Mabey Thomas, Honsawek Sittisak
Thomas Mabey, Sittisak Honsawek, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
World J Orthop. 2015 Jan 18;6(1):95-105. doi: 10.5312/wjo.v6.i1.95.
Osteoarthritis (OA) is a debilitating degenerative joint disease particularly affecting weightbearing joints within the body, principally the hips and knees. Current radiographic techniques are insufficient to show biochemical changes within joint tissue which can occur many years before symptoms become apparent. The need for better diagnostic and prognostic tools is heightened with the prevalence of OA set to increase in aging and obese populations. As inflammation is increasingly being considered an important part of OAs pathophysiology, cytokines are being assessed as possible candidates for biochemical markers. Cytokines, both pro- and anti-inflammatory, as well as angiogenic and chemotactic, have in recent years been studied for relevant characteristics. Biochemical markers show promise in determination of the severity of disease in addition to monitoring of the efficacy and safety of disease-modifying OA drugs, with the potential to act as diagnostic and prognostic tools. Currently, the diagnostic power of interleukin (IL)-6 and the relationship to disease burden of IL-1β, IL-15, tumor necrosis factor-α, and vascular endothelial growth factor make these the best candidates for assessment. Grouping appropriate cytokine markers together and assessing them collectively alongside other bone and cartilage degradation products will yield a more statistically powerful tool in research and clinical applications, and additionally aid in distinguishing between OA and a number of other diseases in which cytokines are known to have an involvement. Further large scale studies are needed to assess the validity and efficacy of current biomarkers, and to discover other potential biomarker candidates.
骨关节炎(OA)是一种使人衰弱的退行性关节疾病,尤其会影响身体的负重关节,主要是髋关节和膝关节。当前的放射学技术不足以显示关节组织内的生化变化,这些变化可能在症状出现前许多年就已发生。随着骨关节炎在老龄和肥胖人群中的患病率预计将会增加,对更好的诊断和预后工具的需求也日益迫切。由于炎症越来越被认为是骨关节炎病理生理学的一个重要部分,细胞因子正被评估为可能的生化标志物候选物。近年来,促炎和抗炎细胞因子以及血管生成和趋化细胞因子都已针对相关特性进行了研究。生化标志物除了可用于监测改善病情的骨关节炎药物的疗效和安全性外,在确定疾病严重程度方面也很有前景,有潜力作为诊断和预后工具。目前,白细胞介素(IL)-6的诊断能力以及它与IL-1β、IL-15、肿瘤坏死因子-α和血管内皮生长因子的疾病负担之间的关系,使其成为评估的最佳候选物。将合适的细胞因子标志物组合在一起,并与其他骨和软骨降解产物一起进行综合评估,将在研究和临床应用中产生一个统计学效力更强的工具,此外还有助于区分骨关节炎和已知细胞因子有参与的其他多种疾病。需要进一步开展大规模研究,以评估当前生物标志物的有效性和功效,并发现其他潜在的生物标志物候选物。