Abstract
Objective: Early and accurate evaluation of the presence and activity of synovitis is extremely important in the diagnosis and treatment of rheumatoid arthritis. Myeloid related protein 8/14 (MRP8/14), also known as calprotectin or S100A8/A9 is considered as a sensitive marker for local inflammatory activity in rheumatoid arthritis. The aim of this study is to demonstrate the efficacy of MRP8/14 as a marker of disease activity in RA. Methods: Thirty-one patients with diagnosis of RA who received treatment without biological drugs at our institution were included in this study. Serum MRP8/14, CRP and MMP-3 were tested in all patients. Disease activity was evaluated using DAS28-CRP and SDAI. Ultrasonography was performed on the wrists and MCP joints of both hands using semi-quantitative scale of power Doppler signal. The sum of scales in joints was calculated as the PD score. The correlation of MRP8/14 with serum biomarkers, disease activity and ultrasonography examination was investigated. Result: Serum MRP8/14 was strongly correlated with CRP (r = 0.63) and MMP-3 (r = 0.69). A correlation was observed between serum MRP8/14 and DAS28-CRP (r = 0.53) and SDAI (r = 0.66). No significant correlation was found between PD scores and MRP8/14. Conclusion: This study demonstrated that MRP8/14 is correlated with evaluated disease activity and markers of serum inflammatory response in patients not using biological drugs. MRP8/14 is considered an effective new method for objective evaluation of synovitis in RA.
Highlights
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease which mainly causes inflammation of the joint synovium
A strong correlation was observed between Myeloid related protein 8/14 (MRP8/14) and C-reactive protein (CRP), the serum markers of inflammatory response and matrix metalloproteinase-3 (MMP-3), a marker of cartilage destruction (Table 2)
According to the evaluation using DAS28-CRP, remission was observed in 15 cases (48.4%), low disease activity in 8 cases (25.8%), moderate disease activity in 7 cases (22.6%), and severe disease activity in 1 case (3.2%)
Summary
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease which mainly causes inflammation of the joint synovium. Prolonged synovitis leads to progression of joint destruction and joint degeneration. Early intervention and adequate synovitis control are necessary to prevent joint destruction. Early and accurate evaluation of the presence and activity of synovitis is extremely important in the diagnosis and treatment of rheumatoid arthritis. Myeloid related protein (MRP) 8/14 has attracted attention in recent years as an index of synovitis activity in rheumatoid arthritis patients. We hypothesized that if the relationship between MRP8/14 as an index of synovitis and existing RA disease activity evaluation methods was adequately clarified, easy and objective evaluation of the RA condition using MRP8/14 would be feasible. The purpose of this study is to demonstrate the efficacy of MRP8/14 as a marker of disease activity in RA
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