Calprotectin, an available prognostic biomarker in systemic sclerosis: a systematic review

Clin Rheumatol. 2021 May;40(5):1709-1715. doi: 10.1007/s10067-020-05446-0. Epub 2020 Oct 12.


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.

Publication types

  • Systematic Review

MeSH terms

  • Biomarkers
  • Calgranulin A
  • Feces
  • Humans
  • Leukocyte L1 Antigen Complex*
  • Prognosis
  • Scleroderma, Systemic* / diagnosis


  • Biomarkers
  • Calgranulin A
  • Leukocyte L1 Antigen Complex