CRP (C-Reactive Protein)

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New! PT10V CRP 1V

PT10V CRP 1V helps veterinarians to diagnose systemic inflammation, and to monitor their patients effectively.

Ordering information

REF (Cat. No.) IVR-PT11V

Product Name PT10V CRP 1V

CRP

Species Canine

Specimen Serum, Plasma

Packing Unit 20 cartridges/Box

For more information

For more information about PT10V, visit vet.

PT10V CRP 1V Clinical Leaflet 1.0 180912-EN

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In-Vitro Diagnostics Clinical Leaflet

PT10V CRP 1V

CRP (C-Reactive Protein)

? To show and quantify the degree if systemic inflammation is present. ? To monitor response to treatment. ? To check recovery and complications after surgery. ? To act as a rule-out marker for patient discharge. ? To support to detect relapse of illness.

PT10V CRP 1V



CRP as a Major Biomarker of Systemic Inflammation

Canine C-reactive protein (CRP) is a well-established inflammatory marker in dogs. Healthy dogs have low circulating concentrations of CRP, whereas there is a rapid and marked increase in CRP concentration during systemic inflammatory disease. After an inflammatory stimulus, an increase in blood CRP concentration occurs within 4-6 hours, reaching the maximum after 24-48 hours. The CRP concentration can clear after 48-72 hours with successful treatment in general. The magnitude of increase in CRP concentration reflects the degree of systemic inflammation, and successful treatment leads to a rapid decline in CRP concentration. These properties make CRP a valuable marker for health screening at wellness visits, and monitoring of treatment or surgery efficacy as described in Fig. 1.

Why use CRP in routine and critical clinical settings?

? CRP can show if systemic inflammation is present, even when there are no other obvious clinical signs. (CRP can be used for a health screening parameter at wellness visits.)

? CRP can quantify the degree of inflammation. ? CRP can monitor response to treatment because CRP is not affected by drug treatment. ? CRP can monitor recovery and complications after surgery. ? CRP can be used as a rule-out marker for patient discharge after surgery or treatment. ? CRP can be useful to detect relapse of illness.

It is recommended to use CRP results together with patient history and other clinical findings, for example, CBC and biochemistry results.

[Fig. 1] A diagnostic window of C-reactive protein (CRP)

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Factors and Diseases affecting on CRP Levels

Healthy dogs

Diseases associated with increased CRP level

Healthy dogs generally have CRP levels < 10 mg/L, although some clinically healthy dogs can have slightly higher values (up to 25 mg/L).

The reference interval of PT10V CRP 1V is < 10 mg/L.

- Factors not affecting CRP level

? Age ? Breed ? Gender ? Circadian rhythms ? Repeated venous blood sampling

- Factors affecting CRP level

The following factors have been found to affect the CRP levels with significant difference.

? Pregnancy: High levels of CRP can occur in female dogs during pregnancy within 1.0 ~ 1.5 months after ovulation (ex: up to 90 mg/L).

? Exercise: Strenuous exercise is associated with an increase in CRP levels (ex: racing sled dogs).

The table shows examples of potential diseases encountered in canine systemic inflammations, and related to induce high CRP levels, based on recent literature surveys.

Infectious diseases

Bacterial Parasitic

Bordatella bronchiseptica pneumonia Escherichiosis Ehrlichiosis Leptospirosis Staphylococcus aureus infection Pyometra Bacterial enteritis Leishmaniasis Babesiasis canis Trypanosomiasis Dirofilariasis (HW disease) Demodicosis

Viral Parvovirus infection

Inflammatory disorders

Arthritis Acute pancreatitis Periodontitis Rheumatoid arthritis Inflammatory bowel disease Steroid-responsive meningitis arteritis (SRMA) Pneumonia

Immune-mediated disease

Immune-mediated hemolytic anemia (IMHA) Type II immune-mediated polyarthritis (IMPA)

Tissue damage

Surgery (ex: ovariohysterectomy) Traumatic injury

Neoplasia/Tumor Lymphoma Pyogranuloma

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CRP has a wide Diagnostic Window

1. Wellness exam & health screening

[When] Patient

- visits for wellness exam, - or is ill but does only show subtle clinical signs, - or is suspected by systemic inflammation.

[How] Use CRP on every patient

- To rule out the systemic inflammation - To identify the degree of the systemic

inflammation

? Normal - "CRP < 10 mg/L"

? Grey zone - "CRP 10-30 mg/L"

? Systemic inflammation - "CRP 30-100 mg/L"

? Severe systemic inflammation - "CRP > 100 mg/L"

2. Monitoring treatment efficacy

[When] Patient - Is identified as the systemic inflammation, - and is being treated by drug therapy. (ex: Corticosteroids, NSAIDs, Opioids therapy)

[How] Use CRP on the patient - To monitor the treatment efficacy by comparing the CRP level measured at the pre-diagnosis stage

[Example] - In Fig. 2, CRP was measured serially during a 27week follow-up period in a dog suffering from type II IMPA. - CRP implies a valuable unbiased marker of inflammatory activity during steroid therapy.

[Fig. 2] Example of a CRP time course during treatment (Ref: Acta Veterinaria Scandinavia, 2006, 48:9)

CRP has a wide Diagnostic Window (Continued)

3. Monitoring healing process after surgery

4. Detection of relapse of illness

[When] Patient

- Underwent a surgical operation. (ex: soft tissue surgery, or orthopedic surgery)

[When] Patient

- with increased CRP level shows relapse of illness after treatment or surgery.

[How] Use CRP on the patient

- To monitor recovery and post-operative effects after surgery by comparing the CRP level measured at the pre-surgical stage

[How] Use CRP on the patient

- To detect the relapse of original disease (ex: IMPA) or a new disease as a complication

[Example]

- In Fig. 3, CRP level and WBC count were measured serially during 15 days in a female dog which was ovariohysterectomized after suffering from pyometra and peritonitis.

- The CRP levels before and after surgery matched the clinical symptoms better than WBC counts.

[Fig. 3] Example of a CRP time-course post-surgery (Courtesy of Ul Soo Choi, DVM, Ph.D, ref: Master Thesis of Young-Chul Choi, 2014)

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How Reliable is PT10V CRP1V Testing?

CRP Performance and Reliability

Introduction

C-reactive protein (CRP) is a major acute phase protein (APP) in the dog. As a part of innate immune response, CRP changes its serum concentration in response to a systemic inflammation. In contrast to classical inflammatory markers such as the white blood cell count, CRP reacts more rapidly and with a shorter half-life period. Due to its rapid response, CRP is a sensitive diagnostic and prognostic marker to monitor systemic inflammations, as present in infectious diseases, immune mediated diseases, neoplasias, and surgery. In this respect, PT10V CRP 1V was developed by using a canine species-specific antigen-antibody aggregation method and is composed of single CRP test.

Precision

Material and Methods: Precision test was performed by using in-house quality control materials at two different concentrations, based on a standard guideline (CLSI EP5-A2). There were 2 replica on a run and 2 runs on a day during 20 days (80 replica in total).

Results: Total precision was calculated using the statistical SW, Analyse-It?. Excellent precision is outlined in Table 1 as both levels show a CV% equal to or less than 5.0%

Level Level 1 Level 2

[Table 1] Precision results

Mean 16 mg/L 60 mg/L

SD 0.79 mg/L 2.70 mg/L

Total CV 5.0% 4.3%

[Fig. 4] Method comparison for canine samples

Method Comparison

Material and Methods: Gentian canine CRP assay in Roche P-modular was used as a reference method. 3 different lots of PT10V CRP 1V were used to account for lot variation, based on a standard guideline (CLSI EP09-A3).

Results: The Passing-Bablok regressions between Gentian CRP assay and PT10V CRP 1V for canine samples are shown in Fig. 4. The PT10V CRP 1V assay is highly accurate as exemplified by a Pearson's corelation coefficient (R) of 0.976 (n = 289), and a mean bias of 2.9%.

[Fig. 5] Hook effect

Hook Effect

Material and Methods: A high stock solution and working solutions were made using canine CRP recombinant proteins (HyTest, Finland) and normal plasma (Lampire, USA).

Results: The dose-response curve in Fig. 5 shows that PT10V CRP 1V has no hook effect up to 1000 mg/L.

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This research was conducted by Samsung Electronics Co., Ltd.

CARE for our companions

PT10V is a portable veterinary clinical chemistry analyzer that meets the needs of veterinary clinics while providing a smart solution to improve efficiency.

70 ?l

Inject Sample * Plasma or Serum

Step 1

CARE with PT10V

Step 2

C ompact A ccessible R eliable E asy to use

p3

Ste

Insert Cartridge

Get Results

Cartridge Configuration

Model Code IVR-PT01V

Panel PT10V Pre-surgical 10V

IVR-PT02V PT10V Comprehensive 16V

IVR-PT03V PT10V Liver11V

Test Analytes

*Calculated values

ALB, ALP, ALT, BUN, CREA, GLU, TP, A/G ratio*, B/C ratio*, GLOB*

ALB, ALP, ALT, AMY, BUN, Ca, CHOL, CREA, GLU, PHOS, TBIL, TP, TRIG A/G ratio*, B/C ratio*, GLOB*

ALB, ALP, ALT, AST, BUN, GGT, GLU, TBIL, TP, A/G ratio*, GLOB*

IVR-PT04V PT10V Kidney 8V

ALB, AMY, BUN, Ca, CREA, GLU, PHOS, B/C ratio*

IVR-PT05V PT10V Electrolyte Test 4V

Na, K, Cl, Na/K ratio*

IVR-PT07V PT10V Liver monitoring 3V

ALT, GGT, TBIL

IVR-PT08V IVR-PT09V IVR-PT10V NeIVwR-PT11V

PT10V Kidney monitoring 4V PT10V Large Animal 14V PT10V Diabetes 4V

BUN, CREA, PHOS, B/C ratio* ALB, ALP, AST, BUN, Ca, CK, CREA, GGT, GLU, TBIL, TP, A/G ratio*, B/C ratio*, GLOB* CHOL, FRUC, GLU, TRIG

PT10V CRP 1V

CRP

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