title: A new method of monitoring osteomyelitis.
abstract: Chronic infections of bone such as osteomyelitis are frequent events, especially in immunocompromised or diabetic patients, and costly on a national level. Incorrect treatment or delayed diagnosis may lead to loss of the affected extremity or mandible. The aim of this study was to assess the possible value of urinary lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) concentrations in the monitoring of mandibular osteomyelitis. Patients were assigned to the following groups: group 1 (n=85), control; group 2a (n=38), patients with active disease; group 2b (n=25), patients of group 2a 6 months after successful treatment; group 2c (n=7), patients of group 2a with ongoing osteomyelitis 6 months after treatment. The range and upper limit of normal values (HP(max) and LP(max)) were determined in group 1. Levels of LP and HP were measured by high-performance liquid chromatography and fluorescence detection. There was a significant decrease (mean 45.43% for HP and 32.12% for LP) in samples of group 2b compared to 2a (P<0.001 for HP and LP). There was a significant increase in HP values in samples from group 2c compared to 2a (P=0.018). The urinary concentrations of HP and LP appear to act as a marker of disease activity, with a decrease reflecting treatment success and an increase or stable values indicating persistent disease. An inexpensive tool (US$5 per analysis) for the monitoring of osteomyelitis is described.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Heller-Str. 16, D-24105 Kiel, Germany. acil@mkg.uni-kiel.de
authors.forename: I N G
authors.initials: IN
authors.lastname: Springer
authors.forename: J
authors.initials: J
authors.lastname: Wiltfang
authors.forename: A
authors.initials: A
authors.lastname: Dunsche
authors.forename: G C
authors.initials: GC
authors.lastname: Lier
authors.forename: M
authors.initials: M
authors.lastname: Bartsch
authors.forename: P H
authors.initials: PH
authors.lastname: Warnke
authors.forename: E L
authors.initials: EL
authors.lastname: Barth
authors.forename: H
authors.initials: H
authors.lastname: Terheyden
authors.forename: Paul A J
authors.initials: PA
authors.lastname: Russo
authors.forename: N
authors.initials: N
authors.lastname: Czech
authors.forename: Y
authors.initials: Y
authors.lastname: Acil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D002845:Chromatography / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D005453:Fluorescence; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000175:diagnosis / Q000601:surgery / Q000652:urine*; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000601:surgery / Q000652:urine*; D012008:Recurrence; D012737:Sex Factors
chemical_list: D000596:Amino Acids; D015415:Biomarkers; C015484:pyridinoline; C036020:deoxypyridinoline