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- Hammer, HB, et al.
(författare)
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CALPROTECTIN, A SENSITIVE MARKER OF INFLAMMATION, IS ROBUSTLY ASSESSED IN PLASMA FROM PATIENTS WITH ESTABLISHED RA BY USE OF DIFFERENT LABORATORY METHODS
- 2022
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 81, s. 1775-1775
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Calprotectin (S100A8/S100A9, MRP8/MRP14) in plasma has been shown to be more sensitive than C-Reactive Protein (CRP) or Erythrocyte Sedimentation Rate (ESR) in reflecting inflammatory activity in patients with rheumatoid arthritis (RA).1,2ObjectivesThe present objective was to explore the robustness of laboratory examination of calprotectin by comparing the results from assessments by use of two different methods.MethodsFrozen plasma samples from a study of 177 patients with established RA initiating biologic disease modifying drugs were analysed for calprotectin levels at baseline and after 1, 2, 3, 6 and 12 months by use of either enzyme-linked immunosorbent assay (ELISA) or fluoroenzyme immunoassay (FEIA).The ELISA technique used kits from Calpro AS (Oslo, Norway) and the samples were assessed in a semi-automatic analysis machine Dynex DS2 (Dynex Technologies, Virginia, USA) at Diakonhjemmet hospital. The Calpro AS kits included all necessary buffers, cleansing solutions, enzyme substrate, standards, and controls (high and low calprotectin levels) and their protocol was used for the calprotectin assessments. The standards and controls were used as the mean of two measures, while all the patient samples were analysed as single measures.As a sub-study in NORA (a study exploring personalized medicine in RA by including several study cohorts from the Nordic countries), the same plasma samples were additionally assessed by FEIA. The FEIA technology used the EliATM calprotectin 2 wells in a Research Use Only setting on the PhadiaTM 2500 instrument (Phadia AB, Uppsala, Sweden) with a 1:50 dilution.Spearman was used for correlation assessments. To explore differences across concentration levels the baseline calprotectin levels were divided into 3 groups based on results from the Calpro AS assay (normal levels; ≤ 910 µg/L; moderately elevated; 911-2000 µg/L, highly elevated; > 2000 µg/L).ResultsA total of 917 samples from the 177 patients (mean (SD) age 52.9 (13) years, disease duration 10 years (ranging from a few months to 46 years), 81% women, 78% anti-CCP IgG positive and 81% RF IgM positive) were included. The median of the correlation coefficients between the two methods at the six visits was 0.96 (range 0.91-0.97). Correlations were very high for normal levels (0.91) but somewhat lower for moderate and highly elevated levels (0.85 and 0.79, respectively). There were no significant differences between the associations depending on age, sex, or disease duration, nor on the anti-CCP IgG and RF IgM status of the patient.ConclusionThe present study supports the robustness of calprotectin analyses, showing similar results across two different analytical methods, and that the concentrations were not influenced by demographic or immunological variables. Being a robust and more sensitive marker of inflammation than the commonly used CRP and ESR, calprotectin analyses should be available for assessments of RA patients in routine clinical care.References[1]Hammer, H.B., et al., Calprotectin (a major leucocyte protein) is strongly and independently correlated with joint inflammation and damage in rheumatoid arthritis. Ann Rheum Dis, 2007. 66(8): p. 1093-7.[2]Hilde Haugedal Nordal HH et al. Calprotectin (S100A8/A9) has the strongest association with ultrasound-detected synovitis and predicts response to biologic treatment: results from a longitudinal study of patients with established rheumatoid arthritis Arthritis Research & Therapy (2017) 19:3Disclosure of InterestsHilde Berner Hammer Speakers bureau: AbbVie, Lilly and Novartis, Sigve Lans Pedersen: None declared, Isabel Gehring: None declared, Linda Mathsson-Alm: None declared, Joe Sexton: None declared, Johan Askling Grant/research support from: AbbVie, AstraZeneca, Bristol Myers Squibb, Eli Lilly, Janssen, Merck, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB
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- Larsen, LB, et al.
(författare)
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New ice core evidence for a volcanic cause of the A.D. 536 dust veil
- 2008
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Ingår i: Geophysical Research Letters. ; 35:L04708
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Tidskriftsartikel (refereegranskat)abstract
- New and well-dated evidence of sulphate deposits in Greenland and Antarctic ice cores indicate a substantial and extensive atmospheric acidic dust veil at A.D. 533–534 ± 2 years. This was likely produced by a large explosive, near equatorial volcanic eruption, causing widespread dimming and contributing to the abrupt cooling across much of the Northern Hemisphere known from historical records and tree-ring data to have occurred in A.D. 536. Tree-ring data suggest that this was the most severe and protracted short-term cold episode across the Northern Hemisphere in the last two millennia, even surpassing the severity of the cold period following the Tambora eruption in 1815.
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- Stevens, D, et al.
(författare)
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PLASMA CALPROTECTIN WAS ASSESSED IN MULTIPLE BIOLOGICAL TREATMENT STRATEGIES FOR EARLY RHEUMATOID ARTHRITIS
- 2022
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 81, s. 515-515
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Plasma calprotectin is a sensitive inflammatory marker in patients with rheumatoid arthritis (RA) and reflects activation of granulocytes and macrophages. Plasma calprotectin has not previously been studied in a head-to-head trial of multiple biological mechanisms of action versus active conventional therapy (ACT) with methotrexate and prednisolone.ObjectivesTo assess the effect of treatment on plasma calprotectin levels in patients with early RA by determining the 24-week change in the four arms of the NORD-STAR Study, a large multicenter randomized head-to-head clinical trial of ACT versus tumor necrosis factor inhibition, T-cell co-stimulation inhibition, and interleukin-6 inhibition (1).MethodsCalprotectin was analyzed in plasma samples at baseline, week 4 and week 24 from 400 treatment naïve patients with early RA in the NORD-STAR Study. Samples were analyzed using a calprotectin ELISA alkaline phosphatase (ALP) kit from CalproLab (Oslo, Norway) in a Dynex DS2 processing system (normal levels <910 µg/L). Patients were assessed by clinical (CRP, 28 SJC/TJC, physician global) and patients’ reported assessments. Crude and adjusted linear regression analyses were performed in R 4.0.3 with calprotectin levels at week 24 as the outcome. The four arms were represented by three dummy variables. The adjustment variables were age, sex, anti-CCP status and country. Both analyses were adjusted for baseline calprotectin levels.ResultsAt baseline, the mean time since diagnosis was 15.7 days (SD) (22.9), mean age 53.7 (15.0) years, ACPA positive 81%, and female 66%. Mean calprotectin levels were 1931 (1495) µg/L at baseline, 866 (951) µg/L at week 4, and 629 (661) µg/L at week 24. At baseline, normal calprotectin levels (<910 µg/L) were observed in 27% of all patients (ACT 22%, certolizumab-pegol and methotrexate 30%, abatacept and methotrexate 25%, tocilizumab and methotrexate 31%). At week 24, normal calprotectin levels were observed in 82% of all patients (ACT 68%, certolizumab-pegol and methotrexate 91%, abatacept and methotrexate 80%, tocilizumab and methotrexate 90%).Observed calprotectin levels at week 24 were significantly lower in patients treated with certolizumab-pegol and methotrexate -336µg/L (97) (p< 0.006) or tocilizumab and methotrexate -284 (99) (p < 0.004), versus ACT when adjusted for age, sex, anti-CCP status, baseline calprotectin level, and country; however, a significant difference was not observed in patients treated with abatacept and methotrexate -110 (96) (p = 0.25). The Figure 1 shows the average percentage change in calprotectin levels from baseline to week 24 for all treatment groups.Figure 1.Average percentage change in calprotectin levels from baseline to week 24. ACT: active conventional therapy, CZP+MTX: certolizumab-pegol and methotrexate, ABA+MTX: abatacept and methotrexate, TCZ+MTX: tocilizumab and methotrexate.ConclusionCalprotectin, a sensitive biomarker of inflammation, normalized in the majority of patients. The decline differed between treatment groups and was largest in patients treated with a TNF inhibitor and methotrexate, suggesting that calprotectin reflects the activity of specific inflammatory pathways rather than overall inflammation. The findings of this study should be further explored.References[1]Hetland ML, et. al., Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial. BMJ. 2020 Dec 2;371:m4328. doi: 10.1136/bmj.m4328. PMID: 33268527; PMCID: PMC7708829.AcknowledgementsI would like to acknowledge the NORD-STAR Study group.Disclosure of InterestsDavid Stevens: None declared, Marte Heiberg: None declared, Amirhossein Kazemi: None declared, Ronald van Vollenhoven: None declared, Jon Lampa: None declared, Anna Rudin: None declared, Kristina Lend: None declared, Merete Lund Hetland: None declared, Mikkel Østergaard: None declared, Michael Nurmohamed: None declared, Kim Hørslev-Petersen: None declared, Dan Nordström Consultant of: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Björn Gudbjornsson: None declared, Till Uhlig: None declared, Espen A Haavardsholm: None declared, Hilde Berner Hammer Speakers bureau: AbbVie, Novartis, and Lilly.
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