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Serum Calprotectin Level for Diagnosis and detection of Disease Activity in Rheumatoid Arthritis

Received: 9 March 2014     Published: 30 March 2014
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Abstract

Background: Early diagnosis of rheumatoid arthritis and timely detection of progression are global challenges. However, lack of sensitivity and imprecision of the currently available biomarkers have impaired the ability to implement potentially effective therapies in a timely manner. The present study aimed to evaluate the clinical utility of serum calprotectin in diagnosis as well as assessment of rheumatoid arthritis activity. Methods: serum calprotectin levels were measured in 60 Egyptian patients with rheumatoid arthritis (35 patients with active rheumatoid arthritis vs. 25 patients with quiescent disease) and 20 healthy subjects who served as a control group. Results: Serum calprotectin showed a highly significant elevation in patients with rheumatoid arthritis. Moreover, its level showed a highly significant increase during disease activity. Significant positive correlations were found between serum calprotectin and other markers of disease activity (ESR, CRP, WBCs, and platelets). Serum calprotectin at a cut- off level of 450 ng /mL, had 75% sensitivity &90% specificity for diagnosis of rheumatoid arthritis. Optimum cut-off level of calprotectin for prediction of disease activity was 950 ng /mL with 80% sensitivity, 76% specificity. Conclusion: serum calprotectin is a promising marker for diagnosis and monitoring of disease activity in patients with rheumatoid arthritis.

Published in International Journal of Immunology (Volume 2, Issue 1)
DOI 10.11648/j.iji.20140201.12
Page(s) 6-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Calprotectin, Rheumatoid, Arthritis, CRP

References
[1] Helmick C.G., Felson D.T., Lawrence R.C., et al. Estimates of the Prevalence of Arthritis and other Rheumatic Conditions in the United States: Part I. Arthritis Rheum 2008; 58(1):15–25.
[2] Visser H. Early Diagnosis of Rheumatoid Arthritis. Best Practice and Research Clinical Rheumatology 2005; 19 (1): 155-172.
[3] Ostergaard M., Ejbjerg B., Szkudlarek M. Imaging in Early Rheumatoid Arthritis: Roles of Magnetic Resonance Imaging Ultrasonography, Conventional Radiography and Computed Tomography. Best Practice and Research Clinical Rheumatology 2005; 19 (1): 91-116.
[4] Sokka T. and Pincus T.. Erythrocyte Sedimentation Rate, C - reactive protein, or Rheumatoid Factor are Normal at Presentation in 35%-45% of Patients with Rheumatoid Arthritis Seen between 1980 and 2004: Analyses from Finland and the United States. J Rheumatol 2009; 36: 1387-1390.
[5] Riel P. and Fransen J. Established Rheumatoid Arthritis: Clinical Assessments. Best Practice and Research Clinical Rheumatology 2007; 21 (5): 807-825.
[6] Chen Y.S., Yan W., Geczy C.L., et al. Serum levels of soluble receptor for advanced glycation end products and of S100 proteins are associated with inflammatory, autoantibody, and classical risk markers of joint and vascular damage in rheumatoid arthritis. Arthritis Res Ther. 2009; 11:R39.
[7] Hammer H.B., Odegard S., Fagerhol M.K. Calprotectin (a major leucocyte protein) is strongly and independently correlated with Joint Inflammation and Damage in Rheumatoid Arthritis. Ann Rheum Dis. 2007; 66:1093–1097.
[8] Andrés Cerezo L., Mann H., Pecha O., et al. Decreases in serum levels of S100A8/9 (calprotectin) correlate with improvements in total swollen joint count in patients with recent-onset rheumatoid arthritis. Arthritis Res Ther. 2011; 13(4):R122.
[9] Foell D., Wittkowski H.,Vogl T., et al. S100 proteins expressed in phagocytes: a novel group of damage-associated molecular pattern molecules .Journal of Leukocyte Biology 2007; 81: 28-37.
[10] Hammer H.B., Haavardsholm E.K. , Kvien T.K. Calprotectin (a major leucocyte protein) is associated with the levels of anti-CCP and rheumatoid factor in a longitudinal study of patients with very early rheumatoid arthritis. Scand J Rheumatol 2008; 37:179–182.
[11] Aletaha D., Neogi T., Silman A.J. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Ann. Rheum. Dis. 2010; 69 (9): 1580–1288.
[12] Fransen J., Stucki G., van Riel L.C.M. Rheumatoid Arthritis Measures Disease Activity Score (DAS), Disease Activity Score-28 (DAS28), Rapid Assessment of Disease Activity in Rheumatology (RADAR), and Rheumatoid Arthritis Disease Activity Index (RADAI) Arthritis & Rheumatism. Arthritis Care & Research 2003; 49(5): 214 –224.
[13] Tobón G.J., Youinou P., Saraux, A.The environment, geo-epidemiology, and autoimmune disease: Rheumatoid arthritis. JAutoimmun. 2010; 35(1):10-14.
[14] Madland T.M., Hordvik M., Haga H.J., et al. Leukocyte protein calprotectin and outcome in rheumatoid arthritis. Scand J Rheumatol 2002 ;31:351- 354.
[15] De Seny D., Fillet M., Ribbens C., et al. Monomeric Calgranulins Measured by SELDI-TOF Mass Spectrometry and Calprotectin Measured by ELISA as Biomarkers in Arthritis. Clinical Chemistry 2008; 54: 1066-1075.
[16] Hammer H.B., Odegard S., Syversen S.W., et al. Calprotectin (a major S100 leucocyte protein) predicts 10-year radiographic progression in patients with rheumatoid arthritis. Ann Rheum Dis.2010; 69:150–154.
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  • APA Style

    Nanees Adel, Marcel William, Reham Al Swaff, Sherin Hassan. (2014). Serum Calprotectin Level for Diagnosis and detection of Disease Activity in Rheumatoid Arthritis. International Journal of Immunology, 2(1), 6-10. https://doi.org/10.11648/j.iji.20140201.12

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    ACS Style

    Nanees Adel; Marcel William; Reham Al Swaff; Sherin Hassan. Serum Calprotectin Level for Diagnosis and detection of Disease Activity in Rheumatoid Arthritis. Int. J. Immunol. 2014, 2(1), 6-10. doi: 10.11648/j.iji.20140201.12

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    AMA Style

    Nanees Adel, Marcel William, Reham Al Swaff, Sherin Hassan. Serum Calprotectin Level for Diagnosis and detection of Disease Activity in Rheumatoid Arthritis. Int J Immunol. 2014;2(1):6-10. doi: 10.11648/j.iji.20140201.12

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  • @article{10.11648/j.iji.20140201.12,
      author = {Nanees Adel and Marcel William and Reham Al Swaff and Sherin Hassan},
      title = {Serum Calprotectin Level for Diagnosis and detection of Disease Activity in Rheumatoid Arthritis},
      journal = {International Journal of Immunology},
      volume = {2},
      number = {1},
      pages = {6-10},
      doi = {10.11648/j.iji.20140201.12},
      url = {https://doi.org/10.11648/j.iji.20140201.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20140201.12},
      abstract = {Background: Early diagnosis of rheumatoid arthritis and timely detection of progression are global challenges. However, lack of sensitivity and imprecision of the currently available biomarkers have impaired the ability to implement potentially effective therapies in a timely manner. The present study aimed to evaluate the clinical utility of serum calprotectin in diagnosis as well as assessment of rheumatoid arthritis activity. Methods: serum calprotectin levels were measured in 60 Egyptian patients with rheumatoid arthritis (35 patients with active rheumatoid arthritis vs. 25 patients with quiescent disease) and 20 healthy subjects who served as a control group. Results: Serum calprotectin showed a highly significant elevation in patients with rheumatoid arthritis. Moreover, its level showed a highly significant increase during disease activity. Significant positive correlations were found between serum calprotectin and other markers of disease activity (ESR, CRP, WBCs, and platelets). Serum calprotectin at a cut- off level of 450 ng /mL, had 75% sensitivity &90% specificity for diagnosis of rheumatoid arthritis. Optimum cut-off level of calprotectin for prediction of disease activity was 950 ng /mL with 80% sensitivity, 76% specificity. Conclusion: serum calprotectin is a promising marker for diagnosis and monitoring of disease activity in patients with rheumatoid arthritis.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Serum Calprotectin Level for Diagnosis and detection of Disease Activity in Rheumatoid Arthritis
    AU  - Nanees Adel
    AU  - Marcel William
    AU  - Reham Al Swaff
    AU  - Sherin Hassan
    Y1  - 2014/03/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.iji.20140201.12
    DO  - 10.11648/j.iji.20140201.12
    T2  - International Journal of Immunology
    JF  - International Journal of Immunology
    JO  - International Journal of Immunology
    SP  - 6
    EP  - 10
    PB  - Science Publishing Group
    SN  - 2329-1753
    UR  - https://doi.org/10.11648/j.iji.20140201.12
    AB  - Background: Early diagnosis of rheumatoid arthritis and timely detection of progression are global challenges. However, lack of sensitivity and imprecision of the currently available biomarkers have impaired the ability to implement potentially effective therapies in a timely manner. The present study aimed to evaluate the clinical utility of serum calprotectin in diagnosis as well as assessment of rheumatoid arthritis activity. Methods: serum calprotectin levels were measured in 60 Egyptian patients with rheumatoid arthritis (35 patients with active rheumatoid arthritis vs. 25 patients with quiescent disease) and 20 healthy subjects who served as a control group. Results: Serum calprotectin showed a highly significant elevation in patients with rheumatoid arthritis. Moreover, its level showed a highly significant increase during disease activity. Significant positive correlations were found between serum calprotectin and other markers of disease activity (ESR, CRP, WBCs, and platelets). Serum calprotectin at a cut- off level of 450 ng /mL, had 75% sensitivity &90% specificity for diagnosis of rheumatoid arthritis. Optimum cut-off level of calprotectin for prediction of disease activity was 950 ng /mL with 80% sensitivity, 76% specificity. Conclusion: serum calprotectin is a promising marker for diagnosis and monitoring of disease activity in patients with rheumatoid arthritis.
    VL  - 2
    IS  - 1
    ER  - 

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Author Information
  • Internal Medicine Departments, Faculty of Medicine, Ain Shams University, Cairo, Egypt

  • Internal Medicine Departments, Faculty of Medicine, Ain Shams University, Cairo, Egypt

  • Internal Medicine Departments, Faculty of Medicine, Ain Shams University, Cairo, Egypt

  • Clinical Pathology Departments, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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