AMT is a viable option in the treatment of nonhealing corneal ulcers of various depth and etiologies. Perforations up to 3 mm can be safely managed by fibrin glue and AMT. These techniques lead to rapid reconstruction of the corneal surface and can give a good final functional result or allow keratoplasty to be done in more favorable conditions.
Introduction
In the management of juvenile idiopathic arthritis (JIA), there is a
lack of diagnostic and prognostic biomarkers. This study assesses the
use of serum calprotectin (sCal) as a marker to monitor disease
activity, and as a classification and prognosis tool of response to
treatment or risk of flares in patients with JIA.
Methods
Eighty-one patients with JIA from the CAP48 multicentric cohort were
included in this study, as well as 11 non-paediatric healthy controls.
An ELISA method was used to quantify sCal with a commercial
kit.
Results
Patients with an active disease compared with healthy controls and
with patients with inactive disease showed an eightfold and a twofold
increased level of sCal, respectively. sCal was found to be correlated
with the C-reactive protein (CRP) and even more strongly with the
erythrocyte sedimentation rate. Evolution of DAS28 scores correlated
well with evolution of sCal, as opposed to evolution of CRP. With regard
to CRP, sCal could differentiate forms with active oligoarthritis from
polyarthritis and systemic forms. However, sCal brought an added value
compared with the CRP as a prognosis marker. Indeed, patients with
active disease and reaching minimal disease activity (according to
Juvenile Arthritis Disease Activity Score) at 6 months following the
test had higher sCal levels, while patients with inactive disease had
higher sCal levels if a flare was observed up to 3–9 months following
the test.
Conclusions
This study confirms the potential uses of sCal as a biomarker in the
diagnosis and follow-up of JIA.
BackgroundManagement of juvenile idiopathic arthritis (JIA) lacks of diagnostic and prognostic biomarkers. Therefore, this study was designed to assess the use of serum calprotectin (sCal) as a marker of disease activity and its monitoring, and as a classification and prognosis tool of response to treatment or risk of flares in patients with JIA. MethodsEighty-one patients with JIA from the CAP48 multicentric cohort were included in this study, as well as 11 healthy controls. Enzyme-linked immunosorbent assay (ELISA) method was used to quantify sCal with a commercial kit. Mann-Whitney tests were used to compare results, correlations were assessed with Spearman’s rank correlation coefficients and Receiver Operating Characteristic curves were also generated to evaluate serum calprotectin as a prognostic tool.ResultsPatients with an active disease compared to healthy controls and to patients with inactive disease showed an 8-fold and a 2-fold increased level of sCal respectively. sCal was found to be correlated with the CRP and even more strongly with the ESR. Evolution of DAS28 scores correlated well with evolution of sCal, as opposed to evolution of CRP. As for the CRP, sCal could differentiate forms with active oligoarthritis from polyarthritis or systemic forms. However, sCal brought an added value compared to the CRP as a prognosis marker. Indeed, patients with active disease and good responder to treatment (pediACR > 30) at 6 months following the sample test had higher sCal levels, while patients with inactive disease had higher sCal levels in case a flare was observed up to 3 to 9 months following the sample test.ConclusionsThis study confirms the potential uses of serum calprotectin as a biomarker in diagnosis and follow-up in JIA.
IntroductionIn the management of juvenile idiopathic arthritis (JIA), there is a lack of diagnostic and prognostic biomarkers. This study assesses the use of serum calprotectin (sCal) as a marker to monitor disease activity, and as a classification and prognosis tool of response to treatment or risk of flares in patients with JIA. MethodsEighty-one patients with JIA from the CAP48 multicentric cohort were included in this study, as well as 11 non-pediatric healthy controls. An enzyme-linked immunosorbent assay (ELISA) method was used to quantify sCal with a commercial kit.ResultsPatients with an active disease compared to healthy controls and to patients with inactive disease showed an 8-fold and a 2-fold increased level of sCal respectively. sCal was found to be correlated with the CRP and even more strongly with the ESR. Evolution of DAS28 scores correlated well with evolution of sCal, as opposed to evolution of CRP. With regard to CRP, sCal could differentiate forms with active oligoarthritis from polyarthritis and systemic forms. However, sCal brought an added value compared to the CRP as a prognosis marker. Indeed, patients with active disease and reaching minimal disease activity (according to JADAS) at 6 months following the test had higher sCal levels, while patients with inactive disease had higher sCal levels if a flare was observed up to 3 to 9 months following the test.ConclusionsThis study confirms the potential uses of serum calprotectin as a biomarker in the diagnosis and follow-up of JIA.
BackgroundJuvenile idiopathic arthritis (JIA) represents a very heterogeneous disease, and our objectives were to describe the first Belgian cohort of children with JIA, assess their disease characteristics and outcome and identify potential markers of prognosis.MethodsThe CAP48 cohort is a multicentric observational study of children with a recent or well-established diagnosis of JIA (naïve or not to treatment at baseline), evaluated every 6 months during a follow-up of 5 to 10 years.ResultsThere were 125 children included in the cohort, composed of 25 naïve and 100 established patients. The patients had a median age of 6.2 and 4.2 years at onset in the naïve and established cohort respectively, with a predominance of female. All subtypes of JIA were represented in both cohorts. The mean DAS28-CRP and JADAS10-CRP at baseline in naïve patients was 2.52 and 6.0 respectively. Uveitis occurred in 19% of patients and was strongly associated with presence of antinuclear antibodies (odds ratio of 6). Fifty-five percent of naïve patients were in remission at 12 months of follow-up according to the ACR criteria and JADAS10 scores, in contrast with 100% achieving DAS28 remission. ConclusionThis first cohort study in Belgium allowed to compare its data to other existing cohorts and to evaluate quality of care in Belgian French-speaking hospitals. Additionally, it highlighted a superiority of JADAS10 over DAS28 to monitor and evaluate remission in JIA. This study also underlined a need for more accurate markers of prognosis to improve treatment and long-term outcomes.
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