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Mediators of Inflammation
Volume 2014, Article ID 484280, 5 pages
http://dx.doi.org/10.1155/2014/484280
Review Article

Bone Remodelling Markers in Rheumatoid Arthritis

1Department of Rheumatology, Hôpital Nord, Place Victor Pauchet, 80054 Amiens, France
2INSERM U1088, 1 rue des Louvels, 80000 Amiens, France

Received 23 October 2013; Revised 2 February 2014; Accepted 3 February 2014; Published 15 April 2014

Academic Editor: Frédérique Ponchel

Copyright © 2014 Patrice Fardellone et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bone loss in rheumatoid arthritis (RA) patients results from chronic inflammation and can lead to osteoporosis and fractures. A few bone remodeling markers have been studied in RA witnessing bone formation (osteocalcin), serum aminoterminal propeptide of type I collagen (PINP), serum carboxyterminal propeptide of type I collagen (ICTP), bone alkaline phosphatase (BAP), osteocalcin (OC), and bone resorption: C-terminal telopeptide of type 1 collagen (I-CTX), N-terminal telopeptide of type 1 collagen (I-NTX), pyridinolines (DPD and PYD), and tartrate-resistant acid phosphatase (TRAP). Bone resorption can be seen either in periarticular bone (demineralization and erosion) or in the total skeleton (osteoporosis). Whatever the location, bone resorption results from activation of osteoclasts when the ratio between osteoprotegerin and receptor activator of nuclear factor kappa-B ligand (OPG/RANKL) is decreased under influence of various proinflammatory cytokines. Bone remodeling markers also allow physicians to evaluate the effect of drugs used in RA like biologic agents, which reduce inflammation and exert a protecting effect on bone. We will discuss in this review changes in bone markers remodeling in patients with RA treated with biologics.