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Although a number of surrogate biomarkers exist for measuring the metabolic products of bone resorption, the serum CTX marker was chosen because it is both highly correlated to bone turnover rate and already available for detection in a laboratory test carried out by a major lab testing corporation.
The N-terminal telopeptide (NTX), also known as amino-terminal collagen crosslinks, is the N-terminal telopeptide of fibrillar collagens such as collagen type I and type II.It is used as a biomarker to measure the rate of bone turnover.
Bone biopsy is considered the gold standard to quantify bone turnover; however, it is invasive, complex and costly to perform and subject to significant measurement errors. [ 1 ] Measurements of serum or urine biomarkers of bone turnover are simple, cheap, quick, and non-invasive in measuring changes in bone metabolism, but only provide ...
Richard Eastell (born 12 February 1953) is a British medical doctor and Professor of Bone Metabolism at the University of Sheffield. [1] He was born in Shipley (West Yorkshire) and attended the Salt Grammar School, [citation needed] later graduating from the University of Edinburgh in 1977 with an MB ChB and in 1984 with an MD [2] and achieved prominence as an expert in osteoporosis.
Bone tissue is removed by osteoclasts, and then new bone tissue is formed by osteoblasts. Both processes utilize cytokine (TGF-β, IGF) signalling.In osteology, bone remodeling or bone metabolism is a lifelong process where mature bone tissue is removed from the skeleton (a process called bone resorption) and new bone tissue is formed (a process called ossification or new bone formation).
Markers of bone turnover in urine eg. Pyridinoline; Elevated levels of serum and urinary hydroxyproline are also found. Bone scans are useful in determining the extent and activity of the condition. If a bone scan suggests Paget's disease, the affected bone(s) should be X-rayed to confirm the diagnosis.
Patients whom are diagnosed with multiple myeloma have approximately 80-100% chance of developing bone complications due to an increase in activity and/or formation of osteoclasts and a decrease activity of osteoblasts. [20] [21] In a stage II clinical trial, denosumab decreased bone turnover markers by blocking the RANKL/RANK pathway. [21]
Due to the high rate of bone turnover, metabolites are theorized to be capable of detecting bone metastasis. [15] Use of bone markers for detection and screening is an active field of research, though radiographic evidence remains the gold standard. [15] However, once the presence of a bone metastasis has been established, tumor metabolic ...