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Kiełbowski K, Stańska W, Bakinowska E, Rusiński M, Pawlik A. The Role of Alarmins in the Pathogenesis of Rheumatoid Arthritis, Osteoarthritis, and Psoriasis. Curr Issues Mol Biol 2024; 46:3640-3675. [PMID: 38666958 PMCID: PMC11049642 DOI: 10.3390/cimb46040228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Alarmins are immune-activating factors released after cellular injury or death. By secreting alarmins, cells can interact with immune cells and induce a variety of inflammatory responses. The broad family of alarmins involves several members, such as high-mobility group box 1, S100 proteins, interleukin-33, and heat shock proteins, among others. Studies have found that the concentrations and expression profiles of alarmins are altered in immune-mediated diseases. Furthermore, they are involved in the pathogenesis of inflammatory conditions. The aim of this narrative review is to present the current evidence on the role of alarmins in rheumatoid arthritis, osteoarthritis, and psoriasis. We discuss their potential involvement in mechanisms underlying the progression of these diseases and whether they could become therapeutic targets. Moreover, we summarize the impact of pharmacological agents used in the treatment of these diseases on the expression of alarmins.
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Affiliation(s)
- Kajetan Kiełbowski
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.K.); (E.B.); (M.R.)
| | - Wiktoria Stańska
- Department of Medical Biology, Medical University of Warsaw, 00-575 Warsaw, Poland;
| | - Estera Bakinowska
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.K.); (E.B.); (M.R.)
| | - Marcin Rusiński
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.K.); (E.B.); (M.R.)
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.K.); (E.B.); (M.R.)
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Moshfegh CM, Elkhatib SK, Watson GF, Drake J, Taylor ZN, Reed EC, Lauten TH, Clopp AJ, Vladimirov VI, Case AJ. S100a9 Protects Against the Effects of Repeated Social Defeat Stress. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:919-929. [PMID: 37881565 PMCID: PMC10593888 DOI: 10.1016/j.bpsgos.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/07/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Background Posttraumatic stress disorder, a consequence of psychological trauma, is associated with increased inflammation and an elevated risk of developing comorbid inflammatory diseases. However, the mechanistic link between this mental health disorder and inflammation remains elusive. We previously found that S100a8 and S100a9 messenger RNA, genes that encode the protein calprotectin, were significantly upregulated in T lymphocytes and positively correlated with inflammatory gene expression and the mitochondrial redox environment in these cells. Therefore, we hypothesized that genetic deletion of calprotectin would attenuate the inflammatory and redox phenotype displayed after psychological trauma. Methods We used a preclinical mouse model of posttraumatic stress disorder known as repeated social defeat stress (RSDS) combined with pharmacological and genetic manipulation of S100a9 (which functionally eliminates calprotectin). A total of 186 animals (93 control, 93 RSDS) were used in these studies. Results Unexpectedly, we observed worsening of behavioral pathology, inflammation, and the mitochondrial redox environment in mice after RSDS compared with wild-type animals. Furthermore, loss of calprotectin significantly enhanced the metabolic demand on T lymphocytes, suggesting that this protein may play an undescribed role in mitochondrial regulation. This was further supported by single-cell RNA sequencing analysis demonstrating that RSDS and loss of S100a9 primarily altered genes associated with mitochondrial function and oxidative phosphorylation. Conclusions These data demonstrate that the loss of calprotectin potentiates the RSDS-induced phenotype, which suggests that its observed upregulation after psychological trauma may provide previously unexplored protective functions.
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Affiliation(s)
- Cassandra M. Moshfegh
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Safwan K. Elkhatib
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Gabrielle F. Watson
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - John Drake
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas
| | - Zachary N. Taylor
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas
| | - Emily C. Reed
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas
- Department of Medical Physiology, Texas A&M University, Bryan, Texas
| | - Tatlock H. Lauten
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas
- Department of Medical Physiology, Texas A&M University, Bryan, Texas
| | - Amelia J. Clopp
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas
- Department of Medical Physiology, Texas A&M University, Bryan, Texas
| | - Vladimir I. Vladimirov
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas
- Department of Psychiatry, University of Arizona, Phoenix, Arizona
- Lieber Institute for Brain Development, Johns Hopkins University, Baltimore, Maryland
| | - Adam J. Case
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas
- Department of Medical Physiology, Texas A&M University, Bryan, Texas
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Hammer HB, Pedersen SL, Jonsson MK, Mathsson-Alm L, Gehring I, Sexton J, Haavardsholm EA, Askling J. Calprotectin, a sensitive marker of inflammation, is robustly assessed in plasma from patients with early or established rheumatoid arthritis by use of different laboratory methods. Scand J Clin Lab Invest 2023; 83:330-335. [PMID: 37343245 DOI: 10.1080/00365513.2023.2225223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/01/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
Calprotectin (S100A8/S100A9, MRP8/MRP14) is a major leukocyte protein found to be more sensitive than C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) as a marker of inflammation in patients with rheumatoid arthritis (RA). The present objective was to explore the robustness of calprotectin assessments by comparing two different laboratory methods assessing calprotectin in plasma samples from patients with early or established RA. A total of 212 patients with early RA (mean (SD) age 52(13.3) years, disease duration 0.6(0.5) years) and 177 patients with established RA (mean (SD) age 52.9(13.0) years, disease duration 10.0(8.8) years) were assessed by clinical, laboratory, and ultrasound examinations. Frozen plasma samples (-80 °C) were analysed for calprotectin levels at baseline, 1, 2, 3, 6 and 12 months by use of either enzyme-linked immunosorbent assay (ELISA) or fluoroenzyme immunoassay (FEIA). The ELISA technique used kits from Calpro AS and the FEIA technology was assessed on an automated Thermo Fisher Scientific instrument. The results showed high correlations between the two methods at baseline and during follow-up, with Spearman correlation at baseline 0.93 (p < 0.001) in the early and 0.96 (p < 0.001) in the established RA cohorts. The correlations between each of the two calprotectin assessments and clinical examinations had similar range. Calprotectin correlated well with clinical examinations, with at least as high correlations as CRP and ESR. The present study showed similar results for the two analytical methods, supporting the robustness of calprotectin analyses, and suggest calprotectin in plasma to be included in the assessments offered by clinical routine laboratories.
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Affiliation(s)
- Hilde Berner Hammer
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Maria K Jonsson
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | | | | | - Joe Sexton
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Espen A Haavardsholm
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johan Askling
- Department of Medicine, Karolinska Institutet, Solna, Sweden
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Zhou H, Zhao C, Shao R, Xu Y, Zhao W. The functions and regulatory pathways of S100A8/A9 and its receptors in cancers. Front Pharmacol 2023; 14:1187741. [PMID: 37701037 PMCID: PMC10493297 DOI: 10.3389/fphar.2023.1187741] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Inflammation primarily influences the initiation, progression, and deterioration of many human diseases, and immune cells are the principal forces that modulate the balance of inflammation by generating cytokines and chemokines to maintain physiological homeostasis or accelerate disease development. S100A8/A9, a heterodimer protein mainly generated by neutrophils, triggers many signal transduction pathways to mediate microtubule constitution and pathogen defense, as well as intricate procedures of cancer growth, metastasis, drug resistance, and prognosis. Its paired receptors, such as receptor for advanced glycation ends (RAGEs) and toll-like receptor 4 (TLR4), also have roles and effects within tumor cells, mainly involved with mitogen-activated protein kinases (MAPKs), NF-κB, phosphoinositide 3-kinase (PI3K)/Akt, mammalian target of rapamycin (mTOR) and protein kinase C (PKC) activation. In the clinical setting, S100A8/A9 and its receptors can be used complementarily as efficient biomarkers for cancer diagnosis and treatment. This review comprehensively summarizes the biological functions of S100A8/A9 and its various receptors in tumor cells, in order to provide new insights and strategies targeting S100A8/A9 to promote novel diagnostic and therapeutic methods in cancers.
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Affiliation(s)
- Huimin Zhou
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cong Zhao
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rongguang Shao
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanni Xu
- NHC Key Laboratory of Biotechnology of Antibiotics, National Center for New Microbial Drug Screening, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wuli Zhao
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Shi JT, Chen N, Xu J, Goyal H, Wu ZQ, Zhang JX, Xu HG. Diagnostic Accuracy of Fecal Calprotectin for Predicting Relapse in Inflammatory Bowel Disease: A Meta-Analysis. J Clin Med 2023; 12:jcm12031206. [PMID: 36769850 PMCID: PMC9917450 DOI: 10.3390/jcm12031206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Fecal calprotectin (FC) levels correlate with the disease activity of inflammatory bowel diseases (IBD); however, the utility of FC in predicting IBD relapse remains to be determined. We aim to evaluate the efficacy of fecal calprotectin in predicting the relapse of inflammatory bowel disease. We searched Pubmed (MEDLINE), Embase, Web of Science, and the Cochrane library databases up to 7 July 2021. Our study estimated the pooled sensitivity and specificity, summary receiver operating characteristic (SROC) curve, and the optimal cut-off value for predicting IBD relapse using a multiple threshold model. A total of 24 prospective studies were included in the meta-analysis. The optimal FC cut-off value was 152 μg/g. The pooled sensitivity and specificity of FC was 0.720 (0.528 to 0.856) and 0.740 (0.618 to 0.834), respectively. FC is a useful, non-invasive, and inexpensive biomarker for the early prediction of IBD relapse. An FC value of 152 μg/g is an ideal threshold to identify patients with a high relapse probability.
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Affiliation(s)
- Jin-Tong Shi
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Nuo Chen
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jia Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hemant Goyal
- Division of Gastroenterology, Hepatology & Nutrition, University of Texas Health Sciences Center, Houston, TX 77030, USA
- Correspondence: (H.G.); (H.-G.X.)
| | - Zhi-Qi Wu
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jie-Xin Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hua-Guo Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- Correspondence: (H.G.); (H.-G.X.)
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The Role of Serum Calprotectin in Defining Disease Outcomes in Non-Systemic Juvenile Idiopathic Arthritis: A Pilot Study. Int J Mol Sci 2023; 24:ijms24021671. [PMID: 36675189 PMCID: PMC9866398 DOI: 10.3390/ijms24021671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Serum calprotectin (MRP8/14) is currently being studied as a promising biomarker of disease activity and outcome in patients with juvenile idiopathic arthritis (JIA) but the data in the literature are conflicting. The aim of our study was to investigate the potential role of serum calprotectin as biomarker of disease activity and flare/remission in a group of nsJIA patients during a follow-up period of 18 months. In this prospective longitudinal study, two groups of patients with ns-JIA (55 active patients and 56 patients in remission according to Wallace's criteria) and a control group (50 children) were recruited at baseline from January 2020 to September 2021. JIA patients were followed for up to 18 months at four timepoints: 3 months (T1), 6 months (T2), 12 months (T3) and 18 months (T4). At each timepoint, the following were recorded: JADAS27, blood counts, ESR, CRP, albumin, ferritin and serum calprotectin. To illustrate the performance of calprotectin, Kaplan-Meier curves were constructed from baseline to relapse/remission, dichotomizing patients at baseline in positive/negative on the basis progressive calprotectin cut-offs. Associations between baseline factors and relapse were determined using Cox regression models. Multivariate models were constructed to analyze the effect of covariates. Comparing baseline clinical and laboratory data of the three groups (active vs. inactive JIA vs. controls), only serum calprotectin reached statistical significance (active patients vs. inactive (p = 0.0016) and vs. controls (p = 0.0012)). In the inactive group, during the 18 months of follow up, 31 patients (55.3%) had a relapse. Comparing the baseline data of relapsers vs. non-relapsers, serum calprotectin showed higher levels (p = 0.001) in relapsers. In survival analysis, a log rank test showed significant differences of up to 12 ng/mL (p = 0.045). Multivariate Cox regression confirmed that only baseline calprotectin levels were independently associated with disease recurrence. In the active group, in the 12 months of follow-up, 19 patients (38%) entered remission of the disease. In addition, in this group, the only statistical difference at the baseline was the value of MPR8/14 (p = 0.0001). Log rank test showed significant differences up to 10 ng/mL (p = 0.003). In the multivariate Cox regression, serum calprotectin levels at baseline were independently associated with remission. In conclusion, our study would suggest a dual role for calprotectin in predicting future relapse and treatment response in patients with nsJIA, thus influencing therapeutic decisions and management of these patients during follow up.
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Zeng J, Liu X, Liu J, Wu P, Yang L. Linkage of calprotectin with inflammation, activity and treatment response of rheumatoid arthritis: a meta-analysis. Biomark Med 2022; 16:1239-1249. [PMID: 36661047 DOI: 10.2217/bmm-2022-0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Aim: This meta-analysis aimed to investigate the clinical value of calprotectin in rheumatoid arthritis (RA) patients. Methods: The data regarding blood calprotectin levels in RA patients were retrieved from PubMed, Embase, Web of Science and Cochrane databases. Results: Thirty-one eligible articles were included. Calprotectin was increased in RA patients compared with healthy controls (mean difference [MD] = 1.48, 95% CI: 1.16-1.79). Calprotectin was positively associated with C-reactive protein (correlation coefficient [CC] = 0.58, 95% CI: 0.53-0.63) and disease activity score (CC = 0.48, 95% CI: 0.38-0.58) in RA patients. Interestingly, calprotectin showed an increased trend in RA responders compared with nonresponders, but without statistical significance (MD = 0.38, 95% CI: -0.09-0.85). Conclusion: Blood calprotectin relates to disease risk, inflammation and activity in RA patients.
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Affiliation(s)
- Jiashun Zeng
- Department of Immunology & Rheumatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xiaoxia Liu
- Department of Immunology & Rheumatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Jun Liu
- Department of Immunology & Rheumatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Pengjia Wu
- Department of Immunology & Rheumatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Lei Yang
- Department of Immunology & Rheumatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
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Inciarte-Mundo J, Frade-Sosa B, Sanmartí R. From bench to bedside: Calprotectin (S100A8/S100A9) as a biomarker in rheumatoid arthritis. Front Immunol 2022; 13:1001025. [PMID: 36405711 PMCID: PMC9672845 DOI: 10.3389/fimmu.2022.1001025] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/19/2022] [Indexed: 12/30/2022] Open
Abstract
S100A9/S100A8 (calprotectin), a member of the S100 protein family, has been shown to play a pivotal role in innate immunity activation. Calprotectin plays a critical role in the pathogenesis of rheumatoid arthritis (RA), as it triggers chemotaxis, phagocyte migration and modulation of neutrophils and macrophages. Higher calprotectin levels have been found in synovial fluid, plasma, and serum from RA patients. Recent studies have demonstrated better correlations between serum or plasma calprotectin and composite inflammatory disease activity indexes than c-reactive protein (CRP) or the erythrocyte sedimentation rate (ESR). Calprotectin serum levels decreased after treatment, independently of the DMARD type or strategy. Calprotectin has shown the strongest correlations with other sensitive techniques to detect inflammation, such as ultrasound. Calprotectin independently predicts radiographic progression. However, its value as a biomarker of treatment response and flare after tapering is unclear. This update reviews the current understanding of calprotectin in RA and discusses possible applications as a biomarker in clinical practice.
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Affiliation(s)
- José Inciarte-Mundo
- Biological aggression and Response Mechanisms, Inflammatory joint diseases (IJDs), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Beatriz Frade-Sosa
- Rheumatology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Raimon Sanmartí
- Biological aggression and Response Mechanisms, Inflammatory joint diseases (IJDs), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain,Rheumatology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain,*Correspondence: Raimon Sanmartí,
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Korolkova AA, Khizha VV, Kozlova DI, Maslyanskiy AL, Vavilova TV. Сalprotectin in the blood plasma as a new biomarker for assessing the activity of rheumatoid arthritis. BULLETIN OF SIBERIAN MEDICINE 2022. [DOI: 10.20538/1682-0363-2022-3-59-66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Aim. To study the potential use and information value of calprotectin in the blood plasma as a new biomarker for determining the activity of rheumatoid arthritis (RA).Materials and methods. The study included 113 people. The treatment group consisted of 79 patients diagnosed with RA; the average age was 58 (± 11.66) years, the median duration of the disease was 10 [6; 15] years. The control group encompassed 34 healthy volunteers; the average age was 40 (± 11.14) years. RA activity was determined according to the Disease Activity Score (DAS) 28 and the Clinical Disease Activity Index (CDAI). The concentration of calprotectin in the blood plasma was determined by the solid-phase enzyme-linked immunosorbent assay. The obtained results were compared with laboratory and clinical parameters, as well as with composite indices (DAS28, CDAI) of RA activity. For mathematical data processing, Spearman’s rank correlation coefficient, linear discriminant analysis, and ROC analysis were used.Results. In the group of patients with RA, the level of calprotectin in the blood was higher than in the control group. A statistically significant relationship was revealed between the level of calprotectin in the blood and all standard parameters of RA activity. The ROC analysis showed that the sensitivity, specificity, and diagnostic accuracy in assessing articular syndrome, as well as moderate and high RA activity according to the composite indices DAS28 and CDAI were higher for calprotectin than for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The linear discriminant analysis showed that a combination of ESR and calprotectin levels was the most informative; following it, the probability of correct classification of RA activity, according to the DAS28 index, was 71%. For the CDAI index, only one marker, calprotectin, resulted in a statistically significant classification with a probability of 70.5 %.Conclusion. Сalprotectin in the blood plasma is a promising laboratory biomarker for assessing synovitis activity in RA demonstrating higher accuracy, sensitivity, and specificity than traditional acute-phase reactants.
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Affiliation(s)
| | - V. V. Khizha
- I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences
| | - D. I. Kozlova
- I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences
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Frade-Sosa B, Ponce A, Inciarte-Mundo J, Morlà R, Ruiz-Esquide V, Macías L, Azuaga AB, Ramirez J, Cañete JD, Yague J, Auge JM, Gomez-Puerta JA, Sanmarti R. Plasma calprotectin as a biomarker of ultrasound synovitis in rheumatoid arthritis patients receiving IL-6 antagonists or JAK inhibitors. Ther Adv Musculoskelet Dis 2022; 14:1759720X221114105. [PMID: 36148395 PMCID: PMC9486267 DOI: 10.1177/1759720x221114105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/29/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives To analyse the accuracy of plasma calprotectin in patients with rheumatoid arthritis (RA) receiving monoclonal antibodies against IL-6 receptors (anti-rIL-6) or JAK inhibitors (JAKis) in detecting ultrasound (US) synovitis and compare it with acute phase reactants [high-sensitivity C-reactive protein (hs-CRP) and ESR]. Methods An observational cross-sectional study of RA patients receiving anti-rIL-6 (tocilizumab or sarilumab) or JAKi, (baricitinib or tofacitinib) was made. Plasma calprotectin for the diagnosis of US synovitis [synovial hypertrophy grade (SH) ⩾ 2 plus power Doppler signal (PD) ⩾ 1] was analysed using receiver operating characteristic curves (ROCs). The performance of ESR and hs-CRP was also studied. The three ROC curves were compared to determine which had the highest discriminatory power. Associations between plasma calprotectin and US scores were made using correlation analysis. Results Sixty-three RA patients were included. Mean plasma calprotectin levels were significantly higher in patients with US synovitis than in those without (0.89 ± 0.85 vs 0.30 ± 0.12 μg/ml; p = 0.0003). A moderate correlation between calprotectin and all US scores (HS score Rho = 0.479; PD score Rho = 0.492; and global score Rho = 0.495) was found. The discriminatory capacity of plasma calprotectin showed an AUC of 0.795 (95% CI: 0.687-0.904). The AUC of hs-CRP and ESR was 0.721 and 0.564, respectively. hs-CRP serum levels showed a low positive correlation with the three US scores (Rho < 0.40). After analysis according to the drugs administered, the correlation disappeared in patients receiving anti-rIL-6. Conclusion Plasma calprotectin may be a sensitive biomarker of synovial inflammation in RA patients treated with anti-rIL-6 or JAKi.
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Affiliation(s)
| | | | | | - Rosa Morlà
- Department of Rheumatology, Hospital Clinic of
Barcelona, Barcelona, Spain
| | | | - Laura Macías
- Biochemistry and Molecular Genetics Department,
Hospital Clínic of Barcelona, Barcelona, Spain
| | - Ana Belen Azuaga
- Department of Rheumatology, Hospital Clinic of
Barcelona, Barcelona, Spain
| | - Julio Ramirez
- Department of Rheumatology, Hospital Clinic of
Barcelona, Barcelona, Spain
| | - Juan D. Cañete
- Department of Rheumatology, Hospital Clinic of
Barcelona, Barcelona, Spain
| | - Jordi Yague
- Department of Immunology, Hospital Clinic –
CDB, Barcelona, Spain
| | - Josep M. Auge
- Biochemistry and Molecular Genetics
Department, Hospital Clínic of Barcelona, Barcelona, Spain
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11
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Wu YY, Li XF, Wu S, Niu XN, Yin SQ, Huang C, Li J. Role of the S100 protein family in rheumatoid arthritis. Arthritis Res Ther 2022; 24:35. [PMID: 35101111 PMCID: PMC8802512 DOI: 10.1186/s13075-022-02727-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/16/2022] [Indexed: 12/14/2022] Open
Abstract
Rheumatoid arthritis is a chronic systemic autoimmune disease characterized by synovial hyperplasia, inflammatory cell infiltration, and proliferation of inflammatory tissue (angiogranuloma). The destruction of joints and surrounding tissues eventually causes joint deformities and dysfunction or even loss. The S100 protein family is one of the biggest subtribes in the calcium-binding protein family and has more than 20 members. The overexpression of most S100 proteins in rheumatoid arthritis is closely related to its pathogenesis. This paper reviews the relationship between S100 proteins and the occurrence and development of rheumatoid arthritis. It will provide insights into the development of new clinical diagnostic markers and therapeutic targets for rheumatoid arthritis.
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Affiliation(s)
- Yuan-Yuan Wu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China
| | - Xiao-Feng Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China.,Postdoctoral Station of Clinical Medicine of Anhui Medical University, Hefei, Anhui, China
| | - Sha Wu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China
| | - Xue-Ni Niu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China
| | - Su-Qin Yin
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China
| | - Cheng Huang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China.
| | - Jun Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China.
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12
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S100A8/A9 Is a Marker for the Release of Neutrophil Extracellular Traps and Induces Neutrophil Activation. Cells 2022; 11:cells11020236. [PMID: 35053354 PMCID: PMC8773660 DOI: 10.3390/cells11020236] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 12/12/2022] Open
Abstract
Neutrophils are the most abundant innate immune cells in the circulation and they are the first cells recruited to sites of infection or inflammation. Almost half of the intracellular protein content in neutrophils consists of S100A8 and S100A9, though there has been controversy about their actual localization. Once released extracellularly, these proteins are thought to act as damage-associated molecular patterns (DAMPs), though their mechanism of action is not well understood. These S100 proteins mainly form heterodimers (S100A8/A9, also known as calprotectin) and this heterocomplex is recognized as a useful biomarker for several inflammatory diseases. We observed that S100A8/A9 is highly present in the cytoplasmic fraction of neutrophils and is not part of the granule content. Furthermore, we found that S100A8/A9 was not released in parallel with granular content but upon the formation of neutrophil extracellular traps (NETs). Accordingly, neutrophils of patients with chronic granulomatous disease, who are deficient in phorbol 12-myristate 13-acetate (PMA)-induced NETosis, did not release S100A8/A9 upon PMA stimulation. Moreover, we purified S100A8/A9 from the cytoplasmic fraction of neutrophils and found that S100A8/A9 could induce neutrophil activation, including adhesion and CD11b upregulation, indicating that this DAMP might amplify neutrophil activation.
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Xavier A, Cesaro A. Impact of Exercise Intensity on Calprotectin Levels in Healthy Volunteers and Patients with Inflammatory Rheumatic Diseases. Life (Basel) 2021; 11:377. [PMID: 33922149 PMCID: PMC8143494 DOI: 10.3390/life11050377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022] Open
Abstract
Exercise influences inflammatory response and immune system performance. The regular practice of a moderate activity positively regulates immunity and the inflammatory process, while intensive training depresses it and enhances inflammatory marker secretion. Calprotectin is involved in the inflammatory process, promoting neutrophil recruitment, cell degranulation, and inflammatory mediators. Furthermore, calprotectin has been associated with various inflammatory diseases, including inflammatory rheumatic diseases. The present review explores the effect of exercise on calprotectin levels in both healthy and inflammatory rheumatic conditions. Data show that the intensity duration and the type of exercise modulate calprotectin levels and participant inflammatory status. The exact role of calprotectin in the exercise response is yet unknown. Calprotectin could constitute an interesting biomarker for monitoring both the effect of exercise on the inflammatory process in healthy volunteers and the efficiency of exercise treatment programs in a patient with inflammatory rheumatic disease.
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Affiliation(s)
| | - Annabelle Cesaro
- I3MTO (Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux et Articulaire)/EA 4708, Université d’Orléans, 45000 Orléans, France;
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Kotsiou OS, Papagiannis D, Papadopoulou R, Gourgoulianis KI. Calprotectin in Lung Diseases. Int J Mol Sci 2021; 22:ijms22041706. [PMID: 33567747 PMCID: PMC7915440 DOI: 10.3390/ijms22041706] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 12/14/2022] Open
Abstract
Calprotectin (CLP) is a heterodimer formed by two S-100 calcium-binding cytosolic proteins, S100A8 and S100A9. It is a multifunctional protein expressed mainly by neutrophils and released extracellularly by activated or damaged cells mediating a broad range of physiological and pathological responses. It has been more than 20 years since the implication of S100A8/A9 in the inflammatory process was shown; however, the evaluation of its role in the pathogenesis of respiratory diseases or its usefulness as a biomarker for the appropriate diagnosis and prognosis of lung diseases have only gained attention in recent years. This review aimed to provide current knowledge regarding the potential role of CLP in the pathophysiology of lung diseases and describe how this knowledge is, up until now, translated into daily clinical practice. CLP is involved in numerous cellular processes in lung health and disease. In addition to its anti-microbial functions, CLP also serves as a molecule with pro- and anti-tumor properties related to cell survival and growth, angiogenesis, DNA damage response, and the remodeling of the extracellular matrix. The findings of this review potentially introduce CLP in daily clinical practice within the spectrum of respiratory diseases.
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Affiliation(s)
- Ourania S. Kotsiou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
- Department of Nursing, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
- Correspondence:
| | - Dimitrios Papagiannis
- Department of Nursing, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | - Rodanthi Papadopoulou
- Human Nutrition, School of Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER, UK;
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Baloun J, Kropáčková T, Hulejová H, Tomčík M, Růžičková O, Šléglová O, Gatterová J, Vencovský J, Pavelka K, Šenolt L. Chemokine and Cytokine Profiles in Patients with Hand Osteoarthritis. Biomolecules 2020; 11:biom11010004. [PMID: 33375165 PMCID: PMC7822191 DOI: 10.3390/biom11010004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The development of hand osteoarthritis (HOA) and its progression into the erosive subset are unclear, but inflammation is suspected to be the main source. To verify the involvement of inflammation in HOA pathogenesis, we evaluate serum inflammatory mediators and their association with HOA-related clinical features in patients. Methods: 153 participants (50 non-erosive HOA patients, 54 erosive HOA patients, and 49 healthy control subjects) were included in this study. All patients underwent clinical examination, which included assessment of tender and swollen small hand joints, ultrasound (US) examination, and self-reported measures (e.g., AUSCAN or algofunctional indexes). Serum inflammatory mediators were quantified using human cytokine 27-plex immunoassay. We employed linear modelling, correlation analysis, and resampling statistics to evaluate the association of these mediators to HOA. Results: We identified increased levels of nine inflammatory mediators (e.g., eotaxin, monocyte chemoattractant protein 1, interleukin-8, and tumour necrosis factor) in HOA patients compared to healthy controls. Increased mediators correlated with ultrasound findings as well as with clinically tender and swollen joint counts in patients with erosive HOA. However, none of the mediators distinguished between erosive and non-erosive HOA subtypes. Conclusion: Our findings support the hypothesis on the involvement of inflammation in HOA.
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Affiliation(s)
- Jiří Baloun
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
| | - Tereza Kropáčková
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
| | - Hana Hulejová
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
| | - Michal Tomčík
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
| | - Olga Růžičková
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
| | - Olga Šléglová
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
| | - Jindřiška Gatterová
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
| | - Jiří Vencovský
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
| | - Karel Pavelka
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
| | - Ladislav Šenolt
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (J.B.); (T.K.); (H.H.); (M.T.); (O.R.); (O.Š.); (J.G.); (J.V.); (K.P.)
- Department of Rheumatology, 1st Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic
- Correspondence: ; Tel.: +420-234-075-232
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Suárez Ferrer C, Abadía Barno M, Martín Arranz E, Jochems A, García Ramírez L, Poza Cordón J, Jaquotot Herranz M, Cerpa Arencibia A, Martín Arranz MD. The use of serum calprotectin as a biomarker for inflammatory activity in inflammatory bowel disease. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 111:744-749. [PMID: 31476872 DOI: 10.17235/reed.2019.5797/2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION simple, reliable and non-invasive biomarkers are needed to enable the early detection of inflammatory activity for the correct management of inflammatory bowel disease (IBD). One of these biomarkers may be serum calprotectin (SC). MATERIAL AND METHODS a prospective study was performed of patients with IBD due to undergo a colonoscopy as part of the common clinical practice. The study parameters included SC, fecal calprotectin (FC) and conventional blood test parameters. Clinical indices (Harvey and Walmsley) and relevant endoscopic scores were completed for each scenario (Simple Endoscopic Score Crohn Disease [SES-CD] and Mayo). RESULTS fifty-three patients were included in the study, 51% (27 patients) with ulcerative colitis (UC) and 49% (26 patients) with Crohn's disease (CD). The CS values in UC were significantly higher with an endoscopic Mayo score 2/3 (median score 10.39 mg/ml [IQR: 7.4-12.2]) compared to those with a Mayo score of 0/1 (median 4.07 mg/ml [IQR: 2.9-7.2]) (p = 0.01). The area under the ROC curve (AUCROC) was 0.85 and the sensitivity and specificity were 83.3% and 81.25%, respectively, for a SC cut-off point of 4.4 mg/dl. Furthermore, a higher AUCROC was obtained in comparison with other serological markers for activity (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], hemoglobin [Hb] and platelets). There were no statistically significant differences in the comparison between SC and endoscopic findings in CD (SES CD > 3: 20.1 [IQR: 16.8-23.4] vs SESC ≤ 3:6.25 [IQR: 5.4-7.1]) (p = 0.8). CONCLUSIONS SC is a good indirect marker of inflammatory activity and there was a correlation with endoscopic findings in UC. However, there were no statistically significant differences in the case of CD.
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Van Hoovels L, Vander Cruyssen B, Bogaert L, Van den Bremt S, Bossuyt X. Pre-analytical and analytical confounders of serum calprotectin as a biomarker in rheumatoid arthritis. Clin Chem Lab Med 2020; 58:40-49. [PMID: 31665107 DOI: 10.1515/cclm-2019-0508] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/15/2019] [Indexed: 12/20/2022]
Abstract
Background There is a need for additional biomarkers to assist in the diagnosis and prognosis of rheumatoid arthritis (RA). The aim of our study was to evaluate the (pre-analytical, analytical and clinical) performance of serum calprotectin as a marker of inflammation in RA. Methods The study population included 463 rheumatologic patients (including 111 RA patients and 352 controls) who for the first time consulted a rheumatologist, 20 healthy controls and 27 patients with an infectious disease. Calprotectin was measured (using four different assays) in serum or in serum and EDTA plasma (healthy controls and infectious disease group). For rheumatologic patients, results for C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were available. Results Results for blood calprotectin were assay- and matrix-dependent, with higher values found in serum than in plasma. Serum calprotectin was higher in RA patients than in rheumatologic diseased controls and in healthy controls. Serum calprotectin was lower in RA patients than in patients with an infectious disease. Serum calprotectin was associated with disease activity (DAS score). The area under the curve (AUC) to discriminate RA from controls was 0.756 for CRP, 0.714 for ESR and 0.726-0.783 for calprotectin. Conclusions Our data document that calprotectin measurement is assay- and matrix-dependent. Serum calprotectin is associated with disease activity. Additional (prospective) studies are warranted to further evaluate the prognostic and diagnostic value of blood calprotectin measurements.
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Affiliation(s)
- Lieve Van Hoovels
- Department of Laboratory Medicine, Onze-Lieve Vrouw Hospital, Moorselbaan 164, 9300 Aalst, Belgium, Phone: +32 (0)53/72 47 91.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | | | - Laura Bogaert
- Department of Laboratory Medicine, Onze-Lieve Vrouw Hospital, Aalst, Belgium
| | | | - Xavier Bossuyt
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine, University Hospital Leuven, Leuven, Belgium
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18
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Jarlborg M, Courvoisier DS, Lamacchia C, Martinez Prat L, Mahler M, Bentow C, Finckh A, Gabay C, Nissen MJ. Serum calprotectin: a promising biomarker in rheumatoid arthritis and axial spondyloarthritis. Arthritis Res Ther 2020; 22:105. [PMID: 32375861 PMCID: PMC7201559 DOI: 10.1186/s13075-020-02190-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 04/22/2020] [Indexed: 12/21/2022] Open
Abstract
Background Calprotectin (S100A8/S100A9 protein) is known as a damage-associated molecular pattern (DAMP) protein and reflects mainly neutrophil activation. Serum calprotectin levels might be a good alternative to acute-phase protein as a biomarker in inflammatory rheumatic diseases. The aim of this study is to investigate the association of serum calprotectin with disease activity and severity in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA). Methods Serum calprotectin was measured in patients with RA, axSpA, and PsA from the prospective Swiss Clinical Quality Management (SCQM) registry. Asymptomatic first-degree relatives of RA patients were used as healthy controls (HC). Outcomes included swollen joint count (SJC), Disease Activity Score (DAS), Health Assessment questionnaire (HAQ), joint radiographs, and ultrasound power Doppler (USPD) score for RA; Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS) and coxitis for axSpA; and SJC and Disease Activity Index for PSoriatic Arthritis (DAPSA) for PsA. Comparison of outcomes by calprotectin quartile levels was performed using Kruskal-Wallis tests for continuous outcomes or trend tests for categorical outcomes. Results A total of 1729 subjects [RA = 969, axSpA = 451, PsA = 237, and HC = 72] were included. Median levels of serum calprotectin were higher in each disease group compared to HC (p < 0.01). In RA patients, all clinical outcomes were statistically different between quartiles of serum calprotectin, indicating an association between calprotectin levels and higher disease activity (SJC, DAS, and USPD scores) and severity (joint radiographs and HAQ). In axSpA, an association between calprotectin levels and ASDAS score (p < 0.01) and prevalence of coxitis (p = 0.02) was observed. For PsA patients, SJC and DAPSA did not differ across calprotectin quartiles. Conclusions This large study supports the association of serum calprotectin levels with disease activity in both RA and axSpA, but not in PsA.
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Affiliation(s)
- Matthias Jarlborg
- Geneva University Hospital, 26 avenue de Beau-Séjour, 1206, Geneva, Switzerland.
| | | | - Céline Lamacchia
- Geneva University Hospital, 26 avenue de Beau-Séjour, 1206, Geneva, Switzerland
| | | | | | | | - Axel Finckh
- Geneva University Hospital, 26 avenue de Beau-Séjour, 1206, Geneva, Switzerland
| | - Cem Gabay
- Geneva University Hospital, 26 avenue de Beau-Séjour, 1206, Geneva, Switzerland
| | - Michael J Nissen
- Geneva University Hospital, 26 avenue de Beau-Séjour, 1206, Geneva, Switzerland
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Aghdashi MA, Seyedmardani S, Ghasemi S, Khodamoradi Z. Evaluation of Serum Calprotectin Level and Disease Activity in Patients with Rheumatoid Arthritis. Curr Rheumatol Rev 2020; 15:316-320. [PMID: 30666913 DOI: 10.2174/1573397115666190122113221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Rheumatoid Arthritis (RA) is the most common type of chronic inflammatory arthritis with unknown etiology marked by a symmetric, peripheral polyarthritis. Calprotectin also can be used as a biomarker of disease activity in inflammatory arthritis and other autoimmune diseases. OBJECTIVES In this study, we evaluated the association between serum calprotectin level and severity of RA activity. METHODS A cross-sectional study was conducted on 44 RA patients with disease flare-up. Serum samples were obtained from all patients to measure calprotectin, ESR, CRP prior to starting the treatment and after treatment period in the remission phase. Based on Disease Activity Score 28 (DAS28), disease activity was calculated. RESULTS Of 44 RA patients, 9(20.5%) were male and 35(79.5%) were female. The mean age of our cases was 53±1.6 years. Seventeen (38.6%) patients had moderate DAS28 and 27(61.4%) had high DAS28. The average level of calprotectin in the flare-up phase was 347.12±203.60 ng/ml and 188.04±23.58 ng/ml in the remission phase. We did not find any significant association between calprotectin and tender joint count (TJC; P=0.22), swollen joint count (SJC; P=0.87), and general health (GH; P=0.59), whereas significant associations were found between the calprotectin level and ESR (p=0.001) and DAS28 (p=0.02). The average calprotectin level in moderate DAS28 (275.21±217.96 ng/ml) was significantly lower than that in high DAS28 (392.4±183.88 ng/ml) (p=0.05). CONCLUSION We showed that the serum level of calprotectin can be a useful and reliable biomarker in RA activity and its severity. It also can predict treatment response.
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Affiliation(s)
- Mir Amir Aghdashi
- Department of internal Medicine, Division of Rheumatology, Urmia University of Medical Sciences, Urmia, Iran
| | - Seyedmostafa Seyedmardani
- Department of internal Medicine, Division of Rheumatology, Urmia University of Medical Sciences, Urmia, Iran
| | - Sholeh Ghasemi
- Department of internal Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Zohre Khodamoradi
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Neutrophil Extracellular Trap Formation Correlates with Favorable Overall Survival in High Grade Ovarian Cancer. Cancers (Basel) 2020; 12:cancers12020505. [PMID: 32098278 PMCID: PMC7072166 DOI: 10.3390/cancers12020505] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
It is still a question of debate whether neutrophils, often found in the tumor microenvironment, mediate tumor-promoting or rather tumor-inhibiting activities. The present study focuses on the involvement of neutrophils in high grade serous ovarian cancer (HGSOC). Macroscopic features classify two types of peritoneal tumor spread in HGSOC. Widespread and millet sized lesions characterize the miliary type, while non-miliary metastases are larger and associated with better prognosis. Multi-omics and FACS data were generated from ascites samples. Integrated data analysis demonstrates a significant increase of neutrophil extracellular trap (NET)-associated molecules in non-miliary ascites samples. A co-association network analysis performed with the ascites data further revealed a striking correlation between NETosis-associated metabolites and several eicosanoids. The congruence of data generated from primary neutrophils with ascites analyses indicates the predominance of NADPH oxidase 2 (NOX)-independent NETosis. NETosis is associated with protein S100A8/A9 release. An increase of the S100A8/CRP abundance ratio was found to correlate with favorable survival of HGSOC patients. The analysis of additional five independent proteome studies with regard to S100A8/CRP ratios confirmed this observation. In conclusion, NET formation seems to relate with better cancer patient outcome.
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Plant D, Barton A. Adding value to real-world data: the role of biomarkers. Rheumatology (Oxford) 2020; 59:31-38. [PMID: 31329972 PMCID: PMC6909909 DOI: 10.1093/rheumatology/kez113] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/28/2019] [Indexed: 12/13/2022] Open
Abstract
Adding biomarker information to real world datasets (e.g. biomarker data collected into disease/drug registries) can enhance mechanistic understanding of intra-patient differences in disease trajectories and differences in important clinical outcomes. Biomarkers can detect pathologies present early in disease potentially paving the way for preventative intervention strategies, which may help patients to avoid disability, poor treatment outcome, disease sequelae and premature mortality. However, adding biomarker data to real world datasets comes with a number of important challenges including sample collection and storage, study design and data analysis and interpretation. In this narrative review we will consider the benefits and challenges of adding biomarker data to real world datasets and discuss how biomarker data have added to our understanding of complex diseases, focusing on rheumatoid arthritis.
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Affiliation(s)
- Darren Plant
- Manchester Academic Health Science Centre, The University of Manchester, Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, UK
- Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Anne Barton
- Manchester Academic Health Science Centre, The University of Manchester, Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, UK
- Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
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Bach M, Moon J, Moore R, Pan T, Nelson JL, Lood C. A Neutrophil Activation Biomarker Panel in Prognosis and Monitoring of Patients With Rheumatoid Arthritis. Arthritis Rheumatol 2020; 72:47-56. [PMID: 31353807 PMCID: PMC6935396 DOI: 10.1002/art.41062] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/25/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Exaggerated neutrophil activation and formation of neutrophil extracellular traps (NETs) are linked to inflammation and autoimmunity, including rheumatoid arthritis (RA). However, whether NETs are present in the circulation of RA patients and contribute to inflammation and disease progression has not been carefully addressed. We undertook this study to assess markers of neutrophil activation and NET formation in plasma samples, investigating whether they add clinical value in improving the determination of prognosis and monitoring in RA patients. METHODS Markers of neutrophil activation (calprotectin) and cell death (NETs) were analyzed, using enzyme-linked immunosorbent assay, in serum and plasma obtained from patients in 3 cross-sectional RA cohorts and sex-matched healthy controls. A longitudinal inception cohort (n = 247), seen for a median follow-up of 8 years, was used for predictive analyses. RESULTS Markers of neutrophil activation and cell death were increased in RA patients compared to healthy individuals (P < 0.0001). Calprotectin levels correlated with the Clinical Disease Activity Index (r = 0.53, P < 0.0001) and could be used to distinguish between patients with disease in remission and those with active disease, an observation not seen when examining C-reactive protein levels. A biomarker panel consisting of anti-citrullinated protein antibody and calprotectin could predict erosive disease (odds ratio [OR] 7.5, P < 0.0001) and joint space narrowing (OR 4.9, P = 0.001). NET levels were associated with markers of inflammation (P = 0.0002). Furthermore, NETs and a "neutrophil activation signature" biomarker panel had good predictive value in identifying patients who were developing extraarticular nodules (OR 5.6, P = 0.006). CONCLUSION Neutrophils undergo marked activation and cell death in RA. Neutrophil biomarkers can provide added clinical value in the monitoring and prognosis of RA patients and may allow for early preventive treatment intervention.
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Affiliation(s)
- Mary Bach
- Division of Rheumatology, Department of Medicine,
University of Washington, Seattle, WA, USA
| | | | - Richard Moore
- Division of Rheumatology, Department of Medicine,
University of Washington, Seattle, WA, USA
| | - Tiffany Pan
- Fred Hutchinson Cancer Research Center, Seattle, WA,
USA
| | - J. Lee Nelson
- Division of Rheumatology, Department of Medicine,
University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA,
USA
| | - Christian Lood
- Division of Rheumatology, Department of Medicine,
University of Washington, Seattle, WA, USA
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Zandstra J, van de Geer A, Tanck MWT, van Stijn-Bringas Dimitriades D, Aarts CEM, Dietz SM, van Bruggen R, Schweintzger NA, Zenz W, Emonts M, Zavadska D, Pokorn M, Usuf E, Moll HA, Schlapbach LJ, Carrol ED, Paulus S, Tsolia M, Fink C, Yeung S, Shimizu C, Tremoulet A, Galassini R, Wright VJ, Martinón-Torres F, Herberg J, Burns J, Levin M, Kuijpers TW. Biomarkers for the Discrimination of Acute Kawasaki Disease From Infections in Childhood. Front Pediatr 2020; 8:355. [PMID: 32775314 PMCID: PMC7388698 DOI: 10.3389/fped.2020.00355] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/28/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Kawasaki disease (KD) is a vasculitis of early childhood mimicking several infectious diseases. Differentiation between KD and infectious diseases is essential as KD's most important complication-the development of coronary artery aneurysms (CAA)-can be largely avoided by timely treatment with intravenous immunoglobulins (IVIG). Currently, KD diagnosis is only based on clinical criteria. The aim of this study was to evaluate whether routine C-reactive protein (CRP) and additional inflammatory parameters myeloid-related protein 8/14 (MRP8/14 or S100A8/9) and human neutrophil-derived elastase (HNE) could distinguish KD from infectious diseases. Methods and Results: The cross-sectional study included KD patients and children with proven infections as well as febrile controls. Patients were recruited between July 2006 and December 2018 in Europe and USA. MRP8/14, CRP, and HNE were assessed for their discriminatory ability by multiple logistic regression analysis with backward selection and receiver operator characteristic (ROC) curves. In the discovery cohort, the combination of MRP8/14+CRP discriminated KD patients (n = 48) from patients with infection (n = 105), with area under the ROC curve (AUC) of 0.88. The HNE values did not improve discrimination. The first validation cohort confirmed the predictive value of MRP8/14+CRP to discriminate acute KD patients (n = 26) from those with infections (n = 150), with an AUC of 0.78. The second validation cohort of acute KD patients (n = 25) and febrile controls (n = 50) showed an AUC of 0.72, which improved to 0.84 when HNE was included. Conclusion: When used in combination, the plasma markers MRP8/14, CRP, and HNE may assist in the discrimination of KD from both proven and suspected infection.
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Affiliation(s)
- Judith Zandstra
- Sanquin Research and Landsteiner Laboratory, Department of Immunopathology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Annemarie van de Geer
- Sanquin Research and Landsteiner Laboratory, Department of Blood Cell Research, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Michael W T Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Diana van Stijn-Bringas Dimitriades
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Cathelijn E M Aarts
- Sanquin Research and Landsteiner Laboratory, Department of Blood Cell Research, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Sanne M Dietz
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Robin van Bruggen
- Sanquin Research and Landsteiner Laboratory, Department of Blood Cell Research, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Nina A Schweintzger
- Department of General Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Werner Zenz
- Department of General Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Marieke Emonts
- Pediatric Infectious Diseases and Immunology Department, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Dace Zavadska
- Department of Pediatrics, Riga Stradins University, Riga, Latvia
| | - Marko Pokorn
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Effua Usuf
- Medical Research Council Unit the Gambia (MRCG) at LSHTM, Serrekunda, Gambia
| | - Henriette A Moll
- Department of General Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Luregn J Schlapbach
- Pediatric Intensive Care Unit, Lady Cilento Children's Hospital, Pediatric Critical Care Research Group, Brisbane, QLD, Australia
| | - Enitan D Carrol
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool Institute of Infection and Global Health, Liverpool, United Kingdom
| | - Stephane Paulus
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool Institute of Infection and Global Health, Liverpool, United Kingdom
| | - Maria Tsolia
- Second Department of Pediatrics, P. & A. Kyriakou Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Colin Fink
- Micropathology Ltd., University of Warwick, Warwick, United Kingdom
| | - Shunmay Yeung
- Department of Clinical Research, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Section of Paediatric Infectious Diseases, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Chisato Shimizu
- Kawasaki Disease Research Center, Rady's Children's Hospital-San Diego, University of California, San Diego, San Diego, CA, United States
| | - Adriana Tremoulet
- Kawasaki Disease Research Center, Rady's Children's Hospital-San Diego, University of California, San Diego, San Diego, CA, United States
| | - Rachel Galassini
- Section of Paediatric Infectious Diseases, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Victoria J Wright
- Section of Paediatric Infectious Diseases, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, University of Santiago, Santiago de Compostela, Spain
| | - Jethro Herberg
- Section of Paediatric Infectious Diseases, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Jane Burns
- Kawasaki Disease Research Center, Rady's Children's Hospital-San Diego, University of California, San Diego, San Diego, CA, United States
| | - Michael Levin
- Section of Paediatric Infectious Diseases, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Taco W Kuijpers
- Sanquin Research and Landsteiner Laboratory, Department of Blood Cell Research, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Abstract
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease characterized by inflammatory cell infiltration, high levels of cytokines, and erosion of cartilage and bone in joints. Calprotectin (CLP), as a recently described member of S100 family proteins, is a heterodimeric complex of S100A8 and S100A9. Currently, plenty of studies have indicated significantly increased serum and synovial fluid levels of CLP in patients with RA. It was reported that CLP was related to cell differentiation, migration, apoptosis, and production of pro-inflammatory factors in RA. In addition, there are the positive relationships between serum, synovial CLP and traditional acute phase reactants, disease activity, ultrasound and radiographic progression of joints, and treatment response of RA. In this review, we mainly discuss the role of CLP in the pathogenesis of RA as well as its potential to estimate clinical disease progression of RA patients.
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25
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Wang Y, Liang Y. Clinical significance of serum calprotectin level for the disease activity in active rheumatoid arthritis with normal C-reactive protein. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:1009-1014. [PMID: 31933912 PMCID: PMC6945154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 12/25/2018] [Indexed: 06/10/2023]
Abstract
BACKGROUND There was limited data concerning predicting ability of calprotectin for disease activity of rheumatoid arthritis (RA) patients with normal C-reactive protein (CRP) level. This study was conducted to evaluate serum calprotectin levels in active RA patients and analyze its predicting value for disease activity evaluation despite normal CRP level. METHODS A total of 162 patients with active RA patients with normal CRP levels and 57 healthy subjects were enrolled. Serum calprotectin was measured by using a commercially available enzyme-linked immunosorbent assay (ELISA), and baseline clinical characteristics were collected. The DAS-28 scores were evaluated as indictors of disease activity. The predicting value of calprotectin in disease activity of RA patients with normal CPR was analyzed by using univariate and multivariate analysis and receiver operating characteristic curve. RESULTS Serum levels of calprotectin of patients with active RA were significantly higher than that of the healthy controls (3.5±3.2 vs. 2.5±0.8, P<0.01). Univariate analysis showed that serum calprotectin levels were significantly associated with the disease activity of RA. The mean serum calprotectin levels of patients with a high disease activity (DAS-28>5.1) was significantly higher than that of RA patients with low-moderate disease activity (4.3±3.5 vs. 2.6±1.1, P<0.01). Serum calprotectin levels also was evaluated as an independent predictive factor for disease activity of RA in multivariate analysis (OR, 2.31; 95% CI, 1.12-6.84; P<0.01). CONCLUSIONS Serum calprotectin levels can be used as a promising indictor for disease activity in active RA patients while CRP fails to do so.
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Affiliation(s)
- Yanping Wang
- Department of The Health Management Center, Xiangya Hospital of Central South UniversityChangsha 410008, PR China
| | - Ying Liang
- Xiangya School of Public Health, Central South UniversityChangsha 410008, PR China
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26
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Cherlin S, Plant D, Taylor JC, Colombo M, Spiliopoulou A, Tzanis E, Morgan AW, Barnes MR, McKeigue P, Barrett JH, Pitzalis C, Barton A, Consortium MATURA, Cordell HJ. Prediction of treatment response in rheumatoid arthritis patients using genome-wide SNP data. Genet Epidemiol 2018; 42:754-771. [PMID: 30311271 PMCID: PMC6334178 DOI: 10.1002/gepi.22159] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/06/2018] [Accepted: 07/28/2018] [Indexed: 01/13/2023]
Abstract
Although a number of treatments are available for rheumatoid arthritis (RA), each of them shows a significant nonresponse rate in patients. Therefore, predicting a priori the likelihood of treatment response would be of great patient benefit. Here, we conducted a comparison of a variety of statistical methods for predicting three measures of treatment response, between baseline and 3 or 6 months, using genome-wide SNP data from RA patients available from the MAximising Therapeutic Utility in Rheumatoid Arthritis (MATURA) consortium. Two different treatments and 11 different statistical methods were evaluated. We used 10-fold cross validation to assess predictive performance, with nested 10-fold cross validation used to tune the model hyperparameters when required. Overall, we found that SNPs added very little prediction information to that obtained using clinical characteristics only, such as baseline trait value. This observation can be explained by the lack of strong genetic effects and the relatively small sample sizes available; in analysis of simulated and real data, with larger effects and/or larger sample sizes, prediction performance was much improved. Overall, methods that were consistent with the genetic architecture of the trait were able to achieve better predictive ability than methods that were not. For treatment response in RA, methods that assumed a complex underlying genetic architecture achieved slightly better prediction performance than methods that assumed a simplified genetic architecture.
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Affiliation(s)
- Svetlana Cherlin
- Institute of Genetic MedicineNewcastle UniversityNewcastle upon TyneUK
| | - Darren Plant
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
| | - John C. Taylor
- Leeds Institute of Cancer and PathologyUniversity of LeedsLeedsUK
- NIHR Leeds Biomedical Research CentreLeeds Teaching Hospitals NHS TrustLeedsUK
| | - Marco Colombo
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and InformaticsUniversity of EdinburghEdinburghUK
| | - Athina Spiliopoulou
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and InformaticsUniversity of EdinburghEdinburghUK
| | - Evan Tzanis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of London and Barts Health NHS TrustLondonUK
| | - Ann W. Morgan
- NIHR Leeds Biomedical Research CentreLeeds Teaching Hospitals NHS TrustLeedsUK
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
| | - Michael R. Barnes
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of London and Barts Health NHS TrustLondonUK
| | - Paul McKeigue
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and InformaticsUniversity of EdinburghEdinburghUK
| | - Jennifer H. Barrett
- Leeds Institute of Cancer and PathologyUniversity of LeedsLeedsUK
- NIHR Leeds Biomedical Research CentreLeeds Teaching Hospitals NHS TrustLeedsUK
| | - Costantino Pitzalis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of London and Barts Health NHS TrustLondonUK
| | - Anne Barton
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal ResearchThe University of ManchesterManchesterUK
| | - MATURA Consortium
- Institute of Genetic MedicineNewcastle UniversityNewcastle upon TyneUK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
- Leeds Institute of Cancer and PathologyUniversity of LeedsLeedsUK
- NIHR Leeds Biomedical Research CentreLeeds Teaching Hospitals NHS TrustLeedsUK
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and InformaticsUniversity of EdinburghEdinburghUK
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of London and Barts Health NHS TrustLondonUK
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal ResearchThe University of ManchesterManchesterUK
| | - Heather J. Cordell
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
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27
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Gong H, Su WJ, Cao ZY, Lian YJ, Peng W, Liu YZ, Zhang Y, Liu LL, Wu R, Wang B, Zhang T, Wang YX, Jiang CL. Hippocampal Mrp8/14 signaling plays a critical role in the manifestation of depressive-like behaviors in mice. J Neuroinflammation 2018; 15:252. [PMID: 30180864 PMCID: PMC6122683 DOI: 10.1186/s12974-018-1296-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 08/29/2018] [Indexed: 12/17/2022] Open
Abstract
Background Depression is one of the most common mental disorders characterized mainly by low mood and loss of interest or pleasure. About a third of patients with depression do not respond to classic antidepressant treatments. Recent evidence suggests that Mrp8/14 (myeloid-related protein 8/14) plays a crucial role in cognitive dysfunction and neuroinflammatory diseases, yet its role in mood regulation remains largely uninvestigated. In the present work, we explored the potential role of Mrp8/14 in the progression of depression. Methods After 4 weeks of chronic unpredictable mild stress (CUMS), depressive-like symptoms and Mrp8/14 were determined. To verify the effects of Mrp8/14 on depressive-like behaviors, the inhibitor TAK-242 and recombinant Mrp8/14 were used. Furthermore, the molecular mechanisms in Mrp8/14-induced behavioral and biological changes were examined in vivo and ex vivo. Results Four-week CUMS contributed to the development of depressive symptoms. Mrp8 and Mrp14 were upregulated in the hippocampus and serum after exposure to CUMS. Pharmacological inhibition of Mrp14 attenuated CUMS-induced TLR4/NF-κB signaling activation and depressive-like behaviors. Furthermore, central administration of recombinant Mrp8, Mrp14, and Mrp8/14 resulted in neuroinflammation and depressive-like behaviors. Mrp8/14-provoked proinflammatory effects and depressive-like behaviors were improved by pretreatment with a TLR4 inhibitor. Moreover, pharmacological inhibition of TLR4 reduced the release of nitric oxide and reactive oxygen species in Mrp8/14-activated BV2 microglia. Conclusions These data suggest that the hippocampal Mrp8/14-TLR4-mediated neuroinflammation contributes to the development of depressive-like behaviors. Targeting the Mrp8/14 may be a novel promising antidepressant approach. Electronic supplementary material The online version of this article (10.1186/s12974-018-1296-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hong Gong
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China.,Hainan Branch of Chinese PLA General Hospital, Sanya, 572013, People's Republic of China
| | - Wen-Jun Su
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Zhi-Yong Cao
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China.,Department of Psychiatry, The 102nd Hospital of PLA, Changzhou, 213003, People's Republic of China
| | - Yong-Jie Lian
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Wei Peng
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yun-Zi Liu
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yi Zhang
- Department of Psychiatry, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Lin-Lin Liu
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Ran Wu
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Bo Wang
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Ting Zhang
- Department of Navy Medicine, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yun-Xia Wang
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Chun-Lei Jiang
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China.
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28
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Kropáčková T, Šléglová O, Růžičková O, Vencovský J, Pavelka K, Šenolt L. Lower serum clusterin levels in patients with erosive hand osteoarthritis are associated with more pain. BMC Musculoskelet Disord 2018; 19:264. [PMID: 30053814 PMCID: PMC6064100 DOI: 10.1186/s12891-018-2179-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/10/2018] [Indexed: 01/27/2023] Open
Abstract
Background The aims of this study were to analyse the serum concentrations of clusterin (CLU) in patients with hand osteoarthritis (OA) and in healthy controls, to compare CLU levels between patients with erosive and non-erosive disease, and to examine the association of CLU levels with clinical and laboratory parameters. Methods A total of 135 patients with hand OA (81 with erosive and 54 with non-erosive disease) and 53 healthy individuals were included in this study. All patients underwent clinical and hand joint ultrasound examination. The Australian/Canadian (AUSCAN) hand osteoarthritis index, algofunctional index and a visual analogue scale (VAS) for the measurement of pain were assessed. Serum levels of CLU were measured by an enzyme-linked immunosorbent assay (ELISA). Results Serum levels of CLU were significantly lower in patients with hand OA than in control subjects (p < 0.0001). In addition, patients with erosive hand OA had significantly lower CLU levels than those with non-erosive disease (p = 0.044). Negative correlations between CLU levels and pain as assessed by the AUSCAN score and the VAS were found in patients with erosive hand OA (r = − 0.275; p = 0.013 and r = − 0.220; p = 0.049, respectively). Conclusion The present study demonstrates that lower concentrations of CLU are found in hand OA patients than in healthy individuals, especially in those with erosive disease, and that CLU concentrations have a negative association with hand pain.
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Affiliation(s)
- Tereza Kropáčková
- Institute of Rheumatology, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Olga Šléglová
- Institute of Rheumatology, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Olga Růžičková
- Institute of Rheumatology, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Vencovský
- Institute of Rheumatology, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Karel Pavelka
- Institute of Rheumatology, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ladislav Šenolt
- Institute of Rheumatology, Prague, Czech Republic. .,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
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29
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Serum calprotectin may reflect inflammatory activity in patients with active rheumatoid arthritis despite normal to low C-reactive protein. Clin Rheumatol 2018; 37:2055-2062. [DOI: 10.1007/s10067-018-4091-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 01/22/2023]
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30
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Torun MT, Ünver E, Yalçın Y, Kanmaz L, Seçkin E. The importance of calprotectin levels in obstructive sleep apnea syndrome severity. Curr Med Res Opin 2018; 34:401-405. [PMID: 28933970 DOI: 10.1080/03007995.2017.1383890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is mostly seen in adult populations. It is known that increased levels of several inflammatory mediators play roles in OSAS and related comorbidities. Calprotectin is an inflammatory mediator that increases in some diseases such as Behçet's syndrome, bowel diseases and cardiovascular and cerebrovascular diseases. AIMS The purpose of this study was to investigate whether calprotectin can be used as a biomarker in OSAS by determining the relation between serum calprotectin levels and OSAS severity. STUDY DESIGN Cohort study. METHODS A prospective study was planned. Eighty-three patients undergoing polysomnography were included in the study and evaluated prospectively. Thirty patients were classified as non-OSAS (group 1), 18 as mild OSAS (group 2), 15 as moderate OSAS (group 3) and 20 as severe OSAS (group 4). Calprotectin values were measured in the non-OSAS patients (group 1) and in the patients with OSAS (groups 2, 3 and 4). The OSAS groups were also compared with each other. RESULTS Serum calprotectin values ranged between 70.61 and 1468.04 ng/ml. No significant difference in calprotectin levels was found between the OSAS and normal groups. However, statistically significantly increased calprotectin values were determined in the severe OSAS group (group 4) when all groups were compared. CONCLUSION Calprotectin values were elevated in OSAS patients and it can be used as a marker of severe OSAS. Future studies can support our study.
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Affiliation(s)
- Mümtaz Taner Torun
- a Department of Otorhinolaryngology, Head and Neck Surgery , Bandırma State Hospital , Bandırma , Balıkesir , Turkey
| | - Ethem Ünver
- b Department of Chest Diseases , Erzincan University , Erzincan , Turkey
| | - Yusuf Yalçın
- c Department of Otorhinolaryngology, Head and Neck Surgery , Soma Fer Hospital , Soma , Manisa , Turkey
| | - Lutfi Kanmaz
- d Department of Otorhinolaryngology, Head and Neck Surgery , Erzincan University , Erzincan , Turkey
| | - Ender Seçkin
- d Department of Otorhinolaryngology, Head and Neck Surgery , Erzincan University , Erzincan , Turkey
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31
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Xia C, Braunstein Z, Toomey AC, Zhong J, Rao X. S100 Proteins As an Important Regulator of Macrophage Inflammation. Front Immunol 2018; 8:1908. [PMID: 29379499 PMCID: PMC5770888 DOI: 10.3389/fimmu.2017.01908] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/14/2017] [Indexed: 12/17/2022] Open
Abstract
The S100 proteins, a family of calcium-binding cytosolic proteins, have a broad range of intracellular and extracellular functions through regulating calcium balance, cell apoptosis, migration, proliferation, differentiation, energy metabolism, and inflammation. The intracellular functions of S100 proteins involve interaction with intracellular receptors, membrane protein recruitment/transportation, transcriptional regulation and integrating with enzymes or nucleic acids, and DNA repair. The S100 proteins could also be released from the cytoplasm, induced by tissue/cell damage and cellular stress. The extracellular S100 proteins, serving as a danger signal, are crucial in regulating immune homeostasis, post-traumatic injury, and inflammation. Extracellular S100 proteins are also considered biomarkers for some specific diseases. In this review, we will discuss the multi-functional roles of S100 proteins, especially their potential roles associated with cell migration, differentiation, tissue repair, and inflammation.
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Affiliation(s)
- Chang Xia
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China.,Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, United States
| | - Zachary Braunstein
- Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
| | - Amelia C Toomey
- Department of Health Sciences, University of Missouri, Columbia, MO, United States
| | - Jixin Zhong
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, United States
| | - Xiaoquan Rao
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, United States
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Nordal HH, Fagerhol MK, Halse AK, Hammer HB. Calprotectin (S100A8/A9) should preferably be measured in EDTA-plasma; results from a longitudinal study of patients with rheumatoid arthritis. Scand J Clin Lab Invest 2017; 78:102-108. [PMID: 29278951 DOI: 10.1080/00365513.2017.1419371] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Calprotectin (S100A8/A9), a protein expressed in neutrophils and monocytes/macrophages in circulation and inflamed tissue, is associated with measures of disease activity in rheumatoid arthritis (RA) patients both when measured in ethylenediaminetetraacetic acid (EDTA)-plasma and in serum. We wanted to explore if EDTA-plasma or serum should be preferred for calprotectin as a marker of disease activity. Calprotectin was analysed in EDTA-plasma and serum by enzyme-linked immunosorbent assay (ELISA) at baseline in 141 RA patients, starting biologic disease-modifying anti-rheumatic drugs (bDMARDs), and after three months. Differences between plasma and serum levels of calprotectin were assessed by Wilcoxon signed rank test. Variability was assessed by quartile coefficient of dispersion. Spearman's test explored correlations between calprotectin in plasma and serum and between calprotectin (plasma or serum) and clinical/ultrasound (US) measures of disease activity. Bland Altman plots were used for method comparisons. Conventional inflammatory markers were evaluated for comparison. Calprotectin had similar variability when measured in plasma and serum, but there was a significant difference in concentrations between plasma and serum (p < .001). The correlation coefficients at baseline between calprotectin measured in plasma/serum and measures of disease activity were rs = 0.62/0.46 for sum power Doppler score (PD), rs = 0.60/0.48 for assessor's global visual analogue scale (VAS), rs = 0.59/0.43 for sum grey scale (GS) score and rs = 0.47/0.37 for swollen joint count of 32, all p < .001. Similar differences were found after three months. Calprotectin measured in plasma showed the strongest associations with assessments of disease activity, and EDTA-plasma should preferably be used when evaluating disease activity in RA patients.
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Affiliation(s)
- Hilde Haugedal Nordal
- a Broegelmann Research Laboratory, Department of Clinical Science , University of Bergen , Bergen , Norway.,b Department of Rheumatology , Haukeland University Hospital , Bergen , Norway
| | | | - Anne-Kristine Halse
- b Department of Rheumatology , Haukeland University Hospital , Bergen , Norway.,d Department of Clinical Science , University of Bergen , Bergen , Norway
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Nielsen UB, Bruhn LV, Ellingsen T, Stengaard-Pedersen K, Hornung N. Calprotectin in patients with chronic rheumatoid arthritis correlates with disease activity and responsiveness to methotrexate. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 78:62-67. [PMID: 29228799 DOI: 10.1080/00365513.2017.1413591] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Calprotectin (myeloid-related protein 8/14) is elevated in inflammatory diseases and a correlation of serum calprotectin and disease activity in rheumatoid arthritis (RA) has been shown. In this study, we investigated plasma calprotectin as a disease marker in patients with chronic RA treated with methotrexate (MTX) monotherapy and compared plasma calprotectin with C-reactive protein (CRP) in this matter. METHODS Seventy-six patients with chronic RA were included in this open prospective study and of these 40 were included prior to initiation of MTX therapy. The patients were followed with laboratory and clinical parameters for 52-56 weeks. Plasma calprotectin was analyzed at the start of study and at various intervals. Radiographic evaluation was performed at baseline and after 17.2 months and progression in joint destruction was measured with Larsen score. The response to MTX was evaluated according to the American College of Rheumatology criteria. RESULTS Patients starting MTX treatment had significantly higher levels of plasma calprotectin compared to patients well established on MTX therapy (p = .008). Among the 40 patients naive to MTX, 25 responded to MTX therapy and serum calprotectin decreased significantly in these patients (p = .0007). The radiographic damage showed no relation to calprotectin. CONCLUSIONS Plasma calprotectin is associated with disease activity in patients with chronic RA and is more strongly correlated to MTX response compared to CRP. The role of calprotectin as a disease marker is promising and the advantages compared to CRP needs to be further investigated.
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Affiliation(s)
| | | | - Torkell Ellingsen
- c Department of Reumatology , Odense University Hospital , Odense C , Denmark
| | | | - Nete Hornung
- a Department of Clinical Biochemistry , Randers Regional Hospital , Randers NØ , Denmark
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Lira-Junior R, Öztürk VÖ, Emingil G, Bostanci N, Boström EA. Salivary and Serum Markers Related to Innate Immunity in Generalized Aggressive Periodontitis. J Periodontol 2017; 88:1339-1347. [DOI: 10.1902/jop.2017.170287] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ronaldo Lira-Junior
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Stockholm, Sweden
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Veli Özgen Öztürk
- Department of Periodontology, School of Dentistry, Adnan Menderes University, Aydın, Turkey
| | - Gulnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Nagihan Bostanci
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Stockholm, Sweden
| | - Elisabeth A. Boström
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Stockholm, Sweden
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Relationship between serum calprotectin (S100A8/9) and clinical, laboratory and ultrasound parameters of disease activity in rheumatoid arthritis: A large cohort study. PLoS One 2017; 12:e0183420. [PMID: 28832684 PMCID: PMC5568227 DOI: 10.1371/journal.pone.0183420] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/03/2017] [Indexed: 01/08/2023] Open
Abstract
Background Calprotectin may be a sensitive biomarker of rheumatoid arthritis (RA) disease activity. Objectives In the current study, we investigated whether calprotectin is a better biomarker than CRP for predicting clinical activity and ultrasound parameters in patients with RA. Methods A total of 160 patients with RA underwent clinical (swollen joint count—SJC, tender joint count—TJC, Disease Activity Score—DAS28, Clinical Disease Activity Index—CDAI, and simplified Disease Activity Index—SDAI) and ultrasound (German US7) examination. Clinical and laboratory measures were correlated with ultrasound findings using Spearman´s correlation coefficient. Differences in serum calprotectin levels in patients with variable disease activity according to the DAS28-ESR and CDAI scores were assessed using ANOVA. Multivariate regression analysis was used to determine the predictive values of calprotectin, CRP and SJC for CDAI and PD US synovitis scores. Results Serum calprotectin was significantly associated with DAS28-ESR (r = 0.321, p<0.001), DAS28-CRP (r = 0.346, p<0.001), SDAI (r = 0.305, p<0.001), CDAI (r = 0.279, p<0.001) scores and CRP levels (r = 0.556, p<0.001). Moreover, calprotectin was significantly correlated with GS (r = 0.379, p<0.001) and PD synovitis scores (r = 0.419, p<0.001). The multivariate regression analysis showed that calprotectin is a better predictor of the CDAI score and PD US synovitis than CRP. Conclusions The results of this study support an additional role of calprotectin in assessing inflammatory activity in patients with RA.
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Jonsson MK, Sundlisæter NP, Nordal HH, Hammer HB, Aga AB, Olsen IC, Brokstad KA, van der Heijde D, Kvien TK, Fevang BTS, Lillegraven S, Haavardsholm EA. Calprotectin as a marker of inflammation in patients with early rheumatoid arthritis. Ann Rheum Dis 2017; 76:2031-2037. [DOI: 10.1136/annrheumdis-2017-211695] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/03/2017] [Accepted: 07/24/2017] [Indexed: 11/04/2022]
Abstract
ObjectivesCalprotectin is an inflammatory marker of interest in rheumatoid arthritis (RA). We evaluated whether the level of calprotectin was associated with disease activity, and if it was predictive of treatment response and radiographic progression in patients with early RA.MethodsPlasma from disease-modifying antirheumatic drug (DMARD)-naïve patients with RA fulfilling 2010 American College of Rheumatology/European League Against Rheumatism classification criteria with symptom duration <2 years was analysed for calprotectin at baseline, and after 1, 3 and 12 months. All patients received treat-to-target therapy, as part of a randomised controlled strategy trial (ARCTIC). The association between calprotectin, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) and measures of disease activity were assessed by correlations. We used likelihood ratios and logistic regression models to assess the predictive value of the baseline inflammatory markers for treatment response and radiographic damage.Results215 patients were included: 61% female, 82% anti-citrullinated peptide antibody positive, mean (SD) age 50.9 (13.7) years and median (25, 75 percentile) symptom duration 5.8 (2.8, 10.5) months. Calprotectin was significantly correlated with Clinical Disease Activity Index (r=0.32), ESR (r=0.50) and ultrasonography power Doppler (r=0.42) before treatment onset. After 12 months of treatment, calprotectin, but not ESR and CRP, was significantly correlated with power Doppler (r=0.27). Baseline levels of calprotectin, ESR and CRP were not predictive of treatment response, but high levels of calprotectin were associated with radiographic progression in multivariate models.ConclusionsCalprotectin was correlated with inflammation assessed by ultrasound before and during DMARD treatment, and was also associated with radiographic progression. The data support that calprotectin may be of interest as an inflammatory marker when assessing disease activity in different stages of RA.Trial registration numberNCT01205854; Post-results.
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Austermann J, Zenker S, Roth J. S100-alarmins: potential therapeutic targets for arthritis. Expert Opin Ther Targets 2017; 21:739-751. [PMID: 28494625 DOI: 10.1080/14728222.2017.1330411] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION In arthritis, inflammatory processes are triggered by numerous factors that are released from joint tissues, promoting joint destruction and pathological progression. During inflammation, a novel family of pro-inflammatory molecules called alarmins is released, amplifying inflammation and joint damage. Areas covered: With regard to the role of the alarmins S100A8 and S100A9 in the pathogenesis of arthritis, recent advances and the future prospects in terms of therapeutic implications are considered. Expert opinion: There is still an urgent need for novel treatment strategies addressing the local mechanisms of joint inflammation and tissue destruction, offering promising therapeutic alternatives. S100A8 and S100A9, which are the most up-regulated alarmins during arthritis, are endogenous triggers of inflammation, defining these proteins as promising targets for local suppression of arthritis. In murine models, the blockade of S100A8/S100A9 ameliorates inflammatory processes, including arthritis, and there are several lines of evidence that S100-alarmins may already be targeted in therapeutic approaches in man.
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Affiliation(s)
- Judith Austermann
- a Institute of Immunology , University of Münster , Münster , Germany
| | - Stefanie Zenker
- a Institute of Immunology , University of Münster , Münster , Germany
| | - Johannes Roth
- a Institute of Immunology , University of Münster , Münster , Germany
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Andrés Cerezo L, Šumová B, Prajzlerová K, Veigl D, Damgaard D, Nielsen CH, Pavelka K, Vencovský J, Šenolt L. Calgizzarin (S100A11): a novel inflammatory mediator associated with disease activity of rheumatoid arthritis. Arthritis Res Ther 2017; 19:79. [PMID: 28446208 PMCID: PMC5405489 DOI: 10.1186/s13075-017-1288-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 03/31/2017] [Indexed: 01/09/2023] Open
Abstract
Background Calgizzarin (S100A11) is a member of the S100 protein family that acts in different tumors by regulating a number of biologic functions. Recent data suggest its association with low-grade inflammation in osteoarthritis (OA). The aim of our study is to compare S100A11 expression in the synovial tissues, synovial fluid and serum of patients with rheumatoid arthritis (RA) and osteoarthritis (OA) and to characterize the potential association between S100A11 and disease activity. Methods S100A11 protein expression was detected in synovial tissue from patients with RA (n = 6) and patients with OA (n = 6) by immunohistochemistry and immunofluorescence. Serum and synovial fluid S100A11 levels were measured by ELISA in patients with RA (n = 40) and patients with OA (n = 34). Disease activity scores in 28 joints based on C-reactive protein (DAS28-CRP) were used to assess disease activity. Cytokine content in peripheral blood mononuclear cells (PBMCs), synovial fibroblasts (SFs) and synovial fluid was analysed by ELISA, western blotting or cytometric bead array. Results S100A11 expression was significantly up-regulated in the synovial lining and sublining layers (p < 0.01) and vessels (p < 0.05) of patients with RA compared to patients with OA, and was associated with fibroblasts and T cells. S100A11 was significantly increased in synovial fluid (p < 0.0001) but not in serum (p = 0.158) from patients with RA compared to patients with OA when adjusted for age and sex. Synovial fluid S100A11 correlated with DAS28 (r = 0.350, p = 0.027), serum CRP (r = 0.463, p = 0.003), synovial fluid leukocyte count (r = 0.677, p < 0.001), anti-cyclic citrullinated peptide antibodies (anti-CCP) (r = 0.424, p = 0.006) and IL-6 (r = 0.578, p = 0.002) and IL-8 (r = 0.740, p < 0.001) in synovial fluid from patients with RA. PBMCs and SFs isolated from patients with RA synthesized and spontaneously secreted higher levels of S100A11 in comparison with PBMCs and SFs from patients with OA (p = 0.011 and 0.03, respectively). S100A11 stimulated the production of the pro-inflammatory cytokine IL-6 by PBMCs (p < 0.05) and SFs (p < 0.01). Conclusions Our data provide the first evidence of S100A11 up-regulation and its association with inflammation and disease activity in patients with RA. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1288-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lucie Andrés Cerezo
- Institute of Rheumatology, Na Slupi 4, 12850, Prague, Czech Republic. .,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Barbora Šumová
- Institute of Rheumatology, Na Slupi 4, 12850, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Klára Prajzlerová
- Institute of Rheumatology, Na Slupi 4, 12850, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Veigl
- First Orthopaedic Clinic, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Dres Damgaard
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Claus Henrik Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Karel Pavelka
- Institute of Rheumatology, Na Slupi 4, 12850, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Vencovský
- Institute of Rheumatology, Na Slupi 4, 12850, Prague, Czech Republic.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ladislav Šenolt
- Institute of Rheumatology, Na Slupi 4, 12850, Prague, Czech Republic. .,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
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Bae SC, Lee YH. Calprotectin levels in rheumatoid arthritis and their correlation with disease activity: a meta-analysis. Postgrad Med 2017; 129:531-537. [PMID: 28425837 DOI: 10.1080/00325481.2017.1319729] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We evaluated the relationship between calprotectin levels and rheumatoid arthritis (RA), and the correlation between plasma/serum calprotectin and RA activity. METHODS We searched PUBMED, EMBASE, and Cochrane databases and performed meta-analyses comparing plasma/serum or synovial fluid calprotectin levels in RA patients and controls, and correlation coefficients between calprotectin levels and disease activity for 28 joints (DAS28) as well as C-reactive protein (CRP) in RA patients. RESULTS Sixteen studies including 849 RA patients and 266 controls were available for meta-analysis. Meta-analysis showed that calprotectin levels were significantly higher in the RA group than in the control group (SMD = 2.337, 95% CI = 1.544-3.130, p < 1.0 × 10-8). Stratification by rheumatoid factor (RF) status revealed significantly elevated calprotectin levels in the RF-positive RA group compared to that of the RF-negative RA group (SMD = 0.574, 95% CI = 0.345-0.804, p = 9.2 × 10-7). Meta-analysis of correlation coefficients identified a significant positive correlation between calprotectin levels and CRP or DAS28 (correlation coefficient for CRP = 0.566, 95% CI = 0.512-0.615, p < 1.0 × 10-8; correlation coefficient for DAS28 = 0.438, 95% CI = 0.269-0.518, p = 2.5 × 10-6). Calprotectin levels in synovial fluid were significantly higher in the RA group than in the control group (SMD = 2.891, 95% CI = 1.067-4.715, p = 0.002). CONCLUSIONS Our meta-analysis demonstrates that circulating and synovial fluid calprotectin levels are high in patients with RA, and that circulating calprotectin levels positively correlate with RA activity.
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Affiliation(s)
- Sang-Cheol Bae
- a Department of Rheumatology , Hanyang University Hospital for Rheumatic Diseases , Seoul , Korea
| | - Young Ho Lee
- a Department of Rheumatology , Hanyang University Hospital for Rheumatic Diseases , Seoul , Korea.,b Division of Rheumatology, Department of Internal Medicine , Korea University College of Medicine , Seoul , Korea
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Závada J, Hánová P, Hurňáková J, Szczuková L, Uher M, Forejtová Š, Klein M, Mann H, Olejárová M, Růžičková O, Šléglová O, Hejduk K, Pavelka K. The relationship between synovitis quantified by an ultrasound 7-joint inflammation score and physical disability in rheumatoid arthritis - a cohort study. Arthritis Res Ther 2017; 19:5. [PMID: 28086960 PMCID: PMC5237153 DOI: 10.1186/s13075-016-1208-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 12/09/2016] [Indexed: 12/30/2022] Open
Abstract
Background Restoring normal physical functioning is a major therapeutic aim in the management of rheumatoid arthritis (RA). It is unknown, whether the extent of synovial inflammation quantified by musculoskeletal ultrasound (US) can predict current or future capacity for physical functioning. To answer this question we investigated the longitudinal relationship between physical function assessed by the health assessment questionnaire (HAQ) and the German 7-joint ultrasound score (US7S) in a prospective cohort of patients with RA. Methods Patients with RA (n = 185 (46 with incident and 139 with prevalent disease) were followed for 30.9 ± 9.1 months. Baseline and annual assessments comprised the disease activity score in 28 joints (DAS28), HAQ and US7S. The US7S includes semiquantitative measurements of synovitis assessed by greyscale (GS) and power Doppler (PD) in seven joints of the clinically dominant hand and foot, which are then aggregated in PD and GS synovitis sum-scores (PDsynSS and GSsynSS). A linear mixed-effect model was used to assess the longitudinal relationship between GSsynSS, PDsynSS and HAQ. We used standard and time-lag models to explore the association between HAQ, and GSsynSS, PDsynSS and DAS28 measured at the same time or at the previous visit 12 months ago, respectively. Results When the standard model was applied, in univariate analyses HAQ score was positively associated with GSsynSS and PDsynSS with β coefficients significantly higher in incident than in prevalent disease. In multivariate analysis both synSSs were individually no longer significant predictors of HAQ score. When using the time-lag model, after adjustment for the previous DAS28 or HAQ score, both PDsynSS and GSsynSS were significantly and negatively associated with the current HAQ. Conclusions US7 PD and GS synovitis sum-scores alone were positively associated with current functional status reflected by the HAQ in patients with RA, and this relationship was stronger in patients with early disease. When combined with the DAS28 or HAQ, US7 PD and GS synovitis sum-scores were predictive of the change in HAQ score over one year. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1208-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jakub Závada
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic.
| | - Petra Hánová
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Jana Hurňáková
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Lenka Szczuková
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Uher
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Šárka Forejtová
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Martin Klein
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Herman Mann
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Marta Olejárová
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Olga Růžičková
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Olga Šléglová
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
| | - Karel Hejduk
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Karel Pavelka
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Na Slupi 4, 12850, Prague, Czech Republic
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Nordal HH, Brokstad KA, Solheim M, Halse AK, Kvien TK, Hammer HB. Calprotectin (S100A8/A9) has the strongest association with ultrasound-detected synovitis and predicts response to biologic treatment: results from a longitudinal study of patients with established rheumatoid arthritis. Arthritis Res Ther 2017; 19:3. [PMID: 28081709 PMCID: PMC5234113 DOI: 10.1186/s13075-016-1201-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/01/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Calprotectin (S100A8/A9 or MRP8/14) and S100A12 (leukocyte-derived proteins), interleukin 6 (IL-6) and vascular endothelial growth factor (VEGF) are markers of inflammation and angiogenesis. Ultrasound (US) is sensitive for detection of greyscale synovitis and power Doppler (PD) vascularization. The objective of the present study was to explore the associations between calprotectin, S100A12, IL-6, VEGF, erythrocyte sedimentation rate, C-reactive protein and a comprehensive US assessment in patients with rheumatoid arthritis (RA) starting biologic disease-modifying anti-rheumatic drug (bDMARD) treatment. METHODS A total of 141 patients with RA were assessed by US, clinical examination and biomarker levels at baseline and at 1, 2, 3, 6 and 12 months after initiation of bDMARDs. US assessment of 36 joints and 4 tendon sheaths were scored semi-quantitatively (0-3 scale). European League Against Rheumatism (EULAR) response was calculated. Statistical assessments performed to explore the associations between biomarkers and US sum scores included Spearman's rank correlation analysis as well as linear and linear mixed model regression analyses. RESULTS Calprotectin showed the overall strongest correlations with both US sum scores (r s = 0.25-0.62) and swollen joint counts (of 32) (r s = 0.24-0.47) (p < 0.05 at all examinations). An association with US sum scores remained after we adjusted for age, sex, disease duration and all the other markers in a regression analysis at baseline. Decreased calprotectin at the first month was predictive of both EULAR response (p ≤ 0.001) and decreased sum PD scores at 3, 6 and 12 months (p ≤ 0.05). CONCLUSIONS Calprotectin had the highest association with US synovitis and predicted treatment response. It may thus be considered as a marker for evaluating inflammation and responsiveness in patients with RA on bDMARD treatment. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) identifier: ACTRN12610000284066 . Registered on 8 April 2010 (retrospectively registered).
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Affiliation(s)
- Hilde Haugedal Nordal
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Haukeland University Hospital, The Laboratory Building, 5th floor, Jonas Lies vei 87, N-5021, Bergen, Norway. .,Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.
| | - Karl Albert Brokstad
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Haukeland University Hospital, The Laboratory Building, 5th floor, Jonas Lies vei 87, N-5021, Bergen, Norway
| | - Magne Solheim
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anne-Kristine Halse
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Tore K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Xia C, Braunstein Z, Toomey AC, Zhong J, Rao X. S100 Proteins As an Important Regulator of Macrophage Inflammation. Front Immunol 2017. [PMID: 29379499 DOI: 10.3389/fimmu.2017.01908/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
The S100 proteins, a family of calcium-binding cytosolic proteins, have a broad range of intracellular and extracellular functions through regulating calcium balance, cell apoptosis, migration, proliferation, differentiation, energy metabolism, and inflammation. The intracellular functions of S100 proteins involve interaction with intracellular receptors, membrane protein recruitment/transportation, transcriptional regulation and integrating with enzymes or nucleic acids, and DNA repair. The S100 proteins could also be released from the cytoplasm, induced by tissue/cell damage and cellular stress. The extracellular S100 proteins, serving as a danger signal, are crucial in regulating immune homeostasis, post-traumatic injury, and inflammation. Extracellular S100 proteins are also considered biomarkers for some specific diseases. In this review, we will discuss the multi-functional roles of S100 proteins, especially their potential roles associated with cell migration, differentiation, tissue repair, and inflammation.
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Affiliation(s)
- Chang Xia
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China.,Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, United States
| | - Zachary Braunstein
- Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
| | - Amelia C Toomey
- Department of Health Sciences, University of Missouri, Columbia, MO, United States
| | - Jixin Zhong
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, United States
| | - Xiaoquan Rao
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, United States
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Serum Calprotectin Discriminates Subclinical Disease Activity from Ultrasound-Defined Remission in Patients with Rheumatoid Arthritis in Clinical Remission. PLoS One 2016; 11:e0165498. [PMID: 27832086 PMCID: PMC5104448 DOI: 10.1371/journal.pone.0165498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/12/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Clinical remission in some patients with rheumatoid arthritis (RA) may be associated with ongoing synovial inflammation that is not always detectable on clinical examination or reflected by laboratory tests but can be visualized by musculoskeletal ultrasound. The goal of our study was to determine the levels of serum calprotectin, a major leukocyte protein, in patients with RA in clinical remission and to investigate the ability of serum calprotectin levels to distinguish patients in ultrasound-defined remission from those with residual ultrasound subclinical inflammation. METHODS Seventy RA patients in clinical remission underwent clinical and ultrasound examination. Ultrasound examination was performed according to the German US7 score. Ultrasound remission was defined as grey scale (GS) range 0-1 and power Doppler (PD) range 0. The levels of serum calprotectin and C-reactive protein (CRP) were determined. The discriminatory capacity of calprotectin and CRP in detecting residual ultrasound inflammation was assessed using ROC curves. RESULTS The total number of patients fulfilling the DAS28-ESR, DAS28-CRP, SDAI and CDAI remission criteria was 58, 67, 32 and 31, respectively. Residual synovial inflammation was found in 58-67% of the patients who fulfilled at least one set of clinical remission criteria. Calprotectin levels were significantly higher in patients with residual synovial inflammation than in those with ultrasound-defined remission (mean 2.5±1.3 vs. 1.7±0.8 μg/mL, p<0.005). Using ultrasound-defined remission criteria, calprotectin had an AUC of 0.692, p<0.05 using DAS28-ESR remission criteria and an AUC of 0.712, p<0.005 using DAS28-CRP remission criteria. Calprotectin correctly distinguished ultrasound remission from subclinical activity in 70% of patients. CRP (AUC DAS28-ESR = 0.494, p = NS; AUC DAS28-CRP = 0.498, p = NS) had lower and insignificant discriminatory capacity. CONCLUSION The present study demonstrates the potential of calprotectin to distinguish RA patients in both clinical and ultrasound-defined remission from patients in clinical remission but with residual subclinical disease activity.
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Kiyeko GW, Hatterer E, Herren S, Di Ceglie I, van Lent PL, Reith W, Kosco-Vilbois M, Ferlin W, Shang L. Spatiotemporal expression of endogenous TLR4 ligands leads to inflammation and bone erosion in mouse collagen-induced arthritis. Eur J Immunol 2016; 46:2629-2638. [PMID: 27510283 DOI: 10.1002/eji.201646453] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/24/2016] [Accepted: 08/08/2016] [Indexed: 12/13/2022]
Abstract
Increased expression of endogenous Toll-like receptor 4 (TLR4) ligands (e.g., Tenascin-C, S100A8/A9, citrullinated fibrinogen (cFb) immune complexes) has been observed in patients with rheumatoid arthritis (RA). However, their roles in RA pathogenesis are not well understood. Here, we investigated the expression kinetics and role of endogenous TLR4 ligands in the murine model of collagen-induced arthritis (CIA). Tenascin-C was upregulated in blood early in CIA, and correlated positively with the clinical score at day 56. Levels of S100A8/A9 increased starting from day 28, peaking at day 42, and correlated positively with joint inflammation. Levels of anti-cFb antibodies increased during the late phase of CIA and correlated positively with both joint inflammation and cartilage damage. Blockade of TLR4 activation at the time of the first TLR4 ligand upregulation prevented clinical and histological signs of arthritis. A TLR4-dependent role was also observed for Tenascin-C and cFb immune complexes in osteoclast differentiation in vitro. Taken together, our data suggests that the pathogenic contribution of TLR4 in promoting joint inflammation and bone erosion during CIA occurs via various TLR4 ligands arising at different stages of disease. The data also suggests that Blockade of TLR4 with monoclonal antibodies is a promising strategy in RA treatment.
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Affiliation(s)
| | | | | | - Irene Di Ceglie
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Peter L van Lent
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Walter Reith
- Department of Pathology and Immunology, University of Geneva, School of Medicine, Geneva, Switzerland
| | | | | | - Limin Shang
- NovImmune SA, Plan-Les-Ouates, Geneva, Switzerland.
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Korkmaz H, Tabur S, Savaş E, Özkaya M, Aksoy ŞN, Aksoy N, Akarsu E. Evaluation of Serum S100A8/S100A9 Levels in Patients with Autoimmune Thyroid Diseases. Balkan Med J 2016; 33:547-551. [PMID: 27761284 DOI: 10.5152/balkanmedj.2016.15881] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 04/19/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The correlation of S100A8/S100A9 with various inflammatory conditions, including autoimmune diseases have been reported. There is no study investigating the levels of S100A8/S100A9 in autoimmune thyroid diseases (AITD). AIMS We aimed to evaluate the level of serum S100A8/S100A9 in AITD. STUDY DESIGN Case control study. METHODS Fifty patients with AITD (25 Hashimoto's thyroiditis (HT) and 25 Graves' disease (GD)) were included in the study. Twenty seven healthy subjects participated as a control group. Blood samples were obtained in the 3 months after the initiation of medical treatment. Serum levels of total antioxidant status (TAS), total oxidative status (TOS), total free sulfhydryl (SH), lipid hydroperoxide (LOOH) and S100A8/S100A9 were analyzed. RESULTS The patients with AITD had significantly higher S100A8/S100A9, OSI, LOOH and TOS levels than the healthy control group. There was no significant difference between GD and HT patients in terms of S100A8/S100A9, TOS and OSI levels. S100A8/S100A9 level was positively correlated with LOOH, TOS and OSI levels but negatively correlated with -SH level in the patients with AITD. CONCLUSION Serum S100A8/S100A9 levels were increased in patients with AITD and positively correlated with LOOH, TOS and OSI whereas negatively correlated with SH.
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Affiliation(s)
- Hakan Korkmaz
- Department of Endocrinology and Metabolic Disease, Edirne State Hospital, Edirne, Turkey
| | - Suzan Tabur
- Division of Endocrinology, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Esen Savaş
- Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Mesut Özkaya
- Division of Endocrinology, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Şefika Nur Aksoy
- Department of Clinical Biochemistry, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Nurten Aksoy
- Department of Clinical Biochemistry, Harran University School of Medicine, Şanlıurfa, Turkey
| | - Ersin Akarsu
- Division of Endocrinology, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
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Inciarte-Mundo J, Ramirez J, Hernández MV, Ruiz-Esquide V, Cuervo A, Cabrera-Villalba SR, Pascal M, Yagüe J, Cañete JD, Sanmarti R. Calprotectin and TNF trough serum levels identify power Doppler ultrasound synovitis in rheumatoid arthritis and psoriatic arthritis patients in remission or with low disease activity. Arthritis Res Ther 2016; 18:160. [PMID: 27391315 PMCID: PMC4938924 DOI: 10.1186/s13075-016-1032-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/23/2016] [Indexed: 11/23/2022] Open
Abstract
Background Serum levels of calprotectin, a major S100 leucocyte protein, are associated with disease activity in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients. Higher drug trough serum levels are associated with good response in patients treated with tumour necrosis factor inhibitors (TNFi). Power Doppler ultrasound (PDUS) synovitis is predictive of flare and progression of structural damage in patients in clinical remission. The purpose of this study was to analyse the accuracy of calprotectin and TNFi trough serum levels in detecting PDUS synovitis in RA and PsA patients in clinical remission or with low disease activity who were receiving TNFi. Methods We conducted a cross-sectional study of 92 patients (42 with RA, 50 with PsA) receiving adalimumab (ADA), etanercept (ETN) or infliximab who were in remission or had low disease activity (28-joint Disease Activity Score based on erythrocyte sedimentation rate <3.2). Associations of calprotectin, TNFi trough serum levels and acute phase reactants with PDUS synovitis were assessed using correlation and linear regression analyses. The accuracy and discriminatory capacity in detecting PDUS synovitis was assessed using ROC curves. Results PDUS synovitis was found in 62.4 % of RA patients and 32 % of PsA patients. Both RA and PsA patients with PDUS synovitis had higher calprotectin levels and lower TNFi trough serum levels. Calprotectin positively correlated with ultrasound scores (all r coefficients >0.50 in RA). Calprotectin correlated with the PDUS synovitis score in patients treated with ADA and ETN. Using PDUS synovitis (yes or no) as the reference variable, calprotectin had an AUC of 0.826. The best cut-off was ≥1.66 μg/ml, with a likelihood ratio of 2.77. C-reactive protein (AUC 0.673) and erythrocyte sedimentation rate (AUC 0.731) had a lower discriminatory capacity. TNFi trough serum levels were significantly associated with PDUS synovitis (OR 0.67, 95 % CI 0.52–0.85, p < 0.001) but their accuracy (AUC <0.5) was less than that of calprotectin. TNFi trough serum levels were inversely correlated with calprotectin and PDUS synovitis in RA and PsA patients receiving ADA and ETN. Conclusions Calprotectin and TNFi trough serum levels may help identify PDUS synovitis in RA and PsA patients in clinical remission or with low disease activity.
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Affiliation(s)
- José Inciarte-Mundo
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain
| | - Julio Ramirez
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain
| | - Maria Victoria Hernández
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain
| | - Virginia Ruiz-Esquide
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain
| | - Andrea Cuervo
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain
| | - Sonia Raquel Cabrera-Villalba
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain
| | - Mariona Pascal
- Department of Immunology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jordi Yagüe
- Department of Immunology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Juan D Cañete
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain
| | - Raimon Sanmarti
- Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain.
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Soliman AF, Elnady BM, Shaker RHM, Mansour AI. Potential role of calprotectin as a monitoring biomarker for clinical and sonographic activity and treatment outcome in recent-onset rheumatoid arthritis. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2016. [DOI: 10.4103/1110-161x.189824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nair SC, Welsing PMJ, Choi IYK, Roth J, Holzinger D, Bijlsma JWJ, van Laar JM, Gerlag DM, Lafeber FPJG, Tak PP. A Personalized Approach to Biological Therapy Using Prediction of Clinical Response Based on MRP8/14 Serum Complex Levels in Rheumatoid Arthritis Patients. PLoS One 2016; 11:e0152362. [PMID: 27029006 PMCID: PMC4814133 DOI: 10.1371/journal.pone.0152362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/13/2016] [Indexed: 02/02/2023] Open
Abstract
Objectives Measurement of MRP8/14 serum levels has shown potential in predicting clinical response to different biological agents in rheumatoid arthritis (RA). We aimed to develop a treatment algorithm based on a prediction score using MRP8/14 measurements and clinical parameters predictive for response to different biological agents. Methods Baseline serum levels of MRP8/14 were measured in 170 patients starting treatment with infliximab, adalimumab or rituximab. We used logistic regression analysis to develop a predictive score for clinical response at 16 weeks. MRP8/14 levels along with clinical variables at baseline were investigated. We also investigated how the predictive effect of MRP8/14 was modified by drug type. A treatment algorithm was developed based on categorizing the expected response per drug type as high, intermediate or low for each patient and optimal treatment was defined. Finally, we present the utility of using this treatment algorithm in clinical practice. Results The probability of response increased with higher baseline MRP8/14 complex levels (OR = 1.39), differentially between the TNF-blockers and rituximab (OR of interaction term = 0.78), and also increased with higher DAS28 at baseline (OR = 1.28). Rheumatoid factor positivity, functional disability (a higher HAQ), and previous use of a TNF-inhibitor decreased the probability of response. Based on the treatment algorithm 80 patients would have been recommended for anti-TNF treatment, 8 for rituximab, 13 for another biological treatment (other than TNFi or rituximab) and for 69 no recommendation was made. The predicted response rates matched the observed response in the cohort well. On group level the predicted response based on the algorithm resulted in a modest 10% higher response rate in our cohort with much higher differences in response probability in individual patients treated contrary to treatment recommendation. Conclusions Prediction of response using MRP8/14 levels along with clinical predictors has potential in personalizing treatment for RA patients starting biological anti-rheumatic treatment, and might increase cost-effectiveness.
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Affiliation(s)
- S. C. Nair
- Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands
- * E-mail:
| | - P. M. J. Welsing
- Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands
| | - I. Y. K. Choi
- Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - J. Roth
- Institute of Immunology, University Hospital Muenster, Muenster, Germany
| | - D. Holzinger
- Department of Pediatric Rheumatology and Immunology, University Children's Hospital Muenster, Muenster, Germany
| | - J. W. J. Bijlsma
- Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands
| | - J. M. van Laar
- Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands
| | - D. M. Gerlag
- Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - F. P. J. G. Lafeber
- Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands
| | - P. P. Tak
- Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
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