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Fertaki S, Giannoutsou P, Orkoula MG. Combining Raman Microspectroscopy and X-ray Microcomputed Tomography for the Study of Bone Quality in Apolipoprotein-Deficient Animal Models. Molecules 2023; 28:7196. [PMID: 37894675 PMCID: PMC10609250 DOI: 10.3390/molecules28207196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/04/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Raman microspectroscopy and X-ray microcomputed tomography (micro-CT) were used for assessment of the quality of the femur and tibia bones in apolipoprotein-deficient mice compared to control littermates. The cortical and trabecular bone was investigated separately. Raman spectra revealed no differences in the bioapatite-to-collagenous matrix ratio of the cortical bone. The quantities of calcium and collagen, which were measured using atomic absorption spectrometry and thermogravimetric analysis, respectively, were also found to be equal in the two groups. Density and morphometric parameters, which were measured using micro-CT, verified the cortical mineral stability. Bone quality indices were measured using Raman spectra. A decreased collagen crosslink (trivalent-to-divalent) ratio revealed delayed maturation of the collagen network. Such a decrease has been reported in the literature to be connected to decreased bone strength. For the trabecular bone, micro-CT revealed severe osteoporosis in the knock-out group, which was evident from a decreased mineral density, trabecular thickness and increased bone surface/volume ratio. The trabecular bone was not accessible for Raman spectroscopy. According to these results, the cortical and trabecular femur bone is expected to exhibit proneness to fracturing, each for a different reason. A combination of the two techniques was regarded as necessary for an overall assessment of bone quality.
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Affiliation(s)
- Stefani Fertaki
- Department of Pharmacy, University of Patras, 265 04 Patras, Greece
- Foundation for Research and Technology, Institute of Chemical Engineering and High Temperatures, FORTH/ICE-HT, 265 04 Patras, Greece
| | - Panagiota Giannoutsou
- Department of Pharmacy, University of Patras, 265 04 Patras, Greece
- Foundation for Research and Technology, Institute of Chemical Engineering and High Temperatures, FORTH/ICE-HT, 265 04 Patras, Greece
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2
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Bolger MW, Tekkey T, Kohn DH. The Contribution of Perilacunar Composition and Mechanical Properties to Whole-Bone Mechanical Outcomes in Streptozotocin-Induced Diabetes. Calcif Tissue Int 2023; 113:229-245. [PMID: 37261462 PMCID: PMC11144452 DOI: 10.1007/s00223-023-01098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023]
Abstract
Osteocytes are the most abundant cell type in bone and remodel their local perilacunar matrix in response to a variety of stimuli and diseases. How the perilacunar composition and mechanical properties are affected by type 1 diabetes (T1D), and the contribution of these local changes to the decline in whole-bone functional properties that occurs with diabetes remains unclear. 12-14 week old C57/BL6 male mice were administered a series of low-dose streptozotocin injections and sacrificed at baseline (BL), 3 (D3) and 7 weeks (D7) following confirmation of diabetes, along with age-matched controls (C3, C7). Femora were then subjected to a thorough morphological (μCT), mechanical (four-point bending, nanoindentation), and compositional (HPLC for collagen cross-links, Raman spectroscopy) analysis at the whole-bone and local (perilacunar and intracortical) levels. At the whole-bone level, D7 mice exhibited 10.7% lower ultimate load and 26.4% lower post-yield work relative to C7. These mechanical changes coincided with 52.2% higher levels of pentosidine at D7 compared to C7. At the local level, the creep distance increased, while modulus and hardness decreased in the perilacunar region relative to the intracortical for D7 mice, suggesting a spatial uncoupling in skeletal adaptation. D7 mice also exhibited increased matrix maturity in the 1660/1690 cm-1 ratio at both regions relative to C7. The perilacunar matrix maturity was predictive of post-yield work (46%), but perilacunar measures were not predictive of ultimate load, which was better explained by cortical area (26%). These results show that diabetes causes local perilacunar composition perturbations that affect whole-bone level mechanical properties, implicating osteocyte maintenance of its local matrix in the progression of diabetic skeletal fragility.
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Affiliation(s)
- Morgan W Bolger
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Tara Tekkey
- Department of Chemistry, College of Literature, Science and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - David H Kohn
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA.
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, 1011 N. University Ave., Ann Arbor, MI, 48109, USA.
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Lehmann TP, Iwańczyk-Skalska E, Harasymczuk J, Jagodziński PP, Głowacki M. Gene Expression in MC3T3-E1 Cells Treated with Diclofenac and Methylprednisolone. Genes (Basel) 2023; 14:genes14010184. [PMID: 36672925 PMCID: PMC9859560 DOI: 10.3390/genes14010184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids (GCs) are often used to treat articular-skeletal disorders. The extended use of NSAIDs and GCs have adverse effects on bone metabolism, reducing bone quality and impairing fracture healing. In the present study, we used mouse pre-osteoblast cells MC3T3-E1 to demonstrate the effects of diclofenac (DF) and methylprednisolone (MP) on cell proliferation and gene expression. Cells were incubated with three doses of DF or MP: 0.5 µM, 5 µM, and 50 µM. MP decreased cell viability even after 24 h, but DF inhibited cell viability after only seven days of treatment. The cells were lysed after one, two, three, and seven days of treatment, and gene expression was analyzed by reverse transcription and quantitative PCR (RT-qPCR) assays. DF did not significantly affect the expression of the osteogenic marker genes. MP modified the expression of Osx, Runx, and Col1a1. We concluded that MP is a more potent inhibitor of mouse pre-osteoblast differentiation and viability than is DF. Our results suggest that prolonged DF treatment could be less harmful to osteoblasts than MP treatment.
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Affiliation(s)
- Tomasz P. Lehmann
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Święcickiego 6, 60-781 Poznan, Poland
- Correspondence: ; Tel.: +48-618-546-513; Fax: +48-618-546-510
| | - Ewa Iwańczyk-Skalska
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Święcickiego 6, 60-781 Poznan, Poland
| | - Jerzy Harasymczuk
- Department of Paediatric Surgery, Traumatology and Urology, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Paweł P. Jagodziński
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Święcickiego 6, 60-781 Poznan, Poland
| | - Maciej Głowacki
- Department of Paediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences, 28 Czerwca 1956 135/147, 61-545 Poznan, Poland
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Takahata M, Shimizu T, Yamada S, Yamamoto T, Hasegawa T, Fujita R, Kobayashi H, Endo T, Koike Y, Amizuka N, Todoh M, Okumura JI, Kajino T, Iwasaki N. Bone biopsy findings in patients receiving long-term bisphosphonate therapy for glucocorticoid-induced osteoporosis. J Bone Miner Metab 2022; 40:613-622. [PMID: 35333984 DOI: 10.1007/s00774-022-01323-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/01/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Bisphosphonates (BPs) have been shown to reduce the incidence of vertebral fractures during the first year or two of glucocorticoid (GC) treatments and are therefore recommended as a first-line treatment for GC-induced osteoporosis (GIO). However, there are theoretical concerns about the long-term use of BPs in low-turnover osteoporosis caused by chronic GC therapy. MATERIALS AND METHODS We analyzed the trabecular microarchitecture, bone metabolism, and material strength of iliac crest bone biopsy samples from 10 female patients with rheumatoid arthritis who received an average of 6.7 years of BP therapy for GIO (GIOBP group), compared with those of 10 age- and bone mineral density (BMD)-matched non-rheumatoid arthritis postmenopausal women (reference group). RESULTS Patients in the GIOBP group had a significantly greater fracture severity index, as calculated from the number and the extent of vertebral fractures compared with the reference patients. Micro-computed tomography analysis showed that the degree of mineralization and trabecular microarchitecture were significantly lower in the GIOBP group than in the reference patients. Patients in the GIOBP group exhibited lower bone contact stiffness, determined by micro-indentation testing, than in the reference group. The contact stiffness of the bone was negatively correlated with the fracture severity index and the daily prednisolone dosage. Immunohistochemistry and serum bone turnover markers showed decreased osteoclastic activity, impaired mineralization, and an increased fraction of empty lacunae in the GIOBP group. CONCLUSION Our findings indicate that patients receiving long-term BP for GIO are still at high risk for fragility fractures because of poor bone quality.
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Affiliation(s)
- Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Tomohiro Shimizu
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Satoshi Yamada
- Division of Mechanical and Aerospace Engineering, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Tomomaya Yamamoto
- Division of Oral Health Science, Department of Developmental Biology of Hard Tissue, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Tomoka Hasegawa
- Division of Oral Health Science, Department of Developmental Biology of Hard Tissue, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Ryo Fujita
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Hideyuki Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Yoshinao Koike
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Norio Amizuka
- Division of Mechanical and Aerospace Engineering, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Masahiro Todoh
- Division of Mechanical and Aerospace Engineering, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Jun-Ichiro Okumura
- Department of Orthopedic Surgery, Sapporo City General Hospital, Sapporo, Hokkaido, Japan
| | - Tomomichi Kajino
- Department of Orthopedic Surgery, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
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Regulation of TNF-Induced Osteoclast Differentiation. Cells 2021; 11:cells11010132. [PMID: 35011694 PMCID: PMC8750957 DOI: 10.3390/cells11010132] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 12/27/2022] Open
Abstract
Increased osteoclast (OC) differentiation and activity is the critical event that results in bone loss and joint destruction in common pathological bone conditions, such as osteoporosis and rheumatoid arthritis (RA). RANKL and its decoy receptor, osteoprotegerin (OPG), control OC differentiation and activity. However, there is a specific concern of a rebound effect of denosumab discontinuation in treating osteoporosis. TNFα can induce OC differentiation that is independent of the RANKL/RANK system. In this review, we discuss the factors that negatively and positively regulate TNFα induction of OC formation, and the mechanisms involved to inform the design of new anti-resorptive agents for the treatment of bone conditions with enhanced OC formation. Similar to, and being independent of, RANKL, TNFα recruits TNF receptor-associated factors (TRAFs) to sequentially activate transcriptional factors NF-κB p50 and p52, followed by c-Fos, and then NFATc1 to induce OC differentiation. However, induction of OC formation by TNFα alone is very limited, since it also induces many inhibitory proteins, such as TRAF3, p100, IRF8, and RBP-j. TNFα induction of OC differentiation is, however, versatile, and Interleukin-1 or TGFβ1 can enhance TNFα-induced OC formation through a mechanism which is independent of RANKL, TRAF6, and/or NF-κB. However, TNFα polarized macrophages also produce anabolic factors, including insulin such as 6 peptide and Jagged1, to slow down bone loss in the pathological conditions. Thus, the development of novel approaches targeting TNFα signaling should focus on its downstream molecules that do not affect its anabolic effect.
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Yi X, Liu X, Kenney HM, Duan R, Lin X, Schwarz E, Yao Z. TNF-Polarized Macrophages Produce Insulin-like 6 Peptide to Stimulate Bone Formation in Rheumatoid Arthritis in Mice. J Bone Miner Res 2021; 36:2426-2439. [PMID: 34585777 PMCID: PMC8688308 DOI: 10.1002/jbmr.4447] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 01/05/2023]
Abstract
The risk of osteoporosis is increased in rheumatoid arthritis (RA). Anti-tumor necrosis factor (TNF) therapy has markedly improved the outcomes of RA patients but does not improve osteoporosis in some reports. This could be a combined result of disease severity and other therapeutic agents, such as glucocorticoids that accelerate osteoporosis progression. We evaluated the effects of anti-TNF therapy on osteoporosis in an animal model of RA and explored the possible mechanisms involved. Six-week-old TNF transgenic (TNF-Tg) mice with early stage erosive arthritis were treated with TNF antibody (Ab) or control immunoglobulin (IgG) weekly for 4 weeks. We found that TNF Ab completely blocked the development of erosive arthritis in TNF-Tg mice, but only slightly increased vertebral bone mass, associated with reduction in parameters of both bone resorption and formation. Similarly, TNF Ab slightly increased trabecular bone mass in tibias of 8-month-old TNF-Tg mice with advanced erosive arthritis. Interestingly, TNFα increased osteoblast differentiation from mouse bone marrow stromal cells (BMSCs) containing large number of macrophages but not from pure mesenchymal progenitor cells (MPCs). TNFα-polarized macrophages (TPMs) did not express iNos and Arginase 1, typical markers of inflammatory and resident macrophages. Interestingly, TPMs stimulated osteoblast differentiation, unlike resident and inflammatory macrophages polarized by IL-4 and interferon-λ, respectively. RNA-seq analysis indicated that TPMs produced several anabolic factors, including Jagged1 and insulin like 6 (INSL6). Importantly, inhibition of either Jagged1 or INSL6 blocked TNFα-induced osteoblast differentiation. Furthermore, INSL6 Ab significantly decreased the expansion of TNF-induced MPCs in BMSCs, and anti-TNF Ab reduced INSL6 expression by macrophages in vitro and in TNF-Tg mice in vivo. We conclude that TPMs produce INSL6 to stimulate bone formation and anti-TNF Ab blocks not only enhanced bone resorption but also the anabolic effect of TPMs on bone, limiting its effect to increase bone mass in this model of RA. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Xiangjiao Yi
- Department of Pathology and Laboratory Medicine, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Xin Liu
- Department of Pathology and Laboratory Medicine, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA
| | - H Mark Kenney
- Department of Pathology and Laboratory Medicine, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Rong Duan
- Department of Pathology and Laboratory Medicine, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Xi Lin
- Department of Pathology and Laboratory Medicine, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Edward Schwarz
- Department of Pathology and Laboratory Medicine, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA.,Department of Orthopedic Surgery, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Zhenqiang Yao
- Department of Pathology and Laboratory Medicine, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, USA
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7
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Multimodal characterization of the bone-implant interface using Raman spectroscopy and nanoindentation. Med Eng Phys 2020; 84:60-67. [DOI: 10.1016/j.medengphy.2020.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/27/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023]
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8
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Lespessailles E, Chapurlat R. High fracture risk patients with glucocorticoid-induced osteoporosis should get an anabolic treatment first. Osteoporos Int 2020; 31:1829-1834. [PMID: 32780152 DOI: 10.1007/s00198-020-05568-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/23/2020] [Indexed: 12/29/2022]
Abstract
Long-term glucocorticoid (GC) therapy induces glucocorticoid-induced osteoporosis (GIOP) and its associated fractures. Most specialty organizations recommend bisphosphonates as first-line therapies based only on bone mineral density efficacy data. Effective treatment of GIOP based on head-to-head trials with fracture endpoint has not yet been established. The pathophysiologic mechanisms of GIOP that lead to the detrimental effects on bone are not yet fully elucidated. Although GCs in an early and transitory period promote osteoclastic activity, in the current paper, we outline why GIOP is in fact a disease of the bone formation and then provide the rationale for the use of bone-forming agents as first-line therapy for patients with high fracture risk in GIOP.
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Affiliation(s)
- E Lespessailles
- EA 4708 - I3MTO Laboratory, University of Orleans, 45067, Orleans, France.
- Department of Rheumatology, Translational Medicine Research Platform, Regional Hospital of Orleans, 14 avenue de l'hopital, 45067, Orleans Cedex 2, France.
| | - R Chapurlat
- INSERM UMR 1033, University of Lyon, Hôpital E Herriot, Lyon, France
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9
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Mandair GS, Oest ME, Mann KA, Morris MD, Damron TA, Kohn DH. Radiation-induced changes to bone composition extend beyond periosteal bone. Bone Rep 2020; 12:100262. [PMID: 32258252 PMCID: PMC7125315 DOI: 10.1016/j.bonr.2020.100262] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer patients receiving radiotherapy for soft tissue sarcomas are often at risk of post-irradiation (post-RTx) bone fragility fractures, but our understanding of factors controlling radiation-induced bone injury is limited. Previous studies have evaluated post-RTx changes to cortical bone composition in the periosteum of irradiated tibiae, but have not evaluated effects of irradiation in deeper tissues, such as endosteal or mid-cortical bone, and whether there are differential spatial effects of irradiation. In this study, we hypothesize that post-RTx changes to cortical bone composition are greater in endosteal compared to mid-cortical or periosteal bone. METHODS A pre-clinical mouse model of limited field hindlimb irradiation was used to evaluate spatial and temporal post-RTx changes to the metaphyseal cortex of irradiated tibiae. Irradiation was delivered unilaterally to the hindlimbs of 12-wk old female BALB/cJ mice as 4 consecutive daily doses of 5 Gy each. RTx and non-RTx tibiae were obtained at 0, 2, 4, 8, and 12 wks post-RTx (n = 9 mice/group/time). Raman spectroscopy was used to evaluate spatial and temporal post-RTx changes to cortical bone composition in age-matched RTx and non-RTx groups. RESULTS Significant early spatial differences in mineral/matrix and collagen crosslink ratios were found between endosteal and periosteal or mid-cortical bone at 2-wks post-RTx. Although spatial differences were transient, mineral/matrix ratios significantly decreased and collagen crosslink ratios significantly increased with post-RTx time throughout the entire tibial metaphyseal cortex. CONCLUSIONS Irradiation negatively impacts the composition of cortical bone in a spatially-dependent manner starting as early as 2-wks post-RTx. Long-term progressive post-RTx changes across all cortical bone sites may eventually contribute to the increased risk of post-RTx bone fragility fractures.
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Affiliation(s)
| | - Megan E. Oest
- Department of Orthopedic Surgery, Upstate Medical University, Syracuse, NY, USA
| | - Kenneth A. Mann
- Department of Orthopedic Surgery, Upstate Medical University, Syracuse, NY, USA
| | | | - Timothy A. Damron
- Department of Orthopedic Surgery, Upstate Medical University, Syracuse, NY, USA
| | - David H. Kohn
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, USA
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10
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Sato D, Takahata M, Ota M, Fukuda C, Hasegawa T, Yamamoto T, Amizuka N, Tsuda E, Okada A, Hiruma Y, Fujita R, Iwasaki N. Siglec-15-targeting therapy protects against glucocorticoid-induced osteoporosis of growing skeleton in juvenile rats. Bone 2020; 135:115331. [PMID: 32217159 DOI: 10.1016/j.bone.2020.115331] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023]
Abstract
Effective treatment of juvenile osteoporosis, which is frequently caused by glucocorticoid (GC) therapy, has not been established due to limited data regarding the efficacy and adverse effects of antiresorptive therapies on the growing skeleton. We previously demonstrated that sialic acid-binding immunoglobulin-like lectin 15 (Siglec-15) targeting therapy, which interferes with osteoclast terminal differentiation in the secondary, but not primary, spongiosa, increased bone mass without adverse effects on skeletal growth, whereas bisphosphonate, a first-line treatment for osteoporosis, increased bone mass but impaired long bone growth in healthy growing rats. In the present study, we investigated the efficacy of anti-Siglec-15 neutralizing antibody (Ab) therapy against GC-induced osteoporosis in a growing rat model. GC decreased bone mass and deteriorated mechanical properties of bone, due to a disproportionate increase in bone resorption. Both anti-Siglec-15 Ab and alendronate (ALN) showed protective effects against GC-induced bone loss by suppressing bone resorption, which was more pronounced with anti-Siglec-15 Ab treatment, possibly due to a reduced negative impact on bone formation. ALN induced histological abnormalities in the growth plate and morphological abnormalities in the long bone metaphysis but did not cause significant growth retardation. Conversely, anti-Siglec-15 Ab did not show any negative impact on the growth plate and preserved normal osteoclast and chondroclast function at the primary spongiosa. Taken together, these results suggest that anti-Siglec-15 targeting therapy could be a safe and efficacious prophylactic therapy for GC-induced osteoporosis in juvenile patients.
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Affiliation(s)
- Dai Sato
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
| | - Masahiro Ota
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Chie Fukuda
- Specialty Medicine Research Laboratories I, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Tomoka Hasegawa
- Hokkaido University, Department of Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Sapporo, Japan
| | - Tomomaya Yamamoto
- Hokkaido University, Department of Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Sapporo, Japan
| | - Norio Amizuka
- Hokkaido University, Department of Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Sapporo, Japan
| | - Eisuke Tsuda
- Specialty Medicine Research Laboratories I, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Akiko Okada
- Specialty Medicine Research Laboratories I, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Yoshiharu Hiruma
- Pharmacovigilance Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Ryo Fujita
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
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11
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Wang T, Yu X, He C. Pro-inflammatory Cytokines: Cellular and Molecular Drug Targets for Glucocorticoid-induced-osteoporosis via Osteocyte. Curr Drug Targets 2020; 20:1-15. [PMID: 29618305 DOI: 10.2174/1389450119666180405094046] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/11/2018] [Accepted: 03/21/2018] [Indexed: 02/08/2023]
Abstract
Glucocorticoids are widely used to treat varieties of allergic and autoimmune diseases, however, long-term application results in glucocorticoid-induced osteoporosis (GIOP). Inflammatory cytokines: tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) play important regulatory roles in bone metabolism, but their roles in GIOP remain largely unknown. Osteocytes can modulate the formation and function of both osteoblasts and osteoclasts, directly via gap junctions, or indirectly by transferring molecule signaling. Apoptotic osteocytes release RANKL, HMGB1 and pro-inflammatory cytokines to stimulate osteoclastogenesis. Moreover, osteocytes can secrete FGF23 to regulate bone metabolism. Exposure to high levels of GCs can drive osteocyte apoptosis and influence gap junctions, leading to bone loss. GCs treatment is regarded to produce more FGF23 to inhibit bone mineralization. GCs also disrupt the vascular to decrease osteocyte feasibility and mineral appositional rate, resulting in a decline in bone strength. Apoptotic bodies from osteocytes induced by GCs treatment can enhance production of TNF-α and IL-6. On the other hand, TNF-α and IL-6 show synergistic effects by altering osteocytes signaling towards osteoclasts and osteoblasts. In addition, TNF-α can induce osteocyte apoptosis and attribute to a worsened bone quality in GCs. IL-6 and osteocytes may interact with each other. Therefore, we hypothesize that GCs regulate osteocyteogenesis through TNF-α and IL-6, which are highly expressed around osteocyte undergoing apoptosis. In the present review, we summarized the roles of osteocytes in regulating osteoblasts and osteoclasts. Furthermore, the mechanism of GCs altered relationship between osteocytes and osteoblasts/osteoclasts. In addition, we discussed the roles of TNF-α and IL-6 in GIOP by modulating osteocytes. Lastly, we discussed the possibility of using pro-inflammatory signaling pathway as therapeutic targets to develop drugs for GIOP.
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Affiliation(s)
- Tiantian Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.,Laboratory of Endocrinology and Metabolism, Department of Endocrinology, National Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610041, China
| | - Xijie Yu
- Laboratory of Endocrinology and Metabolism, Department of Endocrinology, National Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610041, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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12
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Aeberli D, Fankhauser N, Zebaze R, Bonel H, Möller B, Villiger PM. Effect of rheumatoid arthritis and age on metacarpal bone shaft geometry and density: A longitudinal pQCT study in postmenopausal women. Semin Arthritis Rheum 2019; 50:220-227. [PMID: 31466837 DOI: 10.1016/j.semarthrit.2019.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/27/2019] [Accepted: 08/05/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to elucidate the effects of changes in the geometry and density of the metacarpal bone of patients with rheumatoid arthritis (RA). METHODS This prospective study included consecutive postmenopausal RA patients who met the American College of Rheumatology Criteria and healthy controls (HC). Peripheral quantitative computed tomography scans at 50% of the total metacarpal shaft (third metacarpal bone) were obtained at baseline and follow-ups. Use of bisphosphonates (BP), glucocorticoids (GC), biologics, and disease-modifying anti-rheumatic drugs (DMARD) was monitored (baseline to follow-up). Total cross-sectional area (CSA), cortical-transitional zone and compact zone CSA, cortical volumetric bone mineral density, and compact cortex porosity were measured. A linear mixed-effects model was used to determine significant differences in the rate of change in the RA and control groups and in RA patient subgroups. RESULTS Thirty-nine RA patients and 42 consecutive postmenopausal HC were followed for 63 months. RA and HC depicted a time-dependent increase of medullary CSA (+0.41 mm2/year, P < 0.0001), while total CSA remained stable (P = 0.2). RA status was associated with a loss of cortical bone mineral density (interaction: -3.08 mg/mm3; P = 0.014). In RA subgroup analysis, GC use ≥5 mg/day was positively correlated with a fourfold increase of medullary CSA (0.67 mm2/year P = 0.009), which resulted in a three- to fourfold loss of cortical density (-6.6 mg/mm3/year; P = 0.002) and cortical CSA (-0.57 mm2/year, P = 0.004). Patients with high disease activity and high GC dose at baseline demonstrated an increase in the total CSA (0.29 mm2/y; P = 0.049) and a loss of cortical BMD (-5.73 mg/mm3/y; P = 0.05) despite good clinical response. CONCLUSION Increase in medullary metacarpal CSA and thinning of the cortical CSA are physiological and time dependent. RA status is associated with loss in cortical density. Even upon biological therapy, low glucocorticoid dose affects metacarpal bone shaft geometry and density over time.
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Affiliation(s)
- D Aeberli
- Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, 3010 Bern Switzerland.
| | - N Fankhauser
- Clinical Trial Unit (CTU), University of Bern, 3012 Bern, Switzerland
| | - R Zebaze
- Department of Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia; Department of Medicine, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia
| | - H Bonel
- Department of Radiology, University Hospital and University of Bern, Switzerland
| | - B Möller
- Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, 3010 Bern Switzerland
| | - P M Villiger
- Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, 3010 Bern Switzerland
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13
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Raman spectroscopy applications in rheumatology. Lasers Med Sci 2019; 34:827-834. [DOI: 10.1007/s10103-019-02719-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/10/2019] [Indexed: 12/27/2022]
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14
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Unal M, Uppuganti S, Leverant CJ, Creecy A, Granke M, Voziyan P, Nyman JS. Assessing glycation-mediated changes in human cortical bone with Raman spectroscopy. JOURNAL OF BIOPHOTONICS 2018; 11:e201700352. [PMID: 29575566 PMCID: PMC6231413 DOI: 10.1002/jbio.201700352] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/21/2018] [Indexed: 05/13/2023]
Abstract
Establishing a non-destructive method for spatially assessing advanced glycation end-products (AGEs) is a potentially useful step toward investigating the mechanistic role of AGEs in bone quality. To test the hypothesis that the shape of the amide I in the Raman spectroscopy (RS) analysis of bone matrix changes upon AGE accumulation, we incubated paired cadaveric cortical bone in ribose or glucose solutions and in control solutions for 4 and 16 weeks, respectively, at 37°C. Acquiring 10 spectra per bone with a 20X objective and a 830 nm laser, RS was sensitive to AGE accumulation (confirmed by biochemical measurements of pentosidine and fluorescent AGEs). Hyp/Pro ratio increased upon glycation using either 0.1 M ribose, 0.5 M ribose or 0.5 M glucose. Glycation also decreased the amide I sub-peak ratios (cm-1 ) 1668/1638 and 1668/1610 when directly calculated using either second derivative spectrum or local maxima of difference spectrum, though the processing method (eg, averaged spectrum vs individual spectra) to minimize noise influenced detection of differences for the ribose-incubated bones. Glycation however did not affect these sub-peak ratios including the matrix maturity ratio (1668/1690) when calculated using indirect sub-band fitting. The amide I sub-peak ratios likely reflected changes in the collagen I structure.
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Affiliation(s)
- Mustafa Unal
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN 37232
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Calen J. Leverant
- Department of Chemical & Biomolecular Engineering, Vanderbilt University, Nashville, TN 37232
| | - Amy Creecy
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232
| | - Mathilde Granke
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Paul Voziyan
- Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Jeffry S. Nyman
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN 37232
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232
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15
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Hillyard KCL, Shabbir S, Sirisena UN, Hogarth M, Sahu A. Insufficiency fractures: A rare cause of foot and ankle pain in three patients with rheumatoid arthritis. Radiol Case Rep 2018; 13:855-861. [PMID: 30002787 PMCID: PMC6039983 DOI: 10.1016/j.radcr.2018.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/24/2018] [Accepted: 05/26/2018] [Indexed: 11/23/2022] Open
Abstract
Insufficiency fractures are recognized but rare complications in patients with longstanding rheumatoid arthritis. Such fractures are typically solitary and are rarely seen to affect the foot and ankle. We describe 3 women with longstanding rheumatoid arthritis, treated with one, or a combination of, corticosteroids, DMARDs and anti-TNF, presenting with foot and ankle pain with no prior history of trauma. MRIs showed rare multiple florid insufficiency fractures of the foot and ankle, in 2 cases bilaterally, which were managed conservatively. These cases highlight the importance of considering insufficiency fractures in similar patients presenting with foot and ankle pain. Radiographs may fail to demonstrate these lesions, delaying diagnosis, and worsening patient outcome, therefore in such cases MRI is a valuable modality.
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Affiliation(s)
| | - Shabnam Shabbir
- Radiology Department, Ealing Hospital, Uxbridge Rd, Southall, London UB1 3HW, UK
| | | | - Maxine Hogarth
- Radiology Department, Ealing Hospital, Uxbridge Rd, Southall, London UB1 3HW, UK
| | - Ajay Sahu
- Radiology Department, Ealing Hospital, Uxbridge Rd, Southall, London UB1 3HW, UK
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16
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Samuels JS, Holland L, López M, Meyers K, Cumbie WG, McClain A, Ignatowicz A, Nelson D, Shashidharamurthy R. Prostaglandin E2 and IL-23 interconnects STAT3 and RoRγ pathways to initiate Th17 CD4 + T-cell development during rheumatoid arthritis. Inflamm Res 2018; 67:589-596. [PMID: 29713730 DOI: 10.1007/s00011-018-1153-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The chronic inflammation associated with rheumatoid arthritis (RA) leads to focal and systemic bone erosion of the joints resulting in a crippling disability. Recent reports indicate an increase in the incidence of RA in the coming years, placing a significant burden on healthcare resources. The incidence of RA is observed to be increasing with age and a significant proportion of those new cases will be aggressively erosive. FINDINGS The altered physiology, due to immune disturbances, contributes towards RA pathogenesis. The imbalance of inflammatory cytokines and non-cytokine immune modulators such as prostaglandin E2 (PGE2) and IL-23-induced pathogenic IL-17, plays a crucial role in persistent inflammation and bone degradation during RA. However, the molecular mechanism of IL-23, a key cytokine, and PGE2 in the development and perpetuation of IL-17 producing effector Th17 cells is poorly understood. CONCLUSION This review focuses on research findings that provide insight into the contribution of PGE2 and IL-23 during the development of pathogenic Th17 cells. We also highlight the key transcriptional factors required for Th17 development and therapeutic strategies to disrupt the interaction between IL-23 and IL-17 to prevent the end-organ damage in RA.
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Affiliation(s)
- Janaiya S Samuels
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - Lauren Holland
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - María López
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - Keya Meyers
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - William G Cumbie
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - Anna McClain
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - Aleksandra Ignatowicz
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - Daryllynn Nelson
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA
| | - Rangaiah Shashidharamurthy
- Department of Pharmaceutical Sciences, School of Pharmacy, Philadelphia College of Osteopathic Medicine-Georgia Campus, Room 3031, 625 Old Peachtree Road, NW, Suwanee, GA, 30024, USA.
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Feng G, Ochoa M, Maher JR, Awad HA, Berger AJ. Sensitivity of spatially offset Raman spectroscopy (SORS) to subcortical bone tissue. JOURNAL OF BIOPHOTONICS 2017; 10:990-996. [PMID: 28464501 PMCID: PMC5971662 DOI: 10.1002/jbio.201600317] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/15/2017] [Accepted: 02/28/2017] [Indexed: 05/04/2023]
Abstract
The development of spatially offset Raman spectroscopy (SORS) has enabled deep, non-invasive chemical characterization of turbid media. Here, we use SORS to measure subcortical bone tissue and depth-resolved biochemical variability in intact, exposed murine bones. We also apply the technique to study a mouse model of the genetic bone disorder osteogenesis imperfecta. The results suggest that SORS is more sensitive to disease-related biochemical differences in subcortical trabecular bone and marrow than conventional Raman measurements.
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Affiliation(s)
- Guanping Feng
- University of Rochester, The Institute of Optics, 275 Hutchinson Road, Rochester, New York 14627
| | - Marien Ochoa
- University of Rochester, The Institute of Optics, 275 Hutchinson Road, Rochester, New York 14627
- University of Rochester, Department of Biomedical Engineering, 207 Robert B. Goergen Hall, Rochester, New York 14627
| | - Jason R. Maher
- University of Rochester, The Institute of Optics, 275 Hutchinson Road, Rochester, New York 14627
| | - Hani A. Awad
- University of Rochester, Department of Biomedical Engineering, 207 Robert B. Goergen Hall, Rochester, New York 14627
- University of Rochester Medical Center, The Center for Musculoskeletal Research, 601 Elmwood Avenue, Rochester, New York 14642
| | - Andrew J. Berger
- University of Rochester, The Institute of Optics, 275 Hutchinson Road, Rochester, New York 14627
- University of Rochester, Department of Biomedical Engineering, 207 Robert B. Goergen Hall, Rochester, New York 14627
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18
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Raman Plus X: Biomedical Applications of Multimodal Raman Spectroscopy. SENSORS 2017; 17:s17071592. [PMID: 28686212 PMCID: PMC5539739 DOI: 10.3390/s17071592] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 12/11/2022]
Abstract
Raman spectroscopy is a label-free method of obtaining detailed chemical information about samples. Its compatibility with living tissue makes it an attractive choice for biomedical analysis, yet its translation from a research tool to a clinical tool has been slow, hampered by fundamental Raman scattering issues such as long integration times and limited penetration depth. In this review we detail the how combining Raman spectroscopy with other techniques yields multimodal instruments that can help to surmount the translational barriers faced by Raman alone. We review Raman combined with several optical and non-optical methods, including fluorescence, elastic scattering, OCT, phase imaging, and mass spectrometry. In each section we highlight the power of each combination along with a brief history and presentation of representative results. Finally, we conclude with a perspective detailing both benefits and challenges for multimodal Raman measurements, and give thoughts on future directions in the field.
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19
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Beier EE, Sheu TJ, Resseguie EA, Takahata M, Awad HA, Cory-Slechta DA, Puzas JE. Sclerostin activity plays a key role in the negative effect of glucocorticoid signaling on osteoblast function in mice. Bone Res 2017; 5:17013. [PMID: 28529816 PMCID: PMC5422922 DOI: 10.1038/boneres.2017.13] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/02/2016] [Accepted: 01/10/2017] [Indexed: 12/11/2022] Open
Abstract
Stress during prenatal development is correlated with detrimental cognitive and behavioral outcomes in offspring. However, the long-term impact of prenatal stress (PS) and disrupted glucocorticoid signaling on bone mass and strength is not understood. In contrast, the detrimental effect of lead (Pb) on skeletal health is well documented. As stress and Pb act on common biological targets via glucocorticoid signaling pathways and co-occur in the environment, this study first sought to assess the combined effect of stress and Pb on bone quality in association with alterations in glucocorticoid signaling. Bone parameters were evaluated using microCT, histomorphometry, and strength determination in 8-month-old male mouse offspring subjected to PS on gestational days 16 and 17, lifetime Pb exposure (100 p.p.m. Pb in drinking water), or to both. Pb reduced trabecular bone mass and, when combined with PS, Pb unmasked an exaggerated decrement in bone mass and tensile strength. Next, to characterize a mechanism of glucocorticoid effect on bone, prednisolone was implanted subcutaneously (controlled-release pellet, 5 mg·kg-1 per day) in 5-month-old mice that decreased osteoblastic activity and increased sclerostin and leptin levels. Furthermore, the synthetic glucocorticoid dexamethasone alters the anabolic Wnt signaling pathway. The Wnt pathway inhibitor sclerostin has several glucocorticoid response elements, and dexamethasone administration to osteoblastic cells induces sclerostin expression. Dexamethasone treatment of isolated bone marrow cells decreased bone nodule formation, whereas removal of sclerostin protected against this decrement in mineralization. Collectively, these findings suggest that bone loss associated with steroid-induced osteoporosis is a consequence of sclerostin-mediated restriction of Wnt signaling, which may mechanistically facilitate glucocorticoid toxicity in bone.
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Affiliation(s)
- Eric E Beier
- Department of Environmental Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
- Department of Environmental and Occupational Medicine, Rutgers University, Piscataway, NJ, USA
| | - Tzong-Jen Sheu
- Center for Musculoskeletal Research, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - Emily A Resseguie
- Department of Environmental Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - Masahiko Takahata
- Center for Musculoskeletal Research, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - Hani A Awad
- Center for Musculoskeletal Research, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - Deborah A Cory-Slechta
- Department of Environmental Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - J Edward Puzas
- Department of Environmental Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
- Center for Musculoskeletal Research, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
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20
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21
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Hartmann K, Koenen M, Schauer S, Wittig-Blaich S, Ahmad M, Baschant U, Tuckermann JP. Molecular Actions of Glucocorticoids in Cartilage and Bone During Health, Disease, and Steroid Therapy. Physiol Rev 2016; 96:409-47. [PMID: 26842265 DOI: 10.1152/physrev.00011.2015] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cartilage and bone are severely affected by glucocorticoids (GCs), steroid hormones that are frequently used to treat inflammatory diseases. Major complications associated with long-term steroid therapy include impairment of cartilaginous bone growth and GC-induced osteoporosis. Particularly in arthritis, GC application can increase joint and bone damage. Contrarily, endogenous GC release supports cartilage and bone integrity. In the last decade, substantial progress in the understanding of the molecular mechanisms of GC action has been gained through genome-wide binding studies of the GC receptor. These genomic approaches have revolutionized our understanding of gene regulation by ligand-induced transcription factors in general. Furthermore, specific inactivation of GC signaling and the GC receptor in bone and cartilage cells of rodent models has enabled the cell-specific effects of GCs in normal tissue homeostasis, inflammatory bone diseases, and GC-induced osteoporosis to be dissected. In this review, we summarize the current view of GC action in cartilage and bone. We further discuss future research directions in the context of new concepts for optimized steroid therapies with less detrimental effects on bone.
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Affiliation(s)
- Kerstin Hartmann
- Institute for Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany; and Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Mascha Koenen
- Institute for Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany; and Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Schauer
- Institute for Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany; and Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Stephanie Wittig-Blaich
- Institute for Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany; and Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Mubashir Ahmad
- Institute for Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany; and Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Ulrike Baschant
- Institute for Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany; and Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Jan P Tuckermann
- Institute for Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany; and Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
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22
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Koletsi D, Eliades T, Zinelis S, Bourauel C, Eliades G. Disease and functional loading effect on the structural conformation and mechanical properties of the mandibular condyle in a transgenic rheumatoid arthritis murine model: an experimental study. Eur J Orthod 2016; 38:615-620. [PMID: 26888831 DOI: 10.1093/ejo/cjw010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIM The aim of the present study was to investigate the effect of rheumatoid arthritis (RA) and functional loading through diet modification on the structural conformation and the mechanical properties of the mandibular condyle in a transgenic mouse model and compare to healthy littermates. MATERIALS AND METHODS Four-week-old hybrid male mice from mixed background CBAxC57BL/6 were used. Four groups of animals were formed consisting of five animals each, either presenting RA (transgenic line hTNF 197), or wild-type (control), half receiving ordinary (hard) diet and half receiving soft diet within each category. Following sacrifice, resin-embedded and metallographically polished condylar specimens were evaluated employing scanning electron microscopy/ Energy dispersive x-ray spectroscopy and also tested for mechanical properties, through Vickers microhardness (HV100) measurements. RESULTS The multivariable analysis revealed significantly lower HV100 values for the RA groups after adjusting for diet (β = -10; 95% confidence interval: -16, -4; P = 0.001), while functional loading through diet modification did not appear as a significant predictor of the outcome. CONCLUSIONS There was evidence of compromised mechanical properties of the mandibular condylar bone for the diseased animals, whereas no association between functional loading and mechanical properties of the condyle could be established.
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Affiliation(s)
- Despina Koletsi
- Department of Oral Technology, School of Dentistry, University of Bonn, Germany, Departments of.,Orthodontics and.,Dental Biomaterials, School of Dentistry, University of Athens, Greece, and
| | - Theodore Eliades
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Spiros Zinelis
- Dental Biomaterials, School of Dentistry, University of Athens, Greece, and
| | - Christoph Bourauel
- Department of Oral Technology, School of Dentistry, University of Bonn, Germany, Departments of
| | - George Eliades
- Dental Biomaterials, School of Dentistry, University of Athens, Greece, and
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23
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Mellibovsky L, Prieto-Alhambra D, Mellibovsky F, Güerri-Fernández R, Nogués X, Randall C, Hansma PK, Díez-Perez A. Bone Tissue Properties Measurement by Reference Point Indentation in Glucocorticoid-Induced Osteoporosis. J Bone Miner Res 2015; 30:1651-6. [PMID: 25736591 DOI: 10.1002/jbmr.2497] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/26/2015] [Accepted: 03/02/2015] [Indexed: 11/07/2022]
Abstract
Glucocorticoids, widely used in inflammatory disorders, rapidly increase bone fragility and, therefore, fracture risk. However, common bone densitometry measurements are not sensitive enough to detect these changes. Moreover, densitometry only partially recognizes treatment-induced fracture reductions in osteoporosis. Here, we tested whether the reference point indentation technique could detect bone tissue property changes early after glucocorticoid treatment initiation. After initial laboratory and bone density measurements, patients were allocated into groups receiving calcium + vitamin D (Ca+D) supplements or anti-osteoporotic drugs (risedronate, denosumab, teriparatide). Reference point indentation was performed on the cortical bone layer of the tibia by a handheld device measuring bone material strength index (BMSi). Bone mineral density was measured by dual-energy X-ray absorptiometry (DXA). Although Ca+D-treated patients exhibited substantial and significant deterioration, risedronate-treated patients exhibited no significant change, and both denosumab- and teriparatide-treated participants exhibited significantly improved BMSi 7 weeks after initial treatment compared with baseline; these trends remained stable for 20 weeks. In contrast, no densitometry changes were observed during this study period. In conclusion, our study is the first to our knowledge to demonstrate that reference point indentation is sensitive enough to reflect changes in cortical bone indentation after treatment with osteoporosis therapies in patients newly exposed to glucocorticoids.
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Affiliation(s)
- Leonardo Mellibovsky
- Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, RETICEF, Instituto Carlos III, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, RETICEF, Instituto Carlos III, Barcelona, Spain
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- GREMPAL Research Group, Idiap Jordi Gol Primary Care Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Mellibovsky
- Castelldefels School of Telecom and Aerospace Engineering (EETAC), Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Roberto Güerri-Fernández
- Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, RETICEF, Instituto Carlos III, Barcelona, Spain
| | - Xavier Nogués
- Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, RETICEF, Instituto Carlos III, Barcelona, Spain
| | - Connor Randall
- Department of Physics, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Paul K Hansma
- Department of Physics, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Adolfo Díez-Perez
- Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, RETICEF, Instituto Carlos III, Barcelona, Spain
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24
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Goldberg S, Glogauer J, Grynpas MD, Glogauer M. Deletion of filamin A in monocytes protects cortical and trabecular bone from post-menopausal changes in bone microarchitecture. Calcif Tissue Int 2015; 97:113-24. [PMID: 25894069 DOI: 10.1007/s00223-015-9994-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/01/2015] [Indexed: 02/05/2023]
Abstract
The objective of the study was to determine the in vivo role of Filamin A (FLNA) in osteoclast generation and function, through the assessment of trabecular bone morphology, bone turnover, and the resulting changes in mechanical properties of the skeleton in mice with targeted deletion of FLNA in pre-osteoclasts. Using a conditional targeted knockdown of FLNA in osteoclasts, we assessed bone characteristics in vivo including micro-computed tomography (micro-ct), histomorphometric analyses, and bone mechanical properties. These parameters were assessed in female mice at 5 months of age, in an aging protocol (comparing 5-month-old and 11-month-old mice) and an osteoporosis protocol [ovariectomized (OVX) at 5 months of age and then sacrificed at 6 and 11 months of age]. In vivo bone densitometry, mechanical and histomorphometric analyses revealed a mild osteoporotic phenotype in the FLNA-null 5-month and aging groups. The WT and FLNA-KO bones did not appear to age differently. However, the volumetric bone mineral density decrease associated with OVX in WT is absent in FLNA-KO-OVX groups. The skeleton in the FLNA-KO-OVX group does not differ from the FLNA-KO group both in mechanical and structural properties as shown by mechanical testing of femora and vertebrae and histomorphometry of vertebrae. Additionally, FLNA-KO femora are tougher and more ductile than WT femora. The result of this study indicates that while FLNA-KO bones are weaker than WT bones, they do not age differently and are protected from estrogen-mediated post-menopausal osteoporosis.
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Affiliation(s)
- S Goldberg
- Matrix Dynamics Group- Faculty of Dentistry, Fitzgerald Building 150 College Street, Toronto, ON, M5S3E2, Canada,
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25
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Maher JR, Chuchuen O, Henderson MH, Kim S, Rinehart MT, Kashuba ADM, Wax A, Katz DF. Co-localized confocal Raman spectroscopy and optical coherence tomography (CRS-OCT) for depth-resolved analyte detection in tissue. BIOMEDICAL OPTICS EXPRESS 2015; 6:2022-35. [PMID: 26114026 PMCID: PMC4473741 DOI: 10.1364/boe.6.002022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/01/2015] [Accepted: 05/04/2015] [Indexed: 05/21/2023]
Abstract
We report the development of a combined confocal Raman spectroscopy (CRS) and optical coherence tomography (OCT) instrument (CRS-OCT) capable of measuring analytes in targeted biological tissues with sub-100-micron spatial resolution. The OCT subsystem was used to measure depth-resolved tissue morphology and guide the acquisition of chemically-specific Raman spectra. To demonstrate its utility, the instrument was used to accurately measure depth-resolved, physiologically-relevant concentrations of Tenofovir, a microbicide drug used to prevent the sexual transmission of HIV, in ex vivo tissue samples.
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Affiliation(s)
- Jason R. Maher
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Oranat Chuchuen
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Marcus H. Henderson
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Sanghoon Kim
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Matthew T. Rinehart
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Angela D. M. Kashuba
- University of North Carolina Eshelman School of Pharmacy and University of North Carolina Center for AIDS Research, University of North Carolina, Chapel Hill, NC, USA
- Department of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Adam Wax
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - David F. Katz
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Obstetrics and Gynecology, Duke University, Durham, NC 27708, USA
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Demers JLH, Esmonde-White FW, Esmonde-White KA, Morris MD, Pogue BW. Next-generation Raman tomography instrument for non-invasive in vivo bone imaging. BIOMEDICAL OPTICS EXPRESS 2015; 6:793-806. [PMID: 25798304 PMCID: PMC4361434 DOI: 10.1364/boe.6.000793] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/15/2015] [Accepted: 01/15/2015] [Indexed: 05/20/2023]
Abstract
Combining diffuse optical tomography methods with Raman spectroscopy of tissue provides the ability for in vivo measurements of chemical and molecular characteristics, which have the potential for being useful in diagnostic imaging. In this study a system for Raman tomography was developed and tested. A third generation microCT coupled system was developed to combine 10 detection fibers and 5 excitation fibers with laser line filtering and a Cytop reference signal. Phantom measurements of hydroxyapatite concentrations from 50 to 300 mg/ml had a linear response. Fiber placement and experiment design was optimized using cadaver animals with live animal measurements acquired to validate the systems capabilities. Promising results from the initial animal experiments presented here, pave the way for a study of longitudinal measurements during fracture healing and the scaling of the Raman tomography system towards human measurements.
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Affiliation(s)
- Jennifer-Lynn H. Demers
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, 03755,
USA
- JLHD and FEW have made equal contributions to the manuscript
| | - Francis W.L. Esmonde-White
- University of Michigan, Department of Chemistry, Ann Arbor, Michigan, 48109,
USA
- Current affiliation: Kaiser Optical Systems, Inc, Ann Arbor Michigan, 48103,
USA
- JLHD and FEW have made equal contributions to the manuscript
| | - Karen A. Esmonde-White
- University of Michigan Medical School, Department of Internal Medicine-Division of Rheumatology, Ann Arbor, Michigan, 48109,
USA
| | - Michael D. Morris
- University of Michigan, Department of Chemistry, Ann Arbor, Michigan, 48109,
USA
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, 03755,
USA
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Mandair GS, Morris MD. Contributions of Raman spectroscopy to the understanding of bone strength. BONEKEY REPORTS 2015; 4:620. [PMID: 25628882 DOI: 10.1038/bonekey.2014.115] [Citation(s) in RCA: 210] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/24/2014] [Indexed: 02/07/2023]
Abstract
Raman spectroscopy is increasingly commonly used to understand how changes in bone composition and structure influence tissue-level bone mechanical properties. The spectroscopic technique provides information on bone mineral and matrix collagen components and on the effects of various matrix proteins on bone material properties as well. The Raman spectrum of bone not only contains information on bone mineral crystallinity that is related to bone hardness but also provides information on the orientation of mineral crystallites with respect to the collagen fibril axis. Indirect information on collagen cross-links is also available and will be discussed. After a short introduction to bone Raman spectroscopic parameters and collection methodologies, advances in in vivo Raman spectroscopic measurements for animal and human subject studies will be reviewed. A discussion on the effects of aging, osteogenesis imperfecta, osteoporosis and therapeutic agents on bone composition and mechanical properties will be highlighted, including genetic mouse models in which structure-function and exercise effects are explored. Similarly, extracellular matrix proteins, proteases and transcriptional proteins implicated in the regulation of bone material properties will be reviewed.
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Affiliation(s)
- Gurjit S Mandair
- Department of Chemistry, University of Michigan , Ann Arbor, MI, USA
| | - Michael D Morris
- Department of Chemistry, University of Michigan , Ann Arbor, MI, USA
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Wu CT, Lu TY, Chan DC, Tsai KS, Yang RS, Liu SH. Effects of arsenic on osteoblast differentiation in vitro and on bone mineral density and microstructure in rats. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:559-65. [PMID: 24531206 PMCID: PMC4050517 DOI: 10.1289/ehp.1307832] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/11/2014] [Indexed: 05/05/2023]
Abstract
BACKGROUND Arsenic is a ubiquitous toxic element and is known to contaminate drinking water in many countries. Several epidemiological studies have shown that arsenic exposure augments the risk of bone disorders. However, the detailed effect and mechanism of inorganic arsenic on osteoblast differentiation of bone marrow stromal cells and bone loss still remain unclear. OBJECTIVES We investigated the effects and mechanism of arsenic on osteoblast differentiation in vitro and evaluated bone mineral density (BMD) and bone microstructure in rats at doses relevant to human exposure from drinking water. METHODS We used a cell model of rat primary bone marrow stromal cells (BMSCs) and a rat model of long-term exposure with arsenic-contaminated drinking water, and determined bone microstructure and BMD in rats by microcomputed tomography (μCT). RESULTS We observed significant attenuation of osteoblast differentiation after exposure of BMSCs to arsenic trioxide (0.5 or 1 μM). After arsenic treatment during differentiation, expression of runt-related transcription factor-2 (Runx2), bone morphogenetic protein-2 (BMP-2), and osteocalcin in BMSCs was inhibited and phosphorylation of enhanced extracellular signal-regulated kinase (ERK) was increased. These altered differentiation-related molecules could be reversed by the ERK inhibitor PD98059. Exposure of rats to arsenic trioxide (0.05 or 0.5 ppm) in drinking water for 12 weeks altered BMD and microstructure, decreased Runx2 expression, and increased ERK phosphorylation in bones. In BMSCs isolated from arsenic-treated rats, osteoblast differentiation was inhibited. CONCLUSIONS Our results suggest that arsenic is capable of inhibiting osteoblast differentiation of BMSCs via an ERK-dependent signaling pathway and thus increasing bone loss.
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Affiliation(s)
- Cheng-Tien Wu
- Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
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Kocijan R, Finzel S, Englbrecht M, Engelke K, Rech J, Schett G. Decreased quantity and quality of the periarticular and nonperiarticular bone in patients with rheumatoid arthritis: a cross-sectional HR-pQCT study. J Bone Miner Res 2014; 29:1005-14. [PMID: 24123099 DOI: 10.1002/jbmr.2109] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 09/08/2013] [Accepted: 09/19/2013] [Indexed: 01/01/2023]
Abstract
Rheumatoid arthritis (RA) is a highly bone destructive disease. Although it is well established that RA leads to bone loss and increased fracture risk, current knowledge on the microstructural changes of bone in RA is still limited. The purpose of this study was to assess the microstructure of periarticular and nonperiarticular bone in female and male RA patients and compare it with respective healthy controls. We performed two high-resolution peripheral quantitative computed tomography (HR-pQCT; Xtreme-CT) scans, one of the distal radius and one of the ultradistal radius in 90 patients with RA (60 females, 30 males) and 70 healthy controls (40 females, 30 males) matched for sex, age, and body mass index. Volumetric bone mineral density (vBMD), bone geometry, and bone microstructure including trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), cortical thickness (Ct.Th) and cortical porosity (Ct.Po) were assessed. At the distal and ultradistal radius, trabecular (p=0.005 and p<0.001) and cortical BMD (p<0.001 and p<0.001) were significantly decreased in male and female patients with RA, respectively. BV/TV was also decreased at both sites, based on lower Tb.N in female RA (p<0.001 for both sites) and lower Tb.Th (p=0.034 and p=0.005) in male RA patients compared with respective healthy controls. Cortical thinning (p=0.018 and p=0.002) but not Ct.Po (p=0.070 and p=0.275) was pronounced in male and female RA patients at the distal radius. Cortical perimeter was increased in male and female RA patients at both sites. Multiple regression models showed that bone geometry (cortical perimeter) is predominantly influenced by age of the RA patient, cortical thickness by both age and disease duration, and trabecular microstructure predominantly by the disease duration. In summary, these data show profound deterioration of bone microstructure in the appendicular skeleton of RA patients at both periarticular and nonperiarticular sites.
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Affiliation(s)
- Roland Kocijan
- Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany; St. Vincent Hospital-Medical Department II, The VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria
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Esmonde-White KA, Esmonde-White FWL, Holmes CM, Morris MD, Roessler BJ. Alterations to bone mineral composition as an early indication of osteomyelitis in the diabetic foot. Diabetes Care 2013; 36:3652-4. [PMID: 23920085 PMCID: PMC3816922 DOI: 10.2337/dc13-0510] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Osteomyelitis in the diabetic foot is a major risk factor for amputation, but there is a limited understanding of early-stage infection, impeding limb-preserving diagnoses. We hypothesized that bone composition measurements provide insight into the early pathophysiology of diabetic osteomyelitis. RESEARCH DESIGN AND METHODS Compositional analysis by Raman spectroscopy was performed on bone specimens from patients with a clinical diagnosis of osteomyelitis in the foot requiring surgical intervention as either a biopsy (n = 6) or an amputation (n = 11). RESULTS An unexpected result was the discovery of pathological calcium phosphate minerals in addition to normal bone mineral. Dicalcium phosphate dihydrate, also called brushite, and uncarbonated apatite were found to be exclusively associated with infected bone. CONCLUSIONS Compositional measurements provided a unique insight into the pathophysiology of osteomyelitis in diabetic foot ulcers. At-patient identification of pathological minerals by Raman spectroscopy may serve as an early-stage diagnostic approach.
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Maher JR, Inzana JA, Awad HA, Berger AJ. Overconstrained library-based fitting method reveals age- and disease-related differences in transcutaneous Raman spectra of murine bones. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:077001. [PMID: 23817761 PMCID: PMC3697032 DOI: 10.1117/1.jbo.18.7.077001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Clinical diagnoses of bone health and fracture risk typically rely on measurements of bone density or structure, but the strength of a bone is also dependent on its chemical composition. Raman spectroscopy has been used extensively in ex vivo studies to measure the chemical composition of bone. Recently, spatially offset Raman spectroscopy (SORS) has been utilized to measure bone transcutaneously. Although the results are promising, further advancements are necessary to make noninvasive, in vivo measurements of bone with SORS that are of sufficient quality to generate accurate predictions of fracture risk. In order to separate the signals from bone and soft tissue that contribute to a transcutaneous measurement, we developed an overconstrained extraction algorithm that is based on fitting with spectral libraries. This approach allows for accurate spectral unmixing despite the fact that similar chemical components (e.g., type I collagen) are present in both bone and soft tissue. The algorithm was utilized to transcutaneously detect biochemical differences in the tibiae of wild-type mice between 1 and 7 months of age and between the tibiae of wild-type mice and a mouse model of osteogenesis imperfecta. These results represent the first diagnostically sensitive, transcutaneous measurements of bone using SORS.
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Affiliation(s)
- Jason R Maher
- The Institute of Optics, University of Rochester, 275 Hutchison Road, Rochester, New York 14627, USA
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Manning LI, Briggs AM, Van Doornum S, Kale A, Kantor S, Wark JD. Glucocorticoid-induced bone loss is associated with abnormal intravertebral areal bone mineral density distribution. Int J Endocrinol 2013; 2013:768579. [PMID: 23737778 PMCID: PMC3662195 DOI: 10.1155/2013/768579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 04/16/2013] [Indexed: 01/28/2023] Open
Abstract
Individuals with glucocorticoid-induced osteoporosis experience vertebral fractures at an increased rate and at higher vertebral areal bone mineral density (aBMD) than individuals with primary osteoporosis. Standard posteroanterior- (PA-) projection dual energy X-ray absorptiometry (DXA) lacks the diagnostic sensitivity required for reliable estimation of vertebral fracture risk in individuals. Assessment of subregional vertebral aBMD using lateral-projection DXA may improve the predictive value of DXA parameters for fracture. One hundred and four individuals were recruited and grouped for this study: primary osteoporosis with no history of vertebral fracture (n = 43), glucocorticoid-induced bone loss (n = 13), and healthy controls (n = 48). Standard PA-projection and supine-lateral scans were performed, and lateral scans were analysed according to an established protocol to measure aBMD within 6 subregions. Main effects for subregion and group were assessed and observed, by ANCOVA. Ratios were calculated between subregions and compared between groups, to overcome the potentially confounding influence of variability in subregional geometry. Significantly lower values were observed in the glucocorticoid group for the ratios of (i) anterior subregion: whole vertebral body and (ii) posterior: whole vertebral body when compared to the primary osteoporosis and control groups (P < 0.05). Lower anterior subregional aBMD in individuals on glucocorticoid therapy may help to explain the increased vertebral fracture risk in this patient group.
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Affiliation(s)
- Louise I. Manning
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - Andrew M. Briggs
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia
- Arthritis Victoria and Osteoporosis Victoria, Elsternwick, VIC 3185, Australia
| | - Sharon Van Doornum
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - Ashwini Kale
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - Susan Kantor
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - John D. Wark
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- *John D. Wark:
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Bone fragility beyond strength and mineral density: Raman spectroscopy predicts femoral fracture toughness in a murine model of rheumatoid arthritis. J Biomech 2012; 46:723-30. [PMID: 23261243 DOI: 10.1016/j.jbiomech.2012.11.039] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 11/12/2012] [Accepted: 11/13/2012] [Indexed: 01/22/2023]
Abstract
Clinical prediction of bone fracture risk primarily relies on measures of bone mineral density (BMD). BMD is strongly correlated with bone strength, but strength is independent of fracture toughness, which refers to the bone's resistance to crack initiation and propagation. In that sense, fracture toughness is more relevant to assessing fragility-related fracture risk, independent of trauma. We hypothesized that bone biochemistry, determined by Raman spectroscopy, predicts bone fracture toughness better than BMD. This hypothesis was tested in tumor necrosis factor-transgenic mice (TNF-tg), which develop inflammatory-erosive arthritis and osteoporosis. The left femurs of TNF-tg and wild type (WT) littermates were measured with Raman spectroscopy and micro-computed tomography. Fracture toughness was assessed by cutting a sharp notch into the anterior surface of the femoral mid-diaphysis and propagating the crack under 3 point bending. Femoral fracture toughness of TNF-tg mice was significantly reduced compared to WT controls (p=0.04). A Raman spectrum-based prediction model of fracture toughness was generated by partial least squares regression (PLSR). Raman spectrum PLSR analysis produced strong predictions of fracture toughness, while BMD was not significantly correlated and produced very weak predictions. Raman spectral components associated with mineralization quality and bone collagen were strongly leveraged in predicting fracture toughness, reiterating the limitations of mineralization density alone.
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