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Panizzi L, Vignes M, Dittmer KE, Waterland MR, Rogers CW, Sano H, McIlwraith CW, Riley CB. Infrared Spectroscopy of Synovial Fluid Shows Accuracy as an Early Biomarker in an Equine Model of Traumatic Osteoarthritis. Animals (Basel) 2024; 14:986. [PMID: 38612225 PMCID: PMC11011100 DOI: 10.3390/ani14070986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Osteoarthritis is a leading cause of lameness and joint disease in horses. A simple, economical, and accurate diagnostic test is required for routine screening for OA. This study aimed to evaluate infrared (IR)-based synovial fluid biomarker profiling to detect early changes associated with a traumatically induced model of equine carpal osteoarthritis (OA). Unilateral carpal OA was induced arthroscopically in 9 of 17 healthy thoroughbred fillies; the remainder served as Sham-operated controls. The median age of both groups was 2 years. Synovial fluid (SF) was obtained before surgical induction of OA (Day 0) and weekly until Day 63. IR absorbance spectra were acquired from dried SF films. Following spectral pre-processing, predictive models using random forests were used to differentiate OA, Sham, and Control samples. The accuracy for distinguishing between OA and any other joint group was 80%. The classification accuracy by sampling day was 87%. For paired classification tasks, the accuracies by joint were 75% for OA vs. OA Control and 70% for OA vs. Sham. The accuracy for separating horses by group (OA vs. Sham) was 68%. In conclusion, SF IR spectroscopy accurately discriminates traumatically induced OA joints from controls.
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Affiliation(s)
- Luca Panizzi
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand; (L.P.); (C.W.R.)
| | - Matthieu Vignes
- School of Mathematical and Computational Sciences, Massey University, Palmerston North 4442, New Zealand;
| | - Keren E. Dittmer
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand; (L.P.); (C.W.R.)
| | - Mark R. Waterland
- School of Natural Sciences, Massey University, Palmerston North 4442, New Zealand;
| | - Chris W. Rogers
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand; (L.P.); (C.W.R.)
- School of Agriculture and Environment, Massey University, Palmerston North 4442, New Zealand
| | - Hiroki Sano
- Veterinary Specialty Hospital Hong Kong, G/F—2/F 165-171 Wan Chai Road, Wan Chai, Hong Kong, China;
| | - C. Wayne McIlwraith
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, CO 80523, USA;
| | - Christopher B. Riley
- Department of Clinical Studies, Ontario Veterinary College, Guelph, ON N1G 2W1, Canada
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Panizzi L, Dittmer KE, Vignes M, Doucet JS, Gedye K, Waterland MR, Rogers CW, Sano H, McIlwraith CW, Riley CB. Plasma and Synovial Fluid Cell-Free DNA Concentrations Following Induction of Osteoarthritis in Horses. Animals (Basel) 2023; 13:ani13061053. [PMID: 36978592 PMCID: PMC10044647 DOI: 10.3390/ani13061053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/03/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
Biomarkers for osteoarthritis (OA) in horses have been extensively investigated, but translation into clinical use has been limited due to cost, limited sensitivity, and practicality. Identifying novel biomarkers that overcome these limitations could facilitate early diagnosis and therapy. This study aimed to compare the concentrations of synovial fluid (SF) and plasma cell-free DNA (cfDNA) over time in control horses with those with induced carpal OA. Following an established model, unilateral carpal OA was induced in 9 of 17 healthy Thoroughbred fillies, while the remainder were sham-operated controls. Synovial fluid and plasma samples were obtained before induction of OA (Day 0) and weekly thereafter until Day 63, and cfDNA concentrations were determined using fluorometry. The SF cfDNA concentrations were significantly higher for OA joints than for sham-operated joints on Days 28 (median 1430 μg/L and 631 μg/L, respectively, p = 0.017) and 63 (median 1537 μg/L and 606 μg/L, respectively, p = 0.021). There were no significant differences in plasma cfDNA between the OA and the sham groups after induction of carpal OA. Plasma cfDNA measurement is not sufficiently sensitive for diagnostic purposes in this induced model of OA. Synovial fluid cfDNA measurement may be used as a biomarker to monitor early disease progression in horses with OA.
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Affiliation(s)
- Luca Panizzi
- School of Veterinary Science, College of Science, Massey University, Palmerston North 4442, New Zealand; (K.E.D.); (K.G.); (C.W.R.); (H.S.); (C.B.R.)
- Correspondence:
| | - Keren E. Dittmer
- School of Veterinary Science, College of Science, Massey University, Palmerston North 4442, New Zealand; (K.E.D.); (K.G.); (C.W.R.); (H.S.); (C.B.R.)
| | - Matthieu Vignes
- School of Mathematical and Computational Sciences, College of Science, Massey University, Palmerston North 4442, New Zealand;
| | - Jennie S. Doucet
- Department of Biology, Faculty of Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Kristene Gedye
- School of Veterinary Science, College of Science, Massey University, Palmerston North 4442, New Zealand; (K.E.D.); (K.G.); (C.W.R.); (H.S.); (C.B.R.)
| | - Mark R. Waterland
- School of Natural Sciences, College of Science, Massey University, Palmerston North 4442, New Zealand;
| | - Chris W. Rogers
- School of Veterinary Science, College of Science, Massey University, Palmerston North 4442, New Zealand; (K.E.D.); (K.G.); (C.W.R.); (H.S.); (C.B.R.)
- School of Agriculture and Environment, College of Science, Massey University, Palmerston North 4442, New Zealand
| | - Hiroki Sano
- School of Veterinary Science, College of Science, Massey University, Palmerston North 4442, New Zealand; (K.E.D.); (K.G.); (C.W.R.); (H.S.); (C.B.R.)
| | - C. Wayne McIlwraith
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, School of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523-1601, USA;
| | - Christopher B. Riley
- School of Veterinary Science, College of Science, Massey University, Palmerston North 4442, New Zealand; (K.E.D.); (K.G.); (C.W.R.); (H.S.); (C.B.R.)
- Department of Clinical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
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Jambor AN, Shelton EM, Kijowski R, Henak CR, Campagnola PJ. Assessing collagen alterations in enzymatic degradation models of osteoarthritis via second harmonic generation microscopy. Osteoarthritis Cartilage 2021; 29:1590-1599. [PMID: 34454101 PMCID: PMC8542598 DOI: 10.1016/j.joca.2021.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 07/30/2021] [Accepted: 08/16/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Structural changes in the collagen II architecture of osteoarthritis (OA) are poorly understood, which is a large shortcoming in the early diagnosis of this disease. Though degradation can be simulated by enzymes including trypsin and bacterial collagenase, the specific structural features of each digestion and their relationship to naturally occurring OA remain unclear. EXPERIMENTAL DESIGN We used collagen sensitive/specific Second Harmonic Generation (SHG) microscopy in conjunction with optical scattering measurements to probe the resulting architecture changes in bovine knee cartilage upon trypsin and collagenase degradation. Image features extracted from SHG images were used to train a linear discriminant (LD) model capable of classifying enzymatic degradation, which was then applied to human cartilage with varied modified Mankin histological scores. RESULTS The treatment of cartilage with these enzymes resulted in more disorganized collagen structure, where this effect was greatest with collagenase treatment. Using the LD model, we classified the control and degraded tissues in the three zones with >92% accuracy, showing that these enzymes have distinct activity on the collagen assembly. Application of the LD model to human cartilage indicated that collagenase effects were more representative of in vivo degeneration and were also consistent with damage beginning at the articular surface and progressing into deeper zones. CONCLUSIONS SHG and optical scattering measurements successfully delineate trypsin and collagenase degradation and suggest that collagen alterations in human OA are better simulated by the latter mechanism. These results lay the groundwork for using high-resolution SHG and optical scattering as an earlier diagnostic tool than is currently available.
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Affiliation(s)
- Alexander N. Jambor
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA
| | - Emily M. Shelton
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA,Department of Physics, University of Wisconsin-Madison, 1150 University Ave, Madison, WI 53706, USA
| | - Richard Kijowski
- Department of Radiology, 600 Highland Ave, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Corinne R. Henak
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA,Department of Mechanical Engineering, University of Wisconsin-Madison, 1513 University Ave, Madison, WI 53706, USA,,
| | - Paul J. Campagnola
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA,,
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Detection and Evaluation of Serological Biomarkers to Predict Osteoarthritis in Anterior Cruciate Ligament Transection Combined Medial Meniscectomy Rat Model. Int J Mol Sci 2021; 22:ijms221910179. [PMID: 34638520 PMCID: PMC8508613 DOI: 10.3390/ijms221910179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 01/07/2023] Open
Abstract
Biomarkers are essential tools in osteoarthritis (OA) research, clinical trials, and drug development. Detecting and evaluating biomarkers in OA research can open new avenues for researching and developing new therapeutics. In the present report, we have explored the serological detection of various osteoarthritis-related biomarkers in the preclinical model of OA. In this surgical OA model, we disrupted the medial tibial cartilage’s integrity via anterior cruciate ligament transection combined with medial meniscectomy (ACLT+MMx) of a single joint of Wistar rats. The progression of OA was verified, as shown by the microscopic deterioration of cartilage and the increasing cartilage degeneration scoring from 4 to 12 weeks postsurgery. The concentration of serological biomarkers was measured at two timepoints, along with the complete blood count and bone electrolytes, with biochemical analysis further conducted. The panel evaluated inflammatory biomarkers, bone/cartilage biomarkers, and lipid metabolic pathway biomarkers. In chronic OA rats, we found a significant reduction of total vitamin D3 and C-telopeptide fragments of type II (CTX-II) levels in the serum as compared to sham-operated rats. In contrast, the serological levels of adiponectin, leptin, and matrix metallopeptidase (MMP3) were significantly enhanced in chronic OA rats. The inflammatory markers, blood cell composition, and biochemical profile remained unchanged after surgery. In conclusion, we found that a preclinical model of single-joint OA with significant deterioration of the cartilage can lead to serological changes to the cartilage and metabolic-related biomarkers without alteration of the systemic blood and biochemical profile. Thus, this biomarker profile provides a new tool for diagnostic/therapeutic assessment in OA scientific research.
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Common Biochemical and Magnetic Resonance Imaging Biomarkers of Early Knee Osteoarthritis and of Exercise/Training in Athletes: A Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11081488. [PMID: 34441422 PMCID: PMC8391340 DOI: 10.3390/diagnostics11081488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
Knee osteoarthritis (OA) is the most common joint disease of the world population. Although considered a disease of old age, OA also affects young individuals and, more specifically among them, those practicing knee-joint-loading sports. Predicting OA at an early stage is crucial but remains a challenge. Biomarkers that can predict early OA development will help in the design of specific therapeutic strategies for individuals and, for athletes, to avoid adverse outcomes due to exercising/training regimens. This review summarizes and compares the current knowledge of fluid and magnetic resonance imaging (MRI) biomarkers common to early knee OA and exercise/training in athletes. A variety of fluid biochemical markers have been proposed to detect knee OA at an early stage; however, few have shown similar behavior between the two studied groups. Moreover, in endurance athletes, they are often contingent on the sport involved. MRI has also demonstrated its ability for early detection of joint structural alterations in both groups. It is currently suggested that for optimal forecasting of early knee structural alterations, both fluid and MRI biomarkers should be analyzed as a panel and/or combined, rather than individually.
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Brindo da Cruz IC, Velosa APP, Carrasco S, Dos Santos Filho A, Tomaz de Miranda J, Pompeu E, Fernandes TL, Bueno DF, Fanelli C, Goldenstein-Schainberg C, Fabro AT, Fuller R, Silva PL, Capelozzi VL, Teodoro WR. Post-Adipose-Derived Stem Cells (ADSC) Stimulated by Collagen Type V (Col V) Mitigate the Progression of Osteoarthritic Rabbit Articular Cartilage. Front Cell Dev Biol 2021; 9:606890. [PMID: 33829012 PMCID: PMC8019831 DOI: 10.3389/fcell.2021.606890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/22/2021] [Indexed: 12/25/2022] Open
Abstract
Collagen is essential for cartilage adhesion and formation. In the present study, histology, immunofluorescence, morphometry, and qRT-PCR suggested that adipose-derived stem cells (ADSCs) stimulated by type V collagen (Col V) induce a significant increase of type II collagen (Col II) in the degenerative area of surgical-induced osteoarthritic rabbit articular cartilage (OA). In vitro, the effects of Col V on the proliferation and differentiation of ADSC were investigated. The expression of the cartilage-related genes Col2a1 and Acan was significantly upregulated and Pou5fl was downregulated post-ADSC/Col V treatment. Post-ADSC/Col V treatment, in vivo analyses revealed that rabbits showed typical signs of osteoarthritic articular cartilage regeneration by hematoxylin and eosin (H&E) and Safranin O/Fast Green staining. Immunohistochemical staining demonstrated that the volume of Col II fibers and the expression of Col II protein were significantly increased, and apoptosis Fas ligand positive significantly decreased post-ADSC/Col V treatment. In conclusion, the expression of Col II was higher in rabbits with surgical-induced osteoarthritic articular cartilage; hence, ADSC/Col V may be a promising therapeutic target for OA treatment.
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Affiliation(s)
- Isabele Camargo Brindo da Cruz
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Ana Paula Pereira Velosa
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Solange Carrasco
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Antonio Dos Santos Filho
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Jurandir Tomaz de Miranda
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Eduardo Pompeu
- Bioterism Center of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Tiago Lazzaretti Fernandes
- Sport Medicine Division, Faculdade de Medicina, Institute of Orthopaedics and Traumatology of the Hospital das Clinicas, Universidade de São Paulo, FMUSP, São Paulo, Brazil.,Hospital Sírio-Libanês, São Paulo, Brazil
| | | | - Camila Fanelli
- Laboratory of Cellular, Genetic and Molecular Nephrology, Renal Division, University of São Paulo, São Paulo, Brazil
| | - Cláudia Goldenstein-Schainberg
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Alexandre Todorovic Fabro
- Department of Pathology of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil.,Respiratory Medicine Laboratory, Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Ricardo Fuller
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Pedro Leme Silva
- Laboratory of Pulmonary Investigation, Centro de Ciências da Saúde, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,National Institute of Science and Technology for Regenerative Medicine, Rio de Janeiro, Brazil
| | - Vera Luiza Capelozzi
- Department of Pathology of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
| | - Walcy Rosolia Teodoro
- Rheumatology Division of the Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP, São Paulo, Brazil
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Luo Y, Li J, Wang B, Zhang Q, Bian Y, Wang R. Protective effect of glycyrrhizin on osteoarthritis cartilage degeneration and inflammation response in a rat model. J Bioenerg Biomembr 2021; 53:285-293. [PMID: 33725224 DOI: 10.1007/s10863-021-09889-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
This study was conducted to investigate the protective effects of glycyrrhizin on a rat model of osteoarthritis and elucidate the underlying mechanism. Rat osteoarthritis was established by using medial meniscectomy (MMx) and an anterior cruciate ligament transaction (ACLT). Glycyrrhizin (2, 4, and 10 mg/kg) was administered by intra-articular knee injection for 12 weeks. Incapacitance test was performed to determine mechanical hyperalgesia. Enzyme-linked immunosorbent assay (ELISA) was performed to measure cartilage degradation and inflammation-related markers. Quantitative reverse transcription PCR (RT-qPCR) and Western blot were performed to determine the mRNA and protein levels of genes, respectively. The results demonstrated that treatment with glycyrrhizin ameliorated mechanical hyperalgesia and bilateral joints oedema in a rat model of osteoarthritis. Treatment with 10 mg/kg glycyrrhizin also suppressed serum enzymes including matrix metalloproteinase (MMP)-1, MMP-3, prostaglandin E2, and C-telopeptide of type II collagen (CTX-II). In addition to inhibition of cartilage matrix catabolic related markers, treatment with glycyrrhizin also decreased the levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and iNOS in serum and cartilage. The underlying mechanism study demonstrated that treatment with glycyrrhizin inhibited HMGB1 and the TLR4/NF-κB signaling pathway. In summary, treatment with glycyrrhizin ameliorated cartilage degeneration and inflammation in osteoarthritis rats by the regulation of HMGB1 and the TLR4/NF-κB signaling pathway.
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Affiliation(s)
- Yingying Luo
- Departments of Pediatric Bone Oncology, Cangzhou Combine Traditional Chinese and Western Medicine Hospital, No. 31 Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Jian Li
- Departments of Otorhinolaryngology and Geriatrics, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China
| | - Bin Wang
- Departments of Otorhinolaryngology and Geriatrics, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China.
| | - Qin Zhang
- Departments of Pediatric Bone Oncology, Cangzhou Combine Traditional Chinese and Western Medicine Hospital, No. 31 Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Yajie Bian
- Department of Dermatology, Langfang City Dacheng County Traditional Chinese Medicine Hospital, Cultural Street in Xincheng District, Dacheng County, Langfang, 065900, Hebei, China
| | - Ruipei Wang
- Departments of Otorhinolaryngology and Geriatric, Langfang City Dacheng County Hospital, No.47 Xinhua East Street, Dacheng County, Langfang, 065900, Hebei, China
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Gao K, Zhu W, Liu W, Ma D, Li H, Yu W, Wang L, Cao Y, Jiang Y. Diagnostic value of the blood monocyte-lymphocyte ratio in knee osteoarthritis. J Int Med Res 2019; 47:4413-4421. [PMID: 31342819 PMCID: PMC6753563 DOI: 10.1177/0300060519860686] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Knee osteoarthritis (KOA) is a chronic inflammatory disease. The monocyte–lymphocyte ratio (MLR) was reported to be a non-invasive, cost-effective marker in various systemic diseases, but it has not yet been investigated in KOA. This cross-sectional study evaluated the diagnostic value of MLR in KOA. Methods Two hundred and five KOA patients and 120 healthy control subjects were enrolled. Patient data, including age, sex, blood cell counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, red blood cell distribution width, and the Kellgren–Lawrence (KL) score were recorded. Results One hundred nineteen patients (55 men, 64 women) were included, with a mean age of 55.47 ± 9.23 years. KOA patients showed a significantly higher MLR, neutrophil–lymphocyte ratio (NLR), and platelet–lymphocyte ratio (PLR) than controls. The MLR area under the curve was 0.81, which was higher than that of NLR and PLR. Multiple logistic regression analysis revealed blood MLR as an independent predictor of KOA. Correlation analysis showed that MLR was positively correlated with ESR and CRP levels. MLR and NLR were significantly higher in KL4 patients than in KL1–3 patients. Conclusions MLR has a high diagnostic value for KOA, so could be a reliable disease marker.
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Affiliation(s)
- Kun Gao
- Guangdong Provincial Key Laboratory of Proteomics, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China.,Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Wenxiu Zhu
- Shenzhen Longgang Traditional Chinese Medicine Hospital, Shenzhen 518116, China
| | - Weidong Liu
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Dujun Ma
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Heng Li
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Weiji Yu
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Lixin Wang
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Yafei Cao
- Guangdong Provincial Key Laboratory of Proteomics, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China.,Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Yong Jiang
- Guangdong Provincial Key Laboratory of Proteomics, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
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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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10
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Kisand K, Tamm AE, Lintrop M, Tamm AO. New insights into the natural course of knee osteoarthritis: early regulation of cytokines and growth factors, with emphasis on sex-dependent angiogenesis and tissue remodeling. A pilot study. Osteoarthritis Cartilage 2018; 26:1045-1054. [PMID: 29782915 DOI: 10.1016/j.joca.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study was conducted to identify cytokine profiles associated with radiographic phenotypes of knee osteoarthritis (rKOA) with a focus on early stage of the disease. METHODS The pilot population study involved 60 middle-aged patients (mean age 50 ± 7.3y.). Standardized weight-bearing anteroposterior and axial radiographs were used to assess rKOA severity in tibiofemoral (TFJ) of patellofemoral joint (PFJ) by grading system (grades 0-3). Luminex (xMAP®) technology was used to simultaneously assess 60 biomarkers (BMs). RESULTS Several pathways of angiogenic (CXCL10/IP-10, FGF1/2, PDGF-AA/BB, ANG1, RANTES), tissue remodeling/fibrosis (MMP1/3, TIMP2/3/4, TGFβ), and fat tissue (leptin) BMs associated with rKOA severity already in very early phase (grade 1). We identified several sets of cytokines as key markers of early knee osteoarthritis (KOA) predicting radiographic features in logistic-regression models (AUC = 0.80-0.97). Marked sex-specificity of rKOA course was detected: upregulation of angiogenesis dominated in females, whereas the activation of tissue remodeling was dominant in males. Several of these shifts, e.g., decrease of CXCL10/IP-10, took place only in grade 1 KOA and disappeared or reversed in later stages. OA of different knee-joint compartments has distinct profiles of cytokines. A broad list of BMs (TIMP2/3/4, MMP1/3, TGFβ1/2, vWF-A2, sE-selectin and leptin) associated with OA in the PFJ. CONCLUSION Our results demonstrate that substantial and time-limited shifts in the angiogenic and TIMP/MMP systems occur in the early stage of KOA. Our study findings highlight the sex-, grade- and compartment-dependent shifts in above processes. The data may contribute to the individualized prevention of KOA in the future.
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Affiliation(s)
- K Kisand
- Department of Immunology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
| | - A E Tamm
- Department of Sports Medicine and Rehabilitation, University of Tartu, Tartu, Estonia.
| | - M Lintrop
- Department of Radiology, University of Tartu, Tartu, Estonia.
| | - A O Tamm
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
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11
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Watt FE. Osteoarthritis biomarkers: year in review. Osteoarthritis Cartilage 2018; 26:312-318. [PMID: 29107060 DOI: 10.1016/j.joca.2017.10.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/09/2017] [Accepted: 10/17/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To summarise important findings from biomarker studies relevant to osteoarthritis (OA), published between April 2016 and March 2017; to consider these findings in the context of new discoveries and technologies, and clinical and scientific need in OA. DESIGN Studies were selected by PubMed search, conducted between 01/04/2016 and 01/03/2017. MeSH terms [biomarker] AND [OA] were used; the search was restricted to Human, English language and Full Text Available publications, which yielded 50 eligible publications. Any biomarker was considered, including non-proteins and other clinical measurements. RESULTS Three main areas are overviewed: 1) Studies examining highly validated biomarkers, in the FNIH OA Biomarkers Consortium and elsewhere, particularly their ongoing application and validation. Control reference intervals, work on predictive validity and other longitudinal studies examining prognostic value of biomarkers in large cohorts are reviewed. 2) Novel studies relating to biomarkers of inflammation are discussed, including complement, the performance of markers of so-called 'cold inflammation' and results from clinical trials including biomarkers. 3) Discovery studies, including whole blood RNA, proteomics and metabolomics are reviewed, with an emphasis on new technologies. CONCLUSIONS Discovery, characterisation and qualification of various biomarkers is ongoing; several novel protein and non-protein candidate biomarkers have been reported this year. Biomarkers provide us with an opportunity to better diagnose and stratify the disease, via established panels or new discovery approaches. Improving quality of sampling and testing, and measuring large numbers of markers simultaneously in large cohorts would seem likely to identify new clinically applicable biomarkers, which are still much needed in this disease.
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Affiliation(s)
- F E Watt
- Arthritis Research UK Centre for Osteoarthritis Pathogenesis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7FY, United Kingdom.
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12
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Legrand CB, Lambert CJ, Comblain FV, Sanchez C, Henrotin YE. Review of Soluble Biomarkers of Osteoarthritis: Lessons From Animal Models. Cartilage 2017; 8:211-233. [PMID: 28618869 PMCID: PMC5625856 DOI: 10.1177/1947603516656739] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Osteoarthritis (OA) is one of the leading causes of disability within the adult population. Currently, its diagnosis is mainly based on clinical examination and standard radiography. To date, there is no way to detect the disease at a molecular level, before the appearance of structural changes and symptoms. So an attractive alternative for monitoring OA is the measurement of biochemical markers in blood, urine, or synovial fluid, which could reflect metabolic changes in joint tissue and therefore disease onset and progression. Animal models are relevant to investigate the early stage of OA and metabolic changes occurring in joint tissues. The goal of this narrative review is to summarize the scientific data available in the literature on soluble biomarkers in animal models of OA. Design A literature search was conducted using the PubMed/Medline and Scopus databases between February 1995 and December 2015. All original articles, systematic and narrative reviews published in French or in English were considered. Results We summarized the data of 69 studies and proposed a classification scheme for OA biomarkers in animal studies, largely inspired by the BIPEDS classification. Conclusions Studies about biomarkers and animal models indicate that some markers could be valuable to monitor OA progression and assess therapeutic response in some animal models.
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Affiliation(s)
- Catherine B. Legrand
- Bone and Cartilage Research Unit, Arthropôle Liège, University of Liège, Institute of Pathology, CHU Sart-Tilman, Liège, Belgium
| | - Cécile J. Lambert
- Bone and Cartilage Research Unit, Arthropôle Liège, University of Liège, Institute of Pathology, CHU Sart-Tilman, Liège, Belgium
| | - Fanny V. Comblain
- Bone and Cartilage Research Unit, Arthropôle Liège, University of Liège, Institute of Pathology, CHU Sart-Tilman, Liège, Belgium
| | - Christelle Sanchez
- Bone and Cartilage Research Unit, Arthropôle Liège, University of Liège, Institute of Pathology, CHU Sart-Tilman, Liège, Belgium
| | - Yves E. Henrotin
- Bone and Cartilage Research Unit, Arthropôle Liège, University of Liège, Institute of Pathology, CHU Sart-Tilman, Liège, Belgium
- Department of Physical Therapy and Rehabilitation, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
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13
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Mobasheri A, Bay-Jensen AC, van Spil WE, Larkin J, Levesque MC. Osteoarthritis Year in Review 2016: biomarkers (biochemical markers). Osteoarthritis Cartilage 2017; 25:199-208. [PMID: 28099838 DOI: 10.1016/j.joca.2016.12.016] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 12/09/2016] [Accepted: 12/14/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE The aim of this "Year in Review" article is to summarize and discuss the implications of biochemical marker related articles published between the Osteoarthritis Research Society International (OARSI) 2015 Congress in Seattle and the OARSI 2016 Congress in Amsterdam. METHODS The PubMed/MEDLINE bibliographic database was searched using the combined keywords: 'biomarker' and 'osteoarthritis'. The PubMed/MEDLINE literature search was conducted using the Advanced Search Builder function (http://www.ncbi.nlm.nih.gov/pubmed/advanced). RESULTS Over two hundred new biomarker-related papers were published during the literature search period. Some papers identified new biomarkers whereas others explored the biological properties and clinical utility of existing markers. There were specific references to several adipocytokines including leptin and adiponectin. ADAM Metallopeptidase with Thrombospondin Type 1 motif 4 (ADAMTS-4) and aggrecan ARGS neo-epitope fragment (ARGS) in synovial fluid (SF) and plasma chemokine (CeC motif) ligand 3 (CCL3) were reported as potential new knee biomarkers. New and refined proteomic technologies and novel assays including a fluoro-microbead guiding chip (FMGC) for measuring C-telopeptide of type II collagen (CTX-II) in serum and urine and a novel magnetic nanoparticle-based technology (termed magnetic capture) for collecting and concentrating CTX-II, were described this past year. CONCLUSION There has been steady progress in osteoarthritis (OA) biomarker research in 2016. Several novel biomarkers were identified and new technologies have been developed for measuring existing biomarkers. However, there has been no "quantum leap" this past year and identification of novel early OA biomarkers remains challenging. During the past year, OARSI published a set of recommendations for the use of soluble biomarkers in clinical trials, which is a major step forward in the clinical use of OA biomarkers and bodes well for future OA biomarker development.
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Affiliation(s)
- A Mobasheri
- Department of Veterinary Pre-Clinical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, GU2 7AL, United Kingdom; Faculty of Health and Medical Sciences, Duke of Kent Building, University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
| | - A-C Bay-Jensen
- Rheumatology, Biomarkers and Research, Nordic Bioscience A/S, Herlev, Denmark
| | - W E van Spil
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - J Larkin
- C3 DPU, Immunoinflammation Therapeutic Area, GlaxoSmithKline, King of Prussia, PA, 19406, United States
| | - M C Levesque
- AbbVie Bioresearch Center, 100 Research Drive, Worcester, MA, 01605, United States
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Desando G, Bartolotti I, Vannini F, Cavallo C, Castagnini F, Buda R, Giannini S, Mosca M, Mariani E, Grigolo B. Repair Potential of Matrix-Induced Bone Marrow Aspirate Concentrate and Matrix-Induced Autologous Chondrocyte Implantation for Talar Osteochondral Repair: Patterns of Some Catabolic, Inflammatory, and Pain Mediators. Cartilage 2017; 8:50-60. [PMID: 27994720 PMCID: PMC5154420 DOI: 10.1177/1947603516642573] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The low regenerative potential of cartilage contributed to the development of different cell therapies aimed to improve the clinical outcome in young patients with Osteochondral Lesions of the Talus (OLT). This study is designed to assess the regenerative potential of autologous matrix-induced Bone Marrow Aspirate Concentrate (mBMAC) and matrix-induced Autologous Chondrocyte Implantation (mACI) evaluating, on a small number of osteochondral biopsies, the expression of some catabolic, inflammatory, and pain mediators. DESIGN Twenty-two patients with OLT were analyzed in this study; 7 were treated with mACI and 15 with mBMAC. Informed consent was obtained from all the patients. Clinical assessments were performed pre-operatively and at 12, 24, and 36 months after surgery using the American Orthopedic Foot and Ankle Society (AOFAS). Histology and immunohistochemistry were used to assess cartilage repair at 24 months. Data were analyzed using non-parametric Wilcoxon-Mann-Whitney and Spearman tests. RESULTS A remarkable improvement in AOFAS score was noticed for both treatments up to 36 months; however, patients treated with mACI reported the best AOFAS score. Various degrees of tissue remodeling were observed by histological analysis for both cell strategies. However, mBMAC treatment showed a higher expression of some fibrous and hypertrophic markers compared to mACI group. A mild positivity for nerve growth factor, as pain mediator, was noticed for both treatments.M. CONCLUSIONS Our findings demonstrated the best histological and clinical results following mACI treatment since different fibrotic and hypertrophic features were evident in the mBMAC group at 24-month follow-up.
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Affiliation(s)
| | - Isabella Bartolotti
- Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Francesca Vannini
- 1Clinic of Orthopaedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Carola Cavallo
- Laboratory RAMSES, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Francesco Castagnini
- 1Clinic of Orthopaedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Roberto Buda
- 1Clinic of Orthopaedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Sandro Giannini
- 1Clinic of Orthopaedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Massimiliano Mosca
- 1Clinic of Orthopaedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Erminia Mariani
- Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopedic Institute, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Brunella Grigolo
- Laboratory RAMSES, Rizzoli Orthopedic Institute, Bologna, Italy; Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopedic Institute, Bologna, Italy
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15
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Madry H, Kon E, Condello V, Peretti GM, Steinwachs M, Seil R, Berruto M, Engebretsen L, Filardo G, Angele P. Early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 2016; 24:1753-62. [PMID: 27000393 DOI: 10.1007/s00167-016-4068-3] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/23/2016] [Indexed: 12/28/2022]
Abstract
There is an increasing awareness on the importance in identifying early phases of the degenerative processes in knee osteoarthritis (OA), the crucial period of the disease when there might still be the possibility to initiate treatments preventing its progression. Early OA may show a diffuse and ill-defined involvement, but also originate in the cartilage surrounding a focal lesion, thus necessitating a separate assessment of these two entities. Early OA can be considered to include a maximal involvement of 50 % of the cartilage thickness based on the macroscopic ICRS classification, reflecting an OARSI grade 4. The purpose of this paper was to provide an updated review of the current status of the diagnosis and definition of early knee OA, including the clinical, radiographical, histological, MRI, and arthroscopic definitions and biomarkers. Based on current evidence, practical classification criteria are presented. As new insights and technologies become available, they will further evolve to better define and treat early knee OA.
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Affiliation(s)
- Henning Madry
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Strasse 100, Building 37-38, 66421, Homburg/Saar, Germany.
- Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Strasse 100, Building 37-38, 66421, Homburg/Saar, Germany.
| | - Elizaveta Kon
- NABI Laboratory, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy
| | - Vincenzo Condello
- Dipartimento di Ortopedia, Responsabile di Struttura Semplice di Traumatologia dello, Sport Knee Surgery and Sports Traumatology, Ospedale Sacro Cuore - Don Calabria, Via Don, Sempreboni, 5, 37024, Negrar, Verona, Italy
| | - Giuseppe M Peretti
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Matthias Steinwachs
- SportClinic Zürich, Klinik Hirslanden, Witellikerstrasse 40, 8032, Zurich, Switzerland
| | - Romain Seil
- Service de Chirurgie Orthopédique, Centre de L'Appareil Locomoteur, de Médecine du Sport et de Prévention, Centre Hospitalier de Luxembourg-Clinique d'Eich and Sports Medicine Research Laboratory, Luxembourg Institute of Health, 78, rue d'Eich, 1460, Luxembourg, Luxembourg
| | - Massimo Berruto
- Centro di Eccellenza per L'attività Ortopedica, Reumatologica e Riabilitativa, L'Istituto Ortopedico Gaetano Pini è un'Azienda Ospedaliera di rilievo nazionale, P.zza A. Ferrari, 1, 20122, Milan, Italy
| | - Lars Engebretsen
- Department of Orthopedic Surgery, Oslo University Hospital and Oslo Sports Trauma Research Center, 0407, Oslo, Norway
| | - Giuseppe Filardo
- Biomechanics Laboratory, II Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy
| | - Peter Angele
- Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany
- Sporthopaedicum Regensburg, Hildegard von Bingen Strasse 1, 93053, Regensburg, Germany
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16
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Presence of gout is associated with increased prevalence and severity of knee osteoarthritis among older men: results of a pilot study. J Clin Rheumatol 2016; 21:63-71. [PMID: 25710856 DOI: 10.1097/rhu.0000000000000217] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Gout and osteoarthritis (OA) are the most prevalent arthritides, but their relationship is neither well established nor well understood. OBJECTIVES We assessed whether a diagnosis of gout or asymptomatic hyperuricemia (AH) is associated with increased prevalence/severity of knee OA. METHODS One hundred nineteen male patients aged 55 to 85 years were sequentially enrolled from the primary care clinics of an urban Veterans Affairs hospital, assessed and categorized into 3 groups: gout (American College of Rheumatology Classification Criteria), AH (serum urate ≥6.8 mg/dL, no gout), and control (serum urate <6.8 mg/dL, no gout). Twenty-five patients from each group subsequently underwent formal assessment of knee OA presence and severity (American College of Rheumatology Clinical/Radiographic Criteria, Kellgren-Lawrence grade). Musculoskeletal ultrasound was used to detect monosodium urate deposition at the knees and first metatarsophalangeal joints. RESULTS The study showed 68.0% of gout, 52.0% of AH, and 28.0% of age-matched control subjects had knee OA (gout vs control, P = 0.017). Odds ratio for knee OA in gout versus control subjects was 5.46 prior to and 3.80 after adjusting for body mass index. Gout subjects also had higher Kellgren-Lawrence grades than did the control subjects (P = 0.001). Subjects with sonographically detected monosodium urate crystal deposition on cartilage were more likely to have OA than those without (60.0 vs 27.5%, P = 0.037), with crystal deposition at the first metatarsophalangeal joints correlating most closely with OA knee involvement. CONCLUSIONS Knee OA was more prevalent in gout patients versus control subjects and intermediate in AH. Knee OA was more severe in gout patients versus control subjects.
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17
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Lim NH, Vincent TL, Nissim A. In vivo optical imaging of early osteoarthritis using an antibody specific to damaged arthritic cartilage. Arthritis Res Ther 2015; 17:376. [PMID: 26703223 PMCID: PMC4718036 DOI: 10.1186/s13075-015-0898-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/10/2015] [Indexed: 02/07/2023] Open
Abstract
Background The lack of specific and sensitive serum and radiographic biomarkers for early diagnosis of osteoarthritis (OA) as well as for monitoring subtle changes in disease activity in clinical trials has hampered the development of treatments for OA. We previously showed that 1-11E, a human single chain fragment variable (scFv) specific to collagen type II that has been post-translationally modified by reactive oxidants (ROS-CII), binds exclusively to arthritic cartilage. Here we test the validity of 1-11E as a radiographic biomarker for early disease in experimental OA. Methods Murine OA was induced by destabilisation of the medial meniscus (DMM) in adult male mice. Immunohistochemistry of destabilised or sham-operated knees was performed from 2 to 8 weeks post-surgery with Cy5.5-labelled 1-11E and negative control scFv, C7. Prospective in vivo optical images were taken 4 and 8 weeks post-DMM following intra-articular injection of Cy5.5-labelled scFvs, or intravenous injection of Cy5.5-labelled full length monoclonal antibodies (mAbs). Results Specific cartilage staining with 1-11E was apparent as early as 4 weeks post-DMM at the time of earlier cartilage degradation assessed by histology. Prospective in vivo optical images taken 4 and 8 weeks post-DMM following local intra-articular injection of Cy5.5-labelled scFv (n = 7) showed specific in vivo retention of Cys5.5-1-11E scFv following local administration into the knee joint (tissue half-life >78 hours, n = 7, signal to noise ratio (SNR) > 2.1). Specific localization of Cys-5.5-1-11E-mAb to DMM knees (SNR >1.65) was also observed (p < 0.01, n = 8, SNR >1.65). In both cases the SNR increased with time post-DMM. Conclusions 1-11E binds specifically to early osteoarthritic cartilage and can be used as a radiographic biomarker following local or systemic delivery to facilitate early diagnosis and monitor disease progression in OA.
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Affiliation(s)
- Ngee Han Lim
- Centre for Biochemical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK.
| | - Tonia L Vincent
- Arthritis Research UK Centre for OA Pathogenesis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, UK.
| | - Ahuva Nissim
- Centre for Biochemical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK.
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18
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Tourville TW, Poynter ME, DeSarno MJ, Struglics A, Beynnon BD. Relationship between synovial fluid ARGS-aggrecan fragments, cytokines, MMPs, and TIMPs following acute ACL injury: A cross-sectional study. J Orthop Res 2015; 33:1796-803. [PMID: 26123869 PMCID: PMC5508558 DOI: 10.1002/jor.22961] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 05/27/2015] [Indexed: 02/04/2023]
Abstract
Severe knee trauma, such as an ACL disruption, produces aggrecan degradation as evidenced by elevated synovial fluid (SF) N-terminal (393) Alanine-Arginine-Glycine-Serine (ARGS) neoepitope (or ARGS-aggrecan) and is associated with inflammatory activity soon after injury. However, it is not known if this process persists for a substantial time interval following the initial trauma. The purpose of this study was to evaluate relationships between SF ARGS concentrations and an array of cytokines, matrix metalloproteases (MMPs), and tissue inhibitor of metalloproteases (TIMPs) during the initial 6 months following ACL rupture. SF samples from 67 ACL-injured subjects (29 women) were analyzed within 6 months of injury (18-155 days), immediately prior to surgical ACL reconstruction. Relationships between ARGS and individual analyte concentrations, as well as MMP/TIMP ratios were evaluated. Statistically significant relationships were found between ARGS and basic fibroblast growth factor (FGF2) (p=0.03) and TIMP-3 (p=0.01). Our findings suggest that FGF2, considered to be primarily catabolic in articular cartilage, is not downregulated as ARGS concentration declines over time since injury. In addition, these results support the hypothesis that an upregulation of TIMP-3, the primary aggrecanase inhibitor, is elicited in response to increased aggrecan degradation, which may inhibit further cleavage.
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Affiliation(s)
- Timothy W. Tourville
- Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, Vermont
| | - Matthew E. Poynter
- Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont
| | - Michael J. DeSarno
- Deptartment of Medical Biostatistics, University of Vermont College of Medicine, Burlington, Vermont
| | - André Struglics
- Department of Orthopedics, Lund University, Clinical Sciences Lund, Lund, Sweden
| | - Bruce D. Beynnon
- Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, Vermont
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Wyseure T, Mosnier LO, von Drygalski A. Advances and challenges in hemophilic arthropathy. Semin Hematol 2015; 53:10-9. [PMID: 26805902 DOI: 10.1053/j.seminhematol.2015.10.005] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2004] [Revised: 11/05/2004] [Accepted: 12/01/2005] [Indexed: 12/13/2022]
Abstract
Hemophilic arthropathy is a form of joint disease that develops secondary to joint bleeding and presents with synovial hypertrophy, cartilage and bony destruction. The arthropathy can develop despite clotting factor replacement and is especially disabling in the aging population. Pathobiological tissue changes are triggered by release of hemoglobin and iron deposition in the joint, but the sequence of events and the molecular mechanisms resulting in joint deterioration are incompletely understood. Treatment options other than clotting factor replacement are limited. Improvements in the treatment of hemophilia necessitate a better understanding of the processes that lead to this disabling condition and better diagnostic tools. Towards that end, studies of the molecular mechanisms leading to the arthropathy, as well as the development of sensitive imaging techniques and biomarkers are needed. These will pave the way to identify the cause of acute pain such as joint bleeding or synovitis, detect early, potentially reversible structural changes, and predict progression of disease. This review describes current imaging techniques and the development of high resolution musculoskeletal ultrasound with power Doppler to afford point-of-care diagnosis and management, the potential utility of diagnostic biomarkers, and summarizes our current knowledge of the pathobiology of hemophilic arthropathy.
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Affiliation(s)
- Tine Wyseure
- The Scripps Research Institute, Department of Molecular and Experimental Medicine, La Jolla, CA, USA
| | - Laurent O Mosnier
- The Scripps Research Institute, Department of Molecular and Experimental Medicine, La Jolla, CA, USA
| | - Annette von Drygalski
- The Scripps Research Institute, Department of Molecular and Experimental Medicine, La Jolla, CA, USA; University of California at San Diego, Department of Medicine, San Diego, CA, USA.
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20
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McIlwraith CW, Clegg PD. Science in brief: Report on the Havemeyer Foundation workshop on equine musculoskeletal biomarkers--current knowledge and future needs. Equine Vet J 2015; 46:651-3. [PMID: 25319159 DOI: 10.1111/evj.12339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- C W McIlwraith
- Gail Holmes Equine Orthopaedic Research Center, Colorado State University, Fort Collins, USA
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Biomarkers for osteoarthritis: Can they be used for risk assessment? A systematic review. Maturitas 2015; 82:36-49. [PMID: 25963100 DOI: 10.1016/j.maturitas.2015.04.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/06/2015] [Indexed: 11/20/2022]
Abstract
The identification of early biochemical predictors of osteoarthritis (OA) has been the focus of much research over the past few years. However, it still is unclear whether current biochemical markers can be used in prognostic risk assessment of OA. The aim of this systematic review is to evaluate the possible prognostic application of blood and urinary biochemical markers of knee and hip OA. Abstract and full text selection was done by two independent reviewers. A total of 25 relevant publications including 37 biochemical markers of bone and cartilage turnover and inflammation associated with some aspects of OA were reviewed. Most of those biomarkers were studied only once or twice. Due to heterogeneity of both OA-phenotype and determinant among the publications, meta-analysis of the studied biochemical markers was not possible. There was strong evidence for urinary C-terminal telopeptide of collagen type II (uCTX-II) as a prognostic marker for knee OA progression and serum cartilage oligomeric protein (COMP) level as prognostic marker for incidence of knee and hip OA. Evidence for prognostic value of C-reactive protein is still inconclusive. International standardization of future investigations should be pursued to obtain more high-quality, homogenous data on the full spectrum of biochemical OA markers.
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Mabey T, Honsawek S. Cytokines as biochemical markers for knee osteoarthritis. World J Orthop 2015; 6:95-105. [PMID: 25621214 PMCID: PMC4303794 DOI: 10.5312/wjo.v6.i1.95] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 03/24/2014] [Accepted: 07/17/2014] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA) is a debilitating degenerative joint disease particularly affecting weightbearing joints within the body, principally the hips and knees. Current radiographic techniques are insufficient to show biochemical changes within joint tissue which can occur many years before symptoms become apparent. The need for better diagnostic and prognostic tools is heightened with the prevalence of OA set to increase in aging and obese populations. As inflammation is increasingly being considered an important part of OAs pathophysiology, cytokines are being assessed as possible candidates for biochemical markers. Cytokines, both pro- and anti-inflammatory, as well as angiogenic and chemotactic, have in recent years been studied for relevant characteristics. Biochemical markers show promise in determination of the severity of disease in addition to monitoring of the efficacy and safety of disease-modifying OA drugs, with the potential to act as diagnostic and prognostic tools. Currently, the diagnostic power of interleukin (IL)-6 and the relationship to disease burden of IL-1β, IL-15, tumor necrosis factor-α, and vascular endothelial growth factor make these the best candidates for assessment. Grouping appropriate cytokine markers together and assessing them collectively alongside other bone and cartilage degradation products will yield a more statistically powerful tool in research and clinical applications, and additionally aid in distinguishing between OA and a number of other diseases in which cytokines are known to have an involvement. Further large scale studies are needed to assess the validity and efficacy of current biomarkers, and to discover other potential biomarker candidates.
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Heard BJ, Rosvold JM, Fritzler MJ, El-Gabalawy H, Wiley JP, Krawetz RJ. A computational method to differentiate normal individuals, osteoarthritis and rheumatoid arthritis patients using serum biomarkers. J R Soc Interface 2015; 11:20140428. [PMID: 24920114 DOI: 10.1098/rsif.2014.0428] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The objective of this study was to develop a method for categorizing normal individuals (normal, n = 100) as well as patients with osteoarthritis (OA, n = 100), and rheumatoid arthritis (RA, n = 100) based on a panel of inflammatory cytokines expressed in serum samples. Two panels of inflammatory proteins were used as training sets in the construction of two separate artificial neural networks (ANNs). The first training set consisted of all proteins (38 in total) and the second consisted of only the significantly different proteins expressed (12 in total) between at least two patient groups. Both ANNs obtained high levels of sensitivity and specificity, with the first and second ANN each diagnosing 100% of test set patients correctly. These results were then verified by re-investigating the entire dataset using a decision tree algorithm. We show that ANNs can be used for the accurate differentiation between serum samples of patients with OA, a diagnosed RA patient comparator cohort and normal/control cohort. Using neural network and systems biology approaches to manage large datasets derived from high-throughput proteomics should be further explored and considered for diagnosing diseases with complex pathologies.
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Affiliation(s)
- Bryan J Heard
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Joshua M Rosvold
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada Department of Civil Engineering, Faculty of Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Marvin J Fritzler
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Hani El-Gabalawy
- Arthritis Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - J Preston Wiley
- Sports Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Roman J Krawetz
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada Department of Anatomy and Cell Biology, University of Calgary, Calgary, Alberta, Canada
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Lotz M, Martel-Pelletier J, Christiansen C, Brandi ML, Bruyère O, Chapurlat R, Collette J, Cooper C, Giacovelli G, Kanis JA, Karsdal MA, Kraus V, Lems WF, Meulenbelt I, Pelletier JP, Raynauld JP, Reiter-Niesert S, Rizzoli R, Sandell LJ, Van Spil WE, Reginster JY. Republished: Value of biomarkers in osteoarthritis: current status and perspectives. Postgrad Med J 2014; 90:171-8. [PMID: 24534711 PMCID: PMC3934547 DOI: 10.1136/postgradmedj-2013-203726rep] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Osteoarthritis affects the whole joint structure with progressive changes in cartilage, menisci, ligaments and subchondral bone, and synovial inflammation. Biomarkers are being developed to quantify joint remodelling and disease progression. This article was prepared following a working meeting of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis convened to discuss the value of biochemical markers of matrix metabolism in drug development in osteoarthritis. The best candidates are generally molecules or molecular fragments present in cartilage, bone or synovium and may be specific to one type of joint tissue or common to them all. Many currently investigated biomarkers are associated with collagen metabolism in cartilage or bone, or aggrecan metabolism in cartilage. Other biomarkers are related to non-collagenous proteins, inflammation and/or fibrosis. Biomarkers in osteoarthritis can be categorised using the burden of disease, investigative, prognostic, efficacy of intervention, diagnostic and safety classification. There are a number of promising candidates, notably urinary C-terminal telopeptide of collagen type II and serum cartilage oligomeric protein, although none is sufficiently discriminating to differentiate between individual patients and controls (diagnostic) or between patients with different disease severities (burden of disease), predict prognosis in individuals with or without osteoarthritis (prognostic) or perform so consistently that it could function as a surrogate outcome in clinical trials (efficacy of intervention). Future avenues for research include exploration of underlying mechanisms of disease and development of new biomarkers; technological development; the ‘omics’ (genomics, metabolomics, proteomics and lipidomics); design of aggregate scores combining a panel of biomarkers and/or imaging markers into single diagnostic algorithms; and investigation into the relationship between biomarkers and prognosis.
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Affiliation(s)
- M Lotz
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, , La Jolla, California, USA
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Vos LM, Kuijer R, Huddleston Slater JJR, Bulstra SK, Stegenga B. Inflammation is more distinct in temporomandibular joint osteoarthritis compared to the knee joint. J Oral Maxillofac Surg 2013; 72:35-40. [PMID: 24210930 DOI: 10.1016/j.joms.2013.08.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/10/2013] [Accepted: 08/16/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Most of the current understanding of articular cartilage maintenance and degradation is derived from large load-bearing synovial joints, in particular the knee joint. The aim of this study was to identify valuable degradation markers for cartilage degradation in the temporomandibular joint (TMJ) by comparing the relative concentrations of carboxyterminal telopeptides of collagen types I and II (CTX-I and CTX-II), cartilage oligomeric matrix protein (COMP), and prostaglandin E2 (PGE2) in synovial fluid (SF) of TMJ and knee joints with cartilage degradation. MATERIALS AND METHODS In this cross-sectional comparative study, participants were recruited from the University Medical Center Groningen, The Netherlands. Patients with TMJ osteoarthritis were compared with patients with knee osteoarthritis. The outcome variables were the relative SF concentrations of CTX-I, CTX-II, COMP, and PGE2. An independent samples Mann-Whitney U test was used to compare the relative concentrations. RESULTS Thirty consecutive patients (9 male, 21 female; mean age, 40.1 yr; standard deviation, 15.3 yr) with TMJ osteoarthritis and 31 consecutive patients (20 male, 11 female; mean age, 37.4 yr; standard deviation, 13.7 yr) who were scheduled for arthroscopy of the knee joint participated in this study. Significant differences were found between relative concentrations of COMP (P = .000) and PGE2 (P = .005), and no significant differences were found between relative concentrations of CTX-I (P = .720) and CTX-II (P = .242). CONCLUSIONS Relative SF concentrations of COMP and PGE2 showed significant differences between the TMJ and the knee joint, suggesting that there are differences in pathophysiology and that the inflammatory component may be more distinct in the TMJ.
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Affiliation(s)
- Lukas M Vos
- Research Assistant, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Roel Kuijer
- Senior Researcher, Department of Biomaterials, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - James J R Huddleston Slater
- Senior Researcher, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sjoerd K Bulstra
- Professor, Department of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Boudewijn Stegenga
- Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Bedi A, Lynch EB, Sibilsky Enselman ER, Davis ME, DeWolf PD, Makki TA, Kelly BT, Larson CM, Henning PT, Mendias CL. Elevation in circulating biomarkers of cartilage damage and inflammation in athletes with femoroacetabular impingement. Am J Sports Med 2013; 41:2585-90. [PMID: 23959964 PMCID: PMC4048958 DOI: 10.1177/0363546513499308] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Femoroacetabular impingement (FAI) is one of the most common causes of early cartilage and labral damage in the nondysplastic hip. Biomarkers of cartilage degradation and inflammation are associated with osteoarthritis. It was not known whether patients with FAI have elevated levels of biomarkers of cartilage degradation and inflammation. HYPOTHESIS Compared with athletes without FAI, athletes with FAI would have elevated levels of the inflammatory C-reactive protein (CRP) and cartilage oligomeric matrix protein (COMP), a cartilage degradation marker. STUDY DESIGN Controlled laboratory study. METHODS Male athletes with radiographically confirmed FAI (n = 10) were compared with male athletes with radiographically normal hips with no evidence of FAI or hip dysplasia (n = 19). Plasma levels of COMP and CRP were measured, and subjects also completed the Short Form-12 (SF-12) and Hip Disability and Osteoarthritis Outcome Score (HOOS) surveys. RESULTS Compared with controls, athletes with FAI had a 24% increase in COMP levels and a 276% increase in CRP levels as well as a 22% decrease in SF-12 physical component scores and decreases in all of the HOOS subscale scores. CONCLUSION Athletes with FAI demonstrate early biochemical signs of increased cartilage turnover and systemic inflammation. CLINICAL RELEVANCE Chondral injury secondary to the repetitive microtrauma of FAI might be reliably detected with biomarkers. In the future, these biomarkers might be used as screening tools to identify at-risk patients and assess the efficacy of therapeutic interventions such as hip preservation surgery in altering the natural history and progression to osteoarthritis.
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Affiliation(s)
- Asheesh Bedi
- Corresponding author: Department of Orthopaedic Surgery University of Michigan 24 Frank Lloyd Wright Drive, Lobby A Ann Arbor, MI 48106
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Lafeber FPJG, van Spil WE. Osteoarthritis year 2013 in review: biomarkers; reflecting before moving forward, one step at a time. Osteoarthritis Cartilage 2013; 21:1452-64. [PMID: 23954702 DOI: 10.1016/j.joca.2013.08.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 07/25/2013] [Accepted: 08/03/2013] [Indexed: 02/02/2023]
Abstract
In 2010, in Osteoarthritis and Cartilage, we published a comprehensive systematic review applying the consensus BIPED criteria (Burden of Disease, Investigative, Prognostic, Efficacy of Intervention and Diagnostic) criteria on serum and urinary biochemical markers for knee and hip osteoarthritis (OA) using publications that were available at that time. It appeared that none of the biochemical markers at that time were sufficiently discriminating to allow diagnosis and prognosis of OA in individual or limited numbers of patients, nor performed so consistently that they could function as primary outcome parameters in clinical trials. Also at present, almost 3 years later, this ultimate goal has not been reached (yet). Frankly, it might be questioned whether we are making the most adequate steps ahead and maybe we have to take a step back to reconsider our approaches. Some reflections are made and discussed: A critical review of molecular metabolism in OA and validation of currently investigated marker molecules in this may be vital and may lead to new and better markers. Creating cohorts in which synovial fluid (SF) is obtained in a systematic way, together with serum and urine, may also bring the field a further step ahead. Thirdly, better understanding of different phenotypes (subtypes) of OA may facilitate identification and validation of biochemical markers. Finally, the systems biology approach as discussed in the last years OA in review on biomarkers, although very complex, might provide steps forward. Looking ahead, we are optimistic but realistic in our expectations, we believe that the field can be brought forward by critically and cautiously reconsidering our approaches, and making changes forward, one step at a time.
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Affiliation(s)
- F P J G Lafeber
- Rheumatology & Clin. Immunol., University Medical Centre Utrecht, The Netherlands.
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Svoboda SJ, Harvey TM, Owens BD, Brechue WF, Tarwater PM, Cameron KL. Changes in serum biomarkers of cartilage turnover after anterior cruciate ligament injury. Am J Sports Med 2013; 41:2108-16. [PMID: 23831890 DOI: 10.1177/0363546513494180] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Biomarkers of cartilage turnover and joint metabolism have a potential use in detecting early degenerative changes after a traumatic knee joint injury; however, no study has analyzed biomarkers before an anterior cruciate ligament (ACL) injury and again after injury or in comparison with a similar group of uninjured controls. HYPOTHESIS Changes in serum biomarker levels and the ratio of cartilage degradation to synthesis, from baseline to follow-up, would be significantly different between ACL-injured patients and uninjured controls. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS This case-control study was conducted to examine changes in serum biomarkers of cartilage turnover following ACL injury in a young athletic population. Specifically, 2 markers for type II collagen and aggrecan synthesis (CPII and CS846, respectively) and 2 markers of types I and II degradation and type II degradation only (C1,2C and C2C, respectively) were studied. Preinjury baseline serum samples and postinjury follow-up samples were obtained for 45 ACL-injured cases and 45 uninjured controls matched for sex, age, height, and weight. RESULTS Results revealed significant decreases in C1,2C (P = .042) and C2C (P = .006) over time in the ACL-injured group when compared with the controls. The change in serum concentrations of CS846 from baseline to follow-up was also significantly different between the ACL-injured patients and uninjured controls (P = .002), as was the change between groups in the ratio of C2C:CPII over time (P = .013). No preinjury differences in the ratio of C1,2C:CPII or C2C:CPII were observed between groups; however, postinjury differences were observed for both ratios. CONCLUSION Changes in biomarker concentrations after an ACL injury suggest an alteration in cartilage turnover and joint metabolism in those sustaining ACL injuries compared with uninjured matched controls.
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Affiliation(s)
- Steven J Svoboda
- John A. Feagin Jr Sports Medicine Fellowship, Department of Orthopedic Surgery, Keller Army Hospital, West Point, NY 10996, USA
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29
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Abstract
Objective: We performed comprehensive proteomic analyses of articular cartilage by using the isobaric tags for relative and absolute quantitation (iTRAQ) method, and searched for candidate biomarkers for osteoarthritis (OA). Methods: Articular cartilage was collected from patients with OA or femoral neck fracture for the control group. Molecular variations were detected by the iTRAQ method, and quantitative analyses were performed by western blot. Results: Using the iTRAQ method, we identified 76 proteins with different expression levels in OA patients and the control group. Among these proteins, we selected LECT2 (leukocyte cell-derived chemotaxin-2), BAALC (brain and acute leukemia, cytoplasmic), and PRDX6 (peroxiredoxin-6), which had not been reported as biomarkers for OA. Conclusions: Use of these proteins in combination with conventional OA biomarkers may better reflect the grade and prognosis of OA.
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Affiliation(s)
- Daiki Ikeda
- Department of Orthopaedic Surgery, Fujita Health University Hospital , Toyoake, Aichi , Japan and
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30
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Alteration of cartilage degeneration and inflammation markers in temporomandibular joint osteoarthritis occurs proportionally. J Oral Maxillofac Surg 2013; 71:1659-64. [PMID: 23932112 DOI: 10.1016/j.joms.2013.06.201] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 06/10/2013] [Accepted: 06/11/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE There is a growing interest in markers for cartilage degradation in synovial joints because of their potential diagnostic and prognostic value. Therefore, the aim of this study was to identify valuable degradation markers for temporomandibular joint (TMJ) osteoarthritis (OA) by comparing the relative concentrations of carboxyterminal telopeptides type I and II (CTX-I and II), cartilage oligomeric matrix protein (COMP), and prostaglandin E2 (PGE2) in the synovial fluid (SF) of TMJs with OA with those of healthy symptom-free TMJs. MATERIALS AND METHODS In this cross-sectional case-control study, participants were recruited from the University Medical Center Groningen (Groningen, the Netherlands). Cases were defined as patients with TMJ OA, and control patients had symptom-free TMJs. The outcome variables were the relative concentrations of CTX-I, CTX-II, COMP, and PGE2 in osteoarthritic TMJ SF compared with symptom-free joints. An independent-samples Mann-Whitney U test was used to compare the relative concentrations. RESULTS Thirty cases (9 male, 21 female; mean age, 40.1 yr; standard deviation, 15.3 yr) and 10 controls (5 male, 5 female; mean age, 30.3 yr; standard deviation, 10.8 yr) were studied. No significant differences in relative concentrations of CTX-I (P = .548), CTX-II (P = .842), COMP (P = .140), and PGE2 (P = .450) were found between the groups. Unexpected low relative concentrations of CTX-I and high relative concentrations of CTX-II were observed. CONCLUSIONS Assumed changes in the SF concentration of CTX-I, CTX-II, COMP, and PGE2 in TMJ OA seem to occur proportionally. Furthermore, the unexpected large contribution of CTX-II suggests that this marker may be useful to quantify cartilage degradation in TMJ OA.
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31
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Lotz M, Martel-Pelletier J, Christiansen C, Brandi ML, Bruyère O, Chapurlat R, Collette J, Cooper C, Giacovelli G, Kanis JA, Karsdal MA, Kraus V, Lems WF, Meulenbelt I, Pelletier JP, Raynauld JP, Reiter-Niesert S, Rizzoli R, Sandell LJ, Van Spil WE, Reginster JY. Value of biomarkers in osteoarthritis: current status and perspectives. Ann Rheum Dis 2013; 72:1756-63. [PMID: 23897772 PMCID: PMC3812859 DOI: 10.1136/annrheumdis-2013-203726] [Citation(s) in RCA: 199] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Osteoarthritis affects the whole joint structure with progressive changes in cartilage, menisci, ligaments and subchondral bone, and synovial inflammation. Biomarkers are being developed to quantify joint remodelling and disease progression. This article was prepared following a working meeting of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis convened to discuss the value of biochemical markers of matrix metabolism in drug development in osteoarthritis. The best candidates are generally molecules or molecular fragments present in cartilage, bone or synovium and may be specific to one type of joint tissue or common to them all. Many currently investigated biomarkers are associated with collagen metabolism in cartilage or bone, or aggrecan metabolism in cartilage. Other biomarkers are related to non-collagenous proteins, inflammation and/or fibrosis. Biomarkers in osteoarthritis can be categorised using the burden of disease, investigative, prognostic, efficacy of intervention, diagnostic and safety classification. There are a number of promising candidates, notably urinary C-terminal telopeptide of collagen type II and serum cartilage oligomeric protein, although none is sufficiently discriminating to differentiate between individual patients and controls (diagnostic) or between patients with different disease severities (burden of disease), predict prognosis in individuals with or without osteoarthritis (prognostic) or perform so consistently that it could function as a surrogate outcome in clinical trials (efficacy of intervention). Future avenues for research include exploration of underlying mechanisms of disease and development of new biomarkers; technological development; the ‘omics’ (genomics, metabolomics, proteomics and lipidomics); design of aggregate scores combining a panel of biomarkers and/or imaging markers into single diagnostic algorithms; and investigation into the relationship between biomarkers and prognosis.
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Affiliation(s)
- M Lotz
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, , La Jolla, California, USA
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Kumm J, Tamm A, Lintrop M, Tamm A. Diagnostic and prognostic value of bone biomarkers in progressive knee osteoarthritis: a 6-year follow-up study in middle-aged subjects. Osteoarthritis Cartilage 2013; 21:815-22. [PMID: 23523608 DOI: 10.1016/j.joca.2013.03.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 02/22/2013] [Accepted: 03/12/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the value of bone markers in early-stage progressive knee osteoarthritis (OA), a population-based cohort of middle-aged subjects with chronic knee complaints was followed over 6 years (two consecutive two 3-year periods). METHODS Tibiofemoral (TF) and patellofemoral (PF) radiographs were graded in 128 subjects (mean age at baseline 45 ± 6.2 years) in 2002, 2005 and 2008. Bone formation was assessed by the serum concentration of procollagen type I amino-terminal propeptide (sPINP); bone resorption by the level of the C-terminal cross-linked telopeptides of type I collagen (sCTx-I); and bone mineralization by the values of osteocalcin (sOC) by electrochemiluminescence immunoassay. A novel marker of bone resorption, urinary osteocalcin midfragments (uMidOC), was assayed using enzyme linked immunosorbent assay (ELISA). RESULTS Several diagnostic associations were found between the bone markers (PINP, OC, MidOC) and progressive OA expressed by TF osteophytosis. The increasing output of MidOC demonstrated several-fold higher risk for progressive TF osteophytosis [odds ratio (OR) 5.32; 95% confidence interval (CI) 1.41-20.06, P = 0.014] than other bone markers. The values of PINP had prognostic value for subsequent more severely expressed knee OA progression [r(s) = 0.460, P = 0.005]. CONCLUSIONS Bone metabolism is activated in early-stage knee OA. OA progression was preceded by the enhanced bone formation (by PINP) and accompanied by the activation of bone formation (by PINP), non-collagenous bone resorption (by MidOC), as well as by changes in mineralization (by OC). All three bone markers had diagnostic value, and one of them, PINP, had also a predictive value for knee OA progression, especially for progressive osteophytosis.
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Affiliation(s)
- J Kumm
- Clinic of Internal Medicine, University of Tartu, Tartu, Estonia.
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33
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Bai JPF, Alekseyenko AV, Statnikov A, Wang IM, Wong PH. Strategic applications of gene expression: from drug discovery/development to bedside. AAPS J 2013; 15:427-37. [PMID: 23319288 PMCID: PMC3675744 DOI: 10.1208/s12248-012-9447-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 12/04/2012] [Indexed: 01/08/2023] Open
Abstract
Gene expression is useful for identifying the molecular signature of a disease and for correlating a pharmacodynamic marker with the dose-dependent cellular responses to exposure of a drug. Gene expression offers utility to guide drug discovery by illustrating engagement of the desired cellular pathways/networks, as well as avoidance of acting on the toxicological pathways. Successful employment of gene-expression signatures in the later stages of drug development depends on their linkage to clinically meaningful phenotypic characteristics and requires a biologically meaningful mechanism combined with a stringent statistical rigor. Much of the success in clinical drug development is hinged on predefining the signature genes for their fitness for purposes of application. Specific examples are highlighted to illustrate the breadth and depth of the potential utility of gene-expression signatures in drug discovery and clinical development to targeted therapeutics at the bedside.
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Affiliation(s)
- Jane P F Bai
- Office of Clinical Pharmacology, Office of Translational Science, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD 20993, USA.
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Two Single-Nucleotide Polymorphisms in ADAM12 Gene Are Associated with Early and Late Radiographic Knee Osteoarthritis in Estonian Population. ARTHRITIS 2013; 2013:878126. [PMID: 23606964 PMCID: PMC3625563 DOI: 10.1155/2013/878126] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 03/01/2013] [Accepted: 03/04/2013] [Indexed: 11/22/2022]
Abstract
Objectives. To investigate associations of selected single-nucleotide polymorphisms (SNPs) in ADAM12 gene with radiographic knee osteoarthritis (rKOA) in Estonian population. Methods. The rs3740199, rs1871054, rs1278279, and rs1044122 SNPs in ADAM12 gene were genotyped in 438 subjects (303 women) from population-based cohort, aged 32 to 57 (mean 45.4). The rKOA features were evaluated in the tibiofemoral joint (TFJ) and patellofemoral joint. Results. The early rKOA was found in 51.4% of investigated subjects (72% women) and 12.3% of participants (63% women) had advanced stage of diseases. The A allele of synonymous SNP rs1044122 was associated with early rKOA in TFJ, predominantly with the presence of osteophytes in females (OR 1.57; 95% CI 1.08–2.29, P = 0.018). The C allele of intron polymorphism rs1871054 carried risk for advanced rKOA, mostly to osteophyte formation in TFJ in males (OR 3.03; 95% CI 1.11–7.53, P = 0.018). Also the CCAA haplotype of ADAM12 was associated with osteophytosis, again mostly in TFJ in males (P = 0.014). For rs3740199 and rs1278279, no statistically significant associations were observed. Conclusion.
ADAM12 gene variants are related to rKOA risk during the early and late stages of diseases. The genetic risk seems to be predominantly associated with the appearance of osteophytes—a marker of bone remodelling and neochondrogenesis.
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35
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Serum non-coding RNAs as biomarkers for osteoarthritis progression after ACL injury. Osteoarthritis Cartilage 2012; 20:1631-7. [PMID: 22944527 PMCID: PMC3478481 DOI: 10.1016/j.joca.2012.08.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 08/09/2012] [Accepted: 08/22/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to examine serum non-coding RNAs as potential biomarkers for cartilage damage associated with anterior cruciate ligament (ACL) injury. METHODS Serum was obtained from 80 patients 1 year after surgery for ACL injury and 60 normal donors without overt skeletal injury. Total serum RNA was isolated, small non-coding RNAs profiled by TaqMan array MicroRNA (miRNA) analysis and individual small RNA assays performed by quantitative TaqMan RT-PCR (qPCR). Semi-quantitative magnetic resonance imaging (MRI) analysis was performed using Whole Organ Magnetic Resonance Knee Score (WORMS) scoring for analysis of cartilage damage. RESULTS Initial TaqMan array miRNA profiling showed an increased serum concentration of a small nucleolar RNA (snoRNA), U48, in five patients with cartilage damage compared with that in five patients without cartilage damage and six normal donors. Independent qPCR analysis of snoRNAs in serum from all patients and normal donors showed a strong association between the serum level of another snoRNA, U38, and cartilage damage in ACL injury patients and together with snoRNA, U48, clear distinction between ACL injury patients and normal donors. CONCLUSION SnoRNAs U38 and U48 are significantly elevated in the serum of patients developing cartilage damage at 1 year after ACL injury. Serum levels of U38 have the potential to facilitate early diagnosis of patients with cartilage damage after ACL injury. This study suggests serum non-coding RNAs may serve as novel noninvasive biomarkers for the detection and assessment of cartilage damage after ACL injury.
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Mobasheri A. Osteoarthritis year 2012 in review: biomarkers. Osteoarthritis Cartilage 2012; 20:1451-64. [PMID: 22842200 DOI: 10.1016/j.joca.2012.07.009] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Revised: 07/02/2012] [Accepted: 07/17/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE Biomarkers provide useful diagnostic information by detecting cartilage degradation in osteoarthritis (OA), reflecting disease-relevant biological activity and predicting the course of disease progression. They also serve as surrogate endpoints in the drug discovery process. The aim of this narrative review was to focus on OA biomarker-related papers published between the osteoarthritis research society international (OARSI) 2011 meeting in San Diego and the OARSI 2012 meeting in Barcelona. METHODS The PubMed/MEDLINE and SciVerse Scopus bibliographic databases were searched using the keywords: 'biomarker' and 'osteoarthritis' and/or 'biomarker' and 'proteomics'. RESULTS Ninety-eight papers were found with the keywords 'biomarker' and 'osteoarthritis'. Fifteen papers were found with the keywords 'biomarker' and 'proteomics'. Review articles were also included. The most relevant published studies focused on extracellular matrix (ECM) molecules in body fluids. Enrichment of the deamidated epitope of cartilage oligomeric matrix protein (D-COMP) suggests that OA disease progression is associated with post-translational modifications that may show specificity for particular joint sites. Fibulin-3 peptides (Fib3-1 and Fib3-2) have been proposed as potential biomarkers of OA along with follistatin-like protein 1 (FSTL1), a new serum biomarker with the capacity to reflect the severity of joint damage. The 'membrane attack complex' (MAC) component of complement has also been implicated in OA. CONCLUSION Novel OA biomarkers are needed for sub-clinical disease diagnosis. Proteomic techniques are beginning to yield useful data and deliver new OA biomarkers in serum and urine. Combining biochemical markers with tissue and cell imaging techniques and bioinformatics (i.e., machine learning, clustering, data visualization) may facilitate the development of biomarker combinations enabling earlier detection of OA.
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Affiliation(s)
- A Mobasheri
- Musculoskeletal Research Group, School of Veterinary Medicine and Science, Faculty of Medicine and Health Sciences, The University of Nottingham, Sutton Bonington Campus, Sutton Bonington, UK.
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Kumm J, Tamm A, Lintrop M, Tamm A. The value of cartilage biomarkers in progressive knee osteoarthritis: cross-sectional and 6-year follow-up study in middle-aged subjects. Rheumatol Int 2012; 33:903-11. [PMID: 22821260 DOI: 10.1007/s00296-012-2463-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 07/07/2012] [Indexed: 01/24/2023]
Abstract
To determine the possible diagnostic and prognostic value of cartilage biomarkers in early-stage progressive and nonprogressive knee osteoarthritis (OA) in a population-based cohort of middle-aged subjects with chronic knee pain. Design tibiofemoral (TF) and patellofemoral (PF) radiographs were graded in 128 subjects (mean age at baseline, 45 ± 6.2 years) in 2002, 2005, and 2008. Cartilage degradation was assessed by urinary C-telopeptide fragments of type II collagen (uCTx-II), synthesis by serum type II A procollagen N-terminal propeptide (sPIIANP), and articular tissue turnover in general by cartilage oligomeric matrix protein (sCOMP). Several diagnostic associations were found between all studied biomarkers and progressive osteophytosis. COMP and CTx-II had a predictive value for subsequent progressive osteophytosis in multiple knee compartments and in case of CTx-II-also for progressive JSN. Over the first 3 years (2002-2005), significant associations were observed between COMP and progressive osteophytosis, whereas 3 years later (2005-2008) between CTx-II and progressive JSN. Thus, the associations between cartilage markers (COMP, CTx-II) and progression of radiographic OA features--osteophytes and JSN--were different between 2002-2005 and 2005-2008. Logistic regression revealed that for every unit increase in COMP level, there was 33 % higher risk for TF osteophyte progression. During early-stage OA, the presence and progression of osteophytosis is accompanied by increased level of cartilage biomarkers. This is the first study to demonstrate biochemical differences over the course of knee OA, illustrating a phasic nonpersistent character of OA with periods of progression and stabilization.
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Affiliation(s)
- Jaanika Kumm
- Clinic of Internal Medicine, University of Tartu, L.Puusepa 6-222, Tartu 51014, Estonia.
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Chu CR, Williams AA, Coyle CH, Bowers ME. Early diagnosis to enable early treatment of pre-osteoarthritis. Arthritis Res Ther 2012; 14:212. [PMID: 22682469 PMCID: PMC3446496 DOI: 10.1186/ar3845] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Osteoarthritis is a prevalent and disabling disease affecting an increasingly large swathe of the world population. While clinical osteoarthritis is a late-stage condition for which disease-modifying opportunities are limited, osteoarthritis typically develops over decades, offering a long window of time to potentially alter its course. The etiology of osteoarthritis is multifactorial, showing strong associations with highly modifiable risk factors of mechanical overload, obesity and joint injury. As such, characterization of pre-osteoarthritic disease states will be critical to support a paradigm shift from palliation of late disease towards prevention, through early diagnosis and early treatment of joint injury and degeneration to reduce osteoarthritis risk. Joint trauma accelerates development of osteoarthritis from a known point in time. Human joint injury cohorts therefore provide a unique opportunity for evaluation of pre-osteoarthritic conditions and potential interventions from the earliest stages of degeneration. This review focuses on recent advances in imaging and biochemical biomarkers suitable for characterization of the pre-osteoarthritic joint as well as implications for development of effective early treatment strategies.
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Affiliation(s)
- Constance R Chu
- Cartilage Restoration Center, Department of Orthopaedic Surgery, University of Pittsburgh, Biomedical Science Tower E1640, 200 Lothrop Street, PA 15261, USA.
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Weng X, Liao Q, Li K, Li Y, Mi M, Zhong D. Screening serum biomarker of knee osteoarthritis using a phage display technique. Clin Biochem 2012; 45:303-8. [DOI: 10.1016/j.clinbiochem.2011.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 10/21/2011] [Accepted: 12/16/2011] [Indexed: 10/14/2022]
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Abstract
PURPOSE OF REVIEW Osteoarthritis is a joint disease characterized by a nonsymptomatic, preradiographical phase that if distinguished would allow earlier osteoarthritis diagnosis. Biochemical biomarkers offer a potential nonradiographical alternative to detect early, nonsymptomatic osteoarthritis. RECENT FINDINGS Biomarker development for osteoarthritis diagnosis is still in the forefront of the research repertoire in osteoarthritis. A number of previously identified biomarkers derived from cartilage breakdown or enzymes that cause cartilage degeneration still have prominence and are now better characterized with increasing use in identifying disease severity, progression, and testing treatment options. Combinations of cartilage-derived and bone-derived biomarkers have been used to subgroup osteoarthritis patients that could impact treatment and address the importance of bone turnover in cartilage integrity. Increasingly, inflammation markers have been used to profile osteoarthritis progression attesting to the inflammatory nature of osteoarthritis. The application of proteomic technologies has generated several new, nonconventional biomarkers that could allow better profiling of osteoarthritis. SUMMARY Biomarker combinations have the ability to subgroup the heterogenous osteoarthritis population to allow a better scrutiny of diagnosis and treatment options. The application of different technological platforms to osteoarthritis would allow a better understanding of its pathology and could provide for appropriate candidates for earlier detection of osteoarthritis.
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The prevalence and progression of radiographic knee osteoarthritis over 6 years in a population-based cohort of middle-aged subjects. Rheumatol Int 2011; 32:3545-50. [PMID: 22083615 DOI: 10.1007/s00296-011-2221-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 10/22/2011] [Indexed: 10/15/2022]
Abstract
Details of the development of early knee osteoarthritis (OA) are largely unknown. The prevalence and progression of radiographic knee OA over 6 years in middle-aged subjects with chronic knee pain is investigated. In a prospective population-based study, tibiofemoral (TF) and patellofemoral (PF) radiographs were graded in 128 subjects (mean age 45 ± 6.2 years) for the presence of osteophytes and joint space narrowing (JSN). Radiographic progression was defined as: (i) the presence of osteophytes and/or JSN in subjects with no previous OA or (ii) an increase in the grade and/or number of already existing osteophytes and/or JSN. Altogether 56% (72/128) of subjects had knee OA, the majority of them was diagnosed with OA grade 1. In 57% of cases, radiographic OA was based on the presence of osteophytes alone versus 13% on JSN. More than 1/3 of subjects had isolated PF joint involvement. Knee OA progression rate over 6 years was 56% (71/128). During 6 years, a non-linear course of radiographic OA progression with intermittent periods of progression and stabilization was observed. Individual course of OA revealed distinct subsets of radiographic progression. Osteophytosis is an important early radiographic sign of OA and its progression. Isolated PF joint involvement is a frequent expression of knee OA. In middle-aged subjects, the progression rate of knee OA over 6 years was 56%. A non-linear course of radiographic OA progression was observed. Several radiographic subsets refer to the heterogeneity of the OA process.
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