Plasma and Synovial Fluid CXCL12 Levels Are Correlated With Disease Severity in Patients With Knee Osteoarthritis

Background: The aim is to determine whether CXC chemokine ligand-12 (CXCL12) levels in plasma and synovial fluid (SF) of patients with knee osteoarthritis (OA) are correlated with the disease severity. In addition, we set out to investigate whether a peripheral blood test can avoid aspirating patients to determine CXCL12 levels. Methods: This study consisted of 244 patients with knee OA and 244 age-and gender-matched healthy controls. Osteoarthritis progression was classified based on Kellgren-Lawrence (KL) by evaluating radiographic changes observed in anteroposterior knee radiography. The CXCL12 levels in the plasma and SF were measured by a quantitative sandwich enzyme-linked immunosorbent assay. Results: Plasma CXCL12 levels were higher in OA patients as compared with controls (P < .0001). There was a positive correlation between levels of CXCL12 and grade (P < .0001). Base on the receiver operating characteristic curve, the optimal cutoff value of plasma CXCL12 levels as an indicator for screening of OAwas estimated to be 5.5 ng/mL, which yielded a sensitivity of 78.4% and a specificity of 80.2%, with the area under the curve at 0.850 (95% confidence interval[CI], 0.816-0.889; P < .0001). In multivariate analysis, there was an increased risk of active OA associated with plasma CXCL12 levels >= 10.5 ng/mL (odds ratio, 6.76; 95% CI, 3.88-12.53; P < .0001) after adjusting for possible confounders. Similarly, there was an increased risk of active OA associated with SF CXCL12 levels >= 15.0 ng/mL (odds ratio, 8.45; 95% CI, 3.23-18.22; P < .0001) after adjusting for possible confounders. Conclusion: The CXCL12 levels in the plasma and SF may serve as effective biomarkers for the severity of OA.