P87

SERUM MRP 8/14 LEVELS IN PATIENTS

WITH JUVENILE IDIOPATHIC ARTHRITIS
Ganeva M., Stefanov St., Telcharova A., Mihaylova D.
Department of Rheumatology, University Children's Hospital, Sofia, Bulgaria

BACKGROUND:

Juvenile idiopathic arthritis (JIA) is the most

common chronic inflammatory joint disease in
childhood with prevalence one in 1000 children.
Assessment of disease activity in children with
JIA includes measurement of laboratory
parameters of inflammation such as the
erythrocyte sedimentation rate (ESR) or Creactive protein (CRP). Recently, the levels of
the pro-inflammatory S100 proteins, S100A8/9
(also known as calprotectin or myeloid-related
protein (MRP) 8/14), in serum have been shown
to correlate well with active joint count and
with response to treatment.

METHODS:
Samples were collected from 32 patients (23
girls and 9 boys) fulfilling the ILAR criteria for
JIA (19 oligoarthritis, 13 polyarthritis) with a
median age of 7,98 yrs. The groups were
further subdivided according to time of
diagnosis and course of disease. MRP 8/14 was
measured by Bhlmann MRP8/14 Calprotectin
ELISA kit (Bhlmann Laboratories, Switzerland).
CRP and ESR were measured as part of routine
clinical assessment. The levels of IL-6 were
measured using immunoturbidimetric assay.
Parametric tests were used for analyses.

The highest serum levels of MRP 8/14 were

observed in the polyarthritis subgroup (n=6)
with poor response to treatment 14.718.80
g/ml, followed by the polyarthritis subgroup
(n=7)
with
newly
diagnosed
disease

13.687.98 g/ml. MRP8/14 concentrations

were significantly higher in the polyarthritis
subgroup (n=6) with poor response to treatment
compared to the oligoarthritis subgroup (n=12)
with disease flare (p<0,05).
In the whole group good correlation was found
between levels of MRP8/14 and CRP (r=0.72).
Correlations
between
MRP8/14
and
ESR
(r=0.49), and MRP8/14 and IL-6 (r=0.50) were
slightly lower.
The levels of MRP 8/14 correlate well with the
number of actively inflamed joints in part of the
patients only.

MRP 8/14 Levels (mg/ml)

16
14
12
10
8

Newly diagnosed
Poor response/
Disease flare

6
4
2

JIA Patients Subgroups

Oligoarthritis

n=6

Poor response/
Disease flare

25

n=7

n=12
n=7

Newly diagnosed

40
35

RESULTS:
High serum level of MRP8/14 was observed in
23 (65.7%) of the 32 children with JIA. The
levels of MRP8/14 were significantly higher in
the polyarthritis group compared to the
oligoarthritis (p<0,05). Similarly, the levels of
CRP and IL-6 were significantly higher in
polyarthritis (p<0,05).

70

50

60
50
40

30

20

30

20

15
10
5
0

Oligoarthritis Polyarthritis

60

40

30

Oligoarthritis Polyarthritis

IL-6 (pg/ml)

CRP (mg/l)

ESR (mm/h)
45

Polyarthritis

20

10

10

0
Oligoarthritis Polyarthritis

Oligoarthritis Polyarthritis

CONCLUSION:
Highest levels of MRP8/14 were detected in the
polyarthritis group which corresponds with the
poorer prognosis of this group. A good
correlation between concentrations of MRP8/14
and CRP was observed. A longitudinal follow-up
of MRP8/14 serum levels is needed in order to
monitor the disease activity, identify patients
with higher risk for relapse, and response to
treatment in individual patients.

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