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Introduction: Osteocalcin (OC) is a small bone matrix protein exclusively found in mineralized tissue. OC measured in serum or plasma provides an index of bone formation. In the present study a sensitive inhibition ELISA was established that could quantify fragments derived from the OC Mid-region in human urine.
Methods: The ELISA was based on a monoclonal antibody directed against residues 21-29 of human OC (Mid-OC Urine ELISA). OC fragments were isolated from human urine by immunoaffinity chromatography. OC fragments were purified further by reversed phase high performance chromatography for characterization by N-terminal sequencing and mass-spectrometry. OC fragments were assayed in bone cell culture supernatants and in serum and urine from patients undergoing anti-resorptive bisphosphonate therapy using the Mid-OC urine ELISA.
Results and Conclusion: It was demonstrated that the release of OC fragments was highly correlated with osteoclast-mediated pit formation (r^2= 0.89) and with an established marker of bone resorption (CTX; r^2=0.91). Mid-OC values were decreased markedly after 3 and 10 days of anti-resorptive bisphosphonate treatment further indicating that the marker reflects bone resorption. The molecular characterization revealed that most of these molecules were less than 15 amino acids in length and many contained modified aspartyl residues (D-aspartyl and isoaspartyl) characteristic of aged proteins. The presence of such modifications shows that these molecules have resided in the bone matrix for an extended period and thus they cannot be derived directly from bone formation. In conclusion, these findings demonstrate that OC-fragments are released during osteoclastic bone resorption and that the quantification of specific age-modified OC fragments can provide an index of bone resorption.
DOI: Clin. Lab. 2004;50:585-598
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