C-reactive protein: a marker or a player?
Résumé
It has been suggested that type 2 diabetes may in part be precipitated or accelerated by an acute phase reaction as part of the innate immune response, in which large amounts of cytokines are released from adipose tissue, creating a low-grade inflammatory milieu. Also, there is solid evidence that atherosclerosis is an immune-mediated inflammatory disease. Therefore, it is reasonable to imply low-grade inflammation as an important pathogenetic factor in terms of atherosclerosis and cardiovascular events in type 2 diabetes patients. Over the past years, there have been a lot of promising clinical markers proposed to link inflammation and atherosclerosis. Of these markers, high sensitive C-reactive protein (hsCRP) might be a prognostic marker for further cardiovascular events, although recently refuted. In this issue of Clinical Science, Castoldi et al demonstrate that in type 2 diabetic patients, categorized in low (<1.0 mg/L), medium (1.0-3.0 mg/L) and high (>3 mg/L), serum levels of hsCRP correlate with LPS-stimulated release of IL-1β and IL-6 in whole blood. This finding may indicate that low-grade inflammatory activity might influence cytokine production in these patients.
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