Test closer for early detection of osteoarthritis
27 February 2001
A simple diagnostic test for early detection of people susceptible to osteoarthritis (OA) may be a step closer following an Australian mother and daughter study.
The findings have been submitted for publication in the journal Arthritis & Rheumatism.
Osteoarthritis commonly affects women after the menopause, although it hasn’t been clear at what age OA actually starts developing. X-rays of women usually show changes due to OA only after the menopause.
But now, researcher Dr David Hunter from Sydney’s Royal North Shore Hospital and his colleagues have results that suggest that changes occur in the cartilage of women with OA many years before the menopause.
Because there is known to be a strong genetic component to osteoarthritis—that is, it is often inherited—the research team looked at whether changes occurred in the cartilage of daughters whose mothers had OA.
They looked at 117 randomly selected women (aged 50-75) and 50 of their daughters (average age of 33) and found that the daughters of mothers with knee osteoarthritis had a higher than usual breakdown of the collagen in the knee joint. Collagen is the major protein in cartilage and helps form a ‘scaffold’, providing cartilage with its strength and stretching ability.
Dr Hunter said: ‘We were surprised, as the current evidence using plain X-rays suggests that osteoarthritis develops after the age of the menopause. Our evidence suggests that at least in those who are genetically predisposed it begins much earlier’.
These findings confirm earlier Australian research and could pave the way for a simple test to provide an early warning for people susceptible to osteoarthritis.
‘A number of groups around the world are investigating the use of markers, in the blood and urine, of both cartilage and bone degeneration [so-called biomarkers]. At present they remain research tools and are not clinically available. These definitely show promise in detecting disease before it becomes symptomatic and thus are potentially useful in early detection of those susceptible to osteoarthritis,’ said Dr Hunter.
But it seems the research doesn’t stop there.
Twin research
Research done at the unit has shown that a person’s risk of developing osteoarthritic changes in their spine is 70 per cent inherited.
The team is currently investigating female twins after the menopause to try to identify the genes responsible for the development of osteoarthritis. This will work towards the long-term goal of developing suitable therapies for prevention and treatment of this disabling condition.
Dr Hunter added that they were still looking for a number of twins (must be female and have gone through menopause) to take part in this study. Those interested can phone 1800 500 431.
The team will also start clinical trials to assess medications that are thought to halt or reverse the progression of osteoarthritis.
‘We are targeting people who have injured their knees, which most commonly occurs playing sport. People who have a significant knee injury that damages the cartilage within the knee usually develop osteoarthritis within 10 years of their initial injury, irrespective of their age,’ Dr Hunter said.
The team is targeting these subjects for study because of their high likelihood of developing osteoarthritis, and in this study the aim is to prevent the development of osteoarthritis.
Last Reviewed: 02 March 2001
