Dept of Rheumatology, Diakonhjemmet Hospital, Box 23, 0319 Oslo, Norway.
Arthritis Res Ther. 2011;13(5):R178. doi: 10.1186/ar3503. Epub 2011 Oct 26.
Calprotectin (MRP8/MRP14, S100A8/A9) is associated with disease activity in patients with rheumatoid arthritis (RA). Ultrasonography (US) is a reliable method for evaluation of synovitis (B-mode (BM) and power Doppler (PD)). The present objectives were to explore in RA patients the associations between calprotectin and a comprehensive US examination, as well as the responsiveness of calprotectin compared to other inflammatory markers during anti-TNF treatment.
A total of 20 RA patients starting treatment with adalimumab were examined longitudinally by US (BM and PD (semi-quantitative scores 0 to 3) of 78 joints, 36 tendons/tendon groups and 2 bursae) and clinically at baseline and after 1, 3, 6 and 12 months. Associations between the US sum scores and the inflammatory markers calprotectin, serum amyloid A (SAA), CRP and ESR were explored by correlation and linear regression analyses, and the response to treatment was assessed by Standardized Response Mean (SRM).
The inflammatory markers, clinical examinations and US sum scores improved during treatment (P < 0.001). Of the inflammatory markers, calprotectin had the highest correlation coefficients with the total BM and PD sum scores (median (range) 0.59 (0.37 to 0.76) for BM and 0.56 (0.38 to 0.72) for PD). Even higher correlations were found between calprotectin and sum US scores of reduced number of joint counts. Calprotectin made a considerable contribution to total US sum scores in the linear regression analyses (P = 0.001 to 0.031) and among the inflammatory markers, calprotectin had the highest SRM (0.84 at one month).
Calprotectin was associated with the sum scores from a comprehensive US assessment and was responsive to change during anti-TNF treatment. Thus, examination of this leukocyte protein could be of additional value in the assessment of RA patients on biologic treatment.
钙卫蛋白（MRP8/MRP14、S100A8/A9）与类风湿关节炎（RA）患者的疾病活动度相关。超声检查（US）是评估滑膜炎（B 型（BM）和能量多普勒（PD））的可靠方法。本研究的目的是在 RA 患者中探讨钙卫蛋白与全面 US 检查之间的关系，以及在接受抗 TNF 治疗期间，钙卫蛋白与其他炎症标志物的反应性。
共 20 例开始接受阿达木单抗治疗的 RA 患者进行了前瞻性纵向超声检查（BM 和 PD（78 个关节、36 个肌腱/肌腱群和 2 个滑囊的半定量评分 0 至 3）和临床检查，在基线时以及治疗后 1、3、6 和 12 个月时）。通过相关性和线性回归分析，探讨了 US 总分与炎症标志物钙卫蛋白、血清淀粉样蛋白 A（SAA）、CRP 和 ESR 之间的关系，并通过标准化反应均值（SRM）评估了治疗反应。
在治疗过程中，炎症标志物、临床检查和 US 总分均有所改善（P < 0.001）。在炎症标志物中，钙卫蛋白与 BM 和 PD 总分的相关性最高（中位数（范围）0.59（0.37 至 0.76）用于 BM 和 0.56（0.38 至 0.72）用于 PD）。在减少关节计数的联合 US 评分中，钙卫蛋白与总评分之间的相关性更高。在线性回归分析中，钙卫蛋白对总 US 评分有显著贡献（P = 0.001 至 0.031），并且在炎症标志物中，钙卫蛋白的 SRM 最高（1 个月时为 0.84）。
钙卫蛋白与全面 US 评估的总分相关，并且在抗 TNF 治疗期间对变化有反应。因此，在评估接受生物治疗的 RA 患者时，检测这种白细胞蛋白可能具有额外的价值。
