A cure for osteoarthritis (OA) remains elusive. This is due in large part to two major obstacles, inability to detect OA sufficiently early before the onset of irreversible signs and recalcitrant symptoms, and inability to identify individuals at high risk of progression based on traditionally used metrics (age, sex, body mass index, knee pain and joint space width). The latter challenge is responsible for low powering of clinical trials and numerous drug trial failures. Using a systematic, unbiased and iterative approach, we have created a multiple reaction monitoring (MRM) proteomic panel for serum-based prediction of knee OA structural progression and diagnosis of knee OA. The selection of proteins was based on results of extensive discovery proteomic studies in synovial fluid, urine, and serum from knee OA radiographic progressors and non-progressors (with 3-4 year follow-up) and controls. The ultimate goals of this work are to qualify these new biomarker candidates in the contexts of knee OA progression and OA diagnosis in larger well-phenotyped cohorts from the Osteoarthritis Initiative, the Johnston County Osteoarthritis Project and the Chingford cohorts. With this further qualification, these new biomarker tools will be very significant for their potential utility for clinical trial and clinical use to inform strategies for phenotyping and earlier identification and treatment of OA patients. We also intend to pursue formal Food and Drug Administration (FDA) qualification of the optimal marker set yielded by this proposal to facilitate their use as drug development tools.

Public Health Relevance

We have created a specialized biomarker panel blood test that determines whether an individual is at high risk for progressive knee osteoarthritis (OA). Some of these biomarkers are also very strong diagnostics for knee OA. This project will verify the capabilities of these biomarkers in larger well-characterized cohorts. The long- term goal of these studies is to establish the clinical utility of these biomarkers so they can be used to improve the chance of success of clinical trials and be used by doctors when evaluating whether a patient has early knee OA or knee OA that is likely to be aggressive in order to treat it earlier and more effectively.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
1R01AR071450-01
Application #
9289779
Study Section
Skeletal Biology Structure and Regeneration Study Section (SBSR)
Program Officer
Lester, Gayle E
Project Start
2017-04-01
Project End
2020-03-31
Budget Start
2017-04-01
Budget End
2018-03-31
Support Year
1
Fiscal Year
2017
Total Cost
$689,367
Indirect Cost
$255,803
Name
Duke University
Department
Physiology
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705