Abstract
Introduction Osteoarthritis (OA) is a chronic, debilitating joint disease characterized by the degeneration of articular cartilage, sclerosis of the subchondral bone, and osteophyte formation. This work aimed at estimating the level of urinary C-terminal telopeptide of type II collagen (CTX-II) as a biomarker of cartilage turnover and to determine its relation with radiological and functional assessment of knee OA. Patients and methods The current study included 40 postmenopausal women with symptomatic knee OA fulfilling the American Rheumatism Association clinical diagnostic criteria for knee OA. A total of 20 healthy volunteers were enrolled as a control group. Patients were assessed radiologically using the Kellgren-Lawrence grading system and functionally using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Urinary CTX-II was measured for the patient and control groups. Results There was no statistically significant difference as regards age and BMI between patients and controls. Disease duration affects both function assessed using the WOMAC and cartilage degradation assessed using urinary CTX-II. There was a statistically significant correlation between the WOMAC and urinary CTX-II, whereas there was no statistically significant correlation between the Kellgren-Lawrence scale and both urinary CTX-II and the WOMAC. Conclusion This study further confirms that urinary CTX-II is an index of early cartilage degradation in knee OA even before radiological changes occurs. The functional assessment using the WOMAC is an easy inexpensive method in reflecting cartilage degradation. Moreover, this work supports the lack of association between the functional status of knee OA patients assessed using the WOMAC and their radiological severity measured using the Kellgren-Lawrence grading scale.
Highlights
Osteoarthritis (OA) is a chronic, debilitating joint disease characterized by the degeneration of articular cartilage, sclerosis of the subchondral bone, and osteophyte formation
The control group consisted of 20 postmenopausal healthy female volunteers without clinical or radiological evidence of knee OA
The control group consisted of 20 postmenopausal healthy female volunteers with matched age and BMI
Summary
Osteoarthritis (OA) is a chronic, debilitating joint disease characterized by the degeneration of articular cartilage, sclerosis of the subchondral bone, and osteophyte formation. Biochemical markers are molecules derived from connective tissue matrices that are released into biologic fluid during the process of tissue turnover [3,4] Such biochemical markers might be useful for the early identification of patients with OA, or patients at high risk for progression, for monitoring disease progression and for assessing therapeutic response in OA [4,5,6]. In OA, evidence of increased cleavage of type II collagen in the diseased articular cartilage has been obtained, including cleavage by collagenases of the triple helical domain [7,8,9,10] and by collagenases and other proteases of the nonhelical telopeptide domain [11], resulting in loss of fibril structure, tensile strength, and macromolecular organization of the extracellular matrix. Enzymelinked immunosorbent assay (ELISA) was used to assess CTX-II in urine [3,12]
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