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Hay AM, Rhoades MJ, Bangerter S, Ferguson SA, Lee H, T. Gill M, Page GL, Pope A, Measom GJ, Hager RL, Seeley MK. Serum Cartilage Oligomeric Matrix Protein Concentration Increases More After Running Than Swimming for Older People. Sports Health 2024; 16:534-541. [PMID: 37697665 PMCID: PMC11195858 DOI: 10.1177/19417381231195309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Knee osteoarthritis is common in older people. Serum cartilage oligomeric matrix protein (sCOMP) is a biomarker of knee articular cartilage metabolism. The purpose of this study was 2-fold: to (1) determine acute effects of running and swimming on sCOMP concentration in older people; and (2) investigate relationships between sCOMP concentration change due to running and swimming and measures of knee health in older people. HYPOTHESES Running would result in greater increase in sCOMP concentration than swimming, and increase in sCOMP concentration due to running and swimming would associate positively with measures of poor knee health. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 3. METHODS A total of 20 participants ran 5 km and 19 participants swam 1500 m. sCOMP concentration was measured immediately before, immediately after, and 15, 30, and 60 minutes after running or swimming. sCOMP concentration change due to running and swimming was compared. Correlations between sCOMP concentration change due to running and swimming, and other measures of knee health were evaluated, including the Tegner Activity Scale and Knee injury and Osteoarthritis Outcome Score. RESULTS sCOMP concentration increased 29% immediately after running, relative to baseline, but only 6% immediately after swimming (P < 0.01). No significant relationship was observed between acute sCOMP change due to running and swimming, and observed measures of knee health (P > 0.05). Participants with clinically relevant knee symptoms exhibited greater sCOMP concentration before and after running and swimming (P = 0.03) and had greater body mass (P = 0.04). CONCLUSION Running results in greater acute articular cartilage metabolism than swimming; however, the chronic effects of this are unclear. Older people with clinically relevant knee symptoms possess greater sCOMP concentration and are heavier, independent of exercise mode and physical activity level. CLINICAL RELEVANCE These results describe the effects of exercise (running and swimming) for older physically active persons, with and without knee pain.
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Affiliation(s)
- Alexandra M. Hay
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | | | | | - Seth A. Ferguson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Martha T. Gill
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Garritt L. Page
- Department of Statistics, Brigham Young University, Provo, Utah
| | - Andrew Pope
- Department of Statistics, Brigham Young University, Provo, Utah
| | - Gary J. Measom
- Department of Nursing, Utah Valley University, Orem, Utah
| | - Ronald L. Hager
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Matthew K. Seeley
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
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Liphardt AM, Godonou ET, Dreiner M, Mündermann A, Tascilar K, Djalal N, Heer M, Schett G, Zaucke F, Niehoff A. Immobilization by 21 days of bed rest results in type II collagen degradation in healthy individuals. Osteoarthritis Cartilage 2024; 32:177-186. [PMID: 37989468 DOI: 10.1016/j.joca.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To investigate the effects of 21 days of bed rest immobilization (with and without exercise and nutrition interventions) on type II collagen biomarker concentrations in healthy individuals. DESIGN Twelve healthy male participants (age 34.2 ± 8.3 years; body mass index 22.4 ± 1.7 kg/m²) were exposed to 6 days ambulatory baseline data collection (BDC), 21 days head-down-tilt bed rest (HDT, CON) + interventions (HDT + resistive vibration exercise (2 times/week, 25 minutes): RVE; HDT + RVE + whey protein (0.6 g/kg body weight/day) and bicarbonate supplementation (90 mmol KHCO3/day: NeX), and 6 days of re-ambulation (R) in a cross-over designed study. The starting HDT condition was randomized (CON-RVE-NEX, RVE-NEX-CON, NEX-CON-RVE). Blood and urine samples were collected before, during, and after HDT. Serum concentrations (s) of CPII, C2C, C1,2C, and urinary concentrations (u) of CTX-II and Coll2-1NO2 were measured. RESULTS Twenty-one days of HDT resulted in increased sCPII (p < 0.001), sC2C (p < 0.001), and sC1,2C (p = 0.001) (highest increases: sCPII (+24.2% - HDT5), sC2C (+24.4% - HDT7), sC1,2C (+13.5% - HDT2). sC2C remained elevated at R+1 (p = 0.002) and R+6 (p < 0.001) compared to baseline. NeX led to lower sCPII (p < 0.001) and sC1,2C (p = 0.003) compared to CON. uCTX-II (second void and 24-hour urine) increased during HDT (p < 0.001, highest increase on HDT21: second void +82.8% (p < 0.001); 24-hour urine + 77.8% (p < 0.001). NeX resulted in lower uCTX-II concentrations in 24-hour urine (p = 0.012) compared to CON. CONCLUSIONS Twenty-one days of bed rest immobilization results in type II collagen degradation that does not recover within 6 days of resuming ambulation. The combination of resistive vibration exercise and protein/bicarbonate supplementation minimally counteracted this effect.
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Affiliation(s)
- Anna-Maria Liphardt
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Elie-Tino Godonou
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Maren Dreiner
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Köln, Germany.
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel Switzerland; Department of Spine Surgery, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
| | - Koray Tascilar
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Nadja Djalal
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Martina Heer
- IU International University of Applied Sciences, Health Sciences, Erfurt, Germany; Department of Nutrition and Food Science, Nutritional Physiology, University of Bonn, Bonn, Germany.
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopaedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Köln, Germany; Cologne Center for Musculoskeletal Biomechanics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Köln, Germany.
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Mündermann A, Nüesch C, Herger S, Liphardt AM, Chammartin F, De Pieri E, Egloff C. Load-induced blood marker kinetics in patients with medial knee compartment osteoarthritis are associated with accumulated load and patient reported outcome measures. F1000Res 2024; 12:299. [PMID: 38882712 PMCID: PMC11179051 DOI: 10.12688/f1000research.131702.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2024] [Indexed: 06/18/2024] Open
Abstract
Background This study aimed to quantify the mechanoresponse of 10 blood marker candidates for joint metabolism to a walking stress test in patients with knee osteoarthritis and to determine the association among marker kinetics and with accumulated load and patient reported outcomes. Methods 24 patients with knee osteoarthritis completed questionnaires, and a 30-minute walking stress test with six blood serum samples and gait analysis. Concentrations of cartilage oligomeric matrix protein (COMP), matrix metalloproteinases (MMP)-1, -3, and -9, epitope resulting from cleavage of type II collagen by collagenases (C2C), type II procollagen (CPII), interleukin (IL)-6, proteoglycan (PRG)-4, A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4, and resistin were determined by enzyme-linked immunosorbent assays, Joint load (moments and compartmental forces) was estimated using musculoskeletal modeling using gait analysis data. Results COMP and MMP-3 showed an immediate increase after the walking stress followed by a decrease. MMP-9 and resistin showed a delayed decrease below pre-stress levels. ∆COMP correlated with ∆MMP-3 for most time points. ∆MMP-9 correlated with ∆resistin for most time points. The load-induced increase in blood marker levels correlated among blood markers and time points. C2C and resistin correlated positively and C2C/CPII and MMP2 correlated negatively with load during gait. Immediate relative ∆CPII and ∆MMP1 and delayed relative ∆COMP, ∆IL6, ∆C2C, ∆CPII, ∆MMP1 and ∆MMP3 correlated with the load accumulated during the walking stress. Baseline C2C levels correlated with Knee Osteoarthritis Outcome Score (KOOS) subscales and load-induced changes in MMP-3 with KOOS and Short Form 36 quality of life subscores (P<0.05). Conclusions The distinct and differentiated physiological response to the walking stress depends on accumulated load and appears relevant for patient reported osteoarthritis outcome and quality of life and warrants further investigation in the context of disease progression.ClinicalTrials.gov registration: NCT02622204.
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Affiliation(s)
- Annegret Mündermann
- Department of Clinical Research, University of Basel, Basel, 4031, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, 4123, Switzerland
- Department of Orthopaedics and Trauamtology, University Hospital Basel, Basel, 4031, Switzerland
| | - Corina Nüesch
- Department of Clinical Research, University of Basel, Basel, 4031, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, 4123, Switzerland
- Department of Orthopaedics and Trauamtology, University Hospital Basel, Basel, 4031, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, 4031, Switzerland
| | - Simon Herger
- Department of Biomedical Engineering, University of Basel, Allschwil, 4123, Switzerland
- Department of Orthopaedics and Trauamtology, University Hospital Basel, Basel, 4031, Switzerland
| | - Anna-Maria Liphardt
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, 91054, Germany
- Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Frédérique Chammartin
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen & FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Enrico De Pieri
- Department of Biomedical Engineering, University of Basel, Allschwil, 4123, Switzerland
| | - Christian Egloff
- Department of Orthopaedics and Trauamtology, University Hospital Basel, Basel, 4031, Switzerland
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Silva J, Borges L, Weimann E, Belmiro Dias B, Gomes Faria F, Ferreira Salgado B, de Freitas P, Cristina Pithon-Curi T, Hatanaka E. A Single Bout of High Heels Dancing Causes an Increase in Circulating Markers of Muscle Tissue Degradation and MMP-3 in Young Healthy Women. TRANSLATIONAL SPORTS MEDICINE 2023; 2023:8852889. [PMID: 38654916 PMCID: PMC11022759 DOI: 10.1155/2023/8852889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/08/2023] [Accepted: 05/26/2023] [Indexed: 04/26/2024]
Abstract
Prolonged wearing of high heels can cause chronic injury and inflammation. Herein, we investigated the presence of muscle injury, inflammation, and neutrophil function in young women after a single bout of stiletto dance class. Sixteen volunteers (23.4 ± 3.8 years; 61.7 ± 8.1 kg; 23.4 ± 2.3 kg/m2; and 27.2 ± 3.8% body fat) participated in the study. The plasma biomarkers matrix metalloproteinase 3 (MMP-3), muscle damage (myoglobin (Mb), total creatine kinase (CK), and lactate dehydrogenase (LDH)), and inflammation (interleukin 8 (IL-8), tumour necrosis factor-alpha (TNF-α), interleukin (IL]-1β, and IL-6) were quantified before and immediately after a single stiletto class (60 min) of moderate intensity. After class, our data showed that the plasma concentration of MMP-3, Mb, and CK increased by 56% (p = 0.04; d = 0.8), 113% (p = 0.007; d = 1.1), and 21% (p < 0.001; d = 0.4), respectively. Reactive oxygen species produced by neutrophils and the plasma concentration of IL-8, TNF-α, IL-1β, and IL-6 were not affected under the study conditions. We concluded that a single bout of stiletto dance class caused muscle damage but did not alter the plasma concentration of proinflammatory cytokines. These findings are crucial in preventing the progress of chronic injuries that are often noted in dancers with synovitis and arthritis.
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Affiliation(s)
- Jamila Silva
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Leandro Borges
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Eleine Weimann
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Beatriz Belmiro Dias
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Flavio Gomes Faria
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Beatriz Ferreira Salgado
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Paulo de Freitas
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Tania Cristina Pithon-Curi
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Elaine Hatanaka
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esportes (ICAFE), Universidade Cruzeiro do Sul, São Paulo, Brazil
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Petrigna L, Trovato B, Roggio F, Castorina A, Musumeci G. Molecular Assessment of Healthy Pathological Articular Cartilages in Physically Active People: A Scoping Review. Int J Mol Sci 2023; 24:ijms24043662. [PMID: 36835076 PMCID: PMC9963910 DOI: 10.3390/ijms24043662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/28/2023] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
Physiological aging triggers a cascade of negative effects on the human body and the human joint is only one of the several compartments affected by this irreversible and natural process. Osteoarthritis and cartilage degeneration can cause pain and disability; therefore, identifying the molecular processes underlying these phenomena and the biomarkers produced during physical activity is of critical importance. In the present review, the main goal was to identify and discuss the articular cartilage biomarkers analyzed in studies in which physical or sports activities were adopted and eventually to propose a standard operating procedure for the assessment. Articles collected from Pubmed, Web of Science, and Scopus were scrutinized to detect reliable cartilage biomarkers. The principal articular cartilage biomarkers detected in these studies were cartilage oligomeric matrix protein, matrix metalloproteinases, interleukins, and carboxy-terminal telopeptide. The articular cartilage biomarkers identified in this scoping review may aid in a better comprehension of where research on the topic is heading and offer a viable instrument for streamlining investigations on cartilage biomarker discovery.
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Affiliation(s)
- Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology, and Movement Science, School of Medicine, University of Catania, Via S. Sofia No. 97, 95123 Catania, Italy
| | - Bruno Trovato
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology, and Movement Science, School of Medicine, University of Catania, Via S. Sofia No. 97, 95123 Catania, Italy
| | - Federico Roggio
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology, and Movement Science, School of Medicine, University of Catania, Via S. Sofia No. 97, 95123 Catania, Italy
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Alessandro Castorina
- Laboratory of Cellular and Molecular Neuroscience (LCMN), School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology, and Movement Science, School of Medicine, University of Catania, Via S. Sofia No. 97, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia No. 97, 95123 Catania, Italy
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
- Correspondence:
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Dreiner M, Munk T, Zaucke F, Liphardt AM, Niehoff A. Relationship between different serum cartilage biomarkers in the acute response to running and jumping in healthy male individuals. Sci Rep 2022; 12:6434. [PMID: 35440750 PMCID: PMC9018733 DOI: 10.1038/s41598-022-10310-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/06/2022] [Indexed: 12/14/2022] Open
Abstract
The effect of physical activity on serum cartilage biomarkers is largely unknown. The purpose of the study was to systematically analyze the acute effect of two frequently used exercise interventions (running and jumping) on the correlation of seven serum biomarkers that reflect cartilage extracellular matrix metabolism. Fifteen healthy male volunteers (26 ± 4 years, 181 ± 4 cm, 77 ± 6 kg) participated in the repeated measurement study. In session 1, the participants accomplished 15 × 15 series of reactive jumps within 30 min. In session 2, they ran on a treadmill (2.2 m/s) for 30 min. Before and after both exercise protocols, four blood samples were drawn separated by 30 min intervals. Serum concentrations of seven biomarkers were determined: COMP, MMP-3, MMP-9, YKL-40, resistin, Coll2-1 and Coll2-1 NO2. All biomarkers demonstrated an acute response to mechanical loading. Both the COMP and MMP-3 responses were significantly (p = 0.040 and p = 0.007) different between running and jumping (COMP: jumping + 31%, running + 37%; MMP-3: jumping + 14%, running + 78%). Resistin increased only significantly (p < 0.001) after running, and Coll2-1 NO2 increased significantly (p = 0.001) only after jumping. Significant correlations between the biomarkers were detected. The relationships between individual serum biomarker concentrations may reflect the complex interactions between degrading enzymes and their substrates in ECM homeostasis.
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Affiliation(s)
- Maren Dreiner
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Tobias Munk
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopaedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Anna-Maria Liphardt
- Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany. .,Faculty of Medicine, Cologne Center for Musculoskeletal Biomechanics (CCMB), University of Cologne, Cologne, Germany.
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Herger S, Vach W, Liphardt AM, Nüesch C, Egloff C, Mündermann A. Experimental-analytical approach to assessing mechanosensitive cartilage blood marker kinetics in healthy adults: dose-response relationship and interrelationship of nine candidate markers. F1000Res 2022; 10:490. [PMID: 35284064 PMCID: PMC8907551 DOI: 10.12688/f1000research.52159.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose: To determine the suitability of selected blood biomarkers of articular cartilage as mechanosensitive markers and to investigate the dose-response relationship between ambulatory load magnitude and marker kinetics in response to load. Methods: Serum samples were collected from 24 healthy volunteers before and at three time points after a 30-minute walking stress test performed on three test days. In each experimental session, one of three ambulatory loads was applied: 100% body weight (BW); 80%BW; 120%BW. Serum concentrations of COMP, MMP-3, MMP-9, ADAMTS-4, PRG-4, CPII, C2C and IL-6 were assessed using commercial enzyme-linked immunosorbent assays. A two-stage analytical approach was used to determine the suitability of a biomarker by testing the response to the stress test (criterion I) and the dose-response relationship between ambulatory load magnitude and biomarker kinetics (criterion II). Results. COMP, MMP-3 and IL-6 at all three time points after, MMP-9 at 30 and 60 minutes after, and ADAMTS-4 and CPII at immediately after the stress test showed an average response to load or an inter-individual variation in response to load of up to 25% of pre-test levels. The relation to load magnitude on average or an inter-individual variation in this relationship was up to 8% from load level to load level. There was a positive correlation for the slopes of the change-load relationship between COMP and MMP-3, and a negative correlation for the slopes between COMP, MMP-3 and IL-6 with MMP-9, and COMP with IL6. Conclusions: COMP, MMP-3, IL-6, MMP-9, and ADAMTS-4 warrant further investigation in the context of articular cartilage mechanosensitivity and its role in joint degeneration and OA. While COMP seems to be able to reflect a rapid response, MMP-3 seems to reflect a slightly longer lasting, but probably also more distinct response. MMP-3 showed also the strongest association with the magnitude of load.
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Affiliation(s)
- Simon Herger
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland.,Department of Spine Surgery, University Hospital Basel, Basel, BS, 4031, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, BL, 4123, Switzerland
| | - Werner Vach
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland.,Department of Clinical Research, University of Basel, Basel, BS, 4031, Switzerland.,Basel Academy for Quality and Research in Medicine, Basel, Switzerland
| | - Anna-Maria Liphardt
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Corina Nüesch
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland.,Department of Spine Surgery, University Hospital Basel, Basel, BS, 4031, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, BL, 4123, Switzerland.,Department of Clinical Research, University of Basel, Basel, BS, 4031, Switzerland
| | - Christian Egloff
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland.,Department of Spine Surgery, University Hospital Basel, Basel, BS, 4031, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, BL, 4123, Switzerland.,Department of Clinical Research, University of Basel, Basel, BS, 4031, Switzerland
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Östlind E, Eek F, Stigmar K, Sant’Anna A, Ekvall Hansson E, Struglics A. Associations Between Physical Activity, Self-reported Joint Function, and Molecular Biomarkers in Working Age Individuals With Hip and/or Knee Osteoarthritis. CLINICAL MEDICINE INSIGHTS: ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2022; 15:11795441221081063. [PMID: 35342314 PMCID: PMC8950022 DOI: 10.1177/11795441221081063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/28/2022] [Indexed: 11/18/2022]
Abstract
Objective: Previous research has suggested an association between physical activity (PA), joint function, and molecular biomarkers, but more studies are needed. The aim of this study was to explore the associations between PA or self-reported joint function and molecular biomarkers of cartilage and inflammation in individuals with hip and/or knee osteoarthritis (OA). Specific objectives were to explore the correlations between (1) the change over 3 months in self-reported PA/joint function and the change in molecular biomarkers (2) objectively measured PA and molecular biomarkers measured at 3-month follow-up. Design: Working age participants (n = 91) were recruited from a cluster randomized controlled trial. Self-reported PA, joint function, and serum samples were collected at baseline and after 3 months. Serum concentrations of the inflammatory marker C-reactive protein (CRP) and the cartilage markers Alanine-Arginine-Glycine-Serine (ARGS)-aggrecan, cartilage oligomeric matrix protein (COMP), and type II collagen C2C were analyzed by immunoassays. Objectively measured PA (steps/day) was collected during 12 weeks from activity trackers used by 53 participants. Associations were analyzed with Spearman’s rank correlation. Results: There was a weak negative correlation between the change in self-reported PA and the change in COMP (rs = −0.256, P = .040) but not for the other molecular biomarkers. There were no correlations between the change in self-reported joint function and the change in molecular biomarkers or between the average steps/day and the molecular biomarkers at follow-up (rs ⩽ −0.206, P ⩾ .06). Conclusion: In general, no or only weak associations were found between PA/joint function and molecular biomarkers. Future research recommends including participants with lower PA, extend the follow-up, and use a design that allows comparisons.
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Affiliation(s)
- Elin Östlind
- Research Group Physiotherapy, Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Dalby Healthcare Center, Region Skåne, Lund, Sweden
| | - Frida Eek
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
| | - Kjerstin Stigmar
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | | | - Eva Ekvall Hansson
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | - André Struglics
- Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
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9
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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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10
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Herger S, Vach W, Liphardt AM, Nüesch C, Egloff C, Mündermann A. Experimental-analytical approach to assessing mechanosensitive cartilage blood marker kinetics in healthy adults: dose-response relationship and interrelationship of nine candidate markers. F1000Res 2021; 10:490. [PMID: 35284064 PMCID: PMC8907551 DOI: 10.12688/f1000research.52159.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/23/2023] Open
Abstract
Purpose: To determine the suitability of selected blood biomarkers of articular cartilage as mechanosensitive markers and to investigate the dose-response relationship between ambulatory load magnitude and marker kinetics in response to load. Methods: Serum samples were collected from 24 healthy volunteers before and at three time points after a 30-minute walking stress test performed on three test days. In each experimental session, one of three ambulatory loads was applied: 100% body weight (BW); 80%BW; 120%BW. Serum concentrations of COMP, MMP-3, MMP-9, ADAMTS-4, PRG-4, CPII, C2C and IL-6 were assessed using commercial enzyme-linked immunosorbent assays. A two-stage analytical approach was used to determine the suitability of a biomarker by testing the response to the stress test (criterion I) and the dose-response relationship between ambulatory load magnitude and biomarker kinetics (criterion II). Results. COMP, MMP-3 and IL-6 at all three time points after, MMP-9 at 30 and 60 minutes after, and ADAMTS-4 and CPII at immediately after the stress test showed an average response to load or an inter-individual variation in response to load of up to 25% of pre-test levels. The relation to load magnitude on average or an inter-individual variation in this relationship was up to 8% from load level to load level. There was a positive correlation for the slopes of the change-load relationship between COMP and MMP-3, and a negative correlation for the slopes between COMP, MMP-3 and IL-6 with MMP-9, and COMP with IL6. Conclusions: COMP, MMP-3, IL-6, MMP-9, and ADAMTS-4 warrant further investigation in the context of articular cartilage mechanosensitivity and its role in joint degeneration and OA. While COMP seems to be able to reflect a rapid response, MMP-3 seems to reflect a slightly longer lasting, but probably also more distinct response. MMP-3 showed also the strongest association with the magnitude of load.
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Affiliation(s)
- Simon Herger
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, BS, 4031, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, BL, 4123, Switzerland
| | - Werner Vach
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland
- Department of Clinical Research, University of Basel, Basel, BS, 4031, Switzerland
- Basel Academy for Quality and Research in Medicine, Basel, Switzerland
| | - Anna-Maria Liphardt
- Department of Internal Medicine 3 – Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Corina Nüesch
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, BS, 4031, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, BL, 4123, Switzerland
- Department of Clinical Research, University of Basel, Basel, BS, 4031, Switzerland
| | - Christian Egloff
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, BS, 4031, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, BS, 4031, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, BL, 4123, Switzerland
- Department of Clinical Research, University of Basel, Basel, BS, 4031, Switzerland
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11
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König S, Jockenhöfer C, Billich C, Beer M, Machann J, Schmidt-Trucksäss A, Schütz U. Long distance running - Can bioprofiling predict success in endurance athletes? Med Hypotheses 2020; 146:110474. [PMID: 33418424 DOI: 10.1016/j.mehy.2020.110474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/08/2020] [Accepted: 12/21/2020] [Indexed: 12/22/2022]
Abstract
The TransEuropeFootRace (TEFR) was one of the most extreme multistage competitions worldwide. The ultramarathon took the runners over a distance of 4487 km, from Bari, Italy, to the North Cape, Norway, in 64 days. The participating ultra-long-distance runners had to complete almost two marathons per day (~70 km). The race was accompanied by a research team analysing adaptations of different organ systems of the human body that were exposed to a chronic lack of regeneration time. Here, we analyzed runner's urine using mass spectrometric profiling of thousands of low-molecular weight compounds. The results indicated that pre-race molecular factors can predict finishers and separate them from nonfinishers already before the race. These observations were related to the training volume as finishers ran about twice as many kilometers per week before TEFR than nonfinishers, thus apparently achieving a higher performance level and resistance against overuse. While this hypothesis needs to be validated in future long-distance races, the bioprofiling experiments suggest that the competition readiness of the runners is measurable and might be adjustable.
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Affiliation(s)
- Simone König
- Core Unit Proteomics, Interdisciplinary Center for Clinical Research, University of Münster, Germany.
| | - Charlotte Jockenhöfer
- Core Unit Proteomics, Interdisciplinary Center for Clinical Research, University of Münster, Germany
| | - Christian Billich
- Clinic for Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Meinrad Beer
- Clinic for Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Jürgen Machann
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Germany
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Switzerland
| | - Uwe Schütz
- Clinic for Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
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12
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Dong X, Li C, Liu J, Huang P, Jiang G, Zhang M, Zhang W, Zhang X. The effect of running on knee joint cartilage: A systematic review and meta-analysis. Phys Ther Sport 2020; 47:147-155. [PMID: 33279802 DOI: 10.1016/j.ptsp.2020.11.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Although running causes inevitable stress to the joints, data regarding its effect on the cartilage of the knee are conflicting. This systematic review and meta-analysis aimed to evaluate the effect of running on knee joint cartilage. METHODS PubMed, EMBASE, SportDiscus, and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) and cohort studies. The outcome indicators were cartilage oligomeric matrix protein (COMP), cartilage volume and thickness, and T2. RESULTS A total of two RCTs and 13 cohort studies were included. There was no significant difference in cartilage volume between the running and control groups (MD, -115.88 U/I; 95% CI, -320.03 to 88.27; p = 0.27). However, running would decrease cartilage thickness (MD, -0.09 mm; 95%CI, -0.18 to -0.01; p = 0.03) and T2 (MD, -2.78 ms; 95% CI, -4.12 to -1.45; p < 0.001). Subgroup analysis demonstrated that COMP immediately or at 0.5 h after running was significantly increased, but there were no significant changes at 1 h or 2 h. CONCLUSIONS Running has advantages in promoting nutrition penetrating into the cartilage as well as squeezing out the metabolic substance, such as water. Our study found that running had a short-term adverse effect on COMP and did not affect cartilage volume or thickness.
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Affiliation(s)
- Xueping Dong
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Canfeng Li
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Jiyi Liu
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Pengzhou Huang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Guanwei Jiang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Mengdi Zhang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Wentao Zhang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Xintao Zhang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
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13
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Herger S, Nüesch C, Liphardt AM, Egloff C, Mündermann A. Framework for modulating ambulatory load in the context of in vivo mechanosensitivity of articular cartilage. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100108. [DOI: 10.1016/j.ocarto.2020.100108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022] Open
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14
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Liphardt AM, Mündermann A, Heer M, Achtzehn S, Niehoff A, Mester J. Locomotion replacement exercise cannot counteract cartilage biomarker response to 5 days of immobilization in healthy adults. J Orthop Res 2020; 38:2373-2382. [PMID: 32458495 DOI: 10.1002/jor.24753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 02/04/2023]
Abstract
Biomarkers of cartilage metabolism are sensitive to changes in the biological and mechanical environment and can indicate early changes in cartilage homeostasis. The purpose of this study was to determine if a daily locomotion replacement program can serve as a countermeasure for changes in cartilage biomarker serum concentration caused by immobilization. Ten healthy male subjects (mean ± 1 standard deviation; age: 29.4 ± 5.9 years; body mass: 77.7 ± 4.1 kg) participated in the crossover 5-day bed rest study with three interventions: control (CON), standing (STA), and locomotion replacement training (LRT). Serum samples were taken before, during, and after bed rest. Biomarker concentrations were measured using commercial enzyme-linked immunosorbent assays. Cartilage oligomeric matrix protein (COMP) levels after 24 hours of bed rest decreased independently of the intervention (-16.8% to -9.8%) and continued to decrease until 72 hours of bed rest (minimum, -23.2% to -20.6%). LRT and STA did not affect COMP during bed rests (P = .056) but there was a strong tendency for a slower decrease with LRT (-9.4%) and STA (-11.7%) compared with CON (-16.8%). MMP-3 levels decreased within the first 24 hours of bed rest (CON: -22.3%; STA: -14.7%; LRT: -17%) without intervention effect. Both COMP and MMP-3 levels recovered to baseline levels during the 6-day recovery period. MMP-1, MMP-9, and TNF-α levels were not affected by immobilization or intervention. COMP and MMP-3 are mechano-sensitive cartilage biomarkers affected by immobilization, and simple interventions such as standing upright or LRT during bed rest cannot prevent these changes. Clinical significance: simple locomotion interventions cannot prevent cartilage biomarker change during bed rest.
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Affiliation(s)
- Anna-Maria Liphardt
- Department of Internal Medicine 3-Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.,Institute of Biomechanics and Orthopaedics, German Sport University Cologne (DSHS Köln), Köln, Germany
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Martina Heer
- Department of Nutrition and Food Science-Nutrition Physiology, University of Bonn, Bonn, Germany.,Department of Nutrition, International University of Applied Sciences Bad Honnef (IUBH), Bad Honnef, Germany
| | - Silvia Achtzehn
- Institute of Cardiology and Sports Medicine, German Sport University Cologne (DSHS Köln), Köln, Germany.,The German Research Centre of Elite Sport Cologne (Momentum), German Sport University Cologne (DSHS Köln), Köln, Germany
| | - Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne (DSHS Köln), Köln, Germany.,Cologne Center for Musculoskeletal Biomechanics (CCMB), Faculty of Medicine, University of Cologne, Köln, Germany
| | - Joachim Mester
- The German Research Centre of Elite Sport Cologne (Momentum), German Sport University Cologne (DSHS Köln), Köln, Germany
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15
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Firner S, Zaucke F, Heilig J, de Marées M, Willwacher S, Brüggemann GP, Niehoff A. Impact of knee joint loading on fragmentation of serum cartilage oligomeric matrix protein. J Orthop Res 2020; 38:1710-1718. [PMID: 31944379 DOI: 10.1002/jor.24586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/31/2019] [Accepted: 12/21/2019] [Indexed: 02/04/2023]
Abstract
The aim of the study was to examine the effect of mechanical knee joint loading on the fragmentation pattern of serum cartilage oligomeric matrix protein (COMP). Ten healthy men ran with knee orthoses that were passive or active (+30.9 N·m external flexion moments) on a treadmill (30 minute; v = 2.2 m/s). Lower-limb mechanics, serum COMP levels, and fragmentation patterns (baseline; 0, 0.5, 1, 2 hours postrunning) were analyzed. Running with active orthoses enhanced knee flexion moments, ankle dorsiflexion, and knee flexion angles (P < .05). There was an increase in serum COMP (+25%; pre: 8.9 ± 2.4 U/l; post: 10.7 ± 1.9 U/l, P = .001), COMP pentamer/tetramer (+88%; 1.88 ± 0.81, P = .007), trimer (+209%; 3.09 ± 2.65, P = .005), and monomer (+78%; 1.78 ± 0.85, P = .007) after running with passive orthoses and in serum COMP (+41%; pre: 8.5 ± 2.7 U/l; post: 11.3 ± 2.1 U/l, P < .001), COMP pentamer/tetramer (+57%; 1.57 ± 0.39, P = .007), trimer (+86%; 1.86 ± 0.47, P = .005), and monomer (+19%; 1.19 ± 0.34, P = .114) after running with active orthoses. Increased fragmentation might indicate COMP release from cartilage while running. Interestingly, 0.5 h up to 2 hours after running with passive orthoses, trimer (0.5 hour: 2.73 ± 3.40, P = .029; 2 hours: 2.33 ± 2.88, P = .037), and monomer (0.5 hour: 2.23 ± 2.33, P = .007; 1 hour: 2.55 ± 1.96, P = .012; 2 hours: 2.65 ± 2.50, P = .009) increased while after running with active orthoses, pentamer/tetramer (1 hour: 0.79 ± 0.28, P = .029), and trimer (1 hour: 0.63 ± 0.14, P = .005; 2 hours: 0.68 ± 0.34, P = .047) decreased. It seems that COMP degradation and clearance vary depending on joint loading characteristics.
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Affiliation(s)
- Sara Firner
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany
| | - Juliane Heilig
- Center for Biochemistry, Medical Faculty, University of Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Markus de Marées
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr-University Bochum, Bochum, Germany
| | - Steffen Willwacher
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Gert-Peter Brüggemann
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Cologne, Germany
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16
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Mündermann A, Vach W, Pagenster G, Egloff C, Nüesch C. Assessing in vivo articular cartilage mechanosensitivity as outcome of high tibial osteotomy in patients with medial compartment osteoarthritis: Experimental protocol. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100043. [DOI: 10.1016/j.ocarto.2020.100043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/11/2020] [Indexed: 10/24/2022] Open
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17
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Schütz U, Ehrhardt M, Göd S, Billich C, Beer M, Trattnig S. A mobile MRI field study of the biochemical cartilage reaction of the knee joint during a 4,486 km transcontinental multistage ultra-marathon using T2* mapping. Sci Rep 2020; 10:8157. [PMID: 32424133 PMCID: PMC7235258 DOI: 10.1038/s41598-020-64994-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/21/2020] [Indexed: 02/08/2023] Open
Abstract
Nearly nothing is known about the consequences of ultra-long-distance running on knee cartilage. In this mobile MRI field study, we analysed the biochemical effects of a 4,486 km transcontinental multistage ultra-marathon on femorotibial joint (FTJ) cartilage. Serial MRI data were acquired from 22 subjects (20 male, 18 finisher) using a 1.5 T MR scanner mounted on a 38-ton trailer, travelling with the participants of the TransEurope FootRace (TEFR) day by day over 64 stages. The statistical analyses focused on intrachondral T2* behaviour during the course of the TEFR as the main outcome variable of interest. T2* mapping (sagittal FLASH T2* weighted gradient echo) is a validated and highly accurate method for quantitative compositional cartilage analysis of specific weightbearing areas of the FTJ. T2* mapping is sensitive to changes in the equilibrium of free intrachondral water, which depends on the content and orientation of collagen and the proteoglycan content in the extracellular cartilage matrix. Within the first 1,100 km, a significant running load-induced T2* increase occurred in all joint regions: 44.0% femoral-lateral, 42.9% tibial-lateral, 34.9% femoral-medial, and 25.1% tibial-medial. Osteochondral lesions showed no relevant changes or new occurrence during the TEFR. The reasons for stopping the race were not associated with knee problems. As no further T2* elevation was found in the second half of the TEFR but a decreasing T2* trend (recovery) was observed after the 3,500 km run, we assume that no further softening of the cartilage occurs with ongoing running burden over ultra-long distances extending 4,500 km. Instead, we assume the ability of the FTJ cartilage matrix to reorganize and adapt to the load.
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Affiliation(s)
- Uwe Schütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany.
| | - Martin Ehrhardt
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Sabine Göd
- MR Centre of Excellence- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
| | - Christian Billich
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Siegfried Trattnig
- MR Centre of Excellence- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
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18
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Bricca A, Struglics A, Larsson S, Steultjens M, Juhl CB, Roos EM. Impact of Exercise Therapy on Molecular Biomarkers Related to Cartilage and Inflammation in Individuals at Risk of, or With Established, Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Arthritis Care Res (Hoboken) 2020; 71:1504-1515. [PMID: 30320965 DOI: 10.1002/acr.23786] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/09/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the impact of exercise therapy on molecular biomarkers related to cartilage and inflammation in individuals at risk of, or with established, knee osteoarthritis by conducting a systematic review of randomized controlled trials (RCTs). METHODS We conducted a literature search up to September 2017 in 5 major databases with no restriction on publication year or language. Data were extracted from the first available follow-up time point, and we performed a narrative synthesis for the effect of exercise therapy on molecular biomarkers related to cartilage and inflammation. A subset of studies reporting sufficient data was combined in a meta-analysis, using an adjusted random-effects model. RESULTS Twelve RCTs involving 57 study comparisons at 4 to 24 weeks following an exercise-therapy intervention were included. Exercise therapy decreased molecular biomarkers in 17 study comparisons (30%), had no effect in 36 (63%), and increased molecular biomarkers in 4 study comparisons (7%). Meta-analyses of 9 biomarkers showed that exercise therapy was associated with nonsignificant reductions of the C-reactive protein level, C-terminal crosslinking telopeptide of type II collagen, tumor necrosis factor (TNF), soluble TNF receptors 1 and 2, C2C neoepitope of type II collagen, and cartilage oligomeric matrix protein, compared to nonexercising control groups, and exercise therapy had no effect on interleukin-6 and soluble interleukin-6 receptor. CONCLUSION Exercise therapy is not harmful, because it does not increase the concentration of molecular biomarkers related to cartilage turnover and inflammation, implicated in osteoarthritis progression. The overall quality of evidence was downgraded to low because of the limited number of RCTs available.
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Affiliation(s)
- Alessio Bricca
- Herlev and Gentofte Hospitals, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Carsten B Juhl
- University of Southern Denmark, Odense, and Herlev and Gentofte Hospitals, University of Copenhagen, Copenhagen, Denmark
| | - Ewa M Roos
- Herlev and Gentofte Hospitals, University of Copenhagen, Copenhagen, Denmark
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19
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Bjerre‐Bastos JJ, Karsdal MA, Boesen M, Bliddal H, Bay‐Jensen A, Andersen JR, Bihlet AR. The acute and long‐term impact of physical activity on biochemical markers and MRI measures in osteoarthritis—Perspectives for clinical osteoarthritis research. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Jonathan Jetsmark Bjerre‐Bastos
- Nordic Bioscience Clinical Development Herlev Denmark
- Institute of Biomedical Sciences University of Copenhagen Copenhagen Denmark
| | | | - Mikael Boesen
- Department of Radiology University Hospital Bispebjerg and Frederiksberg Copenhagen Denmark
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20
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Effect of total joint replacement in hip osteoarthritis on serum COMP and its correlation with mechanical-functional parameters of gait analysis. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100034. [DOI: 10.1016/j.ocarto.2020.100034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/28/2020] [Indexed: 12/13/2022] Open
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21
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Roberts HM, Law RJ, Thom JM. The time course and mechanisms of change in biomarkers of joint metabolism in response to acute exercise and chronic training in physiologic and pathological conditions. Eur J Appl Physiol 2019; 119:2401-2420. [PMID: 31650307 PMCID: PMC6858392 DOI: 10.1007/s00421-019-04232-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/14/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE The benefits of exercise across the lifespan and for a wide spectrum of health and diseases are well known. However, there remains less clarity as to the effects of both acute and chronic exercise on joint health. Serum biomarkers of joint metabolism are sensitive to change and have the potential to differentiate between normal and adverse adaptations to acute and chronic load. Therefore, the primary objective of this review is to evaluate how serum biomarkers can inform our understanding of how exercise affects joint metabolism. METHODS A comprehensive literature search was completed to identify joint biomarkers previously used to investigate acute and chronic exercise training. RESULTS Identified biomarkers included those related to joint cartilage, bone, synovium, synovial fluid, and inflammation. However, current research has largely focused on the response of serum cartilage oligomeric matrix protein (COMP) to acute loading in healthy young individuals. Studies demonstrate how acute loading transiently increases serum COMP (i.e., cartilage metabolism), which is mostly dependent on the duration of exercise. This response does not appear to be associated with any lasting deleterious changes, cartilage degradation, or osteoarthritis. CONCLUSION Several promising biomarkers for assessing joint metabolism exist and may in future enhance our understanding of the physiological response to acute and chronic exercise. Defining 'normal' and 'abnormal' biomarker responses to exercise and methodological standardisation would greatly improve the potential of research in this area to understand mechanisms and inform practice.
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Affiliation(s)
- Harry M Roberts
- School of Biosciences and Medicine, University of Surrey, The Leggett Building, Daphne Jackson Road, Guildford, GU2 7WG, UK.
| | - Rebecca-Jane Law
- North Wales Centre for Primary Care Research, School of Health Sciences, Bangor University, Bangor, UK
| | - Jeanette M Thom
- School of Medical Sciences, University of New South Wales, Sydney, Australia.,School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK
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22
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Knechtle B, Nikolaidis PT. Physiology and Pathophysiology in Ultra-Marathon Running. Front Physiol 2018; 9:634. [PMID: 29910741 PMCID: PMC5992463 DOI: 10.3389/fphys.2018.00634] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/11/2018] [Indexed: 12/31/2022] Open
Abstract
In this overview, we summarize the findings of the literature with regards to physiology and pathophysiology of ultra-marathon running. The number of ultra-marathon races and the number of official finishers considerably increased in the last decades especially due to the increased number of female and age-group runners. A typical ultra-marathoner is male, married, well-educated, and ~45 years old. Female ultra-marathoners account for ~20% of the total number of finishers. Ultra-marathoners are older and have a larger weekly training volume, but run more slowly during training compared to marathoners. Previous experience (e.g., number of finishes in ultra-marathon races and personal best marathon time) is the most important predictor variable for a successful ultra-marathon performance followed by specific anthropometric (e.g., low body mass index, BMI, and low body fat) and training (e.g., high volume and running speed during training) characteristics. Women are slower than men, but the sex difference in performance decreased in recent years to ~10–20% depending upon the length of the ultra-marathon. The fastest ultra-marathon race times are generally achieved at the age of 35–45 years or older for both women and men, and the age of peak performance increases with increasing race distance or duration. An ultra-marathon leads to an energy deficit resulting in a reduction of both body fat and skeletal muscle mass. An ultra-marathon in combination with other risk factors, such as extreme weather conditions (either heat or cold) or the country where the race is held, can lead to exercise-associated hyponatremia. An ultra-marathon can also lead to changes in biomarkers indicating a pathological process in specific organs or organ systems such as skeletal muscles, heart, liver, kidney, immune and endocrine system. These changes are usually temporary, depending on intensity and duration of the performance, and usually normalize after the race. In longer ultra-marathons, ~50–60% of the participants experience musculoskeletal problems. The most common injuries in ultra-marathoners involve the lower limb, such as the ankle and the knee. An ultra-marathon can lead to an increase in creatine-kinase to values of 100,000–200,000 U/l depending upon the fitness level of the athlete and the length of the race. Furthermore, an ultra-marathon can lead to changes in the heart as shown by changes in cardiac biomarkers, electro- and echocardiography. Ultra-marathoners often suffer from digestive problems and gastrointestinal bleeding after an ultra-marathon is not uncommon. Liver enzymes can also considerably increase during an ultra-marathon. An ultra-marathon often leads to a temporary reduction in renal function. Ultra-marathoners often suffer from upper respiratory infections after an ultra-marathon. Considering the increased number of participants in ultra-marathons, the findings of the present review would have practical applications for a large number of sports scientists and sports medicine practitioners working in this field.
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Affiliation(s)
- Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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23
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Liphardt AM, Mündermann A, Andriacchi TP, Achtzehn S, Heer M, Mester J. Sensitivity of serum concentration of cartilage biomarkers to 21-days of bed rest. J Orthop Res 2018; 36:1465-1471. [PMID: 29077223 DOI: 10.1002/jor.23786] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/13/2017] [Indexed: 02/04/2023]
Abstract
UNLABELLED The objective of the study was to test the hypothesis that serum levels of cartilage oligomeric matrix protein (COMP) would decrease and serum levels of tumor-necrosis factor alpha (TNF-α) and selected matrix metalloproteinases (MMPs) would increase in response to bed rest (BR) and that these changes are unaffected by the intake of potassium bicarbonate or whey protein. Seven and nine healthy male subjects participated in two 21-day 6° head down tilt crossover BR-studies with nutrition interventions. Serum samples were taken before, during, and after BR and biomarker concentrations were measured using commercial enzyme-linked immunosorbent assays. MMP-3 during BR was significantly lower than at baseline (reduction greater 20%; p < 0.001). MMP-3 increased significantly from 14 to 21 days of BR (+7%; p = 0.049). COMP during BR was significantly lower than at baseline (reduction greater 20%; p < 0.001). MMP-3 and COMP returned to baseline within 1 day after BR. MMP-9 on day 3 of BR was significantly lower than at baseline (-31%; p < 0.033) and on days 3, 5, and 14 of BR significantly lower than at the end of and after BR (reduction greater 35%; p < 0.030). The nutritional countermeasures did not affect these results. The observed changes in cartilage biomarkers may be caused by altered cartilage metabolism in response to the lack of mechanical stimulus during BR and inflammatory biomarkers may play a role in changes in biomarker levels. CLINICAL RELEVANCE Immobilization independently from injury can cause altered cartilage biomarker concentration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1465-1471, 2018.
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Affiliation(s)
- Anna-Maria Liphardt
- German Sport University Cologne (DSHS Köln), Training Science and Sport Informatics, Köln, Germany.,German Sport University Cologne (DSHS Köln), Biomechanics and Orthopaedics, Köln, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU) and Universitätsklinikum, Ulmenweg 18, Erlangen, 91054, Germany
| | - Annegret Mündermann
- Clinic for Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Thomas P Andriacchi
- Department of Mechanical Engineering, Stanford University,, Stanford, California
| | - Silvia Achtzehn
- German Sport University Cologne (DSHS Köln), Training Science and Sport Informatics, Köln, Germany
| | - Martina Heer
- Department of Nutrition and Food Science, Nutrition Physiology, University of Bonn, Bonn, Germany
| | - Joachim Mester
- German Sport University Cologne (DSHS Köln), Training Science and Sport Informatics, Köln, Germany
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