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Rheumatology (Oxford). 2020 Jan 6. pii: kez590. doi: 10.1093/rheumatology/kez590. [Epub ahead of print]

MRP8/14 and neutrophil elastase for predicting treatment response and occurrence of flare in patients with juvenile idiopathic arthritis.

Author information

1
Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam.
2
Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam.
3
Department of Paediatric Rheumatology, Leiden University Medical Center, Leiden.
4
Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands.
5
Department of Paediatric Rheumatology and Immunology, University Children's Hospital Muenster, Muenster, Germany.
6
Department of Paediatric Rheumatology, Reade, Amsterdam.
7
Department of Paediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.

Abstract

OBJECTIVE:

To study two neutrophil activation markers, myeloid-related protein (MRP) 8/14 and neutrophil elastase (NE), for their ability to predict treatment response and flare in patients with JIA.

METHODS:

Using samples from two cohorts (I and II), we determined MRP8/14 and NE levels of 32 (I) and 81 (II) patients with new-onset, DMARD-naïve arthritis and compared patients who responded to treatment (defined as fulfilling ≥ adjusted ACRpedi50 response and/or inactive disease) with non-responders (defined as fulfilling < adjusted ACRpedi50 response and/or active disease) at 6 and 12 months. Secondly, we compared biomarker levels of 54 (I) and 34 (II) patients with clinically inactive disease who did or did not suffer from a flare of arthritis after 6 or 12 months. Receiver operating characteristic analyses were carried out to study the predictive value of MRP8/14 and NE for treatment response and flare.

RESULTS:

For both cohorts, baseline MRP8/14 and NE levels for patients who did or did not respond to treatment were not different. Also, MRP8/14 and NE levels were not different in patients who did or did not flare. Receiver operating characteristic analysis of MRP8/14 and NE demonstrated areas under the curve <0.7 in both cohorts.

CONCLUSION:

In our cohorts, MRP8/14 and NE could not predict treatment response. Also, when patients had inactive disease, neither marker could predict flares.

KEYWORDS:

MRP8/14; S100A8/A9; biomarkers; calprotectin; disease activity; flare; juvenile idiopathic arthritis; neutrophil elastase; prediction; treatment response

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