AB0985 EVALUATION OF SERUM CALPROTECTIN (MRP-8/MRP-14) LEVEL IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

Abstract

Background Evaluation of inflammatory activity is an important element in the management of patients with juvenile idiopathic arthritis (JIA), for which C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are traditionally used. However, they might be uninformative in case of subclinical inflammation. The serum level of calprotectin MRP-8/MRP-14 (sCal) correlates well with arthritis activity, as it is produced by activated cells directly in synovia. Objectives We evaluate the level of sCal in patients with JIA depending on the type of therapy in order to assess comprehensively the disease activity for further treatment correction. Methods 74 patients with JIA were examined, 18 of them had oligoarticular disease subtype, 39 – polyarticular, 17 – systemic. The mean age was 11.3 ± 0.4 years; the disease duration was 5.2 ± 0.4 years. Among them, there were 49 (66%) females and 25 (34%) males. All patients were divided into 2 groups depending on the therapy type. Group I consisted of 33 children treated with methotrexate, while 11 of them were in a state of clinical remission. Group II included 41 children treated with biologic DMARDs (adalimumab, etanercept, tocilizumab), while 14 of them achieved clinical remission. All children had normal levels of CRP and ESR. Quantitative indicators distribution is given as a median [5th; 95th percentile], the calculations were carried out using the Mann-Whitney U test. Results Level of sCal in the active disease stage in children of Group I was 8,750 ng/ml [3,700; 17,100], while sCal level in Group II was 2,900 ng/ml [1,200; 24,900]; sCal level in children of Group I which achieved clinical remission – 3,400 ng/ml [1,200; 6,000], and the same indicator in Group II – 1,000 ng/ml [100; 2,800]. sCal level was significantly higher in the group of patients who did not receive biologic DMARDs, both in the active stage of disease (p = 0.000006, U = 71.5) and in the stage of clinical remission (p = 0.00034, U = 11). sCal level is 5,800 ng/ml less in patients with active stage of disease and 2,400 ng/ml less in patients with clinical remission, both treated with biologic DMARDs. In addition, the level of sCal is 5.5 times higher in our patients (3,300 ng/ml) compared with healthy children (600 ng/ml) (p = 0.015). The moderate positive correlation of sCal and JADAS-27 activity index (r-Spearman’s = 0.58) was credibly established. Conclusion The level of sCal can reflects the degree of inflammatory activity in JIA, it is significantly higher in the group of patients who did not receive biologic DMARDs in the treatment regimen, both in the active disease stage (p = 0.000006, U = 71.5) and in the stage of clinical remission (p = 0.00034, U = 11), which indicates the effectiveness of biologic DMARDs in the treatment of JIA. We assume that it would be appropriate to estimate the serum calprotectin level in the comprehensive analysis of clinical status in JIA patients for the further correction of therapy. Disclosure of Interests None declared