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Pre-analytical and analytical confounders of serum calprotectin as a biomarker in rheumatoid arthritis

  • Lieve Van Hoovels EMAIL logo , Bert Vander Cruyssen , Laura Bogaert , Stefanie Van den Bremt and Xavier Bossuyt
Published/Copyright: October 30, 2019
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 58 Issue 1

Abstract

Background

There is a need for additional biomarkers to assist in the diagnosis and prognosis of rheumatoid arthritis (RA). The aim of our study was to evaluate the (pre-analytical, analytical and clinical) performance of serum calprotectin as a marker of inflammation in RA.

Methods

The study population included 463 rheumatologic patients (including 111 RA patients and 352 controls) who for the first time consulted a rheumatologist, 20 healthy controls and 27 patients with an infectious disease. Calprotectin was measured (using four different assays) in serum or in serum and EDTA plasma (healthy controls and infectious disease group). For rheumatologic patients, results for C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were available.

Results

Results for blood calprotectin were assay- and matrix-dependent, with higher values found in serum than in plasma. Serum calprotectin was higher in RA patients than in rheumatologic diseased controls and in healthy controls. Serum calprotectin was lower in RA patients than in patients with an infectious disease. Serum calprotectin was associated with disease activity (DAS score). The area under the curve (AUC) to discriminate RA from controls was 0.756 for CRP, 0.714 for ESR and 0.726–0.783 for calprotectin.

Conclusions

Our data document that calprotectin measurement is assay- and matrix-dependent. Serum calprotectin is associated with disease activity. Additional (prospective) studies are warranted to further evaluate the prognostic and diagnostic value of blood calprotectin measurements.

Keywords: biomarker; rheumatoid arthritis; serum calprotectin

Acknowledgments

We thank Bühlmann, Diasorin, Inova Diagnostics and Thermo Fisher for the donation of the assays and the constructive discussion of the results. Furthermore, we acknowledge Prof. Jörg Steinmann of Labor Dr. Fenner und Kollegen (Hamburg) for providing the R&D protocol of the EliA calprotectin 2 analysis. Finally, we are very thankful to Dr. Julie Jacobs for her work regarding the patient cohort categorization and to the laboratory technicians for their most appreciated efforts regarding the practical work.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: XB has been consultant for Inova Diagnostics and Thermo Fisher Scientific.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2019-0508).

Received: 2019-05-20
Accepted: 2019-09-15
Published Online: 2019-10-30
Published in Print: 2019-12-18

©2020 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2019-0508
Keywords for this article
biomarker; rheumatoid arthritis; serum calprotectin

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Reflex TSH strategy: the good, the bad and the ugly
  4. Review
  5. Shortcomings in the evaluation of biomarkers in ovarian cancer: a systematic review
  6. Mini Review
  7. Clinical application of presepsin as diagnostic biomarker of infection: overview and updates
  8. Opinion Paper
  9. Gut microbiotas and immune checkpoint inhibitor therapy response: a causal or coincidental relationship?
  10. EFLM Paper
  11. Systematic review and meta-analysis of within-subject and between-subject biological variation estimates of 20 haematological parameters
  12. General Clinical Chemistry and Laboratory Medicine
  13. Pre-, post- or no acidification of urine samples for calcium analysis: does it matter?
  14. Pre-analytical and analytical confounders of serum calprotectin as a biomarker in rheumatoid arthritis
  15. Dynamics of soluble syndecan-1 in maternal serum during and after pregnancies complicated by preeclampsia: a nested case control study
  16. Multi-site performance evaluation and Sigma metrics of 20 assays on the Atellica chemistry and immunoassay analyzers
  17. Plasma creatinine medians from patients partitioned by gender and age used as a tool for assessment of analytical stability at different concentrations
  18. Two-center comparison of 10 fully-automated commercial procalcitonin (PCT) immunoassays
  19. Method comparison of four clinically available assays for serum free light chain analysis
  20. Comparison of three different chemiluminescence assays and a rapid liquid chromatography tandem mass spectrometry method for measuring serum aldosterone
  21. Repeatability and reproducibility of lipoprotein particle profile measurements in plasma samples by ultracentrifugation
  22. Reference Values and Biological Variations
  23. A study on reference interval transference via linear regression
  24. Cancer Diagnostics
  25. Unstimulated high-sensitive thyroglobulin is a powerful prognostic predictor in patients with thyroid cancer
  26. Cardiovascular Diseases
  27. Analytical validation of a highly sensitive point-of-care system for cardiac troponin I determination
  28. Acknowledgment
  29. Letters to the Editor
  30. Are icteric and lipemic indices reliable to screen for hyperbilirubinemia and hypertriglyceridemia?
  31. Anti-streptavidin antibodies as a cause of false-positive results of streptavidin-based autoantibody assays
  32. Assessment of complement interference in anti-Müllerian hormone immunoassays
  33. Validating thyroid-stimulating hormone (TSH) reflexive testing cutpoints in a tertiary care institution
  34. Results of the second external quality assessment for human papillomavirus genotyping in Shanghai, China
  35. Development of suitable external quality control material for G6PD deficiency screening with the fluorescent spot test
  36. Non-linearity in commercially available lipase assays: still gaps to close
  37. JAK2, 46/1 haplotype and chronic myelogenous leukemia: diagnostic and therapeutic potential
  38. Congress Abstracts
  39. 11th National Scientifc Congress SPML
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