Data are presented as frequency (%); *: significant as P < 0.05 represents the overall comparison among the three groups; MC: Monte Carlo Exact Test was used for comparison among the three groups; MCP: metacarpophalangeal joint; MSUS: musculoskeletal ultrasonography; PIP: proximal interphalangeal joint.
Declarations
Author contributions
NMAEMS: Conceptualization, Formal analysis, Investigation, Writing—original draft. MTYG: Conceptualization, Writing—original draft. AAMS and ASEB: Methodology, Writing—review & editing, Supervision, Validation. TFM: Methodology, Formal analysis, Investigation, Writing—review & editing, Supervision, Validation. All authors read and approved the final manuscript.
Conflicts of interest
The authors declare no conflicts of interest.
Ethical approval
The study was approved by the Tanta University Hospitals Research Ethical Committee (Approval code: 36061/11/22). This study complies with the Declaration of Helsinki (2013).
Consent to participate
Informed consent to participate in the study was obtained from all participants.
Consent to publication
Not applicable.
Availability of data and materials
The raw data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Choy E. Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis.Rheumatology (Oxford). 2012;51:v3–11. [DOI] [PubMed]
O’Neil LJ, Kaplan MJ. Neutrophils in Rheumatoid Arthritis: Breaking Immune Tolerance and Fueling Disease.Trends Mol Med. 2019;25:215–27. [DOI] [PubMed]
Ometto F, Friso L, Astorri D, Botsios C, Raffeiner B, Punzi L, et al. Calprotectin in rheumatic diseases.Exp Biol Med (Maywood). 2017;242:859–73. [DOI] [PubMed] [PMC]
de Moel EC, Rech J, Mahler M, Roth J, Vogl T, Schouffoer A, et al. Circulating calprotectin (S100A8/A9) is higher in rheumatoid arthritis patients that relapse within 12 months of tapering anti-rheumatic drugs.Arthritis Res Ther. 2019;21:268. [DOI] [PubMed] [PMC]
Hurnakova J, Zavada J, Hanova P, Hulejova H, Klein M, Mann H, et al. Serum calprotectin (S100A8/9): an independent predictor of ultrasound synovitis in patients with rheumatoid arthritis.Arthritis Res Ther. 2015;17:252. [DOI] [PubMed] [PMC]
Lu J, Yu Y, Zhu I, Cheng Y, Sun PD. Structural mechanism of serum amyloid A-mediated inflammatory amyloidosis.Proc Natl Acad Sci U S A. 2014;111:5189–94. [DOI] [PubMed] [PMC]
Ebert R, Benisch P, Krug M, Zeck S, Meißner-Weigl J, Steinert A, et al. Acute phase serum amyloid A induces proinflammatory cytokines and mineralization via toll-like receptor 4 in mesenchymal stem cells.Stem Cell Res. 2015;15:231–9. [DOI] [PubMed]
Agrawal S, Dasgupta B. Musculoskeletal ultrasonography: to keep pace with progress or be left behind?Int J Rheum Dis. 2008;11:109–17. [DOI]
Torgutalp M, Yayla ME, Eroglu DS, Dincer ABK, Yurteri EU, Okatan IE, et al. Serum Calprotectin is Indicating Clinical and Ultrasonographic Disease Activity in Rheumatoid Arthritis, even with Normal C-Reactive Protein Levels.Mediterr J Rheumatol. 2021;32:56–65. [DOI] [PubMed] [PMC]
Boissier MC, Semerano L, Challal S, Saidenberg-Kermanac’h N, Falgarone G. Rheumatoid arthritis: from autoimmunity to synovitis and joint destruction.J Autoimmun. 2012;39:222–8. [DOI] [PubMed]
Wang Q, Chen W, Lin J. The Role of Calprotectin in Rheumatoid Arthritis.J Transl Int Med. 2019;7:126–31. [DOI] [PubMed] [PMC]
De Buck M, Gouwy M, Wang JM, Van Snick J, Opdenakker G, Struyf S, et al. Structure and Expression of Different Serum Amyloid A (SAA) Variants and their Concentration-Dependent Functions During Host Insults.Curr Med Chem. 2016;23:1725–55. [DOI] [PubMed] [PMC]
Martino F, Silvestri E, Grassi W, Garlaschi G, Filippucci E, Martinoli C, et al. Sonographic and power Doppler semeiotics in musculoskeletal disorders. In: Martino F, Silvestri E, Grassi W, Garlaschi G, editors. Musculoskeletal Sonography. Milano: Springer; 2007. pp. 111–55. [DOI]
Shrivastava AK, Singh HV, Raizada A, Singh SK, Pandey A, Singh N, et al. Inflammatory markers in patients with rheumatoid arthritis.Allergol Immunopathol (Madr). 2015;43:81–7. [DOI] [PubMed]
Knijff-Dutmer E, Drossaers-Bakker W, Verhoeven A, van der Sluijs Veer G, Boers M, van der Linden S, et al. Rheumatoid factor measured by fluoroimmunoassay: a responsive measure of rheumatoid arthritis disease activity that is associated with joint damage.Ann Rheum Dis. 2002;61:603–7. [DOI] [PubMed] [PMC]
Serdaroğlu M, Cakirbay H, Değer O, Cengiz S, Kul S. The association of anti-CCP antibodies with disease activity in rheumatoid arthritis.Rheumatol Int. 2008;28:965–70. [DOI] [PubMed] [PMC]
Kastbom A, Strandberg G, Lindroos A, Skogh T. Anti-CCP antibody test predicts the disease course during 3 years in early rheumatoid arthritis (the Swedish TIRA project).Ann Rheum Dis. 2004;63:1085–9. [DOI] [PubMed] [PMC]
Shen C, Sun XG, Liu N, Mu Y, Hong CC, Wei W, et al. Increased serum amyloid A and its association with autoantibodies, acute phase reactants and disease activity in patients with rheumatoid arthritis.Mol Med Rep. 2015;11:1528–34. [DOI] [PubMed]
de Seny D, Cobraiville G, Charlier E, Neuville S, Esser N, Malaise D, et al. Acute-phase serum amyloid a in osteoarthritis: regulatory mechanism and proinflammatory properties.PLoS One. 2013;8:e66769. [DOI] [PubMed] [PMC]
Sorić Hosman I, Kos I, Lamot L. Serum Amyloid A in Inflammatory Rheumatic Disease: A Compendious Review of a Renowned Biomarker.Front Immunol. 2021;11:631299. [DOI] [PubMed] [PMC]
Hwang YG, Balasubramani GK, Metes ID, Levesque MC, Bridges SL Jr, Moreland LW. Differential response of serum amyloid A to different therapies in early rheumatoid arthritis and its potential value as a disease activity biomarker.Arthritis Res Ther. 2016;18:108. [DOI] [PubMed] [PMC]
Connolly M, Marrelli A, Blades M, McCormick J, Maderna P, Godson C, et al. Acute serum amyloid A induces migration, angiogenesis, and inflammation in synovial cells in vitro and in a human rheumatoid arthritis/SCID mouse chimera model.J Immunol. 2010;184:6427–37. [DOI] [PubMed]
Sejersen K, Eriksson MB, Larsson AO. Calprotectin as a biomarker for infectious diseases: A comparative review with conventional inflammatory markers.Int J Mol Sci. 2025;26:6476. [DOI] [PubMed] [PMC]
Hammer HB, Fagerhol MK, Wien TN, Kvien TK. The soluble biomarker calprotectin (an S100 protein) is associated to ultrasonographic synovitis scores and is sensitive to change in patients with rheumatoid arthritis treated with adalimumab.Arthritis Res Ther. 2011;13:R178. [DOI] [PubMed] [PMC]
Inciarte-Mundo J, Ramirez J, Hernández MV, Ruiz-Esquide V, Cuervo A, Cabrera-Villalba SR, et al. Calprotectin and TNF trough serum levels identify power Doppler ultrasound synovitis in rheumatoid arthritis and psoriatic arthritis patients in remission or with low disease activity.Arthritis Res Ther. 2016;18:160. [DOI] [PubMed] [PMC]
