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Goode AP, Cleveland RJ, Kraus VB, Taylor KA, George SZ, Schwartz TA, Renner J, Huebner JL, Jordan JM, Golightly YM. Biomarkers and longitudinal changes in lumbar spine degeneration and low back pain: the Johnston County Osteoarthritis Project. Osteoarthritis Cartilage 2023; 31:809-818. [PMID: 36804589 PMCID: PMC10200763 DOI: 10.1016/j.joca.2023.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 02/07/2023] [Accepted: 02/12/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To determine if baseline biomarkers are associated with longitudinal changes in the worsening of disc space narrowing (DSN), vertebral osteophytes (OST), and low back pain (LBP). DESIGN Paired baseline (2003-2004) and follow-up (2006-2010) lumbar spine radiographs from the Johnston County Osteoarthritis Project were graded for severity of DSN and OST. LBP severity was self-reported. Concentrations of analytes (cytokines, proteoglycans, and neuropeptides) were quantified by immunoassay. Pressure-pain threshold (PPT), a marker of sensitivity to pressure pain, was measured with a standard dolorimeter. Binary logistic regression models were used to estimate odd ratios (OR) and 95% confidence intervals (CI) of biomarker levels with DSN, OST, or LBP. Interactions were tested between biomarker levels and the number of affected lumbar spine levels or LBP. RESULTS We included participants (n = 723) with biospecimens, PPT, and paired lumbar spine radiographic data. Baseline Lumican, a proteoglycan reflective of extracellular matrix changes, was associated with longitudinal changes in DSN worsening (OR = 3.19 [95% CI 1.22, 8.01]). Baseline brain-derived neuropathic factor, a neuropeptide, (OR = 1.80 [95% CI 1.03, 3.16]) was associated with longitudinal changes in OST worsening, which may reflect osteoclast genesis. Baseline hyaluronic acid (OR = 1.31 [95% CI 1.01, 1.71]), indicative of systemic inflammation, and PPT (OR = 1.56 [95% CI 1.02, 2.31]) were associated with longitudinal increases in LBP severity. CONCLUSION These findings suggest that baseline biomarkers are associated with longitudinal changes occurring in structures of the lumbar spine (DSN vs OST). Markers of inflammation and perceived pressure pain sensitivity were associated with longitudinal worsening of LBP.
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Affiliation(s)
- A P Goode
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA.
| | - R J Cleveland
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
| | - V B Kraus
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke Department of Medicine, Duke University, NC, USA.
| | - K A Taylor
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
| | - S Z George
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University, Durham, NC, USA.
| | - T A Schwartz
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - J Renner
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina, Chapel Hill, NC, USA.
| | - J L Huebner
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
| | - J M Jordan
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA; Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Y M Golightly
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.
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Betzler BK, Ng FYC, Huang Y, Bin Abd Razak HR. The Prevalence of Coexisting Lumbar Spondylosis and Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Asian Spine J 2022; 16:839-847. [PMID: 35421911 PMCID: PMC9827201 DOI: 10.31616/asj.2021.0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/02/2021] [Indexed: 01/11/2023] Open
Abstract
STUDY DESIGN A systematic review. PURPOSE This study aimed to evaluate the prevalence of coexisting lumbar spondylosis (LS) and knee osteoarthritis (KOA), which has clinical implications on the screening, diagnosis, and management of orthopedic patients. OVERVIEW OF LITERATURE Due to current global health trends, the number of affected patients is expected to increase substantially. However, no prior systematic reviews have discussed this topic. METHODS A systematic literature search was conducted in June 2021 in the PubMed, Embase, Scopus, CINAHL, and Cochrane CENTRAL databases. Clinical and epidemiological studies that reported quantitative data on the prevalence of coexisting LS and KOA were included. Studies which reported data on only LS or KOA alone were excluded. Odds ratios (ORs) and 95% confidence intervals (CI) for LS or KOA were retrieved or calculated for meta-analysis. Fixed-effects and random-effects models were used, and statistical significance was considered when p<0.05. Heterogeneity was evaluated using Cochran's Q test and the I2 statistic. Risk of bias was assessed using the MINORs (methodological index for nonrandomized studies) criteria. RESULTS This review included nine studies (5,758 patients). Four studies (4,164 patients) defined KOA and LS by a Kellgren-Lawrence (KL) grade of ≥2 and were included in the meta-analysis. Two other studies defined KOA and LS by a joint space narrowing grade of ≥2. The remaining three studies reported other outcomes. The combined ORs of having KOA of KL grade ≥2 due to LS was 1.75 (95% CI, 1.22-2.50; p=0.002), while the combined OR of having LS of KL grade ≥2 due to KOA was 1.84 (95% CI, 1.23-2.77; p=0.003). CONCLUSIONS In patients with either KOA or LS, the odds of having a concurrent knee-spine presentation are significantly increased. This may have implications for clinical decision-making and treatment strategies. Further high-level studies with larger patient populations are required to confirm these results in specific populations.
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Affiliation(s)
- Brjan Kaiji Betzler
- Lee Kong Chian School of Medicine, Nanyang Technological University,
Singapore
| | - Faye Yu Ci Ng
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
| | - Yilun Huang
- Department of Orthopaedic Surgery, Sengkang General Hospital,
Singapore
| | - HR Bin Abd Razak
- Department of Orthopaedic Surgery, Sengkang General Hospital,
Singapore,SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme,
Singapore
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Goode AP, Hu D, George SZ, Schwartz TA, Kraus VB, Huebner JL, Cleveland RJ, Taylor KA, Jordan JM, Golightly YM. Biomarker clusters differentiate phenotypes of lumbar spine degeneration and low back pain: The Johnston County Osteoarthritis Project. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100270. [PMID: 35991624 PMCID: PMC9387345 DOI: 10.1016/j.ocarto.2022.100270] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/11/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Describe the association between biomarkers and lumbar spine degeneration (vertebral osteophytes [OST], facet joint osteoarthritis [FOA], and disc space narrowing [DSN]), for persons with and without low back pain (LBP) and determine whether clusters based on biomarkers differentiate lumbar spine structure with and without LBP. Methods Using data from the Johnston County Osteoarthritis Project (2006-2010), we measured serum N-cadherin, Keratin-19, Lumican, CXCL6, RANTES, HA, IL-6, BDNF, OPG, and NPY, and urinary CTX-II. Biomarkers were used to group participants using k-means cluster analysis. Logistic regression models were used to compare biomarker clusters. Results The sample consisted of 731 participants with biospecimens and lumbar spine radiographic data. Three biomarker subgroups were identified: one characterized by structural degenerative changes; another characterized by structural degenerative changes and inflammation, with pain; and a referent cluster with lower levels of biomarkers, pain, and structural degenerative changes. Compared to the referent subgroup, the structural change subgroup was associated with DSN (OR = 1.94, 95% CI 1.30-2.90) and FOA (OR = 1.72, 95% CI 1.12-2.62), and the subgroup with structural degenerative change, inflammation, and pain was associated with OST with LBP (OR = 1.60, 95% CI 1.04-2.46), FOA with LBP (OR = 1.59, 95% CI 1.04-2.45), and LBP (OR = 1.63, 95% CI 1.11-2.41). The subgroup with structural degenerative changes was more likely to have OST (OR = 1.82, 95% CI 1.06-3.13) and less likely to have FOA with LBP (OR = 0.62, 95% CI 0.40-0.96) compared to the group with inflammation and pain. Conclusion Clustering by biomarkers may assist in differentiating patients for specific clinical interventions aimed at decreasing LBP.
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Affiliation(s)
- Adam P. Goode
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - David Hu
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Steven Z. George
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Todd A. Schwartz
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Virginia B. Kraus
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, NC, USA
| | - Janet L. Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Rebecca J. Cleveland
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Kenneth A. Taylor
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Joanne M. Jordan
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Yvonne M. Golightly
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA
- Division of Physical Therapy, University of North Carolina, Chapel Hill, NC, USA
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Zhang S, Liu W, Chen S, Wang B, Wang P, Hu B, Lv X, Shao Z. Extracellular matrix in intervertebral disc: basic and translational implications. Cell Tissue Res 2022; 390:1-22. [DOI: 10.1007/s00441-022-03662-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/23/2022] [Indexed: 02/06/2023]
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Ishijima M, Nakamura T, Shimizu K, Hayashi K, Kikuchi H, Soen S, Omori G, Yamashita T, Uchio Y, Chiba J, Ideno Y, Kubota M, Kaneko H, Kurosawa H, Kaneko K. Different changes in the biomarker C-terminal telopeptides of type II collagen (CTX-II) following intra-articular injection of high molecular weight hyaluronic acid and oral non-steroidal anti-inflammatory drugs in patients with knee osteoarthritis: a multi-center randomized controlled study. Osteoarthritis Cartilage 2022; 30:852-861. [PMID: 35331859 DOI: 10.1016/j.joca.2022.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES We previously reported, based on a multicenter randomized-control study, that the efficacy of intra-articular injections of hyaluronic acid (IA-HA) was not inferior to that of oral non-steroidal anti-inflammatory drugs (NSAIDs) in patients with knee osteoarthritis (OA). However, the molecular effects on the pathophysiology of knee OA remain unclear. C-terminal telopeptides of type II collagen (CTX-II) is reported to primarily originate from the interface between articular cartilage and subchondral bone, which is a site of potential remodeling in OA. We performed a predefined sub-analysis of the previous study to compare the changes of urinary CTX-II (uCTX-II) in response to IA-HA to those in response to NSAID for knee OA. DESIGN A total of 200 knee OA patients were registered from 20 hospitals and randomized to receive IA-HA (2,700 kDa HA, 5 times at 1-week intervals) or NSAID (loxoprofen sodium, 180 mg/day) for 5 weeks. The uCTX-II levels were measured before and after treatment. RESULTS The uCTX-II levels were significantly increased by IA-HA treatment (337.7 ± 193.8 to 370.7 ± 234.8 ng/μmol Cr) and were significantly reduced by NSAID treatment (423.2 ± 257.6 to 370.3 ± 250.9 ng/μmol Cr). The %changes of uCTX-II induced by IA-HA (11.6 ± 29.5%) and NSAID (-9.0 ± 26.7%) was significantly different (between-group difference: 20.6, 95% confidence intervals: 10.6 to 30.6). CONCLUSIONS While both IA-HA and NSAID improved symptoms of knee OA, uCTX-II levels were increased by IA-HA and reduced by NSAIDs treatment, suggesting these treatments may improve symptoms of knee OA through different modes of action.
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Affiliation(s)
- M Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - T Nakamura
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, Fukuoka, Japan.
| | - K Shimizu
- Department of Orthopaedic Surgery, Gifu University, School of Medicine, Gifu, Japan.
| | - K Hayashi
- Department of Laboratory Sciences, School of Health Sciences, Faculty of Medicine, Gunma University, Gunma, Japan.
| | - H Kikuchi
- Department of Orthopaedic Surgery, Kinki University Sakai Hospital, Osaka, Japan.
| | - S Soen
- Department of Orthopaedic Surgery and Rheumatology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan; Department of Laboratory Sciences, School of Health Sciences, Faculty of Medicine, Gunma University, Gunma, Japan.
| | - G Omori
- Center of Transdisciplinary Research, Institute for Research Promotion, Niigata University, Niigata, Japan.
| | - T Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan.
| | - Y Uchio
- Department of Orthopaedic Surgery, Faculty of Medicine, Shimane University School of Medicine, Shimane, Japan.
| | - J Chiba
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan.
| | - Y Ideno
- Center of Mathematics and Data Sciences, Gunma University, Maebashi, Japan.
| | - M Kubota
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - H Kaneko
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - H Kurosawa
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - K Kaneko
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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Zou Z, Luo X, Chen Z, Zhang YS, Wen C. Emerging microfluidics-enabled platforms for osteoarthritis management: from benchtop to bedside. Theranostics 2022; 12:891-909. [PMID: 34976219 PMCID: PMC8692897 DOI: 10.7150/thno.62685] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/17/2021] [Indexed: 11/12/2022] Open
Abstract
Osteoarthritis (OA) is a prevalent debilitating age-related joint degenerative disease. It is a leading cause of pain and functional disability in older adults. Unfortunately, there is no cure for OA once the damage is established. Therefore, it promotes an urgent need for early detection and intervention of OA. Theranostics, combining therapy and diagnosis, emerges as a promising approach for OA management. However, OA theranostics is still in its infancy. Three fundamental needs have to be firstly fulfilled: i) a reliable OA model for disease pathogenesis investigation and drug screening, ii) an effective and precise diagnostic platform, and iii) an advanced fabrication approach for drug delivery and therapy. Meanwhile, microfluidics emerges as a versatile technology to address each of the needs and eventually boost the development of OA theranostics. Therefore, this review focuses on the applications of microfluidics, from benchtop to bedside, for OA modelling and drug screening, early diagnosis, and clinical therapy. We first introduce the basic pathophysiology of OA and point out the major unfilled research gaps in current OA management including lack of disease modelling and drug screening platforms, early diagnostic modalities and disease-modifying drugs and delivery approaches. Accordingly, we then summarize the state-of-the-art microfluidics technology for OA management from in vitro modelling and diagnosis to therapy. Given the existing promising results, we further discuss the future development of microfluidic platforms towards clinical translation at the crossroad of engineering and biomedicine.
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Affiliation(s)
- Zhou Zou
- Department of Biomedical Engineering, Faculty of Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaohe Luo
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Zhengkun Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Currently at Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Yu Shrike Zhang
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts 02139, United States
| | - Chunyi Wen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
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Ye Z, Zhao S, Liu Z. Prevention of lumbar disc degeneration through co-manipulation of insulin-like growth factor 1 and vascular endothelial growth factor. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1572. [PMID: 34790778 PMCID: PMC8576649 DOI: 10.21037/atm-21-4977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022]
Abstract
Background Associated with abnormal angiogenesis and disc dysfunction, lumbar disc degeneration (LDD) appears to be an important disease suffered by elderly people. Previous studies have highlighted the importance of insufficient insulin-like growth factor 1 (IGF1) and excessive vascular endothelial growth factor (VEGF) in the development and progression of LDD, though a practical therapeutic strategy is lacking. Methods The expression of IGF1 and VEGF was assessed in LDD specimens compared to normal disc tissue as a control. A gene therapy approach was performed, in which an adeno-associated virus (AAV) carrying both IGF1 and shVEGF (AAV-IGF1/shVEGF) was orthotopically injected to the rats that had undergone LDD. The alterations in IGF1 and VEGF levels in the treated disc tissue were confirmed by immunohistochemistry. The outcome of this therapy was assessed by disc cell death using an annexin V-FITC assay and by assessing lumbar proteoglycan and collagen II levels using ELISA. Results IGF1 expression was significantly downregulated in LDD, while VEGF expression was significantly upregulated in LDD, compared to normal controls. Combined AAV-IGF1/shVEGF treatment simultaneously corrected the insufficient IGF1 and the excessive VEGF in LDD rats. Moreover, AAV-IGF1/shVEGF significantly reduced disc cell death in the vertebral pulp and annulus fibrosus and significantly enhanced the lumbar proteoglycan and collagen II levels. Conclusions The simultaneous increase in IGF1 and depletion of VEGF effectively prevented the development of LDD, suggesting its potential as a novel therapeutic approach for LDD which is clinically translatable.
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Affiliation(s)
- Zuozhou Ye
- Department of Orthopedics, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Shan Zhao
- Department of Orthopedics, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Zuoqing Liu
- Department of Orthopedics, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
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Tucci M, Wilson GA, McGuire R, Benghuzzi HA. The Effects of NPY1 Receptor Antagonism on Intervertebral Disc and Bone Changes in Ovariectomized Rats. Global Spine J 2021; 11:1166-1175. [PMID: 32748636 PMCID: PMC8453679 DOI: 10.1177/2192568220939908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
STUDY DESIGN Basic science. OBJECTIVE To compare the effects of a neuropeptide Y1 receptor antagonist (NPY-1RA) to estrogen on maintaining vertebral bone microarchitecture and disc height in a rat model of menopause. METHODS This study was an institutional animal care approved randomized control study with 104 ovariectomized rats and 32 intact control animals. Comparison of disc height, trabecular bone, body weights, circulating levels of NPY and estrogen, and distribution of Y1 receptors in the intervertebral disc in an established rodent osteoporotic model were made at baseline and after 2, 4, and 8 weeks after receiving either an implant containing estrogen or an antagonist to the neuropeptide Y1 receptor. Data was compared statistically using One-way analysis of variance. RESULTS Circulating levels of estrogen increased and NPY decreased following estrogen replacement, with values comparable to ovary-intact animals. NPY-1RA-treated animals had low estrogen and high NPY circulating levels and were similar to ovariectomized control rats. Both NPY-1RA and estrogen administration were able reduce, menopause associated weight gain. NPY-1RA appeared to restore bone formation and maintain disc height, while estrogen replacement prevented further bone loss. CONCLUSION NPY-1RA in osteoporotic rats activates osteoblast production of bone and decreased marrow and body fat more effectively than estrogen replacement when delivered in similar concentrations. Annulus cells had NPY receptors, which may play a role in disc nutrition, extracellular matrix production, and pain signaling cascades.
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Affiliation(s)
- Michelle Tucci
- University of Mississippi Medical Center, Jackson, MS, US,Michelle Tucci, Department of Anesthesiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | | | - Robert McGuire
- University of Mississippi Medical Center, Jackson, MS, US
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A Study on COMP and CTX-II as Molecular Markers for the Diagnosis of Intervertebral Disc Degeneration. BIOMED RESEARCH INTERNATIONAL 2021; 2021:3371091. [PMID: 34395611 PMCID: PMC8357479 DOI: 10.1155/2021/3371091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/07/2021] [Accepted: 07/24/2021] [Indexed: 12/19/2022]
Abstract
Background Diagnosis of intervertebral disc degeneration (IVDD) is challenging at the early stage. The cartilage oligomeric matrix protein (COMP) and extracellular matrix degradation products of C-telopeptide of type II collagen (CTX-II) serve as markers for the serological diagnosis of IVDD. Oxidative stress might cause IVDD and matrix degeneration. Methods A total of 128 male adult Sprague–Dawley (SD) rats were randomly and equally assigned to the experimental and control groups. The experimental group was used to construct IVDD models by acupuncture, while the control group underwent sham operation. The animals were executed every week for 8 weeks after intervertebral disc acupuncture, and serum samples were collected for the estimation of CTX-II and COMP concentrations by enzyme-linked immunosorbent assay (ELISA). Also, the histological changes and caudal magnetic resonance imaging (MRI) changes were examined in the intervertebral disc. Results IVDD in rats worsened with prolonged follow-up after acupuncture. At all the time points, the experimental group showed altered histological and caudal vertebra MRI signals, and serum CTX-II and COMP concentrations were significantly greater than those of the control group. These levels increase with the process of IVDD. Conclusion Serum CTX-II and COMP estimation is a reliable method to diagnose IVDD, and their concentrations show a positive correlation with the process of IVDD.
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Hou Y, Shi G, Guo Y, Shi J. Epigenetic modulation of macrophage polarization prevents lumbar disc degeneration. Aging (Albany NY) 2020; 12:6558-6569. [PMID: 32310825 PMCID: PMC7202517 DOI: 10.18632/aging.102909] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 02/05/2020] [Indexed: 12/25/2022]
Abstract
Inflammation plays an essential role in the development of lumbar disc degeneration (LDD), although the exact effects of macrophage subtypes on LDD remain unclear. Based on previous studies, we hypothesized that M2-polarization of local macrophages and simultaneous suppression of their production of fibrotic transforming growth factor beta 1 (TGFβ1) could inhibit progression of LDD. Thus, we applied an orthotopic injection of adeno-associated virus (AAV) carrying shRNA for DNA Methyltransferase 1 (DNMT1) and/or shRNA for TGFβ1 under a macrophage-specific CD68 promoter to specifically target local macrophages in a mouse model for LDD. We found that shDNMT1 significantly reduced levels of the pro-inflammatory cytokines TNFα, IL-1β and IL-6, significantly increased levels of the anti-inflammatory cytokines IL-4 and IL-10, significantly increased M2 macrophage polarization, significantly reduced cell apoptosis in the disc degeneration zone and significantly reduced LDD-associated pain. The anti-apoptotic and anti-pain effects were further strengthened by co-application of shTGFβ1. Together, these data suggest that M2 polarization of macrophages induced by both epigenetic modulation and suppressed production and release of TGFβ1 from polarized M2 macrophages, may have a demonstrable therapeutic effect on LDD.
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Affiliation(s)
- Yang Hou
- Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Guodong Shi
- Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Yongfei Guo
- Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Jiangang Shi
- Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
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Garnero P, Sornay-Rendu E, Chapurlat R. The cartilage degradation marker, urinary CTX-II, is associated with the risk of incident total joint replacement in postmenopausal women. A 18 year evaluation of the OFELY prospective cohort. Osteoarthritis Cartilage 2020; 28:468-474. [PMID: 31982562 DOI: 10.1016/j.joca.2019.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/06/2019] [Accepted: 12/31/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Identifying objective risk-indicators for total joint replacement (TJR) is useful to enrich population at high risk in OA clinical trials. We investigate the association of urinary CTX-II, a biochemical marker of cartilage breakdown, with the risk of TJR. METHOD 478 postmenopausal women (mean age 65.5 ± 7.5 yr) from the OFELY cohort were studied. CTX-II, serum CTX-I (bone resorption) and PINP (bone formation), were measured at baseline. Association between CTX-II and incidence of TJR was assessed by Cox Hazard Regression. RESULTS During a median (95%CI) 17.8 (15.0-18.1) years follow-up, 38 women sustained a TJR, including hip (n = 29) or knee (n = 9) replacement. CTX-II -but not CTX-I or PINP- was higher in patients with TJR (+34%, P = 0.001 vs women with no TJR). Increased baseline CTX-II levels were associated with a higher risk of TJR with a Hazard Ratio (HR) (95 CI) of 1.45 (1.13-1.85) per 1 SD increase after adjustment for age, BMI and total hip BMD. CTX-II remained significantly associated with the risk of TJR after further adjustment for total WOMAC, prevalent knee OA (KL ≥ 2) and self-reported hip OA [HR (95 CI): 1.31 (1.01-1.71), P = 0,04]. When women were categorized as low and high CTX-II (lower and above the 95 percentile of healthy premenopausal women, respectively), subjects with high levels had an age-BMI-hip BMD adjusted HR (95 CI) of 3.00 (1.54-5.85) compared to women with low levels which remained significant after further adjustment for WOMAC, knee and/or hip OA [HR (95 CI): 2.45 (1.25-4.89), P = 0.01]. CONCLUSION CTX-II is an independent risk indicator of TJR in postmenopausal women suggesting that it may be useful to identify subjects at high risk of TJR.
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Affiliation(s)
- P Garnero
- INSERM research unit 1033-Lyos, Lyon, France.
| | | | - R Chapurlat
- INSERM research unit 1033-Lyos, Lyon, France
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12
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Rousseau JC, Millet M, Croset M, Sornay-Rendu E, Borel O, Chapurlat R. Association of circulating microRNAs with prevalent and incident knee osteoarthritis in women: the OFELY study. Arthritis Res Ther 2020; 22:2. [PMID: 31898522 PMCID: PMC6941326 DOI: 10.1186/s13075-019-2086-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022] Open
Abstract
Objectives In the context of the scarcity of biomarkers for knee osteoarthritis (OA), we examined the associations of prevalent and incident OA with the expression levels of serum miRNAs in subjects with and without OA. Methods With a next-generation sequencing approach, we compared the miRome expression of 10 women with knee OA and 10 age-matched healthy subjects. By real-time qPCR, we analyzed the expression levels of 19 miRNAs at baseline selecting 43 women with prevalent knee OA (Kellgren Lawrence score of 2/3), 23 women with incident knee OA over a 4-year follow-up and 67 healthy subjects without prevalent or incident OA matched for age and body mass index. Results Serum miR-146a-5p was significantly increased in the group of prevalent knee OA compared with controls (relative quantification (RQ); median [Interquartile range] 1.12 [0.73; 1.46] vs 0.85 [0.62; 1.03], p = 0.015). The likelihood of prevalent knee OA was significantly increased (odds ratio [95% confidence interval (CI)] 1.83 [1.21–2.77], p = 0.004) for each quartile increase in serum miR-146a-5p. The women with miR-146a-5p levels above the median (0.851) had a higher risk of prevalent knee OA compared to those below the median [95% CI] 4.62 [1.85–11.5], p = 0.001. Moreover, we found a significant association between the baseline level of serum miR-186-5p and the risk of incident knee OA (Q4 vs Q1–3; odds ratio [95% CI] 6.13 [1.14–32.9], p = 0.034). Conclusion We showed for the first time that miR-146a-5p and miR-186-5p are significantly associated with prevalent and incident knee OA, respectively.
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Affiliation(s)
| | - Marjorie Millet
- INSERM 1033, Pavillon F, Hôpital E. Herriot, 69437, Lyon Cedex 03, France
| | - Martine Croset
- INSERM 1033, Pavillon F, Hôpital E. Herriot, 69437, Lyon Cedex 03, France
| | - Elisabeth Sornay-Rendu
- INSERM 1033, Pavillon F, Hôpital E. Herriot, 69437, Lyon Cedex 03, France.,Hôpital E. Herriot, Hospices Civils de Lyon, Lyon, France
| | - Olivier Borel
- INSERM 1033, Pavillon F, Hôpital E. Herriot, 69437, Lyon Cedex 03, France.,Hôpital E. Herriot, Hospices Civils de Lyon, Lyon, France
| | - Roland Chapurlat
- INSERM 1033, Pavillon F, Hôpital E. Herriot, 69437, Lyon Cedex 03, France.,Hôpital E. Herriot, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Lyon, France
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13
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Kemp GJ, Birrell F, Clegg PD, Cuthbertson DJ, De Vito G, van Dieën JH, Del Din S, Eastell R, Garnero P, Goljanek–Whysall K, Hackl M, Hodgson R, Jackson MJ, Lord S, Mazzà C, McArdle A, McCloskey EV, Narici M, Peffers MJ, Schiaffino S, Mathers JC. Developing a toolkit for the assessment and monitoring of musculoskeletal ageing. Age Ageing 2018; 47:iv1-iv19. [PMID: 30203052 PMCID: PMC6127513 DOI: 10.1093/ageing/afy143] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022] Open
Abstract
The complexities and heterogeneity of the ageing process have slowed the development of consensus on appropriate biomarkers of healthy ageing. The Medical Research Council–Arthritis Research UK Centre for Integrated research into Musculoskeletal Ageing (CIMA) is a collaboration between researchers and clinicians at the Universities of Liverpool, Sheffield and Newcastle. One of CIMA’s objectives is to ‘Identify and share optimal techniques and approaches to monitor age-related changes in all musculoskeletal tissues, and to provide an integrated assessment of musculoskeletal function’—in other words to develop a toolkit for assessing musculoskeletal ageing. This toolkit is envisaged as an instrument that can be used to characterise and quantify musculoskeletal function during ‘normal’ ageing, lend itself to use in large-scale, internationally important cohorts, and provide a set of biomarker outcome measures for epidemiological and intervention studies designed to enhance healthy musculoskeletal ageing. Such potential biomarkers include: biochemical measurements in biofluids or tissue samples, in vivo measurements of body composition, imaging of structural and physical properties, and functional tests. This review assesses candidate biomarkers of musculoskeletal ageing under these four headings, details their biological bases, strengths and limitations, and makes practical recommendations for their use. In addition, we identify gaps in the evidence base and priorities for further research on biomarkers of musculoskeletal ageing.
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Affiliation(s)
- Graham J Kemp
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Fraser Birrell
- Institute of Cellular Medicine, Musculoskeletal Research Group, Newcastle University, Newcastle upon Tyne, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Peter D Clegg
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Daniel J Cuthbertson
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Giuseppe De Vito
- School of Public Health, Physiotherapy and Sports Science, Institute for Sport and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Jaap H van Dieën
- Department of Human Movement Sciences, VU University Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 9, Amsterdam, The Netherlands
| | - Silvia Del Din
- Clinical Ageing Research Unit, Institute of Neuroscience/Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Richard Eastell
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Patrick Garnero
- Division of Bone Diseases, Geneva University Hospital and Faculty of Medicine, 1205 Geneva, Switzerland
| | - Katarzyna Goljanek–Whysall
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | | | - Richard Hodgson
- Centre for Imaging Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester, UK
| | - Malcolm J Jackson
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Sue Lord
- Clinical Ageing Research Unit, Institute of Neuroscience/Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Claudia Mazzà
- Department of Mechanical Engineering & INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Anne McArdle
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Eugene V McCloskey
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Marco Narici
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Derby Royal Hospital, Uttoxeter Road, Derby, UK
| | - Mandy J Peffers
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Stefano Schiaffino
- Venetian Institute of Molecular Medicine (VIMM), Via Orus 2, Padova, Italy
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
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Boisson M, Lefèvre-Colau MM, Rannou F, Nguyen C. Active discopathy: a clinical reality. RMD Open 2018; 4:e000660. [PMID: 29682329 PMCID: PMC5905838 DOI: 10.1136/rmdopen-2018-000660] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 03/21/2018] [Accepted: 03/26/2018] [Indexed: 12/19/2022] Open
Abstract
In the late 1980s, the description by Modic and colleagues of elementary discovertebral changes detected on MRI (Modic classification) suggested for the first time a possible correlation between anatomical and clinical features in a subgroup of patients with non-specific chronic low back pain. Degenerative disc disease is frequent and usually asymptomatic, but Modic 1 changes in the vertebral endplates adjacent to a degenerated disc are associated with inflammatory-like chronic low back pain and low-grade local and systemic inflammation, which led to the concept of ‘active discopathy’. Active discopathy shares some similarities with acute flares of peripheral osteoarthritis. Likewise, what triggers disc activation and how it self-limits remain unknown. A better understanding of mechanisms underlying disc activation and its self-limitation is of clinical relevance because it may enable the design of more targeted pharmacological and non-pharmacological interventions for the subgroup of patients with chronic low back pain and active discopathy. Here, we narratively review current disc-centred biomechanical and biochemical hypotheses of disc activation and discuss evidence of interactions with adverse personal and environmental factors.
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Affiliation(s)
- Margaux Boisson
- AP-HP, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires Paris Centre-Groupe Hospitalier Cochin, Paris, France
| | - Marie-Martine Lefèvre-Colau
- AP-HP, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires Paris Centre-Groupe Hospitalier Cochin, Paris, France.,Faculté de Médecine de Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,ECaMO Team, INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique, Sorbonne Paris Cité, Paris, France.,Institut Fédératif de Recherche sur le Handicap, Paris, France
| | - François Rannou
- AP-HP, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires Paris Centre-Groupe Hospitalier Cochin, Paris, France.,Faculté de Médecine de Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, Faculté des Sciences Fondamentales et Biomédicales, INSERM UMR 1124, UFR Biomédicale des Saints-Pères, Paris, France
| | - Christelle Nguyen
- AP-HP, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires Paris Centre-Groupe Hospitalier Cochin, Paris, France.,Faculté de Médecine de Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, Faculté des Sciences Fondamentales et Biomédicales, INSERM UMR 1124, UFR Biomédicale des Saints-Pères, Paris, France
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15
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Goode AP, Nelson AE, Kraus VB, Renner JB, Jordan JM. Biomarkers reflect differences in osteoarthritis phenotypes of the lumbar spine: the Johnston County Osteoarthritis Project. Osteoarthritis Cartilage 2017; 25:1672-1679. [PMID: 28711584 PMCID: PMC5605465 DOI: 10.1016/j.joca.2017.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 06/02/2017] [Accepted: 07/05/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine differences in biomarker levels between radiographic phenotypes of facet joint osteoarthritis (FOA) only, spine OA only ((disc space narrowing (DSN) and vertebral osteophytes (OST)) or the combination of FOA and spine OA. DESIGN A cross-sectional analysis of data from 555 participants in the Johnston County Osteoarthritis Project was performed. Lumbar spine levels were graded by severity (OST and DSN) and presence (FOA) of degeneration. Biomarkers included hyaluronan (HA) and type II collagen (CTX-II). Adjusted risk ratios (aRRR) were estimated using multinomial regression, with adjustment for age, race, sex, body mass index (BMI), and radiographic OA (knee, hip, hand). Interactions were tested between sex, race and low back symptoms. RESULTS FOA only was present in 22.4%, 14.5% had spine OA only, and 34.6% had the combination of FOA and spine OA. Compared to the reference group of neither FOA or spine OA, a one unit higher ln HA level was associated with 31% higher relative risk ratio (RRR = 1.31 (95% 1.03, 1.67)) of having FOA only, while, a one unit higher lnuCTX-II level was associated with 84% higher relative risk ratio (RRR = 1.84 (95% CI 1.19, 2.84)) of having spine OA only. No significant interactions were identified. CONCLUSION Interestingly, OA affecting the synovial facet joint was associated with a marker of inflammation (HA). Spine OA, affecting intervertebral discs that contain collagen type II, was associated with a marker reflecting collagen type II degradation (CTX-II). These findings suggest that biomarkers may reflect the different pathophysiologic processes of lumbar spine OA phenotypes.
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Affiliation(s)
- Adam P. Goode
- Associate Professor, Department of Orthopedic Surgery, Duke Clinical Research Institute, Duke University School of Medicine
| | - Amanda E. Nelson
- Assistant Professor, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill
| | - Virginia B. Kraus
- Professor, Duke Molecular Physiology Institute and Division of Rheumatology, Duke University School of Medicine, Durham, NC
| | - Jordan B. Renner
- Professor, Thurston Arthritis Research Center, Department of Radiology, University of North Carolina, Chapel Hill
| | - Joanne M. Jordan
- Professor, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill
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16
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Song H, Luo Y, Wang W, Li S, Yang K, Dai M, Shen Y, Zhang Y, Zhang L. Effects of alendronate on lumbar intervertebral disc degeneration with bone loss in ovariectomized rats. Spine J 2017; 17:995-1003. [PMID: 28288923 DOI: 10.1016/j.spinee.2017.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 02/15/2017] [Accepted: 03/08/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Osteoporosis adversely affects disc degeneration cascades, and prophylactic alendronate (ALN) helps delay intervertebral disc degeneration (IDD) in ovariectomized (OVX) rats. However, there remains no information regarding whether ALN affects IDD with bone loss. PURPOSE This study aimed to observe the effects of ALN on degenerative discs with bone loss induced by OVX in rats. STUDY DESIGN This study used controlled in vivo experiments in rodents. METHODS Thirty female Sprague-Dawley rats were randomly assigned to undergo sham surgery (n=10) or OVX surgery (n=20); 3 months later, the OVX animals were injected with either ALN (OVX+ALN, 15 µg/kg/2w, n=10) or normal saline (OVX+vehicle treatment [V], n=10). At 3 months after the ALN intervention, van Gieson staining and immunohistochemistry were used to investigate histologic and metabolic changes in the discs. Bone mineral density (BMD), micro-computed tomography, and biomechanical tests were conducted to determine the biological properties of the vertebrae. RESULTS The OVX+ALN group exhibited significantly reduced morphologic degenerative alterations in both the nucleus pulposus and annulus fibrosus, with a markedly lower IDD score than that of the OVX+V group. The OVX+ALN samples showed increased disc height and decreased cartilage end plate thickness and bony area compared with the OVX+V group. Compared with saline, ALN administration markedly inhibited the type I collagen, matrix metalloprotease (MMP)-1, and MMP-13 expression levels while increasing the type II collagen and aggrecan expression levels in the disc matrix. Compared with the OVX+V group, OVX+ALN vertebrae revealed significantly enhanced BMD with increased biomechanical strength, as well as increased percent bone volume and trabecular thickness. CONCLUSIONS ALN has favorable effects on disc degeneration with bone loss and helps to alleviate IDD while enhancing the biological and mechanical properties of vertebrae and end plates.
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Affiliation(s)
- Huiping Song
- Department of Orthopaedic Surgery, The Affiliated Hospital of North China University of Science and Technology, 73 Jianshe Rd, Tangshan 063000, China
| | - Yang Luo
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050051, China
| | - Wenya Wang
- Department of Pathology, School of Basic Medical Sciences, North China University of Science and Technology, 73 Jianshe Rd, Tangshan, 063000, China
| | - Shuyang Li
- Department of Orthopaedic Surgery, The Affiliated Hospital of North China University of Science and Technology, 73 Jianshe Rd, Tangshan 063000, China
| | - Kai Yang
- Department of Orthopaedic Surgery, The Affiliated Hospital of North China University of Science and Technology, 73 Jianshe Rd, Tangshan 063000, China
| | - Muwei Dai
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050051, China
| | - Yong Shen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050051, China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050051, China
| | - Liu Zhang
- Department of Orthopaedic Surgery, The Affiliated Hospital of North China University of Science and Technology, 73 Jianshe Rd, Tangshan 063000, China.
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17
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Brayda-Bruno M, Viganò M, Cauci S, Vitale JA, de Girolamo L, De Luca P, Lombardi G, Banfi G, Colombini A. Plasma vitamin D and osteo-cartilaginous markers in Italian males affected by intervertebral disc degeneration: Focus on seasonal and pathological trend of type II collagen degradation. Clin Chim Acta 2017; 471:87-93. [PMID: 28545772 DOI: 10.1016/j.cca.2017.05.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 05/02/2017] [Accepted: 05/21/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate plasma vitamin D and cross-linked C-telopeptides of type I (CTx-I) and type II (CTx-II) collagen concentrations in males with lumbar intervertebral disc degeneration (IVD) compared to healthy controls. Improved knowledge might suggest to optimize the vitamin D status of IVD patients and contribute to clarify mechanisms of cartilage degradation. METHODS 79 Italian males with lumbar IVD assessed by Magnetic Resonance Imaging (MRI) and 79 age, sex and BMI-matched healthy controls were enrolled. Plasma 25hydroxyvitamin D (25(OH)D), CTx-I and CTx-II were measured by immunoassays. Circannual seasonality, correlation between biomarkers concentrations and clinical variables were assessed. RESULTS Overall subjects 25(OH)D and CTx-II showed month rhythmicity with acrophase in August/September and October/November, and nadir in February/March and April/May, respectively. An inverse correlation between 25(OH)D and CTx-I, and a direct correlation between CTx-II and CTx-I were observed. IVD patients, particularly with osteochondrosis, showed higher CTx-II than healthy controls. CONCLUSIONS Month of sampling may affect plasma 25(OH)D and CTx-II concentrations. The correlation between CTx-I and CTx-II suggests an interplay between the osteo-cartilaginous endplate and the fibro-cartilaginous disc. The results of this study highlighted that osteochondrosis associates with increased cartilaginous catabolism. Vitamin D supplementation seems more necessary in winter for lumbar IVD patients.
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Affiliation(s)
- Marco Brayda-Bruno
- Scoliosis Unit, Department of Orthopedics and Traumatology-Spine Surgery III, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161 Milan, Italy.
| | - Marco Viganò
- Orthopaedic Biotechnology Lab, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161 Milan, Italy; Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza, 1, 20126 Milan, Italy.
| | - Sabina Cauci
- Department of Medical Area, University of Udine, P.le Kolbe 4, 33100 Udine, Italy.
| | - Jacopo A Vitale
- Laboratory of Biological Structure Mechanics, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161 Milan, Italy.
| | - Laura de Girolamo
- Orthopaedic Biotechnology Lab, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161 Milan, Italy.
| | - Paola De Luca
- Orthopaedic Biotechnology Lab, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161 Milan, Italy.
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161 Milan, Italy.
| | - Giuseppe Banfi
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy.
| | - Alessandra Colombini
- Orthopaedic Biotechnology Lab, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161 Milan, Italy.
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18
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Systemic inflammation and painful joint burden in osteoarthritis: a matter of sex? Osteoarthritis Cartilage 2017; 25:53-59. [PMID: 27546883 DOI: 10.1016/j.joca.2016.08.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/15/2016] [Accepted: 08/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We investigated the association between serum levels of C-reactive protein (CRP) and the extent of multijoint pain among individuals with hip/knee osteoarthritis (OA) and determined whether the association differs by sex. DESIGN Serum CRP and cartilage oligomeric matrix protein (COMP) were determined by enzyme-linked immunosorbent assay (ELISA) in 189 individuals (101 female, 88 male) scheduled for total hip/knee arthroplasty for OA. Patients indicated on a homunculus all painful joints; a summed count was derived. A series of negative binomial regression models was used to investigate the cross-sectional association between painful joint count (outcome) and serum CRP concentrations, adjusting for age, sex, body mass index (BMI), comorbidity count and COMP. An interaction between sex and these biomarkers was tested. RESULTS Mean age: 66 among women, 65 among men. Women had higher mean joint count (3.7 vs 2.5, P < 0.01; 4+ joint count reported by 37% women, 25% men). Median CRP concentration was higher in women (15.4 mg/l vs 9.3, P = 0.07). From adjusted analyses, the effects of both ln(CRP) and ln(COMP) were modified by sex (P < 0.05). Increasing ln(CRP) was associated with greater painful joint count among women, but not men. CONCLUSIONS There may be a dose-response association between painful joint burden in OA and systemic inflammation, and it appears the association is sex-specific, which may in part explain inconsistent findings in the literature. Our results underline the importance of showing sex-specific associations in OA, especially when studying the influence of inflammation.
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19
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Elwakil WA, Mohasseb D, Elkaffash D, Elshereef S, Elshafey M. Serum leptin and osteoporosis in postmenopausal women with primary knee osteoarthritis. EGYPTIAN RHEUMATOLOGIST 2016. [DOI: 10.1016/j.ejr.2016.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Rousseau JC, Sornay-Rendu E, Bertholon C, Garnero P, Chapurlat R. Serum periostin is associated with prevalent knee osteoarthritis and disease incidence/progression in women: the OFELY study. Osteoarthritis Cartilage 2015; 23:1736-42. [PMID: 26072384 DOI: 10.1016/j.joca.2015.05.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 04/28/2015] [Accepted: 05/12/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Our aim was to investigate the relationships between serum periostin (POSTN) and both prevalence and incidence/progression of knee osteoarthritis (OA) in women. METHODS We investigated 594 women (62.7 ± 11.2 yr) from the OFELY cohort. Knee radiographs were scored according to the Kellgren & Lawrence (KL) grading system at baseline and 4 years later. Spine, hip and hand OA were assessed at baseline. Prevalent knee OA was defined by a KL score higher or equal in 2. Progression of KL was defined as an increase of the KL score ≥1 during the 4 years follow-up. Serum POSTN was measured at baseline by ELISA. RESULTS By non-parametric tests, POSTN was significantly lower in 83 women with a KL score ≥2 at baseline, compared to those with a KL score <2 (n = 511; 1101 ± 300 vs 1181 ± 294 ng/ml, P = 0.002) after adjustment for age, body mass index (BMI), treatments and diseases, prevalent hand OA and prevalent lumbar spine OA. By logistic regression analyses, the odds-ratio of knee OA incidence/progression was significantly reduced by 21% (P = 0.043) for each quartile increase in serum POSTN at baseline, after adjustment for age, BMI, prevalent knee OA, prevalent hand OA and prevalent lumbar spine OA. CONCLUSIONS We show for the first time that serum POSTN is associated with prevalence and the risk of development/progression of knee OA in women.
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Affiliation(s)
- J C Rousseau
- INSERM Research Unit 1033, Université de Lyon, 69437 Lyon Cedex 03, France.
| | - E Sornay-Rendu
- INSERM Research Unit 1033, Université de Lyon, 69437 Lyon Cedex 03, France; Service de rhumatologie et pathologie osseuse, Hôpital E.-Herriot, Université de Lyon, 69437 Lyon Cedex 03, France.
| | - C Bertholon
- INSERM Research Unit 1033, Université de Lyon, 69437 Lyon Cedex 03, France.
| | - P Garnero
- INSERM Research Unit 1033, Université de Lyon, 69437 Lyon Cedex 03, France; Cisbio Bioassays, Codolet, France; Service de rhumatologie et pathologie osseuse, Hôpital E.-Herriot, Université de Lyon, 69437 Lyon Cedex 03, France.
| | - R Chapurlat
- INSERM Research Unit 1033, Université de Lyon, 69437 Lyon Cedex 03, France; Service de rhumatologie et pathologie osseuse, Hôpital E.-Herriot, Université de Lyon, 69437 Lyon Cedex 03, France.
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Luo Y, Zhang L, Wang WY, Hu QF, Song HP, Zhang YZ. The inhibitory effect of salmon calcitonin on intervertebral disc degeneration in an ovariectomized rat model. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 24:1691-701. [PMID: 25304649 DOI: 10.1007/s00586-014-3611-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 09/30/2014] [Accepted: 10/01/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Intervertebral disc degeneration related to postmenopausal osteoporosis is an important issue in spinal disorder research. This study aimed to investigate the effects of salmon calcitonin (sCT), as an antiresorptive medication, on lumbar intervertebral disc degeneration using a rat ovariectomy (OVX) model. METHODS Thirty 3-month-old female Sprague-Dawley rats were randomly divided into three groups: the sham-operated (Sham) group and two ovariectomized groups treated with vehicle (OVX+V) or sCT (OVX+CT; 16 IU/kg, sc) on alternate days for 6 months. Treatment began after OVX and continued for 6 months. At the end of the experiment, bone mineral density (BMD), micro-CT analysis, biomechanical testing, histology, and immunohistochemistry were performed for all groups. RESULTS Salmon calcitonin significantly maintained vertebrae BMD, percent bone volume, and biomechanical strength, when compared with the OVX+V group. The changes of mucoid degeneration in the nucleus pulposus and calcification in the middle cartilage endplate were more moderate in the OVX+CT group compared with the OVX+V group, and immunohistochemistry revealed a significant increase in aggrecan and type II collagen expressions, but marked reductions in matrix metalloproteinase (MMP)-1, MMP-3, and MMP-13 expressions in the OVX+CT group. CONCLUSIONS Salmon calcitonin treatment was effective in delaying the process of the disc degeneration in OVX rats. The underlying mechanisms may be related to preservation of structural integrity and function of vertebrae, and affecting extracellular matrix metabolism by modulating the expressions of MMPs, aggrecan and type II collagen to protect the disc from degeneration.
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Affiliation(s)
- Yang Luo
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
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Luo Y, Zhang L, Wang WY, Hu QF, Song HP, Su YL, Zhang YZ. Alendronate retards the progression of lumbar intervertebral disc degeneration in ovariectomized rats. Bone 2013; 55:439-48. [PMID: 23500174 DOI: 10.1016/j.bone.2013.03.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 01/24/2013] [Accepted: 03/05/2013] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Increasing evidence has revealed a positive correlation between postmenopausal osteoporosis and intervertebral disc degeneration, the underlying mechanism of which might be associated with changes in the vertebral bone and endplate. Alendronate (ALN) can increase bone mass and improve the microstructure of osteoporotic vertebrae, which might be helpful in preserving disc morphology and mechanical properties. This study aims to investigate the effects of ALN on lumbar intervertebral disc degeneration related to osteoporosis using an ovariectomized (OVX) rat model. METHODS Thirty female Sprague-Dawley rats aged 3 months were randomly divided into three groups (with 10 rats each) as follows: the Sham group underwent sham surgery; the OVX + ALN group had twice-a-week subcutaneous injections of ALN (15 μg/kg) for 6 months. The OVX + V group received an equivalent volume of saline solution as placebo post-OVX. After animals were sacrificed at 6 months post-OVX, the L3-6 spinal segments were harvested. Bone mineral density (BMD), micro-CT analysis and biomechanical testing were performed to evaluate the bone quality and microstructural changes in the lumbar vertebral bodies. Histological analysis with van Gieson stain and the histological score were used to identify the characteristics of the degenerative discs. The disc height and the thickness of the cartilage endplate were measured and compared. Immunohistochemistry and real-time PCR measurements for aggrecan, type I collagen, type II collagen, and matrix metalloprotease (MMP)-1, MMP-3 and MMP-13 expressions on the disc were performed to assess the underlying molecular signaling changes in matrix metabolism during intervertebral disc degeneration. RESULTS The OVX + ALN group significantly maintained vertebrae BMD, percent bone volume and biomechanical strength, when compared with the OVX + V group. Histological evaluation suggests that there was no significant difference in disc height between the OVX + ALN and Sham groups, and ALN significantly prevented cartilage endplate thickening and the development of abnormal bony tissues within the cartilage endplate. The histological score in the OVX + ALN group was significantly lower than the OVX + V group, suggesting that ALN treatment was effective in delaying the process of the disc degeneration. The results of molecular analysis revealed a significant increase in aggrecan and type II collagen expressions, but marked reductions in MMP-1, MMP-3 and MMP-13 expressions at both the protein and mRNA levels in the OVX + ALN group. CONCLUSIONS ALN can retard the progression of lumbar intervertebral disc degeneration in OVX rats. The underlying mechanisms might be related to preservation of the structural integrity and function of the adjacent structures, including the vertebrae and endplates, which further links with modulations in extracellular matrix metabolism to protect the disc from degeneration. These results suggest that ALN might be a promising drug agent for preventing lumbar intervertebral disc degeneration related to osteoporosis.
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Affiliation(s)
- Yang Luo
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
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Abstract
Lumbar spine osteoarthritis (OA) is very common, with estimates of prevalence ranging from 40-85 %. The process of degeneration of the spine has commonly been classified as OA (disc space narrowing together with vertebral osteophyte formation); however, anatomically, the facet joint is the only synovial joint in the spine that has a similar pathological degenerative process to appendicular joints. Low back pain (LBP) is also a common condition, with nearly 80 % of Americans experiencing at least one episode of LBP in their lifetime. The complex relationship between spine radiographs and LBP has many clinical and research challenges. Specific conservative treatments for spine degeneration have not been established; there has, however, been recent interest in use of exercise therapy, because of some moderate benefits in treating chronic LBP. An understanding of the relationship between spine degeneration and LBP may be improved with further population-based research in the areas of genetics, biomarkers, and pain pathways.
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Affiliation(s)
- Adam P. Goode
- Assistant Professor, Duke University Department of Community and Family Medicine, Durham, NC, 27713, USA, 919-681-6154
| | - Timothy S. Carey
- Professor of Medicine and Director of Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA, 919-966-5011
| | - Joanne M. Jordan
- Professor of Medicine, Epidemiology and Orthopedics and Director of Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA, 919-966-0552
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Goode AP, Marshall SW, Kraus VB, Renner JB, Stürmer T, Carey TS, Irwin DE, Jordan JM. Association between serum and urine biomarkers and lumbar spine individual radiographic features: the Johnston County Osteoarthritis Project. Osteoarthritis Cartilage 2012; 20:1286-93. [PMID: 22890183 PMCID: PMC3608522 DOI: 10.1016/j.joca.2012.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 07/27/2012] [Accepted: 08/06/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE (1) To determine associations between radiographic features of lumbosacral (LS) spine disc space narrowing (DSN) and osteophytes (OST) and joint metabolism biomarkers (serum cartilage oligomeric matrix protein (COMP), hyaluronic acid (HA), collagen neoepitope (C2C), C-propeptide of type II procollagen (CP-II), urine C-terminal cross-linking telopeptide (CTX-II) and N-terminal telopeptide (NTX-I)). (2) To explore interactions with race, gender and low back symptoms. DESIGN Cross-sectional analysis of 547 participants enrolled in the Johnston County (JoCo) Osteoarthritis Project from 2003 to 2004. Mean biomarker levels were estimated with linear regression. Proportional and partial-proportional odds models were used to estimate associations. Interactions were tested with likelihood ratio tests at a P-value < 0.10. Biomarkers were natural log (ln) transformed. RESULTS Significant differences in mean biomarker levels were found across severity of DSN for lnHA and lnC2C and lnCTX-II across severity of both DSN and OST. Moderate-to-strong associations were found between biomarkers of type II collagen and DSN, whereas associations with OST were weak. An association between lnHA and DSN was seen in women (adjusted odds ratio [aOR] = 1.34 (95% confidence intervals (CI) 1.08, 1.65)) but no association among men (aOR = 0.90 (95% CI 0.63, 1.26)). In Caucasians there was a decreased association with NTX-I and OST (aOR = 0.67 (95% CI 0.49, 0.91)) and no association in African Americans (AAs) (aOR = 1.06 (95% CI 0.76, 1.47)). There was a positive association of lnCOMP with DSN among those with low back symptoms (aOR = 1.82 (95% CI 1.02, 3.27)), but no association in those without low back symptoms (aOR = 0.65 (95% CI 0.35, 1.20)). CONCLUSION Joint metabolism biomarkers suggest biological differences in the pathologic process involved in DSN and OST that may be gender (HA) and ethnicity (NTX-I) specific.
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Affiliation(s)
- Adam P. Goode
- Department of Community and Family Medicine, Duke University Medical Center
| | - Stephen W. Marshall
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina
| | | | | | - Til Stürmer
- Department of Epidemiology, University of North Carolina
| | | | - Debra E. Irwin
- Department of Epidemiology, University of North Carolina
| | - Joanne M. Jordan
- Department of Medicine, Orthopedics, and Epidemiology, Division of Rheumatology, Allergy and Immunology, University of North Carolina
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Rousseau JC, Garnero P. Biological markers in osteoarthritis. Bone 2012; 51:265-77. [PMID: 22538364 DOI: 10.1016/j.bone.2012.04.001] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 03/07/2012] [Accepted: 04/03/2012] [Indexed: 12/01/2022]
Abstract
Osteoarthritis (OA) is considered as a chronic disease with a long "silent" period. The diagnosis is generally based on clinical symptoms and radiographic changes. However X-ray has a poor sensitivity and a relatively large precision error that does not allow an early detection of OA or the monitoring of joint damage progression. The limitations of the tools that are currently available for OA assessment have been the impetus to identify specific biological markers that reflect quantitative and dynamic variations in joint remodeling. Research has focused on the structural components of cartilage matrix, especially type II collagen degradation markers. In spite of a significant increase of some markers in individuals with early stage of OA, the large overlap with control subjects indicates that the current biomarkers used alone have limited diagnostic potential. However, the combination of specific markers seems to improve the prediction of disease progression at the individual level. Several types of treatment have been investigated but the lack of medications with definitively demonstrated chondroprotective activity has limited the assessment of the potential role of biomarkers for monitoring patients' responses to the treatment of OA. In this review, we will use the BIPED classification that appeared in 2006 for OA markers to describe the potential usage of a given marker [5]. This article is part of a Special Issue entitled "Osteoarthritis".
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Affiliation(s)
- J Ch Rousseau
- INSERM Unit 1033; Pathophysiology, Diagnosis and Treatments of bone diseases, Université de Lyon, Lyon, France.
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Fukuda I, Ishihara T, Ohmachi S, Sakikawa I, Morita A, Ikeda M, Yamane S, Toyosaki-Maeda T, Takinami Y, Okamoto H, Numata Y, Fukui N. Potential plasma biomarkers for progression of knee osteoarthritis using glycoproteomic analysis coupled with a 2D-LC-MALDI system. Proteome Sci 2012; 10:36. [PMID: 22672759 PMCID: PMC3514375 DOI: 10.1186/1477-5956-10-36] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 05/21/2012] [Indexed: 01/14/2023] Open
Abstract
Background Although osteoarthritis (OA) is a highly prevalent joint disease, to date, no reliable biomarkers have been found for the disease. In this study, we attempted to identify factors the amounts of which significantly change in association with the progression of knee OA. Methods A total of 68 subjects with primary knee OA were enrolled in the study. These subjects were followed up over an 18-month period, and plasma and serum samples were obtained together with knee radiographs every 6 months, i.e., 0, 6, 12 and 18 months after the enrollment. Progressors and non-progressors were determined from the changes on radiographs, and plasma samples from those subjects were subjected to N-glycoproteomic 2D-LC-MALDI analysis. MS peaks were identified, and intensities for respective peaks were compared between the progressors and non-progressors to find the peak intensities of which differed significantly between the two groups of subjects. Proteins represented by the chosen peaks were identified by MS/MS analysis. Expression of the identified proteins was evaluated in synovial tissues from 10 OA knee joints by in situ hybridization, western blotting analysis and ELISA. Results Among the subjects involved in the study, 3 subjects were determined to be progressors, and 6 plasma and serum samples from these subjects were subjected to the analysis together with another 6 samples from the non-progressors. More than 3000 MS peaks were identified by N-glycoproteomic 2D-LC-MALDI analysis. Among them, 4 peaks were found to have significantly different peak intensities between the progressors and non-progressors. MS/MS analysis revealed that these peaks represented clusterin, hemopexin, alpha-1 acid glycoprotein-2, and macrophage stimulating protein, respectively. The expression of these genes in OA synovium was confirmed by in situ hybridization, and for clusterin and hemopexin, by western blotting analysis and ELISA as well. Conclusions In this study, 4 potential biomarkers were identified as potential prognostic markers for knee OA through N-glycoproteomic analysis. To the best of our knowledge, this is the first report for the use of glycoproteomic technology in exploring potential biomarkers for knee OA.
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Affiliation(s)
- Isao Fukuda
- Department of Pathomechanisms, Clinical Research Center, National Hospital Organization Sagamihara Hospital, Sagamihara, Kanagawa, 228-8522, Japan.
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Leckie SK, Bechara BP, Hartman RA, Sowa GA, Woods BI, Coelho JP, Witt WT, Dong QD, Bowman BW, Bell KM, Vo NV, Wang B, Kang JD. Injection of AAV2-BMP2 and AAV2-TIMP1 into the nucleus pulposus slows the course of intervertebral disc degeneration in an in vivo rabbit model. Spine J 2012; 12:7-20. [PMID: 22023960 PMCID: PMC4896143 DOI: 10.1016/j.spinee.2011.09.011] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 07/27/2011] [Accepted: 09/07/2011] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Intervertebral disc degeneration (IDD) is a common cause of back pain. Patients who fail conservative management may face the morbidity of surgery. Alternative treatment modalities could have a significant impact on disease progression and patients' quality of life. PURPOSE To determine if the injection of a virus vector carrying a therapeutic gene directly into the nucleus pulposus improves the course of IDD. STUDY DESIGN Prospective randomized controlled animal study. METHODS Thirty-four skeletally mature New Zealand white rabbits were used. In the treatment group, L2-L3, L3-L4, and L4-L5 discs were punctured in accordance with a previously validated rabbit annulotomy model for IDD and then subsequently treated with adeno-associated virus serotype 2 (AAV2) vector carrying genes for either bone morphogenetic protein 2 (BMP2) or tissue inhibitor of metalloproteinase 1 (TIMP1). A nonoperative control group, nonpunctured sham surgical group, and punctured control group were also evaluated. Serial magnetic resonance imaging (MRI) studies at 0, 6, and 12 weeks were obtained, and a validated MRI analysis program was used to quantify degeneration. The rabbits were sacrificed at 12 weeks, and L4-L5 discs were analyzed histologically. Viscoelastic properties of the L3-L4 discs were analyzed using uniaxial load-normalized displacement testing. Creep curves were mathematically modeled according to a previously validated two-phase exponential model. Serum samples obtained at 0, 6, and 12 weeks were assayed for biochemical evidence of degeneration. RESULTS The punctured group demonstrated MRI and histologic evidence of degeneration as expected. The treatment groups demonstrated less MRI and histologic evidence of degeneration than the punctured group. The serum biochemical marker C-telopeptide of collagen type II increased rapidly in the punctured group, but the treated groups returned to control values by 12 weeks. The treatment groups demonstrated several viscoelastic properties that were distinct from control and punctured values. CONCLUSIONS Treatment of punctured rabbit intervertebral discs with AAV2-BMP2 or AAV2-TIMP1 helps delay degenerative changes, as seen on MRI, histologic sampling, serum biochemical analysis, and biomechanical testing. Although data from animal models should be extrapolated to the human condition with caution, this study supports the potential use of gene therapy for the treatment of IDD.
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Affiliation(s)
- Steven K. Leckie
- Corresponding author. Department of Orthopedic Surgery, University of Pittsburgh Medical Center, BST E1641, 200 Lothrop St, Pittsburgh, PA 15213, USA. Tel.: (412) 648-1090. (S.K. Leckie)
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Pedersen SJ, Sørensen IJ, Lambert RGW, Hermann KGA, Garnero P, Johansen JS, Madsen OR, Hansen A, Hansen MS, Thamsborg G, Andersen LS, Majgaard O, Loft AG, Erlendsson J, Asmussen KH, Jurik AG, Møller J, Hasselquist M, Mikkelsen D, Østergaard M. Radiographic progression is associated with resolution of systemic inflammation in patients with axial spondylarthritis treated with tumor necrosis factor α inhibitors: A study of radiographic progression, inflammation on magnetic resonance imaging, and c. ACTA ACUST UNITED AC 2011; 63:3789-800. [DOI: 10.1002/art.30627] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kraus VB, Burnett B, Coindreau J, Cottrell S, Eyre D, Gendreau M, Gardiner J, Garnero P, Hardin J, Henrotin Y, Heinegård D, Ko A, Lohmander LS, Matthews G, Menetski J, Moskowitz R, Persiani S, Poole AR, Rousseau JC, Todman M. Application of biomarkers in the development of drugs intended for the treatment of osteoarthritis. Osteoarthritis Cartilage 2011; 19:515-42. [PMID: 21396468 PMCID: PMC3568396 DOI: 10.1016/j.joca.2010.08.019] [Citation(s) in RCA: 220] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 08/21/2010] [Accepted: 08/28/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) is a chronic and slowly progressive disease for which biomarkers may be able to provide a more rapid indication of therapeutic responses to therapy than is currently available; this could accelerate and facilitate OA drug discovery and development programs. The goal of this document is to provide a summary and guide to the application of in vitro (biochemical and other soluble) biomarkers in the development of drugs for OA and to outline and stimulate a research agenda that will further this goal. METHODS The Biomarkers Working Group representing experts in the field of OA biomarker research from both academia and industry developed this consensus document between 2007 and 2009 at the behest of the Osteoarthritis Research Society International Federal Drug Administration initiative (OARSI FDA initiative). RESULTS This document summarizes definitions and classification systems for biomarkers, the current outcome measures used in OA clinical trials, applications and potential utility of biomarkers for development of OA therapeutics, the current state of qualification of OA-related biomarkers, pathways for biomarker qualification, critical needs to advance the use of biomarkers for drug development, recommendations regarding practices and clinical trials, and a research agenda to advance the science of OA-related biomarkers. CONCLUSIONS Although many OA-related biomarkers are currently available they exist in various states of qualification and validation. The biomarkers that are likely to have the earliest beneficial impact on clinical trials fall into two general categories, those that will allow targeting of subjects most likely to either respond and/or progress (prognostic value) within a reasonable and manageable time frame for a clinical study (for instance within 1-2 years for an OA trial), and those that provide early feedback for preclinical decision-making and for trial organizers that a drug is having the desired biochemical effect. As in vitro biomarkers are increasingly investigated in the context of specific drug treatments, advances in the field can be expected that will lead to rapid expansion of the list of available biomarkers with increasing understanding of the molecular processes that they represent.
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Affiliation(s)
- V B Kraus
- Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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Inoue R, Ishibashi Y, Tsuda E, Yamamoto Y, Matsuzaka M, Takahashi I, Danjo K, Umeda T, Nakaji S, Toh S. Knee osteoarthritis, knee joint pain and aging in relation to increasing serum hyaluronan level in the Japanese population. Osteoarthritis Cartilage 2011; 19:51-7. [PMID: 21044694 DOI: 10.1016/j.joca.2010.10.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 10/19/2010] [Accepted: 10/26/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate relationship between serum hyaluronan (HA) level and the presence and severity of radiographic knee osteoarthritis (OA) as well as degree of knee pain in Japanese population. DESIGN A total of 616 volunteers participated in this study. Based on the Kellgren-Lawrence (K-L) grade, participants were radiographically classified into three groups: Normal (K-L grade 0 or 1), Moderate (grade 2) and Severe (grade 3 or 4). The degree of knee pain was quantified by visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) Pain. Serum HA levels were compared among the Normal, Moderate and Severe groups, and the relationship between serum HA level and the severity of knee OA was analyzed after age, sex and body mass index (BMI) were adjusted. In addition, the correlation between serum HA level and the degree of knee pain was analyzed in each group. RESULTS Regarding relationship between serum HA level and the severity of radiographic knee OA, serum HA levels of the Moderate and Severe groups were significantly higher than in the Normal group (P<0.001). Furthermore, serum HA level correlated with the severity of radiographic knee OA (r=0.289, P<0.001) after adjusting for age, sex and BMI. Serum HA level correlated with VAS of knee pain and/or KOOS Pain in the Normal and Moderate groups. CONCLUSION Serum HA level has the potential to be useful for the diagnosis of the presence and severity of knee OA.
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Affiliation(s)
- R Inoue
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
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Ichchou L, Allali F, Rostom S, Bennani L, Hmamouchi I, Abourazzak FZ, Khazzani H, El Mansouri L, Abouqal R, Hajjaj-Hassouni N. Relationship between spine osteoarthritis, bone mineral density and bone turn over markers in post menopausal women. BMC WOMENS HEALTH 2010; 10:25. [PMID: 20691114 PMCID: PMC2924252 DOI: 10.1186/1472-6874-10-25] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Accepted: 08/08/2010] [Indexed: 11/22/2022]
Abstract
Background Several studies have observed an inverse relationship between osteoporosis and spinal osteoarthritis, the latter being considered as possibly delaying the development of osteoporosis. The aim of this study was to determine the association between individual radiographic features of spine degeneration, bone mineral density (BMD) and bone-turn over markers. Methods It was a cross sectional study of 277 post menopausal women. BMD of all patients was assessed at the spine and hip using dual-energy X-ray absorptiometry. Lateral spinal radiographs were evaluated for features of disc degeneration. Each vertebral level from L1/2 to L4/5 was assessed for the presence and severity of osteophytes and disc space narrowing (DSN). For Bone turn-over markers, we assessed serum osteocalcin and C-terminal cross-linking telopeptide of type I collagen (CTX). Linear regressions and partial correlation were used respectively to determine the association between each of disc degeneration features, BMD, and both CTX and osteocalcin. Results Mean age of patients was 58.7 ± 7.7 years. Eighty four patients (31.2%) were osteoporotic and 88.44% had spine osteoarthritis. At all measured sites, there was an increase in BMD with increasing severity of disc narrowing while there was no association between severity of osteophytes and BMD. After adjustment for age and BMI, there was a significant negative correlation between CTX and DSN. However, no significant correlation was found between CTX and osteophytes and between osteocalcin and both osteophytes or DSN. Conclusion In post menopausal women the severity of disc narrowing, but not osteophytes, is associated with a generalized increase in BMD and a decreased rate of bone resorption. These results are consistent with the hypothesis that osteoarthritis, through DSN, has a protective effect against bone loss, mediated by a lower rate of bone resorption. However, spine BMD is not a relevant surrogate marker for the assessment of osteoporosis in the spine in patients with osteoarthritis and debate as to the relationship between OA and OP is still open because of the contradictory data in the literature.
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Affiliation(s)
- Linda Ichchou
- Laboratory of Information and Research on Bone Diseases LIRPOS, Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Morocco.
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Bay-Jensen AC, Tabassi NCB, Sondergaard LV, Andersen TL, Dagnaes-Hansen F, Garnero P, Kassem M, Delaissé JM. The response to oestrogen deprivation of the cartilage collagen degradation marker, CTX-II, is unique compared with other markers of collagen turnover. Arthritis Res Ther 2010; 11:R9. [PMID: 20527083 PMCID: PMC2688240 DOI: 10.1186/ar2596] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION The urinary level of the type II collagen degradation marker CTX-II is increased in postmenopausal women and in ovariectomised rats, suggesting that oestrogen deprivation induces cartilage breakdown. Here we investigate whether this response to oestrogen is also true for other type II collagen turnover markers known to be affected in osteoarthritis, and whether it relates to its presence in specific areas of cartilage tissue. METHODS The type II collagen degradation markers CTX-II and Helix-II were measured in the body fluids of premenopausal and postmenopausal women and in those of ovariectomised rats receiving oestrogen or not. Levels of PIIANP, a marker of type II collagen synthesis, were also measured in rats. Rat knee cartilage was analysed for immunoreactivity of CTX-II and PIIANP and for type II collagen expression. RESULTS As expected, urinary levels of CTX-II are significantly increased in postmenopausal women and also in oestrogen deprived rats, although only transiently. However, in neither case were these elevations paralleled by a significant increase of Helix-II levels and PIIANP levels did not change at any time. CTX-II immunoreactivity and collagen expression were detected indifferent cartilage areas. The upper zone is the area where CTX-II immunoreactivity and collagen expression best reflected the differences in urinary levels of CTX-II measured in response to oestrogen. However, correlations between urinary levels of CTX-II and tissue immunostainings in individual rats were not statistically significant. CONCLUSIONS We found only a small effect of oestrogen deprivation on cartilage. It was detected by CTX-II, but not by other type II collagen turnover markers typically affected in osteoarthritis.
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Affiliation(s)
- Anne-Christine Bay-Jensen
- Department of Clinical Cell Biology, IRS/CSFU, University of Southern Denmark, Vejle Hospital, Kabbeltoft 25, 7100 Vejle, Denmark
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Vonk LA, Kroeze RJ, Doulabi BZ, Hoogendoorn RJ, Huang C, Helder MN, Everts V, Bank RA. Caprine articular, meniscus and intervertebral disc cartilage: An integral analysis of collagen network and chondrocytes. Matrix Biol 2010; 29:209-18. [DOI: 10.1016/j.matbio.2009.12.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 12/02/2009] [Accepted: 12/02/2009] [Indexed: 10/20/2022]
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Kraus VB, Kepler TB, Stabler T, Renner J, Jordan J. First qualification study of serum biomarkers as indicators of total body burden of osteoarthritis. PLoS One 2010; 5:e9739. [PMID: 20305824 PMCID: PMC2840035 DOI: 10.1371/journal.pone.0009739] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 02/03/2010] [Indexed: 12/01/2022] Open
Abstract
Background Osteoarthritis (OA) is a debilitating chronic multijoint disease of global proportions. OA presence and severity is usually documented by x-ray imaging but whole body imaging is impractical due to radiation exposure, time and cost. Systemic (serum or urine) biomarkers offer a potential alternative method of quantifying total body burden of disease but no OA-related biomarker has ever been stringently qualified to determine the feasibility of this approach. The goal of this study was to evaluate the ability of three OA-related biomarkers to predict various forms or subspecies of OA and total body burden of disease. Methodology/Principal Findings Female participants (461) with clinical hand OA underwent radiography of hands, hips, knees and lumbar spine; x-rays were comprehensively scored for OA features of osteophyte and joint space narrowing. Three OA-related biomarkers, serum hyaluronan (sHA), cartilage oligomeric matrix protein (sCOMP), and urinary C-telopeptide of type II collagen (uCTX2), were measured by ELISA. sHA, sCOMP and uCTX2 correlated positively with total osteophyte burden in models accounting for demographics (age, weight, height): R2 = 0.60, R2 = 0.47, R2 = 0.51 (all p<10−6); sCOMP correlated negatively with total joint space narrowing burden: R2 = 0.69 (p<10−6). Biomarkers and demographics predicted 35–38% of variance in total burden of OA (total joint space narrowing or osteophyte). Joint size did not determine the contribution to the systemic biomarker concentration. Biomarker correlation with disease in the lumbar spine resembled that in the rest of the skeleton. Conclusions/Significance We have suspected that the correlation of systemic biomarkers with disease has been hampered by the inability to fully phenotype the burden of OA in a patient. These results confirm the hypothesis, revealed upon adequate patient phenotyping, that systemic joint tissue concentrations of several biomarkers can be quantitative indicators of specific subspecies of OA and of total body burden of disease.
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Affiliation(s)
- Virginia B Kraus
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America.
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Liang QQ, Xi ZJ, Bian Q, Cui XJ, Li CG, Hou W, Shi Q, Wang YJ. Herb Formula “Fufangqishe-Pill” Prevents Upright Posture–Induced Intervertebral Disc Degeneration at the Lumbar in Rats. J Pharmacol Sci 2010; 113:23-31. [DOI: 10.1254/jphs.09231fp] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Calleja-Agius J, Muscat-Baron Y, Brincat MP. Estrogens and the intervertebral disc. ACTA ACUST UNITED AC 2009; 15:127-30. [DOI: 10.1258/mi.2009.009016] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intervertebral discs are an integral part of the vertebral column. It has been shown that menopause has a negative effect on bone and on intervertebral discs. Estrogen has a beneficial effect of preserving the health of collagen-containing tissues, including the intervertebral disc. The intervertebral disc allows for mobility of the spine, and maintains a uniform stress distribution of the area of the vertebral endplates. Also, the disc influences spinal height. The disc tissue is adapted for this biomechanical function. The function of the spine is impaired if there is a loss of disc tissue. Narrowing of the disc space due to degeneration of intervertebral discs is associated with a significantly increased risk of vertebral fractures. Estrogen should be seen as the first-choice therapy for bones and other collagen-rich tissues, such as intervertebral discs, because it maintains homeostasis of the bone-remodelling unit. Unlike bisphosphonates, estrogen is unique in its ability to regenerate bone collagen after its disintegration, apart from suppressing osteoclastic activity. Besides, there is insufficient data on deterioration in bone qualities and micro-cracks in patients on long-term bisphosphonates.
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Affiliation(s)
- J Calleja-Agius
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Malta
| | - Y Muscat-Baron
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Malta
| | - M P Brincat
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Malta
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Gensburger D, Arlot M, Sornay-Rendu E, Roux JP, Delmas P. Radiologic assessment of age-related knee joint space changes in women: A 4-year longitudinal study. ACTA ACUST UNITED AC 2009; 61:336-43. [DOI: 10.1002/art.24342] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sumer EU, Schaller S, Sondergaard BC, Tankó LB, Qvist P. Application of biomarkers in the clinical development of new drugs for chondroprotection in destructive joint diseases: a review. Biomarkers 2008; 11:485-506. [PMID: 17056470 DOI: 10.1080/13547500600886115] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Emerging evidence supports the concept that biochemical markers are clinically useful non-invasive diagnostic tools for the monitoring of changes in cartilage turnover in patients with destructive joint diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA). Epidemiological studies demonstrated that measurements of different degradation products of proteins in the extracellular matrix of hyaline cartilage in urine or serum samples are (1) increased in OA or RA patients compared with healthy individuals, (2) correlate with disease activity, and (3) are predictive for the rate of changes in radiographic measures of cartilage loss. The present review provides an updated list of available biomarkers and summarize the research data arguing for their clinical utility. In addition, it addresses the question whether or not the monitoring of biomarkers during different treatment modalities could be a useful approach to characterize the chondro-protective effects of approved and candidate drugs. Finally, it briefly reviews the in vitro/ex vivo experimental settings - isolated chondrocyte cultures and articular cartilage explants - that can assist in the verification of novel markers, but also studies assessing direct effects of drug candidates on chondrocytes. Collectively, biomarkers may acquire a function as established efficacy parameters in the clinical development of novel chondro-protective agents.
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Affiliation(s)
- E U Sumer
- Nordic Bioscience A/S, Herlev, Denmark.
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Eastell R. Bone turnover markers: an appreciation of the contribution of Dr. P.D. Delmas. Bone 2008; 43:649-52. [PMID: 18946897 DOI: 10.1016/j.bone.2008.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- R Eastell
- Academic Unit of Bone Metabolism, Metabolic Bone Centre, Northern General Hospital, Herries Road, Sheffield, South Yorkshire, England, UK.
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Garnero P, Aronstein WS, Cohen SB, Conaghan PG, Cline GA, Christiansen C, Beary JF, Meyer JM, Bingham CO. Relationships between biochemical markers of bone and cartilage degradation with radiological progression in patients with knee osteoarthritis receiving risedronate: the Knee Osteoarthritis Structural Arthritis randomized clinical trial. Osteoarthritis Cartilage 2008; 16:660-6. [PMID: 17993283 DOI: 10.1016/j.joca.2007.10.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Accepted: 10/01/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate whether early changes in biochemical markers of bone (NTX-I) and cartilage (CTX-II [C-terminal crosslinking telopeptide of type II collagen]) degradation are associated with radiological progression in patients with knee osteoarthritis (OA) receiving risedronate. DESIGN Two thousand four hundred and eighty three patients with medial compartment knee OA were randomized in two 24-month studies in North America (NA) and European Union (EU). Studies evaluated risedronate 5 mg/day, 35 mg/week (EU), 50 mg/week (NA), and 15 mg/day (NA and EU), compared to placebo in reducing signs and symptoms and in slowing radiographic progression. One thousand eight hundred and eighty five patients from the pooled EU and NA studies with available NTX-I/CTX-II at both baseline and 6 months and radiographs at baseline and at 24 months were analyzed. RESULTS Risedronate produced a dose-dependent reduction of NTX-I and CTX-II observed at 6 months which continued up to 24 months. Patients who had CTX-II levels returned to low levels (<150 ng/mmol creatinine) at 6 months had a lower risk of radiographic progression at 24 months than patients whose CTX-II levels were increased both at baseline and 6 months [odds-ratio (95% confidence interval): 0.57 (0.39-0.85) after adjustment for demographics and joint space width]. The lowest risk of progression was observed in patients who had low CTX-II levels both at baseline and at 6 months [odds-ratio 0.36 (0.21-0.63)]. No significant association between NTX-I levels and radiological progression was observed. CONCLUSION CTX-II decreased with risedronate in patients with knee OA and levels reached after 6 months were associated with radiological progression at 24 months. Monitoring a marker of cartilage degradation 6 months after initiating treatment may be instructive in identifying patients with low progression.
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Affiliation(s)
- P Garnero
- INSERM Research Unit 664, Lyon, France.
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Cake M, Melrose J. Intervertebral disc is an alternate tissue source of circulating C-telopeptide of type II collagen after menopause or ovariectomy: comment on the article by Sondergaard et al. ARTHRITIS AND RHEUMATISM 2008; 58:1560. [PMID: 18438826 DOI: 10.1002/art.23448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Vosse D, Landewe R, Garnero P, van der Heijde D, van der Linden S, Geusens P. Association of markers of bone- and cartilage-degradation with radiological changes at baseline and after 2 years follow-up in patients with ankylosing spondylitis. Rheumatology (Oxford) 2008; 47:1219-22. [DOI: 10.1093/rheumatology/ken148] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Treatment strategies for osteoarthritis most commonly involve the removal or replacement of damaged joint tissue. Relatively few treatments attempt to arrest, slow down or reverse the disease process. Such options include peri-articular osteotomy around the hip or knee, and treatment of femoro-acetabular impingement, where early intervention may potentially alter the natural history of the disease. A relatively small proportion of patients with osteoarthritis have a clear predisposing factor that is both suitable for modification and who present early enough for intervention to be deemed worthwhile. This paper reviews recent advances in our understanding of the pathology, imaging and progression of early osteoarthritis.
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Affiliation(s)
- T. C. B. Pollard
- Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
| | - S. E. Gwilym
- Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
| | - A. J. Carr
- Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
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Henrotin Y, Addison S, Kraus V, Deberg M. Type II collagen markers in osteoarthritis: what do they indicate? Curr Opin Rheumatol 2007; 19:444-50. [PMID: 17762609 DOI: 10.1097/bor.0b013e32829fb3b5] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW We provide a critical review of recent in-vitro, animal and human clinical studies on type II collagen biomarkers. In describing the human studies, we have applied the BIPED (burden of disease, investigative, prognostic, efficacy of intervention, and diagnostic) classification scheme recently proposed by the Osteoarthritis Biomarkers Network (a consortium of five US National Institutes of Health designated sites). Based on this analysis, we propose an update to the classification of the type II collagen biomarkers. RECENT FINDINGS Various type II collagen epitopes have been described as potential biomarkers for osteoarthritis. Some have demonstrated ability in the following areas: classification of individuals as either diseased or nondiseased; assessment of severity or extent of osteoarthritis; prediction of future onset of osteoarthritis among those without osteoarthritis at baseline or the progression of osteoarthritis among those with existing disease; and monitoring treatment efficacy. SUMMARY Type II collagen biomarkers provide useful information for clinical and research applications. Furthermore, they are promising tools for the monitoring the influence of drug treatment on cartilage metabolism in joint diseases such as osteoarthritis.
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Affiliation(s)
- Yves Henrotin
- Bone and cartilage Research Unit, University of Liège, Institute of Pathology, Level 5, CHU Sart-Tilman, Liège, Belgium.
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Abstract
Osteoarthritis is characterized by progressive destruction of articular cartilage and subchondral bone and synovial reaction. Radiologic findings that form the basis of the diagnosis of osteoarthritis are poorly sensitive to detect early disease and for monitoring progression of joint damage. Blood-based proteomic analyses suggest that biochemical alterations can be observed well before radiologic damage is evidenced. New cartilage-specific markers, including assays for type II collagen synthesis and degradation, have been developed. Recent prospective studies indicate that blood and urine levels of these new markers are associated with progression of joint damage. Biological markers respond rapidly to treatment and therefore will certainly play an important role in the development and the monitoring of disease-modifying therapies. Because osteoarthritis involves different tissues and complex biologic processes, a combination of different biochemical markers appears to be the most promising diagnostic strategy.
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Affiliation(s)
- Patrick Garnero
- Synarc, Molecular Markers, Le Buroparc Batîment T4, 16 rue Montbrillant, 69003 Lyon, France.
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Rousseau JC, Delmas PD. Biological markers in osteoarthritis. ACTA ACUST UNITED AC 2007; 3:346-56. [PMID: 17538566 DOI: 10.1038/ncprheum0508] [Citation(s) in RCA: 161] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2006] [Accepted: 03/20/2007] [Indexed: 12/23/2022]
Abstract
Osteoarthritis (OA) is a progressive disorder characterized by destruction of articular cartilage and subchondral bone, and by synovial changes. The diagnosis of OA is generally based on clinical and radiographic changes, which occur fairly late during disease progression and have poor sensitivity for monitoring disease progression. Progression of joint damage is likely to result primarily from an imbalance between cartilage degradation and repair, so measuring markers of these processes would seem a promising approach to improve the prediction of disease progression at the individual level. Moreover, genetic markers might be useful predictors of prognosis. The lack of fully effective, chondroprotective medications has limited the use of such potential markers to monitor the effect of treatment for OA. Nevertheless, owing to their dynamic changes in response to treatment, biological markers might provide relevant information more rapidly than imaging techniques (such as radiography and MRI) can, and should contribute to our understanding of mechanisms that underlie the clinical efficacy of OA treatments. Most of the identified genes involved in OA encode signal-transduction proteins, which provide the potential for novel therapeutic approaches. In this Review, we will use the recently proposed BIPED (i.e. burden of disease, investigative, prognostic, efficacy of intervention and diagnostic) classification of OA markers to describe the potential usage of a given marker.
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Mazières B, Hucher M, Zaïm M, Garnero P. Effect of chondroitin sulphate in symptomatic knee osteoarthritis: a multicentre, randomised, double-blind, placebo-controlled study. Ann Rheum Dis 2007; 66:639-45. [PMID: 17204566 PMCID: PMC1954603 DOI: 10.1136/ard.2006.059899] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2006] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the efficacy and tolerability of chondroitin sulphate (chondroitin sulphate) in knee osteoarthritis. PATIENTS AND METHODS A 24-week, randomised placebo-controlled trial of chondroitin sulphate (1 g/day) in patients with symptomatic knee osteoarthritis as measured on a visual analogue scale. Pain on daily activities and Lequesne's Index were the primary efficacy criteria. Secondary outcomes included the rate of responders according to the outcome measures in rheumatoid arthritis clinical trials of the Osteoarthritis Research Society International (OMERACT-OARSI) criteria, quality of life, patient's/physician's global assessments and carry-over effect after treatment. Biochemical markers of bone (CTX-I), cartilage (CTX-II) and synovium (hyaluronic acid) metabolism were also measured. Safety was assessed by recording adverse events (AEs). Statistical analysis was performed on the inter-group differences in the intention-to-treat population. RESULTS 307 patients were included in the study. 28 (9%) patients discontinued the study because of lack of efficacy or AEs. At the end of treatment, the decrease in pain was -26.2 (24.9) and -19.9 (23.5) mm and improved function was -2.4 (3.4) (-25%) and -1.7 (3.3) (-17%) in the chondroitin sulphate and placebo groups, respectively (p = 0.029 and 0.109). The OMERACT-OARSI responder rate was 68% in the chondroitin sulphate and 56% in the placebo group (p = 0.03). The investigator's assessments and short form 12 (SF-12) physical component reported improvement more frequently in the chondroitin sulphate than in the placebo group (p = 0.044 and 0.021, respectively). No significant difference was observed between treatment groups for changes in biomarkers over 24 weeks. However, there was a significant difference between non-responders and responders according to the OARSI criteria for 24-week changes of CTX-I (p = 0.018) and CTX-II (p = 0.014). Tolerance was considered to be satisfactory. CONCLUSION This study failed to show an efficacy of chondroitin sulphate on the two primary criteria considered together, although chondroitin sulphate was slightly more effective than placebo on pain, OMERACT-OARSI response rate, investigator's assessment and quality of life.
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Affiliation(s)
- Bernard Mazières
- Department of Rheumatology, Rangueil University Hospital1, Avenue Jean-Poulhes, 31059 Toulouse Cedex 9, France.
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Conrozier T, Ferrand F, Poole AR, Verret C, Mathieu P, Ionescu M, Vincent F, Piperno M, Spiegel A, Vignon E. Differences in biomarkers of type II collagen in atrophic and hypertrophic osteoarthritis of the hip: implications for the differing pathobiologies. Osteoarthritis Cartilage 2007; 15:462-7. [PMID: 17055306 DOI: 10.1016/j.joca.2006.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Accepted: 09/04/2006] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cartilage destruction in osteoarthritis (OA) involves the excessive degradation and increased synthesis of cartilage matrix macromolecules including type II collagen (CII) and proteoglycans. The lack of osteophytes (atrophic form of OA) has been shown to be a disease severity factor in hip OA. Since osteophyte formation involves endochondral ossification and a cartilage intermediate, atrophic OA may also exhibit differences in cartilage turnover compared to hypertrophic OA. Cartilage serum biomarkers may offer an opportunity to identify such differences in patients. AIM To determine whether serum levels of cartilage biomarkers can distinguish between the presence and absence of osteophyte formation in patients with atrophic and hypertrophic hip OA. PATIENTS AND METHODS Fifty-six patients (mean age/standard deviation (SD): 62/11; mean body mass index (BMI)/SD: 27/11) with symptomatic hip OA (American College of Rheumatology criteria; mean Lequesne index/SD: 8.3/4) were classified as having an atrophic or hypertrophic form of OA, according to the absence or presence, respectively, of any osteophyte on a standard radiograph of the pelvis. Minimum joint space width (minJSW) and angles of dysplasia [centre-edge (CE) and head-neck-shaft (HNS)] were determined by computerized measurements. The following serum markers were used which are commercial kits from Ibex Diagnostics (Montreal, QC): proteoglycan aggrecans turnover: CS 846; CII synthesis: C-propeptide (CPII), cleavage by collagenase of type II (C2C) and type I and II (C1,2C) collagens. STATISTICS Patients with atrophic and hypertrophic OA were compared for each variable and step to step logistic regression was used to determine the effect of variables on the belonging to each group. Correlations were examined using linear regression or Spearman test. RESULTS CPII serum levels were significantly lower in the atrophic OA patients (77.3 vs 117.4 ng/mL). There were no significant differences between groups for C2C, C1,2C and CS 846 . CPII and C2C concentrations were highly correlated in hypertrophic OA (P=0.002) but not in atrophic OA (P=0.8). CONCLUSION Atrophic hip OA is characterized by reduced synthetic activity involving type II collagen synthesis. This could account in part for the absence of osteophyte formation. The highly significant correlation between CPII and C2C in hypertrophic but not in atrophic OA suggests that the physiological coupling between CII formation and degradation may be lost in atrophic OA. These differences may therefore help explain the absence of osteophyte in atrophic OA and its association with more rapid disease progression.
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Affiliation(s)
- T Conrozier
- Department of Rheumatology, University Hospital Lyon-sud, Lyon, France.
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Meulenbelt I, Kloppenburg M, Kroon HM, Houwing-Duistermaat JJ, Garnero P, Hellio-Le Graverand MP, DeGroot J, Slagboom PE. Clusters of biochemical markers are associated with radiographic subtypes of osteoarthritis (OA) in subject with familial OA at multiple sites. The GARP study. Osteoarthritis Cartilage 2007; 15:379-85. [PMID: 17052923 DOI: 10.1016/j.joca.2006.09.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2006] [Accepted: 09/09/2006] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the relationship of biochemical markers and radiographic signs of osteoarthritis (ROA) in the subjects with symptomatic osteoarthritis (OA) at multiple sites of the Genetics osteoARthritis and Progression (GARP) study. METHODS We have measured eight biochemical markers, representing tissue turnover of cartilage, bone, synovium, and inflammation. ROA was assessed in the knees, hips, hands, vertebral facet joints and spinal disc degeneration (DD) by using the Kellgren score. A proportionate score was subsequently made for each joint location based on the number of joints with ROA. Principal component and linear mixed model analyses were applied to analyze the data. RESULTS Three different clusters of markers were identified that may reflect different pathophysiological processes of OA. The first component appeared to be reflected by structural markers of cartilage and bone turnover and associated especially in subjects with hip ROA. The second component was reflected by a marker of inflammation and was associated with knee ROA, high Western Ontario and McMaster Universities (WOMAC) scores and body mass index (BMI). The third component included markers of cartilage turnover and was associated with ROA at hands, spine as well as age. High familial aggregation was observed for serum cartilage oligomeric matrix protein (S-COMP) (70%) and serum N-propeptide of collagen type IIA (S-PIIANP) (62%). CONCLUSION Using a large well-characterized study and eight biochemical markers, we were able to observe three components that may reflect different molecular mechanisms (bone, cartilage, synovium turnover and inflammation). Our data suggested that these components contribute differently to ROA at different joint sites.
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Affiliation(s)
- I Meulenbelt
- Department of Molecular Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
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50
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Garnero P. New biochemical markers of cartilage turnover in osteoarthritis: Recent developments and remaining challenges. ACTA ACUST UNITED AC 2007. [DOI: 10.1138/20060244] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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