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• W2022959911 abstract "To the Editor:—The acute phase response, the set of systemic and metabolic changes that follow inflammatory stimuli, apparently plays a major role in host defense.1 Recent findings have raised the possibility that abnormalities of the acute phase response may contribute to increased susceptibility to infection and tissue injury in elderly individuals. Assessments of the serum concentration of C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) are widely used as measures of the acute phase response in a variety of diseases. In a study of 101 elderly subjects, neither ESR or CRP values were found to yield clinically acceptable positive predictive values for inflammatory states, suggesting that there are constitutively elevated values in individuals without inflammation, relatively feeble responses in inflamed individuals, or both.5 Relevant to this observation, the ESR has long been known to increase with advancing age.6–8 In healthy young to middle-aged adults, CRP is typically found in only trace amounts in the plasma. In seven separate studies, only 1.2% of 1,921 healthy adults had CRP levels greater than 1 mg/dL (References available upon request). In contrast, Cox and associates9 reported that 11 of 45 healthy elderly subjects had CRP levels greater than 1 mg/dL, consistent with reports of constitutively elevated levels of acute phase proteins in aging.2–4 To confirm the observation that CRP blood values are altered with normal aging, we determined CRP levels in 37 healthy persons, residing in the community, whose ages ranged from 64 to 89 years (mean 72.1 ± 5.1). Subjects were screened for active inflammatory or necrotizing illnesses and for acute illnesses. All subjects had normal CBC and SMA-6 indices; sera were frozen for subsequent CRP determinations. A Nephelometer Blackman ICS Analyzer II was used to obtain the CRP levels. The lower limit of detection was 0.6 mg/dL. All measurements were done in a single batch. Five subjects (14%), all female, had levels that were greater than 1.0 mg/dL: 1.2, 2.5, 3.6, 4.1, and 5.2. No significant differences in age, self-health rating, number of chronic diseases, number of medications, white blood cell count, red blood cell count, or hemoglobin were found between these five subjects and those with CRP levels less than 1.0 mg/dL. All those with elevated CRP levels were non-smokers. When the results of the study by Cox and associates9 are combined with the present one, 19.5% of apparently healthy elderly individuals were found to have elevated CRP levels in contrast to approximately 1% of younger adults. Observations of acute phase changes in apparently healthy individuals have always been subject to the concern that occult inflammatory states may exist in these subjects.10 Nevertheless, the consistency of such observations in multiple human and animal studies, taken together with more recent studies employing the techniques of molecular biology,2–4 strongly suggests that these changes may reflect a more fundamental, age-related dysregulation. Such dysregulation might play a role in the increased susceptibility to infection seen in the elderly." @default.
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• W2022959911 date "1992-01-01" @default.
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• W2022959911 title "Elevated C-Reactive Protein in Older People" @default.
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• W2022959911 doi "https://doi.org/10.1111/j.1532-5415.1992.tb01843.x" @default.
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