Skip to main content
Top
Published in: International Orthopaedics 6/2015

01-06-2015 | Original Paper

Calcitonin gene-related peptide can be selected as a predictive biomarker on progression and prognosis of knee osteoarthritis

Published in: International Orthopaedics | Issue 6/2015

Login to get access

Abstract

Purpose

The purpose of this study was to examine calcitonin gene-related peptide (CGRP) concentrations in serum and synovial fluid of patients with primary knee osteoarthritis (OA) and healthy controls and to explore their relationship with clinical and radiographic severity of OA.

Methods

Sixty-five patients with primary knee OA and 21 healthy controls were recruited. CGRP concentrations in the serum and synovial fluid were measured using enzyme-linked immunosorbent assays. The radiographic severity of OA was evaluated using the Kellgren and Lawrence (KL) classification. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) was used to assess pain, stiffness and physical function.

Results

Serum and synovial fluid CGRP concentrations tended to be higher with the increase in KL grades (r = 0.565 and r = 0.441, P < 0.001, respectively), and were significantly positively correlated with KL grades, total WOMAC score and each subscale (pain, stiffness and physical function).

Conclusions

The result demonstrated that CGRP in serum and synovial fluid was related to progressive joint damage in knee OA. CGRP can be selected as a biomarker for monitoring disease severity and could be a predictive role on prognosis and progression of knee OA.
Literature
1.
go back to reference Berenbaum F (2013) Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage 21:16–21PubMedCrossRef Berenbaum F (2013) Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage 21:16–21PubMedCrossRef
2.
go back to reference Johnson VL, Hunter DJ (2014) The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol 28:5–15PubMedCrossRef Johnson VL, Hunter DJ (2014) The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol 28:5–15PubMedCrossRef
3.
go back to reference Melikoglu M, Yildirim K, Senel K (2009) Relationship between radiographic grading of osteoarthritis and serum beta-2 microglobulin. Ir J Med Sci 178:151–154PubMedCrossRef Melikoglu M, Yildirim K, Senel K (2009) Relationship between radiographic grading of osteoarthritis and serum beta-2 microglobulin. Ir J Med Sci 178:151–154PubMedCrossRef
4.
go back to reference Mohammed FI, Abd El-Azeem MI, KamalElDin AM (2012) Plasma and synovial fluid osteopontin levels in patients with knee osteoarthritis: relation to radiological grade. Egypt Rheumatol 34:131–136CrossRef Mohammed FI, Abd El-Azeem MI, KamalElDin AM (2012) Plasma and synovial fluid osteopontin levels in patients with knee osteoarthritis: relation to radiological grade. Egypt Rheumatol 34:131–136CrossRef
5.
go back to reference Sun JM, Sun LZ, Liu J, Su BH, Shi L (2013) Serum interleukin-15 levels are associated with severity of pain in patients with knee osteoarthritis. Dis Markers 35:203–206PubMedCentralPubMedCrossRef Sun JM, Sun LZ, Liu J, Su BH, Shi L (2013) Serum interleukin-15 levels are associated with severity of pain in patients with knee osteoarthritis. Dis Markers 35:203–206PubMedCentralPubMedCrossRef
6.
go back to reference Honsawek S, Tanavalee A, Sakdinakiattikoon M, Chayanupatkul M, Yuktanandana P (2009) Correlation of plasma and synovial fluid osteopontin with disease severity in knee osteoarthritis. Clin Biochem 42:808–812PubMedCrossRef Honsawek S, Tanavalee A, Sakdinakiattikoon M, Chayanupatkul M, Yuktanandana P (2009) Correlation of plasma and synovial fluid osteopontin with disease severity in knee osteoarthritis. Clin Biochem 42:808–812PubMedCrossRef
7.
go back to reference Honsawek S, Chayanupatkul M, Tanavalee A, Sakdinakiattikoon M, Deepaisarnsakul B, Yuktanandana P, Ngarmukos S (2009) Relationship of plasma and synovial fluid BMP-7 with disease severity in knee osteoarthritis patients: a pilot study. Int Orthop 33:1171–1175PubMedCentralPubMedCrossRef Honsawek S, Chayanupatkul M, Tanavalee A, Sakdinakiattikoon M, Deepaisarnsakul B, Yuktanandana P, Ngarmukos S (2009) Relationship of plasma and synovial fluid BMP-7 with disease severity in knee osteoarthritis patients: a pilot study. Int Orthop 33:1171–1175PubMedCentralPubMedCrossRef
8.
go back to reference Bellucci F, Meini S, Cucchi P, Catalani C, Nizzardo A, Riva A, Guidelli GM, Ferrata P, Fioravanti A, Maggi CA (2013) Synovial fluid levels of bradykinin correlate with biochemical markers for cartilage degradation and inflammation in knee osteoarthritis. Osteoarthritis Cartilage 21:1774–1780PubMedCrossRef Bellucci F, Meini S, Cucchi P, Catalani C, Nizzardo A, Riva A, Guidelli GM, Ferrata P, Fioravanti A, Maggi CA (2013) Synovial fluid levels of bradykinin correlate with biochemical markers for cartilage degradation and inflammation in knee osteoarthritis. Osteoarthritis Cartilage 21:1774–1780PubMedCrossRef
9.
go back to reference Wang Y, Xu D, Long L, Deng X, Tao R, Huang G (2014) Correlation between plasma, synovial fluid and articular cartilage Interleukin-18 with radiographic severity in 33 patients with osteoarthritis of the knee. Clin Exp Med 14:297–304PubMedCrossRef Wang Y, Xu D, Long L, Deng X, Tao R, Huang G (2014) Correlation between plasma, synovial fluid and articular cartilage Interleukin-18 with radiographic severity in 33 patients with osteoarthritis of the knee. Clin Exp Med 14:297–304PubMedCrossRef
10.
go back to reference Kapoor M, Martel-Pelletier J, Lajeunesse D, Pelletier JP, Fahmi H (2011) Role of proinflammatory cytokines in the pathophysiology of osteoarthritis. Nat Rev Rheumatol 7:33–42PubMedCrossRef Kapoor M, Martel-Pelletier J, Lajeunesse D, Pelletier JP, Fahmi H (2011) Role of proinflammatory cytokines in the pathophysiology of osteoarthritis. Nat Rev Rheumatol 7:33–42PubMedCrossRef
11.
go back to reference Russell FA, King R, Smillie SJ, Kodji X, Brain SD (2014) Calcitonin gene-related peptide: physiology and pathophysiology. Physiol Rev 94:1099–1142PubMedCrossRef Russell FA, King R, Smillie SJ, Kodji X, Brain SD (2014) Calcitonin gene-related peptide: physiology and pathophysiology. Physiol Rev 94:1099–1142PubMedCrossRef
12.
go back to reference Saito T, Koshino T (2000) Distribution of neuropeptides in synovium of the knee with osteoarthritis. Clin Orthop Relat Res (376):172–182 Saito T, Koshino T (2000) Distribution of neuropeptides in synovium of the knee with osteoarthritis. Clin Orthop Relat Res (376):172–182
13.
go back to reference Bowler KE, Worsley MA, Broad L, Sher E, Benschop R, Johnson K, Yates JM, Robinson PP, Boissonade FM (2013) Evidence for anti-inflammatory and putative analgesic effects of a monoclonal antibody to calcitonin gene-related peptide. Neuroscience 228:271–282PubMedCrossRef Bowler KE, Worsley MA, Broad L, Sher E, Benschop R, Johnson K, Yates JM, Robinson PP, Boissonade FM (2013) Evidence for anti-inflammatory and putative analgesic effects of a monoclonal antibody to calcitonin gene-related peptide. Neuroscience 228:271–282PubMedCrossRef
14.
go back to reference Raap T, Justen HP, Miller LE, Cutolo M, Scholmerich J, Straub RH (2000) Neurotransmitter modulation of interleukin 6 (IL-6) and IL-8 secretion of synovial fibroblasts in patients with rheumatoid arthritis compared to osteoarthritis. J Rheumatol 27:2558–2565PubMed Raap T, Justen HP, Miller LE, Cutolo M, Scholmerich J, Straub RH (2000) Neurotransmitter modulation of interleukin 6 (IL-6) and IL-8 secretion of synovial fibroblasts in patients with rheumatoid arthritis compared to osteoarthritis. J Rheumatol 27:2558–2565PubMed
15.
go back to reference Hernanz A, Medina S, de Miguel E, Martı́n-Mola E (2003) Effect of calcitonin gene-related peptide, neuropeptide Y, substance P, and vasoactive intestinal peptide on interleukin-1β, interleukin-6 and tumor necrosis factor-alpha production by peripheral whole blood cells from rheumatoid arthritis and osteoarthritis patients. Regul Pept 115:19–24PubMedCrossRef Hernanz A, Medina S, de Miguel E, Martı́n-Mola E (2003) Effect of calcitonin gene-related peptide, neuropeptide Y, substance P, and vasoactive intestinal peptide on interleukin-1β, interleukin-6 and tumor necrosis factor-alpha production by peripheral whole blood cells from rheumatoid arthritis and osteoarthritis patients. Regul Pept 115:19–24PubMedCrossRef
16.
go back to reference Yaraee R, Ebtekar M, Ahmadiani A, Sabahi F (2003) Neuropeptides (SP and CGRP) augment pro-inflammatory cytokine production in HSV-infected macrophages. Int Immunopharmacol 3:1883–1887PubMedCrossRef Yaraee R, Ebtekar M, Ahmadiani A, Sabahi F (2003) Neuropeptides (SP and CGRP) augment pro-inflammatory cytokine production in HSV-infected macrophages. Int Immunopharmacol 3:1883–1887PubMedCrossRef
17.
go back to reference Zhang L, Hoff AO, Wimalawansa SJ, Cote GJ, Gagel RF, Westlund KN (2001) Arthritic calcitonin/α calcitonin gene-related peptide knockout mice have reduced nociceptive hypersensitivity. Pain 89:265–273PubMedCrossRef Zhang L, Hoff AO, Wimalawansa SJ, Cote GJ, Gagel RF, Westlund KN (2001) Arthritic calcitonin/α calcitonin gene-related peptide knockout mice have reduced nociceptive hypersensitivity. Pain 89:265–273PubMedCrossRef
18.
go back to reference Bullock CM, Wookey P, Bennett A, Mobasheri A, Dickerson I, Kelly S (2014) Peripheral calcitonin gene-related peptide receptor activation and mechanical sensitization of the joint in rat models of osteoarthritis pain. Arthrit Rheumatol 66:2188–2200CrossRef Bullock CM, Wookey P, Bennett A, Mobasheri A, Dickerson I, Kelly S (2014) Peripheral calcitonin gene-related peptide receptor activation and mechanical sensitization of the joint in rat models of osteoarthritis pain. Arthrit Rheumatol 66:2188–2200CrossRef
19.
go back to reference Fernihough J, Gentry C, Bevan S, Winter J (2005) Regulation of calcitonin gene-related peptide and TRPV1 in a rat model of osteoarthritis. Neurosci Lett 388:75–80PubMedCrossRef Fernihough J, Gentry C, Bevan S, Winter J (2005) Regulation of calcitonin gene-related peptide and TRPV1 in a rat model of osteoarthritis. Neurosci Lett 388:75–80PubMedCrossRef
20.
go back to reference Kellegren J, Lawrence J (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:494–501CrossRef Kellegren J, Lawrence J (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:494–501CrossRef
21.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: 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 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: 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 15:1833–1840PubMed
22.
go back to reference Chen G, Hao J, Xi Y, Wang W, Wang Z, Li N, Li W (2008) The therapeutic effect of vasoactive intestinal peptide on experimental arthritis is associated with CD4+CD25+ T regulatory cells. Scand J Immunol 68:572–578PubMedCrossRef Chen G, Hao J, Xi Y, Wang W, Wang Z, Li N, Li W (2008) The therapeutic effect of vasoactive intestinal peptide on experimental arthritis is associated with CD4+CD25+ T regulatory cells. Scand J Immunol 68:572–578PubMedCrossRef
23.
go back to reference Požgan U, Caglič D, Rozman B, Nagase H, Turk V, Turk B (2010) Expression and activity profiling of selected cysteine cathepsins and matrix metalloproteinases in synovial fluids from patients with rheumatoid arthritis and osteoarthritis. Biol Chem 391:571–579PubMed Požgan U, Caglič D, Rozman B, Nagase H, Turk V, Turk B (2010) Expression and activity profiling of selected cysteine cathepsins and matrix metalloproteinases in synovial fluids from patients with rheumatoid arthritis and osteoarthritis. Biol Chem 391:571–579PubMed
24.
go back to reference Ayral X, Pickering E, Woodworth T, Mackillop N, Dougados M (2005) Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis—results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthritis Cartilage 13:361–367PubMedCrossRef Ayral X, Pickering E, Woodworth T, Mackillop N, Dougados M (2005) Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis—results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthritis Cartilage 13:361–367PubMedCrossRef
25.
go back to reference Sokolove J, Lepus CM (2013) Role of inflammation in the pathogenesis of osteoarthritis: latest findings and interpretations. Ther Adv Musculoskelet Dis 5:77–94PubMedCentralPubMedCrossRef Sokolove J, Lepus CM (2013) Role of inflammation in the pathogenesis of osteoarthritis: latest findings and interpretations. Ther Adv Musculoskelet Dis 5:77–94PubMedCentralPubMedCrossRef
26.
go back to reference Zhou SJ, Sun ZX, Liu J (2013) Neopterin concentrations in synovial fluid may reflect disease severity in patients with osteoarthritis. Scand J Clin Lab Invest 73:344-348 Zhou SJ, Sun ZX, Liu J (2013) Neopterin concentrations in synovial fluid may reflect disease severity in patients with osteoarthritis. Scand J Clin Lab Invest 73:344-348
27.
go back to reference Liu M, Hu C (2012) Association of MIF in serum and synovial fluid with severity of knee osteoarthritis. Clin Biochem 45:737–739PubMedCrossRef Liu M, Hu C (2012) Association of MIF in serum and synovial fluid with severity of knee osteoarthritis. Clin Biochem 45:737–739PubMedCrossRef
28.
go back to reference Scrivo R, Conigliaro P, Riccieri V, Di Franco M, Alessandri C, Spadaro A, Perricone R, Valesini G (2015) Distribution of interleukin-10 family cytokines in serum and synovial fluid of patients with inflammatory arthritis reveals different contribution to systemic and joint inflammation. Clin Exp Immunol 179:300–308PubMedCrossRef Scrivo R, Conigliaro P, Riccieri V, Di Franco M, Alessandri C, Spadaro A, Perricone R, Valesini G (2015) Distribution of interleukin-10 family cytokines in serum and synovial fluid of patients with inflammatory arthritis reveals different contribution to systemic and joint inflammation. Clin Exp Immunol 179:300–308PubMedCrossRef
29.
go back to reference Mabey T, Honsawek S, Saetan N, Poovorawan Y, Tanavalee A, Yuktanandana P (2014) Angiogenic cytokine expression profiles in plasma and synovial fluid of primary knee osteoarthritis. Int Orthop 38:1885–1892PubMedCrossRef Mabey T, Honsawek S, Saetan N, Poovorawan Y, Tanavalee A, Yuktanandana P (2014) Angiogenic cytokine expression profiles in plasma and synovial fluid of primary knee osteoarthritis. Int Orthop 38:1885–1892PubMedCrossRef
30.
go back to reference Honsawek S, Yuktanandana P, Tanavalee A, Chirathaworn C, Anomasiri W, Udomsinprasert W, Saetan N, Suantawee T, Tantavisut S (2012) Plasma and synovial fluid connective tissue growth factor levels are correlated with disease severity in patients with knee osteoarthritis. Biomarkers 17:303–308PubMedCrossRef Honsawek S, Yuktanandana P, Tanavalee A, Chirathaworn C, Anomasiri W, Udomsinprasert W, Saetan N, Suantawee T, Tantavisut S (2012) Plasma and synovial fluid connective tissue growth factor levels are correlated with disease severity in patients with knee osteoarthritis. Biomarkers 17:303–308PubMedCrossRef
31.
go back to reference Bullock CM, Kelly S (2013) Calcitonin gene-related peptide receptor antagonists: beyond migraine pain—a possible analgesic strategy for osteoarthritis? Curr Pain Headache Rep 17:375PubMedCentralPubMedCrossRef Bullock CM, Kelly S (2013) Calcitonin gene-related peptide receptor antagonists: beyond migraine pain—a possible analgesic strategy for osteoarthritis? Curr Pain Headache Rep 17:375PubMedCentralPubMedCrossRef
33.
go back to reference Dallos A, Kiss M, Polyanka H, Dobozy A, Kemeny L, Husz S (2006) Effects of the neuropeptides substance P, calcitonin gene-related peptide, vasoactive intestinal polypeptide and galanin on the production of nerve growth factor and inflammatory cytokines in cultured human keratinocytes. Neuropeptides 40:251–263PubMedCrossRef Dallos A, Kiss M, Polyanka H, Dobozy A, Kemeny L, Husz S (2006) Effects of the neuropeptides substance P, calcitonin gene-related peptide, vasoactive intestinal polypeptide and galanin on the production of nerve growth factor and inflammatory cytokines in cultured human keratinocytes. Neuropeptides 40:251–263PubMedCrossRef
34.
go back to reference Kobayashi M, Squires GR, Mousa A, Tanzer M, Zukor DJ, Antoniou J, Feige U, Poole AR (2005) Role of interleukin-1 and tumor necrosis factor α in matrix degradation of human osteoarthritic cartilage. Arthrit Rheuma 52:128–135CrossRef Kobayashi M, Squires GR, Mousa A, Tanzer M, Zukor DJ, Antoniou J, Feige U, Poole AR (2005) Role of interleukin-1 and tumor necrosis factor α in matrix degradation of human osteoarthritic cartilage. Arthrit Rheuma 52:128–135CrossRef
35.
go back to reference Inoue K, Masuko-Hongo K, Okamoto M, Nishioka K (2005) Induction of vascular endothelial growth factor and matrix metalloproteinase-3 (stromelysin) by interleukin-1 in human articular chondrocytes and synoviocytes. Rheumatol Int 26:93–98PubMedCrossRef Inoue K, Masuko-Hongo K, Okamoto M, Nishioka K (2005) Induction of vascular endothelial growth factor and matrix metalloproteinase-3 (stromelysin) by interleukin-1 in human articular chondrocytes and synoviocytes. Rheumatol Int 26:93–98PubMedCrossRef
36.
go back to reference Rowan A, Koshy P, Shingleton W, Degnan B, Heath J, Vernallis A, Spaull J, Life P, Hudson K, Cawston T (2001) Synergistic effects of glycoprotein 130 binding cytokines in combination with interleukin-1 on cartilage collagen breakdown. Arthrit Rheuma 44:1620–1632CrossRef Rowan A, Koshy P, Shingleton W, Degnan B, Heath J, Vernallis A, Spaull J, Life P, Hudson K, Cawston T (2001) Synergistic effects of glycoprotein 130 binding cytokines in combination with interleukin-1 on cartilage collagen breakdown. Arthrit Rheuma 44:1620–1632CrossRef
37.
go back to reference Saxler G, Loer F, Skumavc M, Pfortner J, Hanesch U (2007) Localization of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with painful osteoarthritis and of patients with painless failed total hip arthroplasties. Eur J Pain 11:67–74PubMedCrossRef Saxler G, Loer F, Skumavc M, Pfortner J, Hanesch U (2007) Localization of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with painful osteoarthritis and of patients with painless failed total hip arthroplasties. Eur J Pain 11:67–74PubMedCrossRef
38.
go back to reference Benschop RJ, Collins EC, Darling RJ, Allan BW, Leung D, Conner EM, Nelson J, Gaynor B, Xu J, Wang XF, Lynch RA, Li B, McCarty D, Oskins JL, Lin C, Johnson KW, Chambers MG (2014) Development of a novel antibody to calcitonin gene-related peptide for the treatment of osteoarthritis-related pain. Osteoarthritis Cartilage 22:578–585PubMedCrossRef Benschop RJ, Collins EC, Darling RJ, Allan BW, Leung D, Conner EM, Nelson J, Gaynor B, Xu J, Wang XF, Lynch RA, Li B, McCarty D, Oskins JL, Lin C, Johnson KW, Chambers MG (2014) Development of a novel antibody to calcitonin gene-related peptide for the treatment of osteoarthritis-related pain. Osteoarthritis Cartilage 22:578–585PubMedCrossRef
39.
go back to reference Bigal ME, Walter S, Rapoport AM (2013) Calcitonin gene-related peptide (CGRP) and migraine current understanding and state of development. Headache 53:1230–1244PubMedCrossRef Bigal ME, Walter S, Rapoport AM (2013) Calcitonin gene-related peptide (CGRP) and migraine current understanding and state of development. Headache 53:1230–1244PubMedCrossRef
Metadata
Title
Calcitonin gene-related peptide can be selected as a predictive biomarker on progression and prognosis of knee osteoarthritis
Publication date
01-06-2015
Published in
International Orthopaedics / Issue 6/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2744-4

Other articles of this Issue 6/2015

International Orthopaedics 6/2015 Go to the issue