HSS Journal

, Volume 6, Issue 2, pp 171–176 | Cite as

Aggrecan and Cartilage Oligomeric Matrix Protein in Serum and Synovial Fluid of Patients with Knee Osteoarthritis

  • Mohammed M. El-Arman
  • Ghada El-Fayoumi
  • ElWaleid El-Shal
  • Ibrahim El-Boghdady
  • Atef El-Ghaweet
Original Article

Abstract

Aggrecan and cartilage oligomeric matrix protein (COMP) which are important degradation products of articular cartilage may be promising diagnostic markers in serum and/or synovial fluid for diagnosis of knee osteoarthritis (OA). Our objective was to measure serum and synovial fluid levels of aggrecan and COMP in patients with OA of the knee joint to find out if they could be of diagnostic value in OA and if their levels correlate with the clinical and radiological manifestations of the disease. Sixty-six patients suffering from primary knee OA with effusion (26 males and 40 females) were studied. Twenty individuals (six males and 14 females) with recent traumatic knee effusion matched for age and sex were chosen to serve as a control group. All subjects had thorough clinical and radiological (X-ray and MRI) evaluation. Aggrecan and COMP in serum and synovial fluid were measured by ELISA. Serum and synovial fluid aggrecan and COMP levels were significantly higher than the control. Serum and synovial fluid aggrecan and COMP levels were positively correlated with age, body mass index, disease duration, plain X-ray and MRI scores. In OA, serum and synovial fluid aggrecan and COMP levels are elevated and represent useful markers in the diagnosis. Moreover, these elevated levels positively correlated with radiological joint damage but not with clinical disease parameters. These markers have the potential to be used for monitoring articular cartilage destruction and response to different therapeutic modalities.

Keywords

aggrecan cartilage oligomeric matrix protein osteoarthritis 

References

  1. 1.
    Kuettner K and Goldberg V (1995). Osteoarthritic disorders. In: Rosemont IL (ed). Illinois: American Academy of Orthopedic Surgeons. pp 247–60.Google Scholar
  2. 2.
    Cucchiarini M,Thurn T, Weimer A, Kohn D, Terwilliger EF, Madry H.(2006). Restoration of the extracellular matrix in human osteoarthritic articular cartilage by overexpression of the transcription factor SOX9. Arthritis Rheum; 56(1):158–67CrossRefGoogle Scholar
  3. 3.
    Neustadt DH (2006). Intra-articular injections for osteoarthritis of the knee. Cleve Clin J Med; 73(10):897–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Frederick W and Nancy L (2002). The long-term outcome of osteoarthritis: Rates and predictors of joint space narrowing in symptomatic patients with knee osteoarthritis; J Rheumatol. 29(1):139–46Google Scholar
  5. 5.
    Anita W, Stephen S and Judith S (2002). The determinants of change in tibial cartilage volume in osteoarthritis knees. Arthritis Rheum; 46 (8): 2065–72.CrossRefGoogle Scholar
  6. 6.
    Schmidt B, Gavenis K and Kippels M (2002). New potential markers for cartilage degradation of the knee joint. Scand J Rheumatol; 31: 151–7.Google Scholar
  7. 7.
    Altman R, Asch E and Bloch D (1986). Development of criteria for the classification and reporting of osteoarthritis. Arthritis Rheum; 29: 1039–49.CrossRefPubMedGoogle Scholar
  8. 8.
    Huskisson E (1982). Measurement of pain. J Rheumatol; 9: 678–9.Google Scholar
  9. 9.
    Gunn J (1976): Clinical examination of the knee joint. Bone joint Surg; 5: 10–15Google Scholar
  10. 10.
    Jones A, Hokinsm V and Patizick M (1992). Evaluation of a method for clinically assessing osteoarthritis of the knee. Ann Rheum Dis; 51: 243–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Aichroth P, Freeman M and Samilli L (1978). Deformities of the knee joint. J Bone Joint Surg Am; 50: 60–75.Google Scholar
  12. 12.
    Lequesne G, Mery C and Samson M (1987). Indexes of severity for osteoarthritis of the hip and knee. Validation value in comparison with other assessment tests. Scand J Rheumatol; 65 (suppl.): 85–9.CrossRefGoogle Scholar
  13. 13.
    Bellamy N, Buchanan W and Goldsmith C (1995). A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol; 15: 1833–40.Google Scholar
  14. 14.
    Neidhart M, Hauser N , Paulsson M,DiCesare P,Michel B and Hauselmann H (1997). Small fragments of cartilage oligomeric matrix protein in synovial fluid and serum as markers for cartilage degradation. Br J Rheumatol; 36: 1151–60.CrossRefPubMedGoogle Scholar
  15. 15.
    Seliem H, Afiefy T and Radwan H (1998). Value of MRI in detection of disease progression in knee osteoarthritis. Egypt Rheumatol Rehab; 25(4): 531–8.Google Scholar
  16. 16.
    Duncan S and Owen J (1997). Aspiration and injection of joints and soft tissues. In: Kelly W, Harris E, Ruddy S and Seldge C (eds): Textbook of Rheumatology, 5th edn. Philadelphia: Saunders. pp 591–7.Google Scholar
  17. 17.
    Lohmander S, Lark M, Dahibergle L, WalakovitsL and Roos H (1992). Cartilage matrix metabolism in osteoarthritis : Markers in synovial fluid, serum and urine.Clin Biochem; 25:167–74.CrossRefPubMedGoogle Scholar
  18. 18.
    Garnero P, Piperno M and Gineyts E (2001). Cross sectional evaluation of biochemical markers of bone, cartilage, and synovial tissue metabolism in patients with knee osteoarthritis: Relations with disease activity and joint damage. Ann Rheum Dis; 60: 619–26.CrossRefPubMedGoogle Scholar
  19. 19.
    Peterfy G (2002). Imaging of the disease process. Current Opinion in Rheum; 14 (5): 590–6.CrossRefGoogle Scholar
  20. 20.
    Bruyere O, Collette J, Kothari M, Zaim S, White D, Genant H, Peterfy C, Burlet N, Ethgtn D, Montague T, Dabrowski C and Reginster GY (2006). Osteoarthritis, magnetic resonance imagining and biochemical markers: A one year prospective study. Ann Rheum Dis; 65 (8): 1050–54.CrossRefPubMedGoogle Scholar
  21. 21.
    Lohmander L, Inoescu M and Jugessur H (1999). Changes in joint cartilage aggrecan after knee injury and in osteoarthritis. Arthritis Rheum; 42: 534–44.CrossRefPubMedGoogle Scholar
  22. 22.
    Otterness G, Swindell C and Zimmerer A (2000). Analysis of 14 molecular markers for monitoring osteoarthritis. Osteoarthritis Cart; 8 (3): 180–5.CrossRefGoogle Scholar
  23. 23.
    Larsson S, Lohmander LS, Struglics A. (2009). Synovial fluid level of aggrecan ARGS fragments is a more sensitive marker of joint disease than glycosaminoglycan or aggrecan levels: a cross-sectional study. Arthritis Res Ther; 11(3):R92.CrossRefPubMedGoogle Scholar
  24. 24.
    Cawston T, Ellis J and Humm G (1995). IL-1 and 14, oncostatin M in combination promotes the release of collagen fragments from bovine nasal cartilage in culture. Biochem Biophys Res Comm; 215: 377–85.CrossRefPubMedGoogle Scholar
  25. 25.
    Clark A, Jordan J and Villim V (1999). Serum cartilage oligomeric matrix protein reflects osteoarthritis presence and severity. Arthritis Rheum; 42: 2356–64.CrossRefPubMedGoogle Scholar
  26. 26.
    Villim V, Olejarova M and Kraus B (2002). Serum levels of cartilage oligomeric matrix protein correlate with radiographic progression of knee osteoarthritis. Osteoarthritis Cart; 10:707–13.CrossRefGoogle Scholar
  27. 27.
    Huang K, Wu LD (2008). Aggrecanase and aggrecan degradation in osteoarthritis: a review. J Int Med Res; 36(6):1149–60.PubMedGoogle Scholar
  28. 28.
    Svetlova MS, Vezikova NN, Romashina VV, Sobanina TS, Pavlov IuL, Chepliukova IA (2008). Cartilage oligomeric matrix protein, a possible marker of synovitis in early knee joint osteoarthrosis. Klin Med (Mosk); 86(11):65–8.Google Scholar
  29. 29.
    Fuller C, Barr A and Sharif M (2001). Cross sectional comparison of synovial fluid biochemical markers in equine osteoarthritis and the correlation of these markers with articular cartilage damage. Osteoarthritis Cart; 9: 49–55CrossRefGoogle Scholar
  30. 30.
    Bleasel J, Poole R and Heinegard D (1999). Changes in serum cartilage marker levels indicate altered cartilage metabolism in families with osteoarthritis-related type II collagen gene mutation. Arthritis Rheum; 42:39–45.CrossRefPubMedGoogle Scholar
  31. 31.
    Wislowska M and Jablonska B (2005). Serum cartilage oligomeric matrix protein (COMP) in rheumatoid arthritis and knee osteoarthritis. Clin Rheumatol; 24(3):278–84CrossRefPubMedGoogle Scholar
  32. 32.
    Dragomir A, KrausV and Renner J (2002). Serum cartilage oligomeric matrix protein and clinical signs and symptoms of potential pre-radiographic hip and knee pathology. Osteoarthritis Cart; 10: 687–91.CrossRefGoogle Scholar
  33. 33.
    Belcher C, Yaqub R and Fawthrop F (1997). Synovial fluid chondroitin and keratan sulfate epitopes, glycosaminoglycans, and hyaluronan in arthritic and normal knees. Ann Rheum Dis; 56: 299–307.CrossRefPubMedGoogle Scholar
  34. 34.
    Petersson I, Boegard B and Svensson D (1998). Changes in cartilage and bone metabolism identified by serum markers in early osteoarthritis of the knee joint. Br J Rheumatol; 37:46–50.CrossRefPubMedGoogle Scholar
  35. 35.
    Conrozier T, Saxne T and Shan F (1998). Serum concentrations of cartilage oligomeric matrix protein and bone sialoprotein in hip osteoarthritis: A one year prospective study. Ann Rheum Dis; 57:527–32.CrossRefPubMedGoogle Scholar
  36. 36.
    Lohmander S, Dahlberg L and Eyre D (1998). Longitudinal and cross-sectional variability in markers of joint metabolism in patients with knee pain and articular cartilage abnormalities. Osteoarthritis Cart; 6:351–61.CrossRefGoogle Scholar
  37. 37.
    Saxne T, Geborek P and Mansson B (1995). Knee joint synovial fluid content of aggrecan predicts knee/ hip joint destruction in rheumatoid arthritis. Trans Orthop Res Soc; 20: 344–7.Google Scholar
  38. 38.
    Sharif M, Saxne T and Shepstone L (1995). Relationship between serum cartilage oligomeric matrix protein levels and disease progression in osteoarthritis of the knee joint. Br J Rheumatol; 34: 306–10.CrossRefPubMedGoogle Scholar
  39. 39.
    Otterness I, Weiner E and Swiltldell A (2001). Analysis of 14 molecular markers for monitoring osteoarthritis. Osteoarthritis Cart; 9: 224–31.CrossRefGoogle Scholar
  40. 40.
    Bruyere O, Collette J and Ethgen O (2003). Biochemical markers of bone and cartilage remodeling in prediction of long-term progression of knee osteoarthritis. J Rheumatol; 30: 1043–50.PubMedGoogle Scholar
  41. 41.
    Campion G, McCrae F and Schnitzer T (1991). Levels of keratan sulfate in the serum and synovial fluid of patients with osteoarthritis of the knee. Arthritis Rheum; 34: 254–9.CrossRefGoogle Scholar
  42. 42.
    Thonar J, Masuda K and Lenz M (1995). Serum markers of systemic disease processes in osteoarthritis. J Rheumatol; 22: 68–70.Google Scholar
  43. 43.
    Ratcliffe A, Flatow E and Roth N (1996). Biochemical markers in synovial fluid identify early osteoarthritis of the glenohumeral joint. Clin Orthop; 330: 45–53.CrossRefPubMedGoogle Scholar
  44. 44.
    Chevalier X (1997). Is a biological marker for osteoarthritis within reach? Rev Rheum Engl Ed; 64(10): 562–77.Google Scholar
  45. 45.
    Disler G, McCauley R and Kelman G (1996). Fat suppressed three-dimensional spoiled gradient echo MR imaging of hyaline cartilage defects in the knee. AJR; 167: 127–32.PubMedGoogle Scholar
  46. 46.
    Waldschmidt J, Rilling R and Kajdacsy A (1997). In vitro and in vivo MR imaging of hyaline cartilage: Zonal anatomy, imaging pitfalls, and pathologic conditions. Radiographics; 17: 1392–8.Google Scholar
  47. 47.
    Villim V, Vytasek R and Olejarova M (2001). Serum cartilage oligomeric matrix protein reflects the presence of clinically diagnosed synovitis in patients with knee osteoarthritis. Osteoarthritis Cart; 9:612–8.CrossRefGoogle Scholar
  48. 48.
    Fragonas E, Mlynarik V and Jellus V (1998). Correlation between biochemical composition and magnetic resonance appearance of articular cartilage. Osteoarthritis Cart; 6(1): 24–32.CrossRefGoogle Scholar

Copyright information

© Hospital for Special Surgery 2010

Authors and Affiliations

  • Mohammed M. El-Arman
    • 1
  • Ghada El-Fayoumi
    • 2
  • ElWaleid El-Shal
    • 2
  • Ibrahim El-Boghdady
    • 2
  • Atef El-Ghaweet
    • 2
  1. 1.Department of Clinical PathologyMansoura UniversityMansouraEgypt
  2. 2.Department of Rheumatology and RehabilitationMansoura UniversityMansouraEgypt

Personalised recommendations