Objective

Multiple biochemical biomarkers have been previously investigated for the diagnosis, prognosis and response to treatment of articular cartilage damage, including osteoarthritis (OA). Synovial fluid (SF) biomarker measurement is a potential method to predict treatment response and effectiveness. However, the significance of different biomarkers and their correlation to clinical outcomes remains unclear. This systematic review evaluated current SF biomarkers used in investigation of cartilage degeneration or regeneration in the knee joint and correlated these biomarkers with clinical outcomes following cartilage repair or regeneration interventions.

Method

PubMed, Institute of Science Index, Scopus, Cochrane Central Register of Controlled Trials, and Embase databases were searched. Studies evaluating SF biomarkers and clinical outcomes following cartilage repair intervention were included. Two researchers independently performed data extraction and Quality Assessment of Diagnostic Accuracy Score 2 (QUADAS-2) analysis. Biomarker inclusion, change following intervention and correlation with clinical outcome was compared.

Results

9 studies were included. Study heterogeneity precluded meta-analysis. There was significant variation in sampling and analysis. 33 biomarkers were evaluated in addition to microRNA and catabolic/anabolic ratios. Five studies reported on correlation of biomarkers with six biomarkers significantly correlated with clinical outcomes following intervention. However, correlation was only demonstrated in isolated studies.

Conclusion

This review demonstrates significant difficulties in drawing conclusions regarding the importance of SF biomarkers based on the available literature. Improved standardisation for collection and analysis of SF samples is required. Future publications should also focus on clinical outcome scores and seek to correlate biomarkers with progression to further understand the significance of identified markers in a clinical context.

Registration number

PROSPERO CRD42022304298. Study protocol available on PROSPERO website.

中文翻译：

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关于滑液生物标志物预测软骨修复治疗临床结果的潜在价值的系统评价

客观的

先前已经研究了多种生化生物标志物用于关节软骨损伤（包括骨关节炎（OA））的诊断、预后和对治疗的反应。滑液 (SF) 生物标志物测量是预测治疗反应和有效性的潜在方法。然而，不同生物标志物的意义及其与临床结果的相关性仍不清楚。该系统评价评估了当前用于膝关节软骨退化或再生研究的 SF 生物标志物，并将这些生物标志物与软骨修复或再生干预后的临床结果相关联。

方法

检索了 PubMed、Institute of Science Index、Scopus、Cochrane Central Register of Controlled Trials 和 Embase 数据库。纳入评估软骨修复干预后 SF 生物标志物和临床结果的研究。两名研究人员独立进行了诊断准确性评分 2 (QUADAS-2) 分析的数据提取和质量评估。比较了生物标志物的纳入、干预后的变化以及与临床结果的相关性。

结果

纳入了 9 项研究。研究异质性排除了荟萃分析。抽样和分析存在显着差异。除了 microRNA 和分解代谢/合成代谢比率外，还评估了 33 个生物标志物。五项研究报告了生物标志物与六种生物标志物的相关性与干预后的临床结果显着相关。然而，相关性仅在孤立的研究中得到证实。

结论

这篇综述表明，根据现有文献得出关于 SF 生物标志物重要性的结论存在很大困难。需要改进 SF 样品收集和分析的标准化。未来的出版物还应关注临床结果评分，并寻求将生物标志物与进展相关联，以进一步了解已识别标志物在临床环境中的重要性。

注册号码

PROSPERO CRD42022304298。PROSPERO 网站上提供研究方案。