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Non-isomerized C-telopeptide fragments are highly sensitive markers for monitoring disease activity and treatment efficacy in Paget's disease of bone.
J Bone Miner Res. 2005 Apr; 20(4):588-95.JB

Abstract

A new resorption assay measuring non-isomerized collagen type I C-telopeptide fragments (alpha-alpha CTX) was evaluated in a cohort comprising 32 Pagetic patients and 48 healthy controls. alpha-alpha CTX was found to be a sensitive marker for assessing disease activity and monitoring treatment efficacy in Paget's disease of bone compared with isomerized CTX (beta-beta CTX) and a number of other established bone turnover markers.

INTRODUCTION

Collagen type I fragments are generated by resorbing osteoclasts, and some of them can be measured using a C-telopeptide (CTX) immunoassay. The C-telopeptide of collagen type I comprises a DG-motif susceptible to isomerization. In newly synthesized collagen, this motif is in the native form denoted alpha, but spontaneously converts to an isomerized form (beta) during aging of bone. CTX fragments composed of at least two alpha CTX chains (alpha-alpha CTX) originating from degradation of newly formed bone can be determined in the urine using a newly developed sandwich ELISA. The aim of this study was to assess the ability of this marker to monitor disease activity and treatment efficacy in patients with Paget's disease compared with established bone turnover markers.

MATERIALS AND METHODS

A total of 32 patients diagnosed with Paget's disease of bone was included in the study. All received 400 mg/day of oral tiludronate for 3 months. Urinary alpha-alpha CTX (U alpha-alpha CTX) was measured at baseline and at 1 and 6 months after discontinuation of therapy and in 48 untreated age-matched and healthy controls. Other markers of bone turnover, including urinary beta-beta CTX, N-terminal cross-linking telopeptide of type I collagen, and deoxypyridinoline, were also measured for comparison.

RESULTS AND CONCLUSIONS

The U alpha-alpha CTX marker showed a marked reduction (-82% and -77% at 1 and 6 months of treatment, respectively) in response to antiresorptive therapy in patients with Paget's disease. The response to treatment in this marker exceeded that of the other markers (p < 0.01). The alpha-alpha CTX marker also provided a high correlation (r = 0.89) to disease activity as assessed by scintigraphic activity index. In conclusion, alpha-alpha CTX seems to be a sensitive marker for assessing disease activity and monitoring treatment efficacy in Paget's disease.

Authors+Show Affiliations

Centre for Clinical and Basic Research, Ballerup, Denmark. pa@ccbr.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

15765177

Citation

Alexandersen, Peter, et al. "Non-isomerized C-telopeptide Fragments Are Highly Sensitive Markers for Monitoring Disease Activity and Treatment Efficacy in Paget's Disease of Bone." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 4, 2005, pp. 588-95.
Alexandersen P, Peris P, Guañabens N, et al. Non-isomerized C-telopeptide fragments are highly sensitive markers for monitoring disease activity and treatment efficacy in Paget's disease of bone. J Bone Miner Res. 2005;20(4):588-95.
Alexandersen, P., Peris, P., Guañabens, N., Byrjalsen, I., Alvarez, L., Solberg, H., & Cloos, P. A. (2005). Non-isomerized C-telopeptide fragments are highly sensitive markers for monitoring disease activity and treatment efficacy in Paget's disease of bone. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(4), 588-95.
Alexandersen P, et al. Non-isomerized C-telopeptide Fragments Are Highly Sensitive Markers for Monitoring Disease Activity and Treatment Efficacy in Paget's Disease of Bone. J Bone Miner Res. 2005;20(4):588-95. PubMed PMID: 15765177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-isomerized C-telopeptide fragments are highly sensitive markers for monitoring disease activity and treatment efficacy in Paget's disease of bone. AU - Alexandersen,Peter, AU - Peris,Pilar, AU - Guañabens,Nuria, AU - Byrjalsen,Inger, AU - Alvarez,Luisa, AU - Solberg,Helene, AU - Cloos,Paul Ac, Y1 - 2004/12/06/ PY - 2003/11/20/received PY - 2004/06/08/revised PY - 2004/11/17/accepted PY - 2005/3/15/pubmed PY - 2005/12/13/medline PY - 2005/3/15/entrez SP - 588 EP - 95 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 20 IS - 4 N2 - UNLABELLED: A new resorption assay measuring non-isomerized collagen type I C-telopeptide fragments (alpha-alpha CTX) was evaluated in a cohort comprising 32 Pagetic patients and 48 healthy controls. alpha-alpha CTX was found to be a sensitive marker for assessing disease activity and monitoring treatment efficacy in Paget's disease of bone compared with isomerized CTX (beta-beta CTX) and a number of other established bone turnover markers. INTRODUCTION: Collagen type I fragments are generated by resorbing osteoclasts, and some of them can be measured using a C-telopeptide (CTX) immunoassay. The C-telopeptide of collagen type I comprises a DG-motif susceptible to isomerization. In newly synthesized collagen, this motif is in the native form denoted alpha, but spontaneously converts to an isomerized form (beta) during aging of bone. CTX fragments composed of at least two alpha CTX chains (alpha-alpha CTX) originating from degradation of newly formed bone can be determined in the urine using a newly developed sandwich ELISA. The aim of this study was to assess the ability of this marker to monitor disease activity and treatment efficacy in patients with Paget's disease compared with established bone turnover markers. MATERIALS AND METHODS: A total of 32 patients diagnosed with Paget's disease of bone was included in the study. All received 400 mg/day of oral tiludronate for 3 months. Urinary alpha-alpha CTX (U alpha-alpha CTX) was measured at baseline and at 1 and 6 months after discontinuation of therapy and in 48 untreated age-matched and healthy controls. Other markers of bone turnover, including urinary beta-beta CTX, N-terminal cross-linking telopeptide of type I collagen, and deoxypyridinoline, were also measured for comparison. RESULTS AND CONCLUSIONS: The U alpha-alpha CTX marker showed a marked reduction (-82% and -77% at 1 and 6 months of treatment, respectively) in response to antiresorptive therapy in patients with Paget's disease. The response to treatment in this marker exceeded that of the other markers (p < 0.01). The alpha-alpha CTX marker also provided a high correlation (r = 0.89) to disease activity as assessed by scintigraphic activity index. In conclusion, alpha-alpha CTX seems to be a sensitive marker for assessing disease activity and monitoring treatment efficacy in Paget's disease. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15765177/Non_isomerized_C_telopeptide_fragments_are_highly_sensitive_markers_for_monitoring_disease_activity_and_treatment_efficacy_in_Paget's_disease_of_bone_ L2 - https://doi.org/10.1359/JBMR.041212 DB - PRIME DP - Unbound Medicine ER -