Abstract
BackgroundAn early detection of Osteoarthritis is urgently needed and still not possible until today. The aim of the study was to assess whether molecular biomarkers of cartilage turnover are associated with longitudinal change in knee cartilage thickness during a 2 year period in individuals with increased risk of developing knee osteoarthritis. A secondary aim was to assess whether prior knee injury or subjective patient-reported outcomes at baseline (BL) were associated with articular cartilage changes. Nineteen volleyball players (mean age 46.5 ± 4.9 years, 47% male) with a 30-year history of regular high impact training were recruited. The serum biomarkers Cpropeptide of type II procollagen (CPII), cartilage oligomeric matrix protein (COMP), collagenase generated carboxy-terminal neoepitope of type II collagen (sC2C), cartilage intermediate layer protein 2 (CILP-2), and the urine biomarkers C-telopeptide of type II collagen (CTX-II) and collagenase-generated peptide(s) of type II collagen (C2C-HUSA) were assessed at BL and at 2 year follow up (FU). Femorotibial cartilage thinning, thickening and absolute thickness change between BL and FU was evaluated from magnetic resonance imaging. Subjective clinical status at BL was evaluated by the International Knee Documentation Committee Subjective Knee Form and the Short-Form 36 Physical Component Score.ResultsCILP-2 was significantly higher at FU and linearly associated with the absolute cartilage thickness change during the experimental period. Prior injury was a predictor of increased absolute cartilage thickness change.ConclusionMeasuring the change in the cartilage biomarker CILP-2 might be a valid and sensitive method to detect early development of knee osteoarthritis as CILP-2 appears to be related to cartilage thickness loss in certain individuals with increased risk of developing knee osteoarthritis. Prior knee injury may be predictive of increased articular cartilage thickness change.
Highlights
An early detection of Osteoarthritis is urgently needed and still not possible until today
The C-telopeptide of type II collagen (CTX-II), which is often used as an urine biomarker of articular cartilage degradation, is elevated in OA patients compared to controls (Christgau et al, 2001) and associated with the risk (Cibere et al, 2009) and severity of radiographically defined OA (Christgau et al, 2001, Reijman et al, 2004, Jordan et al, 2006), as well as with magnetic resonance imaging (MRI) diagnosed knee cartilage defects (Ding et al, 2005)
When comparing serum and urine biomarkers at BL and follow up (FU), cartilage intermediate layer protein 2 (CILP-2) was significantly lower at BL (Fig. 1a, p = 0.017, effect size = 0.60)
Summary
An early detection of Osteoarthritis is urgently needed and still not possible until today. I.e. radiographic assessment, knee osteoarthritis (OA) is diagnosed at a relatively late stage of the disease when the knee joint is characterized by substantial cartilage changes (e.g. narrowing of the knee joint space and osteophyte formation) By this time, patients often suffer from functional impairments and pain (Kraus et al, 2011). The C-telopeptide of type II collagen (CTX-II), which is often used as an urine biomarker of articular cartilage degradation, is elevated in OA patients compared to controls (Christgau et al, 2001) and associated with the risk (Cibere et al, 2009) and severity of radiographically defined OA (Christgau et al, 2001, Reijman et al, 2004, Jordan et al, 2006), as well as with MRI diagnosed knee cartilage defects (Ding et al, 2005). Serum levels of cartilage intermediate layer protein 2 (CILP-2)
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