Studies on the C-reactive protein I. Observations on normal Filipinos and hospital patients

The demonstration of the C-reactive protein in the serum of patients in the acute phase of an infection has been used principally as a measure of the activity of certain disease processes, particularly, rheumatic fever, (6)(7)(8). The clinician who has to institute therapeuitc regimen for such patients has to judge the efficacy of his treatment by clinical signs and symptoms as well as by laboratory tests and herein has the C-reactive protein determination been most useful. For this reason, many of the local clinicians who avail themselves of tests for the presence of this protein begin to associate the test with rheumatic fever and this as a specific test for the diseaseThe observations included in this study stresses mainly two things. It demonstrates the specificity of the presence of the C-reactive protein in serum as an evidence of the occurrence of some pathologic condition, for this active component is not detectable in normal individuals as shown by the results among normal Filipino medical students, none of whom gave a precipitate with the specific C-reactive protein antiserum. The converse of this statement is not implied, however, for it does not follow that any pathologic condition should give a positive CRP testOn the other hand, the active component can be demonstrated in a very diverse group of clinical conditions as shown in Table I. The number of positive results obtained in this study is not to be taken as an indication of any difference in the frequency of appearance of the protein in the different clinical conditions listed. The number merely represent the availability of clinical material subjected to the testThese results, therefore, corroborate previous observations and emphasizes the fact that the C-reactive protein is an abnormal protein in human serum not found among normal individuals and that the appearance of the C-reactive protein is a non-specific reaction and therefore cannot be used as a diagnostic criterion for any one single clinical condition.

Studies on the C-reactive protein: II. Clinical experience in the evaluation of rheumatic activity

1. The C-reactive protein is a sensitive indicator of changes of the inflammatory state in a patient and has been utilized in the evaluation of rheumatic activity2. There is very good agreement between the usual indices of rheumatic activity and the C-reactive protein both in instances of obvious activity and inactivity of the disease process3. Further evidence of good parallelism between the state of rheumatic activity and the C-reactive protein was found in correlation of histological sections of auricular appendages, removed during mitral commisurotomy, with the clinical state of the patient4. Factors influencing behaviours of the C-reactive protein, such as its suppression by salicylates or adrenocortical hormones, were also discussed.