Proinflammatory cytokines in CRP baseline regulation

Adv Clin Chem. 2009;48:111-36. doi: 10.1016/s0065-2423(09)48005-3.


Low-grade inflammation, a minor elevation in the baseline concentration of inflammatory markers such as C-reactive protein (CRP), is nowadays recognized as an important underlying condition in many common diseases. Concentrations of CRP under 10 mg/1 are called low-grade inflammation and values above that are considered as clinically significant inflammatory states. Epidemiological studies have revealed demographic and socioeconomic factors that associate with CRP concentration; these include age, sex, birth weight, ethnicity, socioeconomic status, body mass index (BMI), fiber consumption, alcohol intake, and dietary fatty acids. At the molecular level, production of CRP is induced by proinflammatory cytokines IL-1, IL-6, and IL-17 in the liver, although extra hepatic production most likely contributes to systemic concentrations. The cytokines are produced in response to, for example, steroid hormones, thrombin, C5a, bradykinin, other cytokines, UV-light, neuropeptides and bacterial components, such as lipopolysaccharide. Cytokines exert their biological effects on CRP by signaling through their receptors on hepatic cells and activating different kinases and phosphatases leading to translocation of various transcription factors on CRP gene promoter and production of CRP protein. Genetic polymorphisms in the interleukin genes as well as in CRP gene have been associated with minor elevation in CRP. As minor elevation in CRP is associated with both inflammatory and noninflammatory conditions, it should be noticed that the elevation might just reflect distressed or injured cells homeostasis maintenance in everyday life, rather than inflammation with classical symptoms of redness, swelling, heat, and pain.

Publication types

  • Review

MeSH terms

  • C-Reactive Protein / immunology
  • C-Reactive Protein / metabolism*
  • Cytokines / immunology
  • Cytokines / metabolism*
  • Humans
  • Inflammation / immunology*
  • Inflammation / metabolism
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism*
  • Polymorphism, Genetic
  • Receptors, Interleukin / immunology
  • Receptors, Interleukin / metabolism*
  • Signal Transduction / immunology
  • Socioeconomic Factors


  • Cytokines
  • Inflammation Mediators
  • Receptors, Interleukin
  • C-Reactive Protein