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Gehrke B, Alves Coelho MC, Brasil d'Alva C, Madeira M. Long-term consequences of osteoporosis therapy with bisphosphonates. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 68:e220334. [PMID: 37948565 PMCID: PMC10916794 DOI: 10.20945/2359-4292-2022-0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/10/2022] [Indexed: 11/12/2023]
Abstract
Bisphosphonates (BPs) are medications widely used in clinical practice to treat osteoporosis and reduce fragility fractures. Its beneficial effects on bone tissue have been consolidated in the literature for the last decades. They have a high affinity for bone hydroxyapatite crystals, and most bisphosphonates remain on the bone surface for a long period of time. Benefits of long-term use of BPs: Large and important trials (Fracture Intervention Trial Long-term Extension and Health Outcomes and Reduced Incidence with Zoledronic acid Once Yearly-Pivotal Fracture Trial) with extended use of alendronate (up to 10 years) and zoledronate (up to 6 years) evidenced significant gain of bone mineral density (BMD) and vertebral fracture risk reduction. Risks of long-term use of BPs: The extended use of antiresorptive therapy has drawn attention to two extremely rare, although severe, adverse events. That is, atypical femoral fracture and medication-related osteonecrosis of the jaw are more common in patients with high cumulative doses and longer duration of therapy. BPs have demonstrated safety and effectiveness throughout the years and evidenced increased BMD and reduced fracture risks, resulting in reduced morbimortality, and improved quality of life. These benefits overweight the risks of rare adverse events.
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Affiliation(s)
- Bárbara Gehrke
- Programa de Pós-graduação em Fisiopatologia Clínica e Experimental (FISCLINEX), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil,
- Centro de Pesquisa Clínica Multiusuário (CePeM), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
- Divisão de Endocrinologia, Departamento de Medicina Interna, Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Maria Caroline Alves Coelho
- Programa de Pós-graduação em Fisiopatologia Clínica e Experimental (FISCLINEX), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
- Centro de Pesquisa Clínica Multiusuário (CePeM), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
- Divisão de Endocrinologia, Departamento de Medicina Interna, Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Catarina Brasil d'Alva
- Núcleo de Atendimento Multidisciplinar às Doenças Osteometabólicas, Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - Miguel Madeira
- Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
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Martínez-Parra L, Piñol-Cancer M, Sanchez-Cano C, Miguel-Coello AB, Di Silvio D, Gomez AM, Uriel C, Plaza-García S, Gallego M, Pazos R, Groult H, Jeannin M, Geraki K, Fernández-Méndez L, Urkola-Arsuaga A, Sánchez-Guisado MJ, Carrillo-Romero J, Parak WJ, Prato M, Herranz F, Ruiz-Cabello J, Carregal-Romero S. A Comparative Study of Ultrasmall Calcium Carbonate Nanoparticles for Targeting and Imaging Atherosclerotic Plaque. ACS NANO 2023; 17:13811-13825. [PMID: 37399106 PMCID: PMC10900527 DOI: 10.1021/acsnano.3c03523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Atherosclerosis is a complex disease that can lead to life-threatening events, such as myocardial infarction and ischemic stroke. Despite the severity of this disease, diagnosing plaque vulnerability remains challenging due to the lack of effective diagnostic tools. Conventional diagnostic protocols lack specificity and fail to predict the type of atherosclerotic lesion and the risk of plaque rupture. To address this issue, technologies are emerging, such as noninvasive medical imaging of atherosclerotic plaque with customized nanotechnological solutions. Modulating the biological interactions and contrast of nanoparticles in various imaging techniques, including magnetic resonance imaging, is possible through the careful design of their physicochemical properties. However, few examples of comparative studies between nanoparticles targeting different hallmarks of atherosclerosis exist to provide information about the plaque development stage. Our work demonstrates that Gd (III)-doped amorphous calcium carbonate nanoparticles are an effective tool for these comparative studies due to their high magnetic resonance contrast and physicochemical properties. In an animal model of atherosclerosis, we compare the imaging performance of three types of nanoparticles: bare amorphous calcium carbonate and those functionalized with the ligands alendronate (for microcalcification targeting) and trimannose (for inflammation targeting). Our study provides useful insights into ligand-mediated targeted imaging of atherosclerosis through a combination of in vivo imaging, ex vivo tissue analysis, and in vitro targeting experiments.
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Affiliation(s)
- Lydia Martínez-Parra
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- Euskal Herriko Unibertsitatea (UPV/EHU), 20018 Donostia, Spain
| | - Marina Piñol-Cancer
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- Euskal Herriko Unibertsitatea (UPV/EHU), 20018 Donostia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Carlos Sanchez-Cano
- Donostia International Physics Center, Paseo Manuel de Lardizabal 4, Donostia, 20018, Spain
- Ikerbasque, Basque Foundation for Science, 48013 Bilbao, Spain
- Polimero eta Material Aurreratuak: Fisika, Kimika eta Teknologia, Kimika Fakultatea, Euskal Herriko Unibertsitatea (UPV/EHU), 20018 Donostia, Spain
| | - Ana B Miguel-Coello
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
| | - Desirè Di Silvio
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
| | - Ana M Gomez
- Instituto de Química Orgánica General, IQOG-CSIC, 28006 Madrid, Spain
| | - Clara Uriel
- Instituto de Química Orgánica General, IQOG-CSIC, 28006 Madrid, Spain
| | - Sandra Plaza-García
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
| | - Marta Gallego
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
| | - Raquel Pazos
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
| | - Hugo Groult
- Biotechnologies et Chimie des Bioressources pour la Santé, Littoral Environment et Sociétés (LIENSs Laboratory), UMR CNRS 7266, 17000 La Rochelle, France
| | - Marc Jeannin
- Laboratoire des Sciences de l'Ingénieur pour l'Environnement (LaSIE), UMR-CNRS 7536, La Rochelle Université, 7356 La Rochelle, France
| | - Kalotina Geraki
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot OX11 0DE, United Kingdom
| | - Laura Fernández-Méndez
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- Euskal Herriko Unibertsitatea (UPV/EHU), 20018 Donostia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Ainhize Urkola-Arsuaga
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
| | - María Jesús Sánchez-Guisado
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- Euskal Herriko Unibertsitatea (UPV/EHU), 20018 Donostia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Juliana Carrillo-Romero
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- Basque Res & Technol Alliance BRTA, GAIKER, Technol Ctr, 48170 Zamudio, Spain
| | - Wolfgang J Parak
- Center for Hybrid Nanostructures (CHyN), Universität Hamburg, 22607 Hamburg, Germany
| | - Maurizio Prato
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- Ikerbasque, Basque Foundation for Science, 48013 Bilbao, Spain
| | - Fernando Herranz
- NanoMedMol, Instituto de Química Médica, Consejo Superior de Investigaciones Científicas (IQM-CSIC), Madrid 28006, Spain
| | - Jesús Ruiz-Cabello
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Ikerbasque, Basque Foundation for Science, 48013 Bilbao, Spain
- Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Susana Carregal-Romero
- Center for Cooperative Research in Biomaterials (CIC biomaGUNE), Basque Research and Technology Alliance (BRTA), 20014 Donostia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Ikerbasque, Basque Foundation for Science, 48013 Bilbao, Spain
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Klara J, Lewandowska-Łańcucka J. How Efficient are Alendronate-Nano/Biomaterial Combinations for Anti-Osteoporosis Therapy? An Evidence-Based Review of the Literature. Int J Nanomedicine 2022; 17:6065-6094. [PMID: 36510618 PMCID: PMC9738991 DOI: 10.2147/ijn.s388430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Because of the systemic nature of osteoporosis, the associated escalation in fracture risk affects virtually all skeletal sites. The problem is serious since it is estimated that more than 23 million men and women are at high risk of osteoporotic-like breakages in the European Union. Alendronate (ALN) is the most commonly prescribed oral nitrogen-containing bisphosphonate (BP) for the prevention and the therapy of osteoporosis. This is also one of the most intensely studied drugs in this field. However, ALN is characterized by restricted oral absorption and bioavailability and simultaneously its administration has serious side-effects (jaw osteonecrosis, irritation of the gastrointestinal system, nausea, musculoskeletal pain, and cardiovascular risks). Therefore, delivery systems enabling controlled release and local action of this drug are of great interest, being widely researched and presented in the literature. In this review, we discuss the current trends in the design of various types of alendronate carriers. Our paper is focused on the most recent developments in the field of nano/biomaterials-based systems for ALN delivery, including nano/microformulations, synthetic/natural polymeric and inorganic materials, hydrogel-based materials, scaffolds, coated-like structures, as well as organic-inorganic hybrids. Topics related to the treatment of complex bone diseases including osteoporosis have been covered in several more general reviews; however, the systems for this particular drug have not yet been discussed in detail.
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Affiliation(s)
- Joanna Klara
- Faculty of Chemistry, Jagiellonian University, Kraków, 30-387, Poland
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Kim AS, Girgis CM, McDonald MM. Osteoclast Recycling and the Rebound Phenomenon Following Denosumab Discontinuation. Curr Osteoporos Rep 2022; 20:505-515. [PMID: 36201122 PMCID: PMC9718877 DOI: 10.1007/s11914-022-00756-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE OF REVIEW Inhibition of receptor activator of nuclear factor kappa-B ligand (RANKL) with denosumab is an effective treatment in a number of conditions including osteoporosis where suppression of bone resorption is desired. However, denosumab discontinuation is associated with rebound increase in bone resorption and subsequent loss in bone mass and a rapid return to baseline fracture risk. We review recent data on the rebound increase in bone resorption following denosumab discontinuation and the potential mechanisms behind this phenomenon. RECENT FINDINGS Osteoclasts have been considered to be highly specialised cells that undergo apoptosis after fulfilling their function of bone resorption. However, recent studies suggest that osteoclasts are longer lived cells which migrate through vasculature and are capable of undergoing fission into a novel cell type (the osteomorph) and re-fusion in a process termed osteoclast recycling. The life cycle of the osteoclast is more complex than previously appreciated. Osteoclast recycling provides a novel mechanistic framework to examine changes in osteoclast biology in response to treatment of bone diseases and provides an exciting new avenue towards personalised medicine.
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Affiliation(s)
- Albert S Kim
- Bone Biology Program, Garvan Institute of Medical Research, Sydney, Australia
- Faculty of Medicine UNSW Sydney, St Vincent's Clinical School, Kensington, NSW, Australia
- Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia
| | - Christian M Girgis
- Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Michelle M McDonald
- Bone Biology Program, Garvan Institute of Medical Research, Sydney, Australia.
- Faculty of Medicine UNSW Sydney, St Vincent's Clinical School, Kensington, NSW, Australia.
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