Cartilage Fragment a Biomarker for Osteoarthritis

Researchers have found that the level of the CTX-II fragment of cartilage in patients with osteoarthritis (OA) strongly correlates with the severity of the disease and propose its use as a biomarker to replace currently used radiographic techniques as the preferred method for diagnosing the syndrome.

Investigators at the Erasmus Medical Center (Rotterdam, NL) determined the levels of CTX-II in a study population that comprised 1,235 men and women over 55 years of age who were enrolled in the Rotterdam Study (a population-based cohort study) and who were followed up for a mean of 6.6 years. At the beginning of the study 19% of the subjects had clear radiographic evidence of OA in at least one knee and 10% had OA in at least one hip.
In their paper published in the August 2004 issue of Arthritis & Rheumatism, the investigators reported that patients with CTX-II levels in the highest quartile had a 4.2-fold increased risk of having radiographic OA of the knee and of the hip compared with subjects with a CTX-II level in the lowest quartile. Those patients with the highest concentrations of CTX-II were six times more likely to experience rapid, destructive progression of OA at the knee and eight times more likely at the hip. The subjects with the highest CTX-II levels also had the highest complaints of joint pain. The strong correlation between CTX-II and the incidence and severity of OA was found to be independent of age, sex, and body mass index.

"This is the first large follow-up study in which the use of CTX-II as a biomarker for cartilage degradation and disease progression has been investigated,” said first author M. Reijman, MSc, a researcher at the Erasmus Medical Center. "Based on the results, we conclude that the CTX-II concentration is markedly associated with the prevalence and progression of OA of the knee and hip, and that these associations are independent of known risk factors for radiographic OA. The presence of joint pain seems to augment this relationship, which might reflect the effects of an ongoing OA process. Further research is necessary to establish the clinical utility of this novel biomarker for OA.”



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