C-terminal telopeptide of type I collagen (ICTP)

The C-terminal type I collagen telopeptide is formed in the process of collagen fiber degradation. It is a marker of the intensification of the bone resorption process. The indications for testing the concentration of this marker are, among others, osteoporosis, Paget’s disease and disorders of calcium and phosphate metabolism.

What is the c-terminal telopeptide type I collagen?

ICTP is a peptide that is produced during the degradation of type I collagen. So what is collagen then? It is a protein that is the main building block of the bone matrix and connective tissue. There are several types of it, but the most common type of collagen in our body is type I. It is responsible for the formation of our tendons and bone tissue, skin connective tissue, scar tissue and subcutaneous tissue.

The collagen is destroyed through the action of enzymes collagenosesType I collagen C-telopeptide is one of the products of this enzymatic degradation. C-terminal telopeptide is used in laboratory diagnostics as a marker of osteolysis (bone resorption process). A high concentration of the c-terminal type I collagen telopeptide is mainly observed in ailments characterized by excessive bone turnover and increased activity of osteoclast cells. The test is used to diagnose osteoporosis, cancer and bone metastases, and hyperparathyroidism. In patients suffering from osteoporosis, ICTP testing helps to determine the risk of osteoporotic fractures and to monitor the anti-resorptive treatment used.

C-terminal type I collagen telopeptide – when do we perform?

The main indications for a c-telopeptide test are presented below.

1. Conditions with excessive activity of osteoclasts, intensifying the processes of bone resorption, osteoporosis, osteodystrophy, calcium-phosphate disturbances.

2. Metabolic diseases of bone tissue (Paget’s disease, adynamic bone disease).

3. Assessment of the correctness of bone turnover in children.

Test material: serum or daily urine collection. The determinations are carried out using immunoenzymatic methods.

Preparation for the test: on an empty stomach (at least 8 hours).

The course of the study: one-time blood sampling from a vein in the arm.

Time to wait for the result: 1 Day.

Standards:

(when the material is serum)

– premenopausal women – less than 4000 pmol / L;

– postmenopausal women –
less than 7000 pmol / L;

– kids –
7500 ± 5000 pmol/l.

However, when the test is performed on a daily urine collection, the standards are as follows:

– premenopausal women – less than 450 μg / mmol creatinine;

– postmenopausal women – less than 800 μg / mmol creatinine;

– men – less than 450 μg / mmol creatinine.

Comments: ICTP is a type I collagen degradation peptide. It contains cross-linking. The concentration of this telopeptide is also influenced by bone formation, therefore this marker is rather an index of bone turnover.

Typically, testing of the C-terminal telopeptide of type I collagen is performed together with other markers, e.g. bone matrix collagen degradation products (deoxypyridinoline, pyridinoline), tartrate-resistant acid phosphatase and the N-terminal telopeptide of the type I collagen chain. it is possible to correctly interpret the results.

Elevated concentration of C-terminal type I collagen telopeptide

High levels of this enzyme are observed, as previously mentioned, in people with osteoporosis. For this reason, marking the marker is important in determining the condition of bone tissue in postmenopausal women and in the elderly, who are at the highest risk of osteoporosis. Moreover, thanks to the examination, the risk of osteoporotic fractures can be determined. High levels of C-terminal type I collagen telopeptide may also be a consequence of taking glucocorticosteroids, which increase bone turnover and contribute to the development of steroidal osteoporosis. In addition, the concentration of the ICTP marker is high in people suffering from certain cancers, e.g. multiple myeloma, and in the case of bone metastases of thyroid, breast, prostate or lung cancer. These neoplasms destroy bone tissue, sometimes to such an extent that it causes pathological bone fractures.

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