ORIGINAL PAPER
Measurement of blood calprotectin (MRP-8/MRP-14) levels in patients with juvenile idiopathic arthritis
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Submission date: 2016-12-22
Final revision date: 2017-02-01
Acceptance date: 2017-02-08
Online publication date: 2017-03-22
Publication date: 2017-02-28
Reumatologia 2017;55(1):18-22
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ABSTRACT
Objectives: The aim of the investigation was to compare blood calprotectin (MRP8/14, S100A 8/9) levels in patients with systemic-onset, polyarticular, RF-negative and oligoarticular subtypes of juvenile idiopathic arthritis (JIA), and to explore links between blood calprotectin levels and clinical and laboratory markers of JIA activity.
Material and methods: Measurement of calprotectin in blood serum was performed in 160 patients with JIA followed up at Lviv Regional Council Public Institution “Western-Ukrainian Specialised Children’s Medical Centre”. Seventeen patients with systemic-onset JIA (sJIA) and 49 patients with other JIA subtypes (RF-negative polyarthritis and oligoarthritis) in the active phase of the disease were included in this study. Determination of calprotectin levels in blood serum was performed using EK-MRP8/14 Buhlmann Calprotectin reagents (Buhlmann, Switzerland) by the ELISA method.
Results: The results of the investigations showed that blood calprotectin levels were higher in patients with systemic-onset subtype of the disease (median 13,800 ng/ml), and differed significantly from levels in healthy children (median 1,800 ng/ml, p = 0.00002), levels in patients with articular subtypes of JIA (median 2,700 ng/ml, p = 0.000008), and patients with RF-negative polyarthritis (median 3,800 ng/ml, p = 0.003226) and oligoarthritis (median 2,500 ng/ml, p = 0.000009). The highest blood calprotectin levels were found in patients with newly diagnosed sJIA, the median being 32,500 ng/ml (range: 13,800–177,000 ng/ml). Direct correlations were found between blood calprotectin and JADAS 27 activity score (p = 0.000009), ESR (p = 0.000079) and CRP (p = 0.000058).
Conclusions: Blood calprotectin level is one of the measures that can be used to confirm the diagnosis of sJIA and to monitor the disease activity and therapy effectiveness.
REFERENCES (14)
1.
Foell D, Wittkowski H, Vogl T, et al. S100 proteins expressed in phagocytes: a novel group of damage-associated molecular pattern molecules. J Leukoc Biol 2007; 81: 28-37.
2.
Holzinger D, Kessel Ch, Omenetti A, et al. From bench to bedside and back again: translational research in autoinflammation. Nat Rev Rheumatol 2015; 11: 573-585.
3.
Kessel C, Holzinger D, Foell D. Phagocyte-derived S100 proteins in autoinflammation: putative role in pathogenesis and usefulness as biomarkers. Clin Immunol 2013; 147: 229-241.
4.
Vogl T, Tenbrock K, Ludwig S, et al. Mrp8 and Mrp14 are endogenous activators of Toll-like receptor 4, promoting lethal, endotoxin-induced shock. Nature Medicine 2007; 13: 1042-1049.
5.
Wittkowski H, Frosch M, Wulffraat N, et al. S100A12 is a novel molecular marker differentiating systemic-onset juvenile idiopathic arthritis from other causes of fever of unknown origin. Arthritis Rheum 2008; 58: 3924-3931.
6.
Foell D, Wulffraat N, Wedderburn LR. Methotrexate withdrawal at 6 vs 12 months in juvenile idiopathic arthritis in remission: a randomized clinical trial. JAMA 2010; 303: 1266-1273.
7.
Swart JF, de Roock S, Prakken BJ. Understanding inflammation in juvenile idiopathic arthritis: How immune biomarkers guide clinical strategies in the systemic onset subtype. Eur J Immunol 2016; 46: 2068-2077.
8.
Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile.
9.
idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 2004; 31: 390-392.
10.
Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet 2007; 369: 767-778.
11.
Frosch M, Ahlmann M, Vogl T, et al. The myeloid-related proteins 8 and 14 complex, a novel ligand of toll-like receptor 4, and interleukin-1 form a positive feedback mechanism in systemic-onset juvenile idiopathic arthritis. Arthritis Rheum 2009; 60: 883-891.
12.
Shenoi S, Ou JN, Ni C. Comparison of biomarkers for systemic juvenile idiopathic arthritis. Pediatr Res 2015; 78: 554-558.
13.
Holzinger D, Frosch M, Kastrup A, et al. The Toll-like receptor 4 agonist MRP8/14 protein complex is a sensitive indicator for disease activity and predicts relapses in systemic-onset juvenile idiopathic arthritis. Ann Rheum Dis 2012; 71: 974-980.
14.
Gohar F, Husmann E, Haas PJ, et al. PReS-FINAL-2216: Biomarkers MRP8/14 and S100A12 correspond with flare and remission clinical status in Sojia patients in the AID-NET register. Pediatr Rheumatol Online J 2013; 11 (Suppl 2): 206.
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