Mads Abildtrup1, Gabrielle H Kingsley1, David L Scott2. 1. From the Department of Rheumatology, King's College London School of Medicine, Weston Education Centre; Department of Rheumatology, University Hospital Lewisham; Department of Rheumatology, King's College Hospital, London, UK.M. Abildtrup, BSc (Hons), Medical Student, Department of Rheumatology, King's College London School of Medicine, Weston Education Centre; G.H. Kingsley, MB ChB, PhD, FRCP, Professor of Clinical Rheumatology, Department of Rheumatology, King's College London School of Medicine, Weston Education Centre, and Department of Rheumatology, University Hospital Lewisham; D.L. Scott, BSc, MD, FRCP, Professor of Clinical Rheumatology, Department of Rheumatology, King's College London School of Medicine, Weston Education Centre, and Department of Rheumatology, King's College Hospital. 2. From the Department of Rheumatology, King's College London School of Medicine, Weston Education Centre; Department of Rheumatology, University Hospital Lewisham; Department of Rheumatology, King's College Hospital, London, UK.M. Abildtrup, BSc (Hons), Medical Student, Department of Rheumatology, King's College London School of Medicine, Weston Education Centre; G.H. Kingsley, MB ChB, PhD, FRCP, Professor of Clinical Rheumatology, Department of Rheumatology, King's College London School of Medicine, Weston Education Centre, and Department of Rheumatology, University Hospital Lewisham; D.L. Scott, BSc, MD, FRCP, Professor of Clinical Rheumatology, Department of Rheumatology, King's College London School of Medicine, Weston Education Centre, and Department of Rheumatology, King's College Hospital. d.scott1@nhs.net david.l.scott@kcl.ac.uk.
Abstract
OBJECTIVE: Calprotectin (myeloid-related protein 8/14), a heterodimeric complex of calcium-binding proteins, is expressed in granulocytes and monocytes. Calprotectin levels are high in synovial tissue, particularly in activated cells adjacent to the cartilage-pannus junction. This systematic review evaluates the use of calprotectin as an indicator of disease activity, therapeutic response, and prognosis in rheumatoid arthritis (RA). METHODS: Medline, Scopus, and the Cochrane Library (1970-2013) were searched for studies containing original data from patients with RA in whom calprotectin levels were measured in plasma/serum and/or synovial fluid (SF). We included studies examining associations between calprotectin levels and clinical and laboratory assessments, disease progression, and therapeutic response. There were no restrictions for sample size, disease duration, or length of followup. RESULTS: We evaluated 17 studies (1988-2013) with 1065 patients enrolled; 11 were cross-sectional and 8 had longitudinal designs with 2 studies reporting cross-sectional and longitudinal data. Systemic and SF levels of calprotectin were raised in RA. There was a wide range of levels and marked interstudy and intrastudy variability. Calprotectin levels were high in active disease and were particularly high in rheumatoid factor (RF)-positive patients. Levels fell with effective treatment. Longitudinal data showed that calprotectin was a significant and independent predictor of erosive progression and therapeutic responses, particularly in patients who received effective biological treatments. CONCLUSION: SF calprotectin levels are high, suggesting there is substantial local production by inflamed synovium. Blood calprotectin levels, though highly variable, are elevated in active RA and fall with effective therapy. High baseline calprotectin levels predict future erosive damage.
OBJECTIVE: Calprotectin (myeloid-related protein 8/14), a heterodimeric complex of calcium-binding proteins, is expressed in granulocytes and monocytes. Calprotectin levels are high in synovial tissue, particularly in activated cells adjacent to the cartilage-pannus junction. This systematic review evaluates the use of calprotectin as an indicator of disease activity, therapeutic response, and prognosis in rheumatoid arthritis (RA). METHODS: Medline, Scopus, and the Cochrane Library (1970-2013) were searched for studies containing original data from patients with RA in whom calprotectin levels were measured in plasma/serum and/or synovial fluid (SF). We included studies examining associations between calprotectin levels and clinical and laboratory assessments, disease progression, and therapeutic response. There were no restrictions for sample size, disease duration, or length of followup. RESULTS: We evaluated 17 studies (1988-2013) with 1065 patients enrolled; 11 were cross-sectional and 8 had longitudinal designs with 2 studies reporting cross-sectional and longitudinal data. Systemic and SF levels of calprotectin were raised in RA. There was a wide range of levels and marked interstudy and intrastudy variability. Calprotectin levels were high in active disease and were particularly high in rheumatoid factor (RF)-positive patients. Levels fell with effective treatment. Longitudinal data showed that calprotectin was a significant and independent predictor of erosive progression and therapeutic responses, particularly in patients who received effective biological treatments. CONCLUSION: SF calprotectin levels are high, suggesting there is substantial local production by inflamed synovium. Blood calprotectin levels, though highly variable, are elevated in active RA and fall with effective therapy. High baseline calprotectin levels predict future erosive damage.
Authors: Anna Medkova; Josef Srovnal; Jarmila Potomkova; Jana Volejnikova; Vladimir Mihal Journal: World J Pediatr Date: 2018-06-01 Impact factor: 2.764
Authors: Jana Hurnakova; Hana Hulejova; Jakub Zavada; Martin Komarc; Lucie Andres Cerezo; Herman Mann; Jiri Vencovsky; Karel Pavelka; Ladislav Senolt Journal: Clin Rheumatol Date: 2018-04-14 Impact factor: 2.980
Authors: Mary Bach; Jeonghun Moon; Richard Moore; Tiffany Pan; J Lee Nelson; Christian Lood Journal: Arthritis Rheumatol Date: 2019-12-03 Impact factor: 10.995
Authors: Mikel Alberdi-Saugstrup; Susan Nielsen; Pernille Mathiessen; Claus Henrik Nielsen; Klaus Müller Journal: Clin Rheumatol Date: 2016-08-25 Impact factor: 2.980
Authors: Coline Haxaire; Narine Hakobyan; Tania Pannellini; Camila Carballo; David McIlwain; Tak W Mak; Scott Rodeo; Suchitra Acharya; Daniel Li; Jackie Szymonifka; Xiangqian Song; Sébastien Monette; Alok Srivastava; Jane E Salmon; Carl P Blobel Journal: Blood Date: 2018-05-18 Impact factor: 22.113
Authors: Karen F Johnstone; Yuping Wei; Peter D Bittner-Eddy; Gerrit W Vreeman; Ian A Stone; Jonathan B Clayton; Cavan S Reilly; Travis B Walbon; Elisa N Wright; Susan L Hoops; William S Boyle; Massimo Costalonga; Mark C Herzberg Journal: Infect Immun Date: 2021-06-07 Impact factor: 3.441
Authors: Rahul Kalla; Nicholas A Kennedy; Nicholas T Ventham; Ray K Boyapati; Alex T Adams; Elaine R Nimmo; Micaela R Visconti; Hazel Drummond; Gwo-Tzer Ho; Rebecca J Pattenden; David C Wilson; Jack Satsangi Journal: Am J Gastroenterol Date: 2016-09-06 Impact factor: 12.045