Department of Biochemistry and Environmental Chemistry, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania.
Department M4, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania; Rheumatology Clinic, Clinical Emergency Hospital, Târgu Mureș, Romania.
Clin Interv Aging. 2020 Apr 8;15:501-518. doi: 10.2147/CIA.S242288. eCollection 2020.
Serum biomarkers of osteoarticular diseases have been in the limelight of current clinical research trends. Laboratory validation of defined and candidate biomarkers for both osteoarthritis and osteoporosis is of key importance for future decisional algorithms in the diagnosis, monitoring, and prognosis of these diseases. The current guidelines recommend the use of collagen degradation remnants, eg, CTX-I and CTX-II, in the complementary diagnosis of both osteoporosis and osteoarthritis. Besides the collagen degradation markers, enzymes that regulate bone and articular metabolism are useful in the clinical evaluation of osteoarticular pathologies. Along these, several other recommended and new nominee molecules have been recently studied. Wnts and Wnt-related molecules have a cardinal role in the bone-joint homeostasis, making them a promising target not only for pharmaceutical modulation, but also to be considered as soluble biomarkers. Sclerostin and dickkopf, two inhibitor molecules of the Wnt/β-catenin signaling, might have a dual role in the assessment of the clinical manifestations of the osteoarticular unit. In osteoarthritis, besides fragments of collagen type II many pathway-related molecules have been studied and proposed for biomarker validation. The most serious limitation is that a significant proportion of studies lack statistical power due to the reduced number of cases enrolled. Serum biomarkers of bone and joint turnover markers represent an encouraging possibility for the diagnosis and prognosis of osteoarticular diseases, although further studies and laboratory validations should be carried out as to solely rely on them.
骨关节炎和骨质疏松症的血清生物标志物一直是当前临床研究趋势的焦点。对于这些疾病的诊断、监测和预后的未来决策算法，对骨关节炎和骨质疏松症的定义和候选生物标志物进行实验室验证至关重要。目前的指南建议在骨质疏松症和骨关节炎的补充诊断中使用胶原蛋白降解残余物，如 CTX-I 和 CTX-II。除了胶原蛋白降解标志物外，调节骨骼和关节代谢的酶在骨关节炎病理的临床评估中也很有用。除此之外，最近还研究了其他几种推荐的和新的候选分子。Wnt 和 Wnt 相关分子在骨骼-关节稳态中起着重要作用，使它们不仅成为药物调节的有前途的靶点，而且还可以被认为是可溶性生物标志物。骨硬化蛋白和 Dickkopf 是 Wnt/β-catenin 信号通路的两种抑制剂分子，在评估骨关节炎的临床表现时可能具有双重作用。在骨关节炎中，除了 II 型胶原蛋白片段外，许多与途径相关的分子也被研究并提出用于生物标志物验证。最严重的限制是，由于纳入的病例数量减少，相当一部分研究缺乏统计学意义。骨和关节转换标志物的血清生物标志物为骨关节炎和骨质疏松症的诊断和预后提供了一个令人鼓舞的可能性，尽管需要进行更多的研究和实验室验证，才能仅仅依靠它们。
