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Schini M, Vilaca T, Gossiel F, Salam S, Eastell R. Bone Turnover Markers: Basic Biology to Clinical Applications. Endocr Rev 2022; 44:417-473. [PMID: 36510335 PMCID: PMC10166271 DOI: 10.1210/endrev/bnac031] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
Bone turnover markers (BTMs) are used widely, in both research and clinical practice. In the last 20 years, much experience has been gained in measurement and interpretation of these markers, which include commonly used bone formation markers bone alkaline phosphatase, osteocalcin, and procollagen I N-propeptide; and commonly used resorption markers serum C-telopeptides of type I collagen, urinary N-telopeptides of type I collagen and tartrate resistant acid phosphatase type 5b. BTMs are usually measured by enzyme-linked immunosorbent assay or automated immunoassay. Sources contributing to BTM variability include uncontrollable components (e.g., age, gender, ethnicity) and controllable components, particularly relating to collection conditions (e.g., fasting/feeding state, and timing relative to circadian rhythms, menstrual cycling, and exercise). Pregnancy, season, drugs, and recent fracture(s) can also affect BTMs. BTMs correlate with other methods of assessing bone turnover, such as bone biopsies and radiotracer kinetics; and can usefully contribute to diagnosis and management of several diseases such as osteoporosis, osteomalacia, Paget's disease, fibrous dysplasia, hypophosphatasia, primary hyperparathyroidism, and chronic kidney disease-mineral bone disorder.
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Affiliation(s)
- Marian Schini
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tatiane Vilaca
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Fatma Gossiel
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Syazrah Salam
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Richard Eastell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Numan MS, Amiable N, Brown JP, Michou L. Paget's disease of bone: an osteoimmunological disorder? DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:4695-707. [PMID: 26316708 PMCID: PMC4544727 DOI: 10.2147/dddt.s88845] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Osteoimmunology represents a large area of research resulting from the cross talk between bone and immune systems. Many cytokines and signaling cascades are involved in the field of osteoimmunology, originating from various cell types. The RANK/receptor activator of nuclear factor Kappa-B ligand (RANKL)/osteoprotegerin (OPG) signaling has a pivotal role in osteoimmunology, in addition to proinflammatory cytokines such as tumor necrosis factor-α, interleukin (IL)-1, IL-6, and IL-17. Clinically, osteoimmunological disorders, such as rheumatoid arthritis, osteoporosis, and periodontitis, should be classified according to their pattern of osteoimmunological serum biomarkers. Paget’s disease of bone is a common metabolic bone disorder, resulting from an excessively increased bone resorption coupled with aberrant bone formation. With the exception of the cellular responses to measles virus nucleocapsid protein and the interferon-gamma signature, the exact role of the immune system in Paget’s disease of bone is not well understood. The cytokine profiles, such as the increased levels of IL-6 and the interferon-gamma signature observed in this disease, are also very similar to those observed in other osteoimmunological disorders. As a potential osteoimmunological disorder, the treatment of Paget’s disease of bone may also benefit from progress made in targeted therapies, in particular for receptor activator of nuclear factor Kappa-B ligand and IL-6 signaling inhibition.
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Affiliation(s)
- Mohamed S Numan
- CHU de Québec Research Centre, CHU de Québec-Université Laval, Quebec City, QC, Canada ; Division of Rheumatology, Department of Medicine, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Nathalie Amiable
- CHU de Québec Research Centre, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Jacques P Brown
- CHU de Québec Research Centre, CHU de Québec-Université Laval, Quebec City, QC, Canada ; Division of Rheumatology, Department of Medicine, CHU de Québec-Université Laval, Quebec City, QC, Canada ; Department of Rheumatology, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Laëtitia Michou
- CHU de Québec Research Centre, CHU de Québec-Université Laval, Quebec City, QC, Canada ; Division of Rheumatology, Department of Medicine, CHU de Québec-Université Laval, Quebec City, QC, Canada ; Department of Rheumatology, CHU de Québec-Université Laval, Quebec City, QC, Canada
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Coiffier G, Bouvard B, Chopin F, Biver E, Funck-Brentano T, Garnero P, Guggenbuhl P. Common bone turnover markers in rheumatoid arthritis and ankylosing spondylitis: a literature review. Joint Bone Spine 2012; 80:250-7. [PMID: 23142254 DOI: 10.1016/j.jbspin.2012.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 08/02/2012] [Indexed: 11/28/2022]
Abstract
We studied the impact of inflammatory rheumatism and its treatment on the most common bone turnover markers, based on six previously defined questions in a systematic literature review in order to define their place in daily clinical practice. The role of bone is currently considered of particular importance concerning cartilage damage in inflammatory rheumatism (rheumatoid arthritis and ankylosing spondylitis) and the new concept of osteoimmunology has emerged. Some bone turnover markers are available in clinical practice. In spite of rich and extensive literature on bone turnover markers, their use in inflammatory rheumatism or even osteoporosis is not clear, and a systematic literature review became necessary. In spite of a large number of different markers used in literature, few of them that are useful in common practice have been studied in the field of inflammatory rheumatism such as rheumatoid arthritis and ankylosing spondylitis. Although their study enables understanding of the physiopathological mechanisms of osteoporosis in inflammatory rheumatism, their use in current common practice cannot be recommended. Interesting data on the forecast of the structural evolution of rheumatoid arthritis has been found within the framework of clinical research, without any real practical impact today.
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Affiliation(s)
- Guillaume Coiffier
- University hospital of Rennes, Hôpital Sud, Rheumatology Department, 16, boulevard de Bulgarie, 35203, Rennes cedex, France.
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Correlations between biochemical markers in the synovial fluid and severity of rotator cuff disease. Musculoskelet Surg 2009; 93 Suppl 1:S41-8. [PMID: 19711169 DOI: 10.1007/s12306-009-0004-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The role of biochemical factors in the onset and natural history of rotator cuff disease is not fully understood, but it is generally recognised that they could induce tendon damage in association with mechanical and vascular factors. In this study, 5 biochemical parameters were analysed (total protein concentration, matrix metalloproteinase (MMP)-2 or gelatinase A, MMP-9 or gelatinase B, type I collagen telopeptides, hyaluronic acid) in the synovial fluid (SF) aspirated from the gleno-humeral joint of 29 patients undergoing surgical therapy for rotator cuff lesions. Four different groups of patients were identified according to the severity of the lesion: partial tear of the rotator cuff, full thickness tear involving <or-1 tendon, full thickness tear involving >1 tendon and cuff tear arthropathy (CTA). The total SF protein concentration progressively increased with loss of integrity of the rotator cuff, reaching the highest levels in CTA. The absolute enzymatic activity of gelatinases was greater in full thickness tears than in partial tears, while it decreased in CTA. Conversely, the ratio between gelatinases and total protein content reached the highest level in partial tears and then progressively decreased. Collagen I telopeptides were significantly increased in full thickness tears and CTA, whereas the levels of hyaluronic acid decreased with worsening of rotator cuff disease. These findings support the hypothesis that gelatinases, which are involved in physiological tendon remodelling, intervene in the evolution of rotator cuff disease, too. Increased levels of type I collagen telopeptides give evidence that tendon tears are associated with an anatomic loss of tendon tissue and not with simple tendon retraction.
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SYVERSEN SILJEW, LANDEWE ROBERT, van der HEIJDE DÉSIRÉE, BATHON JOANM, BOERS MAARTEN, BYKERK VIVIANP, FITZGERALD OLIVER, GLADMAN DAFNAD, GARNERO PATRICK, GEUSENS PIET, EL-GABALAWY HANI, INMAN ROBERTD, KRAUS VIRGINIA, KVIEN TOREK, MEASE PHILIPJ, ØSTERGAARD MIKKEL, RITCHLIN CHRISTOPHERJ, TAK PAULPETER, TAYLOR WILLIAMJ, MAKSYMOWYCH WALTERP. Testing of the OMERACT 8 Draft Validation Criteria for a Soluble Biomarker Reflecting Structural Damage in Rheumatoid Arthritis: A Systematic Literature Search on 5 Candidate Biomarkers. J Rheumatol 2009; 36:1769-84. [DOI: 10.3899/jrheum.090262] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective.To test the OMERACT 8 draft validation criteria for soluble biomarkers by assessing the strength of literature evidence in support of 5 candidate biomarkers.Methods.A systematic literature search was conducted on the 5 soluble biomarkers RANKL, osteoprotegerin (OPG), matrix metalloprotease (MMP-3), urine C-telopeptide of types I and II collagen (U-CTX-I and U CTX-II), focusing on the 14 OMERACT 8 criteria. Two electronic voting exercises were conducted to address: (1) strength of evidence for each biomarker as reflecting structural damage according to each individual criterion and the importance of each individual criterion; (2) overall strength of evidence in support of each of the 5 candidate biomarkers as reflecting structural damage endpoints in rheumatoid arthritis (RA) and identification of omissions to the criteria set.Results.The search identified 111 articles. The strength of evidence in support of these biomarkers reflecting structural damage was low for all biomarkers and was rated highest for U-CTX-II [score of 6.5 (numerical rating scale 0–10)]. The lowest scores for retention of specific criteria in the draft set went to criteria that refer to the importance of animal studies, correlations with other biomarkers reflecting damage, and an understanding of the metabolism of the biomarker.Conclusion.Evidence in support of any of the 5 tested biomarkers (MMP-3, CTX-I, CTX-II, OPG, RANKL) was inadequate to allow their substitution for radiographic endpoints in RA. Three of the criteria in the draft criteria set might not be required, but few omissions were identified.
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Nielsen FH. A novel silicon complex is as effective as sodium metasilicate in enhancing the collagen-induced inflammatory response of silicon-deprived rats. J Trace Elem Med Biol 2008; 22:39-49. [PMID: 18319139 DOI: 10.1016/j.jtemb.2007.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2006] [Revised: 11/16/2007] [Accepted: 11/20/2007] [Indexed: 11/23/2022]
Abstract
An experiment was conducted with rats to determine whether silicon deprivation affects the inflammatory response to the injection of type II collagen, and to compare the effectiveness of the organic complex arginine silicate inositol (ASI) with inorganic silicon (NaSiO(3)) in mitigating any observed change in response. Dark Agouti rats were fed a ground corn-casein-safflower-based diet containing about 2.8 mg Si/kg. The experimental variables were supplemental 0 and 35 mg Si/kg as either ASI or NaSiO3. After five weeks on their respective treatments, each rat was injected with type II collagen and euthanized four weeks later. Urine was collected before injection during week five and week nine before euthanasia. The silicon-supplemented rats generally exhibited a more marked inflammatory response than the silicon-deprived rats. The circulating number of lymphocytes was higher (p<0.003) and number of neutrophils was lower (p<0.008) in silicon-deprived than silicon-supplemented rats. ASI and NaSiO3 were about equally effective in enhancing these changes. Post-injection of tibial release of prostaglandin E(2) (PGE(2)) (p<0.04), urinary excretion of magnesium (p<0.03) and deoxypyridinoline (p<0.009), and plasma osteopontin (p<0.009), magnesium (p<0.0007) and copper (p<0.004) were higher in silicon-supplemented than silicon-deprived rats. The increases in plasma magnesium (Si x sex, p<0.04) and copper (Si x sex, p<0.02) were more marked in male than female rats. One but not the other silicon supplement when compared to silicon deprivation significantly affected the tibial release of PGE(2), and plasma copper and iron concentrations. However, with the exception of the pre-injection urinary excretion of helical peptide, no other of the variables determined was significantly different between rats fed ASI and those fed NaSiO3. The findings suggest that, in rodents, physiological amounts of silicon promote the immune response, sex may influence the response to dietary silicon, and that both organic silicon complexes and inorganic silicon are similarly effective in preventing changes in inflammation induced by silicon deprivation.
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Affiliation(s)
- Forrest H Nielsen
- USDA, ARS, Grand Forks Human Nutrition Research Center, 2420 2nd Ave N Stop 9034, Grand Forks, ND 58202-9034, USA.
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