C-reactive protein: the nexus between inflammation and protein misfolding diseases.

Abhishek Roy; Johannes Zeller; Tracy L Nero; Johanna Klepetko; Steffen U Eisenhardt; Michael W Parker; James D McFadyen; Karlheinz Peter
Abstract
C-reactive protein (CRP), an acute-phase protein primarily produced by hepatocytes in response to pro-inflammatory cytokines, is a widely used clinical marker for inflammation and tissue damage. In its native state, CRP exists in a stable pentameric form called pCRP. Upon interaction with activated cell membranes, pCRP undergoes a transitional conformation change into activated pCRP (pCRP*) and subsequently fully dissociates into its monomeric subunits (mCRP). pCRP* and mCRP interact with C1q and thereby activate the classical complement system pathway and both exert pro-inflammatory effects on platelets and endothelial cells. Although classically recognized as a marker of acute inflammation, CRP is increasingly implicated in the pathogenesis of protein-misfolding pathologies, notably neurodegenerative diseases and amyloidosis. This review explores the complex interplay between CRP, encompassing its isoforms pCRP, pCRP*, and mCRP, and misfolded proteins, examining the specific contributions to inflammation and neurodegenerative disease pathogenesis. We analyze the clinical significance of variations in CRP levels in patients with protein-misfolding diseases, discuss underlying mechanisms, and highlight potential implications of these findings for drug discovery and therapeutic targeting of CRP.
Journal FRONTIERS IN IMMUNOLOGY
ISSN 1664-3224
Published 01 Jan 2025
Volume 16
Issue
Pages 1612703
DOI 10.3389/fimmu.2025.1612703
Type Journal Article | Review
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