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Gonzalez D, Fortuna F, Jacobsen DG, Fritzler A, Jamardo J, Ibar C, Gomez ME, Gonzalez A, Maggi L, Maidana P, Mesch V, Fabre B. Analytical evaluation of the Snibe β-isomerized C-terminal telopeptide of type I collagen (β-CTX-I) automated method. Clin Chem Lab Med 2024; 62:e136-e139. [PMID: 38373113 DOI: 10.1515/cclm-2023-1394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Diego Gonzalez
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Federico Fortuna
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, 62963 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) , Buenos Aires, Argentina
| | - Dario G Jacobsen
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Analy Fritzler
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Juan Jamardo
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Carolina Ibar
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Maria E Gomez
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Analia Gonzalez
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Liliana Maggi
- Laboratorio Centro Diagnóstico Rossi 62963 , Buenos Aires, Argentina
| | - Patricia Maidana
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Laboratorio Centro Diagnóstico Rossi 62963 , Buenos Aires, Argentina
| | - Viviana Mesch
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
| | - Bibiana Fabre
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), 62963 Universidad de Buenos Aires , Buenos Aires, Argentina
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Demeuse J, Massonnet P, Schoumacher M, Grifnée E, Huyghebaert L, Dubrowski T, Peeters S, Le Goff C, Cavalier E. Innovative workflow for the identification of cathepsin K cleavage sites in type I collagen. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1228:123864. [PMID: 37634391 DOI: 10.1016/j.jchromb.2023.123864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/09/2023] [Accepted: 08/19/2023] [Indexed: 08/29/2023]
Abstract
Since the late 1990s, cathepsin K cleavage sites in type I collagen have been extensively studied due to its ability to release bone resorption biomarkers such as CTX and NTX. However, gel-based methods and N-sequencing used in these studies lack sensitivity, especially for small to medium peptides. In this work, we propose a degradomics mass spectrometry-based workflow that combines protein digestion, Nano-LC-UDMSE, and several software tools to identify cathepsin K cleavage sites. This workflow not only identified previously known cleavage sites, but also discovered new ones. Multiple cleavage hotspots were found and described in type I α1 and type I α2 collagen, many of which coincided with pyridinoline crosslinks, known to stabilize the triple helix. Our results allowed us to establish a chronology of digestion and conclude that cathepsin K preferentially cleaves the extremities of type I collagen before the helical part. We also found that cathepsin K preferentially cleaves amino acid residues with long and hydrophobic lateral chains at the beginning of digestion, whereas no preferred amino acid residues were identified later in the digestion. In conclusion, our workflow successfully identified new cleavage sites and can be easily applied to other proteins or proteases.
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Affiliation(s)
- Justine Demeuse
- Department of Clinical Chemistry, CIRM, University of Liège, 4000 Liège, Belgium.
| | - Philippe Massonnet
- Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Matthieu Schoumacher
- Department of Clinical Chemistry, CIRM, University of Liège, 4000 Liège, Belgium
| | - Elodie Grifnée
- Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Loreen Huyghebaert
- Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Thomas Dubrowski
- Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Stéphanie Peeters
- Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Caroline Le Goff
- Department of Clinical Chemistry, CIRM, University of Liège, 4000 Liège, Belgium; Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, CIRM, University of Liège, 4000 Liège, Belgium; Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
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3
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Ladang A, Rauch F, Delvin E, Cavalier E. Bone Turnover Markers in Children: From Laboratory Challenges to Clinical Interpretation. Calcif Tissue Int 2023; 112:218-232. [PMID: 35243530 DOI: 10.1007/s00223-022-00964-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/17/2022] [Indexed: 01/25/2023]
Abstract
Bone turnover markers (BTMs) have been developed many years ago to study, in combination with imaging techniques, bone remodeling in adults. In children and adolescents, bone metabolism differs from adults since it implies both growth and bone remodeling, suggesting an age- and gender-dependent BTM concentration. Therefore, specific studies have evaluated BTMs in not only physiological but also pathological conditions. However, in pediatrics, the use of BTMs in clinical practice is still limited due to these many children-related specificities. This review will discuss about physiological levels of BTMs as well as their modifications under pathological conditions in children and adolescents. A focus is also given on analytical and clinical challenges that restrain BTM usefulness in pediatrics.
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Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU de Liège, Liège, Belgium.
| | - Frank Rauch
- Shriners Hospital for Children, McGill University, Montreal, Canada
| | - Edgard Delvin
- Centre & Department of Biochemistry, Ste-Justine University Hospital Research, Université de Montréal, Montreal, Canada
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4
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Schini M, Vilaca T, Gossiel F, Salam S, Eastell R. Bone Turnover Markers: Basic Biology to Clinical Applications. Endocr Rev 2022; 44:417-473. [PMID: 36510335 PMCID: PMC10166271 DOI: 10.1210/endrev/bnac031] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
Bone turnover markers (BTMs) are used widely, in both research and clinical practice. In the last 20 years, much experience has been gained in measurement and interpretation of these markers, which include commonly used bone formation markers bone alkaline phosphatase, osteocalcin, and procollagen I N-propeptide; and commonly used resorption markers serum C-telopeptides of type I collagen, urinary N-telopeptides of type I collagen and tartrate resistant acid phosphatase type 5b. BTMs are usually measured by enzyme-linked immunosorbent assay or automated immunoassay. Sources contributing to BTM variability include uncontrollable components (e.g., age, gender, ethnicity) and controllable components, particularly relating to collection conditions (e.g., fasting/feeding state, and timing relative to circadian rhythms, menstrual cycling, and exercise). Pregnancy, season, drugs, and recent fracture(s) can also affect BTMs. BTMs correlate with other methods of assessing bone turnover, such as bone biopsies and radiotracer kinetics; and can usefully contribute to diagnosis and management of several diseases such as osteoporosis, osteomalacia, Paget's disease, fibrous dysplasia, hypophosphatasia, primary hyperparathyroidism, and chronic kidney disease-mineral bone disorder.
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Affiliation(s)
- Marian Schini
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tatiane Vilaca
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Fatma Gossiel
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Syazrah Salam
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Richard Eastell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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5
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Guzman A, Kurgan N, Moniz SC, McCarthy SF, Sale C, Logan-Sprenger H, Elliott-Sale KJ, Hazell TJ, Klentrou P. Menstrual Cycle Related Fluctuations in Circulating Markers of Bone Metabolism at Rest and in Response to Running in Eumenorrheic Females. Calcif Tissue Int 2022; 111:124-136. [PMID: 35429247 DOI: 10.1007/s00223-022-00970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/10/2022] [Indexed: 11/02/2022]
Abstract
This study examined potential fluctuations in bone metabolic markers across the menstrual cycle both at rest and after a 30-min bout of continuous running at 80% of V̇O2max. Resting and post-exercise (0, 30, 90 min) sclerostin, parathyroid hormone (PTH), carboxy-terminal cross-linking telopeptide of type I collagen (β-CTXI), and procollagen type 1 N propeptide (PINP) were assessed in 10 eumenorrheic women (age: 21 ± 3 y, BMI: 23.2 ± 3.0 kg.m2) during the mid- to late-follicular (FP: day 8.0 ± 1.4) and mid-luteal (LP: day 22.0 ± 2.5) phases of the menstrual cycle. Ovulation was determined using ovulation kits and daily measurement of oral body temperature upon awakening. Menstrual cycle phase was subsequently confirmed by measurement of plasma estradiol and progesterone. On average, resting estradiol concentrations increased from 46.3 ± 8.9 pg·mL-1 in the FP to 67.3 ± 23.4 pg·mL-1 in the LP (p = 0.015), and resting progesterone increased from 4.12 ± 2.36 ng·mL-1 in the FP to 11.86 ± 4.49 ng·mL-1 in the LP (p < 0.001). At rest, there were no differences between menstrual cycle phases in sclerostin (FP: 260.1 ± 135.0 pg·mL-1; LP: 303.5 ± 99.9 pg·mL-1; p = 0.765), PTH (FP: 0.96 ± 0.64 pmol·L-1; LP: 0.79 ± 0.44 pmol·L-1; p = 0.568), β-CTXI (FP: 243.1 ± 158.0 ng·L-1; LP: 202.4 ± 92.3 ng·L-1; p = 0.198), and PINP (FP: 53.6 ± 8.9 μg·L-1; LP: 66.2 ± 20.2 μg·L-1; p = 0.093). Main effects for time (p < 0.05) were shown in sclerostin, PTH, β-CTXI and PINP, without phase or interaction effects. Sclerostin increased from pre- to immediately post-exercise (45%; p = 0.007), and so did PTH (43%; p = 0.011), both returning to resting concentrations 30 min post-exercise. β-CTXI decreased from pre- to post-exercise (20%; p = 0.027) and was still below its pre-exercise concentrations at 90 min post-exercise (17%; p = 0.013). PINP increased immediately post-exercise (29%; p < 0.001), returning to resting concentrations at 30 min post-exercise. These results demonstrate no effect of menstrual cycle phase on resting bone marker concentrations or on the bone metabolic marker response to intense exercise.
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Affiliation(s)
- Anne Guzman
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Nigel Kurgan
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Sara C Moniz
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Seth F McCarthy
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Craig Sale
- SHAPE Research Centre, Nottingham Trent University, Nottingham, UK
| | | | | | - Tom J Hazell
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Panagiota Klentrou
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada.
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Cavalier E, Eastell R, Jørgensen NR, Makris K, Tournis S, Vasikaran S, Kanis JA, Cooper C, Pottel H, Morris HA. A Multicenter Study to Evaluate Harmonization of Assays for C-Terminal Telopeptides of Type I Collagen (ß-CTX): A Report from the IFCC-IOF Committee for Bone Metabolism (C-BM). Calcif Tissue Int 2021; 108:785-797. [PMID: 33661343 PMCID: PMC8166738 DOI: 10.1007/s00223-021-00816-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Biochemical bone turnover markers are useful tools to assess bone remodeling. C-terminal telopeptide of type I collagen (ß-CTX) has been recommended as a reference marker for bone resorption in research studies. METHODS We describe the results of a multicenter study for routine clinical laboratory assays for ß-CTX in serum and plasma. Four centers (Athens GR, Copenhagen DK, Liege BE and Sheffield UK) collected serum and plasma (EDTA) samples from 796 patients presenting to osteoporosis clinics. Specimens were analyzed in duplicate with each of the available routine clinical laboratory methods according to the manufacturers' instructions. Passing-Bablok regressions, Bland-Altman plots, V-shape evaluation method, and Concordance correlation coefficient for ß-CTX values between serum and plasma specimens and between methods were used to determine the agreement between results. A generalized linear model was employed to identify possible variables that affected the relationship between the methods. Two pools of serum were finally prepared and sent to the four centers to be measured in 5-plicates on 5 consecutive days with the different methods. RESULTS We identified significant variations between methods and between centers although comparison results were generally more consistent in plasma compared to serum. We developed univariate linear regression equations to predict Roche Elecsys®, IDS-iSYS, or IDS ELISA ß-CTX results from any other assay and a multivariable model including the site of analysis, the age, and weight of the patient. The coefficients of determination (R2) increased from approximately 0.80 in the univariate model to approximately 0.90 in the multivariable one, with the site of analysis being the major contributing factor. Results observed on the pools also suggest that long-term storage could explain the difference observed with the different methods on serum. CONCLUSION Our results show large within- and between-assay variation for ß-CTX measurement, particularly in serum. Stability of the analyte could be one of the explanations. More studies should be undertaken to overcome this problem. Until harmonization is achieved, we recommend measuring ß-CTX by the same assay on EDTA plasma, especially for research purposes in large pharmacological trials where samples can be stored for long periods before they are assayed.
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Affiliation(s)
- E Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Domaine du Sart-Tilman, B-4000, Liège, Belgium.
| | - R Eastell
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
| | - N R Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, 2600, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - K Makris
- Clinical Biochemistry Department, KAT General Hospital, 14561, Athens, Greece
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, 14561, Athens, Greece
| | - S Tournis
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, 14561, Athens, Greece
| | - S Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, 6150, Australia
| | - J A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - C Cooper
- The MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - H Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - H A Morris
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, 5000, Australia
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Bhattoa HP, Cavalier E, Eastell R, Heijboer AC, Jørgensen NR, Makris K, Ulmer CZ, Kanis JA, Cooper C, Silverman SL, Vasikaran SD. Analytical considerations and plans to standardize or harmonize assays for the reference bone turnover markers PINP and β-CTX in blood. Clin Chim Acta 2021; 515:16-20. [PMID: 33382995 PMCID: PMC8033406 DOI: 10.1016/j.cca.2020.12.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/11/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
Procollagen type I N-propeptide (PINP) and the C-terminal telopeptide of type I collagen (β-CTX) in blood have been designated as reference bone turnover markers in osteoporosis by the International Osteoporosis Foundation (IOF) and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). The IFCC Committee on Bone Metabolism (C-BM) has examined current commercial assays and performed a multicentre study to examine the agreement between assays for PINP and β-CTX in serum and plasma. The results of these studies will inform our work towards the harmonization of PINP assays and the standardization of β-CTX assays in blood, with the development of common calibrators and reference measurement procedures in collaboration with the reagent manufacturing industry. Successful achievement of these goals will help develop universally acceptable practice guidelines for the management of osteoporosis with the inclusion of common reference intervals and treatment targets for PINP and β-CTX.
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Affiliation(s)
- Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium
| | - Richard Eastell
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Niklas R Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, DK-2600 Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 14561 Athens, Greece; Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, Athens, Greece
| | - Candice Z Ulmer
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK and Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Cyrus Cooper
- The MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Stuart L Silverman
- Cedars-Sinai Medical Center and UCLA School of Medicine, Beverly Hills, CA, USA
| | - Samuel D Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia.
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Abstract
Osteoporosis (OP) is a condition where there is low bone density and microarchitectural deterioration which can predispose to fragility fractures. There is a wealth of literature on OP from the developed countries, but less so from Asia. This review will explore the field of OP research in South-East Asia with regard to the epidemiology, the diagnosis of OP and the role of laboratory tests in the management of OP, with emphasis on 25-dihydroxyvitamin D and bone turnover markers.
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Affiliation(s)
- Subashini C Thambiah
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400 UPM, Selangor, Malaysia
| | - Swan Sim Yeap
- Department of Medicine, Subang Jaya Medical Centre, 47500 Subang Jaya, Selangor, Malaysia
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9
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Evans W, Nevill A, McLaren SJ, Ditroilo M. The effect of intermittent running on biomarkers of bone turnover. Eur J Sport Sci 2019; 20:505-515. [PMID: 31322477 DOI: 10.1080/17461391.2019.1646811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Intermittent exercise might be an efficient means of exercise for improving bone strength and quality. The aim of our study was to examine the effect of intermittent running on bone turnover markers using altered exercise-to-rest intervals. Twelve males completed one control (no exercise), and three, 45-min intermittent protocols (5, 20, and 80 s intervals) matched for distance and speed. Fasted venous blood samples were collected at baseline, 1, 2 and 24 h post-exercise. Carboxyterminal crosslinked telopeptide (CTX-I) and procollagen type 1 amino-terminal propeptide (P1NP) were used as markers of bone resorption and formation. After adjustment for baseline, CTX-I concentration at 1 h was higher (very likely to most likely small) for 5 s (30.2%; ±90% confidence limits: 10%), 20 s (2.9.0%; ±10%) and 80 s (32.0%; ±10%) compared to control. The very likely small effect remained for 5 s at 2 h (30.2%; ±15%). The effect for 20 and 80 s was possibly trivial and possibly small/possibly trivial (∼14.5%; ±∼15%). Differences in P1NP concentrations were likely to very likely trivial (∼7.4%; ±∼7.6%). Circulating CTX-I concentration is affected acutely by intermittent running with short-interval (5 s) intermittent loading resulting in a prolonged attenuation in circadian rhythm of CTX-I up to 2 h that was not demonstrated as clearly by longer intervals despite matched internal and external training load.
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Affiliation(s)
- W Evans
- Faculty of Health Sciences and Wellbeing, Sport and Exercise Sciences, University of Sunderland, Sunderland, UK
| | - A Nevill
- Faculty of Education, Health & Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - S J McLaren
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK.,The Rugby Football League, Leeds, UK
| | - M Ditroilo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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10
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Christensen GL, Halgreen JR, Milenkovski M, Köse A, Quardon N, Jørgensen NR. Bone turnover markers are differentially affected by pre-analytical handling. Osteoporos Int 2019; 30:1137-1141. [PMID: 30680430 DOI: 10.1007/s00198-019-04837-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/02/2019] [Indexed: 12/19/2022]
Abstract
UNLABELLED Given that bone turnover markers are often shipped to central laboratories, it is essential to be aware of factors that will affect stability. We have evaluated how sample type, time before separation of blood samples, and time between separation and analysis affect the stability of four bone turnover markers. INTRODUCTION Bone turnover markers are often shipped to central laboratories for analysis, which require knowledge of the stability of the markers of interest in different sample materials. The aim of the current study was to evaluate how time before separation of blood samples and time between separation and analysis affect the stability of four bone turnover markers in serum and plasma samples. METHODS Serum, EDTA, and Lithium heparin (LiHep) plasma samples from seven osteoporosis patients and three healthy controls were collected and stored at room temperature for up to 72 h before separation and analysis. After separation, samples were stored at room temperature for up to 72 h and re-analyzed. The bone turnover markers N-terminal pro-collagen type 1 extension pro-peptide (P1NP), bone-specific alkaline phosphatase (BAP), C-terminal teleopeptide cross links of collagen type 1 (CTX), and osteocalcin (OC) were analyzed using the automated iSYS IDS platform. RESULTS P1NP and BAP were stable in both plasma and serum for 72 h before centrifugation. CTX levels were higher in EDTA plasma at all time points compared to LiHep plasma and serum. The use of EDTA plasma prolonged the stability of CTX as compared to LiHep plasma and serum. Osteocalcin showed high tendency to degrade in all sample types and concentrations were significantly lower after 24 h of storage. CONCLUSIONS For the bone turnover markers P1NP and BAP, the use of both plasma and serum is recommended. Samples for CTX analysis should be taken as EDTA plasma. Samples for osteocalcin analysis can be taken in either type of plasma or serum, but should be analyzed within 3 h or preserved at - 18 °C.
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Affiliation(s)
- G L Christensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - J R Halgreen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - M Milenkovski
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - A Köse
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - N Quardon
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - N R Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
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Jørgensen NR, Møllehave LT, Hansen YBL, Quardon N, Lylloff L, Linneberg A. Comparison of two automated assays of BTM (CTX and P1NP) and reference intervals in a Danish population. Osteoporos Int 2017; 28:2103-2113. [PMID: 28455749 DOI: 10.1007/s00198-017-4026-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/27/2017] [Indexed: 11/25/2022]
Abstract
UNLABELLED Bone turnover markers are used for monitoring osteoporosis treatment. Therefore, we evaluated the agreement between different assays for CTX and PINP and established reference intervals in a cohort of 2300 individuals. We found poor agreement between assays and different reference intervals. This highlights the importance of harmonization of the assays. INTRODUCTION Two reference markers for bone turnover have been proposed: CTX bone resorption and P1NP for bone formation. The purpose of the current study was to establish reference intervals for the two markers in a Danish cohort and to determine the agreement on the two platforms. METHODS Fasting sera from 2308 individuals (1250 males and 1058 females, age range 24-76 years) participating in the Health2006 study were analyzed for CTX and P1NP using the automated IDS-iSYS analyzer and the automated Cobas e411 analyzer. Participants in anti-osteoporotic treatment were excluded, while subjects on hormonal contraceptives were included. RESULTS There was significant disagreement between both the two P1NP assays with a mean difference of -3 μg/L (LoA -19 to 14) (p < 0.001) and the two CTX assays with a mean difference of 13 ng/L (LoA-187 to 214) (p < 0.001). For CTX, there was a systematic bias: at low values, Cobas measured a higher value than iSYS and at higher concentrations, iSYS measured increasingly higher values than Cobas. Based on the results, we propose three reference intervals for each sex: 25-29, 30-39, and 40-80 years for men, and 25-29, >30 (pre-menopausal), and >30 years (post-menopausal) for women. CONCLUSIONS There is significant disagreement between the IDS-iSYS and Roche Cobas assays for both reference markers. Consequently, the reference intervals for an adult, healthy population are different depending on the analysis method used. Therefore, repeated measurements of patient samples used for monitoring of treatment should be done on the same assay. Moreover, assay-specific reference intervals should be used. Harmonization of assays for BTM is highly warranted.
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Affiliation(s)
- N R Jørgensen
- Research Center for Ageing and Osteoporosis, Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
- OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - L T Møllehave
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Copenhagen, Denmark
| | - Y B L Hansen
- Research Center for Ageing and Osteoporosis, Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - N Quardon
- Research Center for Ageing and Osteoporosis, Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - L Lylloff
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - A Linneberg
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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12
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Abstract
Biochemical markers of bone turnover (BTM) are released during bone remodeling and can be measured in blood or urine as noninvasive surrogate markers for the bone remodeling rate. The C-terminal cross-linked telopeptide of type I collagen (βCTX) is released during bone resorption and is specific to bone tissue. Assays have been developed to measure βCTX in blood and in urine; most current use of βCTX measurement for research and in clinical practice is performed on a blood sample. Method-specific differences for serum and plasma βCTX have led to initiatives to standardize or harmonize βCTX commercial assays. βCTX demonstrates significant biological variation due to circadian rhythm and effect of food which can be minimized by standardized sample collection in the fasting state in the morning. While βCTX predicts fracture risk independent of bone mineral density, lack of data has precluded its inclusion in fracture risk calculators. The changes seen in βCTX with antiresorptive therapies have been well characterized and this has led to its widespread use for monitoring therapy in osteoporosis. However, more fracture-based data on appropriate treatment goals for monitoring need to be developed. Evidence is lacking for the use of βCTX in managing "drug holidays" of bisphosphonate treatment in osteoporosis or risk stratifying those at increased risk of developing osteonecrosis of the jaw. βCTX is useful as an adjunct to imaging techniques for the diagnosis of Paget's disease of bone and for monitoring therapy and detecting recurrence. βCTX also shows promise in the management of metastatic bone disease.
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Morris HA, Eastell R, Jorgensen NR, Cavalier E, Vasikaran S, Chubb SAP, Kanis JA, Cooper C, Makris K. Clinical usefulness of bone turnover marker concentrations in osteoporosis. Clin Chim Acta 2016; 467:34-41. [PMID: 27374301 DOI: 10.1016/j.cca.2016.06.036] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
Current evidence continues to support the potential for bone turnover markers (BTM) to provide clinically useful information particularly for monitoring the efficacy of osteoporosis treatment. Many of the limitations identified earlier remain, principally in regard to the relationship between BTM and incident fractures. Important data are now available on reference interval values for CTX and PINP across a range of geographic regions and for individual clinical assays. An apparent lack of comparability between current clinical assays for CTX has become evident indicating the possible limitations of combining such data for meta-analyses. Harmonization of units for reporting serum/plasma CTX (ng/L) and PINP (μg/L) is recommended. The development of international collaborations continues with an important initiative to combine BTM results from clinical trials in osteoporosis in a meta-analysis and an assay harmonization program are likely to be beneficial. It is possible that knowledge derived from clinical studies can further enhance fracture risk estimation tools with inclusion of BTM together with other independent risk factors. Further data of the relationships between the clinical assays for CTX and PINP as well as physiological and pre-analytical factors contributing to variability in BTM concentrations are required.
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Affiliation(s)
- H A Morris
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia.
| | - R Eastell
- Mellanby Centre for Bone Research, University of Sheffield and Metabolic Bone Centre, Northern General Hospital, Herries Road, Sheffield, UK
| | - N R Jorgensen
- Research Centre for Aging and Osteoporosis, Department of Clinical Biochemistry, Rigshospitalet, Ndr Ringvej 57-59, DK-2600 Glostrup, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - E Cavalier
- University of Liège, CHU Sart-Tilman, Domaine du Sart-Tilman, B-4000 Liège, Belgium
| | - S Vasikaran
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - S A P Chubb
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - J A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
| | - C Cooper
- The MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
| | - K Makris
- Clinical Biochemistry Department, KAT General Hospital, 14651 Athens, Greece
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He WT, Liang BC, Shi ZY, Li XY, Li CW, Shi XL. Weak cation exchange magnetic beads coupled with matrix-assisted laser desorption ionization-time of flight-mass spectrometry in screening serum protein markers in osteopenia. SPRINGERPLUS 2016; 5:679. [PMID: 27347465 PMCID: PMC4899343 DOI: 10.1186/s40064-016-2276-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 05/04/2016] [Indexed: 02/04/2023]
Abstract
The present study aimed at investigating the weak cation magnetic separation technology and matrix-assisted laser desorption ionization-time of flight-mass spectrometry (MALDI-TOF-MS) in screening serum protein markers of osteopenia from ten postmenopausal women and ten postmenopausal women without osteopenia as control group, to find a new method for screening biomarkers and establishing a diagnostic model for primary type I osteoporosis. Serum samples were collected from postmenopausal women with osteopenia and postmenopausal women with normal bone mass. Proteins were extracted from serum samples by weak cation exchange magnetic beads technology, and mass spectra acquisition was done by MALDI-TOF-MS. The visualization and comparison of data sets, statistical peak evaluation, model recognition, and discovery of biomarker candidates were handled by the proteinchip data analysis system software(ZJU-PDAS). The diagnostic models were established using genetic arithmetic based support vector machine (SVM). The SVM result with the highest Youden Index was selected as the model. Combinatorial Peaks having the highest accuracy in distinguishing different samples were selected as potential biomarker. From the two group serum samples, a total of 133 differential features were selected. Ten features with significant intensity differences were screened. In the pair-wise comparisons, processing of MALDI-TOF spectra resulted in the identification of ten differential features between postmenopausal women with osteopenia and postmenopausal women with normal bone mass. The difference of features by Youden index showed that the highest features had a mass to charge ratio of 1699 and 3038 Da. A diagnosis model was established with these two peaks as the candidate marker, and the specificity of the model is 100 %, the sensitivity was 90 % by leave-one-out cross validation test. The two groups of specimens in SVM results on the scatter plot could be clearly distinguished. The peak with m/z 3038 in the SVM model was suggested as Secretin by TagIdent tool. To provide further validation, the secretin levels in serum were analyzed using enzyme-linked immunosorbent assays that is a competitive inhibition enzyme immunoassay technique for the in vitro quantitative measurement of secretin in human serum.
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Affiliation(s)
- Wei-Tao He
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310005 China
| | - Bo-Cheng Liang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310005 China
| | - Zhen-Yu Shi
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310005 China
| | - Xu-Yun Li
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310005 China
| | - Chun-Wen Li
- Department of Diagnostics of Traditional Chinese Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, 310005 China
| | - Xiao-Lin Shi
- Department of Osteology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Comparison of clinical cut-points and treatment targets for urine NTX and plasma βCTX-I in osteoporosis. Clin Biochem 2016; 49:529-33. [DOI: 10.1016/j.clinbiochem.2015.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 11/23/2015] [Accepted: 12/04/2015] [Indexed: 12/15/2022]
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Vasikaran SD, Chubb SAP. The use of biochemical markers of bone turnover in the clinical management of primary and secondary osteoporosis. Endocrine 2016; 52:222-5. [PMID: 26906711 DOI: 10.1007/s12020-016-0900-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/11/2016] [Indexed: 02/01/2023]
Abstract
The purpose of the present study was to examine of the current role of bone turnover markers (BTMs) in the management of osteoporosis. Perusal of the literature examines the available evidence for the utility of BTMs for decision to treat and for the monitoring of treatment for osteoporosis. There is no evidence for the use of BTMs for fracture risk calculation, decision to treat or for treatment selection. A very abnormal BTM value may be a clue to the presence of bone pathology other than uncomplicated osteoporosis. Whilst changes to BTMs following various osteoporosis treatments are well defined, their utility in monitoring individual patients has been less well established. Some fracture outcome-based data exist for the use of u-NTX target of <21 nmol BCE/mmol for antiresorptive therapy; the equivalent s-CTX level is ~250 ng/L. Suboptimal BTM response to treatment may indicate non-compliance or the presence of secondary causes of osteoporosis which may need addressing. Studies are needed to establish treatment targets based on fracture outcomes for commonly used BTMs for each established osteoporosis therapy.
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Affiliation(s)
- Samuel D Vasikaran
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, 102-118 Murdoch Drive, Murdoch, WA, 6150, Australia.
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, 6009, Australia.
| | - S A Paul Chubb
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, 102-118 Murdoch Drive, Murdoch, WA, 6150, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, 6009, Australia
- School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, 6009, Australia
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