Objective

Biomarkers in osteoarthritis (OA) could serve as objective clinical indicators for various disease parameters, and act as surrogate endpoints in clinical trials for disease-modifying drugs. The aim of this systematic review was to produce a comprehensive list of candidate molecular biomarkers for knee OA after the 2013 ESCEO review and discern whether any have been studied in sufficient detail for use in clinical settings.

Design

MEDLINE and Embase databases were searched between August 2013 and May 2018 using the keywords “knee osteoarthritis,” “osteoarthritis,” and “biomarker.” Studies were screened by title, abstract, and full text. Human studies on knee OA that were published in the English language were included. Excluded were studies on genetic/imaging/cellular markers, studies on participants with secondary OA, and publications that were review/abstract-only. Study quality and bias were assessed. Statistically significant data regarding the relationship between a biomarker and a disease parameter were extracted.

Results

A total of 80 studies were included in the final review and 89 statistically significant individual molecular biomarkers were identified. C-telopeptide of type II collagen (CTXII) was shown to predict progression of knee OA in urine and serum in multiple studies. Synovial fluid vascular endothelial growth factor concentration was reported by 2 studies to be predictive of knee OA progression.

Conclusion

Despite the clear need for biomarkers of OA, the lack of coordination in current research has led to incompatible results. As such, there is yet to be a suitable biomarker to be used in a clinical setting.

中文翻译：

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用于人类膝关节骨性关节炎的临床相关分子生物标志物：系统评价。

客观的

骨关节炎 (OA) 中的生物标志物可以作为各种疾病参数的客观临床指标，并作为疾病缓解药物临床试验的替代终点。本系统评价的目的是在 2013 年 ESCEO 审查之后产生一份膝关节 OA 候选分子生物标志物的综合列表，并确定是否已经对任何用于临床环境的足够详细的研究进行了研究。

设计

在 2013 年 8 月至 2018 年 5 月期间，使用关键词“膝关节骨关节炎”、“骨关节炎”和“生物标志物”搜索了 MEDLINE 和 Embase 数据库。研究按标题、摘要和全文筛选。包括以英语发表的关于膝关节 OA 的人体研究。不包括关于遗传/影像/细胞标记的研究、对继发性 OA 参与者的研究以及仅审查/摘要的出版物。评估了研究质量和偏倚。提取了关于生物标志物和疾病参数之间关系的统计显着数据。

结果

最终审查共纳入 80 项研究，并确定了 89 个具有统计学意义的个体分子生物标志物。多项研究显示，II 型胶原蛋白的 C 端肽 (CTXII) 可预测尿液和血清中膝关节 OA 的进展。2 项研究报告滑液血管内皮生长因子浓度可预测膝关节 OA 进展。

结论

尽管显然需要 OA 的生物标志物，但当前研究中缺乏协调导致了不相容的结果。因此，还没有合适的生物标志物用于临床环境。