Bone biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives

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Abstract

Bone biomarkers included formation, resorption and regulator are released during the bone remodeling processes. These bone biomarkers have attracted much attention in the clinical assessment of osteoporosis treatment in the past decade. Combination with the measurement of bone mineral density, the clinical applications of bone biomarkers have provided comprehensive information for diagnosis of osteoporosis. However, the analytical approaches of the bone biomarkers are still the challenge for further clinical trials. In this mini-review, we have introduced the functions of bone biomarkers and then recently developed techniques for bone biomarker measurements have been systematically integrated to discuss the possibility for osteoporosis assessment in the early stage.

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Major osteoporotic fragility fractures: Risk factor updates and societal impact.

Paola Pisani, Maria Renna, Francesco Conversano … (2016)

Osteoporosis is a silent disease without any evidence of disease until a fracture occurs. Approximately 200 million people in the world are affected by osteoporosis and 8.9 million fractures occur each year worldwide. Fractures of the hip are a major public health burden, by means of both social cost and health condition of the elderly because these fractures are one of the main causes of morbidity, impairment, decreased quality of life and mortality in women and men. The aim of this review is to analyze the most important factors related to the enormous impact of osteoporotic fractures on population. Among the most common risk factors, low body mass index; history of fragility fracture, environmental risk, early menopause, smoking, lack of vitamin D, endocrine disorders (for example insulin-dependent diabetes mellitus), use of glucocorticoids, excessive alcohol intake, immobility and others represented the main clinical risk factors associated with augmented risk of fragility fracture. The increasing trend of osteoporosis is accompanied by an underutilization of the available preventive strategies and only a small number of patients at high fracture risk are recognized and successively referred for therapy. This report provides analytic evidences to assess the best practices in osteoporosis management and indications for the adoption of a correct healthcare strategy to significantly reduce the osteoporosis burden. Early diagnosis is the key to resize the impact of osteoporosis on healthcare system. In this context, attention must be focused on the identification of high fracture risk among osteoporotic patients. It is necessary to increase national awareness campaigns across countries in order to reduce the osteoporotic fractures incidence.

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Identity of osteoclastogenesis inhibitory factor (OCIF) and osteoprotegerin (OPG): a mechanism by which OPG/OCIF inhibits osteoclastogenesis in vitro.

H Yasuda, N Shima, N Nakagawa … (1998)

The morphogenesis and remodeling of bone depends on the integrated activity of osteoblasts that form bone and osteoclasts that resorb bone. We previously reported the isolation of a new cytokine termed osteoclastogenesis inhibitory factor, OCIF, which specifically inhibits osteoclast development. Here we report the cloning of a complementary DNA of human OCIF. OCIF is identical to osteoprotegerin (OPG), a soluble member of the tumor-necrosis factor receptor family that inhibits osteoclastogenesis. Recombinant human OPG/OCIF specifically acts on bone tissues and increases bone mineral density and bone volume associated with a decrease of active osteoclast number in normal rats. Osteoblasts or bone marrow-derived stromal cells support osteoclastogenesis through cell-to-cell interactions. A single class of high affinity binding sites for OPG/OCIF appears on a mouse stromal cell line, ST2, in response to 1,25-dihydroxyvitamin D3. An anti-OPG/OCIF antibody that blocks the binding abolishes the biological activity of OPG/OCIF. When the sites are blocked with OPG/OCIF, ST2 cells fail to support osteoclastogenesis. These results suggest that the sites are involved in cell-to-cell signaling between stromal cells and osteoclast progenitors and that OPG/OCIF inhibits osteoclastogenesis by interrupting the signaling through the sites.

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Biochemical markers of bone turnover: part I: biochemistry and variability.

Markus Seibel (2005)

With the ageing population in most countries, disorders of bone and mineral metabolism are becoming increasingly relevant to every day clinical practice. Consequently, the interest in, and the need for effective measures to be used in the screening, diagnosis and follow-up of such pathologies has markedly grown. Together with clinical and imaging techniques, biochemical tests play an important role in the assessment and differential diagnosis of metabolic bone disease. In recent years, the isolation and characterisation of cellular and extracellular components of the skeletal matrix have resulted in the development of molecular markers that are considered to reflect either bone formation or bone resorption. These biochemical indices are non-invasive, comparatively inexpensive and, when applied and interpreted correctly, helpful tools in the diagnostic and therapeutic assessment of metabolic bone disease. Part I of this article provides an overview of the basic biochemistry of bone markers, and sources of non-specific variability. Part II (to be published in a subsequent issue of this journal) will review the current evidence regarding the clinical use of biochemical markers of bone remodelling in metabolic and metastatic bone disease.

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Author and article information

Contributors

Chih-Hwa Chen: chihhwache@tmu.edu.tw

Journal

Journal ID (nlm-ta): Biomark Res

Journal ID (iso-abbrev): Biomark Res

Title: Biomarker Research

Publisher: BioMed Central (London )

ISSN (Electronic): 2050-7771

Publication date (Electronic): 18 May 2017

Publication date PMC-release: 18 May 2017

Publication date Collection: 2017

Volume: 5

Electronic Location Identifier: 18

Affiliations

[1 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, , Taipei Medical University, ; Taipei, 11031 Taiwan

[2 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, , Taipei Medical University, ; Taipei, 11031 Taiwan

[3 ]ISNI 0000 0004 0639 0994, GRID grid.412897.1, Bone and Joint Research Center, Department of Orthopedics and Traumatology, , Taipei Medical University Hospital, ; Taipei, 11031 Taiwan

[4 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, School of Medicine, College of Medicine, , Taipei Medical University, ; Taipei, 11031 Taiwan

Article

Publisher ID: 97

DOI: 10.1186/s40364-017-0097-4

PMC ID: 5436437

PubMed ID: 28529755

SO-VID: 478c5b4e-acdd-443d-9f68-1fbc979c7d5b

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Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 15 March 2017

Date accepted : 2 May 2017

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Keywords: bone biomarker,bone formation,bone resorption,regulators,bone turnover,osteoporosis

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Keywords: bone biomarker, bone formation, bone resorption, regulators, bone turnover, osteoporosis

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Bone biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives

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Most cited references 59

Major osteoporotic fragility fractures: Risk factor updates and societal impact.

Identity of osteoclastogenesis inhibitory factor (OCIF) and osteoprotegerin (OPG): a mechanism by which OPG/OCIF inhibits osteoclastogenesis in vitro.

Biochemical markers of bone turnover: part I: biochemistry and variability.

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