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(American Journal of Pathology. 2001;158:1039-1051.)
© 2001 American Society for Investigative Pathology


Regular Articles

Generation of C-Reactive Protein and Complement Components in Atherosclerotic Plaques

Koji Yasojima, Claudia Schwab, Edith G. McGeer and Patrick L. McGeer

From the Department of Psychiatry, Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver, British Columbia, Canada

C-reactive protein (CRP) and complement are hypothesized to be major mediators of inflammation in atherosclerotic plaques. We used the reverse transcriptase-polymerase chain reaction technique to detect the mRNAs for CRP and the classical complement components C1 to C9 in both normal arterial and plaque tissue, establishing that they can be endogenously generated by arteries. When the CRP mRNA levels of plaque tissue, normal artery, and liver were compared in the same cases, plaque levels were 10.2-fold higher than normal artery and 7.2-fold higher than liver. By Western blotting, we showed that the protein levels of CRP and complement proteins were also up-regulated in plaque tissue and that there was full activation of the classical complement pathway. By in situ hybridization, we detected intense signals for CRP and C4 mRNAs in smooth muscle-like cells and macrophages in the thickened intima of plaques. By immunohistochemistry we showed co-localization of CRP and the membrane attack complex of complement. We also detected up-regulation in plaque tissue of the mRNAs for the macrophage markers CD11b and HLA-DR, as well as their protein products. We showed by immunohistochemistry macrophage infiltration of plaque tissue. Because CRP is a complement activator, and activated complement attacks cells in plaque tissue, these data provide evidence of a self-sustaining autotoxic mechanism operating within the plaques as a precursor to thrombotic events.





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J. R. Turk, J. A. Carroll, M. H. Laughlin, T. R. Thomas, J. Casati, D. K. Bowles, and M. Sturek
C-reactive protein correlates with macrophage accumulation in coronary arteries of hypercholesterolemic pigs
J Appl Physiol, September 1, 2003; 95(3): 1301 - 1304.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
S. Kobayashi, N. Inoue, Y. Ohashi, M. Terashima, K. Matsui, T. Mori, H. Fujita, K. Awano, K. Kobayashi, H. Azumi, et al.
Interaction of Oxidative Stress and Inflammatory Response in Coronary Plaque Instability: Important Role of C-Reactive Protein
Arterioscler. Thromb. Vasc. Biol., August 1, 2003; 23(8): 1398 - 1404.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. Oksjoki, H. Jarva, P. T. Kovanen, P. Laine, S. Meri, and M. O. Pentikainen
Association Between Complement Factor H and Proteoglycans in Early Human Coronary Atherosclerotic Lesions: Implications for Local Regulation of Complement Activation
Arterioscler. Thromb. Vasc. Biol., April 1, 2003; 23(4): 630 - 636.
[Abstract] [Full Text] [PDF]


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CirculationHome page
T. Vainas, T. Lubbers, F. R.M. Stassen, S. B. Herngreen, M. P. van Dieijen-Visser, C. A. Bruggeman, P. J.E.H.M. Kitslaar, and G. W. H. Schurink
Serum C-Reactive Protein Level Is Associated With Abdominal Aortic Aneurysm Size and May Be Produced by Aneurysmal Tissue
Circulation, March 4, 2003; 107(8): 1103 - 1105.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
G. J. Blake and P. M. Ridker
C-reactive protein and other inflammatory risk markers in acute coronary syndromes
J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 37S - 42S.
[Abstract] [Full Text] [PDF]


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Arch SurgHome page
M. A. Zimmerman, C. H. Selzman, C. Cothren, A. C. Sorensen, C. D. Raeburn, and A. H. Harken
Diagnostic Implications of C-Reactive Protein
Arch Surg, February 1, 2003; 138(2): 220 - 224.
[Abstract] [Full Text] [PDF]


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CirculationHome page
R. Chenevard, D. Hurlimann, M. Bechir, F. Enseleit, L. Spieker, M. Hermann, W. Riesen, S. Gay, R. E. Gay, M. Neidhart, et al.
Selective COX-2 Inhibition Improves Endothelial Function in Coronary Artery Disease
Circulation, January 28, 2003; 107(3): 405 - 409.
[Abstract] [Full Text] [PDF]


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Arch Intern MedHome page
D. L. Bhatt, E. J. Topol, I. Kushner, and A. Sehgal
The Arterial Inflammation Hypothesis
Arch Intern Med, October 28, 2002; 162(19): 2249 - 2251.
[Full Text] [PDF]


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Circ. Res.Home page
J. C. Mason, Z. Ahmed, R. Mankoff, E. A. Lidington, S. Ahmad, V. Bhatia, A. Kinderlerer, A. M. Randi, and D. O. Haskard
Statin-Induced Expression of Decay-Accelerating Factor Protects Vascular Endothelium Against Complement-Mediated Injury
Circ. Res., October 18, 2002; 91(8): 696 - 703.
[Abstract] [Full Text] [PDF]


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J. Immunol.Home page
S. Nakashima, Z. Qian, S. Rahimi, B. A. Wasowska, and W. M. Baldwin III
Membrane Attack Complex Contributes to Destruction of Vascular Integrity in Acute Lung Allograft Rejection
J. Immunol., October 15, 2002; 169(8): 4620 - 4627.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
G. J. Blake and P. M. Ridker
C-Reactive Protein, Subclinical Atherosclerosis, and Risk of Cardiovascular Events
Arterioscler. Thromb. Vasc. Biol., October 1, 2002; 22(10): 1512 - 1513.
[Full Text] [PDF]


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Sci Aging Knowl EnvironHome page
P. L. McGeer and E. G. McGeer
Innate Immunity, Local Inflammation, and Degenerative Disease
Sci. Aging Knowl. Environ., July 24, 2002; 2002(29): re3 - 3.
[Abstract] [Full Text] [PDF]


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CirculationHome page
D. L. Bhatt and E. J. Topol
Need to Test the Arterial Inflammation Hypothesis
Circulation, July 2, 2002; 106(1): 136 - 140.
[Full Text] [PDF]


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CirculationHome page
C. Buono, C. E. Come, J. L. Witztum, G. F. Maguire, P. W. Connelly, M. Carroll, and A. H. Lichtman
Influence of C3 Deficiency on Atherosclerosis
Circulation, June 25, 2002; 105(25): 3025 - 3031.
[Abstract] [Full Text] [PDF]


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JAMAHome page
T. G. Burnakis, M. Fleming, M. A. Konstam, L. A. Demopoulos, K. D. Grant, E. J. Haldey, M. Pappagallo, M. Minic, P. L. McGeer, E. G. McGeer, et al.
Cardiovascular Events and COX-2 Inhibitors
JAMA, December 12, 2001; 286(22): 2808 - 2813.
[Full Text] [PDF]


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Circ. Res.Home page
G. J. Blake and P. M. Ridker
Novel Clinical Markers of Vascular Wall Inflammation
Circ. Res., October 26, 2001; 89(9): 763 - 771.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
K. Yasojima, C. Schwab, E. G. McGeer, and P. L. McGeer
Complement Components, but Not Complement Inhibitors, Are Upregulated in Atherosclerotic Plaques
Arterioscler. Thromb. Vasc. Biol., July 1, 2001; 21(7): 1214 - 1219.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Cell Physiol.Home page
J. C. Mason, E. A. Lidington, S. R. Ahmad, and D. O. Haskard
bFGF and VEGF synergistically enhance endothelial cytoprotection via decay-accelerating factor induction
Am J Physiol Cell Physiol, March 1, 2002; 282(3): C578 - C587.
[Abstract] [Full Text] [PDF]


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CirculationHome page
K. K. Koh, W. H. Schenke, M. A. Waclawiw, G. Csako, and R. O. Cannon III
Statin Attenuates Increase in C-Reactive Protein During Estrogen Replacement Therapy in Postmenopausal Women
Circulation, April 2, 2002; 105(13): 1531 - 1533.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. P. Burke, R. P. Tracy, F. Kolodgie, G. T. Malcom, A. Zieske, R. Kutys, J. Pestaner, J. Smialek, and R. Virmani
Elevated C-Reactive Protein Values and Atherosclerosis in Sudden Coronary Death: Association With Different Pathologies
Circulation, April 30, 2002; 105(17): 2019 - 2023.
[Abstract] [Full Text] [PDF]




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