title: Differences in biomarkers of cartilage matrix turnover and their changes over 2 years in adolescent and adult volleyball athletes.
abstract: BACKGROUND
  This study aimed the feasibility to assess longitudinal changes in biomarkers of cartilage turnover and to determine their relationship with patient-rated outcomes over 2 years in volleyball athletes.
  
  
  METHODS
  Thirty-seven athletes were studied: 18 adolescents (age 15.9 ± 0.64 years) in a 2-year intensive volleyball training program and 19 adult recreational volleyball players (age 46.5 ± 4.9 years). Blood and serum samples were taken at baseline (BL) and 2-year follow-up (FU). Subjects completed the International Knee Documentation Committee (IKDC) Subjective Knee Form and the Short-Form 36 (SF-36) at BL.
  
  
  RESULTS
  Thirteen adolescents (72%) had open growth plates at BL (BL open adolescents), the rest had closed growth plates at BL (BL closed adolescents), and all but one adolescent had closed growth plates at FU as assessed by MRI. BL open and closed adolescents had greater levels of the cartilage degradation-based biomarkers 45 mer collagenase peptide of type II collagen (C2C-HUSA) and C-telopeptide of type II collagen (CTX-II) than adults. BL open adolescents showed decreases in C2CHUSA, collagen synthesis marker C-propeptide of type II procollagen (CPII), and CTXII, and adults showed increases in cartilage intermediate layer protein 2 (CILP-2) and C2C-HUSA. In adolescents, IKDC scores were correlated with CPII changes. In adults, SF-36 Physical Component Scores were correlated with cartilage oligomeric matrix protein (COMP) changes.
  
  
  CONCLUSIONS
  Significant differences in biomarker levels over time show the feasibility to assess their changes. Greater levels of C2C-HUSA and CTX-II in adolescents than in adults may reflect increased cartilage turnover in response to higher joint loading. CPII and COMP may be more reflective of subjective patient outcomes. These biomarkers may thus be useful in assessing mechanical loading-induced cartilage changes, their associated symptoms, and Osteoarthritis risk in athletes.
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany. heide.boeth@charite.de.
authors.forename: Heide
authors.initials: H
authors.lastname: Boeth
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Aoife
authors.initials: A
authors.lastname: MacMahon
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: A Robin
authors.initials: AR
authors.lastname: Poole
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Buttgereit
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Patrik
authors.initials: P
authors.lastname: Önnerfjord
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Pilar
authors.initials: P
authors.lastname: Lorenzo
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Klint
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Pramhed
authors.affiliation: Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Georg N
authors.initials: GN
authors.lastname: Duda
keywords: Athletes; Biomarkers; Cartilage; Osteoarthritis; Patient-rated outcomes; Volleyball