Abstract
BackgroundOsteoarthritis (OA) is a debilitating chronic multijoint disease of global proportions. OA presence and severity is usually documented by x-ray imaging but whole body imaging is impractical due to radiation exposure, time and cost. Systemic (serum or urine) biomarkers offer a potential alternative method of quantifying total body burden of disease but no OA-related biomarker has ever been stringently qualified to determine the feasibility of this approach. The goal of this study was to evaluate the ability of three OA-related biomarkers to predict various forms or subspecies of OA and total body burden of disease.Methodology/Principal FindingsFemale participants (461) with clinical hand OA underwent radiography of hands, hips, knees and lumbar spine; x-rays were comprehensively scored for OA features of osteophyte and joint space narrowing. Three OA-related biomarkers, serum hyaluronan (sHA), cartilage oligomeric matrix protein (sCOMP), and urinary C-telopeptide of type II collagen (uCTX2), were measured by ELISA. sHA, sCOMP and uCTX2 correlated positively with total osteophyte burden in models accounting for demographics (age, weight, height): R2 = 0.60, R2 = 0.47, R2 = 0.51 (all p<10−6); sCOMP correlated negatively with total joint space narrowing burden: R2 = 0.69 (p<10−6). Biomarkers and demographics predicted 35–38% of variance in total burden of OA (total joint space narrowing or osteophyte). Joint size did not determine the contribution to the systemic biomarker concentration. Biomarker correlation with disease in the lumbar spine resembled that in the rest of the skeleton.Conclusions/SignificanceWe have suspected that the correlation of systemic biomarkers with disease has been hampered by the inability to fully phenotype the burden of OA in a patient. These results confirm the hypothesis, revealed upon adequate patient phenotyping, that systemic joint tissue concentrations of several biomarkers can be quantitative indicators of specific subspecies of OA and of total body burden of disease.
Highlights
Osteoarthritis (OA) is a debilitating chronic multijoint disease with major global impact [1]
We have suspected for some time that the correlation of systemic biomarkers with disease has been hampered by the inability to fully phenotype the burden of OA in a patient, and in a sense, giving systemic biomarkers a ‘bad name’
These results clearly show that all three biomarkers, serum hyaluronan (sHA), serum cartilage oligomeric matrix protein (sCOMP) and uCTX2 are quantitative traits of the radiographic feature of OST while sCOMP is a negative indicator of joint space narrowing affected joint faces in the body
Summary
Osteoarthritis (OA) is a debilitating chronic multijoint disease with major global impact [1]. Systemic (serum or urine) biomarkers offer a potential alternative method of quantifying total body burden of disease but no OA-related biomarker has ever been stringently validated to determine the feasibility of this approach. The distinct features of radiographic OA of joint space loss and osteophyte represent different disease processes that may differ in their associations with biomarkers. These features are highly correlated so it is necessary to adjust for this correlation in order to test the independent association of biomarkers with particular features of OA. Systemic (serum or urine) biomarkers offer a potential alternative method of quantifying total body burden of disease but no OA-related biomarker has ever been stringently qualified to determine the feasibility of this approach. The goal of this study was to evaluate the ability of three OA-related biomarkers to predict various forms or subspecies of OA and total body burden of disease
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