Biomarkers of (osteo)arthritis

Abstract

Arthritic diseases are a major cause of disability and morbidity, and cause an enormous burden for health and social care systems globally. Osteoarthritis (OA) is the most common form of arthritis. The key risk factors for the development of OA are age, obesity, joint trauma or instability. Metabolic and endocrine diseases can also contribute to the pathogenesis of OA. There is accumulating evidence to suggest that OA is a whole-organ disease that is influenced by systemic mediators, inflammaging, innate immunity and the low-grade inflammation induced by metabolic syndrome. Although all joint tissues are implicated in disease progression in OA, articular cartilage has received the most attention in the context of aging, injury and disease. There is increasing emphasis on the early detection of OA as it has the capacity to target and treat the disease more effectively. Indeed it has been suggested that this is the era of "personalized prevention" for OA. However, the development of strategies for the prevention of OA require new and sensitive biomarker tools that can detect the disease in its molecular and pre-radiographic stage, before structural and functional alterations in cartilage integrity have occurred. There is also evidence to support a role for biomarkers in OA drug discovery, specifically the development of disease modifying osteoarthritis drugs. This Special Issue of Biomarkers is dedicated to recent progress in the field of OA biomarkers. The papers in this Special Issue review the current state-of-the-art and discuss the utility of OA biomarkers as diagnostic and prognostic tools.

Keywords: Arthritis; biomarker; diagnostic; musculoskeletal disorders; osteoarthritis; prognostic.

Figure 1.

Applying the biomarker toolbox in the drug discovery and development pathway. This schematic highlights the mutual interdependency of the drug and biomarker development pipelines. Linking a biomarker to a complementary endpoint facilitates the drug discovery process and allows pharmaceutical companies to make rational decisions about the continuity of preclinical studies and clinical trials. Biomarkers can be used at critical decision points to make go/no-go decisions. They can also be used in translational research, bridging the gap between the bench and the bedside. Biomarkers can also be used to identify responders and non-responders and quantify clinical efficacy and patient stratification (i.e. identification of those in need of treatment and selection of patients most likely to respond to treatment). In phase II clinical trials biomarkers can be used for dose determination and safety/efficacy studies. They can also help pharmaceutical companies save costs by enabling drug repositioning and determining the cost/benefit ratio for treatment. In routine clinical practice biomarkers are important diagnostic and prognostic tools for monitoring disease development and monitoring patients compliance. They are also indispensable tools for pharmacovigilance, personalized and precision health care and differentiating compounds from competitors.