Serum calprotectin correlates stronger with inflammation and disease activity in ACPA positive than ACPA negative rheumatoid arthritis

Author:

Sejersen Kristina12ORCID,Weitoft Tomas3ORCID,Knight Ann4,Lysholm Jörgen5,Larsson Anders1,Rönnelid Johan6ORCID

Affiliation:

1. Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University , Uppsala, Sweden

2. Unilabs AB , Stockholm, Sweden

3. Department of Research and Development, Uppsala University/Region Gävleborg , Gävle, Sweden

4. Section of Rheumatology, Department of Medical Sciences, Uppsala University Hospital , Uppsala, Sweden

5. Clinic of Rheumatology, Falun Hospital , Falun, Sweden

6. Department of Immunology, Genetics and Pathology, Uppsala University , Uppsala, Sweden

Abstract

Abstract Objectives The aim of the present study was to evaluate the performance of serum and SF levels of the granulocyte protein calprotectin as an inflammatory biomarker in RA patients with knee synovitis. Methods Seventy-six RA patients with ongoing knee synovitis were included. Data on DAS with 28 joints and their subcomponents and radiological destruction of the affected knee were collected. White blood cell count, CRP, ACPA against cyclic citrullinated peptide version 2 (anti-CCP2), IgM RF and calprotectin were analysed in parallel in circulation and in SF. Counts of polynuclear and mononuclear cells were measured in SF. Results Serum (S)-calprotectin correlated more strongly than SF-calprotectin with inflammatory markers and disease activity. Instead, SF-calprotectin showed a strong correlation to SF counts of white blood cells, and especially to polymorphonuclear cell counts (Spearman’s ρ = 0.72, P < 0.001). S-calprotectin showed markedly stronger correlation with inflammatory markers and disease activity in ACPA positive as compared with ACPA negative RA patients; a similar difference was observed for patients with and without IgM RF. Conclusion The particularly strong association between circulating calprotectin and inflammation in ACPA positive RA is a new argument for a specific role for polymorphonuclear granulocytes/neutrophils in this RA subset. Measurement of calprotectin in SF does not convey any additional benefit compared with measurement in the circulation in RA patients with knee synovitis.

Funder

Uppsala University Hospital Research Fund

Swedish Rheumatism Association

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Rheumatology

Reference39 articles.

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3. iPLA2, a novel determinant in Ca2+- and phosphorylation-dependent S100A8/A9 regulated NOX2 activity;Schenten;Biochim Biophys Acta,2010

4. A radioimmunoassay for a granulocyte protein as a marker in studies on the turnover of such cells;Fagerhol;Bull Eur Physiopathol Respir,1980

5. Identification of p8,14 as a highly abundant heterodimeric calcium binding protein complex of myeloid cells;Edgeworth;J Biol Chem,1991

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