obvious symptoms suggesting a specific diagnosis, it is recommended to exclude these diseases first:

Group of diseases	Predisposing factors	Additional tests needed to make a diagnosis
Respiratory organ damage: Chronic obstructive pulmonary lesions (chronic bronchitis, emphysema); Occupational diseases (silicosis, pneumoconiosis, silicotuberculosis and others).	Work in hazardous industries (constant contact with toxic gases, heavy metals, dust particles, etc.); Long smoking history; Living in an environmentally unfavorable area (near factories, mining facilities); The presence of other pathologies of the respiratory system (bronchial asthma, tuberculosis).	Spirometry with a bronchodilator test is a method that allows you to evaluate the patency of the bronchi and the ability of the lungs to fill with air; X-ray/fluorography of the lungs; Peak flowmetry is a diagnostic method that determines the maximum expiratory flow rate. It is necessary to assess the patency of the bronchial tree; Pulse oximetry is the measurement of oxygen concentration in the blood. Used to determine the presence/absence of respiratory failure.
Chronic gastrointestinal lesions: GERD; Gastritis; Peptic ulcer of the duodenum/stomach; Pancreatitis; Cholecystitis; Crohn's disease; Ulcerative colitis.	Compounded heredity (presence of close relatives with one of the listed pathologies); Smoking; Frequent drinking of alcohol; Regular eating disorders; Overweight; Frequent use of anti-inflammatory drugs (Paracetamol, Ketorol, Citramon, etc.).	FGDS - examination of the walls of the stomach and the initial part of the small intestine using special instruments (endoscopes); X-ray of the stomach/Irrigoscopy is a method that allows one to determine the patency of the digestive tract and the presence of significant damage to the walls of organs; Biochemical blood test; Ultrasound (gallbladder, pancreas, liver).
Damage to the genitourinary organs: Urolithiasis (UCD); Glomerulonephritis; Prostatitis; Infections that are sexually transmitted (chlamydia, mycoplasma/ureaplasma infection, gardnerellosis, etc.)	Compounded heredity (only for ICD and glomerulonephritis); Intermittent sexual intercourse; Congenital defects of the urinary tract (prolapse of the kidney, abnormal position of the ureters, abnormal connection of the ureters and bladder).	General and bacteriological urine analysis; Microflora smear examination; Excretory urography; Ultrasound of the urinary system.
Tumors	Family history is an extremely important factor, especially if close relatives suffered from cancer/sarcomas at a young age; Work with radiation (flaw detection operator, service on nuclear submarines, work at nuclear power plants, etc.); Any chronic inflammatory reaction that has not been adequately treated; Smoking and alcoholism; Contact with carcinogens (working in hazardous industries and living in an environmentally unfavorable area).	Diagnosis depends on the location of the tumor. To establish a diagnosis, computed tomography and biopsy (taking part of the tumor) are almost always used.

An increase in C-reactive protein in oncology is often practically the only manifestation of pathology. This should be remembered in order not to miss a person with this dangerous diagnosis and to carry out timely diagnosis and the necessary treatment measures.

Assessing the risk of heart attack using CRP

What does C-reactive protein indicate if a person does not have inflammatory or oncological diseases? Not long ago, scientists discovered the connection of this substance with the development of vascular complications. This study is especially relevant for people with cardiovascular disease or risk factors.

For people with any of these conditions, a CRP level greater than 1 mg/L indicates a risk of a vascular complication. These patients are significantly more likely to have strokes, heart attacks, kidney damage, or heart failure.

A protein level of 1-3 mg/l indicates medium risk development of pathologies;
Exceeding the limit of 4 mg/l demonstrates high risk vascular accident.

CRP and osteoporosis

Until now, doctors continue to study what this test shows, in addition to inflammation and cardiovascular risk. Recent studies have proven the connection of C-protein with depletion of calcium reserves and pathologies of bone tissue, that is, osteoporosis. Why does this condition occur, and why is it dangerous?

The fact is that maintaining the inflammatory process requires a large amount of enzymes and microelements, including calcium ions. If it lasts long enough, the amount of these substances in the blood becomes insufficient. In this case, they begin to arrive from the depot. For calcium, bones are such a depot.

A decrease in its concentration in bone tissue leads to its increased fragility. For a person with osteoporosis, even a minor injury is enough for him to experience a complete fracture or a “crack in the bone” (incomplete fracture).

At this time, doctors have not determined the exact cutoff for CRP at which the risk of bone changes increases. However, scientists from the NIIR RAMS have found that prolonged excess of this test norm is a serious risk factor for depletion of calcium reserves.

C protein and pregnancy

Domestic and American scientists have long been interested in the connection between the course of pregnancy and this indicator. And after numerous studies, such a connection was discovered. In the absence of inflammatory diseases in a woman, protein levels can partially predict the course of pregnancy. Doctors discovered the following patterns:

With CRP levels above 7 mg/l, the likelihood of developing preeclampsia is more than 70%. This is a serious complication that occurs only in pregnant women, in which there is an increase in pressure, disruption of the kidney filter, damage to the nervous and cardiovascular systems;
An increase in C-protein above 8.8 mg/l increases the risk of preterm birth;
In case of urgent birth (which occurred on time) and an increase in the rate of more than 6.3 mg/l, there is a high risk of chorioamnionitis. This is a bacterial complication that occurs when amniotic fluid, membranes or the endometrium of the uterus are infected.

What C-reactive protein means in each specific case can be quite difficult to determine. Since it can increase due to a large number of reasons, it is necessary to exclude all these factors before forming a prognosis for a pregnant woman. However, in case of correct diagnosis, the obstetrician-gynecologist can plan the optimal management tactics for his patient.

Preparing for analysis

To obtain the most reliable test results, you must adhere to a number of recommendations before donating blood. Preparation for analysis is no different for a child and an adult, so the tips below are relevant for any age.

It is optimal to donate blood in the morning – before 11:00. During the day, hormone levels change and a person undergoes mental and physical exercise. Therefore, when conducting a study at another time, the result may be false positive;
12 hours before the examination, you should not eat, drink alcohol or drinks containing caffeine (Coca-Cola, energy drinks, coffee, strong tea). When taking the test in the daytime/evening, allow a light lunch 4 hours before the procedure;
3-4 hours before taking blood, it is not recommended to smoke, including electronic cigarettes;
Immediately before diagnosis, physical activity and stress should be avoided.

FAQ

Question:
Can increased CRP cause infertility?

Exceeding the norm of this substance is not a direct cause of infertility, but may indicate its presence. Let me explain with an example: in most cases, a girl cannot conceive a child due to an infectious lesion of the uterus, ovaries or fallopian tubes (endometritis, oopharitis and salpingitis, respectively). In addition to other symptoms, the above diseases cause an increase in CRP.

Question:
Is it necessary to measure this indicator in the presence of a disease?

No, in most cases it is not included in the diagnostic standard. Its level is usually assessed when an autoimmune reaction, liver damage is suspected, or when diagnosis is difficult.

Question:
I have rheumatoid arthritis and the doctor constantly orders me this test. Why is he doing this if the diagnosis was made several years ago?

Doctors use the test not only to diagnose the disease, but also to measure its activity. This helps to clarify a person’s condition and adjust treatment.

Question:
Can the concentration of C-protein increase during alcoholism/drug addiction?

Yes, since these substances directly affect the liver and provoke the release of CRP.

Bibliographic link

Read also

Yulia Titova

Comments on this post

Elena Berezovskaya Doctor

C-reactive protein during pregnancy: reasons to panic

Norm C reactive protein during pregnancy

Norm of C-reactive protein

Causes of high C-reactive protein levels

How to influence C-reactive protein levels

Purpose and preparation for analysis

Causes of elevated C-reactive protein

general information

Why is protein elevated?

Testing Features

Treatment methods

C-reactive protein in the blood: normal in tests, why it increases, role in diagnosis

Problems of the last century

How is CRP determined in the laboratory and what do cardiologists need?

Norm SRB? One for all, but...

How and why does C-reactive protein appear during inflammation?

Cause and investigation

but on the other hand

Elevated CRP is involved in the formation of atherosclerosis

The main tasks of the DRR are determined by its “many faces”

What is SRB

Norm

Comparison with ESR

Reasons for the increase

Under what conditions and diseases does it increase:

How informative is it for chronic diseases?

Examples of analysis evaluation for specific diseases:

Reasons for the increase in children

Indicator for women

Increased rate in men

Assessing the risk of heart attack using CRP

CRP and osteoporosis

C protein and pregnancy

Preparing for analysis

FAQ