Calprotectin at PReS 2024: Advancing Paediatric Rheumatology Care

Learn more about circulating calprotectin at booth #11

Gentian looks forward to attending the 31^st annual PReS Meeting, taking place September 11-14. 2024, in Gothenburg, Sweden. At this event, Gentian will showcase its advancements in calprotectin testing, highlighting its importance in paediatric rheumatology. 

“Many rheumatologists find that circulating calprotectin provides valuable insights into disease status, guiding optimal patient care.”

 Elin Godager, Global Product Manager

Circulating calprotectin – the sensitive inflammation marker

Calprotectin is an acute-phase protein, a heterodimer of S100A8 and S100A9, highly expressed by neutrophils. During inflammation, neutrophils migrate to the inflammatory site and secrete large amounts of calprotectin acting as a soluble proinflammatory mediator. Once released, calprotectin can enter the systemic circulation, where its levels in serum and plasma serve as a direct indicator of joint inflammatory activity.^1-4

Using calprotectin to guide treatment decisions in JIA

Circulating calprotectin has proven a great value in assessment and prediction of treatment response, remission and flares in JIA (Juvenile Idiopathic Arthritis), the most common chronic rheumatic disease in children. Studies have shown that calprotectin not only correlates with clinical disease activity scores, ultrasound findings, and other inflammatory biomarkers but can even outperform them in assessing disease activity.

Since rheumatic patients are often treated with a wide range of medications, some of which indirectly lower downstream levels of C-reactive protein (CRP). Calprotectin can therefore be a useful biomarker when CRP is normal or difficult to interpret, reported in RA patients treated with therapies that suppress interleukin-6 (IL-6) or tumour necrosis factor (TNF),^5-8  as well as methotrexate (MTX).^9,10

“Incorporating calprotectin testing into clinical routine provides rheumatologists with confident information of the patients disease activity at crucial decision points during treatment and remission.”

 Dr. Paula Lindner, Scientific Product Manager

Studies that have shown high calprotectin concentrations at baseline are strong predictors of a positive response to various treatments including MTX and biological DMARDs (Disease-modifying antirheumatic drugs). Notably, these patient groups often do not differ in any other clinical or laboratory parameters.^11-14  At discontinuing treatment, low calprotectin levels in patients with stable, clinically inactive remission are linked to a reduced risk of future flares, while high calprotectin levels indicate a risk of flares.^14-17  Therefore, in routine clinical practice, high calprotectin levels may indicate the need to continue treatment, even in clinically inactive disease.

Circulating calprotectin - a biomarker recently recommended by EULAR/PReS

The highest calprotectin levels are recorded in Still’s disease, systemic juvenile idiopathic arthritis (sJIA), where they can support the challenging differentiation with bacterial infection in febrile children.¹⁸ Consequently, the most recent EULAR/PReS recommendations on the management of Still’s disease (presented at EULAR 2024) include calprotectin as a tool to strongly support the diagnosis of Still’s disease.¹⁹

Gentian GCAL® Calprotectin Immunoassay

GCAL^® is a Particle-Enhanced Turbidimetric Immunoassay (PETIA) rapidly performed in only 10 minutes. As open channel assay it is available on a wide range of clinical chemistry platforms.

The assay is IVDR certified.*

Contact us

Explore GCAL^® in your clinical practice and laboratory - fill out the form or send an email to marketing@gentian.com for more information about the product and prices.

References

1. Ometto F et al. Calprotectin in rheumatic diseases. Exp Biol Med (Maywood), 2017
2. Pruenster M et al. S100A8/A9: From basic science to clinical application. Pharmacol Ther, 2016
3. Wang Q et al. The Role of Calprotectin in Rheumatoid Arthritis. J Transl Int Med, 2019
4. Romand X et al. Systemic calprotectin and chronic inflammatory rheumatic diseases. Joint Bone Spine, 2019
5. Andrés Cerezo, L et al. Decreases in serum levels of S100A8/9 (calprotectin) correlate with improvements in total swollen joint count in patients with recent-onset rheumatoid arthritis. Arthritis research & therapy, 2011
6. Inciarte-Mundo J et al. 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
7. Hammer HB et al. The soluble biomarker calprotectin (an S100 protein) is associated to ultrasonographic synovitis scores and is sensitive to change in patients with rheumatoid arthritis treated with adalimumab. Arthritis Res Ther, 2011
8. Jarlborg M et al. Serum calprotectin: a promising biomarker in rheumatoid arthritis and axial spondyloarthritis. Arthritis research & therapy, 2020
9. Nielsen UB et al. Calprotectin in patients with chronic rheumatoid arthritis correlates with disease activity and responsiveness to methotrexate. Scand J Clin Lab Invest, 2018
10. Swart JF et al. Understanding inflammation in juvenile idiopathic arthritis: How immune biomarkers guide clinical strategies in the systemic onset subtype. Eur J Immunol, 2016
11. La C et al. Serum calprotectin (S100A8/A9): a promising biomarker in diagnosis and follow-up in different subgroups of juvenile idiopathic arthritis. RMD Open, 2021
12. Moncrieffe H et al. A subgroup of juvenile idiopathic arthritis patients who respond well to methotrexate are identified by the serum biomarker MRP8/14 protein.Rheumatology (Oxford), 2013
13. Alberdi-Saugstrup M et al. Low pretreatment levels of myeloid-related protein-8/14 and C-reactive protein predict poor adherence to treatment with tumor necrosis factor inhibitors in juvenile idiopathic arthritis. Clin Rheumatol, 2017
14. Anink J et al. MRP8/14 serum levels as a predictor of response to starting and stopping anti-TNF treatment in juvenile idiopathic arthritis. Arthritis Res Ther, 2015
15. Schulze zur Wiesch A et al. Myeloid related proteins MRP8/MRP14 may predict disease flares in juvenile idiopathic arthritis. Clin Exp Rheumatol, 2004
16. Foell D et al. Methotrexate treatment in juvenile idiopathic arthritis: when is the right time to stop? Ann Rheum Dis, 2004
17. Sumner EJ et al. Use of MRP8/14 in clinical practice as a predictor of outcome after methotrexate withdrawal in patients with juvenile idiopathic arthritis. Clin Rheumatol, 2022
18. Park C et al. MRP8/14 serum levels as diagnostic markers for systemic juvenile idiopathic arthritis in children with prolonged fever. Rheumatology (Oxford). 2021
19. The EULAR/PReS recommendations on the management of Still’s disease.’’ Presented by Bruno Fautrel at EULAR 2024

*This website may contain information about products that are not registered for use in your country of residence and may not comply with applicable laws or regulations in that country. We do not take any responsibility for accessing such information in those circumstances.