Kudraszew Emilia, Roszkowski Leszek, Ciechomska Marzena, Wroński Jakub
Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Department of Outpatient Clinics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Front Immunol. 2025 Aug 13;16:1608402. doi: 10.3389/fimmu.2025.1608402. eCollection 2025.
Giant cell arteritis (GCA) is an immune-mediated vasculitis predominantly affecting individuals aged 50 years and older, with clinical manifestations often overlapping with polymyalgia rheumatica (PMR). Despite advances in imaging and the advent of novel steroid-sparing agents, such as tocilizumab, challenges persist in accurately diagnosing and monitoring disease activity. Traditional inflammatory markers like C-reactive protein and erythrocyte sedimentation rate are frequently limited by their inability to fully capture disease dynamics, especially in patients receiving IL-6 inhibitors. In this context, calprotectin (CLP), a heterodimeric complex derived from S100A8/S100A9 proteins, has emerged as a promising biomarker due to its integral role in mediating inflammatory responses and its relative independence from IL-6 pathways. This review synthesizes current evidence on the biological functions of CLP in GCA pathogenesis, its potential utility in distinguishing between different clinical forms of the GCA-PMR spectrum, and its role in assessing disease activity and guiding therapeutic decisions. Furthermore, emerging CLP-targeted therapies in other inflammatory conditions may offer novel treatment avenues for GCA. Future research should focus on validating CLP as a predictive marker for relapse and refining its integration into clinical monitoring protocols to enhance patient outcomes.
巨细胞动脉炎（GCA）是一种免疫介导的血管炎，主要影响50岁及以上的个体，其临床表现常与风湿性多肌痛（PMR）重叠。尽管影像学取得了进展，并且出现了新型的类固醇节省药物，如托珠单抗，但在准确诊断和监测疾病活动方面仍然存在挑战。传统的炎症标志物，如C反应蛋白和红细胞沉降率，常常因其无法充分反映疾病动态而受到限制，特别是在接受IL-6抑制剂治疗的患者中。在这种背景下，钙卫蛋白（CLP），一种由S100A8/S100A9蛋白衍生的异二聚体复合物，由于其在介导炎症反应中的重要作用以及相对独立于IL-6途径，已成为一种有前景的生物标志物。本综述综合了关于CLP在GCA发病机制中的生物学功能、其在区分GCA-PMR谱系不同临床形式中的潜在效用以及其在评估疾病活动和指导治疗决策中的作用的现有证据。此外，在其他炎症性疾病中新兴的CLP靶向疗法可能为GCA提供新的治疗途径。未来的研究应专注于验证CLP作为复发预测标志物，并完善其在临床监测方案中的整合，以改善患者预后。
