C-reactive protein: the nexus between inflammation and protein misfolding diseases

C-reactive protein (CRP), an acute-phase protein primarily produced by hepatocytes in response to pro-inflammatory cytokines, is a widely used clinical marker for inflammation and tissue damage. In its native state, CRP exists in a stable pentameric form called pCRP. Upon interaction with activated...

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Main Authors: Abhishek Roy, Johannes Zeller, Tracy L. Nero, Johanna Klepetko, Steffen U. Eisenhardt, Michael W. Parker, James D. McFadyen, Karlheinz Peter
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1612703/full
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author Abhishek Roy
Abhishek Roy
Johannes Zeller
Johannes Zeller
Tracy L. Nero
Tracy L. Nero
Tracy L. Nero
Johanna Klepetko
Steffen U. Eisenhardt
Michael W. Parker
Michael W. Parker
Michael W. Parker
James D. McFadyen
James D. McFadyen
James D. McFadyen
James D. McFadyen
Karlheinz Peter
Karlheinz Peter
Karlheinz Peter
Karlheinz Peter
author_facet Abhishek Roy
Abhishek Roy
Johannes Zeller
Johannes Zeller
Tracy L. Nero
Tracy L. Nero
Tracy L. Nero
Johanna Klepetko
Steffen U. Eisenhardt
Michael W. Parker
Michael W. Parker
Michael W. Parker
James D. McFadyen
James D. McFadyen
James D. McFadyen
James D. McFadyen
Karlheinz Peter
Karlheinz Peter
Karlheinz Peter
Karlheinz Peter
author_sort Abhishek Roy
collection DOAJ
description C-reactive protein (CRP), an acute-phase protein primarily produced by hepatocytes in response to pro-inflammatory cytokines, is a widely used clinical marker for inflammation and tissue damage. In its native state, CRP exists in a stable pentameric form called pCRP. Upon interaction with activated cell membranes, pCRP undergoes a transitional conformation change into activated pCRP (pCRP*) and subsequently fully dissociates into its monomeric subunits (mCRP). pCRP* and mCRP interact with C1q and thereby activate the classical complement system pathway and both exert pro-inflammatory effects on platelets and endothelial cells. Although classically recognized as a marker of acute inflammation, CRP is increasingly implicated in the pathogenesis of protein-misfolding pathologies, notably neurodegenerative diseases and amyloidosis. This review explores the complex interplay between CRP, encompassing its isoforms pCRP, pCRP*, and mCRP, and misfolded proteins, examining the specific contributions to inflammation and neurodegenerative disease pathogenesis. We analyze the clinical significance of variations in CRP levels in patients with protein-misfolding diseases, discuss underlying mechanisms, and highlight potential implications of these findings for drug discovery and therapeutic targeting of CRP.
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publisher Frontiers Media S.A.
record_format Article
series Frontiers in Immunology
spelling doaj-art-db88f46c38d54c158bd10bce312fbc672025-08-20T02:32:04ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-06-011610.3389/fimmu.2025.16127031612703C-reactive protein: the nexus between inflammation and protein misfolding diseasesAbhishek Roy0Abhishek Roy1Johannes Zeller2Johannes Zeller3Tracy L. Nero4Tracy L. Nero5Tracy L. Nero6Johanna Klepetko7Steffen U. Eisenhardt8Michael W. Parker9Michael W. Parker10Michael W. Parker11James D. McFadyen12James D. McFadyen13James D. McFadyen14James D. McFadyen15Karlheinz Peter16Karlheinz Peter17Karlheinz Peter18Karlheinz Peter19Department of Cardiometabolic Health, The University of Melbourne, Parkville, VIC, AustraliaBaker Heart and Diabetes Institute, Melbourne, VIC, AustraliaBaker Heart and Diabetes Institute, Melbourne, VIC, AustraliaDepartment of Plastic and Hand Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Cardiometabolic Health, The University of Melbourne, Parkville, VIC, AustraliaDepartment of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, AustraliaAustralian Cancer Research Foundation (ACRF) Rational Drug Discovery Centre, St. Vincent’s Institute of Medical Research, Fitzroy, VIC, AustraliaClinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Plastic and Hand Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Cardiometabolic Health, The University of Melbourne, Parkville, VIC, AustraliaDepartment of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, AustraliaAustralian Cancer Research Foundation (ACRF) Rational Drug Discovery Centre, St. Vincent’s Institute of Medical Research, Fitzroy, VIC, AustraliaDepartment of Cardiometabolic Health, The University of Melbourne, Parkville, VIC, AustraliaBaker Heart and Diabetes Institute, Melbourne, VIC, AustraliaDepartment of Clinical Haematology, The Alfred Hospital, Melbourne, VIC, AustraliaThe School of Translational Medicine, Monash University, Melbourne, VIC, AustraliaDepartment of Cardiometabolic Health, The University of Melbourne, Parkville, VIC, AustraliaBaker Heart and Diabetes Institute, Melbourne, VIC, AustraliaThe School of Translational Medicine, Monash University, Melbourne, VIC, AustraliaDepartment of Cardiology, The Alfred Hospital, Melbourne, VIC, AustraliaC-reactive protein (CRP), an acute-phase protein primarily produced by hepatocytes in response to pro-inflammatory cytokines, is a widely used clinical marker for inflammation and tissue damage. In its native state, CRP exists in a stable pentameric form called pCRP. Upon interaction with activated cell membranes, pCRP undergoes a transitional conformation change into activated pCRP (pCRP*) and subsequently fully dissociates into its monomeric subunits (mCRP). pCRP* and mCRP interact with C1q and thereby activate the classical complement system pathway and both exert pro-inflammatory effects on platelets and endothelial cells. Although classically recognized as a marker of acute inflammation, CRP is increasingly implicated in the pathogenesis of protein-misfolding pathologies, notably neurodegenerative diseases and amyloidosis. This review explores the complex interplay between CRP, encompassing its isoforms pCRP, pCRP*, and mCRP, and misfolded proteins, examining the specific contributions to inflammation and neurodegenerative disease pathogenesis. We analyze the clinical significance of variations in CRP levels in patients with protein-misfolding diseases, discuss underlying mechanisms, and highlight potential implications of these findings for drug discovery and therapeutic targeting of CRP.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1612703/fullC-reactive proteinmisfolded proteinsprotein aggregationneurodegenerative diseasesneuroinflammation
spellingShingle Abhishek Roy
Abhishek Roy
Johannes Zeller
Johannes Zeller
Tracy L. Nero
Tracy L. Nero
Tracy L. Nero
Johanna Klepetko
Steffen U. Eisenhardt
Michael W. Parker
Michael W. Parker
Michael W. Parker
James D. McFadyen
James D. McFadyen
James D. McFadyen
James D. McFadyen
Karlheinz Peter
Karlheinz Peter
Karlheinz Peter
Karlheinz Peter
C-reactive protein: the nexus between inflammation and protein misfolding diseases
Frontiers in Immunology
C-reactive protein
misfolded proteins
protein aggregation
neurodegenerative diseases
neuroinflammation
title C-reactive protein: the nexus between inflammation and protein misfolding diseases
title_full C-reactive protein: the nexus between inflammation and protein misfolding diseases
title_fullStr C-reactive protein: the nexus between inflammation and protein misfolding diseases
title_full_unstemmed C-reactive protein: the nexus between inflammation and protein misfolding diseases
title_short C-reactive protein: the nexus between inflammation and protein misfolding diseases
title_sort c reactive protein the nexus between inflammation and protein misfolding diseases
topic C-reactive protein
misfolded proteins
protein aggregation
neurodegenerative diseases
neuroinflammation
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1612703/full
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