Article

More than one in 4 Americans has a musculoskeletal (MSK) disorder that requires
medical diagnosis and treatment. Imaging tools are able to demonstrate structural
changes but cannot reflect the disease activity or symptom severity of MSK
conditions. This is of paramount concern in the aging population, in which
imaging findings have poor correlation with symptoms, and multiple pain
generators frequently coexist. Because levels of inflammatory and matrix
breakdown products address disease activity, evaluation of biomarkers has the
potential to provide assessment of active pain generators above and beyond the
changes observable on imaging studies. This fact has stimulated research interest
in the search for novel biomarkers of disease activity and response to treatment
in body fluids. The goal is to develop panels of multi-biomarkers, which could be
used independently or in conjunction with the imaging tools, for the diagnosis,
prognosis, and treatment validation in MSK diseases.
The current review of MSK
biomarkers is organized into 3 mechanistic categories : the metabolites of
extracellular matrix of MSK tissues; inflammatory cytokines and chemokines; and
pain-related neuropeptides and/or chemicals. Although some representative
biomarkers could be used alone, the fact that MSK diseases are multi-tissue
disorders that involve the muscles, bones, cartilage, and nerves suggests that
panels of biomarkers may have greater potential than any single biomarker used in
isolation. As advances in biotechnology make this a reality, multi-biomarker
panels that include all 3 categories of biomarkers, used either alone or in
combination with imaging tools, has the potential to revolutionize the clinical
approach to MSK diseases.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS