Unveiling the role of C-reactive protein in osteoarthritis: A biomarker of inflammation, severity, and degeneration

Abstract

Osteoarthritis (OA) is a prevalent joint disorder marked by progressive articular cartilage degeneration, underlying bone changes, and joint inflammation. It primarily affects weight-bearing joints such as knees, hips, and spine, significantly causing pain, disability, and diminished quality of life. Inflammation takes a pivotal role in OA's origin and advancement. C-reactive protein (CRP), an acute-phase reactant indicating systemic inflammation, has emerged as a potential biomarker and contributor in this process. Elevated serum CRP levels reflect both systemic and synovial inflammation, offering a valuable measure to assess disease severity and activity. A systematic literature search across databases like Google Scholar, EBSCO, PubMed, Cochrane, and Web of Science yielded 3680 relevant publications up to September 2022, Elevated CRP levels correlate with more pronounced radiographic findings, encompassing joint space reduction and increased osteophyte formation, as well as declining function over time. Moreover, elevated CRP levels correspond to intensified pain scores and escalated analgesic needs. CRP's potential to bind with cartilage components like collagen and proteoglycans might contribute to cartilage degradation. Furthermore, CRP activates immune cells and stimulates the production of pro-inflammatory cytokines, chemokines, and matrix metalloproteinases, all of which contribute to joint inflammation.