Assessment of IL-6, TGF-β1 and CTX-II in the diagnosis of early Post-Traumatic Osteoarthritis of knee

Abstract

Objectives: Osteoarthritis is an inflammatory and degenerative disorder characterized by the degradation of the extracellular matrix. It commences with injuries to the knee that activate inflammatory pathways. Trauma may predispose to osteoarthritis, called post-traumatic osteoarthritis (PTOA). The disease is diagnosed in the later stages with (KL grade>2) as seen by X-ray; measuring the biomarkers present in the body fluids holds significant promise for the early detection and evaluation of PTOA. The study aimed to establish the role of inflammatory and collagen markers such as serum interleukin 6 (IL-6), transforming growth factor beta 1 (TGF-β1), and urine C-terminal cross-linked telopeptide of type II collagen (CTX-II) in the diagnosis of early post-traumatic osteoarthritis of the knee. Methods: This case-control study was conducted among 80 participants, of which 40 were apparently healthy individuals, and 40 were cases with a history of trauma to the knee joint in the past ten to 12 weeks. Baseline characteristics, body mass index (BMI), Visual Analog Score (VAS), and Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) were collected from all the participants. X-ray and MRI were done in the cases. Serum IL-6 and TGF-β1, and urine CTX-II were analyzed by ELISA. Statistical analysis was done with SPSS version 16. A P value ≤ 0.05 was considered statistically significant. Results: The mean serum IL-6, TGF-β1, and urine CTX-II levels were significantly higher in cases than in controls, with P values of 0.025, 0.033, and 0.040 respectively. IL-6 showed correlations with age, WOMAC score, and urine CTX-II values. TGF-β1 showed a positive correlation with VAS. Conclusion: Individuals with previous knee joint trauma exhibited notably elevated serum IL-6, TGF-β1, and urine CTXII levels. Among the three biomarkers, IL-6 seemed to be a potential biomarker of early post-traumatic osteoarthritis in patients with knee injuries.