Skip to main content
SpringerLink
Log in

Laboratory investigations in osteoarthritis

  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Progress in the knowledge of pathogenic mechanisms and a better definition of the disease, together with the availability of new technologies, have recently improved the value of laboratory investigations in osteoarthritis (OA). The main objectives of these findings are early diagnosis, assessment of disease activity and severity, and evaluation of therapeutic effects. In this context, biochemical markers are potentially useful, as they are non-invasive and non-expansive. However, among the numerous substances increasingly proposed for these purposes, very few may be considered as true disease markers in OA; COMP, antigenic keratan sulphate, hyaluronic acid, YKL-40, type III collagen N-propeptide and urinary glucosyl-galactosyl pyridinoline seem to be the most promising. However, serum or urinary determinations of these molecules are difficult to interpret adequately, due to their complex metabolism. Careful analysis of synovial fluid, mainly directed to leukocyte count and crystal detection, is still essential for diagnosis, but also for the evaluation of the levels of important markers of local inflammation, such as metalloproteinases and cytokines, which seem to be crucial in the pathogenesis of OA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lequesne M, Punzi L. Experimental and clinical aspects of osteoarthritis. Conclusions and perspectives. In Reginster J-Y, Henrotin Y, Martel-Pelletier J, Pelletier J-P, Eds. Experimental and clinical aspects of osteoarthritis. Heidelberg: Springer-Verlag. 1999: 480–509.

    Chapter  Google Scholar 

  2. Lohmander LS. The role of molecular markers in monitor breakdown and repair. In Reginster J-Y, Henrotin Y, Martel-Pelletier J, Pelletier J-P, Eds. Experimental and clinical aspects of osteoarthritis. Heidelberg: Springer-Verlag, 1999: 296–311.

    Chapter  Google Scholar 

  3. Altman RD, Lozada CJ. Laboratory findings in osteoarthritis. In Moskowitz RW, Howell DS. Altman RD. Buckwalter JA. Goldberg VM. Eds. Osteoarthritis. 3rd ed. Philadelphia: Saunders. 2001: 273–91.

    Google Scholar 

  4. Ryan LM, Cheung HS. The role of crystals in osteoarthritis. Rheum Dis Clin North Am 1999; 25: 257–67.

    Article  PubMed  CAS  Google Scholar 

  5. Derfus B, Stainberg M, Mandel N, Buday M, Daft L, Ryan L. Characterization of an additional articular cartilage vesicle fraction that generates calcium pyrophosphate dihydrate crystals in vitro. J Rheumatol 1995; 22: 1514–9.

    PubMed  CAS  Google Scholar 

  6. Derfus BA, Kurian JB, Butler JJ, Daft LJ, Carrera GF, Ryan LM. The high prevalence of pathologic calcium crystals in pre-operative knees. J Rheumatol 2002; 29: 570–4.

    PubMed  Google Scholar 

  7. Punzi L, Oliviero F, Ramonda R. Transforming growth factor-beta levels in synovial fluid of osteoarthritis with or without calcium pyrophosphate dihydrate crystals. J Rheumatol 2003; 30: 420–1.

    PubMed  Google Scholar 

  8. Felson DT. The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum 1990; 20: 42–50.

    Article  PubMed  CAS  Google Scholar 

  9. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis of the knee. Arthritis Rheum 1986; 29: 1039–49.

    Article  PubMed  CAS  Google Scholar 

  10. Punzi L, Bertazzolo N, Pianon M, Michelotto M, Cesaro G, Gambari PF. The volume of synovial fluid effusion in psoriatic arthritis. Clin Exp Rheumatol 1995; 13: 535–6.

    PubMed  CAS  Google Scholar 

  11. Altman R, Alarcon G, Appelrough D, et al. The American College of Rheumatology Criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991; 34: 505–14.

    Article  PubMed  CAS  Google Scholar 

  12. Belhorn LR, Hess EV. Erosive osteoarthritis. Semin Arthritis Rheum 1993; 22: 298–306.

    Article  PubMed  CAS  Google Scholar 

  13. Symmons DPM. The disease assessment indices: activity, damage and severity. Baillière’s Clin Rheumatol 1995; 9: 267–85.

    Article  CAS  Google Scholar 

  14. Thonar EJ, Manicourt DH. Noninvasive markers in osteoarthritis. In Moskowitz RW, Howell DS, Altman RD, Buckwalter JA, Goldberg VM. Eds. Osteoarthritis. 3rd ed. Philadelphia: Saunders. 2001; 293–313.

    Google Scholar 

  15. Pelletier JP, Martel-Pelletier J, Abramson SB. Osteoarthritis, an inflammatory disease. Potential implication for the selection of new therapeutic targets. Arthritis Rheum 2001; 6: 1237–47.

    Article  Google Scholar 

  16. Spector TD, Hart DJ, Nandra D, et al. Low-level increases in serum C-reactive protein are present in early osteoarthritis of the knee and predict progressive disease. Arthritis Rheum 1997; 40: 723–7.

    Article  PubMed  CAS  Google Scholar 

  17. Punzi L, Bertazzolo N, Pianon M, Michelotto M, Todesco S. Soluble interleukin-2 receptors and the treatment with hydroxychloroquine in erosive osteoarthritis. J Rheumatol 1996; 23: 1477–8.

    PubMed  CAS  Google Scholar 

  18. Vignon E, Balblanc JC, Mathieu P, Louisot P, Richard M. Metalloprotease activity, phospholipase A2 activity and cytokine concentration in osteoarthritis synovial fluids. Osteoarthritis Cartilage 1993; 1: 115–20.

    Article  PubMed  CAS  Google Scholar 

  19. Bertazzolo N, Punzi L, Stefani MP, et al. Interrelationships between interleukin (IL)-1, IL-6 and IL-8 in synovial fluid of various arthropathies. Agents Actions 1994; 41: 90–2.

    Article  PubMed  CAS  Google Scholar 

  20. Ribbens C, Andre B, Kaye O, et al. Synovial fluid matrix metalloproteinase-3 levels are increased in inflammatory arthritides whether erosive or not. Rheumatology (Oxford) 2000; 39: 1357–65.

    Article  CAS  Google Scholar 

  21. Punzi L, Calò L, Plebani M. Clinical significance of cytokine determination in synovial fluid. Crit Rev Clin Lab Sci 2002; 39: 63–88.

    Article  PubMed  CAS  Google Scholar 

  22. Hauselmann HJ, Rechtenmacher J, Michal L, et al. The superficial layer of human cartilage is more susceptible to interleukin-1-induced damage than the deeper layers. Arthritis Rheum 1996; 39: 478–88.

    Article  PubMed  CAS  Google Scholar 

  23. Pianon M, Punzi L, Bertazzolo N, Rizzi E, Rossini P, Gambari PF. Rapporti tra aggrecano, metalloproteasi (MMP-1) ed interleuchina-1 nel liquido sinoviale dell’osteoartrosi. Confronto con artropatie infiammatorie. Reumatismo 1997; 49: 97–100.

    Google Scholar 

  24. Punzi L, Cavasin F, Cesaro G, et al. Knee synovial fluid in patients with erosive and non erosive osteoarthritis of the hands. Osteoarthritis Cartilage 1992; 1: 64.

    Google Scholar 

  25. Pianon M, Punzi L, Stefani MP, et al. Interleukin-1β, plasminogen activator and inhibitor of plasminogen activator in synovial fluid of rheumatoid arthritis, psoriatic arthritis and osteoarthritis. Agents Actions 1994; 41: 88–9.

    Article  PubMed  CAS  Google Scholar 

  26. Martel-Pelletier J, Di Battista J, Lajeunesse D. Biochemical factors in joint articular tissue degradation in osteoarthritis. In Reginster J-Y, Henrotin Y, Martel-Pelletier J, Pelletier J-P, Eds. Experimental and clinical aspects of osteoarthritis. Heidelberg: Springer-Verlag, 1999: 480–509.

    Google Scholar 

  27. Vincenti MP, Clark JM, Brinckerhoff CE. Using inhibitors of metalloproteinases to treat arthritis. Easier said than done? Arthritis Rheum 1994; 37: 115–26.

    Google Scholar 

  28. Hembry RM, Bagga MR, Reynolds JJ, Hamblen DL. Immunolocalisation studies on six matrix metalloproteinases and their inhibitors TIMP-1 and TIMP-2, in synovia from patients with osteo- and rheumatoid arthritis. Ann Rheum Dis 1995; 54: 25–32.

    Article  PubMed  CAS  Google Scholar 

  29. Goldberg RL, Huff JP, Lenz ME, Glickman P, Katz R, Thonar EJ. Elevated plasma levels of hyaluronate in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum 1991; 34: 799–807.

    Article  PubMed  CAS  Google Scholar 

  30. Sharif M, George E, Shepstone L, et al. Serum hyaluronic acid level as a predictor of disease progression in osteoarthritis of the knee. Arthritis Rheum 1995; 38: 760–7.

    Article  PubMed  CAS  Google Scholar 

  31. Kirkpatrick RB, Emery JG, Connor JR, Dodds R, Lysko PG, Rosenberg M. Induction and expression of human cartilage glycoprotein 39 in rheumatoid inflammatory and peripheral blood monocyte-derived macrophages. Exp Cell Res 1997; 237: 46–54.

    Article  PubMed  CAS  Google Scholar 

  32. Volck B, Ostergaard K, Johansen JS, Garbbarsch C, Price PA. The distribution of YKL-40 in osteoarthritic and normal human articular cartilage. Scand J Rheumatol 1999; 28: 171–9.

    Article  PubMed  CAS  Google Scholar 

  33. Volck B, Johansen JS, Stoltenberg M, et al. Studies on YKL-40 in knee joints of patients with rheumatoid arthritis and osteoarthritis. Involvement of YKL-40 in the joint pathology. Osteoarthritis Cartilage 2001; 9: 203–14.

    Article  CAS  Google Scholar 

  34. Johansen JS, Williamson MK, Rice JS, Price PA. The distribution of YKL-40 in osteoarthritic and normal human cartilage. Scand J Rheumatol 1999; 28: 171–9.

    Article  PubMed  Google Scholar 

  35. Sharif M, Saxne T, Shepstone L, et al. Relationship between serum cartilage oligomeric matrix protein levels and disease progression in osteoarthritis of the knee joint. Br J Rheumatol 1995; 34: 306–10.

    Article  PubMed  CAS  Google Scholar 

  36. Thonar EJ, Lenz ME, Klintworth GK, et al. Quantification of keratan sulphate in blood as a marker of cartilage metabolism. Arthritis Rheum 1985; 28: 1367–76.

    Article  PubMed  CAS  Google Scholar 

  37. Thonar EJ-MA, Masayuki S, Lohmander LS. Body fluid markers of cartilage changes in osteoarthritis. Rheum Dis Clin North Am 1993; 19: 635–57.

    PubMed  CAS  Google Scholar 

  38. Young-min SA, Cawston TE, Griffiths ID. Markers of joint destruction: principles, problems, and potential. Ann Rheum Dis 2001; 60: 545–9.

    Article  PubMed  CAS  Google Scholar 

  39. Garnero P, Piperno M, Gineyts E, Christgau S, Delmas PD, Vignon E. Cross-sectional evaluation of biochemical markers of bone, cartilage, and synovial tissue metabolism in patients with knee osteoarthritis: relations with disease activity and joint damage. Ann Rheum Dis 2001; 60: 619–26.

    Article  PubMed  CAS  Google Scholar 

  40. Otterness IG, Weiner E, Swindell AC, Zimmerer RO, Ionescu M, Poole AR. An analysis of 14 molecular markers for monitoring osteoarthritis. Relationship of the markers to clinical end-points. Osteoarthritis Cartilage 2001; 9: 224–31.

    Article  CAS  Google Scholar 

  41. Schumacher HR Jr, Meng Z, Sieck M, et al. Effect of non steroidal anti-inflammatory drugs on synovial fluid in osteoarthritis. J Rheumatol 1996; 23:1774–7.

    PubMed  CAS  Google Scholar 

  42. Punzi L, Schiavon F, Cavasin F, Ramonda R, Gambari PF, Todesco S. The influence of intra-articular hyaluronic acid on PGE2 and cAMP of synovial fluid. Clin Exp Rheumatol 1989; 7: 247–50.

    PubMed  CAS  Google Scholar 

  43. Hirota W. Intra-articular injection of hyaluronic acid reduces total amounts of leukotriene C4, 6-ketoprostaglandin F1 alpha, prostaglandin F2 alpha and interleukin-1 beta in synovial fluid of patients with internal derangement in disorders of the temporomandibular joint. Br J Oral Maxillofac Surg 1998; 36: 35–8.

    Article  PubMed  CAS  Google Scholar 

  44. Punzi L. The complexity of the mechanisms of action of hyaluronan in joint diseases. Clin Exp Rheumatol 2001; 19: 242–6.

    PubMed  CAS  Google Scholar 

  45. Punzi L, Pianon M, Bertazzolo N, et al. Influence of intraarticular hyaluronate on synovial fluid metalloproteinases and their inhibitor 1 (TIMP1) in osteoarthritis of the knee. Arthritis Rheum 2000; 43:S 274 (Abstract).

    Google Scholar 

  46. Herrero-Beaumont G, Guerrero R, Sanchez-Pernaute O, et al. Cartilage and bone biological markers in the synovial fluid of osteoarthritic patients after hyaluronan injections in the knee. Clin Chim Acta 2001; 308: 107–15.

    Article  PubMed  CAS  Google Scholar 

  47. Cocco R, Tofi C, Fioravanti A, et al. Effects of clodronate on synovial fluid levels of some inflammatory mediators, after intra-articular administration to patients with synovitis secondary to knee osteoarthritis. Boll Soc Ital Biol Sper 1999; 75: 71–6.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Rheumatology, Department of Medical and Surgical Sciences, University of Padova, Via Giustiniani 2, 35128, Padova, Italy

    Leonardo Punzi MD, PhD, Francesca Oliviero, Roberta Ramonda, Chiara Valvason, Paolo Sfriso & Silvano Todesco

Authors
  1. Leonardo Punzi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francesca Oliviero
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberta Ramonda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chiara Valvason
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paolo Sfriso
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Silvano Todesco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leonardo Punzi MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Punzi, L., Oliviero, F., Ramonda, R. et al. Laboratory investigations in osteoarthritis. Aging Clin Exp Res 15, 373–379 (2003). https://doi.org/10.1007/BF03327358

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03327358

Keywords

Search

Navigation