C-reaktivní protein a reakce akutní fáze. 2. část: CRP a řízení zánětlivé odpovědi

Cor Vasa 2002, 43(12):525-535

C-reactive protein and acute phase reactions. Part 2: CRP and inflammatory response management

Pavel Kuneš^1,*, Jan Krejsek²: ¹ Kardiochirurgická klinika; ² Ústav klinické imunologie a alergologie, Fakultní nemocnice a Lékařská fakulta Univerzity Karlovy, Hradec Králové, Česká republika

Part 2 of the review article addresses the role played by CRP in managing the inflammatory response. The resultant extent of inflammatory focus and termination of the inflammatory response are determined by apoptotic cell removal. Apoptotic cells are removed by phagocytosis, with tissue macrophages as the executive factor. Both inflammatory infiltrate cells and the building blocks of the tissue whose involvement has not reached the extent of necrosis undergo apoptosis. The anti-inflammatory action of CRP consists in the induction of the anti-inflammatory phenotype of phagocyting cells. This is mediated by opsonization of apoptotic cells by C3b/iC3b complement fragments, and a decrease in C5b-9 terminal complex formation. Cooperation of CRP, complement, and regulatory factor H is imperative. Provided this cooperation has been impaired, be that of an unbalanced ratio or the absence of some of these components, CRP results in the induction of a pro-inflammatory phenotype of phagocyting cells. This anti-inflammatory action of CRP is also involved in the development of atherosclerosis. The final part of the article briefly discusses the anti-inflammatory action of statins.