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Bone Turnover Markers and Glucocorticoid Treatments

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Biomarkers in Bone Disease

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Abstract

Glucocorticoids (GCs) remain as the cornerstone of therapy in most inflammatory diseases, even if newly developed biological molecules became available. GCs are potent, possess a fast action, and are cheap and relatively easy to prescribe. However, their beneficial therapeutic activity has a nasty counterpart: quite a lot of complications, notably secondary osteoporosis, aseptic bone osteonecrosis, and fractures. The skeleton is continuously remodeling, old bone being resorbed and replaced by new young bone. GCs interfere with the bone turnover and provoke a disequilibrium in favor of bone loss and fragility. The mechanisms of bone fragility consist of a decreased activity and in apoptosis of osteoblasts, as well as an increase in bone resorption. These changes have already been observed histomorphometrically a long time ago in transiliac bone biopsies. Biological parameters of bone turnover, chiefly degradation products of type I collagen, can help to assess atraumatically the bone metabolism. If, in idiopathic osteoporosis, they can have a predictive value of bone loss, they cannot be considered as surrogates for bone mineral density measurements. In GC-OP, the concentrations of the bone turnover markers (BTMs) of bone formation dramatically and rapidly decrease, whereas the BTMs of bone resorption slightly increase. During GC therapy, they cannot be used as predictive tools of bone fragility on an individual basis. Other markers such as RANKL/RANK/osteoprotegerin seem to be promising in this aim, but this still awaits confirmation.

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Abbreviations

ALN:

Alendronate

BDP:

Beclomethasone dipropionate

BMD:

Bone mineral density

BSAP:

Bone-specific alkaline phosphatase

BTMs:

Bone turnover markers

BUD:

Budenoside

CD:

Crohn’s disease

COMP:

Cartilage oligomeric matrix protein

COPD:

Chronic obstructive pulmonary disease

CTX:

Carboxy-terminal cross-linking telopeptide of type I collagen

DAS:

Disease activity score

Dkk-1:

Dickkopf-1

FN:

Femoral neck

GC:

Glucocorticoid

ICTP:

Carboxy-terminal telopeptide of type I collagen

Il-6:

Interleukin-6

JIA:

Juvenile idiopathic arthritis

MMP:

Metalloproteinase

MP:

Methylprednisolone

NTX:

Amino-terminal cross-linking telopeptide of type I collagen

OBS:

Osteoblasts

OC:

Osteocalcin

OCS:

Osteoclasts

OP:

Osteoporosis

OPG:

Osteoprotegerin

PICP:

Procollagen type I C-terminal propeptide

PINP:

Procollagen type I N-terminal propeptide

PTH:

Parathyroid hormone

RA:

Rheumatoid arthritis

RANK:

Receptor activator of nuclear factor NF-kB

RANK-L:

Receptor activator of nuclear factor NF-kB-ligand

rh:

Recombinant human

RIS:

Risedronate

Scl:

Sclerostin

SLE:

Systemic lupus erythematosus

TPTD:

Teriparatide

TRAP:

Tartrate-resistant acid phosphatase

UC:

Ulcerative colitis

uDPD:

Urinary deoxypyridinoline

uPYD:

Urinary pyridinoline

VF:

Vertebral fracture

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Authors and Affiliations

  1. Pôle de Pathologie Rhumatismale, Universite Catholique de Louvain, avenue Hippocrate 10, 1200, Brussels, Belgium

    Jean-Pierre Devogelaer, Anne Durnez & Daniel H. Manicourt

  2. Pôle de Recherche en Endocrinologie, Diabète et Nutrition et Département des Laboratoires Cliniques, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, avenue Hippocrate 10, 1200, Bruxelles, Belgium

    Damien Gruson

  3. AZ Jan Portaels, Gendarmeriestraat 65, 1800, Vilvoorde, Belgium

    Anne Durnez

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  1. Jean-Pierre Devogelaer
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  2. Anne Durnez
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  3. Damien Gruson
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  4. Daniel H. Manicourt
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Correspondence to Jean-Pierre Devogelaer , Anne Durnez , Damien Gruson or Daniel H. Manicourt .

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  1. Sciences Division, King's College, London, United Kingdom

    Victor R. Preedy

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Devogelaer, JP., Durnez, A., Gruson, D., Manicourt, D.H. (2015). Bone Turnover Markers and Glucocorticoid Treatments. In: Preedy, V. (eds) Biomarkers in Bone Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7745-3_23-1

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