Biochemical Markers for Osteoarthritis: Is There any Promising Candidate?

Abstract

Osteoarthritis (OA) is the most common degenerative joint disease. OA affects millions of individuals each year and becoming the most important cause of pain in geriatric population. Progressive destruction of articular cartilage is one of the prominent features of the disease. The diagnosis of OA is generally based on clinical and radiographical findings, which are insufficient to determine early-stage OA and predict disease course. There is a need for biomarkers that help clinicians early diagnose, assess disease activity, predict prognosis and monitor response to therapy. There are a growing number of publications regarding candidate markers in this field. The aim of this paper was to review recent studies on biochemical markers that reflect cartilage, synovial and bone turnover and their clinical use in patients with OA. ÖzOsteoartrit (OA) en sık rastlanan dejeneratif eklem hastalığıdır. OA her yıl milyonlarca kişiyi etkileyerek, geriatrik yaş grubunun en önemli ağrı sebebi haline gelmektedir. Eklem kıkırdağının ilerleyici hasarı hastalığın en belirgin özelliklerinden biridir. Hastalığın tanısı daha çok klinik ve radyolojik olarak konmaktadır, ancak bu yöntemler erken dönemdeki olguları saptamada ve hastalık son durumunu tahmin etmede yetersiz kalmaktadır. OA hastalarında erken tanı konabilmesi, hastalık aktivitesinin değerlendirilmesi ve tedaviye yanıtın izlenebilmesi için biyokimyasal belirteçlere ihtiyaç vardır. Bu alanda aday biyokimyasal belirteçlerin saptanabilmesi için son dönemde birçok çalışma yayınlanmıştır. Bu yazının amacı kıkırdak, sinovyum ve kemik döngüsünü yansıtan bu biyokimyasal belirteçlerin klinik kullanımları ile ilgili yapılan son dönem çalışmaların derlenmesidir.

Effects of Etanercept and Adalimumab on Serum Levels of Cartilage Remodeling Markers in Women with Rheumatoid Arthritis

“…The progressive destruction of articular cartilage, resulting from an imbalance between anabolic and catabolic processes, is an underlying problem in the pathogenesis of rheumatoid arthritis and osteoarthritis [ 3 , 9 , 27 ]. Due to articular cartilage damage, key structural components of the extracellular matrix are lost and released into body fluids as ‘biomarkers’, which can be detected by sensitive immunoassays [ 7 , 12 , 13 ]. Alterations in collagen type II metabolism occur prior to detectable radiographic changes, making this peptide a specific and early marker of arthritic joint diseases [ 5 , 12 ].…”

“…Due to articular cartilage damage, key structural components of the extracellular matrix are lost and released into body fluids as ‘biomarkers’, which can be detected by sensitive immunoassays [ 7 , 12 , 13 ]. Alterations in collagen type II metabolism occur prior to detectable radiographic changes, making this peptide a specific and early marker of arthritic joint diseases [ 5 , 12 ]. The excessive and progressive cleavage of CII by members of the collagenase subfamily of MMPs such as MMP-1, -8, -13, and -14 has been observed in RA, psoriatic arthritis (PsA), and the early stages of OA [ 3 , 5 , 8 , 27 , 28 ].…”

“…In adult cartilage with slow collagen turnover, COMP is located primarily in the interterritorial matrix, where it interacts with the COL3 and NC-4 domains of type IX collagen, stabilizing the collagen fiber network [ 9 , 11 , 59 , 60 , 61 ]. During cartilage erosion, COMP fragments are released first into synovial fluid and then into the blood; thus, it is believed that serum COMP reflects the degree of cartilage breakdown [ 7 , 12 ]. Elevated levels of serum and synovial COMP have been detected in various forms of arthritis, such as RA, OA [ 35 , 62 , 63 ], and PsA [ 64 ].…”

“…Consequently, the breakdown of the collagenous and non-collagenous components of articular cartilage leads to the generation of cartilage-derived molecules and/or their fragments, which are released into the synovial fluid, where they may be filtered into the circulation and urine [ 7 , 10 , 11 ]. For this reason, soluble cartilage-derived biomarkers have been suggested to be powerful tools for the diagnosis, assessment of disease activity, prognosis, and personalized management of both osteoarthritis (OA) and RA [ 5 , 7 , 11 , 12 , 13 ]. Furthermore, due to the lack of non-invasive and effective methods for the early detection and evaluation of treatment outcomes in modern medicine [ 13 ], assessing biochemical markers in biological fluids can serves as a valuable supplementary indicator for imaging cartilage lesions in cases of RA.…”