Bone and Cartilage parameters

In the Western World, approx. 8 –10 % of the population suffer from osteoporosis – often without knowing it since initially the symptoms are interpreted as normal symptoms of old age. The number of undiagnosed patients with osteoporosis-related fractures is estimated to be about 40 % (Source: current Emnid study).

Osteoporosis is diagnosed too rarely, so that only 30 % of the women suffering from osteoporosis are adequately treated (Source: World Osteoporosis Day 2008).
The increasing number of drugs available for treatment of bone diseases requires the use of more rapid and predictive methods to assess therapy efficacy. While detectable and significant changes in bone mineral density (BMD) take 18 to 24 months to develop, bone turnover markers have been shown to detect changes in bone tissue within 3 – 6 months after starting anti-resorptive therapy.

Therefore, measurement of bone turnover markers is increasingly recommended as a key component of therapy management.

A review of novel biomarkers of cartilage synthesis and degradation for clinical and pre-clinical use.

Specific cartilage degradative and biosynthetic events are described in this paper that plays a key role in rheumatoid arthritis and osteoarthritis. These events can be identified and quantified using novel immunoassays that detect the molecular products of these events in various body fluids and tissues, such as synovial fluid, serum, urine and cartilage. Reviewed and summarized are the most recent clinical and pre-clinical data on immunoassays detecting and quantifying biochemical markers for cartilage degradation (CTX-II, C2C, C1,2C and COMP) and cartilage synthesis (CPII, CS846 and YKL-40). It is shown that the enormous scientific progress in the field of arthritis has opened new possibilities for early diagnosis of disease and disease severity (extent of joint destruction), prediction of disease progression and rapid assessment of the efficacy of therapy. Moreover, the availability of these new biomarkers will dramatically enhance the efficiency and effectiveness of drug discovery programs and subsequent clinical trials.

Finally, based on the current state of knowledge (published clinical studies) the possibilities for clinical and research use of the new markers have been summarized in a Clinical Summary Chart and an Arthritis Biomarker Quick Reference Chart.

About 100 million people worldwide suffer from degenerative joint disease and presumably its incidence will further increase due to demographic and lifestyle changes.

The loss of articular cartilage during joint destruction is irreversible and current therapies are unsuitable to stop or even reverse cartilage loss.

Thus, it is of special importance to diagnose degenerative joint diseases as early as possible and to start an appropriate therapy before the disease has become radiologically apparent.
With the measurement of biomarkers, degenerative joint diseases can be a) detected already in the initial stage, b) monitored or c) even predicted.