Investigation of the relationship between fecal calprotectin test and disease activity in spondyloarthritis patients and testing its use as a biomarker
Project no. 20889 · Status: Kapanmış (Yayın bekleniyor) · 2019
Summary
Background and Aims: Spondyloarthritis is a chronic, inflammatory disease group that occurs with axial / peripheral joint involvement and extra-articular involvement, seen in approximately 1% of the population. Evaluation of disease activity is very important for the treatment and follow-up of the disease. Currently, ESR and CRP are commonly used in addition to some disease activity scores to determine disease activity. However, the sensitivity and specificity of these laboratory markers in determining disease activity are not satisfactory. Calprotectin is a calcium binding protein released from macrophages and monocytes during inflammation. This molecule has recently become a laboratory marker that used frequently in the diagnosis and follow-up of inflammatory bowel diseases. Several studies conducted in SpA patients reveal intestinal inflammation suggesting that it may play a role in the pathogenesis of the diseases. In our study, we aimed to test the usefullnes of fecal calprotrotectin as a disease activity predictor in this disease group. Material and Method: A total of 100 patients, 88 of whom were diagnosed with AS according to ASAS criteria and 12 with PsA according to CASPAR criteria, admitted to the Internal Medicine and Rheumatology outpatient clinics of Ege University Faculty of Medicine between October 2019 and February 2020, were included in the study. Considering exclusion criteria, patients over 18 years of age who were not diagnosed with IBD / enteropathic arthritis and who did not have malignancy and gastrointestinal complaints (diarrhea, bloody-mucous stool, abdominal pain) were included in the study. Disease activity scores of the patients such as BASDAI, BASFI, ASDAS were calculated, CRP and ESR results were recorded from the outpatient follow-up and fecal calprotectin test was studied. In addition, patients' age, gender, disease type, disease duration, treatment, uveitis history and smoking were recorded. The correlation between fecal calprotectin levels and disease activity parameters was examined. Results: Fecal calprotectin level was found to be related with ESR level and ASDAS-ESR score, which are among the activity markers. No relationship was found with other activity scores and CRP. FK level was lower in NSAID users and smokers. Conclusion: The level of FK was considered to be inadequate to be used as a disease activity marker; since it was correlated only with ASDAS-ESR associated ESR level; not with other activity markers. Therefore, since FK levels are not attributable to disease activity, AS and PsA patients with high levels of FK should better undergo an endoscopic imaging and biopsy in order to role out the occult intestinal inflammation. Further studuies are needed to elucidate this topic.