Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain.
Blood Rev. 2020 May;41:100642. doi: 10.1016/j.blre.2019.100642. Epub 2019 Nov 20.
In patients with hemophilia, levels of uCTX-II and sCS846 increase 5 days after joint hemorrhage with respect to the initial value. In other words, in patients with established hemophilic arthropathy, the aforesaid biomarkers of joint tissue damage augment shortly after the first joint hemorrhage. In patients with hemophilia treated on demand, a correlation has been found between magnetic resonance imaging scores and the CS846 biomarker. Patients with hemophilia having more than one joint with advanced arthropathy have shown high levels of circulating soluble vascular cell adhesion molecule-1 (sVCAM-1). In addition, sVCAM-1 levels in these patients are associated with the severity of hemophilic arthropathy. In patients with hemophilia, cartilage degradation is increased by 25% compared with controls, as measured by some biomarkers (C2M, CTX-II and COMP). Levels of the cartilage degradation enzyme, ADAMTS5, are 10% lower in patients with hemophilia. Bone formation (PINP) is 25% lower in patients with hemophilia, whereas bone resorption (CTXI) is 30% greater. Acute inflammation (hsCRP) is 50% greater, whereas chronic inflammation (CRPM) is 25% lower. The hsCRP/CRPM ratio is 60% higher in patients with hemophilia than in controls. A panel of biomarkers that combines C2M, CRPM and ADAMTS5 can distinguish patients with hemophilia from controls with 85.3% accuracy. No strong correlation between biomarkers and the radiological and physical examination of the joint has been found.
在血友病患者中，与初始值相比，uCTX-II 和 sCS846 的水平在关节出血后 5 天增加。换句话说，在已经患有血友病性关节病的患者中，上述关节组织损伤的生物标志物在首次关节出血后不久就会增加。在按需治疗的血友病患者中，已经发现磁共振成像评分与 CS846 生物标志物之间存在相关性。患有多个进展性关节炎关节的血友病患者表现出高水平的循环可溶性血管细胞黏附分子-1（sVCAM-1）。此外，这些患者的 sVCAM-1 水平与血友病性关节病的严重程度相关。与对照组相比，血友病患者的软骨降解增加了 25%，这是通过一些生物标志物（C2M、CTX-II 和 COMP）测量的。血友病患者的软骨降解酶 ADAMTS5 水平低 10%。血友病患者的骨形成（PINP）低 25%，而骨吸收（CTX I）高 30%。急性炎症（hsCRP）高 50%，而慢性炎症（CRPM）低 25%。血友病患者的 hsCRP/CRPM 比值比对照组高 60%。包含 C2M、CRPM 和 ADAMTS5 的生物标志物组合可以以 85.3%的准确率将血友病患者与对照组区分开来。尚未发现生物标志物与关节的影像学和体格检查之间存在强相关性。
