Multicenter research is mapping the pathological fingerprint of osteoarthritis and its subtypes.
Mapping the “Pathological Fingerprint” of Osteoarthritis
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#osteoarthritisSecondary#biochemicalmarkers
The study, “C1M, C2M, C3M, PRO-C2, and CRPM in serum reflect different potential pathogenetic domains of osteoarthritis, data from check,” appears in the April 2018 edition of Osteoarthritis and Cartilage.
Co-author Anne-Christine Bay-Jensen, Ph.D. told OTW, “Osteoarthritis (OA) is actually a group of subtypes of disease (e.g. phenotypes or endotypes) with the same endpoint which is joint failure (e.g. total joint replacement).”
“However, the origin, development and progression of the subtypes is different in biology and clinical development. Currently there are limited diagnostic tools available to separate those subtypes, thus efforts are being made to develop and test novel and objective biomarkers for assessing disease subtypes.”
“We focused our research on blood or urinary-based biochemical markers as objective and non-invasive tools for understanding patient subtypes. At OARSI [Osteoarthritis Research Society International] we presented work that was conducted in a collaboration with Dr. van Spil (Utrecht medical center, Netherlands, EU), Dr. Ladel (Merck KGaA, Germany, EU) and Dr. Bay-Jensen (Nordic Bioscience, Denmark, EU).”
“The collaboration has sprung from the APPROACH consortium (an IMI funded project https://www.approachproject.eu/), whose main objective is to identify and validate biomarkers for predictive medicine in OA.”
“For this particular study, 11 biomarkers were assessed in serum or urine of 294 subjects with knee or hip pain complaints from the CHECK [Cohort Hip and Cohort Knee] cohort, a population-based, prospective, 10-year cohort study.”
“All the markers are measures of tissue pathology (“liquid biopsies”) and thus reflect tissue health. As a first round we did component analysis.”
“The purpose of such analysis was to test whether unique components (clusters) exist that may describe or profile patient subtypes. We found three components:
- A cluster of markers that are related to bone resorption and formation
- A cluster of markers associated with inflammation, and
- A cluster of markers associated with tissue inflammation and degradation.”
“This indicates that by measuring these tissue associated markers we may in the future be able to distinguish between different OA subtypes. Ultimately, a better understanding of the biology may provide tools for deciding the best therapeutic approach for the individual patients based on the pathological fingerprint. A fingerprint could be an inflammation-driven phenotype that our group in other studies has demonstrated to be associated with faster progression.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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