The effects of collagen cross linking on aging fracture risks
Research type
Research Study
Full title
The use of HPLC to quantify the cross links in bone as well as test for compliance of BP usage in patients taking BP.
IRAS ID
214772
Contact name
Richard Abel
Contact email
Sponsor organisation
Imperial College London & Imperial College NHS Trust
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Bone has a complex hierarchical structure. As bone ages, the aging at every hierarchical level affects bone strength and fragility as a whole. Recently, research has gone into looking at the nanostructure of bone, namely the mineral crystals and collagen fibrils, and have shown that the nanoscale mechanics could be of great importance to the bone’s mechanical integrity. In particular the collagen cross linking between fibrils in the collagen network. Research suggests that as bone ages, the number of collagen cross links increases, which may reduce elasticity and make bone more brittle. As such, it is important to study age related changes in bone collagen cross links to determine whether they contribute to fracture risks. Moreover, the current gold standard treatment for osteoporosis is the administration of Bisphosphonate (BP). However, recent research has shown the increasing risks of atypical femoral fractures with the use of BP, yet there has been little explanation for the correlation. It is possible that BP leads to increase in collagen cross links due to the over suppression of bone turnover and thus increases fracture risk. If this is so, BP therapy may exacerbate fragility and clinicians will need to shift the focus of osteoporosis treatment, possibly to target the aging in the cross links. We will use high performance liquid chromotography (HPLC) to quantify the collagen cross links in the blood and urine samples collected from patients. We will also measure biomarkers for bone remodelling so that we can check whether BP is associated with over supressed turnover. Moreover, studies have shown that only half of patients persist with BP treatment due to the associated side effects, as such, HPLC will also allow us to determine patients’ compliance with BP if they had been prescribed the treatment and hence allow for more accurate analysis.
REC name
London - Bloomsbury Research Ethics Committee
REC reference
18/LO/0277
Date of REC Opinion
14 Mar 2018
REC opinion
Further Information Favourable Opinion