Calprotectin is an acute-phase protein (heterodimer of S100A8 and S100A9) highly expressed by monocytes and neutrophils. During inflammation, neutrophils migrate to the inflammatory site and secrete large amounts of calprotectin acting as a soluble proinflammatory mediator. Locally released calprotectin enters the systemic circulation where it can be measured in serum and plasma, directly reflecting joint inflammatory activity.1-3
Calprotectin in serum and plasma has been described as valuable biomarker in several chronic inflammatory conditions, including multiple rheumatic conditions. It has been reported to correlate with and partly outperform clinical disease activity scores, ultrasound and other inflammatory biomarkers.
Calprotectin’s bio-marker potential is reported in diagnosis and differentiation, prediction of treatment response and flares, as well as treatment monitoring.1-4 Therefore, incorporating calprotectin testing into clinical practice could significantly enhance the management of these diseases, by allowing for early detection of disease activity, more accurate evaluation of treatment response, and timely identification of disease relapse.
Since the concentration of circulating calprotectin reflects the degree of inflammation in rheumatoid arthritis (RA), it can provide valuable assessment of disease activity, treatment response and relapse. Calprotectin has been proven to be a very sensitive biomarker, allowing detection of even low disease activity distinguishing it from remission.5,6 This is in contrast to C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), which are low in 40% of patients despite active disease.5-7 Moreover, RA patients are often treated with a wide range of medications, some of which indirectly lower downstream levels of CRP. Calprotectin can therefore be a useful biomarker when CRP is normal or difficult to interpret, such as in patients treated with therapies that suppress interleukin-6 (IL-6) or tumour necrosis factor (TNF).8-11 In addition to direct treatment monitoring, calprotectin can also independently predict disease relapse guiding patient monitoring and treatment decisions.12
In care for Juvenile Idiopathic Arthritis (JIA) patients, calprotectin has proven great value in prediction of remission, flares and treatment response. Before treatment, high levels of calprotectin can indicate a positive treatment response13-15, whereas low calprotectin levels can guide safe withdrawal of treatment.15-17 Additionally, during monitoring of patients in remission, calprotectin can provide an early indication of relapse.18
In the case of the systemic autoinflammatory diseases, sJIA and Adult onset Still’s disease (AOSD), calprotectin has been described in diagnosis, predicting relapse, and evaluating disease activity.19 Especially the differentiation of sJIA and AOSD with other inflammatory conditions is challenging,
where calprotectin allows the critical early differentiation. Furthermore, calprotectin levels can be
used as a predictive biomarker for relapse and correlate with treatment response guiding disease
GCAL® for measurement of calprotectin in plasma and serum in the assessment of inflammation and inflammatory response to infection. The GCAL® assay is a novel Particle-Enhanced Turbidimetric Immunoassay (PETIA) that can be applied on a wide range of automated clinical chemistry analysers.
The GCAL® immunoassay is developed and manufactured by Gentian. GCAL® is CE-marked and IVDR certified.
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* The assay might not be registered for use in your country of residence and may not comply with applicable laws or regulations in that country. The assay is not cleared for use in the USA (RUO only).
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Plasma and serum calprotectin in the assessment of infection The biomarker calprotectin is a heterodimer of..