Authors: Aim: To assess the potential usefulness ,of measurements of serum levels of cartilage oligomeric matrix protein (COMP) and YKL-40 in patients with knee osteoarthritis (OA) as biochemical markers of osteoarthritic status. Methods: 40 patients having symptomatic knee OA and meeting the ACR criteria for idiopathic knee OA and 15 healthy subjects matched with age and sex as controls were included in this study. Serum COMP and YKL-40 levels were measured by ELISA tech nique. The levels of these markers were compared according to the changes in joint space width (JSW), Kellgren Lawrence (K-L) grade, age, disease duration, gender, body mass index (BMI) and western Ontario MacMaster (WOMAC) index in our OA patients. Results: There were significant elevations of the serum COMP and YKL-40 in OA pa tients in comparison to the control group (P<0.001), more in hilateral than unilateral cases. There were highly significant positive correlations of both parameters with K-L radiological severity of the disease, but an inverse significant correlation with JSW (P<0.001). As regard • synovitis, there was significant increase of serum YKL-40 (P<0.05) while serum COMP level showed a slight but insignificant increase. There were highly significant positive cor relations of serum COMP and YKL-40 levels with WOMAC index and age (P<0.001) while there were no significant correlations with disease duration and body mass index (BMI) (P>0.05). C-reactive protein (CRP) was significantly higher in OA patients than in controls and showed positive significant correlation with serum level of YKL-40 (P<0.001). There was a positive highly significant correlation between both parameters (P<0.05). Conclusion: From these results we concluded that, the raised levels of serum COMP and YKL-40 can reflect disease severity and multiple joint involvement. YKL-40 may be a useful marker of synovitis in OA. The combined use of both markers can help in early diagnosis and improve prediction of disease status. By Amal F. Soliman, Refaat Mostafa AI-Tanawy, Noha M. Abd-Alnaser, Yasser M. *Ismail and **NaglaaIbrahem Azab. From Departments of Rheumatology & Rehabilitation, *CIinical Pathology, **Biochemistry,Benha Faculty of Medicine, Egypt VALUE OF CARTILAGE OLIGOMERIC MATRIX PROTEIN AND YKL-40 AS BIOCHEMICAL MARKERS IN PATIENTS WITH KNEE OSTEOARTHRITIS The Egyptian Rheumatologist, Vol. 29, No. 2, 2007: P. 105^ 113 : i.: 106 The combined use of several markers in OA patients seems to be necessary to improve pre diction of disease severity (Jung et al., 2006). AIM of the WORK: To assess the potential usefulness of meas urements of serum levels of COMP and YKL- 40 in patients with knee OA as biochemical markers of osteoarthritic status PATIENTS and METHODS: This study is carried out on 40 patients hav ing symptomatic knee OA and 15 healthy sub jects matched for age and sex as controls. All patients fulfilled the criteria of the American College of Rheumatology (ACR) classification criteria for idiopathic OA of the knee (Altaian et al., 1986). They were selected from the out patient clinic of the rheumatology and rehabili tation of Benha University Hospitals. We excluded the following cases: •Secondary OA as joint injury, developmental deformities, osteonecrosis, RA, gout and seronegative arthritides. •Patients who had a history of malignancy, myocardial infarction or elevated liver en zymes. •Patients who received intra-articular injection (steroids, chondroitin polysulphate or hyaluronic acid) for at least one month before this study. All our patients were subjected to the fol lowing: •Full history taking with particular attention to onset, course, disease duration, pain, articu lar gelling, locking and instability. INTRODUCTION: Osteoarthritis is a multifactorial, structural ly complex condition affecting the entire joint. At the molecular level, osteoarthritis (OA) is characterized by an imbalance between the synthesis of cytokines, metalloproteinases, and their natural inhibitors. These changes finally lead to articular cartilage destruction, and changes in the subchondral bone and synovial membrane (Iannone and Lapadula, 2003). The cartilage oligomeric matrix protein (COMP) is a non collagenous protein, the function of which is to bind to type II collagen fibers and stabilize the collagen fiber network in articular cartilage. The amount of this pro tein increases under the influence of cytokines and growth factors. As a result of various dis eases that cause damage to cartilage, fragment of matrix protein are released into synovial fluid and then into blood (Wislowska and Jablonska, 2005). YKL-40, also known as human cartilage glycoprotein 39 (HC gp-39) and chondrex, is produced by degenerated articular cartilage, in flamed or hyperplastic synovium, activated macrophages, neutrophilis (Kirkpatrick et al., 1997). Several studies have suggested that YKL-40 might be a useful new marker for pa tients with OA and rheumatoid arthritis (RA) (Johansen et al., 2001). The diagnosis of OA is generally based on clinical and radiographic changes, which occur fairly late during disease progression and have poor sensitivity for monitoring disease pro gression, so measuring of these markers would seem a promising approach to improve the pre diction of disease progression at the individual level (Taka hashi et al., 2004). Amal
Year: Not Available
Keywords: Not Available
Journal: Not Available
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: Not Available
Local/International: Local
Paper Link: Not Available
Full paper Not Available
View Abstract