engleski

Cross-sectional study of serum calprotectin levels in non-systemic juvenile idiopathic arthritis patients and children with acute inflammatory disease

Introduction: in the past few years, various indicators of disease activity in juvenile idiopathic arthritis (JIA) patients have been investigated, allowing for the interpretation of different aspects of underlying inflammatory process (e.g. clinical, immunological, radiological etc.). Nevertheless, there is still evident lack of satisfactory support in diagnostic and prognostic evaluations in everyday clinical practice, focusing research activities on discovery of adequate biomarker that would support initial diagnosis and allow feasible disease monitoring. While growing number of evidence indicates phagocytic S100 proteins, like MRP8/14 complex (i.e. calprotectin), can be used to detect subclinical inflammatory activity in systemic JIA, their performance in other forms of JIA is still debatable, while in acute infectious diseases it is almost unknown. Objectives: compare serum calprotectin (sCAL), CRP and PCT levels in patients with various forms of non-systemic JIA and previously healthy children with acute febrile illness lasting <3 days, as well as with juvenile arthritis disease activity score (JADAS). Methods: out of 37 patients included in study, 17 were diagnosed with polyarticular form of JIA (pJIA), 8 with oligoarticular form (oJIA), 2 with juvenile spondyloarthritis (jSpA) and 10 with acute febrile respiratory illness of possible viral etiology (AFI). sCAL, PCT and CRP were measured in all of the patients, while JADAS70CRP was measured in all of the JIA patients. Inactive disease was defined as JADAS ≤1. The average duration of JIA was 64, 2 (7- 132) month, and all of the JIA patients were treated with standard therapy, including biological (n=16) and conventional (n=20) DMARDs. sCAL was measured by a commercial ELISA assay (Buhlmann MRP8/14, Switzerland). Results: among JIA patients, 8 pJIA, 4 oJIA and 1 jSPA had inactive disease, while 9 pJIA, 4 oJIA and 1 jSpA had active disease. Average concentration of sCAL among patients with inactive disease was 1, 86 (0, 5-4, 2) μg/mL, while in patients with active disease it was 2, 37 (0, 93-5, 2) μg/mL (p=0, 37). Statistically significant correlation was observed between sCAL and JADAS (Spearman r=0, 523 ; p=0, 005) in JIA patients and between sCAL and CRP (Spearman r=0, 745 ; p=0, 017) in children with AFI. Average concentration of sCAL in children with AFI was 4, 67 (1, 67-8, 32) μg/mL, significantly higher than in patients with inactive (p=0, 0024) or active JIA (p=0, 0084) or in all JIA patients (p=0, 0012).

juvenile idiopathic arthritis ; serum calprotectin

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