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Bjerre-Bastos JJ, Sejersen C, Nielsen HB, Boesen M, Secher NH, Distajo G, Flood V, Henrotin Y, Uebelhoer M, Krustrup P, Kitchen CC, Thudium CS, Andersen JR, Bihlet AR. The Impact of Weight-bearing Exercise, Non-Weight-bearing Exercise, and Cardiovascular Stress on Biochemical Markers of Cartilage Turnover in Patients With Mild to Moderate Knee Osteoarthritis: A Sequential, Cross-Over, Clinical Study. Cartilage 2024:19476035241258170. [PMID: 38853398 DOI: 10.1177/19476035241258170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
OBJECTIVE To investigate how running, cycling, and sedentary cardiovascular stress impact biomarkers of cartilage turnover acutely in subjects with knee osteoarthritis (OA). DESIGN This was a sequential, cross-over, clinical study. Forty subjects with primary knee OA underwent moderate-to-high-intensity cycling, running, and adrenaline infusion on separate days. Blood was sampled before, during, and at 6-time points after intervention. On a control day, similar samples were taken. Biomarkers of type II collagen degradation (C2M, T2CM, Coll2-1, Coll2-1NO2), formation (PRO-C2), and aggrecan degradation (ARGS) were measured. RESULTS Mean age was 60.4 years, 40% were male, 45% had cumulated Kellgren-Lawrence (KL)-grade (Right + Left knee) of 2 to 3 and 55% had 4 to 6. Analyzing overall changes, area under the curve was significantly lower compared with resting values for ARGS and C2M after cycling and for ARGS after running. Considering individual time points, peak changes in biomarker levels showed reduction in C2M shortly following cycling (T20min = -12.3%, 95% confidence interval [CI]: -19.3% to -5.2%). PRO-C2 increased during cycling (T10min = 14.0%, 95% CI = 4.1% to 23.8%) and running (T20min = 16.5%, 95% CI = 4.3% to 28.6%). T2CM decreased after cycling (T50min = -19.9%, 95% CI = -29.2% to -10.6%), running (T50min = -22.8%, 95% CI = -32.1% to -13.5%), and infusion of adrenaline (peak, T50min = -9.8%, 95% CI = -20.0% to 0.4%). A latent increase was seen in Coll2-1 240 minutes after running (T260min = 21.7%, 95% CI = -1.6% to 45.1%). CONCLUSION Exercise had an impact on cartilage markers, but it did not suggest any detrimental effect on cartilage. Changes following adrenaline infusion suggest a sympathomimetic influence on the serological composition of biomarkers.
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Affiliation(s)
- Jonathan J Bjerre-Bastos
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- NBCD A/S, Herlev, Denmark
| | - Casper Sejersen
- Department of Anaesthesiology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bay Nielsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Anaesthesia and Intensive Care Medicine, Zealand University Hospital, Roskilde, Denmark
- Department of Nutrition, Exercise and Sport, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Boesen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Radiology, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark
| | - Niels H Secher
- Department of Anaesthesiology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Yves Henrotin
- Department of Physical and Rehabilitation, VIVALIA, Marche-en-Famenne, Belgium
- Musculoskeletal Innovative Research Lab (mSKIL), University of Liège, Liège, Belgium
| | | | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Carl-Christian Kitchen
- Department of Anaesthesiology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Bjerre-Bastos JJ, Hamrouni N, Henrotin Y, Thudium CS, Bihlet AR. Joint biomarker response to mechanical stimuli in osteoarthritis - A scoping review. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100390. [PMID: 37885822 PMCID: PMC10598037 DOI: 10.1016/j.ocarto.2023.100390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 08/04/2023] [Indexed: 10/28/2023] Open
Abstract
Objective Arthritic cartilage is primed for mechanical damage. Joint biochemical markers (JBM) could provide insight into the impact of mechanical stimulation on joint tissue turnover in osteoarthritis (OA) of potential use in clinical OA research and practice. However, existing studies of the acute impact of physical activities (PA) on JBM often contain risks of substantial bias. The purpose of this scoping review was to critically review and discuss existing reports of acute joint tissue turnover as reflected in JBM in relation to PA in OA and propose considerations for future research. Design We searched PubMed, Embase, and Scopus and reference lists for original reports on the acute impact of PA on JBM in human OA. Identified studies were reviewed by two reviewers forming the basis for the discussion of methodology. Results Search in databases resulted in nine eligible papers after full-text evaluation. Two additional papers were identified through reference lists, resulting in 11 papers included in this review. Ten investigated knee OA and one investigated hand OA. Biomarkers described were related to turnover of type II collagen, aggrecan, and cartilage oligomeric matrix protein. Conclusions The literature is dominated by small, simplistic studies, but suggests that mechanical stimulation can induce acute changes in joint biomarkers. In order to diminish the existing bias in future studies, it is important to recognize methodological considerations e.g. patient and biomarker selection as well as peri-interventional control. Common potential sources of bias include the acute shift in plasma volume due to cardiovascular stress and postural changes.
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Affiliation(s)
- Jonathan J. Bjerre-Bastos
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- NBCD A/S, Herlev, Denmark
- Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Nizar Hamrouni
- Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Yves Henrotin
- Musculoskeletal Innovative Research Lab (mSKIL), Arthropôle Liège, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, CHU Sart-Tilman, 4000 Liège, Belgium
- Physical Therapy and Rehabilitation Department, Princess Paola Hospital, Vivalia, Rue du Vivier, 6900 Marche-en-Famenne, Belgium
- Artialis SA, CHU Sart-Tilman, GIGA Tower, level 3, 4000 Liège, Belgium
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Bjerre-Bastos JJ, Sejersen C, Bihlet AR, Secher NH, Mackey AL, Kitchen CC, Drobinski P, Thudium CS, Nielsen HB. An Estimate of Plasma Volume Changes Following Moderate-High Intensity Running and Cycling Exercise and Adrenaline Infusion. Front Physiol 2022; 13:948087. [PMID: 35936903 PMCID: PMC9355650 DOI: 10.3389/fphys.2022.948087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction: Plasma volume (PV) changes in response to physical activity, possibly as a consequence of adrenergic activation. We estimated changes in PV in response to common exercise modalities; cycling and running as well as adrenaline infusion and control at rest. Methods: On separate days, forty circulatory healthy subjects [aged 60 years (range: 42–75)] with knee osteoarthritis underwent moderate-high intensity cycling, running, and intravenous adrenaline infusion to mimic the circulatory response to exercise. Blood samples were obtained from peripheral veins taken at several pre-defined time points before, during, and after the interventions. PV changes were estimated using venous hemoglobin and the derived hematocrit. The temporal associations between PV and selected biomarkers were explored. Results: Changes in PV were observed during all four interventions, and the response to cycling and running was similar. Compared to rest, PV decreased by -14.3% (95% CI: -10.0 to -18.7) after cycling, -13.9% (95% CI: -10.9 to -17.0) after running, and -7.8% (95% CI: -4.2 to -11.5) after adrenaline infusion. Conclusion: PV decreased in response to moderate-high intensity running and cycling. Adrenaline infusion mimicked the PV change observed during exercise, suggesting a separate influence of autonomic control on blood volume homeostasis. In perspective, a temporal association between PV and biomarker dynamics suggests that consideration of PV changes could be relevant when reporting plasma/serum constituents measured during exercise, but more research is needed to confirm this.
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Affiliation(s)
- Jonathan J. Bjerre-Bastos
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- NBCD A/S, Herlev, Denmark
- *Correspondence: Jonathan J. Bjerre-Bastos,
| | - Casper Sejersen
- Department of Anesthesia, Rigshospitalet, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Niels H. Secher
- Department of Anesthesia, Rigshospitalet, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Abigail L. Mackey
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Sports Medicine, Bispebjerg Hospital, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Carl-Christian Kitchen
- Department of Anesthesia, Rigshospitalet, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Henning Bay Nielsen
- Department of Anesthesiology, Roskilde Hospital, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Östlind E, Eek F, Stigmar K, Sant’Anna A, Ekvall Hansson E, Struglics A. Associations Between Physical Activity, Self-reported Joint Function, and Molecular Biomarkers in Working Age Individuals With Hip and/or Knee Osteoarthritis. CLINICAL MEDICINE INSIGHTS: ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2022; 15:11795441221081063. [PMID: 35342314 PMCID: PMC8950022 DOI: 10.1177/11795441221081063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/28/2022] [Indexed: 11/18/2022]
Abstract
Objective: Previous research has suggested an association between physical activity (PA), joint function, and molecular biomarkers, but more studies are needed. The aim of this study was to explore the associations between PA or self-reported joint function and molecular biomarkers of cartilage and inflammation in individuals with hip and/or knee osteoarthritis (OA). Specific objectives were to explore the correlations between (1) the change over 3 months in self-reported PA/joint function and the change in molecular biomarkers (2) objectively measured PA and molecular biomarkers measured at 3-month follow-up. Design: Working age participants (n = 91) were recruited from a cluster randomized controlled trial. Self-reported PA, joint function, and serum samples were collected at baseline and after 3 months. Serum concentrations of the inflammatory marker C-reactive protein (CRP) and the cartilage markers Alanine-Arginine-Glycine-Serine (ARGS)-aggrecan, cartilage oligomeric matrix protein (COMP), and type II collagen C2C were analyzed by immunoassays. Objectively measured PA (steps/day) was collected during 12 weeks from activity trackers used by 53 participants. Associations were analyzed with Spearman’s rank correlation. Results: There was a weak negative correlation between the change in self-reported PA and the change in COMP (rs = −0.256, P = .040) but not for the other molecular biomarkers. There were no correlations between the change in self-reported joint function and the change in molecular biomarkers or between the average steps/day and the molecular biomarkers at follow-up (rs ⩽ −0.206, P ⩾ .06). Conclusion: In general, no or only weak associations were found between PA/joint function and molecular biomarkers. Future research recommends including participants with lower PA, extend the follow-up, and use a design that allows comparisons.
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Affiliation(s)
- Elin Östlind
- Research Group Physiotherapy, Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Dalby Healthcare Center, Region Skåne, Lund, Sweden
| | - Frida Eek
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
| | - Kjerstin Stigmar
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | | | - Eva Ekvall Hansson
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | - André Struglics
- Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
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Bjerre-Bastos JJ, Nielsen HB, Andersen JR, Karsdal M, Bay-Jensen AC, Boesen M, Mackey AL, Byrjalsen I, Bihlet AR. Does moderate intensity impact exercise and non-impact exercise induce acute changes in collagen biochemical markers related to osteoarthritis? - An exploratory randomized cross-over trial. Osteoarthritis Cartilage 2021; 29:986-994. [PMID: 33676014 DOI: 10.1016/j.joca.2021.02.569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/17/2021] [Accepted: 02/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate acute changes in biochemical markers of cartilage turnover in response to moderate intensity exercise with and without joint impact in humans with knee osteoarthritis. DESIGN We conducted a randomized, cross-over, exploratory clinical study. Twenty subjects with knee osteoarthritis (OA) were randomized, of which twenty completed 30 min of cycling and 15 completed 30 min of running on days 1 week apart. Fasting blood samples were taken before, immediately after and 1, 2, 3, and 24 h after activity was initiated. Midstream spot urine was sampled before and after activity. Serum samples were analyzed for concentrations of fragment of type II collagen degradation, C2M, fragment of type VI collagen degradation, C6M, cartilage oligomeric matrix protein, COMP, marker of type II collagen formation, PRO-C2, and urine for marker of crosslinked type II collagen degradation, CTX-II. To establish a reference, all subjects had similar samples taken during rest on a separate day. Data was analyzed in a restricted maximum likelihood based random effects linear mixed model. RESULTS C2M trended to increase after cycling compared running (13.49%, 95%CI: -0.36-27.34%) and resting (12.88%, 95%CI: 0.2-25.6%) and the type II collagen formation/degradation ratio switched towards degradation after cycling, but not running. C6M trended to decrease after cycling (-8.1%, 95%CI: -14.8 to -1.4%) and running (-6.8%, 95%CI: -14.16-0.55%). CONCLUSION In persons with knee OA moderate intensity exercise without joint impact may induce acute changes in circulating levels of biochemical markers reflecting type II and VI collagen degradation.
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Affiliation(s)
- J J Bjerre-Bastos
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Nordic Bioscience Clinical Development, Herlev, Denmark.
| | - H B Nielsen
- Department of Anesthesia, Zealand University Hospital Roskilde, Denmark; Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark.
| | - J R Andersen
- Nordic Bioscience Clinical Development, Herlev, Denmark.
| | | | | | - M Boesen
- Department of Radiology, Bispebjerg Hospital, Copenhagen, Denmark.
| | - A L Mackey
- Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
| | - I Byrjalsen
- Nordic Bioscience Clinical Development, Herlev, Denmark.
| | - A R Bihlet
- Nordic Bioscience Clinical Development, Herlev, Denmark.
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Bjerre-Bastos JJ, Nielsen HB, Andersen JR, Karsdal M, Boesen M, Mackey AL, Byrjalsen I, Thudium CS, Bihlet AR. A biomarker perspective on the acute effect of exercise with and without impact on joint tissue turnover: an exploratory randomized cross-over study. Eur J Appl Physiol 2021; 121:2799-2809. [PMID: 34156534 DOI: 10.1007/s00421-021-04751-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 06/18/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate acute changes in biochemical markers of bone and cartilage turnover in response to moderate intensity exercise with and without joint impact in healthy human subjects. METHODS A randomized, cross-over, exploratory, clinical study was conducted. Twenty healthy subjects with no history of joint trauma completed 30 min interventions of standardized moderate intensity cycling and running as well as a resting intervention 1 week apart. Blood samples were taken immediately before, four times after exercise and again the next day. Urine was sampled, before, after and the next day. On the day of rest, samples were taken at timepoints similar to the days of exercise. Markers of type I (CTX-I), II (C2M, CTX-II) and VI (C6M) collagen degradation, cartilage oligomeric matrix protein (COMP) and procollagen C-2 (PRO-C2) was measured. TRIAL REGISTRATION NUMBER NCT04542655, 02 September 2020, retrospectively registered. RESULTS CTX-I was different from cycling (4.2%, 95%CI: 0.4-8.0%, p = 0.03) and resting (6.8%, 95%CI: 2.9-10.7%, p = 0.001) after running and the mean change in COMP was different from cycling (10.3%, 95%CI: 1.1-19.5%, p = 0.03), but not from resting (8.6%, 95%CI: - 0.7-17.8%, p = 0.07) after running. Overall, changes in other biomarkers were not different between interventions. CONCLUSION In this exploratory study, running, but not cycling, at a moderate intensity and duration induced acute changes in biomarkers of bone and cartilage extra-cellular matrix turnover.
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Affiliation(s)
- Jonathan J Bjerre-Bastos
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
- Nordic Bioscience Clinical Development, Herlev, Denmark.
| | - Henning Bay Nielsen
- Sanos Clinic, Herlev, Denmark
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Mikael Boesen
- Department of Radiology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Abigail L Mackey
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
- Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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