Ann Rheum Dis doi:10.1136/ard.2006.064741

Calprotectin (a major leukocyte protein) is strongly and independently correlated to joint inflammation and damage in rheumatoid arthritis

  1. Hilde Berner Hammer (h-hammer{at}
  1. Diakonhjemmet Hospital, Norway
    1. Sigrid Ødegård
    1. Diakonhjemmet Hospital, Norway
      1. Magne K Fagerhol (magnek{at}
      1. Ullevål Hospital, Norway
        1. Robert Landewé
        1. University Hospital Maastricht, Netherlands
          1. Désirée van der Heijde
          1. University Hospital Maastricht, Netherlands
            1. Till Uhlig
            1. Diakonhjemmet Hospital, Norway
              1. Petter Mowinckel
              1. Diakonhjemmet Hospital, Norway
                1. Tore K Kvien
                1. Diakonhjemmet Hospital, Norway
                  • Published Online First 18 January 2007


                  Objective: Calprotectin is a major leukocyte protein, shown to correlate well with laboratory and clinical assessments in several inflammatory rheumatic diseases, and high amounts of calprotectin have been found in synovial fluid from patients with rheumatoid arthritis (RA). The objective of the present study was to examine correlations between calprotectin and joint damage.

                  Methods: A total of 145 patients with RA were analysed cross-sectionally with laboratory (calprotectin, CRP and ESR), clinical (28 joint counts (tender, swollen), physician global VAS, DAS28 and RA Articular Damage score (RAAD)) and radiographic (plain hand radiographs; modified Sharp’s method) measurements, at the same day.

                  Results: Calprotectin showed a highly significant correlation with measures of joint damage; modified Sharp score r=0.43 (p<0.001) and RAAD r=0.40 (p<0.001). The association with modified Sharp score and RAAD maintained after adjustment for CRP, ESR, rheumatoid factor, DAS28, sex and age in a multiple regression analysis (p=0.018 and p=0.04, respectively), while neither CRP nor ESR showed any independent associations. Highly significant correlations (p<0.001) were also found between calprotectin and both laboratory and clinical markers of inflammation.

                  Conclusion: Calprotectin was found to significantly and independently explain the variation in the radiological and clinical assessments of joint damage. Longitudinal studies are required to examine whether calprotectin may predict the progression of joint damage in RA.