Assessment of Disease Activity and Progression of Osteoarthritis With Using Molecular Markers of Cartilage and Synovium Turnover

Osteoarthritis (OA) is the most common joint disease, which is characterized by cartilage loss and concomitant alteration of synovium and subchondral bone metabolism. Pain and stiffness in the affected joints are the main complains. It also causes physical functional impairment. The measurement of joint space width by plain radiography is currently established method for assessing the progression of the disease. This method however has some limitations. The most important issue is to determine early OA before significant joint damage has occurred. When there is radiological evidence of OA, significant joint damage has often already occurred. Therefore, there is need for noninvasive methods that can be repeated and have better sensitivity than plain radiography to identify patients at high risk for destructive OA and monitoring drug efficacy. Molecular markers are released into biological fluids during tissue biosynthesis and turnover. They can be measured by immunoassay. Several molecular markers of bone, cartilage and synovium have been described such as crosslinking telopeptide of collagen type II (CTX II), Glc-Gal-PYD, hyaluronic acid, type I collagen. In conclusion, using a newly developed molecular marker, early OA can be properly detected before significant joint destruction has occurred.