Causes of increased CRP in men. C-reactive protein in the blood: increased, normal, causes. How to read a blood test for C-reactive protein

The fastest and most accurate blood test that can indicate onset of inflammatory processes in the human body - blood test SRB, or a test for C-reactive protein. This type of protein is the body's response to the onset of the inflammatory process, this is how the immune system reacts to the change and begins to produce the necessary component in the liver.

A sharp jump in the level of C-reactive protein can be observed during tissue injury, when 6 hours after the injury occurs, its level increases, and after 14 hours it increases several times.

If the problem is detected in a timely manner, a diagnosis is made and treatment begins, then a biochemical study will show a drop in the level of C-reactive protein in the blood within a few days. 2 weeks after the start of treatment, the level of the component is completely normalized and returns to its standard state.

There are also protein indicators when the disease passes from an acute state to a chronic course. With this option, the protein state numbers return to normal and no longer go off scale in the analysis. As soon as the disease relapses, the protein increases again.

It is important to emphasize that it is this type of analysis that allows doctors to distinguish a bacterial infection from a virus, in which the protein complement, although it increases, does not increase much. Moreover, if the origin of the infection is bacterial, the protein level increases almost exponentially.

Atherosclerosis can also be detected using a C-reactive protein blood test. If the protein content in plasma is exceeded, this may indicate a problem with the walls of blood vessels, in the tissues of which an inflammatory process begins. Moreover, such a deviation from the norm can also indicate a variety of diseases associated with the heart muscle, in particular, stroke, hypertension, cardiac death.

Indications for analysis

There are certain indications for which the doctor sends the patient to do a test for C-reactive protein. For example, the test should be taken with some regularity for older people, and especially for those who are likely to develop atherosclerosis, or for those patients who are at risk of developing complications due to diabetes. The analysis is also necessary for those undergoing hemodialysis.

Naturally, in case of heart disease, CRP testing is mandatory. Coronary heart disease, hypertension, all these problems can lead to sudden death of the heart, heart attack, stroke, and the study makes it possible to determine everything in time and, if possible, prevent the development of the problem. There is also a preventive study after coronary artery bypass surgery, which the patient recently underwent.

Cardiac problems generally occupy a serious place in biochemical analysis. And protein research is a priority for cardiac patients.

In addition, collagenosis is considered an indication, in which the study helps to determine the effectiveness of therapy. And, of course, protein always turns out to be the most accurate and effective indicator that helps determine bacterial infection, including sepsis and meningitis. It is worth saying here that during the treatment of an infection, the study of CRP helps to identify its effectiveness and keep drug intake under control. The same can be said about monitoring the treatment of some other diseases, including neoplasms and acute infectious diseases.

Where to take the test and what is the price?

To take a CRP test you will have to fork out approximately 300 rubles and this is the average price. But where to get tested is another question. Today there are a lot of private laboratories that provide a full range of services and do this quite efficiently. There are also state laboratories at hospitals and clinics - they also have a fairly good level of service, but there are often queues there.

The conclusion is: if you can afford to overpay an extra 100-200 rubles, then it’s better to go to a private clinic, which will quickly conduct a CRP study and decipher it even faster. Often, you will have results in your hands the very next day.

How to donate blood

In order for venous blood, which is what is donated for CRP testing, to show everything correctly, the patient must follow a few simple rules before donating blood for testing.

You will have to limit yourself to food 12 hours before the test. The day before the test, avoid drinking alcohol, as well as foods rich in fat and fried foods. Before the analysis itself, it is not recommended to drink juices or products containing caffeine, coffee, tea, or energy drinks. Half an hour before blood sampling, you must not smoke.

Analysis transcript

Naturally, only a doctor can give a correct conclusion based on how much the level of C-reactive protein has increased. An accurate diagnosis is a complex of conclusions, and blood testing plays an important role here.

The analysis adopted reference values from 0 to 1 mg/l, based on this, it is possible to derive a diagram of the values and interpretation:

SRB< 1 мг/л – вероятность сердечно-сосудистых проблем, и тем более их осложнения при таком показателе крайне мала;
1<СРБ<3 мг/л – вероятность можно посчитать на среднем уровне;
CRP > 3 mg/l is already a fairly high probability of disease. Moreover, in a healthy person, such indicators indicate the imminent onset of the process of damage to the cardiovascular muscles and blood vessels, and in a patient with problems, a complication of the course of the disease;
CRP > 10 mg/l – the disease is progressing and additional diagnostic testing is necessary.

Reasons for deviations

As already mentioned, the reasons for deviations in the protein state of a patient may be associated with a number of problems, centered on heart disease, diabetes mellitus, tissue damage and injury, as well as neoplasms.

However, the indicators may also be influenced by such reasons as:

Excess weight and hormonal disorders in the body;
Postoperative complications;
Bacterial infections, tuberculosis, meningitis;
Implant rejection reaction.

Due to the fact that the list is very massive, and only a specialist can understand the true reason for the increase in C-reactive protein levels, the study must be left to a specialized doctor to decipher.

Factors influencing the result

Along with the problems of the body, which give rise to changes in protein state indicators, there are also a number of factors that can influence the overall picture.

First of all, these are pregnancy, taking contraceptives, physical activity and smoking.

Some drugs also cause a change in the amount of protein, which is why the CRP study is carried out only 15 days after the end of treatment for any acute or exacerbation of a chronic disease, otherwise the picture will be blurred and the result will not be sufficiently informative.

C-reactive protein (CRP, CRP) is a protein that sharply increases in the blood plasma during diseases accompanied by intense destruction of body tissues. The level of this protein indicates not only the presence of an acute pathological process - inflammatory, necrotic - but also its activity. In healthy people, CRP in plasma is either not detected even by modern methods, or reaches insignificant concentrations.

Why does CRP appear in blood serum?

C reactive protein activates the immune system to suppress infection and protect the body from harmful tissue breakdown products.

CRP begins to be synthesized in liver cells in response to cell death under the influence of the following factors:

Within six to twelve hours of the onset of cell damage, C-reactive protein levels can increase hundreds of times. The more active the destructive (tissue-destroying) process, the faster the level of CRP in the blood plasma increases, the higher its concentration. When the inflammatory process subsides, the concentration of this protein immediately begins to decrease.

Why is analysis prescribed?

Determining the concentration of CRP in plasma makes it possible to most quickly and accurately diagnose an acute inflammatory process.

Until the end of the last century, another test was widely used for these purposes - erythrocyte sedimentation rate (ESR), since the test for C-reactive protein was performed within 24 hours, and ESR results could be obtained within an hour. In addition, the CRP test at that time was only qualitative - the exact protein concentration was not determined.

However, the ESR indicator, unlike C-reactive protein, decreases very slowly after inflammation subsides, so its value often does not correspond to the nature of the inflammatory process. Now that it is possible to obtain quantitative results in the shortest possible time, C-reactive protein is rightfully the most reliable marker of inflammation.

Determining the level of a marker such as C-reactive protein is used:

for diagnosing acute inflammatory process;
for diagnosing exacerbation of chronic inflammatory disease;
for the diagnosis of malignant neoplasms;
to assess the likelihood of damage to blood vessels and the heart;
to assess the effectiveness of prescribed treatment;
to identify infectious complications of a surgical operation;
to assess the quality of graft engraftment.

If previously the analysis for CRP was used only to identify an acute inflammatory or destructive (associated with tissue destruction) process, today in modern laboratories conducting research using highly sensitive methods, it is possible to determine even the slightest concentrations of this protein, allowing the diagnosis of mild chronic inflammation.

Along with identifying the inflammatory process, dynamic monitoring of C reactive protein levels makes it possible to assess the risk of developing certain cardiovascular diseases. The fact is that a constant, even slight, increase in CRP associated with chronic inflammation leads to the development of atherosclerosis and, as a consequence, to hypertension, myocardial infarction, pulmonary infarction, and ischemic stroke.

Dynamic monitoring of the CRP indicator is also carried out during drug treatment of diseases accompanied by inflammation and necrosis, after surgery, after organ and tissue transplantation. A timely decrease in this indicator indicates that the prescribed treatment is rational, that the operation was not complicated by infection, and that the graft is engrafting successfully.

Indications for testing C-reactive protein for diagnosis and evaluation of treatment effectiveness:

Indications for monitoring CRP levels to assess the risk of developing cardiovascular diseases:

atherosclerosis;
diabetes;
chronic kidney diseases (especially those accompanied by renal failure).

Monitoring the level of C-reactive protein is also necessary after surgery to prevent purulent complications.

Preparing for analysis

The material for the study is venous blood serum taken on an empty stomach. Therefore, before the test, you should refrain from eating for at least eight hours (you are allowed to drink water), and at dinner the day before the test, you should avoid overeating and avoid alcoholic beverages.

Such fasting, as a rule, does not cause much discomfort, since blood sampling is usually carried out in the morning. Persons who do not tolerate the absence of breakfast or the procedure of taking blood from a vein are advised to take a thermos with sweet tea or coffee, or a bar of chocolate to snack on immediately after the procedure.

As a last resort, blood for CRP can be donated during the day, four hours after a light breakfast.

Interpretation of results

The results of the analysis may look different depending on whether the analysis was qualitative or quantitative.

Results of qualitative analysis

The result of a qualitative study has one of the following meanings:

“-” - no reaction, normal (CRP concentration less than 3-5 mg/l);
“+” - weakly positive reaction (CRP concentration more than 3-5 mg/l, but less than 6 mg/l);
“++” - positive reaction (CRP concentration more than 6 mg/l, but less than 9 mg/l);
“+++” - positive reaction (CRP concentration more than 9 mg/l, but less than 12 mg/l);
“++++” - a sharply positive reaction (CRP concentration more than 12 mg/l).

A qualitative test is prescribed when it is not possible to conduct a more informative – quantitative analysis.

Results of quantitative analysis

To diagnose acute destructive pathologies and inflammations, classical research methods are used. To assess the risk of developing vascular pathologies and heart diseases, a special highly sensitive method is used, and the analysis is called hs-CRP. The values of analyzes performed by different methods are interpreted differently.

Interpretation of CRP values obtained by classical methods

SRP standards (may vary in different laboratories, but are necessarily indicated in the analysis form):

Some diseases and conditions in which the concentration of CRP increases in children and adults:

10-30 mg/l – chronic low-grade inflammation (including rheumatoid arthritis), acute viral infection (for example, chicken pox, rubella, measles in children);
over 12 mg/l in newborns – a high probability of sepsis;
40-200 mg/l – active phase of rheumatoid arthritis and other rheumatic diseases; malignant neoplasm (with poor prognosis);
80-1000 mg/l – acute bacterial infection, including inflammation of the lungs, colon, and renal pelvis;
100-300 mg/l and above – acute pancreatic necrosis, myocardial infarction (ischemic and hemorrhagic), sepsis, burns, mechanical injuries, transplant rejection, surgery.

An increase in CRP levels in healthy people can be caused by:

And this is not a complete list of reasons when C-reactive protein may increase in the blood.

Interpretation of hs-CRP values (mg/l)

< 1 – низкая вероятность развития патологий сердца и сосудов.
> 1 and< 3 – средняя вероятность развития патологий сердца и сосудов.
> 3 mg/l – high probability of developing pathologies of the heart and blood vessels.

Determining C reactive protein alone is not enough to make an accurate diagnosis. Firstly, this is a non-specific test - an increase in the CRP value within the same limits can indicate a wide variety of pathologies. Secondly, for diagnosis you need to know many nuances known only to a specialist. Thus, only the attending physician can accurately interpret the results of this test, relying, among other things, on the data of a clinical examination and other studies - laboratory and instrumental.

Where can you get tested in Moscow?

Today, the C reactive protein test can be performed in many clinical laboratories, both public and commercial, for example:

in the private medical company INVITRO - the cost of the analysis is 500 rubles, the cost of blood sampling is 200 rubles;
in the network of medical clinics “Zdorovye” - the cost of analysis is 270 rubles;
in the BION laboratory - the cost of analysis is 420 rubles.

It is best to contact your doctor with this question - he will recommend a laboratory with an optimal balance in price and quality.

CRP is a classic acute phase protein that is considered the most sensitive laboratory marker of infection, inflammation, and tissue damage. Structurally, SRP belongs to the pentraxin family with a MW of 115–135 kDa; it consists of five identical non-glycolyzed polypeptide subunits forming a cyclic disk-shaped pentameric structure. The synthesis of CRP occurs in hepatocytes and is regulated by proinflammatory cytokines, primarily IL-6, as well as IL-1 and TNFα. The half-life of CRP is 19 hours and is a constant value in health and disease. Against the background of inflammation, infection or traumatic injury, the level of CRP quickly increases by 100 times or more. The level of CRP in the blood is more than 5 mg/l already 6 hours after activation of its synthesis in hepatocytes, reaching maximum values after 24–72 hours. The most significant increase in the concentration of C-reactive protein in the blood is detected with bacterial infections (100 mg/l and above ), systemic fungal and viral infections (10-30 mg/l); tuberculosis; rheumatic diseases (rheumatoid arthritis, juvenile chronic arthritis, ankylosing spondylitis, psoriatic arthritis, systemic vasculitis, polymyalgia rheumatica, Reiter's disease, Crohn's disease, rheumatic fever, erythema nodosum, familial Mediterranean fever); necrosis (MI, tumor metastases, acute pancreatitis); injuries (surgery, burns, fractures); malignant neoplasms (lymphoma, carcinoma, sarcoma). A slight increase or normal level of CRP in the blood is observed in some autoimmune diseases, ulcerative colitis, leukemia, and graft-versus-host disease.

It is believed that in the absence of obvious causes (infection, trauma, tumors, autoimmune pathology), a slight increase in the concentration of C-reactive protein in the blood may reflect chronic subclinical inflammation of the vascular wall associated with atherosclerosis. A positive correlation was revealed between the level of CRP in the blood, classical risk factors and markers of atherosclerosis (age, smoking, body mass index, blood pressure, levels of total cholesterol, TG, homocysteine, fibrinogen, D-dimer). According to modern concepts, even a slight increase in CRP concentration is an independent prospective risk factor for cardiovascular complications.

Depending on the purpose of the study, the determination of SRP concentration is carried out using classical and highly sensitive methods. Classical methods are designed to detect elevated levels of CRP in acute inflammation and tissue damage within the concentration range of 5–500 mg/L. The high-sensitivity CRP (hsCRP) assay measures CRP concentrations below 5 mg/L and is used to assess basal hsCRP levels and associated cardiovascular risk.

C-reactive protein (CRP) testing using classical methods is a useful test for screening for internal organ damage; assessing the activity of the pathological process in patients with rheumatic and other chronic inflammatory diseases, as well as in patients with acute pancreatitis; monitoring and control of the effectiveness of therapy for bacterial and viral infections, including intercurrent infections in SLE and other diseases with little or no acute phase response; differential diagnosis of chronic inflammatory diseases (SLE and RA, Crohn's disease and ulcerative colitis). Determining the basal level of hsCRP is important for stratifying patients with rheumatic diseases according to the degree of cardiovascular risk. In addition, an increase in basal CRP concentration is associated with severe destructive joint damage. Since 2010, SRP has served as a laboratory classification criterion for RA.

A basal hsCRP concentration of less than 1 mg/l corresponds to low, 1–3 mg/l – average, more than 3 mg/l – high cardiovascular risk. An hsCRP level of 3 to 10 mg/L is associated with subclinical inflammation, and more than 10 mg/L is associated with systemic persistent inflammation.

Indications for the study

Chronic inflammatory diseases: assessment of the activity of the pathological process, monitoring the effectiveness of therapy;
infectious diseases: diagnosis and monitoring of therapy effectiveness;
tumors;
tissue damage;
determination of the risk of cardiovascular complications in patients with atherosclerosis and diabetes.

Research method. Classic methods for determining CRP include radial immunodiffusion, immunoturbidimetry and immunonephelometry. The hsCRP method is based on increasing the analytical sensitivity of immunochemical methods by 10 or more times using special reagents.

Increased values

Acute diseases:
- bacterial infection;
- neonatal sepsis;
- viral infection;
- postoperative complications;
tissue necrosis:
- myocardial infarction, lung, kidney and other organs;
- acute pancreatitis;
- oncological diseases, metastases;
chronic diseases.

With timely and effective treatment, a CRP blood test will show a decrease in protein concentration within a few days. The indicator returns to normal within a day after starting medication. If the disease has passed from the acute stage to the chronic stage, then the value of C-reactive protein in the blood serum will gradually become zero. But as the disease worsens, it will increase again.

A biochemical blood test, CRP, makes it possible to distinguish a viral infection from a bacterial one. Since with the viral nature of the disease, the protein level does not increase much. But with a bacterial infection, even if it has just begun to develop, the concentration of C-reactive protein in the blood increases exponentially.

In a healthy person, a biochemical blood test for CRP is normally negative.

When to send for a biochemical blood test CRP

The doctor sends the patient a biochemical blood test for CRP in the following cases:

1. Preventive examination of elderly patients.

2. Determination of the likelihood of cardiovascular complications in patients with diabetes, atherosclerosis, and on hemodialysis.

3. Examination of patients with hypertension, coronary heart disease, to prevent possible complications: sudden cardiac death, stroke, myocardial infarction.

4. Identification of complications after coronary bypass surgery.

5. Assessing the risk of restenosis, recurrent myocardial infarction, death after angioplasty in patients with acute coronary syndrome or exertional angina.

6. Monitoring the effectiveness of prevention and treatment of cardiovascular complications using statins and acetylsalicylic acid (aspirin) in patients with cardiac problems.

7. Collagenosis (to determine the effectiveness of therapy and the reactivity of the process).

8. Monitoring the effectiveness of treatment of bacterial infections (for example, meningitis, neonatal sepsis) with antibacterial drugs.

9. Monitoring the effectiveness of treatment of chronic diseases (amyloidosis).

11. Acute infectious diseases.

How to prepare for analysis

Venous blood is donated for a biochemical blood test for CRP. On the eve of blood collection, you must adhere to simple rules:

Interpretation of the CRP blood test

The CRP blood test must be deciphered by a doctor. Only a specialist will be able to correctly assess how much the C-reactive protein level has increased, compare this with the symptoms and prescribe appropriate treatment.

Although the normal biochemical blood test for CRP is negative, reference positive values of 0 to 5 mg/l are accepted. Let's look at the indicators of DRR and condition, they are shown in the table.

C-reactive protein during pregnancy

Elevated CRP levels are not dangerous for a pregnant woman if other tests are normal. Otherwise, it is necessary to look for the cause of the inflammatory process. With toxicosis, readings may increase to 115 mg/l. When increasing to 8 mg/l from 5 to 19 weeks, there is a risk of miscarriage. The reason for an increase in CRP can be viral infections (if the indicator is up to 19 mg/l), bacterial infections (if the indicator is above 180 mg/l).

Reasons for deviations from the norm in the biochemical blood test CRP

1. Acute bacterial (neonatal sepsis) and viral (tuberculosis) infections.

3. Postoperative complications.

5. Diseases of the gastrointestinal tract.

6. Tissue damage (trauma, burn, surgery, acute myocardial infarction).

7. Malignant neoplasms and metastases. (an increase in the level of CRP is observed in cancer of the lungs, prostate, stomach, ovaries and other tumor sites)

8. Arterial hypertension.

9. Diabetes mellitus.

10. Excess body weight.

11. Hormonal imbalance (increased levels of progesterone or estrogen).

12. Systemic rheumatic diseases.

13. Atherogenic dyslipidemia (decreased cholesterol levels, increased triglyceride concentrations).

14. Chronic inflammatory process associated with an increased likelihood of cardiovascular diseases and the occurrence of their complications.

15. Exacerbation of chronic inflammatory (immunopathological and infectious) diseases.

16. Reaction of transplant rejection.

17. Myocardial infarction (an increased level of CRP is determined on the 2nd day of the disease; by the beginning of the 3rd week, the value of C-reactive protein returns to normal).

18. Secondary amyloidosis.

What can affect the analysis result?

Pregnancy, taking oral contraceptives, intense physical activity, hormone replacement therapy, and smoking can cause an increased CRP blood test value.

Taking beta blockers, statin drugs, corticosteroids, non-steroidal anti-inflammatory drugs (ibuprofen, aspirin) can reduce the concentration of CRP in the blood serum.

If it is necessary to establish a baseline C-reactive protein value, then a CRP blood test should be taken 2 weeks after the disappearance of symptoms of any acute or exacerbation of a chronic disease.

Get examined urgently. All doctors.

CRP increases in the presence, in particular, of a systemic disease and in the future will serve as a control for you to stop taking harmful medications for sarcoidosis. You're probably drinking Methpred?

What is C-reactive protein in the blood, its norm and reasons for increased CRP

C-reactive protein (CRP) is a highly sensitive glycoprotein found in blood serum.

The quantitative indicator of CRP in the blood is a particularly valuable diagnostic marker, indicating the onset or presence of an inflammatory process, therefore it is classified as a nonspecific indicator of the acute phase.

The lifespan of the protein is only a few hours, which makes it possible to quickly judge the development and course of the disease. Also, based on the dynamics of changes in the level of C-reactive protein, the effectiveness of the chosen tactics of anti-inflammatory treatment is judged (this conclusion is made by deciphering a series of sequential biochemical blood tests).

The protein is produced in the liver and secreted into the blood serum constantly, and if a person is healthy, then C-reactive protein is always present in the blood in small quantities.

Functions and clinical significance

This protein is considered one of the leading components of innate immunity. C-reactive protein is also responsible for the interconnected work of the innate and adaptive immune systems and is involved in activating the body's defenses.

An increase in CRP levels is an early sign of infection, with the highest levels being characteristic of bacterial rather than viral species.

A group of pro-inflammatory cytokines - interleukins IL-1β, IL-6 and cachectin (TNF-α - tumor necrosis factor) stimulates and regulates the synthesis of CRP.

CRP refers to pattern-recognition receptors, which, when pathogenic organisms are detected, activate the anti-inflammatory work of T-lymphocytes and platelets, and also help professional phagocytes neutralize and remove harmful microbes, particles of damaged tissue and toxins from the body.

Unlike another, well-known “inflammatory marker” - the erythrocyte sedimentation rate (ESR), which can delay the response up to 48 hours, CRP responds by exceeding its normal values within 6 hours from the onset of acute inflammation, and by the end During the first 24 hours, its amount can increase many times over.

This correlation also applies to the opposite mechanism - when inflammation subsides, CRP decreases much faster than ESR, the high level of which can last up to 60 days.

Currently, the high and diverse prognostic significance of C-reactive protein has been proven. For example, deciphering even its insignificant values in combination with indicators of the level of plasma amyloid-A makes it possible to assess the risk of developing diseases of the cardiovascular system: stroke, coronary heart disease, congestive heart failure, myocardial infarction, death. For these purposes, a special biochemical analysis is used - ultrasensitive C-reactive protein (hsCRP).

Deciphering the concentration of CRP in the blood plasma is a good help for determining the duration of taking antibiotics.

The normal level of C-reactive protein in the blood serum of a healthy adult is 0.5-1.0 mg/l, in a child – up to 0.5 mg/l.

The CRP level in healthy women during pregnancy changes dynamically:

18-28 weeks – 2.9±2.5 mg/l;
28-32 weeks – 3.2±2.2 mg/l;
from 32 weeks before birth – 4.3± 2.5 mg/l.

Increased C-reactive protein levels

Is C-reactive protein elevated in the biochemical blood test? So there is a reason for that. The growth of neoplasms, inflammatory and necrotic processes caused by any genesis cause a rapid and significant increase in the CRP index. The most common reasons:

In addition to the diseases and causes listed above, factors that also increase the values of CRP analysis include: heavy physical activity, abuse of anabolic steroids, smoking, and taking oral contraceptives.

A blood test for CRP in children allows for early diagnosis and prevention of the development of certain diseases. Immediately after the birth of the child, the first biochemical test of blood from the umbilical cord allows us to exclude neonatal sepsis.

Children under 3 years of age are characterized by chronic benign agranulocytosis, which can cause unstable, spasmodic increases in CRP levels in the blood. As a rule, by the specified age, this syndrome goes away on its own.

A positive C-reactive protein in an apparently healthy child is one of the main “red flags” to suspect an infectious lesion of the joints and bones of bacterial etiology.

Let us give some specific examples of increased CRP levels depending on the specific pathology.

Any bacterial infection

Neutropenia in adults

Obesity in children

Diabetes mellitus type II

Hemodialysis due to depression

Probability of premature birth

Taking oral contraceptives

If in men the level of CRP chronically remains above 1.7 mg/l, then the chance of depression (and its consequences) increases by 3.1 times, and with persistent values above 3.0 mg/l - already by 4. In women, this no relationship was found between CRP indicators and the tendency to depressive symptoms.

For the female sex there is a completely different pattern, peculiar only to it. Pediatricians are calling for breastfeeding, especially girls, for a reason. Statistics say that when girls breastfeed, in adulthood they have lower levels of CRP and total cholesterol, and therefore a reduced risk of cardiovascular pathologies. Indicators with artificial feeding are almost 50% higher.

When and why is a CRP test prescribed?

A biochemical blood test for CRP allows monitoring of postoperative conditions. Decoding the indicators simplifies the differentiation of infectious and autoimmune diseases, allows you to evaluate the effectiveness of an individually selected treatment regimen, and predict the risk of developing pathologies of the cardiovascular system.

Does the doctor refer CRP for blood biochemistry without any apparent reason or suspicion of the above diseases and factors? This means there are prerequisites for this. An appointment for analysis can also be obtained in the following cases (examples):

medical examination of elderly people;
high blood pressure and early stage of coronary artery disease;
after bypass surgery and angioplasty;
for hemodialysis, diabetes mellitus, atherosclerosis (in order to prevent complications from the cardiovascular system).

Do CRP abnormalities need to be treated?

Positive results in reducing the level of CRP concentration (up to 30%) can be achieved by:

optimization of physical activity;
loss of body weight;
giving up bad habits.

Therefore, when a doctor calls for maintaining a healthy lifestyle, these are not easy words, but, unfortunately, such measures alone cannot do it. C-reactive protein will return to normal only when the pathological and other root causes of its increase are identified and eliminated.

C-reactive protein: determination of diseases by biochemical blood test

Proteins are a necessary component of the human body; there are many types of them. Plasma is the liquid part of the blood, 7-8% consists of these high molecular weight organic compounds. Proteins circulating in it take part in all metabolic processes, perform protective, transport and many other important functions. The concentration of some species is maintained at a constant level in the plasma, while others, such as c-reactive protein (abbreviated as CRP), change when health problems arise. A blood test for CRP allows you to accurately diagnose various inflammatory diseases.

When to use analysis

To find out in what cases the analysis is used, you need to understand: c-reactive protein - what it is, what its distinctive feature is and how exactly it reacts to inflammation. This is a protein synthesized by the liver, sensitive to any inflammatory processes and tissue damage. It is present in small quantities in the body of every healthy person. It is one of the leading components of the innate immune system.

One of the proteins constantly released into the blood serum is c-reactive protein: what is it responsible for and what are the reasons for its increase in level. The main purpose of SRP is to activate the body's defenses. It received the name C-reactive protein or protein because of its ability to perform the following important functions:

CRP belongs to the group of acute phase or rapid response proteins. They are united by one common feature - the ability to significantly increase their concentration in a short time. It is a quantitative characteristic that allows for a blood test for CRP and which shows the intensity of the inflammatory process.

This response to cell death, an increase in c-reactive protein in the blood, can be caused by:

Indications for determining the level of CRP

Widespread clinical use is based on the distinctive feature of CRP - that it is the most sensitive and fastest indicator of inflammation and tissue damage. Outwardly, the disease may not yet have manifested itself, the person is healthy and feels well, but the body has already joined the fight - it is intensively producing antibodies, launching immune defense mechanisms. The level of CRP increases several times within a matter of hours (usually within 4-6 hours) after the appearance of the source of the disease or tissue damage. The maximum concentration, a hundred times higher, is observed within an hour.

“Golden marker” is what clinicians call c-reactive protein and what it is is a highly sensitive compound that is part of blood serum, which allows you to successfully use a blood test for the following purposes:

It is important to know that reactive protein in the blood is not assessed in all cases and this prescription can only be obtained for certain medical indications:

How the research is carried out, preparation for analysis

Before you begin the most important thing - deciphering the results of the study, you should find out the blood test for CRP: what it is, what it involves and how to properly prepare for it. This is a biochemical analysis, or simply biochemistry, - one of the reliable methods of laboratory diagnostics. The material being tested is blood serum taken from the ulnar vein, radial vein, or another vein accessible for inspection and fixation. The procedure requires some preparatory steps:

Blood is taken for analysis usually in the first half of the day, on an empty stomach. In order to get the most reliable result, confirming or refuting the fact that c-reactive protein is present in the blood serum and that it shows the correct values, on the eve of going to the clinic you should follow some small recommendations and a few simple rules:

Due to the fact that the parameter determined by biochemical analysis is an indicator of the acute phase of inflammation, it is CRP that provides the primary reaction of the body. This is the most highly sensitive component of bloodstream plasma; it is important to exclude any factors that could affect the results obtained.

You must notify your doctor if:

Analysis results

Protein in the blood: what is it and how is it different from c-reactive protein. Often the term “blood protein” refers to the content of total protein, i.e. a collection of different proteins that have characteristic properties and are endowed with certain functions. C-reactive protein is specific, both in function and detection. It is not detected by traditional methods; separate biochemical tests are required. The results are displayed in mg/l or mg/ml, this unit of measurement indicates the protein concentration (mg) contained in 1 liter or ml of blood.

A qualitative blood test for c-reactive protein and a more informative quantitative one may be prescribed. For their correct interpretation, it is important to consider the following factors:

According to the recommendations of WHO doctors, the norm is a universal indicator for all groups of people, regardless of age and gender, it is generally accepted that this is 0-5 mg/l. But laboratories, using various reagents and research methods, adhere to their figures. They indicate them in the appropriate forms.

Some medical institutions standardize indicators for smokers and athletes, separating them into separate groups.

The results of a qualitative study range from the minimum value to the maximum concentration, and mean the following:

By deciphering the analysis data and detecting deviations from the norm, it is important to determine how high the reactive protein in the blood is and what are the reasons for such a peculiar reaction of the body. The more severe the disease, the more acute its severity, the greater the deviation and the higher the CRP values. The degree of increase and concentration level (in mg/l) helps to navigate:

C-reactive protein in rheumatoid arthritis in the active stage increases sharply, can reach a value of 400 mg/l and higher;

In all cases, the reactive protein is elevated - the reasons for such deviations may be different.

There is a whole list of diseases that cause the body to produce CRP in large quantities.

Conventionally, they are divided into 3 main groups:

In addition to various pathologies, high CRP values can be caused by the following factors:

The main difference between CRP and other biochemical markers is that it shows only the upper limit, and its excess indicates the development of a particular disease. For an accurate diagnosis, the c-reactive test alone is not enough. In diagnostic practice, the attending physician, in order to reveal the clear picture of the disease, simultaneously with CRP, relies on the following data:

Where to take the study

The final diagnosis is made by the attending physician - a therapist, cardiologist, specialist or general practitioner. He also writes out a referral, interprets the results of venous blood donated for analysis and can recommend a medical center or laboratory that conducts such testing. This may be a government or commercial medical institution. When choosing, it is important to consider the following criteria:

A CRP blood test will help identify pathology in its early stages. An experienced specialist, having made a diagnosis, prescribed adequate treatment and given preventive recommendations, will prevent further development of the disease.

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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 using 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 that 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 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.

General information about the study

C-reactive protein is a glycoprotein produced by the liver and belongs to the acute phase proteins of inflammation. Under the influence of anti-inflammatory cytokines (interleukin-1, tumor necrosis factor-alpha and especially interleukin-6), its synthesis increases within 6 hours, and its concentration in the blood increases 10-100 times within 24-48 hours after the onset of inflammation. The highest levels of CRP (more than 100 mg/l) are observed with bacterial infection. In case of a viral infection, the level of CRP, as a rule, does not exceed 20 mg/l. The concentration of CRP also increases with tissue necrosis (including myocardial infarction, tumor necrosis).

CRP is involved in the activation of complement (a group of proteins that are part of the immune system), monocytes, stimulation of the expression of adhesion molecules ICAM-1, VCAM-1, E-selectin on the surface of the endothelium (they ensure cell interaction), binding and modification of low-density lipids (LDL) , that is, contributes to the development of atherosclerosis.

A progressive increase in CRP is associated with the activity of the inflammatory process and the degree of tissue damage. Moreover, CRP is a more sensitive indicator of active inflammation than the erythrocyte sedimentation rate (ESR), but it increases and disappears before the ESR changes.

An increase in CRP may precede the onset of fever, pain, and other signs of illness. Some experts determine the duration of antibiotic therapy depending on the timing of the decrease in CRP.

In the uncomplicated postoperative period, CRP reaches its maximum values on the third day and decreases to normal levels within a week. Maintaining high values of CRP and the absence of its gradual decrease indicates the addition of an infection.

Separately, the determination of CRP does not make it possible to clarify the diagnosis and nature of the disease, but with high sensitivity it makes it possible to establish the fact of active inflammation or tissue damage. The results of the analysis should be interpreted taking into account the indicators of other laboratory tests, the clinical picture of the disease and the conclusions of instrumental studies.

What is the research used for?

For the diagnosis of various inflammatory diseases caused by infection or autoimmune processes, and to evaluate the effectiveness of their treatment.
For differential diagnosis of bacterial and viral infections (in case of viral infections, the level of CRP is slightly increased).
To determine the activity of the inflammatory, autoimmune process.
For the diagnosis of postoperative infectious complications.
For diagnosing hidden infections.
To assess the need for antibacterial therapy and its duration.
To give a prognosis of the course and possible death in some acute conditions (for example, pancreatic necrosis).
To assess tumor progression and disease relapse (when combined with other tumor markers).
For the differential diagnosis of inflammatory bowel diseases: Crohn's disease (high CRP) and ulcerative colitis (low CRP).
For the differential diagnosis of rheumatoid arthritis (high CRP) and uncomplicated lupus (low CRP).
To monitor the activity of chronic diseases.

When is the study scheduled?

If there is a suspicion of an infectious disease in febrile patients, with neutropenia, suspected meningitis in children, or sepsis in newborns.
When examining patients with autoimmune pathology (arthritis, vasculitis).
During antibacterial therapy.
In the postoperative period (for early detection of infectious complications and assessment of the effectiveness of antibacterial therapy) - if complications develop, the level of CRP will remain elevated or increase for 4-5 days after surgery.
During the treatment of chronic inflammatory diseases.
For organ transplantation (kidneys, hearts).
For preventive examination and monitoring of patients with chronic diseases and neoplasms.