Vascular cell adhesion molecule 1 (VCAM-1) may be a strong predictor of hip and knee joint replacement due to severe osteoarthritis (OA), according to a group of researchers. They also note that inclusion of VCAM-1 levels in risk prediction models resulted in a more accurate classification of individuals.
The details will be published in the August issue of Arthritis & Rheumatism but appear online in a paper titled, “Vascular cell adhesion molecule 1 as a predictor of severe osteoarthritis of the hip and knee joints.”
The study involved 912 healthy individuals in Bruneck, Italy, 60 of whom underwent hip or knee replacement surgery due to severe OA in a 15-year follow-up period. Subjects had a baseline exam in 1990 and follow-up tests were performed every five years until 2005. Blood samples were analyzed for VCAM-1, a sialoglycoprotein expressed on cells in the cartilage and connective tissue.
Results showed that VCAM-1 levels were substantially elevated in the 60 individuals who underwent joint replacement. The highest baseline levels were seen in those who had bilateral joint replacement. “The level of VCAM-1 emerged as a significant predictor of the risk of joint replacement due to severe OA, equaling or even surpassing the effects of age,” the scientists state.
VCAM-1 promotes leukocyte adhesion and homing to sites of inflammation. In chondrocytes, VCAM-1 expression is induced by inflammatory cytokines. This is why increased VCAM-1 levels may emulate active cartilage damage or an inflammatory component in OA, the investigators suggest. In addition, since it mediates the interaction of chondrocytes with immune cells, VCAM-1 may contribute to immune-mediated cartilage damage.