KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
Department of Kinesiology, University of Waterloo, Waterloo, Canada.
J Spinal Cord Med. 2023 Mar;46(2):167-180. doi: 10.1080/10790268.2021.1977905. Epub 2021 Dec 22.
Serum alkaline phosphatase (ALP) is measured as an indicator of bone or liver disease. Bone-specific alkaline phosphatase (B-ALP) is an isoform of ALP found in the bone tissue which can predict fractures and heterotopic ossification.
The aim of this scoping review was to explore the current use of ALP and B-ALP in studies using humans or animal models of SCI, and to identify ways to advance future research using ALP and B-ALP as a bone marker after SCI.
HUMAN STUDIES: 42 studies were included. The evidence regarding changes or differences in ALP levels in individuals with SCI compared to controls is conflicting. For example, a negative correlation between B-ALP and total femur BMD was observed in only one of three studies examining the association. B-ALP seemed to increase after administration of teriparatide, and to decrease after treatment with denosumab. The effects of exercise on ALP and B-ALP levels are heterogeneous and depend on the type of exercise performed. ANIMAL STUDIES: 11 studies were included. There is uncertainty regarding the response of ALP or B-ALP levels after SCI; levels increased after some interventions, including vibration protocols, curcumin supplementation, cycles in electromagnetic field or hyperbaric chamber. Calcitonin or bisphosphonate administration did not affect ALP levels.
Researchers are encouraged to measure the bone-specific isoform of ALP rather than total ALP in future studies in humans of animal models of SCI.
血清碱性磷酸酶（ALP）是衡量骨骼或肝脏疾病的指标。骨特异性碱性磷酸酶（B-ALP）是一种存在于骨组织中的 ALP 同工酶，可预测骨折和异位骨化。
本范围综述旨在探讨目前在使用人类或 SCI 动物模型的研究中使用 ALP 和 B-ALP 的情况，并确定如何利用 ALP 和 B-ALP 作为 SCI 后的骨标志物来推进未来的研究。
人体研究：共纳入 42 项研究。关于 SCI 个体与对照组之间 ALP 水平变化或差异的证据存在矛盾。例如，在三项研究中仅观察到 B-ALP 与总股骨 BMD 之间存在负相关。Teriparatide 给药后 B-ALP 似乎增加，而 denosumab 治疗后则减少。运动对 ALP 和 B-ALP 水平的影响具有异质性，取决于所进行的运动类型。动物研究：共纳入 11 项研究。SCI 后 ALP 或 B-ALP 水平的反应存在不确定性；在某些干预措施后，包括振动方案、姜黄素补充、电磁场或高压舱中的循环，水平增加。降钙素或双膦酸盐给药不影响 ALP 水平。
研究人员鼓励在未来的 SCI 人体或动物模型研究中测量骨特异性同工酶 ALP，而不是总 ALP。
