Cited by 29Osteoarthritis Treatment and MechanismsKnee injuries and reconstruction techniquesHip disorders and treatments

Associations between molecular biomarkers and MR-based cartilage composition and knee joint morphology: data from the Osteoarthritis Initiative

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Joseph, G.B., Nevitt, M.C., McCulloch, C.E., Neumann, J., Lynch, J.A., Heilmeier, U., Lane, N.E., Link, T.M.·2018·Osteoarthritis and Cartilage

Abstract

Objective The purpose of this study was to assess the associations between serum/urine biomarkers for osteoarthritis and magnetic resonance (MR) imaging measures of cartilage composition and joint structure (cartilage, meniscus, and bone marrow), using MR imaging data from the Osteoarthritis Initiative (OAI). Design 141 subjects with Kellgren Lawrence (KL) grades 0-3 in the right knee and with available serum/urine biomarker assays were selected from the OAI. Cartilage magnetic resonance imaging (MRI) T2 measurements were performed in the medial femur, lateral femur, medial tibia, lateral tibia, and patella compartments. Compartment-specific knee morphologic grading [whole-organ magnetic resonance imaging score (WORMS)] in the cartilage, meniscus, and bone marrow was also performed. We focused on associations of serum hyaluronan (sHA), serum cartilage oligomeric matrix protein (sCOMP), serum matrix metalloproteinase-3 (sMMP3), and Urine Carboxy-Terminal Telepeptides of Type II Collagen (uCtX-II)) with MRI parameters (T2, WORMS), assessed using partial correlations adjusted for age, gender, body mass index (BMI), KL grade in both knees, and diabetes status. Results Higher levels of sHA, sMMP3 and sCOMP were correlated (P < 0.05) with T2 of the lateral femur (r = 0.18 to 0.32) and lateral tibia (r = 0.17 to 0.23), and with average T2 of all knee regions (r = 0.23). uCTXII was correlated with patellar T2 (r = 0.19, P = 0.04). Among the morphologic measures, sHA and sMMP3 was positively correlated (r = 0.17 to 0.21, P < 0.05) with meniscal damage. Conclusions This study suggests weak, but statistically significant, correlations between serum biomarkers of OA (sHA, sCOMP, and sMMP3) and MRI T2 measures of cartilage extra-cellular matrix degeneration.

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Crossref · 10.1016/j.joca.2018.04.019

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  • CTX-II correlates with disease severity, being higher in Kellgren-Lawrence grades 3-4 than grade 2.

    “correlating with disease severity (higher in Kellgren-Lawrence grades 3–4 vs. 2)”

    From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [25]

    The Results (Subject Characteristics) report no significant association between uCTXII and Kellgren–Lawrence grade. The study included grades 0–3, so it could not establish that CTX-II is higher in grades 3–4 than in grade 2. (LLM, conf=0.92)

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  • CTX-II correlates with MRI-detected structural abnormalities: osteophytes R = 0.330, bone marrow lesions R = 0.252, and cartilage degradation R = 0.218, p < 0.05.

    “and MRI-detected structural abnormalities (osteophytes R = 0.330, bone marrow lesions R = 0.252, cartilage degradation R = 0.218, p < 0.05)”

    From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [25]

    The Results (Joint Morphology; page unavailable) say that the only significant biomarker association with bone marrow abnormalities was for sMMP3, not uCTXII, and that no primary biomarker was significantly associated with cartilage WORMS scores. The Results (Cartilage MRI T2; page unavailable) report a different uCTXII association—patellar T2, r=0.19, p=0.04. The cited correlations of 0.330, 0.252, and 0.218 are not reported in these passages. (LLM, conf=0.88)

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  • CTX-II is a fragment of type II collagen, which constitutes 90% of cartilage collagen, and is cleaved by collagenases.

    “Specifically, CTX-II is a fragment of type II collagen (90% of cartilage collagen) cleaved by collagenases”

    From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [25]

    The Methods section (Serum and Urine Biomarkers; page not specified) identifies uCTXII as carboxy-terminal telopeptides of type II collagen, supporting its identification as a collagen fragment. Our copy does not state that type II collagen constitutes 90% of cartilage collagen or that collagenases cleave CTX-II. (LLM, conf=0.86)

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  • CTX-II is elevated in urine of knee OA patients.

    “and is elevated in urine of knee OA patients”

    From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [25]

    The Methods identify CTX-II as a urine biomarker measured in this study, but the copy does not report that its level is elevated in knee OA patients relative to people without OA. The Results (Subject Characteristics; page unavailable) report no significant association between urinary CTX-II and KL grade; the reported association with patellar cartilage T2 does not establish the claimed elevation. (LLM, conf=0.72)

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  • Multivariate analysis highlights osteophyte load and synovitis as predictors of CTX-II, suggesting contributions from bone and synovium.

    “with multivariate analysis highlighting osteophyte load and synovitis as predictors, suggesting contributions from bone and synovium [23,24,25].”

    From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [25]

    The Results (Cartilage MRI T2; page unavailable) report an association between uCTXII and patellar cartilage T2, not osteophyte load or synovitis. The Methods (Image Analysis; page unavailable) describe scoring cartilage, meniscal and bone-marrow lesions; searches for osteophytes, synovitis and multivariate predictors found no passage supporting the claimed bone and synovium contributions. (LLM, conf=0.78)

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Research works printed but not linked: 1

  1. [24]Peterfy C Schneider E Nevitt M The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 2008 16 1433 PMC3048821 18786841

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Authors
Joseph, G. B., Nevitt, M. C., McCulloch, C. E., Neumann, J., Lynch, J. A., Heilmeier, U., Lane, N. E., & Link, T. M.
Affiliations
  • University of California, San Francisco (US)
  • University of California, Davis (US)
Corresponding author
  • Joseph, G.B.
  • Nevitt, M.C.
  • McCulloch, C.E.
  • Neumann, J.
  • Lynch, J.A.
  • Heilmeier, U.
  • Lane, N.E.
  • Link, T.M.
Venue
Osteoarthritis and Cartilage
Publisher
Elsevier BV
Published
2018-08
Volume
26
Issue
8
Pages
1070-1077
ISSN
1063-4584 (ISSN-L)
OpenAlex
W2804586097
Cited by
29
References
41
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 6 · 2019: 6
FWCI
3.63
Type
journal article
Language
en
Open access
Locations
  • Osteoarthritis and Cartilage (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • NIH (P50-AR060752, R01-AR064771)
  • National Institutes of Health (N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262)
  • Merck Research Laboratories
  • Novartis Pharmaceuticals Corporation
  • GlaxoSmithKline
  • Pfizer, Inc
Topics
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
  • Health Sciences › Medicine › Surgery › Hip disorders and treatments
Keywords
knee osteoarthritis, serum biomarkers, cartilage composition, meniscal injury, bone marrow lesions, hyaluronic acid, cartilage oligomeric matrix protein, matrix metalloproteinase-3, Whole-Organ Magnetic Resonance Imaging Score, Osteoarthritis Initiative
MeSH terms
Cartilage, Articular, Cross-Sectional Studies, Female, Humans, Hyaluronic Acid, Knee Joint, Magnetic Resonance Imaging, Male, Middle Aged, Peptide Fragments, Biomarkers, Matrix Metalloproteinase 3, Osteoarthritis, Knee, Collagen Type II, Cartilage Oligomeric Matrix Protein

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