Grossi Valentina, Infantino Maria, Manfredi Mariangela, Meacci Francesca, Bellio Emanuele, Bellio Valerio, Gobbi Francesca Li, Ugolini Simone, Catani Stefano, Sarzi-Puttini Piercarlo, Atzeni Fabiola, Benucci Maurizio
Immunology and Allergology Laboratory Unit, San Giovanni di Dio Hospital, Via Torregalli 3, 50143 Florence, Italy.
Immunology and Allergology Laboratory Unit, S. Giovanni di Dio Hospital, Florence, Italy.
Curr Rheumatol Rev. 2017;13(2):93-97. doi: 10.2174/1573397112666160629085231.
The identification and validation of soluble markers provide significant opportunities for managing patients with rheumatic diseases, and calprotectin may be an alternative laboratory biomarker of inflammatory rheumatoid arthritis (RA) and psoriatic arthritis (PsA) even though its levels may vary considerably. The aim of this study was to propose a calprotectin cut-off value that would be useful for distinguishing patients with inflammatory arthritis or noninflammatory arthritis (NIA) in clinical practice.
A commercial enzyme-linked immunosorbent assay was used to measure serum calprotectin levels in patients with RA, ankylosing spondylitis (AS), PsA and controls with NIA. All of the patients had been treated with biological disease-modifying anti-rheumatic drugs (DMARDs) for about 12 months after previous failure on conventional DMARDs.
Receiver operating characteristic (ROC) analysis showed that serum calprotectin levels significantly differentiated the samples of the patients with inflammatory rheumatic disease from those of the controls. A serum calprotectin level of > 0.9 μg/mL (the optimal predictive cut-off value in the ROC analysis) had a sensitivity of 95.3%, a specificity of 82.2%, a positive likelihood ratio (LR) of 5.35 and a negative LR of 0.057.
Our findings suggest that serum calprotectin levels are useful in clinical practice to distinguish patients with inflammatory arthritis and NIA. Further studies of a larger population are suggested.
可溶性标志物的识别与验证为风湿性疾病患者的管理提供了重要契机，钙卫蛋白可能是炎症性类风湿关节炎（RA）和银屑病关节炎（PsA）的一种替代性实验室生物标志物，尽管其水平可能有很大差异。本研究的目的是提出一个钙卫蛋白临界值，该临界值在临床实践中有助于区分炎症性关节炎患者和非炎症性关节炎（NIA）患者。
采用商业酶联免疫吸附测定法测量RA、强直性脊柱炎（AS）、PsA患者以及NIA对照组患者的血清钙卫蛋白水平。所有患者在先前使用传统抗风湿药物（DMARDs）治疗失败后，均接受生物性改善病情抗风湿药物（DMARDs）治疗约12个月。
受试者工作特征（ROC）分析表明，血清钙卫蛋白水平能显著区分炎症性风湿性疾病患者的样本与对照组的样本。血清钙卫蛋白水平>0.9μg/mL（ROC分析中的最佳预测临界值）时，敏感性为95.3%，特异性为82.2%，阳性似然比（LR）为5.35，阴性LR为0.057。
我们的研究结果表明，血清钙卫蛋白水平在临床实践中有助于区分炎症性关节炎患者和NIA患者。建议进一步对更大规模人群进行研究。
