Association between radiographic hand osteoarthritis and RANKL, OPG and inflammatory markers

The aim of the study was to evaluate the association between prevalence and severity of radiographic hand osteoarthritis (OA) and serum levels of systemic inflammatory markers in a community-based population sample.

A cross-sectional observational study was conducted on a population comprised 1452 Chuvashians (763 males, aged 49.23 ± 17.43; and 689 females, aged 50.37 ± 17.47 years). OA was evaluated in 14 joints of each hand using Kellgren and Lawrence (K-L), joint space narrowing (JSN) and osteophyte (OS) scores. Serum levels of systemic inflammatory and osteoclastogenic cytokines were measured by an enzyme-linked immunosorbent assay (ELISA). Statistical analyses included descriptive statistics, correlation analysis and multiple linear regressions.

Monocyte chemotactic protein-1 (MCP-1) and osteoprotegerin (OPG) levels were associated with OA traits, but the statistically significant correlations were weak and/or moderate. In particular, the MCP-1 inflammation marker showed a statistically significant association with JSN (β=0.077, P=0.022) and OS (β=0.067, P=0.024) scores, but not with the number of affected joints (K-L ≥ 2). OPG was significantly correlated with the scores as to the number of affected joints (β=0.063, P=0.035) and OS (β=0.077, P=0.028). No significant associations were found between levels of other inflammatory [interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-17] and osteoclastogenic [receptor activator for nuclear factor κ B ligand (RANKL), macrophage colony-stimulating factor (M-CSF)] cytokines and OA characteristics.

This study strengthens the premise that OPG might be a valid biomarker of hand OA. Confirmation of these results in larger cohorts of patients will reinforce our theory that the RANKL/OPG pathway is a suitable target for developing novel agents against OA.