Biomarkers in Osteoarthritis
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- Sandell, L.J. HSS Jrnl (2012) 8: 33. doi:10.1007/s11420-011-9246-8
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The current gold standard for assessing joint damage in osteoarthritis (OA) remains the plane radiograph. This technique is relatively insensitive and only provides a historical view of the skeletal damage that has already occurred. It does not allow for the early detection of pathological changes in joint tissues. MRI and biochemical biomarkers are likely to be more sensitive than radiology in detecting joint changes that occur in OA.
Developing Biomarkers for the Study of OA
Biomarkers are defined as objective indicators of normal biologic processes, pathogenic processes, or pharmacologic responses to therapeutic interventions. Biomarkers have the potential to decrease the length and cost of clinical trials. Thus, biomarkers that can measure and predict the full spectrum of OA disease progression and outcomes are needed, but few such biomarkers have been validated for this purpose. Many laboratories worldwide are working on the development of these biomarkers. To coordinate these activities and place an organizational emphasis on the goal of usable biomarkers, the Osteoarthritis Research Society International (OARSI), the only organization solely devoted to the study of OA, has established an OA Biomarkers Global Initiative. With support from the National Institute of Arthritis, Musculoskeletal and Skin Diseases and the Arthritis Foundation, OARSI has developed a series of workshops over the past 3 years that have brought together scientists from around the world for meetings. To date, these have included Biochemical Biomarkers: Biology, Validation and Clinical Studies (April, 2009); Genetics and Genomics: New targets in OA (November, 2010); and Imaging Biomarkers (to be held July, 2012). From these meetings have arisen broad goals for OA research  aimed at: increasing awareness of OA as a disease with a long silent period; defining and developing a paradigm of molecular, pre-radiographic, and radiographic OA that can be used in clinical trials; identifying subgroups, e.g., early OA and post-injury OA; influencing research to advance biomarker development; optimizing use of existing samples and clinical study resources; and developing a study of current biomarkers using the samples from the Osteoarthritis Initiative (OAI) of the U.S. Government.
Current Studies Using Biomarkers
The future of OA biomarkers is great. The number of studies currently underway has increased greatly, including longitudinal studies. More research on new biomarkers is underway, and we hope to increase awareness and use of biochemical biomarkers over the next few years. The goal is clear—to move the diagnosis of OA from a radiologic viewpoint back to a pre-radiologic viewpoint and on to the molecular events that initiate cartilage breakdown and joint failure.
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