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Serum creatine kinase isoenzymes in children with osteogenesis imperfecta

P D'Eufemia1, R Finocchiaro2, A Zambrano2

  • 1Department of Pediatrics, "Sapienza", University of Rome, Rome, Italy. patdeufemia@inwind.it.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
|August 27, 2016
PubMed

Insights

Serum creatine kinase isoenzyme (CKbb) levels increase with prolonged bisphosphonate treatment in children with osteogenesis imperfecta and decrease upon discontinuation, aiding in monitoring treatment.

Area of Science:

  • Biochemistry
  • Pediatrics
  • Orthopedics

Background:

  • Creatine kinase isoenzyme BB (CKbb) is crucial for osteoclast function and bone resorption.
  • Previous studies indicated elevated CKbb in children with osteogenesis imperfecta (OI) type 1 on bisphosphonate therapy.
  • This study investigates CK isoenzyme changes during and after neridronate treatment in OI patients.

Purpose of the Study:

  • To evaluate serum creatine kinase isoenzyme activity as a biochemical marker in children with osteogenesis imperfecta undergoing bisphosphonate treatment.
  • To assess the impact of continuous versus discontinued neridronate treatment on CK isoenzyme levels.
  • To explore the potential for CKbb monitoring to prevent over-treatment risks.

Main Methods:

  • Included 18 children with OI type 1, divided into continuous (n=12) and discontinued (n=6) neridronate groups.
  • Measured auxological data, bone metabolism markers, bone mineral density, and serum total CK and isoenzyme activities over 2 years.
  • Analyzed changes in CKbb, CKmb, and C-terminal telopeptide (CTx) levels.

Main Results:

  • Serum CKbb significantly increased with continuous neridronate treatment (p < 0.004) and decreased to undetectable levels after discontinuation.
  • Cardiac muscle creatine kinase isoenzyme (CKmb) levels markedly decreased in both groups.
  • Serum CTx levels remained largely unchanged throughout the study.

Conclusions:

  • Neridronate administration has a cumulative effect on increasing serum CKbb levels, which is reversible upon treatment cessation.
  • Serum CKbb can serve as a valuable biochemical marker for monitoring prolonged bisphosphonate therapy in OI patients.
  • Decreased serum CKmb suggests potential systemic effects of bisphosphonate drugs.

Keywords:
BisphosphonatesBone metabolismCreatine kinase isoenzymesOsteoclastOsteogenesis imperfecta

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