C-reactive protein as a prognostic marker of Plasmodiumfalciparum malaria severity

Bhardwaj, Nitin; Ahmed, Zohaib; Sharma, Supriya; Nayak, Akshatha; Anvikar, Anupkumar R.; Pande, Veena

doi:10.4103/0972-9062.263727

Cited by 21 publications

(5 citation statements)

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“… 96 The CRP level was slightly higher in severe P. falciparum malaria (20 mg/L) compared with uncomplicated malaria (14 mg/L) and healthy controls (1 mg/L) (India). 97 …”

Section: Resultsmentioning

confidence: 99%

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

Lamrous

Repetto

Depp

et al. 2023

JAC-Antimicrobial Resistance

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Objectives C-reactive protein (CRP) and procalcitonin (PCT) are widely used biomarkers in high-income countries. However, evidence for their use in low- and middle-income countries (LMICs) is scant. Because many factors, including rates of endemic disease, comorbidities and genetics, may influence biomarkers’ behaviour, we aimed to review available evidence generated in LMICs. Methods We searched the PubMed database for relevant studies within the last 20 years that originated in regions of interest (Africa, Latin America, Middle East, South Asia or South East Asia), and full-text articles involving diagnosis, prognostication and evaluation of therapeutic response with CRP and/or PCT in adults (n = 88) were reviewed and categorized in 12 predefined focus areas. Results Overall, results were highly heterogeneous, at times conflicting, and often lacking clinically useful cut-off values. However, most studies demonstrated higher levels of CRP/PCT in patients with bacterial versus other infections. HIV and TB patients had consistently higher levels of CRP/PCT versus controls. In addition, higher CRP/PCT levels at baseline and follow-up in HIV, TB, sepsis and respiratory tract infections were associated with poorer prognosis. Conclusions Evidence generated from LMIC cohorts suggests that CRP and PCT may have potential to become effective clinical guiding tools particularly in respiratory tract infections, sepsis and HIV/TB. However, more studies are needed to define potential scenarios for use and cost-effectiveness. Consensus across stakeholders regarding target conditions, laboratory standards and cut-off values would support the quality and applicability of future evidence.

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“… 96 The CRP level was slightly higher in severe P. falciparum malaria (20 mg/L) compared with uncomplicated malaria (14 mg/L) and healthy controls (1 mg/L) (India). 97 …”

Section: Resultsmentioning

confidence: 99%

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

Lamrous

Repetto

Depp

et al. 2023

JAC-Antimicrobial Resistance

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“…Malaria is a serious and, in some unfortunate cases, fatal disease caused by a parasite of the Plasmodium genus. The pathogenesis of malaria is complex and incompletely elucidated [23]. Studies have shown that oxidative stress is common among malaria patients as a result of the activation of the immune responses by the malaria parasite, thereby causing the release of reactive oxygen species (ROS) [24,25].…”

Section: Discussionmentioning

confidence: 99%

Antioxidant status and acute phase reactants in pregnant women infected with Plasmodium falciparum

Atere Adedeji,

Kosamat Yekeen,

Oluwatuyi Precious

et al. 2024

rmj

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INTRODUCTION: Malaria during pregnancy remains a public health issue. The most deadly plasmodium, Plasmodium falciparum, kills about 40% of the world's population, especially pregnant women and children under five. In pregnant women infected with Plasmodium falciparum, MDA, CAT, H2O2, SOD, and GPx were measured as oxidative stress markers and SAA and CRP as acute-phase proteins. METHODS: A total of 90 subjects were recruited for this study, which was subdivided into 30 pregnant women infected with malaria (PWM), 35 pregnant women not infected with malaria (PWN), and 25 healthy women without pregnancy (WWP) who served as the control groups. 5mls of venous blood was collected and dispensed into appropriate bottles for malaria parasite assessment using a rapid diagnostic test (RDT) and MDA, CAT, H2O2, SOD, GPx, SAA, and CRP analysis using conventional laboratory techniques. Statistical analysis was done, and P values under 0.05 were significant. RESULTS: The PWM and PWN groups had significantly higher MDA and H2O2 values, but SOD, GPx, and CAT values were significantly lower (p<0.05). When comparing CRP and SAA levels between PWM, PWN, and control groups, both groups with pregnancy had significantly greater levels (p<0.05). A negative correlation (r = -0.442, p<0.05) was found between MDA and SAA, while positive correlations were seen between CAT and CRP, and SOD and SAA in pregnant women with malaria. CONCLUSION: This study found that malaria during pregnancy increases oxidants and decreases antioxidant enzymes, causing oxidative stress. This study showed that CRP and SAA may indicate malaria infections.

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“…It can be challenging to draw any conclusions regarding the importance of a high CRP level as a prognostic marker for cardiovascular disease because chronic diseases such inflammatory arthritis or SLE can result in chronically elevated CRP (32). As a result, it was suggested that CRP levels above 50 mg/dL are typically caused by a high rate of bacterial infection and have been used as a prognostic indicator for both acute and chronic cases of hepatitis C, dengue fever, and malaria (37)(38)(39).…”

Section: Human Crpmentioning

confidence: 99%

Biological significance of C-reactive protein, the ancient acute phase functionary

Bhattacharya,

Munshi

2023

Front. Immunol.

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C-reactive protein (CRP) is one of the major members of the family of acute phase proteins (APP). Interest in this CRP was the result of a seminal discovery of its pattern of response to pneumococcal infection in humans. CRP has the unique property of reacting with phosphocholine-containing substances, such as pneumococcal C-polysaccharide, in the presence of Ca2+. The attention regarding the origin of CRP and its multifunctionality has gripped researchers for several decades. The reason can be traced to the integrated evolution of CRP in the animal kingdom. CRP has been unequivocally listed as a key indicator of infectious and inflammatory diseases including autoimmune diseases. The first occurrence of CRP in the evolutionary ladder appeared in arthropods followed by molluscs and much later in the chordates. The biological significance of CRP has been established in the animal kingdom starting from invertebrates. Interestingly, the site of synthesis of CRP is mainly the liver in vertebrates, while in invertebrates it is located in diverse tissues. CRP is a multifunctional player in the scenario of innate immunity. CRP acts as an opsonin in the area of complement activation and phagocytosis. Interestingly, CRP upregulates and downregulates both cytokine production and chemotaxis. Considering various studies of CRP in humans and non-human animals, it has been logically proposed that CRP plays a common role in animals. CRP also interacts with Fcγ receptors and triggers the inflammatory response of macrophages. CRP in other animals such as primates, fish, echinoderms, arthropods, and molluscs has also been studied in some detail which establishes the evolutionary significance of CRP. In mammals, the increase in CRP levels is an induced response to inflammation or trauma; interestingly, in arthropods and molluscs, CRP is constitutively expressed and represents a major component of their hemolymph. Investigations into the primary structure of CRP from various species revealed the overall relatedness between vertebrate and invertebrate CRP. Invertebrates lack an acquired immune response; they are therefore dependent on the multifunctional role of CRP leading to the evolutionary success of the invertebrate phyla.

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C-reactive protein as a prognostic marker of Plasmodiumfalciparum malaria severity

Cited by 21 publications

References 1 publication

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

Antioxidant status and acute phase reactants in pregnant women infected with Plasmodium falciparum

Biological significance of C-reactive protein, the ancient acute phase functionary

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