Abstract
BackgroundThis study aimed the feasibility to assess longitudinal changes in biomarkers of cartilage turnover and to determine their relationship with patient-rated outcomes over 2 years in volleyball athletes.MethodsThirty-seven athletes were studied: 18 adolescents (age 15.9 ± 0.64 years) in a 2-year intensive volleyball training program and 19 adult recreational volleyball players (age 46.5 ± 4.9 years). Blood and serum samples were taken at baseline (BL) and 2-year follow-up (FU). Subjects completed the International Knee Documentation Committee (IKDC) Subjective Knee Form and the Short-Form 36 (SF-36) at BL.ResultsThirteen adolescents (72%) had open growth plates at BL (BL open adolescents), the rest had closed growth plates at BL (BL closed adolescents), and all but one adolescent had closed growth plates at FU as assessed by MRI. BL open and closed adolescents had greater levels of the cartilage degradation-based biomarkers 45 mer collagenase peptide of type II collagen (C2C-HUSA) and C-telopeptide of type II collagen (CTX-II) than adults. BL open adolescents showed decreases in C2CHUSA, collagen synthesis marker C-propeptide of type II procollagen (CPII), and CTXII, and adults showed increases in cartilage intermediate layer protein 2 (CILP-2) and C2C-HUSA. In adolescents, IKDC scores were correlated with CPII changes. In adults, SF-36 Physical Component Scores were correlated with cartilage oligomeric matrix protein (COMP) changes.ConclusionSignificant differences in biomarker levels over time show the feasibility to assess their changes. Greater levels of C2C-HUSA and CTX-II in adolescents than in adults may reflect increased cartilage turnover in response to higher joint loading. CPII and COMP may be more reflective of subjective patient outcomes. These biomarkers may thus be useful in assessing mechanical loading-induced cartilage changes, their associated symptoms, and Osteoarthritis risk in athletes.
Highlights
This study aimed the feasibility to assess longitudinal changes in biomarkers of cartilage turnover and to determine their relationship with patient-rated outcomes over 2 years in volleyball athletes
The comparison of International Knee Documentation Committee (IKDC) and Short-Form 36 (SF-36) scores between BL closed adolescents, BL open adolescents, and adults showed no significant differences between the groups (P ≥ 0.145)
IKDC scores were correlated with C-propeptide of type II procollagen (CPII) changes in adolescents, whereas SF-36 scores were correlated with cartilage oligomeric matrix protein (COMP) changes in adults
Summary
This study aimed the feasibility to assess longitudinal changes in biomarkers of cartilage turnover and to determine their relationship with patient-rated outcomes over 2 years in volleyball athletes. Previous findings have suggested that high-impact physical activity (Kujala et al 1994, Kujala et al 1995, Buckwalter and Lane 1997, Amoako and Pujalte 2014) and/or prior knee injury (Muthuri et al 2011, Richmond et al 2013) increase the risk of developing primary OA It is unclear how frequency and intensity of exercise affect human articular cartilage degradation (Hallett and Andrish 1994, Saxon et al 1999). Past studies have investigated longitudinal changes in biomarkers of cartilage turnover in athletes of a high-impact sport, e.g. soccer, over a sports season (O’Kane et al 2006, Hoch et al 2012, Mateer et al 2015), more long-term changes in such biomarkers in an athletic population remain unclear. It is important to understand how subjective clinical outcomes are related to changes in biomarkers of cartilage turnover in athletes, which may help determine which biomarkers are most reflective of such patients’ self-reported status
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