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Association between serum and synovial fluid Dickkopf-1 levels with radiographic severity in primary knee osteoarthritis patients

  • Theologis, Thomas1
  • Efstathopoulos, Nikolaos2
  • Nikolaou, Vasileios2
  • Charikopoulos, Ioannis1
  • Papapavlos, Ioannis1
  • Kokkoris, Panayiotis3
  • Papatheodorou, Athanasios3
  • Nasiri-Ansari, Narjes4
  • Kassi, Eva4
  • 1 Thriasio General Hospital-NHS, Department of Trauma and Orthopaedics, G. Gennimata Avenue, Magoula, Attica, 19600, Greece , Magoula (Greece)
  • 2 National and Kapodistrian University of Athens, 2nd Department of Trauma and Orthopedics, 2-4 Agias Olgas Str, Nea Ionia, Athens, 14233, Greece , Nea Ionia (Greece)
  • 3 251 Hellenic Air Force & VA General Hospital, Department of Endocrinology and Diabetes, Athens, Greece , Athens (Greece)
  • 4 National and Kapodistrian University of Athens, Department of Biological Chemistry, Medical School, 75 Mikras Asias Str, Goudi, Athens, 11527, Greece , Goudi (Greece)
Published Article
Clinical Rheumatology
Publication Date
Apr 27, 2017
DOI: 10.1007/s10067-017-3640-7
Springer Nature


Primary knee osteoarthritis (OA) contributes to disability among middle-aged and elderly people. Dickkopf-1 (Dkk-1) and sclerostin are inhibitors of Wnt/β-catenin signaling pathway implicated in regulation of cartilage homeostasis and bone formation, respectively. We aim to investigate the association between the serum(s) and synovial fluid (SF) Dkk-1 and sclerostin levels and disease severity in patients with primary knee OA. Forty patients aged 56–87 years with primary knee OA and 20 healthy individuals were recruited. Weight-bearing anteroposterior radiographs of the affected knee were used to determine the disease severity according to Kellgren and Lawrence criteria. Dkk-1 and sclerostin levels in serum and SF were measured by ELISA. SF Dkk-1 levels were significantly higher in the OA, compared to control group (180 ± 182 vs 128 ± 330 pg/ml, p < 0.001). However, OA patients did not differ significantly regarding the sDkk-1 concentrations compared to healthy controls (1289.8 pg/ml vs 1214.1, respectively, p = 0.630). SF Dkk-1 levels in Kellgren and Lawrence (KL) grade 4 were significantly elevated compared to those of KL grades 2 and 3 (1.97 vs 2.23 pg/ml, p = 0.017, log transformed because data were not normally distributed), whereas sDkk-1 levels between those groups demonstrated marginally statistically significant difference (1111.8 vs 1415.9 pg/ml, p = 0.057). SFSclerostin and sSclerostin levels did not have any significant difference between the OA and control groups. SF Dkk-1 levels are positively related to the severity of joint damage in knee OA. Sclerostin levels failed to substantiate an association to knee OA progression. Dkk-1 could play a potential role in the degenerative process of OA. Thus, DKK-1 may emerge as a promising future therapeutic manipulation of OA.

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