The use of alkaline phosphatase as a bone turnover marker after spinal cord injury: A scoping review of human and animal studies. (4th March 2023)

• Record Type: Journal Article
• Authors: Ponzano, Matteo; Wiest, Matheus J.; Coleman, André; Newton, Emily; Pakosh, Maureen; Patsakos, Eleni M.; Magnuson, David S. K.; Giangregorio, Lora M.; Craven, B. Catharine
• Is Part Of: Journal of spinal cord medicine. Volume 46:Number 2(2023)
• Page Start: 167
• Page End: 180
• Publication Date: 2023-03-04
• Subjects: Spinal Injury -- Biomarkers -- Bone metabolism -- Phosphate homeostasis; Spinal cord -- Wounds and injuries -- Periodicals; Spinal cord -- Diseases -- Periodicals; 616.8305
• DOI: 10.1080/10790268.2021.1977905
• Languages: English
• ISSNs: 1079-0268

Abstract

Abstract : Background: Serum alkaline phosphatase (ALP) is measured as an indicator of bone or liver disease. Bone-specific alkaline phosphatase (B-ALP) is an isoform of ALP found in the bone tissue which can predict fractures and heterotopic ossification. Objective: The aim of this scoping review was to explore the current use of ALP and B-ALP in studies using humans or animal models of SCI, and to identify ways to advance future research using ALP and B-ALP as a bone marker after SCI. Results: HUMAN STUDIES: 42 studies were included. The evidence regarding changes or differences in ALP levels in individuals with SCI compared to controls is conflicting. For example, a negative correlation between B-ALP and total femur BMD was observed in only one of three studies examining the association. B-ALP seemed to increase after administration of teriparatide, and to decrease after treatment with denosumab. The effects of exercise on ALP and B-ALP levels are heterogeneous and depend on the type of exercise performed. ANIMAL STUDIES: 11 studies were included. There is uncertainty regarding the response of ALP or B-ALP levels after SCI; levels increased after some interventions, including vibration protocols, curcumin supplementation, cycles in electromagnetic field or hyperbaric chamber. Calcitonin or bisphosphonate administration did not affect ALP levels. Conclusion: Researchers are encouraged to measure the bone-specific isoform of ALP rather than total ALP in future studies in humans of animal models of SCI.