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      C-reactive protein as a predictor of disease in smokers and former smokers: a review

      review-article
      1 , 2
      International Journal of Clinical Practice
      Blackwell Publishing Ltd

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          Abstract

          Background:

          Cigarette smoking is a classical and a major risk factor in the development of several diseases with an inflammatory component, including cardiovascular disease and chronic obstructive pulmonary disease. Improvements in assays for protein markers of inflammation have led to many studies on these factors and their roles in disease.

          Aims:

          C-reactive protein (CRP) is one such marker and this review focuses on the evidence for using CRP as a diagnostic marker and how levels of this protein are modified according to the smoking status of the patient, both in terms of the current amount of cigarettes smoked and how CRP levels change following smoking cessation.

          Conclusions:

          Assay of CRP levels may be useful in monitoring disease progression and determining risk of future cardiovascular complications. However, as this marker is also an indicator of acute inflammation and challenges to the immune system, some caution must be exercised in interpreting the available data on CRP levels in patients with different chronic comorbidities.

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          Most cited references51

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          C-reactive protein: a critical update.

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            Reciprocal association of C-reactive protein with adiponectin in blood stream and adipose tissue.

            High-sensitive C-reactive protein (hs-CRP) is a well-known risk factor for coronary artery disease (CAD). Recently, we have demonstrated that adiponectin served as an antiatherogenic plasma protein which was secreted specifically from adipocytes. The present study investigated the association between adiponectin and CRP in the blood stream and adipose tissue. We studied a total of 101 male patients, 71 of whom had angiographically documented coronary atherosclerosis. As a control group, 30 patients with normal coronary angiogram were included. The plasma hs-CRP levels were negatively correlated with the plasma adiponectin levels (r=-0.29, P<0.01). The plasma adiponectin concentrations were significantly lower and the hs-CRP levels were significantly higher in the CAD patients compared with control subjects. The mRNA levels of CRP and adiponectin were analyzed by quantitative real-time polymerase chain reaction method. We found that the CRP mRNA was expressed in human adipose tissue. A significant inverse correlation was observed between the CRP and adiponectin mRNA levels in human adipose tissue (r=-0.89, P<0.01). In addition, the CRP mRNA level of white adipose tissue in adiponectin deficient mice was higher than that of wild-type mice. The reciprocal association of adiponectin and CRP levels in both human plasma and adipose tissue might participate in the development of atherosclerosis.
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              Metabolic and scintigraphic studies of radioiodinated human C-reactive protein in health and disease.

              Plasma and whole-body turnover studies of human C-reactive protein (CRP), isolated from a single normal healthy donor and labeled with 125I, were undertaken in 8 healthy control subjects and 35 hospitalized patients including cases of rheumatoid arthritis, systemic lupus erythematosus, infections, and neoplasia. Plasma clearance of 125I-CRP closely approximated to a monoexponential function and was similar in the control and all patient groups. There was no evidence for accelerated clearance or catabolism of CRP in any of the diseases studied. The 19-h half-life was more rapid than that of most human plasma proteins studied previously, and the fractional catabolic rate was independent of the plasma CRP concentration. The synthesis rate of CRP is thus the only significant determinant of its plasma level, confirming the validity of serum CRP measurement as an objective index of disease activity in disorders associated with an acute-phase response. Approximately 90% of injected radioactivity was recovered in the urine after 7 d, and scintigraphic imaging studies with 123I-labeled CRP in 10 patients with different focal pathology showed no significant localization of tracer. The functions of CRP are thus likely to be effected predominantly in the fluid phase rather than by major deposition at sites of tissue damage or inflammation.
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                Author and article information

                Journal
                Int J Clin Pract
                ijcp
                International Journal of Clinical Practice
                Blackwell Publishing Ltd
                1368-5031
                1742-1241
                November 2009
                : 63
                : 11
                : 1634-1641
                Affiliations
                [1 ]simpleSchool of Medicine, Loma Linda University Loma Linda, CA, USA
                [2 ]simpleUBC Scientific Solutions, Envision House Horsham, West Sussex, UK
                Author notes
                Correspondence to: Serena Tonstad M.D., M.P.H., Ph.D., Professor of Health Promotion & Education, Professor of Preventive Medicine, Loma Linda University, Loma Linda, CA 92354, USA Tel.: + 1 909 558 4741 Fax: + 1 909 558 0471 Email: stonstad@ 123456llu.edu

                Disclosures ST has received honoraria for consulting and lecturing from Pfizer and other manufacturers of drugs for smoking cessation including Novartis and GSK. JLC is employed by UBC Scientific Solutions who were paid consultants to Pfizer in connection with the development of the manuscript

                Article
                10.1111/j.1742-1241.2009.02179.x
                2780563
                19732183
                acbcde0c-e96b-4e96-8377-d73156fff9e9
                Journal compilation © 2009 Blackwell Publishing Ltd

                Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.

                History
                : April 2009
                : June 2009
                Categories
                Review Articles

                Medicine
                Medicine

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