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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.

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



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.


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.


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.


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


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

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