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Osteoarthritis Cartilage. 2014 Feb;22(2):235-41. doi: 10.1016/j.joca.2013.12.004. Epub 2013 Dec 12.

TSG-6 activity as a novel biomarker of progression in knee osteoarthritis.

Author information

1
Department of Microbiology, New York University, School of Medicine, New York, NY 10016, USA. Electronic address: hans-georg.wisniewski@med.nyu.edu.
2
Department of Microbiology, New York University, School of Medicine, New York, NY 10016, USA.
3
Department of Statistics, Harvard University, Cambridge, MA 02138, USA.
4
Department of Orthopedic Surgery, New York University, School of Medicine, and NYU Hospital for Joint Diseases, New York, NY 10003, USA.
5
Department of Medicine, Duke University, School of Medicine, Durham, NC 27710, USA.
6
Department of Medicine, New York University, School of Medicine, and NYU Hospital for Joint Diseases, New York, NY 10003, USA.
7
Department of Orthopedic Surgery, New York University, School of Medicine, and NYU Hospital for Joint Diseases, New York, NY 10003, USA; Department of Biochemistry and Molecular Pharmacology, NYU School of Medicine, New York, NY 10016, USA.

Abstract

OBJECTIVE:

To establish whether there is an association between TSG-6 activity and osteoarthritis progression.

DESIGN:

TSG-6 activity was determined in 132 synovial fluids from patients with OA of the knee, using a novel quantitative TSG-6 activity assay. The association between TSG-6 activities at baseline and four distinct disease progression states, determined at 3-year follow-up, was analyzed using logistic regression.

RESULTS:

There was a statistically significant relationship between TSG-6 activity at baseline and all OA progression states over a 3-year period. Patient knees with TSG-6 activities in the top tenth percentile, compared to the median activity, had an odds ratio (OR) of at least 7.86 (confidence interval (CI) [3.2, 20.5]) for total knee arthroplasty (TKA) within 3 years, and of at least 5.20 (CI [1.8, 13.9]) after adjustment for confounding factors. Receiver operating characteristic (ROC) analysis for knee arthroplasty yielded a cut-off point of 13.3 TSG-6 activity units/ml with the following parameters: area under the curve 0.90 (CI [0.804, 0.996]), sensitivity 0.91 (CI [0.59, 0.99]), specificity 0.82 (CI [0.74, 0.88]) and a negative predictive value (NPV) of 0.99 (CI [0.934, 0.994]).

CONCLUSION:

The TSG-6 activity is a promising independent biomarker for OA progression. Given the high NPV, this assay may be particularly suitable for identifying patients at low risk of rapid disease progression and to assist in the timing of arthroplasty.

KEYWORDS:

Biomarker; Logistic regression; Osteoarthritis progression; ROC curve; TSG-6 activity

PMID:
24333293
PMCID:
PMC3939799
DOI:
10.1016/j.joca.2013.12.004
[Indexed for MEDLINE]
Free PMC Article
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