Science in brief: Report on the Havemeyer Foundation workshop on equine musculoskeletal biomarkers--current knowledge and future needs

Concurrent measurement of serum and radiomic biomarkers in the clinical investigation of equine musculoskeletal injuries: A prospective pilot study

The prevention of musculoskeletal injuries and their related welfare and economic impacts represent an immediate priority for the horse racing industry. This prospective pilot study aimed to evaluate a method to quantitatively analyze scintigraphic features of specific anatomical regions of the horse's appendicular skeleton in combination with secondary measures of musculoskeletal metabolism in blood. Twelve horses referred for scintigraphic assessment of lameness were enrolled. Blood samples were collected immediately prior to the administration of radiotracer. Serum concentrations associated with bone turnover were determined for the following biomarkers: C-terminal telopeptides of type I collagen, proteoglycans and sulfated glycosaminoglycans, collagen type II, osteocalcin, and procollagen II C-terminal propeptide. Scintigraphic images underwent radiomic analysis of discrete regions of the distal limbs and these data were correlated to bone turnover markers. Three lame horses demonstrated asymmetrical radiomic abnormalities. The concentration of osteocalcin in the lame horses was significantly higher when compared to the control group, while no significant changes were observed for the other screened serum biomarkers. Findings from the current study provided evidence that radiomic analysis of equine scintigraphy is feasible. This method has the potential to interrogate which serum markers are associated with musculoskeletal injuries.

Metabolism and global protein glycosylation are differentially expressed in healthy and osteoarthritic equine carpal synovial fluid

BACKGROUND

Carpal osteochondral fragmentation and subsequent post-traumatic osteoarthritis (PTOA) are leading causes of wastage in the equine athlete. Identification of synovial fluid biomarkers could contribute to the diagnosis and understanding of osteoarthritis (OA) pathophysiology.

OBJECTIVE

The aim of this study was to identify differentially expressed metabolic and glycosylation pathways in synovial fluid from healthy horses and horses with naturally occurring carpal OA.

STUDY DESIGN

Cross-sectional, in vivo metabolomics and glycomics study.

METHODS

In cohort 1, carpal synovial fluid (n = 12 horses; n = 6 healthy, n = 6 OA) was analysed using high-resolution liquid chromatography mass spectrometry (LC-MS). In cohort 2 (n = 40 horses; n = 20 healthy, n = 20 OA), carpal synovial fluid was analysed using lectin microarrays and a lubricin sandwich ELISA.

RESULTS

Metabolomic analysis identified >4900 LC-MS features of which 84 identifiable metabolites were differentially expressed (P < .05) between healthy and OA joints, including key pathways related to inflammation (histidine and tryptophan metabolism), oxidative stress (arginine biosynthesis) and collagen metabolism (lysine metabolism). Principle Component Analysis and Partial Least Squares Discriminant Analysis demonstrated separation between healthy and OA synovial fluid. Lectin microarrays identified distinct glycosylation patterns between healthy and OA synovial fluid, including increased Core 1/Core 3 O-glycosylation, increased α-2,3 sialylation and decreased α-1,2 fucosylation in OA. O-glycans predominated over N-glycans in all synovial fluid samples, and synovial fluid lubricin was increased in OA joints as compared to controls.

MAIN LIMITATIONS

The sample size in cohort 1 was limited, and there is inherent variation in severity and duration of joint injury in naturally occurring OA. However, LC-MS identified up to 5000 unique features.

CONCLUSIONS

These data suggest new potential diagnostic and therapeutic targets for equine OA. Future targeted metabolomic and glycomic studies should be performed to verify these results. Lectin microarrays could be investigated as a potential screening tool for the diagnosis and therapeutic monitoring of equine OA.

Biomarkers for equine joint injury and osteoarthritis

We report the results of a symposium aimed at identifying validated biomarkers that can be used to complement clinical observations for diagnosis and prognosis of joint injury leading to equine osteoarthritis (OA). Biomarkers might also predict pre-fracture change that could lead to catastrophic bone failure in equine athletes. The workshop was attended by leading scientists in the fields of equine and human musculoskeletal biomarkers to enable cross-disciplinary exchange and improve knowledge in both. Detailed proceedings with strategic planning was written, added to, edited and referenced to develop this manuscript. The most recent information from work in equine and human osteoarthritic biomarkers was accumulated, including the use of personalized healthcare to stratify OA phenotypes, transcriptome analysis of anterior cruciate ligament (ACL) and meniscal injuries in the human knee. The spectrum of "wet" biomarker assays that are antibody based that have achieved usefulness in both humans and horses, imaging biomarkers and the role they can play in equine and human OA was discussed. Prediction of musculoskeletal injury in the horse remains a challenge, and the potential usefulness of spectroscopy, metabolomics, proteomics, and development of biobanks to classify biomarkers in different stages of equine and human OA were reviewed. The participants concluded that new information and studies in equine musculoskeletal biomarkers have potential translational value for humans and vice versa. OA is equally important in humans and horses, and the welfare issues associated with catastrophic musculoskeletal injury in horses add further emphasis to the need for good validated biomarkers in the horse. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:823-831, 2018.