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New Emerging Biomarkers for Bone Disease: Sclerostin and Dickkopf-1 (DKK1)

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Abstract

A healthy skeleton depends on a continuous renewal and maintenance of the bone tissue. The process of bone remodeling is highly controlled and consists of a fine-tuned balance between bone formation and bone resorption. Biochemical markers of bone turnover are already in use for monitoring diseases and treatment involving the skeletal system, but novel biomarkers reflecting specific biological processes in bone and interacting tissues may prove useful for diagnostic, prognostic, and monitoring purposes. The Wnt-signaling pathway is one of the most important pathways controlling bone metabolism and consequently the action of inhibitors of the pathway such as sclerostin and Dickkopf-related protein 1 (DKK1) have crucial roles in controlling bone formation and resorption. Thus, they might be potential markers for clinical use as they reflect a number of physiological and pathophysiological events in bone and in the cross-talk with other tissues in the human body. This review focuses on the clinical utility of measurements of circulating sclerostin and DKK1 levels based on preanalytical and analytical considerations and on evidence obtained from published clinical studies. While accumulating evidence points to clear associations with a number of disease states for the two markers, and thus, the potential for especially sclerostin as a biochemical marker that may be used clinically, the lack of standardization or harmonization of the assays still hampers the clinical utility of the markers.

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Authors and Affiliations

  1. Department of Medical Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey

    Aylin Sepinci Dincel & Niklas Rye Jørgensen

  2. Department of Clinical Biochemistry, Rigshospitalet, Valdemar Hansens Vej 13 Glostrup, 2600, Copenhagen, Denmark

    Aylin Sepinci Dincel & Niklas Rye Jørgensen

  3. Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Aylin Sepinci Dincel & Niklas Rye Jørgensen

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  1. Aylin Sepinci Dincel
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  2. Niklas Rye Jørgensen
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on behalf of the IOF-IFCC Joint Committee on Bone Metabolism (C-BM)

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Correspondence to Niklas Rye Jørgensen.

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Aylin Sepinci Dincel and Niklas Rye Jørgensen declare that they have no conflict of interest relevant to this manuscript.

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Dincel, A.S., Jørgensen, N.R. & on behalf of the IOF-IFCC Joint Committee on Bone Metabolism (C-BM). New Emerging Biomarkers for Bone Disease: Sclerostin and Dickkopf-1 (DKK1). Calcif Tissue Int 112, 243–257 (2023). https://doi.org/10.1007/s00223-022-01020-9

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