Clinical and Technical Review - Tecomedical

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8 Bone marker and characteristics Biomarker Method Main Sample Type Formation BAP Osteocalcin Intact Osteocalcin N-mid PINP PICP = CICP Resorption ICTP = CTX-MMP Others ELISA IRMA/ ELISA ELISA RIA ELISA Serum Serum Serum Serum Serum A(a) B C D E F G H Pre- & postmenopause + + + + NA Analytical variation + + + + + Treatment response Short time change Within person variation Daily variation Food intake TRAP 5b ELISA Serum ± + ± ± NA + + ± DPD ELISA Urine + + + + + - + + NTx ELISA CTx ELISA + + + + + Sample stability Scores sind: + (yes), - (no), ± (fair/indeterminate), NA (not available) (a) Letters correspond to following, the marker: H. preferably demonstrates high stability in the biological A. shows a difference in the rate of bone turnover pre-and specimen post-menopause (b) In contrast to OPG, sRANKL showed no response to B. demonstrates minimal analytical variation bisphosphonate treatment of osteoporotic postmeno- C. significantly changes in response to treatment pausal women. However, PTH treatment of glucocorticoid D. detect changes in short time interval (months) induced osteoporotic women resulted in a fast (1 month) E. demonstrates minimal within person (biological) variation and sustained increase of sRANKL levels. F. preferably demonstrates little variation over the day (c) Cathepsin K is elevated in patients with established G. no influence by food intake rheumatoid arthritis. + + + + + + ± ± ± + + + + + ± + + + + + + - + + + 5 days 2–8 °C 4hours 2–8 °C 5 days 2–8 °C 5 days 2–8 °C 5 days 2–8 °C 2 days 2–8 °C 7 days 2–8 °C Serum + + + + + - ± ± 1day 2–8 °C Urine + + + + ± - ± + 3 days 2–8 °C Serum + + + + + - - + 1day 2–8 °C Urine + + + + ± - - + ELISA Serum - + - - NA ± + + 7 days 2–8 °C 5 days 2–8 °C sRANKL ELISA Plasma NA + ± (b) - NA NA + ± 1day 2–8 °C Osteoprotegerin (OPG) ELISA Plasma NA + + - NA NA + ± 1day 2–8 °C Cathepsine K ELISA Serum NA (c) + NA NA NA NA + ± 2 days 2–8 °C
Bone marker and their behavior in various bone diseases Biomarker CTX-I NTX-I Free DPD Bone Disease • ↑ Increased values of the biomarker in this disease were observed in various studies as compared to a healthy control group. • ↓ Decreased values of the biomarker in this disease were observed in various studies as compared to a healthy control group. • ↑ Large arrows: indicate large and significant differences. ↑ Small arrows: indicate small to medium differences with the control group. Degradation marker Formation marker Free PYD Helical peptide ICTP TRAP 5b BAP OC PICP/ CICP ↑ Osteoporosis Osteoporose ↑ ↑ ↑ ↑ ↑ ± + ± ↑ ↑ ↑ ↑ Hyperparathyroidism Osteoporose ↑ ↑ ↑ ↑ ↑ ± ↑ + ↑ ↑ ↑ ↑ Hyperthyroidism ↑ ↑ ↑ ↑ ↑ (↑) Bone metastases* ↑ ↑ ↑ ↑ ↑ ↑ (↑) ↑ ↑ Multiple myeoloma ↑ ↑ ↑ ↑ ↓ ± Rickets/ Vitamin-D Deficiency Osteomalacia “adult rickets” ↑ ↑ ↑ ↑ ↓ ↑ ↑ ↑ ↑ ↑ ↑ Paget´s ↑ ↑ ↑ ↑ ↑ ↑ ↑ ↑ Anorexia nervosa (↑) (↑) (↓) (↓↑) (↓) Growth hormone deficiency ↓ ↓ ↓ Renal failure ↑ ↑ ↑ ↑ ↑ ↑ PINP • (↓) (↑): arrows between brackets: different studies suggest inconsistent behavior of this marker in this disease. • ± indicates that according to various studies this marker is not considered as valuable for this disease. • Empty spaces indicate that no information was identified on this biomarker for this disease. * Increased values were observed for urin CTX alpha and Serum BAP in bone metastases. 9
Page 1 and 2: Author: Peter Haima, Ph Clinical an
Page 3 and 4: Figure 1: Soloway 0 = Patients with
Page 5 and 6: Bone Resorption Osteoclast: Large m
Page 7: Bone Turnover - Biochemical Marker
Page 11 and 12: Biomarker according to NIH Osteoart
Page 13 and 14: Cartilage Synthesis - Biochemical M
Page 15 and 16: Cartilage Biomarker and their behav
Page 17 and 18: Bonemarker normal values for childr
Page 19 and 20: Specific recommendations BAP Osteoc
Page 21 and 22: Bone marker - Reference values in a
Page 23 and 24: Cross reactivity - different specie

Clinical and Technical Review - Tecomedical

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