Who Is Afraid of CRP? Elevated Preoperative CRP Levels Might Attenuate the Increase in Inflammatory Parameters in Response to Lung Cancer Surgery

During surgery, ATP from damaged cells induces the release of interleukin-1β, a potent pro-inflammatory cytokine that contributes to the development of postoperative systemic inflammation, sepsis and multi-organ damage. We recently demonstrated that C-reactive protein (CRP) inhibits the ATP-induced...

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Bibliographic Details
Published in:Journal of clinical medicine 2020-10, Vol.9 (10), p.3340
Main Authors: Meyer, Moritz Mecki, Brandenburg, Leon, Hudel, Helge, Agné, Alisa, Padberg, Winfried, Erdogan, Ali, Nef, Holger, Amati, Anca-Laura, Dörr, Oliver, Witte, Biruta, Grau, Veronika
Format: Article
Language:English
Subjects:
Apoptosis
Binding sites
Body temperature
Cancer surgery
Cardiovascular disease
Cell culture
Cholesterol
Hospitals
Inflammation
Ischemia
Laboratories
Lipids
Lung cancer
Medical imaging
Ostomy
Pathogens
Patients
Proteins
Sepsis
Smoking
Thoracic surgery
Trauma
Tumors
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Summary:During surgery, ATP from damaged cells induces the release of interleukin-1β, a potent pro-inflammatory cytokine that contributes to the development of postoperative systemic inflammation, sepsis and multi-organ damage. We recently demonstrated that C-reactive protein (CRP) inhibits the ATP-induced release of monocytic interleukin-1β, although high CRP levels are deemed to be a poor prognostic marker. Here, we retrospectively investigated if preoperative CRP levels correlate with postoperative CRP, leukocyte counts and fever in the context of anatomical lung resection and systematic lymph node dissection as first line lung cancer therapy. No correlation was found in the overall results. In men, however, preoperative CRP and leukocyte counts positively correlated on postoperative days one to two, and a negative correlation of CRP and fever was seen in women. These correlations were more pronounced in men taking statins and in statin-naïve women. Accordingly, the inhibitory effect of CRP on the ATP-induced interleukin-1β release was blunted in monocytes from coronary heart disease patients treated with atorvastatin compared to monocytes obtained before medication. Hence, the common notion that elevated CRP levels predict more severe postoperative inflammation should be questioned. We rather hypothesize that in women and statin-naïve patients, high CRP levels attenuate trauma-induced increases in inflammatory markers.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm9103340