Advance Laboratory Technique

C-reactive
protein

Submitted by:
HUSAM MUAYAD FADHIL
Muhammad Hamad Hamada
  INTRODUCTION

C-reactive protein is a homogeneous molecule with a molecular weight of 118,000

Daltons and a structure that consists of five identical subunits held together by
noncovalent bonds. CRP acts somewhat like an antibody, as it is capable of
opsonization (the coating of foreign particles), agglutination, precipitation, and activation
of complement by the classical pathway.

CRP has been used clinically for monitoring infection, autoimmune disorders and, more
recently, healing after a myocardial infarction (MI). Levels of CRP parallel the course of
the inflammatory response and return to lower undetectable levels as the inflammation
subsides.

CRP demonstrates a large incremental change, with as much as a 100-fold increase in

concentration in acute inflammation, and is the fastest responding and most sensitive
indicator of acute inflammation. CRP increases faster than ESR in responding to
inflammation, whereas the leukocyte count may remain within normal limits despite
infection. An elevated CRP level can signal infection many hours before it can be
confirmed by culture results; therefore, treatment can be prompt. Because of these
characteristics, CRP is the method of choice for screening for inflammatory and
malignant organic diseases and monitoring therapy in inflammatory diseases.

 METHODS

Materials and Reagents

 CRP latex reagent

 Patient serum
 Pipettes
 CRP test slides
 Stirrer (applicator stick)
 Test tubes

Procedures
Slide Method (Qualitative)
1. Prewarm the sample and reagents to room temperature.
2. Place one drop of serum on the glass slide.
3. Resuspend the CRP latex reagent then place one drop of it on the glass slide.
4. Using a stirrer, mix the specimen on the glass slide until the entire circle is filled.
5. Place the glass slide on a mechanical rotator for two minutes. Manually tilt the slide
back and forth if a rotator is not available.
6. Observe for agglutination within two minutes. If there is no agglutination that formed
within that time, report as non-reactive.

Glass slide

CRP Reagent Mechanical Rotator Rotator with glass slides

RESULTS

AGGLUTINATION – REACTIVE
NO AGGLUTINATION – NONREACTIVE

 QUESTIONS FOR RESEARCH

1. Restate the principle of the test in your own words.

This test is based on latex agglutination. When latex particles complexed with human
anti-CRP are mixed with the patient’s serum containing CRPs, a visible agglutination
reaction will occur.

2. Indicate conditions associated with elevation of CRP.

 Significant inflammation (sepsis, fungal infections, etc.)
 Chronic inflammatory condition (inflammatory bowel disease)
 Autoimmune disease (lupus, vasculitis)

3. Give indications of a positive and negative result in CRP testing.

 AGGLUTINATION – positive result
 NO AGGLUTINATION – negative result

4. Compare ESR, CRP, and hs-CRP using at least 3 criteria.

ESR CRP hs-CRP

PARAMETER Inflammation Inflammation Measures the risk
S MEASURED of cardiovascular
disease in healthy
people
SPECIMEN Whole blood Serum Serum
INDICATIONS An inflammatory focus Active inflammation Whether a person
has been present in the somewhere in the is at risk of CV
body for several days body disease
CAUSE Increased fibrinogen Dead and dying (See CRP)
levels which causes red cells which release
blood cells to clump chemicals that
prompt the liver to
produce CRP

REFERENCES:
Stevens, Clinical Immunology and Serology: A Laboratory Perspective (Third Edition)
Turgeon, Immunology and Serology in Laboratory Medicine (Fifth Edition)