The Emerging Role of Calprotectin in Disease Activity and Response to Treatment Among Iraqi Patients with Rheumatoid Arthritis

Background: Calprotectin is a heterodimeric compound belonging to the S100 family, it is mostly produced in leukocytes and is implicated in various human disorders, including tumors and autoimmune diseases.
Objective: To evaluate the usefulness of calprotectin serum level as a valid target for monitoring progression of rheumatoid arthritis (RA) disease and response to tumor necrosis factor-alpha (TNF-α) inhibitor therapy (Infliximab).
Methods: This case-control study comprised 150 participants, consisting of 50 healthy individuals and 100 patients with RA on anti-TNF-α (Infliximab) therapy (50 responders and 50 non-responders). The concentration of calprotectin in the serum was determined using the enzyme-linked immunosorbent assay.
Results: The clinical disease activity index revealed a substantial distinction between patients, specifically responders and non-responders (P <0.001). The study's findings revealed 68% of the patients who responded to treatment were positive for rheumatoid factor (RF), whereas 88% of the non-responders were seropositive. Furthermore, non-responders' patients exhibited a greater presence of anti-citrullinated protein antibodies. According to this study, RA patients who test positive for anti-citrullinated protein antibodies exhibit a diminished response to anti-TNF-α therapy. The serum levels of calprotectin were markedly elevated in non-responder patients compared to both responders and the control group (P <0.001).
Conclusion: Calprotectin serum level may reflect an effective target for monitoring progression of RA disease and response to anti-TNF-α therapy.
Keywords: Calprotectin, rheumatoid arthritis, TNF inhibitor
Citation: Jassim HH, Abbas AA, Alosami MH. The emerging role of calprotectin in disease activity and response to treatment among Iraqi patients with rheumatoid arthritis. Iraqi JMS. 2024; 22(2): 283-290. doi: 10.22578/IJMS.22.2.13