Information about the inflammatory state of an individual is clinically relevant since factors that determine inflammation can be modified.
C-reactive protein (CRP) is an acute phase protein produced by the liver in response to tissue injury, inflammation, or infection. The physiological role of C-reactive protein is to direct inflammatory remnants to phagocytic cells of the lymphatic system for elimination.
Coronary Artery Disease: atherosclerosis is the process in which fatty deposits build up in the inner lining of arteries. It is considered to be a low-grade inflammatory disease.
Studies have shown that plasma levels of CRP are a strong independent predictor of endothelial dysfunction, future myocardial dysfunction, stroke, and peripheral artery disease among individuals without known cardiovascular disease.
Testing CRP levels in the blood is an additional way to assess cardiovascular disease risk. A test called a highly sensitivity C-reactive protein (hs-CRP) assay can help determine cardiovascular disease risk.
C-Reactive Protein and Estrogen Replacement
Hormone replacement therapy for menopausal and postmenopausal women effects CRP levels. The effect of estrogen replacement on CRP is dependent on the route of administration. Studies show that transdermal estrogen replacement does not effect CRP, where oral estrogen replacement therapy increases CRP.
Transdermal estrogen replacement is not subject to first pass metabolism by the liver, this allows for lower doses and exposes tissues to lower drug levels. Lower exposure in the liver impacts protein and lipid synthesis.
As such, in postmenopausal women, oral but not transdermal ET increased CRP by a first-pass hepatic effect. An increase in CRP levels is accompanied by a reduction in IGF-1, an anti-inflammatory growth factor.
Red Wine benefits C-Reactive Protein
Polyphenol rich red wine has pronounced anti-inflammatory effects. In particular, the resveratrol content in red wine helps inhibit tumor necrosis factor a (TNF-a) induced NF-KB activation and inflammatory gene expression and attenuates (lessens) monocyte adhesiveness to human coronary arterial endothelial cells.
At nutritionally relevant concentrations, red wine reduces the susceptibility of LDL cholesterol to (oxidation) lipid peroxidation. Oxidized LDL cholesterol is the prominent component of atheromas (fatty deposits in the arteries). Inhibiting the oxidation of LDL cholesterol blocks the initiation of a cascade of inflammatory mediators in the arterial wall causing a reduction in atherosclerotic processes. The polyphenolic compounds in red wine have antioxidant and anti-inflammatory effects which maintain lower C Reactive Protein levels and lowers the risk of cardiovascular disease.
Sources:
High Sensitivity C Reactive Protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease.
Circulation, 2001 ;103: 1813-1818.
Resveratrol attenuates TNFa induced activation of coronary arterial endothelial cells:
Role of NF-KB inibition
Anna Csiszar, Kira Smith, Nazar Labinsky
Am J Physiology Heart Circulatory Physiology 291: 1694-1699, 2006
Differential effects of oral versus transdermal estrogen replacement therapy
on C-reactive protein in postmenopausal women
Wanpen Vongpatanasin, MD, FACC Meryem Tuncel, MD, Zhongyun Wang, MD
J Am Coll Cardiol, 2003; 41:1358-1363,
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