Calprotectin, an available prognostic biomarker in systemic sclerosis: a systematic review
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REVIEW ARTICLE
Calprotectin, an available prognostic biomarker in systemic sclerosis: a systematic review Bahareh Ebrahimi 1 & MohamadAli Nazarinia 1,2 & Mina Molayem 1 Received: 17 August 2020 / Revised: 1 October 2020 / Accepted: 5 October 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Background Finding easier and less invasive biologic biomarker in the clinical specimen of systemic sclerosis (SSc) patients can be effective in diagnosing and treating SSc-associated multisystem diseases. The complex of S100A8 and S100A9 (Calprotectin) is an easily available prognostic biomarker that secretes from immune cells and is necessary for initiating the immune response to noninfectious inflammation processes. The present study aims to evaluate the effectiveness of Calprotectin in specimen of SSc patients. We reviewed the evidence for Calprotectin in diagnostic and prognostic of SSc patients. Methods This systematic review was done to identify studies on “Calprotectin” within “SSc” patients. PubMed, Web of knowledge, and Scopus were searched for this purpose. A standardized form was used to extract diseases, sample size, biomarkers identified, source of biomarker, and its effects. Results Overall, the 16 articles selected show that the main sources of Calprotectin were plasma, bronchoalveolar lavage fluid, and especially stool. Conclusion The best source of Calprotectin was fecal Calprotectin that could show the inflammation and small intestinal bacterial overgrowth (SIBO) on SSc patients. Also, the most arguable source is plasma because of its low sample size. Comparing the Calprotectin level in different rheumatic diseases showed the specificity of fecal Calprotectin for SSc disease. Nevertheless, it has to be noted that Calprotectin correlates with some other factors such as age, PIP drug, and nonsteroidal anti-inflammatory drugs. Keywords Calgranulin . Calprotectin . SSc . Stool . Systemic sclerosis
Introduction Systemic sclerosis (SSc) is a connective tissue chronic syndrome with unknown etiology. This autoimmune disease is characterized by skin and tissue fibrosis, vasculopathy, and internal organs dysfunction [1–3]. Polymorphonuclear leukocytes (PMNs, neutrophils) and their products take a role in this process [4, 5]. Fibrosis of the organs, the cumulative effects of environmental factors such as viral or bacterial infections, and toxic agents in genetically predisposed hosts lead to autoreactive cellular and humoral immune responses against
* MohamadAli Nazarinia [email protected] 1
Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz 71936-35899, Iran
2
Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
self-systems, which are responsible for acute and chronic organ damage [4–6]. SSc is a highly variable life-threatening multisystem disease. Therefore characterizing patients and understanding their manifestations and the level of their illness is vital because early organ involvement therapy before irreversi
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