Discover the power of calprotectin testing in rheumatology – CECR 2024

Gentian Diagnostics is excited to announce our participation in the Central European Congress of Rheumatology (CECR) 2024, taking place from December 4–6 in Ljubljana, Slovenia. Join us at our booth #9 to learn more about circulating calprotectin testing in rheumatology and beyond.

Why calprotectin testing matters in rheumatology

Calprotectin’s biomarker potential in inflammatory rheumatic diseases is reported in diagnosis and differentiation, prediction of treatment response and flares, as well as treatment monitoring.^1-4 Elevated levels of calprotectin in serum and plasma provide a direct indication of joint inflammation, offering superior sensitivity compared to traditional biomarkers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).^3,5,6

Incorporating calprotectin into clinical practice can enhance patient care in conditions like for rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), psoriatic arthritis (PsA), vasculitis and Still’s by supporting:

1. Sensitive detection of disease activity
2. Accurate differentiation between inflammatory diseases, such as Still’s disease
3. Improved treatment and remission monitoring
4. Prediction of treatment response and disease flares
   
   

EULAR/PReS recommends use of calprotectin in diagnosis of Stills disease

The European Alliance of Associations for Rheumatology (EULAR) and the Paediatric Rheumatology European Society (PReS) have highlighted calprotectin as one of the new biomarkers strongly recommended in the diagnosis of Still’s disease⁷ (formerly known as systemic JIA and adult-onset Still’s disease).

Calprotectin: A key biomarker in diagnosing and monitoring Still’s disease

The innate immune system is key to the development of Still’s disease, with immune cells like neutrophils becoming highly activated. As a marker of neutrophil activation, calprotectin in plasma and serum has proven valuable for:

1. Diagnosing Still’s disease
2. Predicting relapses
3. Assessing disease activity in both children and adults^8-10

Diagnosing Still’s disease can be particularly challenging in patients presenting with fever of unknown origin, making accurate differentiation from other conditions essential. A recent cohort study of 1110 paediatric patients revealed that calprotectin levels were significantly elevated in those with Still’s disease compared to other diagnoses, including infections and autoinflammatory diseases. Notably, calprotectin demonstrated superior accuracy compared to traditional markers like ferritin, procalcitonin, and IL-18, highlighting its value in supporting precise and timely diagnosis.

In patient monitoring, calprotectin has been described as a predictive biomarker for relapse in sJIA, surpassing the performance of ESR and CRP.¹¹ Furthermore, it correlates with treatment response in both sJIA^11,12 and AOSD¹³, providing clinicians with the ability to track the progression of the disease.

Gentian GCAL® Calprotectin Immunoassay:
Seamless lab integration

Gentian’s GCAL^® assay provides a reliable and efficient solution for measuring circulating calprotectin. This Particle-Enhanced Turbidimetric Immunoassay (PETIA):

1. Works on a wide range of automated clinical chemistry analysers
2. Uses avian antibodies to reduce interference from rheumatoid factors and Human Anti-Mouse Antibodies (HAMA)
3. Offers ready-to-use kits with calibrators and controls, tailored for both small and high-volume laboratories

As the first turbidimetric assay for circulating calprotectin, GCAL^® is CE-marked, IVDR certified, and supports laboratories in providing actionable results for patient care.

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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. Hurnakova J et al. Serum calprotectin may reflect inflammatory activity in patients with active rheumatoid arthritis despite normal to low C-reactive protein. Clin Rheumatol. 2018
6. Pincus T and Sokka T. Laboratory tests to assess patients with rheumatoid arthritis: advantages and limitations. Rheum Dis Clin North Am. 2009
7. Fautrel B et al. EULAR/PReS recommendations for the diagnosis and management of Still's disease, comprising systemic juvenile idiopathic arthritis and adult-onset Still's disease. Ann Rheum Dis. 2024
8. 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
9. Jung JY et al. Roles of Interactions Between Toll-Like Receptors and Their Endogenous Ligands in the Pathogenesis of Systemic Juvenile Idiopathic Arthritis and Adult-Onset Still's Disease. Front Immunol. 2020
10. Rao S et al. Adult-onset Still's disease: A disease at the crossroad of innate immunity and autoimmunity. Front Med (Lausanne). 2022
11. Holzinger D et al. The Toll-like receptor 4 agonist MRP8/14 protein complex is a sensitive indicator for disease activity and predicts relapses in systemic-onset juvenile idiopathic arthritis. Ann Rheum Dis. 2012
12. Frosch M et al. The myeloid-related proteins 8 and 14 complex, a novel ligand of toll-like receptor 4, and interleukin-1beta form a positive feedback mechanism in systemic-onset juvenile idiopathic arthritis. Arthritis Rheum. 2009
13. Kim HA et al. Serum S100A8/A9, but not follistatin-like protein 1 and interleukin 18, may be a useful biomarker of disease activity in adult-onset Still's disease. J Rheumatol. 2012

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