MSACL Conference Schedule

Translating Basic Discoveries for Early Detection and Clinical Mangement of Skeletal Disease
Wed 3:30 PM - Session: New Advances
Darren Hillegonds
Skeletal diseases often have a profoundly negative impact on patient survival and quality of life, persistently threatening or directly impacting >70 million Americans. Common hormonal and steroidal treatments also lead to significantly increased short- and long-term fracture risk. The need for improved outcome from early detection and more effective routine management of skeletal disease and bone loss drives the search for new markers of bone health, but existing biomarkers are insufficiently sensitive for routine clinical use. Imaging techniques offer hope of more sensitive bone health assessments, but these techniques (MRI, PET, CT) are often too invasive, expensive, and inconvenient for routine monitoring and disease management.

High precision assessment of skeletal remodeling using a 41Ca tracer may address these problems by providing a simple and highly accurate urine test for timely, non-invasive staging, measurement of therapeutic success, and early detection of progressive disease. 41Ca remains quantifiable via ultra-high sensitivity accelerator mass spectrometry in human urine for many years following a single chemically and radiologically benign oral or intravenous dose; this longevity makes urinary 41Ca content very specific to bone remodeling rates. Because this emerging technique is the only existing assay sufficiently sensitive to detect small changes in bone formation and destruction rates, it bridges a technical gap and could enable translation of the prognostic value of skeletal turnover rate for individualized clinical management.

Our collaborative work is primarily focused on correlating longitudinal changes in urinary 41Ca with key clinical parameters and prognosis in the context of cancer-induced bone disease. Initial work and case studies also suggest utility of the 41Ca technique in the context of renal disease, osteoporosis, and potentially monitoring the healing following hip replacement.

(Research support from Lawrence Livermore National Laboratory, Laboratory Directed Research and Development [04-ERI-09], and the National Institutes of Health [CA127671])