Table of Contents
International Scholarly Research Notices
Volume 2014 (2014), Article ID 653045, 11 pages
http://dx.doi.org/10.1155/2014/653045
Review Article

C-Reactive Protein: An In-Depth Look into Structure, Function, and Regulation

1Endocrine and Metabolic Diseases Research Center, School of Medicine, Zulia University, 20th Avenue, Maracaibo 4004, Venezuela
2Institute of Clinical Immunology, University of Los Andes, Mérida 5101, Mérida, Venezuela

Received 31 August 2014; Accepted 1 November 2014; Published 16 December 2014

Academic Editor: Jose Antonio F. Ramires

Copyright © 2014 Juan Salazar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cardiovascular disease is the leading cause of morbidity and mortality in the adult population worldwide, with atherosclerosis being its key pathophysiologic component. Atherosclerosis possesses a fundamental chronic inflammatory aspect, and the involvement of numerous inflammatory molecules has been studied in this scenario, particularly C-reactive protein (CRP). CRP is a plasma protein with strong phylogenetic conservation and high resistance to proteolysis, predominantly synthesized in the liver in response to proinflammatory cytokines, especially IL-6, IL-1β, and TNF. CRP may intervene in atherosclerosis by directly activating the complement system and inducing apoptosis, vascular cell activation, monocyte recruitment, lipid accumulation, and thrombosis, among other actions. Moreover, CRP can dissociate in peripheral tissue—including atheromatous plaques—from its native pentameric form into a monomeric form, which may also be synthesized de novo in extrahepatic sites. Each form exhibits distinct affinities for ligands and receptors, and exerts different effects in the progression of atherosclerosis. In view of epidemiologic evidence associating high CRP levels with cardiovascular risk—reflecting the biologic impact it bears on atherosclerosis—measurement of serum levels of high-sensitivity CRP has been proposed as a tool for assessment of cardiovascular risk.