Serum Calprotectin

Serum TNFi Troughs, calprotectin correlate with PDUS Synovitis in RA

Calprotectin and drug trough serum levels may help clinicians identify US active synovitis in RA and PsA patients in clinical remission or with low disease activity treated with TNFi.

Sison et al. (2016) Rheumatology Advisor
Calprotectin in rheumatoid arthritis: association with disease activity in a cross-sectional and longitudinal cohort

Calprotectin levels strongly correlate with clinical and laboratory assessments of joint inflammation and also decrease in response to treatment, indicating that calprotectin is a promising marker for assessment and monitoring of disease activity in patients with RA.

García-Arias et al. (2013) Molecular Diagnosis and Therapy
Comparisons of 7- to 78-joint ultrasonography scores: all different joint combinations show equal response to adalimumab treatment in patients with rheumatoid arthritis

The reduced joint combinations were highly associated to the 78-joint score. Furthermore, all the joint combinations presently explored responded well to biological treatment. This indicates that an approach focusing on few joints and tendons gives equivalent information about the inflammatory activity in RA patients as a comprehensive US examination.

 Hammer et al. (2011) Arthritis Research Therapy
Decreases in serum levels of S100A8/9 (calprotectin) correlate with improvements in total swollen joint count in patients with recent-onset rheumatoid arthritis

This study is the first to show normalisation of elevated S100 proteins in patients with recent-onset RA after the initiation of conventional treatment. Therefore, S100A8/9 might potentially be a predictive marker for improvement in the total number of swollen joints in patients in the early phase of RA.

Cerezo et al. (2011) Arthritis Research & Therapy
Biologics: The Story So Far

A publication by the National Rheumatoid Arthritis Society discussing where the situation is with biologics. Covering anti-TNF drugs. Tocilizumab, rituximab and abatacept, amongst others.

 National Rheumatoid Arthritis Society (2013)
BSR and BHPR rheumatoid arthritis guidelines on safety of anti-TNF therapies

In 2001 and 2005, the BSR established and updated guidelines for the use of anti-TNF drugs in RA  [1, 2]. These guidelines indicated which adult RA patients should be eligible for treatment, precautions that need to be taken in the use of anti-TNF and action that should be taken in the event of adverse effects.

 Ding et al. (2010) Rheumatology. Vol. 49, pp 2217-19
Serum calprotectin (S100A8/9): an independent predictor of ultrasound synovitis in patients with rheumatoid arthritis

The serum levels of calprotectin are significantly associated with clinical, laboratory and ultrasound assessments of RA disease activity. These results suggest that calprotectin might be superior to CRP for monitoring ultrasound-determined synovial inflammation in RA patients.

 Humakova et al. (2015) Arthritis Research & Therapy. Vol. 17, pp 252
Serum calprotectin level for diagnosis and detection of disease activity in rheumatoid arthritis

Serum calprotectin at a cut- off level of 450 ng /mL, had 75% sensitivity & 90% specificity for diagnosis of rheumatoid arthritis. Optimum cut-off level of calprotectin for prediction of disease activity was 950 ng /mL with 80% sensitivity, 76% specificity. Conclusion: serum calprotectin is a promising marker for diagnosis and monitoring of disease activity in patients with rheumatoid arthritis.

 Adel et al. (2013) International Journal of Immunology
The soluble biomarker calprotectin (a S100 protein) is associated to ultrasonographic synovitis scores and is sensitive to change in patients with rheumatoid arthritis treated with adalimumab

Calprotectin was associated with the sum scores from a comprehensive US assessment and was responsive to change during anti-TNF treatment. Thus, examination of this leukocyte protein could be of additional value in the assessment of RA patients on biologic treatment.

Hammer et al. (2011) Arthritis Research & Therapy. Vol. 13, pp 178
Measurement of blood calprotectin (MRP-8/MRP-14) levels in patients with juvenile idiopathic arthritis

Blood calprotectin level is one of the measures that can be used to confirm the diagnosis of sJIA and to monitor the disease activity and therapy effectiveness.

Bojko et al. (2017) Reumatologia
Serum Calprotectin: A Potential Biomarker for Neonatal Sepsis

Calprotectin may be considered a promising early, sensitive, specific marker of sepsis thanks to the importance of calprotectin in defence mechanisms and physiological functions of the immune system.

Decembrino et al. (2015) Journal of Immunology Research
Serum calprotectin as a diagnostic marker of late onset sepsis in full-term neonates

Serum calprotectin levels are significantly higher in full-term neonates with late onset neonatal sepsis. Its levels correlated well with other laboratory markers of sepsis and neonatal mortality. It is a sensitive diagnostic marker for late onset neonatal sepsis.

 Abdel-Maaboud et al. (2012) Egyptian Journal of Paediatric Allergy and Immunology. Vol 10, no. 1, pp 19-24
Evaluation of the QUANTUM BLUE sCAL rapid test as a point of care tool to identify patients with peritonsillar abscess

The QUANTUM BLUE sCAL Test (QBT) serves as an appropriate POCT tool to determine calprotectin levels in serum and in saliva. In contrast to the ELISA, the QBT is less time-consuming and requires less expertise. Therefore, the QBT can be used well to determine the PTA score values in everyday clinical practice. By combining the QBT and the PTA score, an even faster and more accurate diagnosis of PTA can be achieved during outpatient management.

Stahl et al. (2021) Scientific Reports
Calprotectin, an Emerging Biomarker of Interest in COVID-19: A Systematic Review and Meta-Analysis

COVID-19 has been shown to present with varied clinical course, necessitating a need for more specific diagnostic tools that could identify severe cases and predict outcomes during COVID-19 infection. Recent evidence has shown an expanded potential role for calprotectin, both as a diagnostic tool and also as a tool in stratifying COVID-19 patients in terms of severity. Therefore, this systematic review and meta-analysis aims to evaluate the levels of calprotectin in severe and non-severe COVID-19 and also identify the implication of raised calprotectin levels. MEDLINE, EMBASE, The Cochrane Library, Web of science and MedRxiv were searched. Meta-analysis was done to compare the serum/fecal levels of calprotectin between severe and non-severe COVID-19 infections.

Udeh et al. (2021) Journal of Clinical Medicine
Sputum and serum calprotectin are useful biomarkers during CF exacerbation

This study demonstrates the superiority of calprotectin (in sputum and serum) as a biomarker of CF exacerbation over better established markers.

 Gray et al. (2010) Journal of Cystic Fibrosis. Vol. 9, pp 193-198
Baseline Elevated Serum Levels of Calprotectin as Independent Marker for Radiographic Spinal Progression in Ankylosing Spondylitis

Calprotectin is an independent predictor for radiographic spinal progression in AS. Compared to CRP, calprotectin is not better in predicting this progression. Furthermore, calprotectin plays a role in inflammation, confirming that radiographic spinal progression is related to inflammation.

 Turina et al. (2013) Annals of the Rheumatic Diseases. Vol 72, no. 3
An evaluation of calprotectin as serum marker of preeclampsia: a systematic review of observational studies

Current evidence suggests that serum calprotectin is significantly raised among women with preeclampsia during the third trimester. Future research is needed to reach firm conclusions regarding its use as a potential screening and surveillance marker during the pregnancy course of women at risk of developing preeclampsia.

 Pergialiotis et al. (2016) Inflammation Research. Vol 65, No. 2, pp. 95-102
Serum Calprotectin and Prealbumin Levels among Ovarian Cancer Patients Aged 30 - 45 Years

Both prealbumin and calprotectin seem to be useful markers for the identification of patients suffering from ovarian cancer.

 Petsa et al. (2017) Open Journal of Obstetrics and Gynaecology. Vol 7, pp. 303-311
Serum Calprotectin, CD26 and EGF to Establish a Panel for the Diagnosis of Lung Cancer

In conclusion, we propose a non-invasive test to identify patients at high-risk for lung cancer from a non-selected population attending a Pulmonary Service. The efficacy of this three-marker panel must be tested in a larger population for lung cancer.

 Biano-Prieto et al. (2015) PLOS one
Serum Calprotectin and Disease Relapse in ANCA-Associated Vasculitis

Failure to suppress calprotectin following induction AAV treatment is associated with greater and faster rates of disease relapse.  These findings have now been confirmed in two independent cohorts.  Calprotectin may be a biomarker predictive of relapse in AAV and should be investigated for use in clinical trials and clinical practice.

Merkel et al. (2014) American College of Rheumatology. Nov 14-19
Simple Blood Test Could Transform Covid Patient Care

A simple test to identify patients at increased risk of death from Covid-19 could be a step closer thanks to a funding grant made by the University of Dundee, with the use of Quantum Blue® sCAL (LF-MRP25).

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Supporting POC diagnosis of Peritonsilar Abscess

The QUANTUM BLUE sCAL Test (QBT) is an appropriate POCT to determine serum and salivary calprotectin levels. Thus, PTA scores can be determined within a short time frame by applying the QBT during outpatient management.

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Park et al: MRP8/14 serum levels as diagnostic markers for systemic juvenile idiopathic arthritis in children with prolonged fever. Rheumatology 2021; 00: 1-11

“Rapid results may enable effective treatment within a window of opportunity preventing disease progression” (sensitivity 84%, specificity 81%):

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Helping to Manage Juvenile Idiopathic Arthritis

Great Ormond Street Hospital User Report – Serum Calprotectin Monitoring

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To establish a test for MRP8/14 protein in childhood arthritis

Ahmed et al. Great Ormond Street Hospital

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Hurnakova: Serum calprotectin discriminates subclinical disease activity from ultra-sound defined remission in patients with RA in clinical remission

Shows the “potential ability of serum calprotectin to discriminate ultrasound-defined remission from subclinical disease activity in RA patients who have achieved clinical remission. Overall, this study suggests that calprotectin might represent a valuable serological biomarker for confirming deep remission in RA patients”

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Park et al: MRP8/14 serum levels as diagnostic markers for systemic juvenile idiopathic arthritis in children with prolonged fever. Rheumatology 2021; 00: 1-11

“Rapid results may enable effective treatment within a window of opportunity preventing disease progression” (sensitivity 84%, specificity 81%):

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Ma et al: Serum Calprotectin Can Differentiate Between Sustained Remission and Low Disease Activity States in Rheumatoid Arthritis. ACR Paediatric Rheumatology symposium

This study demonstrated the role of calprotectin in differentiating subtle low disease activity states. Serum calprotectin was significantly different between low disease activity and remission as defined using different remission criteria. Its utility was seen with point remission as well as longitudinally over 1 year.

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La et al: Serum calprotectin (S100A8/A9): a promising biomarker in diagnosis and follow-up in different subgroups of juvenile idiopathic arthritis

This study confirms the interest of sCal as a potential marker of response to treatment or risk of flares. It also highlights its role as a useful diagnostic tool and marker of disease activity, with a greater specificity than with C-reactive protein.

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Marushko et al: Evaluation of serum calprotectin (MRP-8/MRP-14) levels in patients with juvenile idiopathic arthritis

sCal levels should be used to monitor the subclinical inflammatory activity in patients with JIA.

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A novel Serum Calprotectin (MRP8/14) particle enhanced immuno-turbidimetric assay (sCAL turbo) helps to differentiate SJIA from other diseases in routine clinical laboratory settings

The sCAL turbo assay showed an excellent correlation to the MRP8/14 ELISA used in the previous validation studies (r=0.99, p<0.001). It could reliably differentiate SJIA from all other diagnoses with significant accuracy (cut-off at 9,100 ng/ml, sensitivity 93%, specificity 87%, ROC area under curve 0.961 p<0.001).

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