Testing for Severe Osteoarthritis… Before it Develops?

neck pain osteoarthritisNew research suggests that testing for three specific biomarkers in the blood could predict who will go on to develop severe osteoarthritis, a potential cause of neck pain. Osteoarthritis is a condition that tends to arise later in life after wear and tear on the joints but up until now there was no blood test to let patients know their possible risk of the disease, making preventative efforts hard to promote.

This latest study looked at microRNA in the blood of 816 patients with osteoarthritis and identified 12 possible biomarkers that warranted further investigation for their ability to predict severe disease progression. Christian Beyer, MD, from the University of Erlangen-Nuremberg in Germany, noted in a presentation at the European League Against Rheumatism (EULAR) Congress 2014 that knowing which patients are most likely to develop severe osteoarthritis can help physicians promote health interventions that could slow joint degeneration.

Effects of Osteoarthritis

Osteoarthritis can cause crippling pain and loss of mobility, leading to social isolation, absence from work, difficulties with family life and leisure and a general reduction in quality of life. The condition also has a profound impact on healthcare spending, especially as many countries now have an aging population where OA is increasingly common.

Wear and tear on the joints can make joint replacement necessary, which may include spinal fusion or artificial disc replacement. Hip or knee replacement is more likely, however. In this study, 67 of the 816 patients had at least one surgery to replace a joint affected by severe osteoarthritis and these patients were found to have a higher expression of three specific biomarkers compared to those whose condition was not severe enough to warrant surgical intervention.

What are Biomarkers?

Currently, miRNAs are used as biomarkers for cancer, diabetes, and cardiovascular disease but this is the first time promising biomarkers have been identified for OA. Biomarkers in the form of miRNA, or micro-ribonucleic acid, are non-coding types of RNA that are involved in transcriptional and post-transcriptional regulation of gene expression.

What this means is that these molecules help the body to read our genes and make copies of our DNA when creating new proteins and so forth. If we have more or less of certain types of miRNA then the body will be more or less likely to ‘read’ and ‘copy’ specific genes, determining the extent to which a certain disease or condition will affect us.

Biomarkers for Osteoarthritis

The three miRNAs are miR-454, miR-885-5p, and let-7e, with the latter strongly predictive of the need for surgery for OA of the hip or knee. The lower a person’s levels of let-7e the more likely they were to require such surgery.

Of course, this study only demonstrates a correlation between levels of these biomarkers and disease progression and so the task now for the scientists is to determine why these levels differ. As the study focused only on patients at one hospital it also remains to be seen if the results are confirmed by a larger multi-centre study.

Why Biomarkers Would be Useful for Osteoarthritis

miRNAs represent a useful diagnostic tool as they are easily accessible through blood testing and are not damaged by temperature. Should a person with osteoarthritis be found to have these biomarkers their physician could suggest a more aggressive course of treatment involving exercise, weight management, inflammation control, and good nutrition and stress the likelihood of needing surgery at a later date without serious preventative activity.

Naturally, even those with osteoarthritis who don’t have these three biomarkers should be encouraged to also adopt healthy lifestyle and dietary habits to improve overall health and wellbeing and reduce their risk of other causes of neck pain, back pain and ill health.


European League Against Rheumatism (EULAR) Congress 2014: Abstract OP0003. Presented June 11, 2014.

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