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Rheumatology Advance Access originally published online on September 12, 2007
Rheumatology 2007 46(11):1652-1656; doi:10.1093/rheumatology/kem220
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© 2007 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Serum keratan sulfate is a promising marker of early articular cartilage breakdown

S. Wakitani1, M. Nawata2, A. Kawaguchi1, T. Okabe3, K. Takaoka1, T. Tsuchiya4, R. Nakaoka4, H. Masuda5 and K. Miyazaki5

1Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 2Department of Orthopaedic Surgery, Marunouchi Hospital, 3Department of Orthopaedic Surgery, Shinshu University School of Medicine, 4Division of Medical Devices, National Institute of Health Sciences, 5Department of Pharmaceuticals information, Seikagaku Corporation.

Correspondence to: Shigeyuki Wakitani, MD, Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi, Abeno-ku, Osaka 545-8585, Japan. E-mail: wakitani{at}med.osaka-cu.ac.jp


  Abstract

Objectives. To find serum markers that may serve as indices for an early diagnosis of degeneration or damage of the articular cartilage.

Methods. Twenty-four healthy volunteers, 19 individuals with knee trauma (KT) and 31 with knee osteoarthritis (OA) were evaluated. KT patients were divided into a group (n = 5) with an injury <2 months old (recent KT) and a group (n = 14) with that >2 months old (old KT). Articular cartilage damage was assessed using either arthroscopy or direct observation. Serum concentrations of hyaluronic acid (HA), cartilage proteoglycan aggrecan turnover epitope (CS846) and cartilage oligomeric protein (COMP) were measured using enzyme-linked immunosorbent assay kits and those of keratan sulfate (KS) and chondroitin-6-sulfate (C6S) using high-performance liquid chromatography.

Results. Serum KS in the recent KT group (2095 ± 594 ng/ml) was significantly higher than that in the old KT group (1373 ± 418 ng/ml; P = 0.021), and serum COMP in the recent KT group (1572 ± 182 ng/ml) showed a tendency that was higher than that in the old KT group (1350 ± 250 ng/ml; P = 0.079).

Serum KS in OA patients with Kellgren and Lawrence (KL) grades 0 and I (1456 ± 334 ng/ml) showed a tendency that was higher than that in OA patients with KL grades II, III and IV (1248 ± 220 ng/ml; P = 0.084).

Conclusions. The serum concentration of KS correlated with the damage of the articular cartilage and it was significantly increased even at an early stage after the injury.

KEY WORDS: Keratan sulfate, Glycosaminoglycan, Cartilage oligomeric protein, Cartilage injury, Osteoarthritis, Serum marker

Submitted 11 April 2007; revised version accepted 19 July 2007.
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