Prognostic biomarkers in osteoarthritis.
Prognostic biomarkers in osteoarthritis.
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DOI：
10.1097/bor.0b013e32835a9381
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发表时间：
2013-01
影响因子：
5.1
通讯作者：
Abramson SB
中科院分区：
文献类型：
--
作者：
Attur M;Krasnokutsky-Samuels S;Samuels J;Abramson SB
骨关节炎中存在疾病或疾病进展风险的患者的识别仍然具有挑战性，因为放射照相术对预示软骨和骨异常的分子变化不敏感。因此，对生物化学和成像生物标志物存在广泛的需求。我们描述了这些生物标志物的最新进展，以确定骨关节炎患者谁是疾病进展的风险。目前正在评估的生化标志物包括合成代谢，分解代谢和炎症分子代表不同的生物途径。一些有前途的软骨和骨降解和合成生物标志物正处于不同的开发阶段，等待在更大的人群中进一步验证。许多研究已经显示局部（滑液）和全身（血清和血浆）炎症生物标志物的表达水平升高。这些化学生物标志物正在与成像生物标志物结合进行评估，以预测早期发病和疾病负担。预后生物标志物可用于临床膝关节骨关节炎，以确定疾病以不同速率进展的亚组。这有助于我们理解发病机制，并使我们能够区分异质性膝关节骨关节炎人群中的表型。最终，这些发现可能有助于促进疾病修饰骨关节炎药物（DMOAD）的开发。
Identification of patients at risk for incident disease or disease progression in osteoarthritis remains challenging, as radiography is an insensitive reflection of molecular changes that presage cartilage and bone abnormalities. Thus there is a widely appreciated need for biochemical and imaging biomarkers. We describe recent developments with such biomarkers to identify osteoarthritis patients who are at risk for disease progression. The biochemical markers currently under evaluation include anabolic, catabolic, and inflammatory molecules representing diverse biological pathways. A few promising cartilage and bone degradation and synthesis biomarkers are in various stages of development, awaiting further validation in larger populations. A number of studies have shown elevated expression levels of inflammatory biomarkers, both locally (synovial fluid) and systemically (serum and plasma). These chemical biomarkers are under evaluation in combination with imaging biomarkers to predict early onset and the burden of disease. Prognostic biomarkers may be used in clinical knee osteoarthritis to identify subgroups in whom the disease progresses at different rates. This could facilitate our understanding of the pathogenesis and allow us to differentiate phenotypes within a heterogeneous knee osteoarthritis population. Ultimately, such findings may help facilitate the development of disease-modifying osteoarthritis drugs (DMOADs).