N-terminal telopeptide

Last updated
N-terminal telopeptide
N-terminal telopeptide.svg
Names
Other names
NTX; N-terminal crosslinked telopeptides of collagen 1; Collagen alpha-1(IX) chain
Identifiers
3D model (JSmol)
  • [C@@H](NC([C@@H](NC([C@@H](NC([C@H](CC1=CC=C(O)C=C1)N)=O)CC(O)=O)=O)CCC(O)=O)=O)(C(N[C@H](C(N[C@H](C(NCC(NCC(O)=O)=O)=O)[C@@H](C)O)=O)CO)=O)CCCCN
Properties
C35H53N9O16
Molar mass 855.856 g·mol−1
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).

The N-terminal telopeptide (NTX), also known as amino-terminal collagen crosslinks, is the N-terminal telopeptide of fibrillar collagens such as collagen type I and type II. It is used as a biomarker to measure the rate of bone turnover. NTX can be measured in the urine (uNTX) or serum (serum NTX). [1] The peptide consists of eight amino acids with the sequence YDEKSTGG. [2]

Contents

Usefulness of NTX as a biomarker

Evaluating an individual's rate of bone turnover, termed bone remodeling, directly may be important in assessing his or her potential nonsurgical treatment response as well as evaluating his or her risk of developing complications during healing following surgical intervention. To determine an individual's rate of bone turnover, numerous biomarkers are available in the body fluids that can be correlated to this rate, and one such biomarker is NTX. [1]

However, while NTX does fluctuate in a very sensitive manner in line with bone resorption patterns, they are not very specific, in that they may vary spontaneously without physiologic intervention. For example, NTX levels may drop by 50% from day to day with no treatment, [3] thus, making NTX levels unconvincing evidence of treatment effect. [4]

Conversely, the serum CTX biomarker, described in 2000 by Rosen, appears to be a much more effective and valuable indicator of bone resorption rate. [4]

See also

Related Research Articles

<span class="mw-page-title-main">Parathyroid hormone</span> Mammalian protein found in Homo sapiens

Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone secreted by the parathyroid glands that regulates the serum calcium concentration through its effects on bone, kidney, and intestine.

<span class="mw-page-title-main">Osteoclast</span> Cell that breaks down bone tissue

An osteoclast is a type of bone cell that breaks down bone tissue. This function is critical in the maintenance, repair, and remodeling of bones of the vertebral skeleton. The osteoclast disassembles and digests the composite of hydrated protein and mineral at a molecular level by secreting acid and a collagenase, a process known as bone resorption. This process also helps regulate the level of blood calcium.

<span class="mw-page-title-main">Bisphosphonate</span> Pharmaceutical drugs for preventing bone loss

Bisphosphonates are a class of drugs that prevent the loss of bone density, used to treat osteoporosis and similar diseases. They are the most commonly prescribed drugs used to treat osteoporosis. They are called bisphosphonates because they have two phosphonate groups. They are thus also called diphosphonates.

CTX is a three-letter abbreviation with multiple meanings:

<span class="mw-page-title-main">Alendronic acid</span> Chemical compound

Alendronic acid, sold under the brand name Fosamax among others, is a bisphosphonate medication used to treat osteoporosis and Paget's disease of bone. It is taken by mouth. Use is often recommended together with vitamin D, calcium supplementation, and lifestyle changes.

<span class="mw-page-title-main">Bone resorption</span> Medical condition

Bone resorption is resorption of bone tissue, that is, the process by which osteoclasts break down the tissue in bones and release the minerals, resulting in a transfer of calcium from bone tissue to the blood.

Pachydermoperiostosis (PDP) is a rare genetic disorder that affects both bones and skin. Other names are primary hypertrophic osteoarthropathy or Touraine-Solente-Golé syndrome. It is mainly characterized by pachyderma, periostosis and finger clubbing.

<span class="mw-page-title-main">Acid phosphatase</span> Class of enzymes

Acid phosphatase is an enzyme that frees attached phosphoryl groups from other molecules during digestion. It can be further classified as a phosphomonoesterase. It is stored in lysosomes and functions when these fuse with endosomes, which are acidified while they function; therefore, it has an acid pH optimum. This enzyme is present in many animal and plant species.

<span class="mw-page-title-main">RANKL</span> Mammalian protein found in Homo sapiens

Receptor activator of nuclear factor kappa-Β ligand (RANKL), also known as tumor necrosis factor ligand superfamily member 11 (TNFSF11), TNF-related activation-induced cytokine (TRANCE), osteoprotegerin ligand (OPGL), and osteoclast differentiation factor (ODF), is a protein that in humans is encoded by the TNFSF11 gene.

<span class="mw-page-title-main">Osteonecrosis of the jaw</span> Medical condition

Osteonecrosis of the jaw (ONJ) is a severe bone disease (osteonecrosis) that affects the jaws. Various forms of ONJ have been described since 1861, and a number of causes have been suggested in the literature.

<span class="mw-page-title-main">Tartrate-resistant acid phosphatase</span> Protein-coding gene in the species Homo sapiens

Tartrate-resistant acid phosphatase, also called acid phosphatase 5, tartrate resistant (ACP5), is a glycosylated monomeric metalloprotein enzyme expressed in mammals. It has a molecular weight of approximately 35kDa, a basic isoelectric point (7.6–9.5), and optimal activity in acidic conditions. TRAP is synthesized as latent proenzyme and activated by proteolytic cleavage and reduction. It is differentiated from other mammalian acid phosphatases by its resistance to inhibition by tartrate and by its molecular weight.

Type I collagen is the most abundant collagen of the human body, consisting of around 90% of the body's total collagen in vertebrates. Due to this, it is also the most abundant protein type found in all vertebrates. Type I forms large, eosinophilic fibers known as collagen fibers, which make up most of the rope-like dense connective tissue in the body. Collagen I itself is created by the combination of both a proalpha1 and a proalpha2 chain created by the COL1alpha1 and COL1alpha2 genes respectively. The Col I gene itself takes up a triple-helical conformation due to its Glycine-X-Y structure, x and y being any type of amino acid. Collagen can also be found in two different isoforms, either as a homotrimer or a heterotrimer, both of which can be found during different periods of development. Heterotrimers, in particular, play an important role in wound healing, and are the dominant isoform found in the body.

Senile osteoporosis has been recently recognized as a geriatric syndrome with a particular pathophysiology. There are different classification of osteoporosis: primary, in which bone loss is a result of aging and secondary, in which bone loss occurs from various clinical and lifestyle factors. Primary, or involuntary osteoporosis, can further be classified into Type I or Type II. Type I refers to postmenopausal osteoporosis and is caused by the deficiency of estrogen. While senile osteoporosis is categorized as an involuntary, Type II, and primary osteoporosis, which affects both men and women over the age of 70 years. It is accompanied by vitamin D deficiency, body's failure to absorb calcium, and increased parathyroid hormone.

<span class="mw-page-title-main">Tiludronic acid</span> Chemical compound

Tiludronic acid is a bisphosphonate used for treatment of Paget's disease of bone in human being medicine. It has the tradename Skelid. In veterinary medicine, tiludronic acid is used to treat navicular disease and bone spavin in horses. Its tradenames are Tildren and Equidronate. It is approved for treatment of navicular disease and distal, tarsal osteoarthritis in Europe, and was approved for treatment of navicular disease in the United States in 2014.

NTX may refer to:

<span class="mw-page-title-main">Collagen, type X, alpha 1</span> Protein found in humans

Collagen alpha-1(X) chain is a protein that in humans is a member of the collagen family encoded by the COL10A1 gene.

<span class="mw-page-title-main">Medication-related osteonecrosis of the jaw</span> Medical condition

Medication-related osteonecrosis of the jaw is progressive death of the jawbone in a person exposed to a medication known to increase the risk of disease, in the absence of a previous radiation treatment. It may lead to surgical complication in the form of impaired wound healing following oral and maxillofacial surgery, periodontal surgery, or endodontic therapy.

<span class="mw-page-title-main">Deoxypyridinoline</span> Chemical compound


Deoxypyridinoline, also called D-Pyrilinks, Pyrilinks-D, or deoxyPYD, is one of two pyridinium cross-links that provide structural stiffness to type I collagen found in bones. It is excreted unmetabolized in urine and is a specific marker of bone resorption and osteoclastic activity. It is measured in urine tests and is used along with other bone markers such as alkaline phosphatase, osteocalcin, and N-terminal telopeptide to diagnose bone diseases such as postmenopausal osteoporosis, bone metastasis, and Paget's disease, furthermore, it has been useful in monitoring treatments that contain bone-active agents such as estrogens and bisphosphonates.

<span class="mw-page-title-main">C-terminal telopeptide</span> Chemical compound

The C-terminal telopeptide (CTX), also known as carboxy-terminal collagen crosslinks, is the C-terminal telopeptide of fibrillar collagens such as collagen type I and type II. It is used as a biomarker in the serum to measure the rate of bone turnover. It can be useful in assisting clinicians to determine a patient's nonsurgical treatment response as well as evaluate a patient's risk of developing complications during healing following surgical intervention. The test used to detect the CTX marker is called the Serum CrossLaps, and it is more specific to bone resorption than any other test currently available.

<span class="mw-page-title-main">Bruck syndrome</span> Medical condition

Bruck syndrome is characterized as the combination of arthrogryposis multiplex congenita and osteogenesis imperfecta. Both diseases are uncommon, but concurrence is extremely rare which makes Bruck syndrome very difficult to research. Bruck syndrome is thought to be an atypical variant of osteogenesis imperfecta most resembling type III, if not its own disease. Multiple gene mutations associated with osteogenesis imperfecta are not seen in Bruck syndrome. Many affected individuals are within the same family, and pedigree data supports that the disease is acquired through autosomal recessive inheritance. Bruck syndrome has features of congenital contractures, bone fragility, recurring bone fractures, flexion joint and limb deformities, pterygia, short body height, and progressive kyphoscoliosis. Individuals encounter restricted mobility and pulmonary function. A reduction in bone mineral content and larger hydroxyapatite crystals are also detectable Joint contractures are primarily bilateral and symmetrical, and most prone to ankles. Bruck syndrome has no effect on intelligence, vision, or hearing.

References

  1. 1 2 Iba, Kousuke; Takada, Junichi; Hatakeyama, Naoko; Ozasa, Yasuhiro; Wada, Takuro; Yamashita, Toshihiko (9 October 2008). "Changes in urinary NTX levels in patients with primary osteoporosis undergoing long-term bisphosphonate treatment". Journal of Orthopaedic Science. 13 (5): 438–441. doi:10.1007/s00776-008-1265-z. PMID   18843458. S2CID   26666889.
  2. "N-terminal telopeptide". MarkerDB.
  3. Rosen, HN; Moses, AC; Garber, J; Iloputaife, ID; Ross, DS; Lee, SL; Greenspan, SL (February 2000). "Serum CTX: a new marker of bone resorption that shows treatment effect more often than other markers because of low coefficient of variability and large changes with bisphosphonate therapy". Calcified Tissue International. 66 (2): 100–3. doi:10.1007/pl00005830. PMID   10652955. S2CID   837978.
  4. 1 2 Rosen, HN; Moses, AC; Garber, J; Ross, DS; Lee, SL; Greenspan, SL (November 1998). "Utility of biochemical markers of bone turnover in the follow-up of patients treated with bisphosphonates". Calcified Tissue International. 63 (5): 363–8. doi:10.1007/s002239900541. PMID   9799818. S2CID   20763059.