C-reactive protein and the acute phase reaction in geriatric patients.
The C-reactive protein (CRP), first described as a serum component capable of precipitating the C-polysaccharide of pneumococci, is one of the most important proteins because the serum concentration rises in the acute phase reaction. The acute phase reaction is the nonspecific reaction of the body to noxious stimuli of the most varied kinds, such as infections, burns, neoplasms and tissue trauma. The CRP is synthesized in liver parenchymal cells by cytokines which are derived from stimulated leucocytes and released into the circulation. Because of its molecular structure and in synergy with the complement system, it is able to precipitate and/or lyse microorganisms, thereby rendering them harmless. Measurement of the serum CRP concentration can provide important information with respect to the diagnosis and monitoring of treatment. Due to immunosenescence in geriatric patients the synthesis of CRP appears to be limited to inflammatory stimuli; however, this phenomenon does not appear to be of major clinical relevance. Despite the introduction of new parameters of the acute phase reaction, sometimes with better performance, such as interleukin-6, procalcitonin and the soluble endotoxin receptor sCD14, measurement of CRP for diagnosis and treatment monitoring is still justified even in geriatric patients as testing is rapid, economic and nearly ubiquitously available round the clock. Biochemical markers of the acute phase reaction should always be interpreted together with the clinical picture and their specific limitations.
Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Paracelsus Medical University, General Hospital Nuremberg, Prof. Ernst-Nathan-Str. 1, 90419, Nuremberg, Germany. thomas.bertsch@klinikum-nuernberg.de.
Thomas
T
Bertsch
Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Paracelsus Medical University, General Hospital Nuremberg, Prof. Ernst-Nathan-Str. 1, 90419, Nuremberg, Germany.
Jakob
J
Triebel
Department of General Internal Medicine and Geriatrics, St. John of God Hospital Regensburg, Regensburg, Germany.|Institute of the Biomedicine of Ageing, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Cornelius
C
Bollheimer
Department of Emergency Medicine and Intensive Care, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany.
Michael
M
Christ
Department of General Internal Medicine and Geriatrics, St. John of God Hospital Regensburg, Regensburg, Germany.|Institute of the Biomedicine of Ageing, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Cornel
C
Sieber
Department of Neurology, Saarland University Hospital, Homburg, Germany.
Klaus
K
Fassbender
Department of Geriatrics, Helios Klinikum Schwelm -Chair of Geriatrics of Witten-Herdecke University, Schwelm, Germany.
Hans Jürgen
HJ
Heppner
D000210:Acute-Phase Reaction / Q000097:blood* / Q000175:diagnosis* / Q000276:immunology; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis* / Q000276:immunology; D016207:Cytokines / Q000097:blood*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D018570:Risk Assessment
D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein
Acute phase reaction; C-reactive protein; Geriatrics; Infection; Innate immune response