The importance of elevated basal levels C-reactive protein (CRP) measured by a highly sensitive test has been known for over 10 years. Increased hsCRP concentration correlates with most of the classical risk factors in cardiovascular disease, however. This seriously complicates the interpretation of the elevated concentration. Concentrations of hsCRP are partly genetically determined and can easily be affected positively by lifestyle changes. These two factors lead us to conclude that the setting of hsCRP should not be used routinely at present in assessing the individual risk of complications for atherosclerosis.

• MeSH
• ateroskleróza diagnóza   MeSH
• biologické markery analýza   MeSH
• C-reaktivní protein analýza   fyziologie   MeSH
• kardiovaskulární nemoci diagnóza   MeSH
• lidé MeSH
• rizikové faktory MeSH
• zánět MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• biologické markery MeSH
• C-reaktivní protein MeSH

A man aged 60 years was examined for intense inflammatory response, night sweats, subfebrile and later febrile temperatures and a weight loss of 18 kg in 7 months. CRP was 270 mg / l, i.e. more than 20 times the upper limit of the physiological range. Reactive leukocytosis (10 × 109/l), thrombocytosis (530 × 109/l), increased fibrinogen (greater than 7 g/l), and anemia with hemoglobin of 80 g/l were present. No infection or systemic autoimmune disease has been proven. The patient had normal renal function and had no osteolytic deposits detectable by FDG-PET/CT. The procalcitonin level was not elevated. The bone marrow examination revealed a 30-40% infiltration of proplasmacyte type with admixture of plasmablasts, expressing light chains λ. Monoclonal immunoglobulin IgA λ was at a low concentration of about 8 g/l and the ratio of free light chains κ/λ was 0.13. The extent of bone marrow infiltration and anemia met the criteria for the diagnosis of symptomatic multiple myeloma. Following initiation of the combination therapy using thalidomide, bortezomib and dexamethasone, the maximum decrease in the concentrations of monoclonal immunoglobulin, free light chains and CRP was observed already after the first 2 cycles of treatment. Later, during the following two 2 cycles, the disease began to progress again. The patient underwent successful stem cell collection after the application of cyclophosphamide 2.5 g/m 2 and leukocyte growth factor (G-CSF), and high-dose chemotherapy (melphalan 200 mg/m 2) with the support of stem cell transplantation. At 2 months following high-dose chemotherapy, CRP levels of the physiological range decreased, the blood count was normalized, and monoclonal immunoglobulin was not detectable. Conclusion: The chronic inflammatory response may be due to plasmocytary bone marrow infiltration even if there are no other symptoms of multiple myel-oma present, except for anemia which, however, also involves the inflammatory reaction. In this case, the systemic inflammatory reaction with high CRP levels signalled aggressive behaviour of the disease. Key words: CRP - multiple myeloma - procalcitonin - systemic inflammatory response.

• Klíčová slova
• CRP - multiple myeloma - procalcitonin - systemic inflammatory response,
• MeSH
• bortezomib aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mnohočetný myelom * diagnóza   farmakoterapie   MeSH
• PET/CT MeSH
• protokoly antitumorózní kombinované chemoterapie terapeutické užití   MeSH
• syndrom systémové zánětlivé reakce * etiologie   MeSH
• thalidomid aplikace a dávkování   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• bortezomib MeSH
• thalidomid MeSH

BACKGROUND: Meta-analyses confirm increased circulating C-reactive protein (CRP) levels in depression. Longitudinal studies have linked one-off measurements of CRP at baseline with increased risk of developing depressive symptoms subsequently at follow-up, but studies with repeat CRP measures from the same individuals are scarce. METHODS: We have examined whether longitudinal patterns of inflammation, based on three CRP measurements from childhood to early-adulthood, are associated with the risk of depression in early-adulthood in the Avon Longitudinal Study of Parents and Children, a prospective birth cohort. RESULTS: Using Gaussian mixture modelling of available CRP data from age 9, 15 and 18 years, we identified four population clusters/sub-groups reflecting different longitudinal patterns of CRP: persistently low (N=463, 29.5%); persistently high (N=371, 24%); decreasing (N=360, 23%); increasing (N=367, 23.5%). The increasing group showed a steep increase in CRP levels between adolescence and early-adulthood. Participants in this group had a higher risk of moderate/severe depression at age 18 years, compared with those with persistently low CRP; adjusted odds ratio (OR)=3.78 (95% Confidence Interval (CI), 1.46-9.81; p=0.006). The odds of moderate/severe depression were also increased for the persistently high CRP group, but this was not statistically significant; OR=2.54 (95% CI, 0.90-7.16). LIMITATIONS: Repeat CRP measures were available for a subset, who may not be representative of all cohort participants. CONCLUSIONS: The results suggest that an increasing pattern of inflammation from adolescence to early-adulthood is associated with risk of depression in early-adulthood.

• Klíčová slova
• ALSPAC, C-reactive protein, CRP, Depression, Immunopsychiatry, Inflammation,
• MeSH
• C-reaktivní protein metabolismus   MeSH
• deprese krev   epidemiologie   MeSH
• depresivní poruchy krev   epidemiologie   MeSH
• dítě MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• prospektivní studie MeSH
• riziko MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• C-reaktivní protein MeSH

BACKGROUND: C-reactive protein (CRP) is an acute-phase serum protein produced by the liver. High plasma levels of CRP have been associated primarily with infection, but elevated CRP levels have also been found to be associated with more than one hundred conditions and factors, including social and economic factors. MATERIALS AND METHODS: To evaluate the possible association between individuals' number of children and plasma levels of C-reactive protein, we studied a representative population of 2,426 adults. CRP was analyzed using the high sensitivity method (hsCRP). Individuals were divided into five groups of zero, one, two, three and four and more children. RESULTS: We found that individuals with more children had significantly higher levels of plasma hsCRP than individuals without children or than individuals with a low number of children (p for trend <0.001). This association could reflect the known associations between CRP and higher economic stress, exhaustion, episodic stress and chronic stress. CONCLUSIONS: We found significantly elevated levels of plasma CRP in individuals with more children than in individuals without children or with a low number of children.

• MeSH
• C-reaktivní protein analýza   MeSH
• charakteristiky rodiny * MeSH
• chudoba psychologie   MeSH
• dospělí MeSH
• imunochemie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nefelometrie a turbidimetrie MeSH
• psychický stres komplikace   epidemiologie   MeSH
• socioekonomické faktory MeSH
• únava psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• C-reaktivní protein MeSH

Background: Interleukin-6 (IL-6) is a pleiotropic cytokine with a multitude of pro-inflammatory effects. Serum C-reactive protein (CRP) is an acute phase protein induced mainly by IL-6 in response to inflammatory conditions, particularly infection. The biological functions of CRP include opsonisation, induction of phagocytosis, complement activation, or chemotaxis enhancement. Factors interfering with IL-6-mediated recruitment of innate immune responses, such as the presence of anti-IL6 antibodies, may therefore compromise the host resistance to microbial pathogens. This has major implications for the use of IL-6-targeting biologics, such as tocilizumab or sarilumab in rheumatologic, immune dysregulation diseases, and cancer. Case presentation: 20-month-old Czech female developed severe septic shock with clinical and laboratory signs of systemic inflammation but no increase of CRP or IL-6. The offending pathogen was most likely Staphylococcus aureus, detected in a throat swab; the response to antibiotic treatment was prompt. A defect in the integrity of IL-6/CRP axis was suspected and verified by the detection of neutralizing IL-6 antibodies in the serum of the child. Conclusion: We report a first case of systemic bacterial infection in a patient with anti-IL6 autoantibodies. Disturbed IL-6 signaling, whether iatrogenic by targeted IL-6 blockade or endogenous due to the presence of autoantibodies against IL-6, represents a risk factor for increased infectious susceptibility. Patients with severe bacterial infection without elevation of CRP should be examined for the presence of anti-IL6 autoantibodies.

• Klíčová slova
• C-reactive protein, anti-IL6 autoantibodies, interleukin 6, sarilumab, siltuximab, tocilizumab,
• MeSH
• autoprotilátky krev   MeSH
• C-reaktivní protein MeSH
• interleukin-6 imunologie   MeSH
• kojenec MeSH
• lidé MeSH
• septický šok krev   imunologie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• autoprotilátky MeSH
• C-reaktivní protein MeSH
• interleukin-6 MeSH

AIM: To evaluate recent human studies with respect to the interpretation of whether elevated plasma levels of C-reactive protein (CRP) cause cardiovascular disease (CVD), or whether elevated CRP levels more likely is an innocent bystander. DATA SYNTHESIS: Elevated CRP concentrations are consistently associated with CVD risk. A recent study showed that aggressive statin treatment caused reductions of 50% in LDL cholesterol, 37% in CRP, 44% in CVD events, and 20% in total mortality, and that the highest treatment benefits were obtained in those with the lowest achieved levels of both LDL cholesterol and CRP. However, a reduction in CRP levels after statin treatment could be secondary to the reduced LDL cholesterol levels, and thereby less inflammation in atherosclerotic plaques. We recently performed 4 large Mendelian randomization studies, studies that demonstrated that elevated CRP associate with increased risk of CVD, that genetic variation in the CRP gene associate with increased CRP levels, but that this genetic variation in the CRP gene do not associate with increased risk of CVD. In contrast to previous studies, these new studies had enough statistical power to effectively exclude that genetically elevated CRP cause CVD. CONCLUSION: These data suggest that elevated CRP per se does not cause CVD; however, inflammation per se possibly contributes to CVD. Elevated CRP levels more likely is a marker for the extent of atherosclerosis or for the inflammatory activity and vulnerability of atherosclerotic plaques, and thus simply an innocent bystander in CVD.

• MeSH
• antiflogistika terapeutické užití   MeSH
• ateroskleróza krev   komplikace   farmakoterapie   genetika   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein genetika   metabolismus   MeSH
• dyslipidemie krev   komplikace   farmakoterapie   MeSH
• fenotyp MeSH
• genetická predispozice k nemoci MeSH
• hodnocení rizik MeSH
• kardiovaskulární nemoci krev   etiologie   genetika   prevence a kontrola   MeSH
• lidé MeSH
• lipidy krev   MeSH
• mediátory zánětu krev   MeSH
• medicína založená na důkazech MeSH
• randomizované kontrolované studie jako téma MeSH
• rizikové faktory MeSH
• statiny terapeutické užití   MeSH
• upregulace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antiflogistika MeSH
• biologické markery MeSH
• C-reaktivní protein MeSH
• lipidy MeSH
• mediátory zánětu MeSH
• statiny MeSH

BACKGROUND: Autoantibodies against monomeric C-reactive protein (anti-CRP-Ab) observed in patients with systemic lupus erythematosus (SLE) and lupus nephritis (LN) were suggested to be associated with active LN and a poor response to therapy during short-term follow-up. The aim of this study was to confirm this finding and to investigate the prognostic value of anti-CRP-Ab in patients with LN during long-term follow-up. METHODS: Sera of 57 SLE patients (47 women, 10 men) with biopsy proven LN and 122 healthy individuals were analyzed for the presence of anti-CRP-Ab by in-house ELISA. Anti-CRP-Ab levels were studied in relation to routine laboratory tests, urine analysis, levels of C3, C4, other immunological markers and the overall disease activity as assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). The prognostic value of anti-CRP-Ab was tested in a subgroup of 29 newly diagnosed LN patients (median follow-up 5.9 years). Response to therapy at various time points was assessed with respect to baseline anti-CRP-Ab levels. At least partial response in the first/second year of treatment was considered as a "favorable outcome", while non-response, renal flare or end stage renal disease were considered as "unfavorable outcome". RESULTS: Anti-CRP-Ab were only detected in patients with active renal disease and their levels correlated with SLEDAI (rs = 0.165, p = 0.002). The time to response was shorter in patients being anti-CRP-Ab negative at baseline compared to anti-CRP-Ab positive patients, p = 0.037. In the second year of therapy, baseline anti-CRP-Ab positivity was a significant predictor of "unfavorable outcome" (OR [95% CI] = 15.6 [1.2-771]; p = 0.021). The predictive value of "baseline anti-CRP positivity" further increased when combined with "non-response to therapy in the first year". Baseline anti-CRP-Ab positivity was not a predictor of "unfavorable outcome" at the end of follow-up, (OR [95% CI] = 5.5 [0.6-71.1], p = 0.169). CONCLUSIONS: Baseline serum levels of anti-CRP-Ab seem to be a strong risk factor for a composite outcome of non-response, renal flare or end stage renal disease after two years of standard treatment of LN. The response to therapy seems to be delayed in anti-CRP-Ab positive patients.

• MeSH
• autoantigeny imunologie   MeSH
• autoprotilátky krev   imunologie   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein imunologie   MeSH
• dospělí MeSH
• ELISA MeSH
• lidé MeSH
• následné studie MeSH
• nefritida při lupus erythematodes krev   imunologie   MeSH
• prognóza MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• autoantigeny MeSH
• autoprotilátky MeSH
• biologické markery MeSH
• C-reaktivní protein MeSH

Postoperative complications of rectal resections classified as grade III or higher according to Clavien-Dindo system, which also include anastomotic leaks, are usually life-threatening conditions. Delayed diagnosis may account for almost 18% of deaths. Due to nonspecific clinical signs in the early postoperative period, diagnosing these complications may truly be a challenge for clinicians. Nowadays, with the implementation of the ERAS protocol (enhanced recovery after surgery) and efforts concentrated on quickly delivered treatment to patients suffering from the above-mentioned complications, an appropriate marker with high specificity is required. Postoperative levels of C-reactive protein in blood serum seem promising in this aspect. The presented study aimed to determine the cut-off level of serum C-reactive protein as a possible predictive factor for early diagnosis of serious postoperative complications associated with rectal resections. This could also lead clinicians to the diagnosis of anastomotic leak after other possible options are ruled out. This study is a retrospective observational analysis of patients who underwent open resection of rectal cancer during a one-year period. Collected data included risk factors (age, gender, BMI, bowel preparation), record of complications and C Reactive Protein (CRP) serum levels. The study included 162 patients. Uncomplicated postoperative course was observed in 58 patients (35.8%). Complications were present in 104 cases (64.2%), including surgical site infections (16.7%) and anastomotic leak (9.9%). The mortality rate was 2.5%. Serum CRP threshold predicting relevant complications reached a sensitivity of 83.3% and specificity of 82.7% on POD 4, with a 175.4 mg/L cut-off value, burdened with a 95.7% negative predictive value. Postoperative serum C-reactive protein may be used as a good predictor of infectious complications, including anastomotic leaks. Measuring CRP levels in the early postoperative period may facilitate identification oflow-risk patients ensure early and safe discharges from hospital after rectal resections.

• Klíčová slova
• C-reactive protein, anastomotic leak, complications, open surgery, rectal surgery,
• MeSH
• biologické markery MeSH
• C-reaktivní protein * analýza   MeSH
• časná detekce nádoru MeSH
• lidé MeSH
• nádory rekta * chirurgie   MeSH
• netěsnost anastomózy diagnóza   etiologie   MeSH
• pooperační komplikace diagnóza   MeSH
• retrospektivní studie MeSH
• senzitivita a specificita MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Názvy látek
• biologické markery MeSH
• C-reaktivní protein * MeSH

AIM: The purpose of this study was to investigate the recovery pattern of the plasma inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) after the single-bout maximal exercise. The exercise of different type (continuous vs. intermittent) was performed and also compared in this study. METHODS: Following baseline testing, 30 males were divided into three experimental groups, which completed continuous or intermittent all-out exercise of similar duration or no exercise intervention (Control group). Blood was sampled before and 1 h, 3 h, 5 h after exercise. Serum was analysed for IL-6, CRP, lactate, creatinine, uric acid, cortisol, creatine kinase, lactate dehydrogenase and myoglobin. Diet was standardized during recovery monitoring. RESULTS: Serum IL-6 and CRP concentrations were not significantly changed in the pre- to post-exercise values comparison. These results are evident in both exercise intervention groups as well as in the control group. The only exception is the significant (P=0.03) IL-6 decrease (28.2%) in continuous exercise protocol 3 h after the exercise. Significant changes (P<0.05) were also observed in lactate, cortisol, uric acid and myoglobin, when pre-exercise vs. post-exercise recovery values were compared CONCLUSION: The exercise of all-out intensity and relatively short duration, no matter what type, does not elicit a significant change in the inflammatory markers IL-6 and CRP for the 1h to 5h period of rest following the exercise.

• MeSH
• antropometrie MeSH
• biologické markery metabolismus   MeSH
• C-reaktivní protein metabolismus   MeSH
• cvičení fyziologie   MeSH
• hydrokortison metabolismus   MeSH
• interleukin-6 metabolismus   MeSH
• kreatinin metabolismus   MeSH
• kreatinkinasa metabolismus   MeSH
• kyselina močová metabolismus   MeSH
• L-laktátdehydrogenasa metabolismus   MeSH
• lidé MeSH
• mladý dospělý MeSH
• myoglobin metabolismus   MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• C-reaktivní protein MeSH
• hydrokortison MeSH
• interleukin-6 MeSH
• kreatinin MeSH
• kreatinkinasa MeSH
• kyselina močová MeSH
• L-laktátdehydrogenasa MeSH
• myoglobin MeSH

C-reactive protein (CRP) is a marker of arterial inflammation while lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is related to plaque instability. The aim of this study was to evaluate the correlation between the risk of unstable plaque presenting as acute coronary syndrome (ACS) and Lp-PLA(2), and to assess the influence of statins on interpretation of Lp-PLA(2). A total of 362 consecutive patients presenting to the emergency department (ED) with acute chest pain suggestive of ACS were evaluated by cardiologists as STEMI, NSTEMI, or unstable angina, and non-ACS. Serum biomarkers measured on admission: troponin I, C-reactive protein (Abbott), and Lp-PLA(2) (DiaDexus). Four groups were defined according to the final diagnosis and history of statin medication: ACS/statin-; ACS/statin+; non-ACS/statin-; non-ACS/statin+. Lp-PLA(2) was highest in ACS/statin- group; statins decreased Lp-PLA(2) both in ACS and non-ACS of about 20 %. Lp-PLA(2) was higher in ACS patients in comparison with non-ACS patients group without respect to statin therapy (p<0.001). Lp-PLA(2) predicted worse outcome (in terms of acute coronary syndrome) effectively in patients up to 62 years; limited prediction was found in older patients. C-reactive protein (CRP) failed to discriminate four groups of patients. Statin therapy and age should be taken into consideration while interpreting Lp-PLA(2) concentrations and lower cut-off values should be used for statin-treated persons.

• MeSH
• akutní koronární syndrom krev   diagnóza   MeSH
• aterosklerotický plát krev   farmakoterapie   MeSH
• C-reaktivní protein analýza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• plocha pod křivkou MeSH
• prediktivní hodnota testů MeSH
• senioři MeSH
• stárnutí metabolismus   fyziologie   MeSH
• statiny terapeutické užití   MeSH
• thiolesterhydrolasy krev   MeSH
• troponin I krev   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• C-reaktivní protein MeSH
• LYPLA2 protein, human MeSH Prohlížeč
• statiny MeSH
• thiolesterhydrolasy MeSH
• troponin I MeSH