Avaliação do biomarcador CTX-II em pacientes com ruptura do ligamento cruzado anterior: Estudo piloto^[*]

Resumo

Objetivo Quantificar a concentração urinária do biomarcador telopeptídeo C de ligação cruzada de colágeno de tipo II (C-terminal cross-linked telopeptide of type-II collagen, CTX-II) em casos de lesão isolada do ligamento cruzado anterior (LCA), e comparar as concentrações observadas nessa população com um grupo controle composto por pacientes sem alterações metabólicas no joelho que possam levar à degeneração da cartilagem.

Métodos Este é um estudo piloto transversal com dois grupos: pacientes com ruptura do LCA e grupo controle (cada grupo era composto por 10 indivíduos do sexo masculino, com 18 a 35 anos de idade, e índice de massa corporal inferior a 30 kg/m²). Nos dois grupos, as concentrações urinárias de um biomarcador relacionado à degradação do colágeno de tipo II (CTX-II) foram medidas. No grupo com ruptura do LCA, a relação entre o tempo pós-lesão e a quantidade do biomarcador também foi analisada.

Resultados Houve diferenças significativas nas concentrações urinárias de CTX-II entre o grupo LCA e o grupo controle (p = 0,009). Não foi observada relação significativa entre o tempo de lesão e a quantidade do biomarcador.

Conclusões Pacientes com lesão do LCA apresentaram maiores concentrações urinárias do biomarcador CTX-II do que aqueles sem lesão do LCA (p = 0,009). No entanto, não houve correlação entre a concentração desse biomarcador e o tempo decorrido após a lesão (p> 0,05).

Palavras-chave

osteoartrite - biomarcadores - lesões do ligamento cruzado anterior

^* Trabalho desenvolvido no Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Suporte Financeiro

Não houve suporte financeiro de fontes públicas, comerciais, ou sem fins lucrativos.

Publication History

Received: 12 November 2019

Accepted: 02 March 2020

Article published online:
22 July 2020

• Referências

• 1 Sanders TL, Maradit Kremers H, Bryan AJ. et al. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med 2016; 44 (06) 1502-1507
• 2 Poole AR, Kobayashi M, Yasuda T. et al. Type II collagen degradation and its regulation in articular cartilage in osteoarthritis. Ann Rheum Dis 2002; 61 (Suppl. 02) ii78-ii81
• 3 Lohmander LS, Atley LM, Pietka TA, Eyre DR. The release of crosslinked peptides from type II collagen into human synovial fluid is increased soon after joint injury and in osteoarthritis. Arthritis Rheum 2003; 48 (11) 3130-3139
• 4 Bigoni M, Sacerdote P, Turati M. et al. Acute and late changes in intraarticular cytokine levels following anterior cruciate ligament injury. J Orthop Res 2013; 31 (02) 315-321
• 5 Palmieri-Smith RM, Wojtys EM, Potter HG. Early Cartilage Changes After Anterior Cruciate Ligament Injury: Evaluation With Imaging and Serum Biomarkers-A Pilot Study. Arthroscopy 2016; 32 (07) 1309-1318
• 6 Wang X, Bennell KL, Wang Y. et al. Tibiofemoral joint structural change from 2.5 to 4.5 years following ACL reconstruction with and without combined meniscal pathology. BMC Musculoskelet Disord 2019; 20 (01) 312
• 7 Cohen M, Amaro JT, Ejnisman B. et al. Anterior cruciate ligament reconstruction after 10 to 15 years: association between meniscectomy and osteoarthrosis. Arthroscopy 2007; 23 (06) 629-634
• 8 Chmielewski TL, Trumble TN, Joseph AM. et al. Urinary CTX-II concentrations are elevated and associated with knee pain and function in subjects with ACL reconstruction. Osteoarthritis Cartilage 2012; 20 (11) 1294-1301
• 9 Oiestad BE, Holm I, Aune AK. et al. Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up. Am J Sports Med 2010; 38 (11) 2201-2210
• 10 Bauer DC, Hunter DJ, Abramson SB. et al. Osteoarthritis Biomarkers Network. Classification of osteoarthritis biomarkers: a proposed approach. Osteoarthritis Cartilage 2006; 14 (08) 723-727
• 11 Fosang AJ, Stanton H, Little CB, Atley LM. Neoepitopes as biomarkers of cartilage catabolism. Inflamm Res 2003; 52 (07) 277-282
• 12 Øiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 2009; 37 (07) 1434-1443
• 13 Mobasheri A, Henrotin Y. Biomarkers of (osteo)arthritis. Biomarkers 2015; 20 (08) 513-518
• 14 Cameron M, Buchgraber A, Passler H. et al. The natural history of the anterior cruciate ligament-deficient knee. Changes in synovial fluid cytokine and keratan sulfate concentrations. Am J Sports Med 1997; 25 (06) 751-754
• 15 Harkey MS, Luc BA, Golightly YM. et al. Osteoarthritis-related biomarkers following anterior cruciate ligament injury and reconstruction: a systematic review. Osteoarthritis Cartilage 2015; 23 (01) 1-12
• 16 Ajuied A, Wong F, Smith C. et al. Anterior cruciate ligament injury and radiologic progression of knee osteoarthritis: a systematic review and meta-analysis. Am J Sports Med 2014; 42 (09) 2242-2252
• 17 Higuchi H, Shirakura K, Kimura M. et al. Changes in biochemical parameters after anterior cruciate ligament injury. Int Orthop 2006; 30 (01) 43-47
• 18 Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 2007; 35 (10) 1756-1769
• 19 Mouritzen U, Christgau S, Lehmann HJ, Tankó LB, Christiansen C. Cartilage turnover assessed with a newly developed assay measuring collagen type II degradation products: influence of age, sex, menopause, hormone replacement therapy, and body mass index. Ann Rheum Dis 2003; 62 (04) 332-336
• 20 Jorge PB, Sprey JW, Runco GM, Lima MV, Severino NR, Santili C. Diferença na degeneração articular de acordo com o tipo de esporte. Rev Bras Ortop 2019; 54 (05) 509-515
• 21 Severino RM, Jorge PB, Martinelli MO, de Lima MV, Severino NR, Duarte Junior A. Análise dos níveis séricos do biomarcador CTX-II em atletas profissionais como fator preditivo de degradação articular. Rev Bras Ortop 2015; 50 (03) 331-335
• 22 Wu W, Billinghurst RC, Pidoux I. et al. Sites of collagenase cleavage and denaturation of type II collagen in aging and osteoarthritic articular cartilage and their relationship to the distribution of matrix metalloproteinase 1 and matrix metalloproteinase 13. Arthritis Rheum 2002; 46 (08) 2087-2094
• 23 Nelson F, Billinghurst RC, Pidoux I. et al. Early post-traumatic osteoarthritis-like changes in human articular cartilage following rupture of the anterior cruciate ligament. Osteoarthritis Cartilage 2006; 14 (02) 114-119
• 24 Irie K, Uchiyama E, Iwaso H. Intraarticular inflammatory cytokines in acute anterior cruciate ligament injured knee. Knee 2003; 10 (01) 93-96
• 25 Davis HC, Spang JT, Loeser RF. et al. Time between anterior cruciate ligament injury and reconstruction and cartilage metabolism six-months following reconstruction. Knee 2018; 25 (02) 296-305
• 26 Larsson S, Struglics A, Lohmander LS, Frobell R. Surgical reconstruction of ruptured anterior cruciate ligament prolongs trauma-induced increase of inflammatory cytokines in synovial fluid: an exploratory analysis in the KANON trial. Osteoarthritis Cartilage 2017; 25 (09) 1443-1451
• 27 Kraus VB, Hargrove DE, Hunter DJ, Renner JB, Jordan JM. Establishment of reference intervals for osteoarthritis-related soluble biomarkers: the FNIH/OARSI OA Biomarkers Consortium. Ann Rheum Dis 2017; 76 (01) 179-185
• 28 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 (06) 619-626
• 29 Saberi Hosnijeh F, Siebuhr AS, Uitterlinden AG. et al. Association between biomarkers of tissue inflammation and progression of osteoarthritis: evidence from the Rotterdam study cohort. Arthritis Res Ther 2016; 18: 81
• 30 Deshpande BR, Katz JN, Solomon DH. et al. Number of Persons With Symptomatic Knee Osteoarthritis in the US: Impact of Race and Ethnicity, Age, Sex, and Obesity. Arthritis Care Res (Hoboken) 2016; 68 (12) 1743-1750