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[Rinsho Byori 50 : 30-39, 2002]
High-Sensitivity C-Reactive Protein(CRP) Assay CRP has long been used as a sensitive marker for infectious diseases. Since its serum concentration elevates more than 10mg/dl with gram-negative bacterial infections, the sensitivity can be enough to be around 0.3～0.6mg/dl for the diagnosis. However, the sensitivity should be higher in the early diagnosis of infections in new-borne babies. In addition, recently, it was suggested that atherosclerotic lesions are a kind of vasculitis, and the information could be transmitted via production of inflammatory cytokines and acute phase proteins. In fact, serum CRP and serum amyloid protein A(SAA) levels are elevated even in patients with coronary atherosclerosis without acute coronary syndrome(ACS). However, the level was much lower than the cut-off for diagnosis of bacterial infection. Therefore, the high-sensitive assay method has been applied. As the result, high-sensitivity(hs) CRP assay was found to be one of the most sensitive markers for prediction of future ACS in USA. Combination of hsCRP and atherogenic index such as total cholesterol/HDL cholesterol or LDL cholesterol/HDL cholesterol ratio is more useful. Similarly, it was found that hsCRP could predict the future prevalence of ACS even in Japan. It may be true because production of CRP is independent upon the genetic backgrounds. Early prevention of ACS by the measurement of hsCRP is calculated to be economic even if we measured hsCRF often in subjects without symptoms, because medical cost for treatment of acute myocardial infarction is enormous. In patients with high risk for coronary heart diseases, hsCRP-guided therapy is possible by using aspirin, stains, and antibiotics for prevention of ACS.
*Department of Clinical Sciences and Laboratory Medicine, Kansai Medical University, Moriguchi 570-8507 |