{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T16:54:37Z","timestamp":1776704077396,"version":"3.51.2"},"reference-count":34,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1989,10]]},"abstract":"<jats:p>The relation between the inflammatory cytokine tumour necrosis factor-alpha (TNF or cachectin), which induces acute phase responses, and an established acute phase protein, C-reactive protein, was studied in various infectious and inflammatory diseases in man. All cases with very high serum concentrations of C-reactive protein (150 to 400 mg\/l; normal reference value less than 10 mg\/l) also had raised serum concentrations of TNF (53 to 705 ng\/l; normal reference value less than 40 ng\/l). In 19 out of 91 (21%) of the cases, however, a raised TNF concentration without correspondingly raised C-reactive protein concentration was also noted. Conversely, in 23 out of 106 (22%) cases raised C-reactive protein was observed in the absence of a raised TNF concentration. The ratios were high in allograft rejection and low in myocardial infarction and Kawasaki's disease. The highest mean concentration of circulating TNF was found in bacterial infections, graft rejection, and myocardial infarction. It is concluded that although high C-reactive protein concentrations are usually accompanied by raised TNF concentrations, there are pronounced relative variations in the serum concentrations of these proteins in various disease states, suggesting that there may be independent, disease specific regulatory pathways for TNF and C-reactive protein.<\/jats:p>","DOI":"10.1136\/jcp.42.10.1078","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"1078-1082","source":"Crossref","is-referenced-by-count":26,"title":["Monitoring the acute phase response: comparison of tumour necrosis factor (cachectin) and C-reactive protein responses in inflammatory and infectious diseases."],"prefix":"10.1136","volume":"42","author":[{"given":"C P","family":"Maury","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1989,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1111\/j.0954-6820.1986.tb02785.x","article-title":"Tumour necrosis factor-a. An overview","volume":"220","author":"CPJ, I.Maury","year":"1986","unstructured":"I Maury CPJ. Tumour necrosis factor-a. An overview. Acta Med Scand 1986;220:387-94.","journal-title":"Acta Med Scand"},{"key":"ref_2","first-page":"234","article-title":"Tumor necrosis factor and interleukin 1: cytokines with multiple overlapping biological activities","volume":"56","author":"Le, J.; Vilcek, J.","year":"1987","unstructured":"Le J, Vilcek J. Tumor necrosis factor and interleukin 1: cytokines with multiple overlapping biological activities. Lab Invest 1987;56:234-48.","journal-title":"Lab Invest"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1016\/S0140-6736(86)92007-6","article-title":"Raised serum levels of tumour necrosis factor in parasitic infections","volume":"ii:","author":"Scuderi, P.; Lam, K.S.; Ryan, K.J.","year":"1986","unstructured":"Scuderi P, Lam KS, Ryan KJ, et al. Raised serum levels of tumour necrosis factor in parasitic infections. Lancet 1986;ii: 1364-5.","journal-title":"Lancet"},{"key":"ref_4","first-page":"355","article-title":"Association between tumour necrosis factor in serum and fatal outcome in patients with meningococcal disease","volume":"i:","author":"Waage, A.; Halstensen, A.; Espevik, T.","year":"1987","unstructured":"Waage A, Halstensen A, Espevik T. Association between tumour necrosis factor in serum and fatal outcome in patients with meningococcal disease. Lancet 1987;i:355-7.","journal-title":"Lancet"},{"issue":"1","key":"ref_5","first-page":"132","article-title":"Raised serum levels of cachectin tumor necrosis factor-a in renal allograft rejection","volume":"166","author":"Maury, C.P.J.; Teppo, A.-M.","year":"1987","unstructured":"Maury CPJ, Teppo A-M. Raised serum levels of cachectin tumor necrosis factor-a in renal allograft rejection. J Exp Med 1987;166:1 132-7.","journal-title":"J Exp Med"},{"key":"ref_6","first-page":"1229","article-title":"Evidence for tumour necrosis factor\/cachectin production in cancer","volume":"ii:","author":"Blakwill, F.; Osborne, R.; Burke, F.","year":"1987","unstructured":"Blakwill F, Osborne R, Burke F. Evidence for tumour necrosis factor\/cachectin production in cancer. Lancet 1987;ii:1229-32.","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/0002-9343(88)90576-1","article-title":"Elevated levels of circulating cachectin\/tumor necrosis factor in patients with acquired immunodeficiency syndrome","volume":"85","author":"Lihdevirta, J.; Maury, C.P.J.; Teppo, A.-M.; Repo, H.","year":"1988","unstructured":"Lihdevirta J, Maury CPJ, Teppo A-M, Repo H. Elevated levels of circulating cachectin\/tumor necrosis factor in patients with acquired immunodeficiency syndrome. Am J Med 1988;85: 289-91.","journal-title":"Am J Med"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1002\/anr.1780320206","article-title":"Tumor necrosis factor in the serum of patients with systemic lupus erythematosus","volume":"32","author":"Maury, C.P.J.; Teppo, A.-M.","year":"1989","unstructured":"Maury CPJ, Teppo A-M. Tumor necrosis factor in the serum of patients with systemic lupus erythematosus. Arthritis Rheum 1989;32:146-50.","journal-title":"Arthritis Rheum"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/j.1365-2141.1989.tb04271.x","article-title":"Detection of circulating tumour necrosis factor in systemic histiocytosis","volume":"71","author":"Maury, C.P.J.; Pettersson, T.","year":"1989","unstructured":"Maury CPJ, Pettersson T. Detection of circulating tumour necrosis factor in systemic histiocytosis. Br J Haematol 1989;71:293-5.","journal-title":"Br J Haematol"},{"key":"ref_10","first-page":"651","article-title":"Detection of circulating tumor necrosis factor in Kawasaki disease: pathogenetic implications","volume":"113","author":"Maury, C.P.J.; Teppo, A.-M.; Salo, E.; Pelkonen, P.","year":"1989","unstructured":"Maury CPJ, Teppo A-M, Salo E, Pelkonen P. Detection of circulating tumor necrosis factor in Kawasaki disease: pathogenetic implications. J Lab Clin Med 1989;113:651-4.","journal-title":"J Lab Clin Med"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/j.1365-2796.1989.tb00090.x","article-title":"Circulating tumour necrosis factor-a (cachectin) in myocardial infarction","volume":"225","author":"Maury, C.P.J.; Teppo, A.-M.","year":"1989","unstructured":"Maury CPJ, Teppo A-M. Circulating tumour necrosis factor-a (cachectin) in myocardial infarction. J Intern Med 1989;225: 333-6.","journal-title":"J Intern Med"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1093\/clinchem\/33.11.2024","article-title":"Radioimmunoassay of tumor necrosis factor in serum","volume":"33","author":"Teppo, A.-M.; Maury, C.P.J.","year":"1987","unstructured":"Teppo A-M, Maury CPJ. Radioimmunoassay of tumor necrosis factor in serum. Clin Chem 1987;33:2024-7.","journal-title":"Clin Chem"},{"key":"ref_13","first-page":"284","article-title":"Comparative study of serum amyloidrelated protein and f-2-microglobulin as markers of renal allograft rejection","volume":"22","author":"Maury, C.P.J.; Teppo, A.-M.","year":"1984","unstructured":"Maury CPJ, Teppo A-M. Comparative study of serum amyloidrelated protein and f-2-microglobulin as markers of renal allograft rejection. Clin Nephrol 1984;22:284-92.","journal-title":"Clin Nephrol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/0009-8981(83)90349-2","article-title":"Amyloid A fibril degrading activity in serum in liver disease: relation to serum acute phase and other protein levels","volume":"131","author":"Maury, C.P.J.; Teppo, A.-M.; Salaspuro, M.P.","year":"1983","unstructured":"Maury CPJ, Teppo A-M, Salaspuro MP. Amyloid A fibril degrading activity in serum in liver disease: relation to serum acute phase and other protein levels. Clin Chim Acta 1983;131:29-37.","journal-title":"Clin Chim Acta"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1038\/330662a0","article-title":"Anti-cachectin\/TNF monoclonal antibodies prevent septic shock during lethal bacteraemia","volume":"330","author":"Tracey, K.J.; Fong, Y.; Hesse, D.G.","year":"1987","unstructured":"Tracey KJ, Fong Y, Hesse DG, et al. Anti-cachectin\/TNF monoclonal antibodies prevent septic shock during lethal bacteraemia. Nature 1987;330:662-4.","journal-title":"Nature"},{"key":"ref_16","first-page":"\"738","article-title":"Regulation of lipoprotein lipase synthesis by recombinant tumor necrosis factor-the primary regulatory role of the hormone in 3 T 3-L adipocytes","volume":"251","author":"Price, SR, Olivercrona; T, Pekala; P.H.","year":"1986","unstructured":"Price SR, Olivercrona T, Pekala PH. Regulation of lipoprotein lipase synthesis by recombinant tumor necrosis factor-the primary regulatory role of the hormone in 3 T 3-L adipocytes. Arch Biochem Biophys 1986;251:738-42. H 17 Tracey KJ, Wei H, Manogue KR, et al. Cachectin\/tumor necrosis factor induces cachexia, anemia, and inflammation. J Exp Med 1988;167:121 1-27.","journal-title":"Arch Biochem Biophys; Cachectin\/tumor necrosis factor induces cachexia, anemia, and inflammation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1084\/jem.166.5.1280","article-title":"Tumor necrosis factor\/ cachectin is an effector of skin and gut lesions ofthe acute phase of graft-vs.-host disease","volume":"166","author":"Piguet, P.-F.; Grau, G.E.; Allet, B.; Vassalli, P.","year":"1987","unstructured":"Piguet P-F, Grau GE, Allet B, Vassalli P. Tumor necrosis factor\/ cachectin is an effector of skin and gut lesions ofthe acute phase of graft-vs.-host disease. J Exp Med 1987;166:1280-9.","journal-title":"J Exp Med"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1126\/science.3306918","article-title":"Tumor necrosis factor (cachectin) as an essential mediator in murine cerebral malaria","volume":"237","author":"Grau, G.E.; Fajardo, L.F.; Piguet, P.-F.; Allet, B.; Lambert, P.-H.; Vassalli, P.","year":"1987","unstructured":"Grau GE, Fajardo LF, Piguet P-F, Allet B, Lambert P-H, Vassalli P. Tumor necrosis factor (cachectin) as an essential mediator in murine cerebral malaria. Science 1987;237:1210-12.","journal-title":"Science"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1084\/jem.164.6.1958","article-title":"Two monokines, interleukin I and tumor necrosis factor, render cultured vascular endothelial cells susceptible to lysis by antibodies circulating during Kawasaki syndrome","volume":"164","author":"Leung, D.Y.M.; Geha, R.S.; Newburger, J.W.","year":"1986","unstructured":"Leung DYM, Geha RS, Newburger JW, et al. Two monokines, interleukin I and tumor necrosis factor, render cultured vascular endothelial cells susceptible to lysis by antibodies circulating during Kawasaki syndrome. J Exp Med 1986;164:1958-72.","journal-title":"J Exp Med"},{"key":"ref_20","article-title":"Mechanism of anaemia and cachexia in chronic inflammatory disease: role of cytokines","author":"Maury, C.P.J.; Juvonen, E.; Lahdevirta, J.; Andersson, L.C.","unstructured":"Maury CPJ, Juvonen E, Lahdevirta J, Andersson LC. Mechanism of anaemia and cachexia in chronic inflammatory disease: role of cytokines. Int J Tiss React (In press).","journal-title":"Int J Tiss React"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1172\/JCI112721","article-title":"Cachectin\/ tumor necrosis factor regulates hepatic acute-phase gene expression","volume":"78","author":"Perlmutter, D.H.; Dinarello, C.A.; Punsel, P.I.; Colten, H.R.","year":"1986","unstructured":"Perlmutter DH, Dinarello CA, Punsel PI, Colten HR. Cachectin\/ tumor necrosis factor regulates hepatic acute-phase gene expression. J Clin Invest 1986;78:1349-54.","journal-title":"J Clin Invest"},{"key":"ref_22","first-page":"1259","article-title":"Comparison with interleukin 1I# and tumor necrosis factor-a","volume":"18","year":"1988","unstructured":"Comparison with interleukin 1I# and tumor necrosis factor-a. Eur J Immunol 1988;18:1259-64.","journal-title":"Eur J Immunol"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1084\/jem.168.5.1539","article-title":"Production of tumor necrosis factor\/cachectin by human B cell lines and tonsillar B cells","volume":"168","author":"Sung, S.-S.J.; Jung, L.K.L.; Walters, J.A.; Chen, W.; Wang, C.Y.; Fu, S.M.","year":"1988","unstructured":"Sung S-SJ, Jung LKL, Walters JA, Chen W, Wang CY, Fu SM. Production of tumor necrosis factor\/cachectin by human B cell lines and tonsillar B cells. J Exp Med 1988;168:1539-51.","journal-title":"J Exp Med"},{"key":"ref_24","first-page":"8699","article-title":"Genes for the tumor necrosis factors alpha and beta are linked to the human","volume-title":"major histocompatibility complex. Proc Nati AcadSci USA","volume":"83","author":"Spies, T.; Morton, C.C.; Nedospasov, S.A.; Fiers, W.; Pious, D.; Strominger, J.L.","year":"1986","unstructured":"Spies T, Morton CC, Nedospasov SA, Fiers W, Pious D, Strominger JL. Genes for the tumor necrosis factors alpha and beta are linked to the human major histocompatibility complex. Proc Nati AcadSci USA 1986;83:8699-702."},{"key":"ref_25","first-page":"93042","article-title":"Pretranslational modulation of acute phase hepatic protein synthesis by murine recombinant interleukin 1 (IL-1) and purified human IL-1","volume":"162","author":"Ramadori, G.; Sipe, J.D.; Dinarello, C.A.; Mizel, S.B.; Colten, H.R.","year":"1985","unstructured":"Ramadori G, Sipe JD, Dinarello CA, Mizel SB, Colten HR. Pretranslational modulation of acute phase hepatic protein synthesis by murine recombinant interleukin 1 (IL-1) and purified human IL-1. J Exp Med 1985;162:93042.","journal-title":"J Exp Med"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1083\/jcb.102.2.370","article-title":"Regulation of major acute-phase proteins by hepatocyte-stimulating factors of human squamous carcinoma cells","volume":"102","author":"Baumann, H.; Hill, R.E.; Sander, D.N.; Jahries, G.P.","year":"1986","unstructured":"Baumann H, Hill RE, Sander DN, Jahries GP. Regulation of major acute-phase proteins by hepatocyte-stimulating factors of human squamous carcinoma cells. J Cell Biol 1986;102: 370-83.","journal-title":"J Cell Biol"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/0014-5793(88)80766-X","article-title":"Recombinant human interleukin-6 (IL-6\/BSF-2\/ HSF) regulates the synthesis of acute phase proteins in human hepatocytes","volume":"232","author":"Castell, J.V.; G6mez-Lech6n, M.J.; David, M.; Hirano, T.; Kishimoto, T.; Heinrich, P.C.","year":"1988","unstructured":"Castell JV, G6mez-Lech6n MJ, David M, Hirano T, Kishimoto T, Heinrich PC. Recombinant human interleukin-6 (IL-6\/BSF-2\/ HSF) regulates the synthesis of acute phase proteins in human hepatocytes. FEBS lett 1988;232:347-50.","journal-title":"FEBS lett"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1084\/jem.169.1.333","article-title":"The complex pattern of cytokines in serum from patients with meningococcal septic shock. Association between interleukin 6, interleukin I and fatal outcome","volume":"169","author":"Waage, A.; Brandtzaeg, P.; Halstensen, A.; Kierulf, P.; Espevik, T.","year":"1989","unstructured":"Waage A, Brandtzaeg P, Halstensen A, Kierulf P, Espevik T. The complex pattern of cytokines in serum from patients with meningococcal septic shock. Association between interleukin 6, interleukin I and fatal outcome. J Exp Med 1989;169:333-8.","journal-title":"J Exp Med"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1200\/JCO.1987.5.12.1942","article-title":"Clinical pharmacology of recombinant human tumor necrosis factor in patients with advanced cancer","volume":"5","author":"Chapman, P.B.; Lester, T.J.; Casper, E.S.","year":"1987","unstructured":"Chapman PB, Lester TJ, Casper ES, et al. Clinical pharmacology of recombinant human tumor necrosis factor in patients with advanced cancer. J Clin Oncol 1987;5:1942-51.","journal-title":"J Clin Oncol"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1172\/JCI110847","article-title":"Plasma clearance kinetics ofthe amyloidrelated high density lipoprotein apoprotein, serum amyloid protein (apoSAA) in the mouse: evidence for rapid SAA clearance","volume":"71","author":"Hoffman, J.S.; Benditt, E.P.","year":"1983","unstructured":"Hoffman JS, Benditt EP. Plasma clearance kinetics ofthe amyloidrelated high density lipoprotein apoprotein, serum amyloid protein (apoSAA) in the mouse: evidence for rapid SAA clearance. J Clin Invest 1983;71:926-34.","journal-title":"J Clin Invest"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3109\/03009748509165505","article-title":"Human highdensity lipoprotein associated amyloid A protein. Structural characteristics, relation to apoA-I and A-II concentrations, and plasma clearance kinetics in the rat","volume":"14","author":"Enholm, C.; Teppo, A.-M.; Ohisalo, J.J.; Maury, C.P.J.","year":"1985","unstructured":"Enholm C, Teppo A-M, Ohisalo JJ, Maury CPJ. Human highdensity lipoprotein associated amyloid A protein. Structural characteristics, relation to apoA-I and A-II concentrations, and plasma clearance kinetics in the rat. Scand J Rheumatol 1985;14:201-8.","journal-title":"Scand J Rheumatol"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/j.1749-6632.1982.tb22160.x","article-title":"Kushner 1. Estimation of in vivo Maury rates of C-reactive protein synthesis from serum turnover studies in rabbits","volume":"389","author":"Chelladurai, M.; Macintyre, S.S.","year":"1982","unstructured":"Chelladurai M, Macintyre SS, Kushner 1. Estimation of in vivo Maury rates of C-reactive protein synthesis from serum turnover studies in rabbits. Ann NY Acad Sci 1982;389:437-8.","journal-title":"Ann NY Acad Sci"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/j.1365-2362.1984.tb01190.x","article-title":"Control of the acute phase serum amyloid A and C-reactive protein response. Comparison of total replacement of the hip and knee","volume":"14","author":"Maury, C.P.J.; Teppo, A.-M.; Raunio, P.","year":"1984","unstructured":"Maury CPJ, Teppo A-M, Raunio P. Control of the acute phase serum amyloid A and C-reactive protein response. Comparison of total replacement of the hip and knee. Eur J Clin Invest 1984;14:323-8.","journal-title":"Eur J Clin Invest"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1172\/JCI108949","article-title":"Changes in human serum amyloid A and C-reactive protein after etiocholanolone induced inflammation","volume":"61","author":"McAdam, K.P.W.J.; Elin, F.R.; Sipe, J.D.; Wolff, S.M.","year":"1978","unstructured":"McAdam KPWJ, Elin FR, Sipe JD, Wolff SM. Changes in human serum amyloid A and C-reactive protein after etiocholanolone induced inflammation. J Clin Invest 1978;61:390-4.","journal-title":"J Clin Invest"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.42.10.1078","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T03:52:31Z","timestamp":1765597951000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.42.10.1078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,10]]},"references-count":34,"journal-issue":{"issue":"10","published-online":{"date-parts":[[1989,10,1]]},"published-print":{"date-parts":[[1989,10]]}},"alternative-id":["10.1136\/jcp.42.10.1078"],"URL":"https:\/\/doi.org\/10.1136\/jcp.42.10.1078","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1989,10]]}}}