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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 5/2014

Open Access 01-10-2014 | Research article

Serum sclerostin in high-activity adult patients with juvenile idiopathic arthritis

Authors: Kristyna Brabnikova-Maresova, Katerina Jarosova, Karel Pavelka, Jan J Stepan

Published in: Arthritis Research & Therapy | Issue 5/2014

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Abstract

Introduction

Juvenile idiopathic arthritis (JIA) is a disease associated with loss of bone mass, deterioration in bone mass quality and an increased risk of fractures. The objective of this study was to evaluate factors that predict bone mineral density (BMD) alterations in young adult patients with active JIA before and during therapy with tumour necrosis factor α (TNFα) inhibitors.

Methods

Thirty-one patients (twelve males and nineteen females; mean age =25.1 ± 6.1 years) with active JIA (mean Disease Activity Score in 28 joints (DAS28) =6.36 ± 0.64; mean high-sensitivity C-reactive protein (hsCRP) =18.36 ± 16.95 mg/L) were investigated. The control group consisted of 84 healthy individuals matched by sex and age. BMD, bone turnover markers and serum concentrations of soluble receptor activator of nuclear factor κB ligand, osteoprotegerin, dickkopf Wnt signalling pathway inhibitor 1 (Dkk1) and sclerostin were evaluated.

Results

Baseline BMD values in the lumbar spine, proximal femur, femoral neck and distal radius were significantly lower in patients with JIA compared to healthy control participants. Baseline sclerostin serum concentrations were significantly higher in patients with JIA compared to control participants. After 2 years of treatment with TNFα inhibitors, BMD was significantly increased in the lumbar spine. This increase correlated with a drop in DAS28 score. A statistically significant correlation between hsCRP and Dkk1 was found at baseline, as well as during the 2-year follow-up period. A significant reduction in serum sclerostin after 1 year of therapy was predictive of a drop in DAS28 score observed with a 1-year delay after reduction of serum sclerostin.

Conclusion

A significant correlation between the sclerostin serum concentration and the number of tender and swollen joints, but not BMD, supports the hypothesis that chondrocytes and cells of the subchondral bone may contribute to circulating sclerostin in JIA.
Appendix
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Literature
1.
Pepmueller PH, Cassidy JT, Allen SH, Hillman LS: Bone mineralization and bone mineral metabolism in children with juvenile rheumatoid arthritis. Arthritis Rheum. 1996, 39: 746-757. 10.1002/art.1780390506.CrossRefPubMed
2.
Lien G, Flatø B, Haugen M, Vinje O, Sørskaar D, Dale K, Johnston V, Egeland T, Førre Ø: Frequency of osteopenia in adolescents with early-onset juvenile idiopathic arthritis: a long-term outcome study of one hundred five patients. Arthritis Rheum. 2003, 48: 2214-2223. 10.1002/art.11097.CrossRefPubMed
3.
Felin EM, Prahalad S, Askew EW, Moyer-Mileur LJ: Musculoskeletal abnormalities of the tibia in juvenile rheumatoid arthritis. Arthritis Rheum. 2007, 56: 984-994. 10.1002/art.22420.CrossRefPubMed
4.
Brabnikova Maresova K, Jarosova K, Pavelka K, Stepan JJ: The association between lean mass and bone mineral content in the high disease activity group of adult patients with juvenile idiopathic arthritis. BMC Musculoskelet Disord. 2014, 15: 51-10.1186/1471-2474-15-51.CrossRefPubMedCentralPubMed
5.
Burnham JM, Shults J, Weinstein R, Lewis JD, Leonard MB: Childhood onset arthritis is associated with an increased risk of fracture: a population based study using the General Practice Research Database. Ann Rheum Dis. 2006, 65: 1074-1079. 10.1136/ard.2005.048835.CrossRefPubMedCentralPubMed
6.
Brabnikova Maresova K: Secondary osteoporosis in patients with juvenile idiopathic arthritis. J Osteoporos. 2011, 2011: 569417-10.4061/2011/569417. doi:10.4061/2011/569417CrossRefPubMedCentralPubMed
7.
Glass DA, Bialek P, Ahn JD, Starbuck M, Patel MS, Clevers H, Taketo MM, Long F, McMahon AP, Lang RA, Karsenty G: Canonical Wnt signaling in differentiated osteoblasts controls osteoclast differentiation. Dev Cell. 2005, 8: 751-764. 10.1016/j.devcel.2005.02.017.CrossRefPubMed
8.
Diarra D, Stolina M, Polzer K, Zwerina J, Ominsky MS, Dwyer D, Korb A, Smolen J, Hoffmann M, Scheinecker C, van der Heide D, Landewe R, Lacey D, Richards WG, Schett G: Dickkopf-1 is a master regulator of joint remodeling. Nat Med. 2007, 13: 156-163. 10.1038/nm1538.CrossRefPubMed
9.
Li Y, Li A, Strait K, Zhang H, Nanes MS, Weitzmann MN: Endogenous TNFα lowers maximum peak bone mass and inhibits osteoblastic Smad activation through NF-κB. J Bone Miner Res. 2007, 22: 646-655. 10.1359/jbmr.070121.CrossRefPubMed
10.
Bodine PV, Komm BS: Wnt signaling and osteoblastogenesis. Rev Endocr Metab Disord. 2006, 7: 33-39. 10.1007/s11154-006-9002-4.CrossRefPubMed
11.
12.
Goldring SR: Pathogenesis of bone and cartilage destruction in rheumatoid arthritis. Rheumatology. 2003, 42: ii11-ii16. 10.1093/rheumatology/keg327.CrossRefPubMed
13.
Hofbauer LC, Khosla S, Dunstan CR, Lacey DL, Boyle WJ, Riggs BL: The roles of osteoprotegerin and osteoprotegerin ligand in the paracrine regulation of bone resorption. J Bone Miner Res. 2000, 15: 2-12. 10.1359/jbmr.2000.15.1.2.CrossRefPubMed
14.
Pereira RM, Falco V, Corrente JE, Chahade WH, Yoshinari NH: Abnormalities in the biochemical markers of bone turnover in children with juvenile chronic arthritis. Clin Exp Rheumatol. 1999, 17: 251-255.PubMed
15.
Lien G, Selvaag AM, Flatø B, Haugen M, Vinje O, Sørskaar D, Dale K, Egeland T, Førre Ø: A two-year prospective controlled study of bone mass and bone turnover in children with early juvenile idiopathic arthritis. Arthritis Rheum. 2005, 52: 833-840. 10.1002/art.20963.CrossRefPubMed
16.
Appel H, Ruiz-Heiland G, Listing J, Zwerina J, Herrmann M, Mueller R, Haibel H, Baraliakos X, Hempfing A, Rudwaleit M, Sieper J, Schett G: Altered skeletal expression of sclerostin and its link to radiographic progression in ankylosing spondylitis. Arthritis Rheum. 2009, 60: 3257-3262. 10.1002/art.24888.CrossRefPubMed
17.
Terpos E, Fragiadaki K, Konsta M, Bratengeier C, Papatheodorou A, Sfikakis PP: Early effects of IL-6 receptor inhibition on bone homeostasis: a pilot study in women with rheumatoid arthritis. Clin Exp Rheumatol. 2011, 29: 921-925.PubMed
18.
Garnero P, Tabassi NC, Voorzanger-Rousselot N: Circulating Dickkopf-1 and radiological progression in patients with early rheumatoid arthritis treated with etanercept. J Rheumatol. 2008, 35: 2313-2315. 10.3899/jrheum.080356.CrossRefPubMed
19.
Liu YY, Long L, Wang SY, Guo JP, Ye H, Cui LF, Yuan GH, Li ZG: Circulating Dickkopf-1 and osteoprotegerin in patients with early and longstanding rheumatoid arthritis. Chin Med J (Engl). 2010, 123: 1407-1412.
20.
Wang SY, Liu YY, Ye H, Guo JP, Li R, Liu X, Li ZG: Circulating Dickkopf-1 is correlated with bone erosion and inflammation in rheumatoid arthritis. J Rheumatol. 2011, 38: 821-827. 10.3899/jrheum.100089.CrossRefPubMed
21.
Lamb R, Thomson W, Ogilvie E, Donn R: Wnt-1–inducible signaling pathway protein 3 and susceptibility to juvenile idiopathic arthritis. Arthritis Rheum. 2005, 52: 3548-3553. 10.1002/art.21392.CrossRefPubMed
22.
Pavelka K, Vencovský J: Recommendations of the Czech Society for Rheumatology for the treatment of rheumatoid arthritis. Czech Rheumatol. 2010, 18: 182-191.
23.
Zak M, Hassager C, Lovell DJ, Nielsen S, Henderson CJ, Pedersen FK: Assessment of bone mineral density in adults with a history of juvenile chronic arthritis: a cross-sectional long-term followup study. Arthritis Rheum. 1999, 42: 790-798. 10.1002/1529-0131(199904)42:4<790::AID-ANR24>3.0.CO;2-G.CrossRefPubMed
24.
Brik R, Keidar Z, Schapira D, Israel O: Bone mineral density and turnover in children with systemic juvenile chronic arthritis. J Rheumatol. 1998, 25: 990-992.PubMed
25.
Pye SR, Adams JE, Ward KA, Bunn DK, Symmons DP, O’Neill TW: Disease activity and severity in early inflammatory arthritis predict hand cortical bone loss. Rheumatology. 2010, 49: 1943-1948. 10.1093/rheumatology/keq181.CrossRefPubMedCentralPubMed
26.
Hoff M, Bøyesen P, Haugeberg G, Vis M, Woolf AD, Havaardsholm EA, Dijkmans BA, Kvien TK, Uhlig T, Lems WF: High disease activity is a predictor of cortical hand bone loss in post-menopausal patients with established rheumatoid arthritis: a 5-year multicentre longitudinal study. Rheumatology. 2010, 49: 1676-1682. 10.1093/rheumatology/keq125.CrossRefPubMed
27.
Tanida A, Kishimoto Y, Okano T, Hagino H: Etanercept promotes bone formation via suppression of Dickkopf-1 expression in rats with collagen-induced arthritis. Yonago Acta Med. 2013, 56: 13-19.PubMedCentralPubMed
28.
Kuipers AL, Zhang Y, Yu S, Kammerer CM, Nestlerode CS, Chu Y, Bunker CH, Patrick AL, Wheeler VW, Miljkovic I, Zmuda JM: Relative influence of heritability, environment and genetics on serum sclerostin. Osteoporos Int. 2014, 25: 905-912. 10.1007/s00198-013-2517-0.CrossRefPubMedCentralPubMed
29.
Mödder UI, Hoey KA, Amin S, McCready LK, Achenbach SJ, Riggs BL, Melton LJ, Khosla S: Relation of age, gender, and bone mass to circulating sclerostin levels in women and men. J Bone Miner Res. 2011, 26: 373-379. 10.1002/jbmr.217.CrossRefPubMedCentralPubMed
30.
Amrein K, Amrein S, Drexler C, Dimai HP, Dobnig H, Pfeifer K, Tomaschitz A, Pieber TR, Fahrleitner-Pammer A: Sclerostin and its association with physical activity, age, gender, body composition, and bone mineral content in healthy adults. J Clin Endocrinol Metab. 2012, 97: 148-154. 10.1210/jc.2011-2152.CrossRefPubMed
31.
Chen XX, Baum W, Dwyer D, Stock M, Schwabe K, Ke HZ, Stolina M, Schett G, Bozec A: Sclerostin inhibition reverses systemic, periarticular and local bone loss in arthritis. Ann Rheum Dis. 2013, 72: 1732-1736. 10.1136/annrheumdis-2013-203345.CrossRefPubMedCentralPubMed
32.
Marenzana M, Vugler A, Moore A, Robinson M: Effect of sclerostin-neutralising antibody on periarticular and systemic bone in a murine model of rheumatoid arthritis: a microCT study. Arthritis Res Ther. 2013, 15: R125-10.1186/ar4305.CrossRefPubMedCentralPubMed
33.
Durosier C, van Lierop A, Ferrari S, Chevalley T, Papapoulos S, Rizzoli R: Association of circulating sclerostin with bone mineral mass, microstructure, and turnover biochemical markers in healthy elderly men and women. J Clin Endocrinol Metab. 2013, 98: 3873-3883. 10.1210/jc.2013-2113.CrossRefPubMed
34.
Garnero P, Sornay-Rendu E, Munoz F, Borel O, Chapurlat RD: Association of serum sclerostin with bone mineral density, bone turnover, steroid and parathyroid hormones, and fracture risk in postmenopausal women: the OFELY study. Osteoporos Int. 2013, 24: 489-494. 10.1007/s00198-012-1978-x.CrossRefPubMed
35.
Polyzos SA, Anastasilakis AD, Bratengeier C, Woloszczuk W, Papatheodorou A, Terpos E: Serum sclerostin levels positively correlate with lumbar spinal bone mineral density in postmenopausal women—the six-month effect of risedronate and teriparatide. Osteoporos Int. 2012, 23: 1171-1176. 10.1007/s00198-010-1525-6.CrossRefPubMed
36.
Arasu A, Cawthon PM, Lui LY, Do TP, Arora PS, Cauley JA, Ensrud KE, Cummings SR: Serum sclerostin and risk of hip fracture in older Caucasian women. J Clin Endocrinol Metab. 2012, 97: 2027-2032. 10.1210/jc.2011-3419.CrossRefPubMedCentralPubMed
37.
Ardawi MS, Rouzi AA, Al-Sibiani SA, Al-Senani NS, Qari MH, Mousa SA: High serum sclerostin predicts the occurrence of osteoporotic fractures in postmenopausal women: the Center of Excellence for Osteoporosis Research Study. J Bone Miner Res. 2012, 27: 2592-2602. 10.1002/jbmr.1718.CrossRefPubMed
38.
Moester MJC, Papapoulos SE, Löwik CWGM, van Bezooijen RL: Sclerostin: current knowledge and future perspectives. Calcif Tissue Int. 2010, 87: 99-107. 10.1007/s00223-010-9372-1.CrossRefPubMedCentralPubMed
39.
Robling AG, Niziolek PJ, Baldridge LA, Condon KW, Allen MR, Alam I, Mantila SM, Gluhak-Heinrich J, Bellido TM, Harris SE, Turner CH: Mechanical stimulation of bone in vivo reduces osteocyte expression of Sost/sclerostin. J Biol Chem. 2008, 283: 5866-5875. 10.1074/jbc.M705092200.CrossRefPubMed
40.
Winkler DG, Sutherland MK, Geoghegan JC, Yu C, Hayes T, Skonier JE, Shpektor D, Jonas M, Kovacevich BR, Staehling-Hampton K, Appleby M, Brunkow ME, Latham JA: Osteocyte control of bone formation via sclerostin, a novel BMP antagonist. EMBO J. 2003, 22: 6267-6276. 10.1093/emboj/cdg599.CrossRefPubMedCentralPubMed
41.
Chan BY, Fuller ES, Russell AK, Smith SM, Smith MM, Jackson MT, Cake MA, Read RA, Bateman JF, Sambrook PN, Little CB: Increased chondrocyte sclerostin may protect against cartilage degradation in osteoarthritis. Osteoarthritis Cartilage. 2011, 19: 874-885. 10.1016/j.joca.2011.04.014.CrossRefPubMed
42.
Brunkow ME, Gardner JC, Van Ness J, Paeper BW, Kovacevich BR, Proll S, Skonier JE, Zhao L, Sabo PJ, Fu Y, Alisch RS, Gillett L, Colbert T, Tacconi P, Galas D, Hamersma H, Beighton P, Mulligan J: Bone dysplasia sclerosteosis results from loss of the SOST gene product, a novel cystine knot–containing protein. Am J Hum Genet. 2001, 68: 577-589. 10.1086/318811.CrossRefPubMedCentralPubMed
43.
Rhee Y, Kim WJ, Han KJ, Lim SK, Kim SH: Effect of liver dysfunction on circulating sclerostin. J Bone Miner Metab. 2014, 32: 545-549. 10.1007/s00774-013-0524-z.CrossRefPubMed
44.
Li X, Zhang Y, Kang H, Liu W, Liu P, Zhang J, Harris SE, Wu D: Sclerostin binds to LRP5/6 and antagonizes canonical Wnt signaling. J Biol Chem. 2005, 280: 19883-19887. 10.1074/jbc.M413274200.CrossRefPubMed
45.
Veverka V, Henry AJ, Slocombe PM, Ventom A, Mulloy B, Muskett FW, Muzylak M, Greenslade K, Moore A, Zhang L, Gong J, Qian X, Paszty C, Taylor RJ, Robinson MK, Carr MD: Characterization of the structural features and interactions of sclerostin: molecular insight into a key regulator of Wnt-mediated bone formation. J Biol Chem. 2009, 284: 10890-10900. 10.1074/jbc.M807994200.CrossRefPubMedCentralPubMed
46.
Monroe DG, McGee-Lawrence ME, Oursler MJ, Westendorf JJ: Update on Wnt signaling in bone cell biology and bone disease. Gene. 2012, 492: 1-18. 10.1016/j.gene.2011.10.044.CrossRefPubMedCentralPubMed
47.
Ziolkowska M, Kurowska M, Radzikowska A, Luszczykiewicz G, Wiland P, Dziewczopolski W, Filipowicz-Sosnowska A, Pazdur J, Szechinski J, Kowalczewski J, Rell-Bakalarska M, Maslinski W: High levels of osteoprotegerin and soluble receptor activator of nuclear factor κB ligand in serum of rheumatoid arthritis patients and their normalization after anti–tumor necrosis factor α treatment. Arthritis Rheum. 2002, 46: 1744-1753. 10.1002/art.10388.CrossRefPubMed
48.
Hein GE, Meister M, Oelzner P, Franke S: sRANKL and OPG in serum and synovial fluid of patients with rheumatoid arthritis in comparison to non-destructive chronic arthritis. Rheumatol Int. 2008, 28: 765-769. 10.1007/s00296-007-0514-3.CrossRefPubMed
49.
Xu S, Wang Y, Lu J, Xu J: Osteoprotegerin and RANKL in the pathogenesis of rheumatoid arthritis-induced osteoporosis. Rheumatol Int. 2011, 32: 3397-3403. 10.1007/s00296-011-2175-5.CrossRefPubMed
50.
Skoumal M, Haberhauer G, Kolarz G, Hawa G, Woloszczuk W, Klingler A, Varga F, Klaushofer K: The imbalance between osteoprotegerin and cathepsin K in the serum of patients with longstanding rheumatoid arthritis. Rheumatol Int. 2008, 28: 637-641. 10.1007/s00296-007-0506-3.CrossRefPubMed
51.
Masi L, Simonini G, Piscitelli E, Del Monte F, Giani T, Cimaz R, Vierucci S, Brandi ML, Falcini F: Osteoprotegerin (OPG)/RANK-L system in juvenile idiopathic arthritis: Is there a potential modulating role for OPG/RANK-L in bone injury?. J Rheumatol. 2004, 31: 986-991.PubMed
52.
Sarma PK, Misra R, Aggarwal A: Elevated serum receptor activator of NFκB ligand (RANKL), osteoprotegerin (OPG), matrix metalloproteinase (MMP)3, and ProMMP1 in patients with juvenile idiopathic arthritis. Clin Rheumatol. 2008, 27: 289-294. 10.1007/s10067-007-0701-3.CrossRefPubMed
53.
Spelling P, Bonfá E, Caparbo VF, Pereira RM: Osteoprotegerin/RANKL system imbalance in active polyarticular-onset juvenile idiopathic arthritis: a bone damage biomarker?. Scand J Rheumatol. 2008, 37: 439-444. 10.1080/03009740802116224.CrossRefPubMed
54.
Agarwal S, Misra R, Aggarwal A: Synovial fluid RANKL and matrix metalloproteinase levels in enthesitis related arthritis subtype of juvenile idiopathic arthritis. Rheumatol Int. 2009, 29: 907-911. 10.1007/s00296-008-0805-3.CrossRefPubMed
55.
Sennels H, Sørensen S, Ostergaard M, Knudsen L, Hansen M, Skjødt H, Peters N, Colic A, Grau K, Jacobsen S: Circulating levels of osteopontin, osteoprotegerin, total soluble receptor activator of nuclear factor-κB ligand, and high-sensitivity C-reactive protein in patients with active rheumatoid arthritis randomized to etanercept alone or in combination with methotrexate. Scand J Rheumatol. 2008, 37: 241-247. 10.1080/03009740801910320.CrossRefPubMed
56.
Vis M, Havaardsholm EA, Haugeberg G, Uhlig T, Voskuyl AE, van de Stadt RJ, Dijkmans BA, Woolf AD, Kvien TK, Lems WF: Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NFκB ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis. Ann Rheum Dis. 2006, 65: 1495-1499. 10.1136/ard.2005.044198.CrossRefPubMedCentralPubMed
Metadata
Title
Serum sclerostin in high-activity adult patients with juvenile idiopathic arthritis
Authors
Kristyna Brabnikova-Maresova
Katerina Jarosova
Karel Pavelka
Jan J Stepan
Publication date
01-10-2014
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 5/2014
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-014-0460-x

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