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Review Article

The connection between C‐reactive protein and atherosclerosis

, , & , PhD
Pages 110-120 | Published online: 08 Jul 2009
 

Abstract

The connection between C‐reactive protein (CRP) and atherosclerosis lies on three grounds. First, the concentration of CRP in the serum, which is measured by using highly sensitive (a.k.a. ‘hs’) techniques, correlates with the occurrence of cardiovascular disease. Second, although CRP binds only to Fcγ receptor‐bearing cells and, in general, to apoptotic and damaged cells, almost every type of cultured mammalian cells has been shown to respond to CRP treatment. Many of these responses indicate proatherogenic functions of CRP but are being reinvestigated using CRP preparations that are free of endotoxins, sodium azide, and biologically active peptides derived from the protein itself. Third, CRP binds to modified forms of low‐density lipoprotein (LDL), and, when aggregated, CRP can bind to native LDL as well. Accordingly, CRP is seen with LDL and damaged cells at the atherosclerotic lesions and myocardial infarcts. In experimental rats, human CRP was found to increase the infarct size, an effect that could be abrogated by blocking CRP‐mediated complement activation. In the Apob100/100Ldlr‐/‐ murine model of atherosclerosis, human CRP was shown to be atheroprotective, and the importance of CRP‐LDL interactions in this protection was noted. Despite all this, at the end, the question whether CRP can protect humans from developing atherosclerosis remains unanswered.

Abbreviations
CRP=

C‐reactive protein

Mcrp=

monomeric CRP

PCh=

phosphocholine

Pet=

phosphoethanolamine

Apo=

apolipoprotein

LDL=

low‐density lipoprotein

E‐LDL=

enzymatically modified LDL

ox‐LDL=

oxidized LDL

Abbreviations
CRP=

C‐reactive protein

Mcrp=

monomeric CRP

PCh=

phosphocholine

Pet=

phosphoethanolamine

Apo=

apolipoprotein

LDL=

low‐density lipoprotein

E‐LDL=

enzymatically modified LDL

ox‐LDL=

oxidized LDL

Acknowledgements

This research has been supported by the National Institutes of Health (R01 HL071233), USA.

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