In bone physiology, C-terminal telopeptide (or more formally, crosslink collagen karbokage terminal , and known by the acronym CTX ) is a usable telopeptide as a serum biomarker to measure the rate of bone turnover. This can be useful in assisting the physician to determine the response of the patient's non-surgical treatment as well as evaluating the patient's risk of developing complications during recovery after surgical intervention. The tests used to detect CTX markers are called Serum CrossLaps, and are more specific for bone resorption than other tests available today.
Video C-terminal telopeptide
Osteonecrosis terkait Bisphosphonate pada rahang
In early 2000, the relationship between the use of bisphosphonates and bone physiologic disorders was noted. Strong inhibition of osteoclast function deposited by bisphosphonate therapy may lead to inhibition of normal bone turnover, leading to wound healing after trauma (such as dental surgery) or even spontaneous exposure without healing. Because bisphosphonates are preferably stored in bones with high turnover rates, it may be that the level of bisphosphonates in the jawbone increases selectively.
Maps C-terminal telopeptide
Risk determination
With the advent of dental implants, more dental patients undergo therapy in the oral cavity involving bone healing, such as surgical implant placement and bone grafting procedures. To evaluate the risk of osteonecrosis for patients taking bisphosphonates, the use of CTX biomarkers was introduced in 2000 by Rosen.
Use of CTX biomarker
Although a number of replacement biomarkers exist to measure metabolic products of bone resorption, serum CTX markers are selected because they are highly correlated with bone turnover and are available for detection in laboratory tests conducted by large lab testing firms.
The CTX test measures the presence and concentration of crosslink peptide sequences of type I collagen, found, among other tissues, in bone. This specific peptide sequence is related to bone turnover because it is the part that is cleaved by the osteoclast during bone resorption, and its serum level is therefore proportional to osteoclastic activity at the time the blood sample is taken. Serum levels in healthy patients who did not use bisphosphonates tended to hover above 300 pg/mL.
"Although the normal range of laboratory is said to be between 50 pg/mL and 450 pg/mL, this normal range is not accurately related to the osteoporosis population.A normal normal value is usually more than 300 pg/mL and most commonly 400 pg/mL to 550 pg/mL in patients who did not take bisphosphonates The lower values ​​represent varying degrees of emphasis on normal bone turnover, sometimes also called bone remodeling or bone renewal. "
Patients placed on a 6 month drug holiday showed an increase in their serum CTX values; in one study, patients showed an increase of 155.3 pg/mL for 6 months or a rate of 25.9 pg/mL each month.
Initially, urine CTX levels were sought, but this proved to offer no greater value than NTX values ​​of urine - both tests suffered from large spontaneous fluctuations that were unrelated to therapy or intervention, and were therefore largely unreliable. In contrast, monoclonal antibody testing to detect serum CTX levels has minimal spontaneous disturbance but remarkable changes to antiresorptive therapy, making CTX serum assay both highly sensitive and specific.
See also
N-terminal telopeptide
References
Source of the article : Wikipedia
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