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Abstract Number: 136

Serum Calprotectin (S100A8/9) Is an Independent Predictor of Ultrasound Synovitis in Patients with Rheumatoid Arthritis

Jana Hurnakova1, Jakub Zavada1, Petra Hanova2, Hana Hulejova1, Martin Klein1, Herman F. Mann1, Olga Sleglova1, Martina Olejarova1, Sarka Forejtova3, Olga Ruzickova1, Martin Komarc4, Karel Pavelka1 and Ladislav Senolt3, 1Institute of Rheumatology and Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Prague, Czech Republic, 2Institute of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Prague, Czech Republic, 3Institute of Rheumatology and Department of Rheumatology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 4Institute of biophysics and informatics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czech Republic

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Biomarkers, Disease Activity, rheumatoid arthritis (RA) and ultrasonography

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Session Information

Title: Imaging of Rheumatic Diseases: Ultrasound

Session Type: Abstract Submissions (ACR)

Background/Purpose

Serological biomarkers specifically reflecting pathological processes may have added value in assessing joint inflammation in rheumatoid arthritis (RA). Calprotectin (S100A8/9 protein) has been demonstrated as an important marker of clinical and laboratory disease activity and structural joint damage in RA1. Matrix metalloproteinase-3 (MMP-3) is directly involved in progressive joint damage; however, its role as a marker of disease activity in RA remains unclear2. Musculoskeletal ultrasound has superior sensitivity over clinical examination in evaluating synovial inflammation in RA. The aim of this study was to evaluate the associations between serum calprotectin, MMP-3, clinical and ultrasound parameters of RA disease activity in a cross-sectional study.

Methods

A total of 37 patients with RA (24 females, median disease duration 18 months), underwent clinical examination (DAS28) and 7-joint ultrasound score (US-7) of clinically dominant wrist, second and third metacarpophalangeal and proximal interphalangeal, and second and fifth metatarsophalangeal joints to assess synovitis and tenosynovitis by gray-scale (GS) and power Doppler (PD) ultrasound using semiquantitative grading (0-3). Blood samples were taken at the same day as ultrasound examination was performed and levels of serum calprotectin, MMP-3 and C-reactive protein (CRP) were subsequently measured. Clinical and laboratory measures were correlated with ultrasound findings using Spearman´s correlation coefficient. A multiple regression analysis adjusted for age and sex was used to determine the predictive value of calprotectin, MMP-3 and CRP for PD synovitis.

Results

Calprotectin significantly correlated with DAS28 (r=0.385, p<0.05) and in particular with CRP levels (r=0.629, p<0.001) and swollen joint count (r=0.465, p<0.005). In addition, calprotectin was significantly associated with GS (r=0.359, p<0.05) and PD synovitis (r=0.497, p<0.005). On the other side, no such association was found for MMP-3. Using adjusted multiple regression analysis, calprotectin was the only independent predictor of active PD synovitis (p<0.05).

Conclusion

This study show a significant association between calprotectin and clinical, laboratory as well as ultrasound assessment of RA disease activity. Circulating calprotectin, but not MMP-3, may represent an important biomarker for monitoring synovial inflammation in RA.

References:

1. Andrés Cerezo L, Mann H, Pecha O, et al. Decreases in serum levels of S100A8/9 (calprotectin) correlate with improvements in total swollen joint count in patients with recent-onset rheumatoid arthritis. Arthritis  Res Ther. 2011;13(4):R122.

2. Yamanaka H, Matsuda Y, Tanaka M, et al. Serum matrix metalloproteinase 3 as a predictor of the degree of joint destruction during the six months after measurement, in patients with early rheumatoid arthritis. Arthritis  Rheum. 2000 Apr;43(4):852-8.

Acknowledgements: Supported by project of MHCR for conceptual development of research organization 023728, IGA grant No. NT12437 and GAUK grant No. 1010213.


Disclosure:

J. Hurnakova,
None;

J. Zavada,
None;

P. Hanova,
None;

H. Hulejova,
None;

M. Klein,
None;

H. F. Mann,
None;

O. Sleglova,
None;

M. Olejarova,
None;

S. Forejtova,
None;

O. Ruzickova,
None;

M. Komarc,
None;

K. Pavelka,
None;

L. Senolt,
None.

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