Efficacy of simultaneous determination of bone alkaline phosphatase mass concentration in serum and urinary excretion of pyridinium cross-links for detection of bone metastases

Withold, Wolfgang; Georgescu, Georghe; Khakzad, Hassan; Vosberg, H.; Mueller-Gaertner, H.-W.; Reinauer, H.

doi:10.1016/0009-9120(95)96621-a

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…Interestingly no correlation was found between bone alkaline phosphatase mass concentrations in serum and the urinary excretion of pyridinium cross-links. This is in contrast to previous findings of our group, as well as others, in patients with primary (17) or secondary (18) hyperparathyroidism and bone metaStases (19,20), indicating that in patients after bone marrow transplantation different influencing factors may affect bone formation and resorption, respectively.…”

Section: Discussioncontrasting

confidence: 99%

Relationship between Bone Metabolism and Plasma Cytokine Levels in Patients at Risk of Post-Transplantation Bone Disease after Bone Marrow Transplantation

Withold

Wolf²,

Kollbach³

et al. 1996

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Summary:Bone marrow transplant recipients may carry an increased risk of bone diseases, involving numerous factors that affect bone mineral metabolism. Interleukin-6 is a potent stimulator of bone resorption in vivo. The soluble fraction of interleukin-6 receptor is reported to trigger osteoclast formation by interleukin-6 in vitro.In a cross-sectional study we measured serum bone alkaline phosphatase concentrations and the urinary excretion of pyridinium cross-links in 21 patients after bone marrow transplantation, and investigated the relationship between these values and those for the plasma levels of interleukin-6 and soluble interleukin-6 receptor.Following bone marrow transplantation female -but not male -patients showed higher serum bone alkaline phosphatase values than age-and sex-adjusted controls (p < 0.05). Both female and male patients were characterized by increased urinary excretion values of pyridinium cross-links (p < 0.05). In contrast to a marked increase of interleukin-6 plasma levels (p < 0.001) no significant difference in the soluble interleukin-6 receptor levels was found between patients and apparently healthy persons (p = 0.838). Multiple regression analysis (taking into account different variables of the immunosuppressive regimen applied) revealed the plasma concentration of interleukin-6 as an independent predictor of the urinary excretion of pyridinium cross-links (p < 0.05).In conclusion, in patients following bone marrow transplantation, these findings indicate (a) an increase of bone formation in female -but not in male -patients possibly reflecting primary ovarian failure and (b) an enhancement of bone resorption possibly mediated by circulating interleukin-6.

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Section: Discussioncontrasting

confidence: 99%

Relationship between Bone Metabolism and Plasma Cytokine Levels in Patients at Risk of Post-Transplantation Bone Disease after Bone Marrow Transplantation

Withold

Wolf²,

Kollbach³

et al. 1996

CCLM

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“…It is not at all clear how bone collagen is destroyed in these conditions; there is great controversy as to whether osteoclasts possess a true collagenase that is active at neutral pH. The other area of potential clinical utility for these markers relates to cancer metastatic to bone, where collagen is clearly destroyed and crosslink excretion rises dramatically (46,47). Matrix metalloproteinases have 2 roles in this process: a gelatinase/type IV collagenase is probably involved in the process whereby a metastasizing cell escapes from the vascular space into the tissue, and a local collagenase destroys bone collagen.…”

Section: Studies Of Pyd and Dpyd In Other Disordersmentioning

confidence: 99%

Monitoring collagen degradation in patients with arthritis. The search for suitable surrogates

Greenwald

1996

Arthritis & Rheumatism

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“…Z score analysis revealed a higher discriminating power of bone alkaline phosphatase as compared with total alkaline phosphatase in postmenopausal women (6,24) and in the diagnosis of bone metastases (25). On the other hand, bone alkaline phosphatase values often stay within the reference limits in spite of increased total alkaline phosphatase activities, pointing to an increased diagnostic specificity of bone alkaline phosphatase assays (12,26). Due to increased specificity, in patients receiving anti-resorptive therapy (e. g., with bisphosphonates) bone-specific alkaline phosphatase assays show a greater discriminating power as compared with total alkaline phosphatase activity (6).…”

Section: Diagnostic Validity As Compared With Total Alkaline Phosphatmentioning

confidence: 99%

Review

1996

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A review is given summarizing the present knowledge of bone turnover markers with special emphasis on biological, preanalytical and technical criteria in the proper judgement of efficacy and limitations of the methods employed. The marker substances may be either measures of bone formation or bone resorption.Markers of bone formation are bone alkaline phosphatase, osteocalcin and the carboxyl-terminal propeptide of procollagen type I. Bone alkaline phosphatase has proved to be superior to total alkaline phosphatase activity with respect to diagnostic sensitivity and specificity. Immunochemical techniques for measuring bone alkaline phosphatase show a cross-reactivity of 14-20% with liver alkaline phosphatase. However, this does not compromise the clinical usefulness of these assays except for patients with severe liver diseases. Osteocalcin is strictly bone-specific but shows numerous disadvantages with respect to apparent instability and discordant results as obtained by different methods; however, in certain diagnostic situations (corticosteroid-induced osteopenia, absence of destroyed bone architecture) osteocalcin may serve as a sensitive bone turnover marker. The carboxyl-terminal propeptide of procollagen type I generally shows low discriminating power in the diagnosis of bone diseases.The urinary excretion of pyridinium 'cross-links' has been carefully evaluated so far with respect to analytical performance and clinical usefulness. This marker may be a substitute for 4-hydroxyproline measurements as the method of choice for assessment of bone resorption. There are other degradation products from the telopeptide regions of bone-derived collagen type I which are excreted into the urine (N-telopeptides, CrossLaps™)\ these analytes are promising tools in the assessment of bone resorption but require further evaluation, in particular with respect to their extraskeletal clearance and putative origin outside bone. Moreover, their clinical usefulness may vary depending on the patient group examined. In contrast, the serum concentration of the cross-linked telopeptide region of collagen type I seems to lack both diagnostic specificity and sensitivity in the majority of patient groups. Tartrate-resistant acid phosphatase (as determined by the presently available methods) cannot be recommended as a routine tool for assessment of bone resorption.Brought to you by | University of Arizona Authenticated Download Date | 7/8/15 5:47 AM

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Efficacy of simultaneous determination of bone alkaline phosphatase mass concentration in serum and urinary excretion of pyridinium cross-links for detection of bone metastases

Cited by 8 publications

References 7 publications

Relationship between Bone Metabolism and Plasma Cytokine Levels in Patients at Risk of Post-Transplantation Bone Disease after Bone Marrow Transplantation

Relationship between Bone Metabolism and Plasma Cytokine Levels in Patients at Risk of Post-Transplantation Bone Disease after Bone Marrow Transplantation

Monitoring collagen degradation in patients with arthritis. The search for suitable surrogates

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