The search for biomarkers–chemical indicators of joint health and disease–has been elusive both in humans and in horses. Current research reveals the complexity of the joint, as both a chemical and a mechanical system, according to a review article by Janny C. de Grauw, DVM, PhD, of the Utrecht University in The Netherlands. An injury to the joint starts a complex cycle of normal and disease processes that poses a challenge to researchers looking to identify and target the molecular basis of disease.

“Starting with the assumption that the joint maintains its own dynamic balance, or homeostasis, we can look at what happens when there is injury and disease,” according to de Grauw. “Current research shows complex but promising results, but it’s likely that no single biomarker is associated with specific disease changes.”

It is more productive to look at multiple biomarkers that reflect changes in cartilage as well as the joint capsule and bone. The diseased joint represents a complex biochemical picture that current imaging techniques fail to grasp, making it very difficult to correlate specific biomarkers with structural damage–the current “gold standard” of biomarker research. De Grauw suggests it might be more productive to correlate the biomarkers with clinical signs such as the degree of pain and disability.

Examining the biochemistry of the joint in and out of balance could yield new insights into early detection of joint disease before it becomes debilitating