Relationship between serum biomarkers of cartilage and bone metabolism and joint injury in young Thoroughbred racehorses in training

Brendan F. Jackson Department of Production and Population Health, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL9 7TA, England.

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Suzanne R. Reed Department of Production and Population Health, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL9 7TA, England.

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Joanna S. Price School of Veterinary Sciences, University of Bristol, Langford, Bristol, BS40 5DU, England.

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Kristien L. P. Verheyen Department of Production and Population Health, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL9 7TA, England.

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Abstract

OBJECTIVE To compare serum concentrations of biomarkers of cartilage and bone metabolism between racehorses with a carpal or metacarpophalangeal or metatarsophalangeal (ie, fetlock) joint injury and matched uninjured control horses, determine changes in biomarker concentrations following joint injury, and establish the biomarkers’ diagnostic test performance.

ANIMALS 50 Thoroughbred racehorses with a carpal or fetlock joint injury and 50 matched uninjured horses (control horses).

PROCEDURES Serum concentrations of 2 cartilage synthesis biomarkers (carboxy-terminal propeptide of type II collagen [CPII] and chondroitin sulfate epitope 846 [CS846]), 2 cartilage degradation biomarkers (neoepitope generated by collagenase cleavage of type II collagen [C2C] and cross-linked carboxy-terminal telopeptide fragments of type II collagen [CTX-II]), and serum activity of a bone formation marker (bone-specific alkaline phosphatase [BAP]) were measured around the time of injury diagnosis and monthly thereafter for as long as possible.

RESULTS Injured horses as a group and horses specifically with fetlock joint injuries had significantly lower serum CPII concentrations and significantly higher serum BAP activities than matched control horses. Concentrations of CTX-II were decreased between 2 and 4 months following joint injury. Measurement of CPII concentration at baseline could distinguish between injured horses and control horses with a sensitivity of 82% and specificity of 50%.

CONCLUSIONS AND CLINICAL RELEVANCE Although significant differences in specific biomarker concentrations between horses with carpal and fetlock joint injuries and matched control horses were identified, there was no convincing evidence of the suitability of these biomarkers as diagnostic or prognostic tools in a clinical setting.

Abstract

OBJECTIVE To compare serum concentrations of biomarkers of cartilage and bone metabolism between racehorses with a carpal or metacarpophalangeal or metatarsophalangeal (ie, fetlock) joint injury and matched uninjured control horses, determine changes in biomarker concentrations following joint injury, and establish the biomarkers’ diagnostic test performance.

ANIMALS 50 Thoroughbred racehorses with a carpal or fetlock joint injury and 50 matched uninjured horses (control horses).

PROCEDURES Serum concentrations of 2 cartilage synthesis biomarkers (carboxy-terminal propeptide of type II collagen [CPII] and chondroitin sulfate epitope 846 [CS846]), 2 cartilage degradation biomarkers (neoepitope generated by collagenase cleavage of type II collagen [C2C] and cross-linked carboxy-terminal telopeptide fragments of type II collagen [CTX-II]), and serum activity of a bone formation marker (bone-specific alkaline phosphatase [BAP]) were measured around the time of injury diagnosis and monthly thereafter for as long as possible.

RESULTS Injured horses as a group and horses specifically with fetlock joint injuries had significantly lower serum CPII concentrations and significantly higher serum BAP activities than matched control horses. Concentrations of CTX-II were decreased between 2 and 4 months following joint injury. Measurement of CPII concentration at baseline could distinguish between injured horses and control horses with a sensitivity of 82% and specificity of 50%.

CONCLUSIONS AND CLINICAL RELEVANCE Although significant differences in specific biomarker concentrations between horses with carpal and fetlock joint injuries and matched control horses were identified, there was no convincing evidence of the suitability of these biomarkers as diagnostic or prognostic tools in a clinical setting.

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