The Profile of Markers of Bone Turnover, Inflammation and Extracellular Neutrophil Traps on Bone Mass in Haemophilia and the Development of Haemophilic Arthropathy

Abstract

Background: The aim of the study is to evaluate selected biomarkers of bone turnover, inflammation, neutrophil trap and factors predisposing haemophiliacs to bone loss, and to analyse their relationship with clinical features, treatment and complications. Methods: The levels of interleukin 6 (IL-6); citrullinated histone (CH3); osteocalcin (BGLAP); bone alkaline phosphatase (BALP); N-terminal procollagen type I propeptide (P1NP); and C-terminal collagen type I telopeptide (C1CP) were examined in 60 patients with haemophilia. Results: The cut-off value for BGLAP is 26.41 ng/mL, and 929.7 pg/mL for CH3. There is a statistically significant difference between BGLAP, BALP, C1CP and CH3 concentrations, depending on the prophylaxis used. The median concentration of BGLAP in patients taking the factor on demand is 28.0 ng/mL, BALP 322.5 U/L, C1CP 191.2 ng/mL and CH3 1114.4 pg/mL. In patients taking recombinant coagulation factor VIII/IX as prophylaxis of bleeding, the median BGLAP concentrations are 35.9 ng/mL, BALP 280.9 U/L, C1CP 161.6 ng/mL and CH3 952.5 pg/mL. BGLAP and BALP concentrations are dependent on the development of haemophilic arthropathic. Conclusions: The concentrations of selected markers of bone turnover and NETs may help to identify patients at particular risk of developing haemophilic arthropathy and bone metabolic turnover abnormalities.

Neuroinflammatory markers in patients with haemophilia and healthy controls: Where are the differences?

“…In our study, the IL‐6 levels of PwH were higher but not significantly different compared to the controls, while other studies reported higher IL‐6 levels in blood for PwH 8,32 IL‐6 levels were also elevated in synovial fluid of PwH 33 . Like in our study, no significant differences for IL‐6 between PwH and healthy controls were reported by Czajkowska et al 34 . In our study, IL‐6 was also not significantly elevated in HIV‐positive PwH (data not shown) while Böhmert et al 8 .…”

“…In our study, the IL-6 levels of PwH were higher but not significantly different compared to the controls, while other studies reported higher IL-6 levels in blood for PwH 8,32 IL-6 levels were also elevated in synovial fluid of PwH. 33 Like in our study, no significant differ-ences for IL-6 between PwH and healthy controls were reported by Czajkowska et al 34 In our study, IL-6 was also not significantly elevated in HIV-positive PwH (data not shown) while Böhmert et al 8 have shown in subgroup analyses that IL-6 was higher in PwH who were infected with HIV. An increase in IL-6 was also observed in PwH with target joints, which are defined as joints with four haemorrhages within 6 months or joints with a total of 20 haemorrhages.…”