Oct
2
2012
Editor’s note: This is the second article in a two-part series about osteoarthritis research at the Comparative Orthopaedic Laboratory at the University of Missouri-Columbia. In the first part, we covered the lab’s work with biological joint replacement.
 
 
Using just a single drop of joint fluid, Dr. James Cook’s laboratory can tell you if that joint is predisposed to arthritis, or if the joint already has arthritis but is not yet showing signs and symptoms. They can also tell you the severity of the arthritis, how likely it is to progress, and how quickly it will progress.

This ultra-specific level of insight started with a group of researchers examining dogs and humans with a goal of learning how to predict osteoarthritis before symptoms even crop up. What they discovered was a solution for early osteoarthritis diagnosis that is already approved for use in dogs and appears to be on track for human use in less than a half-decade.

Cook discussed the progress of biomarker research being conducted at his laboratory that could offer people and dogs a sizable advantage in the fight against osteoarthritis.

Mounting a search for biomarkers
Researchers at the Comparative Orthopaedic Laboratory at the University of Missouri-Columbia conducted separate studies on humans and dogs to search for osteoarthritis biomarker panels in each species.

They hypothesized that identifying biomarkers would make it possible to accurately predict the presence and severity of osteoarthritis, which Cook said would help for early diagnosis, staging, and treatment monitoring.

Cook said he was surprised when their studies revealed that humans and dogs shared the exact same seven biomarkers for assessing osteoarthritis.

“It’s pretty amazing that the same panel works for both. This is important for many reasons, one of which is that it allows us to use a lot of our canine validation data to pursue FDA approval for humans,” he said.

Discovering the biomarkers opened up a new range of possibilities when it comes to preventing and treating osteoarthritis, Cook said.

Early detection, early prevention
Many people go to the doctor because aspirin and ibuprofen are no longer strong enough to dull their arthritis pain. By this time, Cook says that they typically already have end-stage osteoarthritis and are relegated to total joint replacement.

If his lab’s biomarkers can provide advanced warning of impending arthritis, Cook says people might be more motivated to take proven preventive measures such as weight loss, diet change, and engagement in non-concussive activities such as swimming or bike riding.

Early detection may also increase the effectiveness of currently available treatments, as well as someday offer new pathways for finding cures, he said.

“The other thing we think these biomarkers will do is to give us better chances for early intervention. A lot of remarkable biological treatments are currently available, but the reason they aren’t being used more often is because we the patients too late - there’s no cartilage to preserve or there are many defects in the joint rather than a focal defect like you would see early on. So with accurate biomarkers, we’ll be able to use a lot of those biological therapies more effectively,” he said.

According to Cook, the University of Missouri is already offering the canine version for clinical-use licensing. The human version is undergoing a validation study in fall 2012, and Cook predicts that if all goes well it will be put to clinical use for humans in three to four years.

Medical benefits on a larger scale
While the biomarker program looks to have simplified diagnosis of canine and human osteoarthritis, Cook said he thinks it could contribute to much larger future discoveries.

“I think the whole biomarker area will expand to a bunch of other areas: cardiovascular, stroke, Alzheimer’s, cancer … I think we’ll get ways to diagnose things much quicker in all areas of medicine,” he said.

Another hope of Cook’s when it comes to biomarkers is that it will offer more transparency and better decision-making for the medical world.

“I think it will help us a lot with evidence-based medicine,” he said. “Really getting away from anecdotal and sensationalism-type claims for things, really putting some true data behind what companies are putting out, what the FDA can approve, what’s really working, and what’s truly cost-effective.”

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