Department of Rheumatology, Diakonhjemmet Hospital, Box 23, Vinderen, N-0319 Oslo, Norway.
Ann Rheum Dis. 2010 Jan;69(1):150-4. doi: 10.1136/ard.2008.103739.
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.
To examine whether calprotectin might be an independent predictor of joint destruction over time.
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.
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.
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.
钙卫蛋白是一种主要的 S100 白细胞蛋白，其血浆水平与类风湿关节炎 (RA) 的炎症临床和实验室标志物以及放射学损伤呈横断面相关。RA 患者的滑液中发现大量钙卫蛋白。
研究钙卫蛋白是否可能是随时间推移关节破坏的独立预测因子。
124 例 RA 患者在基线时和 10 年后接受炎症标志物（钙卫蛋白、C 反应蛋白 (CRP)、红细胞沉降率 (ESR)）、血清学变量（抗环瓜氨酸肽抗体 (抗-CCP)、IgA 类风湿因子 (RF)和 IgM RF）以及关节损伤的放射学和临床评估（手部 X 光片和类风湿关节炎关节损伤 (RAAD) 评分）评估。根据 van der Heijde 改良 Sharp 评分评估放射学损伤进展。
在两次检查中，抗-CCP、IgA 和 IgM RF 阳性患者的钙卫蛋白水平最高。钙卫蛋白与炎症和血清学标志物具有中度至良好的相关性（r = 0.41-0.67）。基线钙卫蛋白水平正常的患者关节损伤程度较低。单变量分析显示基线钙卫蛋白水平与 Sharp 评分和 RAAD 评分的进展呈高度相关。基线钙卫蛋白与 Sharp 评分和多线性回归分析中的 RAAD 评分独立相关，包括 CRP、ESR、抗-CCP 以及人口统计学变量的基线水平。
钙卫蛋白是 10 年后临床和放射学关节损伤的独立预测因子。这些发现支持钙卫蛋白可能是 RA 患者侵蚀性疾病的预后生物标志物的观点。
