CTX-II Detection Service

C-terminal telopeptides of collagen type II (CTX-II), a C-terminal 1/4-length fragment of type II collagen cleavage, is a biomarker that reflects the pathological changes and metabolism of joint tissues. It can be detected in urine, blood and synovial fluid. Creative BioMart Biomarker is capable to provide our customers with superior CTX-II detection service, various detection methods ensuring high sensitivity for detecting biomarkers in different samples with different concentrations.


Type II collagen is a homotrimer of the a1 (II) chain that undergoes hydroxylation, interchain disulfide bonds and triple helix. This molecule is then secreted into the extracellular matrix of the cartilage. With the development of osteoarthritis (OA), the joint components including matrix and cartilage are degraded by proteases, and collagenase cleaves type II collagen, producing two fragments: a 3/4 length fragment and a 1/4 length fragment. The degradation product CTX-II is a 1/4 length fragment of the C-terminus that is released into serum and urine. The urine assay is a competitive ELISA which detects the monomeric and dimeric CTX-II, while only the cross-linked dimer CTX-II can be detected in the serum. The normal CTX-II levels in urine vary with age and gender. The normal levels are as follows (ng/mmol creatinine): females 299, peri-premenopausal females 168, peri-postmenopausal females 318, males 278. The level of CTX-II in patients with OA was 3-fold higher than that in the control, demonstrating that CTX-II can be used as a biomarker for the diagnosis of OA. CTX-II can also be used as a disease burden marker and a prognostic marker. As a marker of cartilage damage, CTX-II is associated with the degree of joint destruction. At the same time, several studies have shown that CTX-II is also valuable in the evaluation of therapeutic efficacy.

The structure of type II collagen.Figure 1. The structure of type II collagen.

Application of CTX-II

  • Serum, urine levels of CTX-II can be used as a biomarker for the diagnosis of OA. CTX-II can also be used as a disease burden marker and a prognostic marker.

Our Advantages

  • Accept a wide range of sample types
  • Provide multiple detection methods, including ELISA, fluoro-microbeads guiding chip (FMGC)
  • Ensure high sensitivity for detecting CTX-II in different samples
  • Ensure high accuracy and repeatable CTX-II detection
  • Ensure a wide kinetic range to detect samples of different concentrations
  • Short experimental period

Workflow of CTX-II Detection at Creative BioMart Biomarker

Creative BioMart Biomarker strictly controls each specific experimental step in the CTX-II detection procedure to ensure high sensitivity, high accuracy and repeatable CTX-II detection.

CTX-II Detection Service

Please feel free to contact us if you would like to know more about CTX-II detection. At Creative BioMart Biomarker, we not only provide high-quality CTX-II detection service, but also provide detection services for other biomarkers. Additionally, our experts can also provide and help design the best solution according to your specific requirements.


  1. Park, Y.M.; et al. Detection of CTX-II in serum and urine to diagnose osteoarthritis by using a fluoro-microbeads guiding chip. Biosensors and Bioelectronics. 2015, 67: 192–199.
  2. Birmingham, J.D.; et al. Collagen biomarkers for arthritis applications. Biomarker Insights. 2006, I: 61–76.
  3. Garnero, P.; et al. Increased urinary type II collagen helical and C telopeptide levels are independently associated with a rapidly destructive hip osteoarthritis. Ann Rheum Dis. 2006, 65(12): 1639–1644.


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