Abstract
S100A8/A9 (Calprotectin) serves as a biomarker for various inflammatory diseases, such as for peritonsillar abscess (PTA). Recently, the PTA score was developed for reliable PTA identification. It uses a combination of characteristic clinical symptoms and elevated calprotectin levels in serum and saliva to determine this score. Although well-established point-of-care tests (POCT) to determine serum or faecal calprotectin levels exist, a reliable and rapid tool to analyse salivary calprotectin has not yet been described. In this study, we analysed the potential of the QUANTUM BLUE sCAL Test (QBT, BÜHLMANN Laboratories AG, Switzerland) to determine S100A8/A9 levels during outpatient management. These QBT measurements are combined with other clinical factors to determine the PTA score. Significantly higher calprotectin levels were determined by QBT in patients with PTA compared to healthy controls. The receiver operating characteristic (ROC) curves for the QBT revealed cut-off values of 2940 ng/ml (sensitivity = 0.88, specificity = 0.78) in serum and 5310 ng/ml (sensitivity = 0.80, specificity = 0.50) in saliva. By adding the QBT results to determine PTA values, a ROC analysis provided a statistical cut-off score of 2.5 points to identify the existence of a PTA with a sensitivity of 100% and a specificity of 89.3%. The QUANTUM BLUE sCAL Test (QBT) is an appropriate POCT to determine serum and salivary calprotectin levels. Thus, PTA scores can be determined within a short time frame by applying the QBT during outpatient management.
Highlights
The myeloid-related proteins S100A8 (MRP8) and S100A9 (MRP14) belong to the S100-protein family and form a calcium-binding heterodimer, calprotectin (S100A8/A9), under physiological conditions[1,2,3]
Increased levels of calprotectin have been found in several diseases, such as in rheumatoid arthritis, inflammatory bowel disease or cardiovascular diseases, indicating to be a more sensitive biomarker for diagnosis and monitoring of disease activity than C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR)[7,8,9,10,11,12,13]
Correlations between salivary calprotectin levels measured by QUANTUM BLUE sCAL Test (QBT) and a “gold standard” enzyme-linked immunosorbent assay (ELISA) test were assessed in a large cohort of patients with various tonsil-related diseases
Summary
The myeloid-related proteins S100A8 (MRP8) and S100A9 (MRP14) belong to the S100-protein family and form a calcium-binding heterodimer, calprotectin (S100A8/A9), under physiological conditions[1,2,3]. The QUANTUM BLUE sCAL Test (QBT, BÜHLMANN Laboratories AG, Switzerland), on the other hand, is designed as a point-of-care testing (POCT) method for quick and simple measurement of calprotectin in serum (sCAL) This rapid test shows a good correlation to ELISA measurements, but is very practical and appears more patient-friendly, since several traumatic invasive treatments can be avoided due to its fast and quantitative results on-site[19,20]. Due to the reduction of invasive medical examination and its simple non-expert handling, the QBT can be considered as a suitable alternative to ELISA measurements for outpatient care It was the aim of the present study to analyse the potential of the QBT to quickly determine salivary S100A8/A9 levels during outpatient consultation and to determine its applicability in the diagnosis of peritonsillar abscess by using the PTA score
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