The C reactive protein or PCR (CRP from English C Reactive Protein) it is an acute phase protein, and is synthesized by our body during an inflammatory state. Analysis of the C reactive protein is then done to look for the presence of inflammation.
A match by high C-reactive protein it is associated with an inflammatory state. Usually the causes of high CRP they are bacterial and fungal infections, rheumatological, immuno-haematological and neoplastic (tumor) diseases. However, it should not be forgotten that the test for the Creattiva protein it is an examination that does not allow the diagnosis of a specific pathology, but is simply an "alarm bell" that our body is subject to an increase in inflammatory state.
PCR - C reactive protein normal values
C reactive protein in adults
Depending on the laboratory and the method of measurement, normal C reactive protein values may vary slightly.
A value of is considered normal CRP <6 mg / L (CRP <0.6 mg / dL).
C reactive protein in infants
In infants, CRP is known to rise nonspecifically in the first days of life: following a this study, the use of the following reference values in neonates has been proposed:
- 0-12 h from birth: CRP <5 mg / L
- 13-24 hours from birth: CRP <15 mg / L
- 25-36 hours from birth: CRP <25 mg / L
- 37-48 hours from birth: CRP <25 mg / L
- 49-60 hours from birth: CRP <20 mg / L
- 61-72 hours from birth: CRP <15 mg / L
- 73-84 hours from birth: CRP <15 mg / L
- 85-96 hours from birth: CRP <10 mg / L
PCR - C reactive protein mechanism of action
There PCR it is an acute phase protein, which is part of innate immunity, and is produced by the liver in the presence of an inflammatory stimulus. C reactive protein, ESR, procalcitonin and presepsin are the most commonly used tests as inflammatory markers, that is, as tests carried out during infections or other inflammatory processes.
C reactive protein is produced together with others acute phase proteins such as alpha and gamma globulins, interleukins, haptoglobin, serum amyloid protein, fibrinogen and alpha1-antitrypsin. The stimulation of PCR production is secondary to the production of another protein, interleukin 6 (IL-6), released by cells circulating in the blood, in particular by macrophages.
The levels of PCR in acute they can increase by tens or hundreds of times compared to normal values. The analysis allows the determination of PCR in the blood and is mainly used in acute cases such as in suspected infections and in chronic conditions for monitoring long-term pathologies.
The C reactive protein it works by binding to phosphorylcholine which is a protein expressed on damaged or dead cells, but also on the surface of microorganisms such as bacteria. PCR acts like opsonizing on bacteria and damaged or dead cells thanks to its bond with the phosphorylcholine exposed on the surface of the latter. The term opsonize means to coat the surface of a cell or microorganism, allowing the attack of complement proteins, and the activation of the classical complement pathway. It also allows the stimulation of the phagocytosis that is, the incorporation of cells or opsonized microorganisms by cells such as macrophages.
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In other words, PCR is part of the mechanism that allows our body to activate the response to an insult, be it infectious, autoimmune or ischemic.
PCR - C reactive protein because the test is performed
There C-reactive protein it is not a diagnostic test in the sense that it does not allow the diagnosis of any pathology with certainty. On the other hand, the analysis of the C reactive protein allows us to understand if an inflammatory state is present: this, combined with other clinical factors such as signs or symptoms found in the physical examination, or as other blood tests carried out together with PCR, allows to place everything in a situation of acute or chronic inflammation, or in a picture of acute exacerbation of a chronic disease.
C reactive protein is also used in the continuation of an infection to evaluate the response to antibiotic or antifungal therapy. Similarly, in chronic diseases it is used in the follow-up to evaluate the response to treatment. Unlike the other test used in inflammation diagnostics, that the ESR (erythro-sedimentation rate, i.e. the speed that red blood cells use to settle on the bottom of a test tube), the PCR changes only moderately during pregnancy, and the case of increased presence of globulins in the blood (hyperglobulinemia) does not change in the course of anemia. For these reasons, PCR is much more specific than ESR in the diagnosis and monitoring of inflammatory events.
Note: PCR is often indicated in blood test reports with the wording s-PCR or s-C reactive protein, where the "s" stands for serum, which derives from serum, that is the non-corpuscular liquid part of the blood.
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High CRP - High C reactive protein
A high C reactive protein (High CRP) is characteristic of acute inflammatory conditions such as bacterial and fungal infections, or in case of an ischemic event (e.g. myocardial infarction), but also in case of chronic inflammatory diseases. A High PCR, as indeed a high ESR, therefore gives the perception that there is an active inflammatory state, the nature of which must however be diagnostic by analyzing specific signs and symptoms, possibly with the help of other blood or radiological analyzes.
Ongoing inflammatory insult, the Creattiva protein begins to increase after about 6-12 hours from the start of the inflammatory stimulus, and reaches its highest peak within 24-48 hours. Once the inflammatory pathology has resolved, the CRP returns to baseline levels within 48 hours (in fact it has a half-life of about 19 hours).
High C Reactive Protein Causes - High CRP Causes
The feedback from high C reactive protein it is often associated with the presence of an inflammatory state in our body (infections, activations of the immune system and in any case everything that leads to the release of inflammatory cytokines in our body). Here are the possibilities acute causes of High CRP:
Bacterial infections: they are the most common type of infection ever, characterized by high fever (> 38 ° C) often accompanied by chills. Bacterial infections represent the most powerful stimulus for the increase of C-reactive protein values: was estimated that, regardless of whether the culprit is a gram + or gram - germ, a bacterial infection causes an increase in CRP greater than 100 mg / l in over 70% of cases. Here are the bacterial infections that most frequently cause high CRP:
Bacterial infections of the teeth and oral cavity: they are quite frequent, very painful infections that can lead to serious complications. Among the most frequent are the dental granulomas, which are infections of the apex of the dental root secondary to caries or ruptures of part of the tooth, and the pulpits, or the inflammation of the pulp of the teeth: if left untreated, they can worsen up to the development of a suppurative granuloma or a real abscess.
Tonsillitis: infection of the tonsils, two symmetrical lymphatic organs located in the oral cavity, in the nasopharynx. A well-known research by Dr. Putto showed an average CRP in bacterial pharyngotonsillitis of 65 mg / L, comparable to that of EBV (Epstein Barr Virus) tonsillitis, but significantly higher than adenovirus vviral tonsillitis).
Bacterial skin infections: are very common infections in elderly, overweight or obese people and not infrequently with circulation problems in the lower limbs (main site of skin and soft tissue infections). We list below the most frequent:
- Erysipelas: Soft tissue infection involving the dermis and the superficial layers of the hypodermis, is characterized by high CRP levels, generally between 50 and 100 mg / L. For example this research conducted in a dermatology department showed mean C-reactive protein values of 78 mg / L.
- Impetigo: infection by pyogenic germs, differs from other types of soft tissues as it is frequent even in the pediatric age. Almost always caused by gram positive bacteria such as Staffilococcus aureus or Pyogenes streptococcus (which is a group A beta hemolytic streptococcus). Characterized by high ESR and C reactive protein.
- Cellulite: inflammation of the subcutaneous connective tissue: it can represent an evolution of a normal erysipelas and can lead to the feared involvement of the connective bands, fasciitis. ESR, CRP and procalcitonin (PCT) are constantly altered during cellulite, in particular CRP usually exceeds 40 mg / L.
- Fasciitis: very serious pathology consisting in the infection of the deep soft tissues that spreads through the connective bands that envelop the tissues, giving deep necrosis, sepsis and septic shock with a high risk of poor prognosis. A score is used to calculate the risk of necrotizing fasciitis LRINEC, which among its parameters also uses the data of PCR> 150 mg / L. A recent study published in Plosone showed a mean C reactive protein of 254 mg / L in patients with necrotizing fasciitis.
Airway infections: they are among the most frequent infections, especially in children and the elderly. Here are the most frequent manifestations of respiratory tract infection:
- Pneumonia: it is a pathology affecting the lung parenchyma. Pneumonia is characterized by inflammation in the alveoli, small “bag-shaped” cavities into which the bronchioles flow. The main cause of pneumonia is bacterial lung infection, during which the alveoli become filled with fluid and / or inflammatory material causing a lack of ventilation. Pneumonia is usually characterized by a productive cough (fat cough), fever, and, later on, difficulty breathing. In general, in bacterial pneumonia the ESR and CRP are very high, in particular CRP often exceeds 100 mg / L. For example, I study 2004 conducted by Almirall J et al. and published in Chest showed, in bacterial pneumonia, one Mean CRP of 110.7 mg / L, with Legionella pneumoniae pneumonia and Streptococcus pneumoniae pneumonia which showed the highest mean CRP values (178 mg / L and 166 mg / L respectively) .The following table shows the study data instead C-reactive protein levels in community-acquired pneumonia, by E. García Vázquez et al. 2003, published in the European Respiratory Journal. According to this article, for example, a value of is considered predictive of S. pneumoniae bacterial pneumonia CRP greater than 250 mg / L. Below are the average levels of Creattiva protein based on the germ responsible for the infection.
|Bacterial agent||No. of patients||Mean CRP (mg / L)|
|Typical lung bacteria||141||160|
|Legionella pneumophila pneumonia||30||252,3|
|Patients with more than one identified pathogen||80|
|Purulent pneumonia + Legionella||2||149|
|Purulent pneumonia + atypical bacteria||12||138|
|Purulent + viral pneumonia||17||167,6|
|Viral pneumonia + Legionella||1||339,8|
|Viral pneumonia + atypical bacteria||6||129|
|Atypical bacteria + Legionella||4||270,3|
|Pneumonia of unknown etiology||383||140,1|
- Bronchitis: it is a very frequent bacterial infection at a young age, it also returns very widespread in elderly patients, as an exacerbation of COPD (Chronic Obstructive Pulmonary Disease). It is characterized by cough and bronchospasm signs and symptoms. The indices of inflammation (CRP, ESR, procalcitonin, presepsin) are easily altered from the first respiratory manifestations.
- Pharyngitis: it's the classic "sore throat", consists of inflammation of the pharynx, the terminal part of the oral cavity that connects it with the nasal cavity, esophagus and larynx. The larynx, in turn, can become inflamed, giving rise to the lherringitis. Both of these pathologies are predominantly viral, with a modest increase in inflammation indices. Less often they are of bacterial etiology, with a conspicuous rise in Reactive Protein C, not rarely greater than 50 mg / L.
- Sinusitis: inflammation of the mucous membrane of the paranasal sinuses (which are divided into frontal sinuses, maxillary sinuses, ethmoid sinuses and sphenoid sinuses) of the cavities located in our facial massif and which have important functions such as moistening and warming the inhaled air, protecting the skull from sudden changes in temperature and trauma and allergen the overall bone weight. There bacterial sinusitis (sinusitis purulent, to distinguish it from viral sinusitis, called serous) is mainly caused by and is characterized by a major increase in ESR and a raising of the C-reactive protein, which is usually between 50 mg / L and 100 mg / L.
CRP and bacterial urinary infections: urinary tract infections are the most frequent infections in women and among the most frequent of all. We pass from asymptomatic bacteriuria (i.e. from the presence of bacteria in the urine without associated symptoms) to classic bacterial cystitis (inflammation of the bladder linked to bacterial infection) to urethritis (inflammation of the urethra, i.e. the tract that connects the bladder with the external) up to "higher" infections such as cystopyelitis and pyelonephritis. The IVU (urinary tract infections, also called UTI, Urinary Tract Infection) can also be not complicated, i.e. cystitis in nonpregnant, non-immunocompromised women without functional or anatomical abnormalities of the urinary tract and who have no signs of systemic infection or tissue invasion, or complicated, that is when they show signs of systemic infection or that in any case do not fall within the criteria previously described. The treatment of complicated infections will be much stronger and "aggressive" than the uncomplicated forms of cystitis. The analysis of the C-reactive protein, as well as the other indices of inflammation (especially procalcitonin) is very useful for assessing the extent of the infection and the course of antibiotic therapy. The germs most frequently responsible are E. coli (Escherichia Coli) in 80-90% of cases, and a heterogeneous group of other microorganisms (Staphylococcus saprophyticus, Staphylococcus epidermidis, Enterococcus fecium and fecalis, Klebsiella pneumoniae and Proteus Mirabilis) in the remaining 10 -20% of cases. Here are the most frequent urinary infections.
Cystitis and C reactive protein: bladder infection, it is very frequent especially in women. It is favored by poor intimate hygiene or by an exaggerated use of detergent products that alter the intestinal bacterial flora, by cold, by the presence of anatomical anomalies such as urinary tract stenosis, stones, uterine or bladder prolapse, or by diseases associated with diabetes, neurological pathologies, from the use of contraceptive devices such as the diaphragm, and, in incontinent or hospitalized patients, from the presence of a bladder catheter. LPCR examination it is very useful as it allows, in a person with urinary symptoms (For example dysuria, i.e. difficulty urinating, pollakiuria, i.e. need to urinate frequently, hematuria, i.e. blood in the urine, or stranguria, i.e. painful urination) to check for the presence of an inflammatory (probably infectious) state of the urinary tract). L'analysis of C reactive protein it is also useful for monitoring the progress of antibiotic therapy. The CRP values can vary from minimal alterations (15-20 mg / L) up to values over 250 mg / L in urosepsis, that is, in complicated cystitis with spread of the infection throughout the body.
Urethritis and PCR: Urethritis is an inflammation of the urethra, the small channel that carries urine from the bladder to the outside of our body. It is often of bacterial origin, linked to a non-optimal intimate hygiene, and the most frequent germs that cause it are Chlamydia Trachomatis, and the Trichomonas and Mycoplasma species. It is associated with a positive urine culture, and with an alteration of the indices of inflammation, C reactive protein and ESR.
Prostatitis and PCR: prostatitis is the inflammation of the prostate, a gland present only in males, essential for fertility and reproduction. If linked to a bacterial infection, it presents with fever, groin pain and difficulty urinating. It often leads to C-reactive protein levels 10-20 times higher than normal levels.
Abdominal and gastrointestinal bacterial infections: they are very frequent infections, and of very variable severity. CRP levels in this type of infections can reach very high values. Here are the most frequent infections of the abdomen and gastrointestinal tract:
- Cholecystitis: inflammation of the gallbladder, more commonly called the gallbladder. This inflammation can be the result of a stone wedged in the infundibulum (the terminal part of this sac-like organ), which prevents the normal outflow of bile and can cause a state of inflammation and tension of the organ, up to superinfection of the gallbladder. Lithiasic cholecystitis (i.e., calculotic, related to gallstones) accounts for more than 85% of cases of gallbladder inflammation. In the remaining 15% the causes are different, and we speak of alitiasic cholecystitis. There cholecystitis it is a very serious acute disease, which is treated with antibiotic and pain relieving therapy, complete fasting and adequate intravenous hydration. Complications of cholecystitis are the spread of the infection through the blood throughout the body (sepsis), with the possible development of SIRS (systemic inflammatory response syndrome). Another fearful complication is the perforation of the gallbladder, with the dissemination of its infected contents into the abdominal cavity, invariably causing peritonitis. In the course of cholecystitis, very high values of the inflammation indices can be recorded, such as ESR, PCR and above all procalcitonin. In particular, CRP often exceeds the threshold of 200 mg / l. One study conducted in Japan found variable C-reactive Protein values in relation to the severity of the disease: CRP around 20 mg / l in uncomplicated cholecystitis, CRP values greater than 130 mg / l in intermediate severity cholecystitis and an average CRP greater than 230 mg / l in complicated severe cholecystitis. Another research highlighted theusefulness of protein C reactive in predicting what type of surgical approach to use: patients with low CRP were operated in most cases laparoscopically (i.e. with minimal surgery, with small surgical wounds), while patients with high CRP (greater than 36 mg / l showed a high risk of laparotomic cholecystectomy (ie with the classic opening of the abdomen with a scalpel).
- Cholangitis: infection of the biliary tract, it is almost always linked to a bacterial superinfection in a situation of reduced biliary outflow, that is when there is a stone or a stenosis of the biliary tract that causes the bile to stagnate. More rarely, it results from congenital anomalies of the biliary tract or from previous abdominal surgery. In some cases, cholangitis can develop as a result of other abdominal infections (pancreatitis, diverticulitis). THE C reactive protein values in cholangitis they often exceed the 100 mg / L threshold.
- Infectious pancreatitis: inflammation of the pancreas, often linked to the presence of stones in the biliary tract or pancreatic tract, which cause a stagnation of the bile and pancreatic juices, which begin to attack the pancreas itself, initially producing local inflammation, then a real necrosis . Other less frequent causes are linked to infections of the biliary tract, to congenital anomalies of the biliary tract. Alcoholics are predisposed to pancreatitis, as are people with hypertriglyceridemia, and those who suffer from impaired calcium metabolism (hypercalcemia with or without primary hyperparathyroidism). In the course of pancreatitis, the inflammatory process is very important and is not uncommon to observe CRP levels above 200 mg / L.
Genital and reproductive system infections: they are infections often transmitted sexually or linked to poor personal hygiene. Here are the most frequent.
- Salpingitis: inflammatory process usually of infectious origin affecting the salpingi (fallopian tubes): the germs most commonly involved are streptococci, staphylococci, and gonococci (Neisseria gonorrhoeae). Scientific evidence have shown relevant changes in PCR in the course of salpingitis, with a mean of 11 mg / l and peaks up to 97 mg / l CRP in salpingitis caused by Chlamydia trachomatis, and a mean C reactive protein of 104 mg / l with peaks up to 250 mg / l in progress of Neisseria gonorrhoeae infection.
- Orchitis: inflammation of the testicles, very painful and accompanied by high values of the indexes of inflammation.
- Epididymitis: an inflammation of the epididymis, the thin, twisted duct that connects each testicle to its vas deferens. Painful disorder, which if left untreated can lead to infertility, is associated with a significant increase in c-reactive protein.
- Balanitis: inflammation, often of infectious origin, of the glans head. Often the values of the phlogosis indices are high, and are accompanied by pain, redness and swelling of the distal (thermal) part of the penis.
Other typical young age infections:
- Ear infection: ear inflammation, mainly manifested by ear pain, hearing loss, fever. At the laboratory level there is a marked increase in ESR and CRP.
- Scarlet fever: infectious disease caused by the toxins of Streptococcus Pyogenes (Group A Streptococcus), manifested by rash (punctate exanthema), pharyngodynia (sore throat), pyrexia (fever) and alteration of the signs of inflammation, with high CRP.
Fungal infections: they are less frequent, most are caused by urinary tract infections caused by fungi (fungi), the most common is Candida.
Viral infections: infections caused by viruses are usually accompanied by lower inflammation index levels than bacterial infections. Normally the CRP does not exceed 50 mg / L, and the fever does not exceed 39 ° C (as always there are exceptions in this case too). Here are the most frequent viral infections with high CRP:
- Influenza and rhinovirus infections (syndrome from cooling or cold): It has been demonstrated a modest increase in CRP in the first week of illness, with a peak towards the 4th day and average values ranging from 10 mg / L to 40 mg / L.
- Measles: viral infection caused by Morbillivirus, is characterized by a modest rise in CRP (<20 mg / L), unless there is underlying bacterial superinfection.
Chronic inflammatory bowel diseases in the initial and active phase, Such as ulcerative colitis or Crohn's disease.
Rheumatological pathologies: the most frequent are rheumatic polymilagia, rheumatoid arthritis, systemic lupus erythematosus (SLE), as well as systemic vasculitis. Being inflammatory pathologies they involve an activation of the inflammatory cascade with activation of IL-6, TNF and consequent increase of the inflammation indices, in particular of ESR and PCR. Here are the most common rheumatological diseases:
Systemic lupus erythematosus (SLE): lupus is a pathology chronic inflammatory autoimmune, which affects the serosa and tissues of various organs in our body. In our country it affects 1500-200 people annually, of which 90% belongs to women. At the biohumoral level, anti-nucleus antibodies, anti-phospholipid antibodies and anti-DNA antibodies are often found. In the phases of inactivity or in active SLE but without affecting the serosa, the values usually do not exceed 20 mg / l, while in the phases of active lupus with serositis, the finding of high CRP is the rule, with values on average above 60 mg / l.
Rheumatoid arthritis: it is a chronic disease that causes pain, swelling (swelling) and joint stiffness with limitation of the range of motion and function of the affected joints. Although the joints are the most involved parts of the body, inflammation can also develop in other organs or areas. It is accompanied by positivity for the rheumatoid factor, a particular antibody directed towards our own organism. In the course of rheumatoid arthritis, the finding of C-reactive protein is rheumatoid factor altered is very common.
Vasculitis of the great vessels:
- Giant cell arteritis
- Takayasu's arteritis
Vasculitis of medium caliber vessels:
- Polyarteritis nodosa
- Kawasaki disease
- Primary granulomatous vasculitis of the central nervous system
Small vessel vasculitis:
- ANCA-associated vasculitis
- Microscopic polyangiitis
- Wegener's granulomatosis
- Churg-Strauss syndrome
- Drug-induced and ANCA-associated vasculitis
- Immune complex vasculitis
- Henoch-Schönlein purpura
- Cryoglobulinemic vasculitis
- Lupus vasculitis
- Rheumatoid vasculitis
- Sjögren's syndrome vasculitis
- Hypocomplementemic urticarial vasculitis
- Behçet's disease
- Goodpasture syndrome
- Serum sickness vasculitis
- Drug-induced vasculitis
- Post-infectious immune complex vasculitis
- Paraneoplastic vasculitis
- Vasculitis induced by lymphoproliferative disease
- Vasculitis induced by myeloproliferative diseases
- Vasculitis associated with carcinoma
- Vasculitis from chronic inflammatory bowel diseases
Pelvic inflammatory disease (Pelvic Inflammatory Disease or PID)
Non-infectious pancreatitis: even in the course of non-infectious pancreatitis, which is the most common form of inflammation of the pancreas, due to the activation of pancreatic enzymes following the occlusion or spasm of the Wirsung duct (stones, alcoholism the most frequent causes), there is an important increase in inflammatory indices. Furthermore, the fact remains that a lithiasic pancreatitis (from stones) can evolve and become overinfected if not treated properly.
Acute joint rheumatism, or rheumatic fever.
Trauma or surgery
Ischemic insults (i.e. related to the reduced blood supply in a certain area of the body), such as myocardial infarction or cerebral ischemia (stroke).
Hematological diseases: lymphomas and multiple myeloma can be characterized by High ESR is high C reactive protein.
Not always the feedback of high C reactive protein it is associated with an acute pathology: often, the CRP is elevated even during chronic inflammatory diseases. Here are some possible ones chronic causes characterized by a High CRP:
Chronic inflammatory bowel diseases (Crohn's disease and ulcerative colitis) in the chronic phase
Terminal pregnancy (minimum increase)
Obesity: Obese people have increased baseline CRP values compared to people of normal weight: in this study a C-reactive protein value greater than 2.2 mg / l has been documented in over 60% of obese people, with about 20% having a CRP even more than 10 mg /l, in the absence of any other inflammatory pathologies in progress.
Neurological diseases such as multiple sclerosis
High C Reactive Protein Symptoms - High CRP Symptoms
Symptoms that may be associated with a High CRP they are mainly those found in the case of a bacterial or fungal (fungal) infection.
The symptoms in the acute phase that may accompany the finding of high c reactive protein will mainly be:
- articolar pains
- sweating alternating with a feeling of cold sometimes accompanied by chills
- possible signs of infection / inflammation in one or more parts of the body, such as:
- redness or swelling (swelling) of the skin in soft tissue infections such as erysipelas or cellulitis (involving the deeper subcutaneous layers),
- problems with urination such as dysuria (burning when urinating) or stranguria (pain when urinating) if there is a urinary tract infection, such as cystitis or pyelonephritis
- cough produced sometimes accompanied by breathing difficulties in case of an airway infection (pneumonia, bronchitis, bronchopulmonary, bronchiolitis in children)
- abdominal pain, nausea, jaundice in the case of a biliary tract or gallbladder infection (cholangitis or cholecystitis)
- sensation of swelling and pain in the oral cavity (to exclude the presence of granuloma or abscess at the dental level)
- Pelvic or groin pain that is accentuated with sexual intercourse and at the end of each menstrual cycle: these are typical symptoms of pelvic inflammatory disease.
- In case theincreased CRP is linked to a chronic inflammatory disease the most common symptoms can be:
- mild fluctuating fever (low-grade fever)
- joint pain with or without swelling (swelling), redness and warmth in the joints
- recurrent diarrhea and abdominal pain in the case of chronic intestinal diseases.
- Weight loss (weight loss), loss of appetite (hyporexia) and energy (asthenia): these are symptoms that must be investigated because they are present in the course of cancer.
Hs-PCR - High sensitivity C reactive protein
High-sensitivity PCR (hs PCR, from English HS-CRP, High Sensivity C-reactive protein) is an analysis that measures the blood values of C reactive protein with an ultrasensitive method, so that even small quantities of this protein can be detected precisely. Unlike the classic PCR test, which is carried out in the suspicion of infections or inflammatory diseases, the hs-PCR is measured in the context of cardiovascular diseases, to understand the risk of a subject, even healthy, of encountering acute ischemic heart (myocardial infarction) and cerebral (ischemic stroke) ischemic problems. In fact, it is believed that even modestly altered levels of hs-PCR are associated with the presence of atheroscelrosis or, in any case, damage to the vascular level. The article by Steven Black, reports that CRP levels between 3 and 10 mg / dl can lead to an increased risk of developing cardiovascular complications (myocardial infarction, ischemic stroke, multiple district vasculopathy), metabolic syndrome is colon cancer.
The levels of hs PCR are divided into bands, with increasing cardiovascular risk from the first (low-zero risk) to the fourth (high risk).
hs-CRP less than 0.48 mg / L
hs-CRP between 0.49 and 1.2 mg / L
hs-CRP between 1.2 and 3.1 mg / L
hs-CRP between 3.1 mg / dL and 10 mg / L
Caution: for highly sensitive Ca-reactive protein values greater than 10 mg / dL the test is not considered significant for the purposes of determining the cardiovascular risk, since such high values probably imply an inflammatory state of another origin (infectious or inflammatory of another nature).
According to the American Heart Association, hs-PCR analysis is very useful for people with intermediate cardiovascular risk (therefore with probability ranging from 10 to 20 %, having a heart attack in the next 10 years). This risk level is defined based on the presence of risk behaviors (smoking, incorrect diet), on the physical condition (obesity, diabetes, cholesterol or excess triglycerides) and on familiarity (presence in the family of people who have suffered from cardiovascular disease or diabetes.
For people with low cardiovascular risk, hs-PCR analysis is less useful, as it does not add information about the future risk of cardiovascular disease. Finally, even in people with a high risk of heart or vascular disease there is no indication of the dosage of the hs-PCR, as all the precautions must be implemented to reduce the risk of heart attack or stroke, regardless of the altered or not values of the highly sensitive C reactive protein.
The hs-PCR dosage must be accompanied by that of the other analyzes that help to frame the cardiovascular risk of an individual: ctotal cholesterol, HDL and LDL cholesterol, triglycerides, homocysteinemia, Lp (a) dosage.
There C-reactive protein was discovered in 1930 by William S. Tillett and Thomas Francis, Jr., who noted how this substance reacted against the pneumococcal polysaccharide C (Streptococcus Pneumonie). The substance was called Fraction C, and in subsequent experiments it was clear how this protein was found in large quantities in the serum of those who had an acute event such as rheumatic fever and infections.
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