Biological and clinical importance of acute phase proteins

Acute phase proteins and the response in general are stably conserved in evolution and are universal within each species. They are thus presumably of benefit to the organism undergoing infection, inflammation and/or tissue damage, although much remains to be learned of the properties and functions of many acute phase reactants. On the other hand, sustained, increased production of SAA is a necessary though not sufficient condition for the development of reactive, systemic AA amyloidosis, a grave complication of chronic infection or inflammation. Monitoring of the acute phase response, particularly by measurement of CRP in man, CRP or SAA in other species, and SAP in the mouse, is a powerful and sensitive test for organic disease or the toxicity of an administered agent. It also provides the most accessible means for objective, quantitative assessment of disease extent and activity, and is valuable in the differential diagnosis of intercurrent infection especially in the immunocompromised host.

The application of new high sensitivity immunoassays for CRP in studies of atherosclerosis has lately revealed very important prognostic associations between previously undetected low grade acute phase responses and the progression and complications, especially of coronary heart disease. These findings open up a new area of considerable fundamental interest and clinical significance, relating mild chronic inflammation to the most common cause of death in the developed world.

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