Calprotectin (a major S100 leucocyte protein) predicts 10-year radiographic progression in patients with rheumatoid arthritis
Calprotectin (a major S100 leucocyte protein) predicts 10-year radiographic progression in patients with rheumatoid arthritis
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DOI：
10.1136/ard.2008.103739
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发表时间：
2010-01-01
影响因子：
27.4
通讯作者：
Kvien, T. K.
中科院分区：
文献类型：
--
作者：
Hammer, H. Berner;Odegard, S.;Kvien, T. K.
背景：血浆钙保护素是一种主要的S100白细胞蛋白，其水平与类风湿性关节炎(RA)的临床和实验室炎症标志物以及放射学损害有关。目的：探讨钙保护素是否可以作为预测关节损害的独立指标。方法：对124例RA患者在治疗前和10年后进行炎症标志物(钙保护素、C反应蛋白(CRP)、血沉(ESR))、血清学指标(抗环瓜氨酸肽抗体(抗CCP)、类风湿因子(RF)和IgM RF)、关节损害的放射学和临床评估(手部X线片和类风湿性关节炎关节损害(RAAD)评分)。根据van der Heijde改良的Sharp评分对放射学损伤的进展进行评估。结果：在两种检查中，抗CCP、IgA和IgM RF阳性患者的钙保护素水平最高。钙保护素与炎症和血清标志物有中等到良好的相关性(r=0.41~0.67)。基线钙保护素水平正常的患者关节损伤程度较低。基线钙保护素水平与Sharp评分和RAAD评分的进展之间存在高度的单变量关联。在多元线性回归分析中，基线钙保护素与Sharp评分和RAAD评分独立相关，包括基线水平的C反应蛋白、血沉、抗CCP水平以及人口统计学变量。结论：钙保护素是10年后临床和放射学关节损害的独立预测因子。这些发现支持钙保护素可能是类风湿关节炎患者侵蚀性疾病预后的生物标记物。
Background: Plasma levels of calprotectin, a major S100 leucocyte protein, are cross-sectionally associated with clinical and laboratory markers of inflammation and with radiographic damage in rheumatoid arthritis (RA). High amounts of calprotectin are found in synovial fluid from patients with RA.Objective: To examine whether calprotectin might be an independent predictor of joint destruction over time.Methods: 124 patients with RA were assessed at baseline and after 10 years with inflammatory markers (calprotectin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)), serological variables (antibodies to cyclic citrullinated peptide (anti-CCP), IgA rheumatoid factor (RF) and IgM RF) and radiographic and clinical assessments of joint damage (hand radiographs and Rheumatoid Arthritis Articular Damage (RAAD) score). Progression of radiographic damage was assessed according to the van der Heijde modified Sharp score.Results: At both examinations the highest calprotectin levels were found in patients positive for anti-CCP, IgA and IgM RF. Calprotectin had moderate to good correlations with inflammatory and serological markers (r=0.41-0.67). Patients with normal baseline calprotectin levels had a lower degree of joint damage. High univariate associations were found between baseline calprotectin levels and progression in the Sharp score as well as the RAAD score. Baseline calprotectin was independently associated with progression in the Sharp score and with the RAAD score in multiple linear regression analyses, including baseline levels of CRP, ESR, anti-CCP in addition to demographic variables.Conclusion: Calprotectin was an independent predictor of clinical and radiographic joint damage after 10 years. These findings support the proposal that calprotectin may be a prognostic biomarker for erosive disease in patients with RA.