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Jenkins TL, Sarmiento Huertas PA, Umemori K, Guilak F, Little D. Tendon-derived matrix crosslinking techniques for electrospun multi-layered scaffolds. J Biomed Mater Res A 2023; 111:1875-1887. [PMID: 37489733 PMCID: PMC10592356 DOI: 10.1002/jbm.a.37588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/26/2023]
Abstract
Tendon tears are common and healing often occurs incompletely and by fibrosis. Tissue engineering seeks to improve repair, and one approach under investigation uses cell-seeded scaffolds containing biomimetic factors. Retention of biomimetic factors on the scaffolds is likely critical to maximize their benefit, while minimizing the risk of adverse effects, and without losing the beneficial effects of the biomimetic factors. The aim of the current study was to evaluate cross-linking methods to enhance the retention of tendon-derived matrix (TDM) on electrospun poly(ε-caprolactone) (PCL) scaffolds. We tested the effects of ultraviolet (UV) or carbodiimide (EDC:NHS:COOH) crosslinking methods to better retain TDM to the scaffolds and stimulate tendon-like matrix synthesis. Initially, we tested various crosslinking configurations of carbodiimide (2.5:1:1, 5:2:1, and 10:4:1 EDC:NHS:COOH ratios) and UV (30 s 1 J/cm2 , 60 s 1 J/cm2 , and 60 s 4 J/cm2 ) on PCL films compared to un-crosslinked TDM. We found that no crosslinking tested retained more TDM than coating alone (Kruskal-Wallis: p > .05), but that human adipose stem cells (hASCs) spread most on the 60 s 1 J/cm2 UV- and 2.5:1:1 EDC-crosslinked films (Kruskal-Wallis: p < .05). Next, we compared the effects of 60 s 1 J/cm2 UV- and 2.5:1:1 EDC-crosslinked to TDM-coated and untreated PCL scaffolds on hASC-induced tendon-like differentiation. UV-crosslinked scaffolds had greater modulus and stiffness than PCL or TDM scaffolds, and hASCs spread more on UV-crosslinked scaffolds (ANOVA: p < .05). Fourier transform infrared spectra revealed that UV- or EDC-crosslinking TDM did not affect the peaks at wavenumbers characteristic of tendon. Crosslinking TDM to electrospun scaffolds improves tendon-like matrix synthesis, providing a viable strategy for improving retention of TDM on electrospun PCL scaffolds.
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Affiliation(s)
- Thomas L. Jenkins
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | | | - Kentaro Umemori
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Washington University, St. Louis, MO
- Shriners Hospitals for Children – St. Louis, St. Louis, MO
| | - Dianne Little
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN
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2
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Liu Z, Niu Y, Fu Z, Dean M, Fu Z, Hu Y, Zou Z. 3D relationship between hierarchical canal network and gradient mineralization of shark tooth osteodentin. Acta Biomater 2023; 168:185-197. [PMID: 37451657 DOI: 10.1016/j.actbio.2023.07.007] [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: 03/12/2023] [Revised: 06/25/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Osteodentin is a dominant mineralized collagenous tissue in the teeth of many fishes, with structural and histological characteristics resembling those of bone. Osteodentin, like bone, comprises osteons as basic structural building blocks, however, it lacks the osteocytes and the lacuno-canalicular network (LCN), which are known to play critical roles in controlling the mineralization of the collagenous matrix in bone. Although numerous vascular canals exist in osteodentin, their role in tooth maturation and the matrix mineralization process remain poorly understood. Here, high resolution micro-computed tomography (micro-CT) and focused ion beam-scanning electron microscopy (FIB-SEM) were used to obtain 3D structural information of osteodentin in shark teeth at multiple scales. We observed a complex 3D network of primary canals with a diameter ranging from ∼10 µm to ∼120 µm, where the canals are surrounded by osteon-like concentric layers of lamellae, with 'interosteonal' tissue intervening between neighboring osteons. In addition, numerous hierarchically branched secondary canals extended radially from the primary canals into the interosteonal tissue, decreasing in diameter from ∼10 µm to hundreds of nanometers. Interestingly, the mineralization degree increases from the periphery of primary canals into the interosteonal tissue, suggesting that mineralization begins in the interosteonal tissue. Correspondingly, the hardness and elastic modulus of the interosteonal tissue are higher than those of the osteonal tissue. These results demonstrate that the 3D hierarchical canal network is positioned to play a critical role in controlling the gradient mineralization of osteodentin, also providing valuable insight into the formation of mineralized collagenous tissue without osteocytes and LCN. STATEMENT OF SIGNIFICANCE: Bone is a composite material with versatile mechanical properties. Osteocytes and their lacuno-canalicular network (LCN) are known to play critical roles during formation of human bone. However, the bone and osteodentin of many fishes, although lacking osteocytes and LCN, exhibit similar osteon-like structure and mechanical functions. Here, using various high resolution 3D characterization techniques, we reveal that the 3D network of primary canals and numerous hierarchically branched secondary canals correlate with the mineralization gradient and micromechanical properties of osteonal and interosteonal tissues of shark tooth osteodentin. This work significantly improves our understanding of the construction of bone-like mineralized tissue without osteocytes and LCN, and provides inspirations for the fabrication of functional materials with hierarchical structure.
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Affiliation(s)
- Zhuanfei Liu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan 430070, China
| | - Yunya Niu
- State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, Wuhan 430070, China
| | - Zeyao Fu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan 430070, China
| | - Mason Dean
- Department of Infectious Diseases & Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | - Zhengyi Fu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan 430070, China
| | - Yongming Hu
- School of Microelectronics, Hubei University, Wuhan 430062, Hubei, China..
| | - Zhaoyong Zou
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan 430070, China.; Hubei Longzhong Laboratory, Wuhan University of Technology Xiangyang Demonstration Zone, Xiangyang 441000, China.
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Gheorghe AM, Stanescu LS, Petrova E, Carsote M, Nistor C, Ghemigian A. Paget's Disease of the Bone and Lynch Syndrome: An Exceptional Finding. Diagnostics (Basel) 2023; 13:2101. [PMID: 37370996 DOI: 10.3390/diagnostics13122101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Our objective is to present an exceptional case of a patient diagnosed with Paget's disease of the bone (PDB) while being confirmed with Lynch syndrome (LS). A 44-year-old woman was admitted for progressive pain in the left forearm 2 years ago, and was partially relieved since admission by non-steroidal anti-inflammatory drugs. Suggestive imaging findings and increased blood bone turnover markers helped the diagnosis of PDB. She was offered zoledronate 5 mg. She had two more episodes of relapse, and a decision of new medication was taken within the following years (a second dose of zoledronate, as well as denosumab 60 mg). Her family history showed PDB (mother) and colorectal cancer (father). Whole exome sequencing was performed according to the manufacturer's standard procedure (Ion AmpliSeq™ Exome RDY S5 Kit). A heterozygous pathogenic variant in the SQSTM1 gene (c.1175C>T, p.Pro392Leu) was confirmed, consistent with the diagnosis of PDB. Additionally, a heterozygous pathogenic variant of MSH2 gene (c.2634+1G>T) was associated with LS. The patient's first-degree relatives (her brother, one of her two sisters, and her only daughter) underwent specific genetic screening and found negative results, except for her daughter, who tested positive for both pathogenic variants while being clinically asymptomatic. The phenotype influence of either mutation is still an open issue. To our current knowledge, no similar case has been published before. Both genetic defects that led to the two conditions appeared highly transmissible in the patient's family. The patient might have an increased risk of osteosarcoma and chondrosarcoma, both due to PDB and LS, and a review of the literature was introduced in this particular matter. The phenotypic expression of the daughter remains uncertain and is yet to be a lifelong follow-up as the second patient harbouring this unique combination of gene anomalies.
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Affiliation(s)
- Ana-Maria Gheorghe
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
| | - Laura-Semonia Stanescu
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- PhD Doctoral School, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Eugenia Petrova
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mara Carsote
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Claudiu Nistor
- Department 4-Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Carol Davila University of Medicine and Pharmacy & Thoracic Surgery Department, Dr. Carol Davila Central Emergency University Military Hospital, 050474 Bucharest, Romania
| | - Adina Ghemigian
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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4
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Impact of test environment on the fracture resistance of cortical bone. J Mech Behav Biomed Mater 2022; 129:105155. [DOI: 10.1016/j.jmbbm.2022.105155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 02/24/2022] [Accepted: 02/27/2022] [Indexed: 11/22/2022]
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Abstract
Understanding the properties of bone is of both fundamental and clinical relevance. The basis of bone’s quality and mechanical resilience lies in its nanoscale building blocks (i.e., mineral, collagen, non-collagenous proteins, and water) and their complex interactions across length scales. Although the structure–mechanical property relationship in healthy bone tissue is relatively well characterized, not much is known about the molecular-level origin of impaired mechanics and higher fracture risks in skeletal disorders such as osteoporosis or Paget’s disease. Alterations in the ultrastructure, chemistry, and nano-/micromechanics of bone tissue in such a diverse group of diseased states have only been briefly explored. Recent research is uncovering the effects of several non-collagenous bone matrix proteins, whose deficiencies or mutations are, to some extent, implicated in bone diseases, on bone matrix quality and mechanics. Herein, we review existing studies on ultrastructural imaging—with a focus on electron microscopy—and chemical, mechanical analysis of pathological bone tissues. The nanometric details offered by these reports, from studying knockout mice models to characterizing exact disease phenotypes, can provide key insights into various bone pathologies and facilitate the development of new treatments.
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Hemmatian H, Conrad S, Furesi G, Mletzko K, Krug J, Faila AV, Kuhlmann JD, Rauner M, Busse B, Jähn-Rickert K. Reorganization of the osteocyte lacuno-canalicular network characteristics in tumor sites of an immunocompetent murine model of osteotropic cancers. Bone 2021; 152:116074. [PMID: 34174502 DOI: 10.1016/j.bone.2021.116074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/04/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022]
Abstract
Mechanosensitive osteocytes are central regulators of bone resorption and formation. However, during the formation of bone metastases, which arise as consequences of breast and prostate cancer and skew homeostatic bone remodeling to favor osteolytic, osteosclerotic or mixed lesions, only a paucity of data exists on tumor-associated osteocyte interaction. Herein, we used a suite of high-resolution imaging and histological techniques to evaluate the effect of osteotropic cancer on cortical bone microarchitecture. Confocal imaging highlighted a direct contact between tumor cells residing in the bone marrow and osteocytes. High-resolution microcomputed tomography revealed a 10-12% larger osteocyte lacuna volume in the presence of tumor cells at day 21 after intratibial injection of EO771-Luc breast and RM1-Luc prostate cancer cells. The 3D representative of the spatial distribution of cortical bone microporosity showed i) a regional accumulation of vascular canals and large lacunae with low connectivity in osteosclerotic regions of interest and ii) an absence of vascular canals and large lacunae in osteolytic regions. These findings pinpoint the relationship between the presence of tumor cells in the bone marrow microenvironment and osteocyte lacunar characteristics and cortical bone blood vessel structure.
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Affiliation(s)
- Haniyeh Hemmatian
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529 Hamburg, Germany
| | - Stefanie Conrad
- Department of Medicine III and Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany
| | - Giulia Furesi
- Department of Medicine III and Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany
| | - Kathrin Mletzko
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529 Hamburg, Germany
| | - Johannes Krug
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529 Hamburg, Germany
| | - Antonio Virgilio Faila
- Microscopy Imaging Facility, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Dominik Kuhlmann
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Martina Rauner
- Department of Medicine III and Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany.
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529 Hamburg, Germany; Interdisciplinary Competence Center for Interface Research (ICCIR), Hamburg, Germany; Forum Medical Technology Health Hamburg (FMTHH), Hamburg, Germany.
| | - Katharina Jähn-Rickert
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529 Hamburg, Germany; Mildred Scheel Cancer Career Center Hamburg, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg.
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7
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The Correlation of Regional Microstructure and Mechanics of the Cervical Articular Process in Adults. MATERIALS 2021; 14:ma14216409. [PMID: 34771937 PMCID: PMC8585171 DOI: 10.3390/ma14216409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/27/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
Purpose: Using micro-CT and finite element analysis to establish regional variation microarchitectures and correlation with mechanical properties of cervical articular facet trabecular bone to predict cervical spine security and material properties. Methods: A total of 144 cervical articular processes (each articular was separate to four region of interest (ROI), superior-anterior (SA), superior-posterior (SP), inferior-anterior (IA), and inferior-posterior (IP) regions) specimens with a volume of 5 × 5 × 5 mm3 were scanned by micro-CT, and allowable stress and other mechanical properties parameters in each region were calculated after mechanical testing, then the effectiveness was verified of finite element models by ABAQUS software. Results: Maximum and minimum values of C2–C7 articular processes and regions are C5 and C7 level, SA and SP regions for bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), whose variation tendency is similar to the Young’s modulus, allowable stress, BMD, maximum force and strain. Between Young’s modulus and all microstructure parameters, especially between BV/TV, bone mineral density (BMD) and Tb.Th, had higher linear regression coefficients R2 = 0.5676, 0.6382, 0.3535, respectively. BMD and yield strength, BV/TV, and allowable stress also had better regression coefficients, R2 = 0.5227, 0.5259, 0.5426, respectively. Conclusions: The contribution of the microstructure and mechanical properties of the C2–C7 cervical spine to the movement of the cervical spine is different and has a good correlation and the effectiveness of the finite element model is also verified that we can correctly calculate the microstructure and mechanical properties of the cervical articular process to evaluate the stability and injury risk of cervical vertebrae by the established model.
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Shoaib Z, Fan TM, Irudayaraj J. Osteosarcoma mechanobiology and therapeutic targets. Br J Pharmacol 2021; 179:201-217. [PMID: 34679192 PMCID: PMC9305477 DOI: 10.1111/bph.15713] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022] Open
Abstract
Osteosarcoma (OS) is the one of the most common primary tumors of bone with less than a 20% 5-year survival rate after the development of metastases. OS is highly predisposed in Paget's disease (PD) of bone, and both have common characteristic skeletal features due to rapid bone remodeling. OS prognosis is location dependent which further emphasizes the likely contribution of the bone microenvironment in its pathogenesis. Mechanobiology is the phenomenon when mechanical cues from the changing physical microenvironment of bone are transduced to biological pathways through mechanosensitive cellular components. Mechanobiology-driven therapies have been used for curbing tumor progression by direct alteration of the physical microenvironment or inhibition of metastasis-associated mechanosensitive proteins. This review emphasizes the contribution of mechanobiology to OS progression, and sheds light on current mechanobiology-based therapies and potential new targets for improving disease management. Additionally, the variety of 3D models currently used to study OS mechanobiology are summarized.
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Affiliation(s)
- Zunaira Shoaib
- Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Timothy M Fan
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Joseph Irudayaraj
- Department of Bioengineering, Nick Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, IL, USA.,Biomedical Research Center, Carle Foundation Hospital, Urbana, IL, USA.,Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, IL, USA
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9
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Muñoz A, Docaj A, Ugarteburu M, Carriero A. Poor bone matrix quality: What can be done about it? Curr Osteoporos Rep 2021; 19:510-531. [PMID: 34414561 DOI: 10.1007/s11914-021-00696-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF THE REVIEW Bone's ability to withstand load resisting fracture and adapting to it highly depends on the quality of its matrix and its regulators. This review focuses on the contribution of bone quality to fracture resistance and possible therapeutic targets for skeletal fragility in aging and disease. RECENT FINDINGS The highly organized, hierarchical composite structure of bone extracellular matrix together with its (re)modeling mechanisms and microdamage dynamics determines its stiffness, strength, and toughness. Aging and disease affect the biological processes regulating bone quality, thus resulting in defective extracellular matrix and bone fragility. Targeted therapies are being developed to restore bone's mechanical integrity. However, their current limitations include low tissue selectivity and adverse side effects. Biological and mechanical insights into the mechanisms controlling bone quality, together with advances in drug delivery and studies in animal models, will accelerate the development and translation to clinical application of effective targeted-therapeutics for bone fragility.
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Affiliation(s)
- Asier Muñoz
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, Steinman Bldg. Room 403C, New York, NY, 10031, USA
| | - Anxhela Docaj
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, Steinman Bldg. Room 403C, New York, NY, 10031, USA
| | - Maialen Ugarteburu
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, Steinman Bldg. Room 403C, New York, NY, 10031, USA
| | - Alessandra Carriero
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, Steinman Bldg. Room 403C, New York, NY, 10031, USA.
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Jähn-Rickert K, Zimmermann EA. Potential Role of Perilacunar Remodeling in the Progression of Osteoporosis and Implications on Age-Related Decline in Fracture Resistance of Bone. Curr Osteoporos Rep 2021; 19:391-402. [PMID: 34117624 DOI: 10.1007/s11914-021-00686-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW We took an interdisciplinary view to examine the potential contribution of perilacunar/canalicular remodeling to declines in bone fracture resistance related to age or progression of osteoporosis. RECENT FINDINGS Perilacunar remodeling is most prominent as a result of lactation; recent advances further elucidate the molecular players involved and their effect on bone material properties. Of these, vitamin D and calcitonin could be active during aging or osteoporosis. Menopause-related hormonal changes or osteoporosis therapies affect bone material properties and mechanical behavior. However, investigations of lacunar size or osteocyte TRAP activity with age or osteoporosis do not provide clear evidence for or against perilacunar remodeling. While the occurrence and potential role of perilacunar remodeling in aging and osteoporosis progression are largely under-investigated, widespread changes in bone matrix composition in OVX models and following osteoporosis therapies imply osteocytic maintenance of bone matrix. Perilacunar remodeling-induced changes in bone porosity, bone matrix composition, and bone adaptation could have significant implications for bone fracture resistance.
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Affiliation(s)
- Katharina Jähn-Rickert
- Heisenberg Research Group, Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany.
- Mildred Scheel Cancer Career Center Hamburg, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Elizabeth A Zimmermann
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Canada.
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Miao XY, Wang XL, Lyu ZH, Ba JM, Pei Y, Dou JT, Gu WJ, Du J, Guo QH, Chen K, Mu YM. Paget’s disease of bone: Report of 11 cases. World J Clin Cases 2021; 9:3478-3486. [PMID: 34002161 PMCID: PMC8107896 DOI: 10.12998/wjcc.v9.i14.3478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/02/2021] [Accepted: 03/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Paget’s disease of bone (PDB) is a rare metabolic bone disease in China and is characterized by increased bone resorption and disorganized bone formation. The main clinical symptoms of PDB are focal or multiple bone pain and deformity with high disability. The disease has high missed diagnosis and misdiagnosis rates. This report summarizes the clinical manifestations, imaging and pathological features, and treatments of 11 patients with PDB at our hospital from 1993 to 2020 in order to improve the recognition and prognosis of PDB.
CASE SUMMARY There were eight male and three female patients whose average age was 48.7 ± 11.0 years with a PDB course of 1-16 years. Nine patients had bone pain and bone deformities in different parts of the body, the majority of which involved the long bones. Laboratory examinations revealed elevated serum alkaline phosphatase (ALP) in all patients with an average of 618 ± 460 IU/L (normal range 0-130 IU/L), and serum calcium and phosphorus levels were in the normal range. Imageology showed that osteolysis was usually combined with osteosclerosis and/or bone deformities in single or multiple bones. 99mTc-methylene diphosphonate bone scintigraphy revealed increased radionuclide uptake in the bone lesions. Six patients underwent bone tissue biopsy, and the typical pathological changes were a mosaic structure of the bone trabeculae with irregularly arranged cement lines and multinuclear osteoclasts. Ten of the 11 patients were effectively treated with bisphosphonates.
CONCLUSION Early diagnosis of the rare disease PDB can be made through elevated ALP levels and typical presentations on bone X-ray and from bone tissue biopsy.
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Affiliation(s)
- Xin-Yu Miao
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Department of Endocrinology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Xian-Ling Wang
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhao-Hui Lyu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jian-Ming Ba
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yu Pei
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jing-Tao Dou
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Wei-Jun Gu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jin Du
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Qing-Hua Guo
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Kang Chen
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yi-Ming Mu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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12
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Weiner S, Raguin E, Shahar R. High resolution 3D structures of mineralized tissues in health and disease. Nat Rev Endocrinol 2021; 17:307-316. [PMID: 33758360 DOI: 10.1038/s41574-021-00479-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 02/06/2023]
Abstract
A thorough knowledge of the structures of healthy mineralized tissues, such as bone or cartilage, is key to understanding the pathological changes occurring during disease. Such knowledge enables the underlying mechanisms that are responsible for pathology to be pinpointed. One high-resolution 3D method in particular - focused ion beam-scanning electron microscopy (FIB-SEM) - has fundamentally changed our understanding of healthy vertebrate mineralized tissues. FIB-SEM can be used to study demineralized matrix, the hydrated components of tissue (including cells) using cryo-fixation and even untreated mineralized tissue. The latter requires minimal sample preparation, making it possible to study enough samples to carry out studies capable of detecting statistically significant differences - a pre-requisite for the study of pathological tissues. Here, we present an imaging and characterization strategy for tissue structures at different length scales, describe new insights obtained on healthy mineralized tissues using FIB-SEM, and suggest future research directions for both healthy and diseased mineralized tissues.
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Affiliation(s)
- Steve Weiner
- Department of Structural Biology, Weizmann Institute of Science, Rehovot, Israel.
| | - Emeline Raguin
- Department of Structural Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Ron Shahar
- Koret School of Veterinary Medicine, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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13
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Stockhausen KE, Qwamizadeh M, Wölfel EM, Hemmatian H, Fiedler IAK, Flenner S, Longo E, Amling M, Greving I, Ritchie RO, Schmidt FN, Busse B. Collagen Fiber Orientation Is Coupled with Specific Nano-Compositional Patterns in Dark and Bright Osteons Modulating Their Biomechanical Properties. ACS NANO 2021; 15:455-467. [PMID: 33404232 DOI: 10.1021/acsnano.0c04786] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Bone continuously adapts to its mechanical environment by structural reorganization to maintain mechanical strength. As the adaptive capabilities of bone are portrayed in its nano- and microstructure, the existence of dark and bright osteons with contrasting preferential collagen fiber orientation (longitudinal and oblique-angled, respectively) points at a required tissue heterogeneity that contributes to the excellent fracture resistance mechanisms in bone. Dark and bright osteons provide an exceptional opportunity to deepen our understanding of how nanoscale tissue properties influence and guide fracture mechanisms at larger length scales. To this end, a comprehensive structural, compositional, and mechanical assessment is performed using circularly polarized light microscopy, synchrotron nanocomputed tomography, focused ion beam/scanning electron microscopy, quantitative backscattered electron imaging, Fourier transform infrared spectroscopy, and nanoindentation testing. To predict how the mechanical behavior of osteons is affected by shifts in collagen fiber orientation, finite element models are generated. Fundamental disparities between both osteon types are observed: dark osteons are characterized by a higher degree of mineralization along with a higher ratio of inorganic to organic matrix components that lead to higher stiffness and the ability to resist plastic deformation under compression. On the contrary, bright osteons contain a higher fraction of collagen and provide enhanced ductility and energy dissipation due to lower stiffness and hardness.
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Affiliation(s)
- Kilian E Stockhausen
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
| | - Mahan Qwamizadeh
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
| | - Eva M Wölfel
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
- Forum Medical Technology Health Hamburg (FMTHH), Butenfeld 34, 22529 Hamburg, Germany
- Interdisciplinary Competence Center for Interface Research (ICCIR), Martinistrasse 52, 20251 Hamburg, Germany
| | - Haniyeh Hemmatian
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
| | - Imke A K Fiedler
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
- Forum Medical Technology Health Hamburg (FMTHH), Butenfeld 34, 22529 Hamburg, Germany
| | - Silja Flenner
- Institute of Materials Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Straße 1, 21502 Geesthacht, Germany
| | - Elena Longo
- Institute of Materials Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Straße 1, 21502 Geesthacht, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
| | - Imke Greving
- Institute of Materials Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Straße 1, 21502 Geesthacht, Germany
| | - Robert O Ritchie
- Materials Sciences Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, United States
| | - Felix N Schmidt
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
- Forum Medical Technology Health Hamburg (FMTHH), Butenfeld 34, 22529 Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center, Lottestrasse 55a, 22529 Hamburg, Germany
- Interdisciplinary Competence Center for Interface Research (ICCIR), Martinistrasse 52, 20251 Hamburg, Germany
- Materials Sciences Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, United States
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14
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Zimmermann EA, Fiedler IAK, Busse B. Breaking new ground in mineralized tissue: Assessing tissue quality in clinical and laboratory studies. J Mech Behav Biomed Mater 2020; 113:104138. [PMID: 33157423 DOI: 10.1016/j.jmbbm.2020.104138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 02/07/2023]
Abstract
Mineralized tissues, such as bone and teeth, have extraordinary mechanical properties of both strength and toughness. This mechanical behavior originates from deformation and fracture resistance mechanisms in their multi-scale structure. The term quality describes the matrix composition, multi-scale structure, remodeling dynamics, water content, and micro-damage accumulation in the tissue. Aging and disease result in changes in the tissue quality that may reduce strength and toughness and lead to elevated fracture risk. Therefore, the capability to measure the quality of mineralized tissues provides critical information on disease progression and mechanical integrity. Here, we provide an overview of clinical and laboratory-based techniques to assess the quality of mineralized tissues in health and disease. Current techniques used in clinical settings include radiography-based (radiographs, dual energy x-ray absorptiometry, EOS) and x-ray tomography-based methods (high resolution peripheral quantitative computed tomography, cone beam computed tomography). In the laboratory, tissue quality can be investigated in ex vivo samples with x-ray imaging (micro and nano-computed tomography, x-ray microscopy), electron microscopy (scanning/transmission electron imaging (SEM/STEM), backscattered scanning electron microscopy, Focused Ion Beam-SEM), light microscopy, spectroscopy (Raman spectroscopy and Fourier transform infrared spectroscopy) and assessment of mechanical behavior (mechanical testing, fracture mechanics and reference point indentation). It is important for clinicians and basic science researchers to be aware of the techniques available in different types of research. While x-ray imaging techniques translated to the clinic have provided exceptional advancements in patient care, the future challenge will be to incorporate high-resolution laboratory-based bone quality measurements into clinical settings to broaden the depth of information available to clinicians during diagnostics, treatment and management of mineralized tissue pathologies.
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Affiliation(s)
| | - Imke A K Fiedler
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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15
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Quantitative and qualitative bone imaging: A review of synchrotron radiation microtomography analysis in bone research. J Mech Behav Biomed Mater 2020; 110:103887. [DOI: 10.1016/j.jmbbm.2020.103887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/13/2020] [Accepted: 05/25/2020] [Indexed: 01/07/2023]
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16
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Jandl NM, von Kroge S, Stürznickel J, Baranowsky A, Stockhausen KE, Mushumba H, Beil FT, Püschel K, Amling M, Rolvien T. Large osteocyte lacunae in iliac crest infantile bone are not associated with impaired mineral distribution or signs of osteocytic osteolysis. Bone 2020; 135:115324. [PMID: 32198110 DOI: 10.1016/j.bone.2020.115324] [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: 12/22/2019] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
The enlargement of osteocyte lacunae via osteocytic osteolysis was previously detected in situations of increased calcium demand (e.g., lactation, vitamin D deficiency). However, it is unclear whether similar processes occur also in the growing infantile skeleton and how this is linked to the mineral distribution within the bone matrix. Human iliac crest biopsies of 30 subjects (0-6 months, n = 14; 2-8 years, n = 6 and 18-25 years, n = 10) were acquired. Bone microarchitecture was assessed by micro-CT, while cellular bone histomorphometry was performed on undecalcified histological sections. Quantitative backscattered electron imaging (qBEI) was conducted to determine the bone mineral density distribution (BMDD) as well as osteocyte lacunar size and density. We additionally evaluated cathepsin K positive osteocytes using immunohistochemistry. Infantile bone was characterized by various signs of ongoing bone development such as higher bone (re)modeling, lower cortical and trabecular thickness compared to young adults. Importantly, a significantly higher osteocyte lacunar density and increased lacunar area were detected. Large osteocyte lacunae were associated with a more heterogeneous bone mineral density distribution of the trabecular bone matrix due to the presence of hypermineralized cartilage remnants, whereas the mean mineralization (i.e., CaMean) was not different in infantile bone. Absence of cathepsin K expression in osteocyte lacunae indicated nonexistent osteocytic osteolysis. Taken together, we demonstrated that the overall mineralization distribution in infantile bone is not altered compared to young adults besides high trabecular mineralization heterogeneity. Our study also provides important reference values for bone microstructure, BMDD and osteocyte characteristics in infants, children and young adults. Infantile bone displays large osteocyte lacunae indicating a developmental phenomenon rather than osteocytic osteolysis. Larger osteocytes may have superior mechanosensory abilities to enable bone adaption during growth.
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Affiliation(s)
- Nico Maximilian Jandl
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Simon von Kroge
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Julian Stürznickel
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Anke Baranowsky
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Kilian Elia Stockhausen
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Herbert Mushumba
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - Frank Timo Beil
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - Michael Amling
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Tim Rolvien
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany.
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17
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Jähn-Rickert K, Wölfel EM, Jobke B, Riedel C, Hellmich M, Werner M, McDonald MM, Busse B. Elevated Bone Hardness Under Denosumab Treatment, With Persisting Lower Osteocyte Viability During Discontinuation. Front Endocrinol (Lausanne) 2020; 11:250. [PMID: 32499755 PMCID: PMC7243474 DOI: 10.3389/fendo.2020.00250] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/06/2020] [Indexed: 12/14/2022] Open
Abstract
Denosumab is a potent osteoclast inhibitor targeted to prevent osteoporotic bone loss and thereby reduce fractures in the aging population. Recently, an elevated risk of rebound fractures following denosumab discontinuation was identified, unless patients were transitioned to an alternative antiresorptive medication. How denosumab affects the interaction of mechanosensitive osteocytes and bone quality remains unknown. We hypothesized that denosumab influences osteocyte function contributing to bone reorganization and increased fractures during discontinuation. Bone quality and osteocytes were assessed in archived iliac crest bone biopsies obtained from patients with high fracture occurrence from 2011 to 2016. Biopsies were obtained due to high fracture occurrence prior and during osteoporosis therapy from (i) patients with at least two semiannual subcutaneous injections of 60 mg denosumab, (ii) patients with rebound fractures during discontinuation, and (iii) patients of a treatment-naive group. In total, biopsies from 43 individuals were analyzed (mean age, 65.5 ± 12.1 years). Our results showed that during denosumab treatment, iliac cortical bone had a higher bone tissue hardness compared to treatment-naive bone (p = 0.0077) and a higher percentage of mineralized osteocyte lacunae (p = 0.0095). The density of empty osteocyte lacunae was higher with denosumab compared to treatment-naive (p = 0.014) and remained high in trabecular bone during discontinuation (p = 0.0071). We conclude that during denosumab treatment, increased bone hardness may contribute to improved fracture resistance. In biopsies from patients with high fracture occurrence, denosumab treatment reduced osteocyte viability, an effect that persisted during treatment discontinuation. High-resolution imaging of osteocyte viability indicates a role for osteocytes as a potential future mechanistic target to understand rebound bone loss and increased fractures with denosumab discontinuation.
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Affiliation(s)
- Katharina Jähn-Rickert
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva M. Wölfel
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Jobke
- Telemedicine Clinic/Unilabs, Barcelona, Spain
| | - Christoph Riedel
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Michelle M. McDonald
- Garvan Institute of Medical Research, Bone Microenvironment Group, Darlinghurst, NSW, Australia
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Björn Busse
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18
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Treurniet S, Eekhoff EMW, Schmidt FN, Micha D, Busse B, Bravenboer N. A Clinical Perspective on Advanced Developments in Bone Biopsy Assessment in Rare Bone Disorders. Front Endocrinol (Lausanne) 2020; 11:399. [PMID: 32714279 PMCID: PMC7344330 DOI: 10.3389/fendo.2020.00399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/18/2020] [Indexed: 01/22/2023] Open
Abstract
Introduction: Bone biopsies have been obtained for many centuries and are one of the oldest known medical procedures in history. Despite the introduction of new noninvasive radiographic imaging techniques and genetic analyses, bone biopsies are still valuable in the diagnosis of bone diseases. Advanced techniques for the assessment of bone quality in bone biopsies, which have emerged during the last decades, allows in-depth tissue analyses beyond structural changes visible in bone histology. In this review, we give an overview of the application and advantages of the advanced techniques for the analysis of bone biopsies in the clinical setting of various rare metabolic bone diseases. Method: A systematic literature search on rare metabolic bone diseases and analyzing techniques of bone biopsies was performed in PubMed up to 2019 week 34. Results: Advanced techniques for the analysis of bone biopsies were described for rare metabolic bone disorders including Paget's disease of bone, osteogenesis imperfecta, fibrous dysplasia, Fibrodysplasia ossificans progressiva, PLS3 X-linked osteoporosis, Loeys-Diets syndrome, osteopetrosis, Erdheim-Chester disease, and Cherubism. A variety of advanced available analytical techniques were identified that may help to provide additional detail on cellular, structural, and compositional characteristics in rare bone diseases complementing classical histopathology. Discussion: To date, these techniques have only been used in research and not in daily clinical practice. Clinical application of bone quality assessment techniques depends upon several aspects such as availability of the technique in hospitals, the existence of reference data, and a cooperative network of researchers and clinicians. The evaluation of rare metabolic bone disorders requires a repertoire of different methods, owing to their distinct bone tissue characteristics. The broader use of bone material obtained from biopsies could provide much more information about pathophysiology or treatment options and establish bone biopsies as a valuable tool in rare metabolic bone diseases.
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Affiliation(s)
- Sanne Treurniet
- Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Elisabeth M. W. Eekhoff
- Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Felix N. Schmidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dimitra Micha
- Department of Clinical Genetics, Amsterdam University Medical Center, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nathalie Bravenboer
- Bone and Calcium Metabolism Lab, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
- *Correspondence: Nathalie Bravenboer
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19
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Nobile S, Nobile L. Assessment of Fracture Toughness in Bone Tissue Engineering. POLYM ENG SCI 2019. [DOI: 10.1002/pen.25246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Stefano Nobile
- Maternal and Child DepartmentOspedali Riuniti di Ancona via F. Corridoni 11 60123 Ancona Italy
- Department of Woman and Child Health and Public HealthDivision of Neonatology, Fondazione Policlinico Universitario A. Gemelli IRCCS Largo A. Gemelli 8 00168 Rome Italy
| | - Lucio Nobile
- Department DICAMUniversity of Bologna‐Campus of Cesena Via Pavese 50 47522 Cesena Italy
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20
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Zimmermann EA, Riedel C, Schmidt FN, Stockhausen KE, Chushkin Y, Schaible E, Gludovatz B, Vettorazzi E, Zontone F, Püschel K, Amling M, Ritchie RO, Busse B. Mechanical Competence and Bone Quality Develop During Skeletal Growth. J Bone Miner Res 2019; 34:1461-1472. [PMID: 30913317 DOI: 10.1002/jbmr.3730] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 02/25/2019] [Accepted: 03/05/2019] [Indexed: 02/01/2023]
Abstract
Bone fracture risk is influenced by bone quality, which encompasses bone's composition as well as its multiscale organization and architecture. Aging and disease deteriorate bone quality, leading to reduced mechanical properties and higher fracture incidence. Largely unexplored is how bone quality and mechanical competence progress during longitudinal bone growth. Human femoral cortical bone was acquired from fetal (n = 1), infantile (n = 3), and 2- to 14-year-old cases (n = 4) at the mid-diaphysis. Bone quality was assessed in terms of bone structure, osteocyte characteristics, mineralization, and collagen orientation. The mechanical properties were investigated by measuring tensile deformation at multiple length scales via synchrotron X-ray diffraction. We find dramatic differences in mechanical resistance with age. Specifically, cortical bone in 2- to 14-year-old cases exhibits a 160% greater stiffness and 83% higher strength than fetal/infantile cases. The higher mechanical resistance of the 2- to 14-year-old cases is associated with advantageous bone quality, specifically higher bone volume fraction, better micronscale organization (woven versus lamellar), and higher mean mineralization compared with fetal/infantile cases. Our study reveals that bone quality is superior after remodeling/modeling processes convert the primary woven bone structure to lamellar bone. In this cohort of female children, the microstructural differences at the femoral diaphysis were apparent between the 1- to 2-year-old cases. Indeed, the lamellar bone in 2- to 14-year-old cases had a superior structural organization (collagen and osteocyte characteristics) and composition for resisting deformation and fracture than fetal/infantile bone. Mechanistically, the changes in bone quality during longitudinal bone growth lead to higher fracture resistance because collagen fibrils are better aligned to resist tensile forces, while elevated mean mineralization reinforces the collagen scaffold. Thus, our results reveal inherent weaknesses of the fetal/infantile skeleton signifying its inferior bone quality. These results have implications for pediatric fracture risk, as bone produced at ossification centers during children's longitudinal bone growth could display similarly weak points. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
| | - Christoph Riedel
- Department of Osteology and Biomechanics, University Medical Center, Hamburg, Germany
| | - Felix N Schmidt
- Department of Osteology and Biomechanics, University Medical Center, Hamburg, Germany
| | - Kilian E Stockhausen
- Department of Osteology and Biomechanics, University Medical Center, Hamburg, Germany
| | - Yuriy Chushkin
- Beamline ID 10, European Synchrotron Radiation Facility, Grenoble, France
| | - Eric Schaible
- Experimental Systems Group, Advanced Light Source, Berkeley, CA, USA
| | - Bernd Gludovatz
- School of Mechanical and Manufacturing Engineering, UNSW Sydney, NSW, Australia
| | - Eik Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg, Germany
| | - Federico Zontone
- Beamline ID 10, European Synchrotron Radiation Facility, Grenoble, France
| | - Klaus Püschel
- Department of Forensic Medicine, University Medical Center, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center, Hamburg, Germany
| | - Robert O Ritchie
- Department of Materials Science and Engineering, University of California, Berkeley, CA, USA.,Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center, Hamburg, Germany
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21
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Schmidt FN, Zimmermann EA, Walsh F, Plumeyer C, Schaible E, Fiedler IAK, Milovanovic P, Rößle M, Amling M, Blanchet C, Gludovatz B, Ritchie RO, Busse B. On the Origins of Fracture Toughness in Advanced Teleosts: How the Swordfish Sword's Bone Structure and Composition Allow for Slashing under Water to Kill or Stun Prey. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2019; 6:1900287. [PMID: 31380168 PMCID: PMC6662059 DOI: 10.1002/advs.201900287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/21/2019] [Indexed: 05/05/2023]
Abstract
The osseous sword of a swordfish (Xiphias gladius) is specialized to incapacitate prey with stunning blows. Considering the sword's growth and maturation pattern, aging from the sword's base to the tip, while missing a mechanosensitive osteocytic network, an in-depth understanding of its mechanical properties and bone quality is lacking. Microstructural, compositional, and nanomechanical characteristics of the bone along the sword are investigated to reveal structural mechanisms accounting for its exceptional mechanical competence. The degree of mineralization, homogeneity, and particle size increase from the base toward the tip, reflecting aging along its length. Fracture experiments reveal that crack-growth toughness vastly decreases at the highly and homogeneously mineralized tip, suggesting the importance of aging effects. Initiation toughness, however, is unchanged suggesting that aging effects on this hierarchical level are counteracted by constant mineral/fibril interaction. In conclusion, the sword of the swordfish provides an excellent model reflecting base-to-tip-wise aging of bone, as indicated by increasing mineralization and decreasing crack-growth toughness toward the tip. The hierarchical, structural, and compositional changes along the sword reflect peculiar prerequisites needed for resisting high mechanical loads. Further studies on advanced teleosts bone tissue may help to unravel structure-function relationships of heavily loaded skeletons lacking mechanosensing cells.
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Affiliation(s)
- Felix N. Schmidt
- Department of Osteology and BiomechanicsUniversity Medical Center Hamburg‐EppendorfLottestrasse 55A22529HamburgGermany
| | - Elizabeth A. Zimmermann
- Department of Osteology and BiomechanicsUniversity Medical Center Hamburg‐EppendorfLottestrasse 55A22529HamburgGermany
| | - Flynn Walsh
- Materials Sciences DivisionLawrence Berkeley National LaboratoryDepartment of Materials Science and EngineeringUniversity of CaliforniaBerkeleyCA94720USA
| | - Christine Plumeyer
- Department of Osteology and BiomechanicsUniversity Medical Center Hamburg‐EppendorfLottestrasse 55A22529HamburgGermany
| | - Eric Schaible
- Advanced Light SourceLawrence Berkeley National LaboratoryBerkeleyCA94720USA
| | - Imke A. K. Fiedler
- Department of Osteology and BiomechanicsUniversity Medical Center Hamburg‐EppendorfLottestrasse 55A22529HamburgGermany
| | - Petar Milovanovic
- Department of Osteology and BiomechanicsUniversity Medical Center Hamburg‐EppendorfLottestrasse 55A22529HamburgGermany
| | - Manfred Rößle
- European Molecular Biology LaboratoryHamburg OutstationHamburg22607Germany
| | - Michael Amling
- Department of Osteology and BiomechanicsUniversity Medical Center Hamburg‐EppendorfLottestrasse 55A22529HamburgGermany
| | - Clément Blanchet
- European Molecular Biology LaboratoryHamburg OutstationHamburg22607Germany
| | - Bernd Gludovatz
- School of Mechanical and Manufacturing EngineeringUNSW SydneyNSW2052Australia
| | - Robert O. Ritchie
- Materials Sciences DivisionLawrence Berkeley National LaboratoryDepartment of Materials Science and EngineeringUniversity of CaliforniaBerkeleyCA94720USA
| | - Björn Busse
- Department of Osteology and BiomechanicsUniversity Medical Center Hamburg‐EppendorfLottestrasse 55A22529HamburgGermany
- Forum Medical Technology Health Hamburg (FMTHH)Hamburg22529Germany
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22
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Milovanovic P, Busse B. Inter-site Variability of the Human Osteocyte Lacunar Network: Implications for Bone Quality. Curr Osteoporos Rep 2019; 17:105-115. [PMID: 30980284 DOI: 10.1007/s11914-019-00508-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW This article provides a review on the variability of the osteocyte lacunar network in the human skeleton. It highlights characteristics of the osteocyte lacunar network in relation to different skeletal sites and fracture susceptibility. RECENT FINDINGS Application of 2D analyses (quantitative backscattered electron microscopy, histology, confocal laser scanning microscopy) and 3D reconstructions (microcomputed tomography and synchrotron radiation microcomputed tomography) provides extended high-resolution information on osteocyte lacunar properties in individuals of various age (fetal, children's growth, elderly), sex, and disease states with increased fracture risk. Recent findings on the distribution of osteocytes in the human skeleton are reviewed. Quantitative data highlighting the variability of the osteocyte lacunar network is presented with special emphasis on site specificity and maintenance of bone health. The causes and consequences of heterogeneous distribution of osteocyte lacunae both within specific regions of interest and on the skeletal level are reviewed and linked to differential bone quality factors and fracture susceptibility.
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Affiliation(s)
- Petar Milovanovic
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestrasse 55A, 22529, Hamburg, Germany
- Laboratory for Anthropology and Skeletal Biology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestrasse 55A, 22529, Hamburg, Germany.
- Forum Medical Technology Health Hamburg (FMTHH), Heisenberg Research Group of Biomedical Sciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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23
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Loaiza S, Ferreira SA, Chinn TM, Kirby A, Tsolaki E, Dondi C, Parzych K, Strange AP, Bozec L, Bertazzo S, Hedegaard MAB, Gentleman E, Auner HW. An engineered, quantifiable in vitro model for analysing the effect of proteostasis-targeting drugs on tissue physical properties. Biomaterials 2018; 183:102-113. [PMID: 30153561 PMCID: PMC6145445 DOI: 10.1016/j.biomaterials.2018.08.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 01/19/2023]
Abstract
Cellular function depends on the maintenance of protein homeostasis (proteostasis) by regulated protein degradation. Chronic dysregulation of proteostasis is associated with neurodegenerative and age-related diseases, and drugs targeting components of the protein degradation apparatus are increasingly used in cancer therapies. However, as chronic imbalances rather than loss of function mediate their pathogenesis, research models that allow for the study of the complex effects of drugs on tissue properties in proteostasis-associated diseases are almost completely lacking. Here, to determine the functional effects of impaired proteostatic fine-tuning, we applied a combination of materials science characterisation techniques to a cell-derived, in vitro model of bone-like tissue formation in which we pharmacologically perturbed protein degradation. We show that low-level inhibition of VCP/p97 and the proteasome, two major components of the degradation machinery, have remarkably different effects on the bone-like material that human bone-marrow derived mesenchymal stromal cells (hMSC) form in vitro. Specifically, whilst proteasome inhibition mildly enhances tissue formation, Raman spectroscopic, atomic force microscopy-based indentation, and electron microscopy imaging reveal that VCP/p97 inhibition induces the formation of bone-like tissue that is softer, contains less protein, appears to have more crystalline mineral, and may involve aberrant micro- and ultra-structural tissue organisation. These observations contrast with findings from conventional osteogenic assays that failed to identify any effect on mineralisation. Taken together, these data suggest that mild proteostatic impairment in hMSC alters the bone-like material they form in ways that could explain some pathologies associated with VCP/p97-related diseases. They also demonstrate the utility of quantitative materials science approaches for tackling long-standing questions in biology and medicine, and could form the basis for preclinical drug testing platforms to develop therapies for diseases stemming from perturbed proteostasis or for cancer therapies targeting protein degradation. Our findings may also have important implications for the field of tissue engineering, as the manufacture of cell-derived biomaterial scaffolds may need to consider proteostasis to effectively replicate native tissues.
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Affiliation(s)
- Sandra Loaiza
- Cancer Cell Protein Metabolism Group, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Silvia A Ferreira
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Tamara M Chinn
- Cancer Cell Protein Metabolism Group, Department of Medicine, Imperial College London, London W12 0NN, UK; Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Alex Kirby
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Elena Tsolaki
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Camilla Dondi
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Katarzyna Parzych
- Cancer Cell Protein Metabolism Group, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Adam P Strange
- Biomaterials and Tissue Engineering, Eastman Dental Institute, University College London, London WC1X 8LD, UK
| | - Laurent Bozec
- Biomaterials and Tissue Engineering, Eastman Dental Institute, University College London, London WC1X 8LD, UK; Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G 1G6, Canada
| | - Sergio Bertazzo
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Martin A B Hedegaard
- Department of Chemical Engineering, Biotechnology and Environmental Technology, University of Southern Denmark, 5230 Odense M, Denmark
| | - Eileen Gentleman
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK.
| | - Holger W Auner
- Cancer Cell Protein Metabolism Group, Department of Medicine, Imperial College London, London W12 0NN, UK.
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24
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Picke AK, Sylow L, Møller LLV, Kjøbsted R, Schmidt FN, Steejn MW, Salbach-Hirsch J, Hofbauer C, Blüher M, Saalbach A, Busse B, Rauner M, Hofbauer LC. Differential effects of high-fat diet and exercise training on bone and energy metabolism. Bone 2018; 116:120-134. [PMID: 30036679 DOI: 10.1016/j.bone.2018.07.015] [Citation(s) in RCA: 27] [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: 01/23/2018] [Revised: 06/25/2018] [Accepted: 07/19/2018] [Indexed: 12/28/2022]
Abstract
Bone microarchitecture and strength are impaired by obesity and physical inactivity, but the underlying molecular regulation of bone metabolism in response to these factors is not well understood. Therefore, we analyzed bone and energy metabolism in male mice fed a high-fat or standard chow diet for 12 weeks with or without free access to running wheels. High-fat diet (HFD) mimicked the human condition of obesity and insulin resistance, including symptoms such as elevated serum glucose and insulin levels and reduced insulin-stimulated glucose uptake into muscle and adipose tissue. Interestingly, HFD also decreased (-44%) glucose uptake into bone marrow. Bone mass was reduced (-45%) by HFD due to a diminished (-45%) bone remodeling rate. Bone matrix quality aspects, such as biomechanical stability, were additionally decreased. Concurrently, the bone marrow adiposity increased (+63%) in response to a HFD. Further, we detected elevated expression of the Wnt signaling inhibitor dickkopf-1 (Dkk-1, +42%) in mice fed a HFD, but this was not reflected in serum samples obtained from obese humans. In mice, exercise attenuated the adverse effects of HFD by reversing the glucose uptake into bone marrow, improving the bone mass and bone matrix quality while decreasing the bone marrow adiposity. This data shows that exercise prevents some, but not all of the negative effects of HFD on bone health and suggests that insulin signaling in bone marrow and Dkk-1 signaling may be involved in the pathogenesis of bone loss induced by HFD.
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Affiliation(s)
- Ann-Kristin Picke
- Division of Endocrinology, Diabetes, and Metabolic Bone Diseases, Department of Medicine III, Technische Universität Dresden, Germany; Center for Healthy Aging, Technische Universität Dresden, Germany
| | - Lykke Sylow
- Molecular Physiology Group, Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Lisbeth L V Møller
- Molecular Physiology Group, Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Rasmus Kjøbsted
- Molecular Physiology Group, Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Felix N Schmidt
- Department of Osteology and Biomechanics, University Medical Center, Hamburg, Germany
| | - Mikkel Wermer Steejn
- Molecular Physiology Group, Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Juliane Salbach-Hirsch
- Division of Endocrinology, Diabetes, and Metabolic Bone Diseases, Department of Medicine III, Technische Universität Dresden, Germany; Center for Healthy Aging, Technische Universität Dresden, Germany
| | - Christine Hofbauer
- University Center of Orthopedics and Traumatology, Technische Universität Dresden, Germany
| | | | - Anja Saalbach
- Department of Dermatology, Venerology and Allergology of Medical Faculty of Leipzig University, Leipzig, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center, Hamburg, Germany
| | - Martina Rauner
- Division of Endocrinology, Diabetes, and Metabolic Bone Diseases, Department of Medicine III, Technische Universität Dresden, Germany; Center for Healthy Aging, Technische Universität Dresden, Germany
| | - Lorenz C Hofbauer
- Division of Endocrinology, Diabetes, and Metabolic Bone Diseases, Department of Medicine III, Technische Universität Dresden, Germany; Center for Healthy Aging, Technische Universität Dresden, Germany; Center for Regenerative Therapies Dresden, Technische Universität Dresden, Germany.
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25
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Rolvien T, Butscheidt S, Zustin J, Amling M. Skeletal dissemination in Paget's disease of the spine. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:453-457. [PMID: 29344730 DOI: 10.1007/s00586-018-5477-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 11/29/2017] [Accepted: 01/13/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Paget's disease of bone (PDB) is a common skeletal disorder that is associated with locally increased bone turnover, skeletal deformity and pain. We report a case of skeletal dissemination in PDB of the spine. METHODS Case report. RESULTS A 46-year-old former professional athlete suffered from disseminated PDB throughout the spine and hips after various surgical interventions including spondylodesis, bone grafting and bone morphogenetic protein (rhBMP-2) administration. Only intravenous zoledronic acid prevented the further progression of skeletal dissemination, which was expressed by a normalization of (bone-specific) alkaline phosphatase levels. The biopsy obtained from the lumbar spine confirmed the diagnosis of PDB in the absence of malignant transformation. CONCLUSIONS We outline skeletal dissemination as a possibly surgery-related complication in a patient with PDB in the lumbar spine. Bisphosphonates remain the treatment of first choice in PDB and surgical interventions should be considered very carefully.
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Affiliation(s)
- Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany.,Department of Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Sebastian Butscheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany
| | - Jozef Zustin
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany.,Pathologie Hamburg, Lademannbogen 61-63, 22339, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany.
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26
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Rolvien T, Nagel F, Milovanovic P, Wuertz S, Marshall RP, Jeschke A, Schmidt FN, Hahn M, Witten PE, Amling M, Busse B. How the European eel (Anguilla anguilla) loses its skeletal framework across lifetime. Proc Biol Sci 2017; 283:rspb.2016.1550. [PMID: 27798301 DOI: 10.1098/rspb.2016.1550] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 09/22/2016] [Indexed: 02/04/2023] Open
Abstract
European eels (Anguilla anguilla) undertake an impressive 5 000 km long migration from European fresh waters through the North Atlantic Ocean to the Sargasso Sea. Along with sexual maturation, the eel skeleton undergoes a remarkable morphological transformation during migration, where a hitherto completely obscure bone loss phenomenon occurs. To unravel mechanisms of the maturation-related decay of the skeleton, we performed a multiscale assessment of eels' bones at different life-cycle stages. Accordingly, the skeleton reflects extensive bone loss that is mediated via multinucleated bone-resorbing osteoclasts, while other resorption mechanisms such as osteocytic osteolysis or matrix demineralization were not observed. Preserving mechanical stability and releasing minerals for energy metabolism are two mutually exclusive functions of the skeleton that are orchestrated in eels through the presence of two spatially segregated hard tissues: cellular bone and acellular notochord. The cellular bone serves as a source of mineral release following osteoclastic resorption, whereas the mineralized notochord sheath, which is inaccessible for resorption processes due to an unmineralized cover layer, ensures sufficient mechanical stability as a part of the notochord sheath. Clearly, an eel's skeleton is structurally optimized to meet the metabolic challenge of fasting and simultaneous sexual development during an exhausting journey to spawning areas, while the function of the vertebral column is maintained to achieve this goal.
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Affiliation(s)
- Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Florian Nagel
- Gesellschaft für Marine Aquakultur mbh, Hafentörn 3, 25761 Büsum, Germany.,Aller Aqua Research GmbH, Hafentörn 3, 25761 Büsum, Germany
| | - Petar Milovanovic
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany.,Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Dr Subotica 4/2, 11000 Belgrade, Serbia
| | - Sven Wuertz
- Leibnitz Institute of Freshwater Ecology and Inland Fisheries, Müggelseedamm 310, 12587 Berlin, Germany
| | - Robert Percy Marshall
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Anke Jeschke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Felix N Schmidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Michael Hahn
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - P Eckhard Witten
- Department of Biology, Research Group Evolutionary Developmental Biology, Ghent University, Ledeganckstraat 35, 9000 Ghent, Belgium
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
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27
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Malgo F, Hamdy NA, Papapoulos SE, Appelman-Dijkstra NM. Impact Microindentation: Consistency of Serial Measurements and Alterations in Patients With Paget's Disease of the Tibia. J Bone Miner Res 2017; 32:2375-2380. [PMID: 28815760 DOI: 10.1002/jbmr.3239] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/27/2017] [Accepted: 08/11/2017] [Indexed: 11/08/2022]
Abstract
Impact microindentation (IMI) is a new technique for the in vivo measurement of tissue-level properties of cortical bone in humans. To address issues related to the proper application of IMI in clinical practice and to directly examine cortical bone properties in patients with tibia pathology, we studied 11 subjects without tibia pathology and nine patients with Paget's disease of the tibia in biochemical remission after bisphosphonate treatment. Serial indentations in the tibias of both legs were performed in all subjects by a single operator until 10 adequate measurements were obtained in each tibia. In patients without Paget's disease (7 men and 4 women; mean age, 61.9 years; range, 51 to 72 years), there was no difference in mean bone material strength index (BMSi) between the dominant and nondominant leg (82.1 ± 1.3 and 81.4 ± 1.3, respectively; p = 0.606). In each individual subject studied, sequential indentations in both legs showed no trends for higher or lower values with time. The standard deviation of unnormalized bone material strength (BMSu) was also comparable between the dominant and nondominant tibia (5.3 and 4.5, respectively; p = 0.657). In patients with Paget's disease (4 men and 5 women; mean age, 69.5 years; range, 55 to 87 years), mean BMSi of the Pagetic tibia was lower, albeit nonsignificantly, than that of the contralateral nonaffected tibia (74.7 ± 1.7 and 78.7 ± 1.3, respectively; p = 0.120). In contrast to subjects without Paget's disease, the SD of adequate BMSu values was significantly larger in the Pagetic tibia compared to that of the non-Pagetic tibia (7.6 versus 5.0, respectively, p = 0.008). These results highlight the consistency of serial IMI measurements as performed by a single operator in the presence as well as absence of tibia pathology and illustrate that the method is able to capture alterations of tissue-level cortical bone properties in patients with Paget's disease of the tibia. © 2017 The Authors.Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.
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Affiliation(s)
- Frank Malgo
- Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
| | - Neveen At Hamdy
- Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
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28
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Hashimoto M, Nagaoka N, Tabata K, Tanaka T, Osumi R, Odagaki N, Hara T, Kamioka H. Three-dimensional morphometry of collagen fibrils in membranous bone. Integr Biol (Camb) 2017; 9:868-875. [PMID: 29091092 DOI: 10.1039/c7ib00073a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The collagen network acts as a scaffold for calcification and its three-dimensional structure influences bone strength. It is therefore important to observe the collagen network in detail and three-dimensionally. In this study, we observed the collagen network of chick embryonic calvariae in membranous bone three-dimensionally using orthogonally arranged FIB-SEM. A 25 × 25 μm area of chick embryonic calvaria was observed at a high resolution (25 nm per pixel). The inside of the bone (i.e. the primary calcified tissue), the bone cells (i.e. the osteoblasts and the osteocytes), the organelles, and the collagen fibrils were observed in detail. These structures were observed three-dimensionally using the Amira software program. In addition, the collagen fibrils of the bone were automatically extracted using the XTracing extension software program, and three-dimensional morphometry was performed. Almost all of the collagen fibrils ran along the longitudinal axis of the trabecular bone. We found that the regularity of the collagen fibril orientation was less remarkable in the osteoblast layer, which contained numerous osteoblasts. The collagen fibril orientation started to show regularity toward the central bone layer, which contained few bone cells.
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Affiliation(s)
- Mana Hashimoto
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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29
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Friedrich RE, Luebke AM, Amling M, Koehne T. Clinical and Microstructural Findings in Paget Disease of the Entire Mandible. J Oral Maxillofac Surg 2017; 76:336-346. [PMID: 28806539 DOI: 10.1016/j.joms.2017.07.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 11/28/2022]
Abstract
Paget disease of bone (PDB) is a chronic progressive bone disorder characterized by localized increased bone turnover and focal areas of woven bone formation. Although skull involvement is common, PDB very rarely affects the mandible. This report describes the clinical and histologic findings in a 75-year-old patient with PDB involving the mandible. Microstructural analyses showed an altered quality of the bone microstructure and calcium depletion of the affected bone. Differential diagnosis of PDB affecting the mandible is discussed.
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Affiliation(s)
- Reinhard E Friedrich
- Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas M Luebke
- Head, Department of Orthopedic Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Amling
- Department Head, Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till Koehne
- Research Associate, Department of Orthodontics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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30
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Ma S, Goh EL, Jin A, Bhattacharya R, Boughton OR, Patel B, Karunaratne A, Vo NT, Atwood R, Cobb JP, Hansen U, Abel RL. Long-term effects of bisphosphonate therapy: perforations, microcracks and mechanical properties. Sci Rep 2017; 7:43399. [PMID: 28262693 PMCID: PMC5338252 DOI: 10.1038/srep43399] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/20/2017] [Indexed: 12/11/2022] Open
Abstract
Osteoporosis is characterised by trabecular bone loss resulting from increased osteoclast activation and unbalanced coupling between resorption and formation, which induces a thinning of trabeculae and trabecular perforations. Bisphosphonates are the frontline therapy for osteoporosis, which act by reducing bone remodelling, and are thought to prevent perforations and maintain microstructure. However, bisphosphonates may oversuppress remodelling resulting in accumulation of microcracks. This paper aims to investigate the effect of bisphosphonate treatment on microstructure and mechanical strength. Assessment of microdamage within the trabecular bone core was performed using synchrotron X-ray micro-CT linked to image analysis software. Bone from bisphosphonate-treated fracture patients exhibited fewer perforations but more numerous and larger microcracks than both fracture and non-fracture controls. Furthermore, bisphosphonate-treated bone demonstrated reduced tensile strength and Young's Modulus. These findings suggest that bisphosphonate therapy is effective at reducing perforations but may also cause microcrack accumulation, leading to a loss of microstructural integrity and consequently, reduced mechanical strength.
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Affiliation(s)
- Shaocheng Ma
- Department of Mechanical Engineering, Faculty of Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W6 8PR, United Kingdom
| | - En Lin Goh
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W6 8PR, United Kingdom
| | - Andi Jin
- Department of Mechanical Engineering, Faculty of Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W6 8PR, United Kingdom
| | - Rajarshi Bhattacharya
- St. Mary’s Hospital, North West London Major Trauma Centre, Imperial College, London, W2 1NY, United Kingdom
| | - Oliver R. Boughton
- Department of Mechanical Engineering, Faculty of Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W6 8PR, United Kingdom
| | - Bhavi Patel
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W6 8PR, United Kingdom
| | - Angelo Karunaratne
- Department of Mechanical Engineering, Faculty of Engineering, University of Moratuwa, Moratuwa, 10400, Sri Lanka
| | - Nghia T. Vo
- Diamond Light Source Ltd, Harwell Science and Innovation Campus, Didcot, OX11 0DE, United Kingdom
| | - Robert Atwood
- Diamond Light Source Ltd, Harwell Science and Innovation Campus, Didcot, OX11 0DE, United Kingdom
| | - Justin P. Cobb
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W6 8PR, United Kingdom
| | - Ulrich Hansen
- Department of Mechanical Engineering, Faculty of Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Richard L. Abel
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W6 8PR, United Kingdom
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31
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Abstract
Paget’s disease of bone (PDB) is the second most common metabolic bone disorder, after osteoporosis. It is characterised by focal areas of increased and disorganised bone turnover, coupled with increased bone formation. This disease usually appears in the late stages of life, being slightly more frequent in men than in women. It has been reported worldwide, but primarily affects individuals of British descent. Majority of PDB patients are asymptomatic, but clinical manifestations include pain, bone deformity and complications, like pathological fractures and deafness. The causes of the disease are poorly understood and it is considered as a complex trait, combining genetic predisposition with environmental factors. Linkage analysis identified SQSTM1, at chromosome 5q35, as directly related to the disease. A number of mutations in this gene have been reported, pP392L being the most common variant among different populations. Most of these variants affect the ubiquitin-associated (UBA) domain of the protein, which is involved in autophagy processes. Genome-wide association studies enlarged the number of loci associated with PDB, and further fine-mapping studies, combined with functional analysis, identified OPTN and RIN3 as causal genes for Paget’s disease. A combination of risk alleles identified by genome-wide association studies led to the development of a score to predict disease severity, which could improve the management of the disease. Further studies need to be conducted to elucidate other important aspects of the trait, such as its focal nature and the epidemiological changes found in some populations. In this review, we summarize the clinical characteristics of the disease and the latest genetic advances to identify susceptibility genes. We also list current available treatments and prospective options.
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32
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Sekita A, Matsugaki A, Ishimoto T, Nakano T. Synchronous disruption of anisotropic arrangement of the osteocyte network and collagen/apatite in melanoma bone metastasis. J Struct Biol 2016; 197:260-270. [PMID: 27989794 DOI: 10.1016/j.jsb.2016.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 12/01/2022]
Abstract
Cancer metastasis to bones increases the risk of fragility fracture by altering bone metabolism and disrupting bone structure. Osteocytes, which organize a dense network that is closely linked with the circumambient matrix, play a key role in regulation of bone microstructure and material properties. The aim of this study was to elucidate the influence of cancer metastasis on the organization of the osteocyte network and collagen/biological apatite (BAp) microstructure in the context of osteocyte/matrix coupling. Using a mouse model intracardially injected with B16F10 melanoma cells or vehicle, the geometric and metabolic changes to osteocytes were analyzed by nano-computed tomography (nano-CT) and histology, and the alignment of collagen fibrils and BAp was analyzed by birefringence measurement and microbeam-X-ray diffraction, respectively. The material properties of bones were further analyzed with nanoindentation method. These experiments revealed that the osteocyte network was markedly disorganized in cancer-bearing bone tissues. The osteocytes showed a variety of residing states in the lacunae; some lacunae were osteolytic while some were replete with immature matrix, suggesting significant disruption in osteocyte/matrix coupling. Collagen/BAp microstructure was also disorganized in cancer-bearing bones as observed by significant decreases in the preferential alignment of both collagen fibrils and BAp; the latter was further shown to be significantly correlated with Young's modulus. The present study revealed that the disruption in the arrangement of the osteocyte network and collagen/BAp microstructure and the deterioration of mechanical function occurred synchronously during cancer bone metastasis.
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Affiliation(s)
- Aiko Sekita
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Aira Matsugaki
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Takuya Ishimoto
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871, Japan.
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33
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Ip V, Toth Z, Chibnall J, McBride-Gagyi S. Remnant Woven Bone and Calcified Cartilage in Mouse Bone: Differences between Ages/Sex and Effects on Bone Strength. PLoS One 2016; 11:e0166476. [PMID: 27829059 PMCID: PMC5102366 DOI: 10.1371/journal.pone.0166476] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/28/2016] [Indexed: 11/27/2022] Open
Abstract
Introduction Mouse models are used frequently to study effects of bone diseases and genetic determinates of bone strength. Murine bones have an intracortical band of woven bone that is not present in human bones. This band is not obvious under brightfield imaging and not typically analyzed. Due to the band’s morphology and location it has been theorized to be remnant bone from early in life. Furthermore, lamellar and woven bone are well known to have differing mechanical strengths. The purpose of this study was to determine (i) if the band is from early life and (ii) if the woven bone or calcified cartilage contained within the band affect whole bone strength. Woven Bone Origin Studies In twelve to fourteen week old mice, doxycycline was used to label bone formed prior to 3 weeks old. Doxycycline labeling and woven bone patterns on contralateral femora matched well and encompassed an almost identical cross-sectional area. Also, we highlight for the first time in mice the presence of calcified cartilage exclusively within the band. However, calcified cartilage could not be identified on high resolution cone-beam microCT scans when examined visually or by thresholding methods. Mechanical Strength Studies Subsequently, three-point bending was used to analyze the effects of woven bone and calcified cartilage on whole bone mechanics in a cohort of male and female six and 13 week old Balb/C mice. Three-point bending outcomes were correlated with structural and compositional measures using multivariate linear regression. Woven bone composed a higher percent of young bones than older bones. However, calcified cartilage in older bones was twice that of younger bones, which was similar when normalized by area. Area and/or tissue mineral density accounted for >75% of variation for most strength outcomes. Percent calcified cartilage added significant predictive power to maximal force and bending stress. Calcified cartilage and woven bone could have more influence in genetic models where calcified cartilage percent is double our highest value.
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Affiliation(s)
- Victoria Ip
- School of Operations Research and Information Engineering, Cornell University, Ithaca, New York, United States of America
| | - Zacharie Toth
- Department of Orthopaedic Surgery, Saint Louis University, Saint Louis, Missouri, United States of America
| | - John Chibnall
- Department of Psychiatry, Saint Louis University, Saint Louis, Missouri, United States of America
| | - Sarah McBride-Gagyi
- Department of Orthopaedic Surgery, Saint Louis University, Saint Louis, Missouri, United States of America
- * E-mail:
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Riedel C, Zimmermann EA, Zustin J, Niecke M, Amling M, Grynpas M, Busse B. The incorporation of fluoride and strontium in hydroxyapatite affects the composition, structure, and mechanical properties of human cortical bone. J Biomed Mater Res A 2016; 105:433-442. [DOI: 10.1002/jbm.a.35917] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/06/2016] [Accepted: 09/27/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Christoph Riedel
- Department of Osteology and Biomechanics; University Medical Center Hamburg-Eppendorf; Lottestrasse 55A Hamburg 22529 Germany
| | - Elizabeth A. Zimmermann
- Department of Osteology and Biomechanics; University Medical Center Hamburg-Eppendorf; Lottestrasse 55A Hamburg 22529 Germany
| | - Jozef Zustin
- Department of Pathology; University Medical Center Hamburg-Eppendorf; Martinistrasse 52 Hamburg 20246 Germany
| | - Manfred Niecke
- Institute of Experimental Physics, University of Hamburg; Luruper Chaussee 149 Hamburg 22761 Germany
| | - Michael Amling
- Department of Osteology and Biomechanics; University Medical Center Hamburg-Eppendorf; Lottestrasse 55A Hamburg 22529 Germany
| | - Marc Grynpas
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; 25 Orde Street Toronto Ontario M5T 3H7 Canada
| | - Björn Busse
- Department of Osteology and Biomechanics; University Medical Center Hamburg-Eppendorf; Lottestrasse 55A Hamburg 22529 Germany
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Wolfram U, Schwiedrzik J. Post-yield and failure properties of cortical bone. BONEKEY REPORTS 2016; 5:829. [PMID: 27579166 DOI: 10.1038/bonekey.2016.60] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/05/2016] [Indexed: 12/22/2022]
Abstract
Ageing and associated skeletal diseases pose a significant challenge for health care systems worldwide. Age-related fractures have a serious impact on personal, social and economic wellbeing. A significant proportion of physiological loading is carried by the cortical shell. Its role in the fracture resistance and strength of whole bones in the ageing skeleton is of utmost importance. Even though a large body of knowledge has been accumulated on this topic on the macroscale, the underlying micromechanical material behaviour and the scale transition of bone's mechanical properties are yet to be uncovered. Therefore, this review aims at providing an overview of the state-of-the-art of the post-yield and failure properties of cortical bone at the extracellular matrix and the tissue level.
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Affiliation(s)
- Uwe Wolfram
- School of Engineering and Physical Science, Institute for Mechanical, Process and Energy Engineering, Heriot-Watt University , Edinburgh, UK
| | - Jakob Schwiedrzik
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Mechanics of Materials and Nanostructures , Thun, Switzerland
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Abstract
Paget's disease of bone is produced by a localized increase in osteoclastic and osteoblastic activity which can progress slowly to involve an entire bone if untreated. A common feature is enlarged bones which are deformed, particularly in weight-bearing regions of the skeleton such as the lower extremity. Pathologic fractures may be a consequence, and nonunion of femoral fractures is not uncommon. Analyses of bone biopsies from patients with Paget's disease indicate that there is a lower, heterogeneous degree of bone mineralization and a younger tissue age than that found in control bone. Pagetic bone also has less resistance to plastic deformation and a straighter crack path than control bone.
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Affiliation(s)
- Frederick R Singer
- Endocrine/Bone Disease Program, John Wayne Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA.
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
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Zimmermann EA, Schaible E, Gludovatz B, Schmidt FN, Riedel C, Krause M, Vettorazzi E, Acevedo C, Hahn M, Püschel K, Tang S, Amling M, Ritchie RO, Busse B. Intrinsic mechanical behavior of femoral cortical bone in young, osteoporotic and bisphosphonate-treated individuals in low- and high energy fracture conditions. Sci Rep 2016; 6:21072. [PMID: 26879146 PMCID: PMC4754644 DOI: 10.1038/srep21072] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/18/2016] [Indexed: 11/20/2022] Open
Abstract
Bisphosphonates are a common treatment to reduce osteoporotic fractures. This treatment induces osseous structural and compositional changes accompanied by positive effects on osteoblasts and osteocytes. Here, we test the hypothesis that restored osseous cell behavior, which resembles characteristics of younger, healthy cortical bone, leads to improved bone quality. Microarchitecture and mechanical properties of young, treatment-naïve osteoporosis, and bisphosphonate-treated cases were investigated in femoral cortices. Tissue strength was measured using three-point bending. Collagen fibril-level deformation was assessed in non-traumatic and traumatic fracture states using synchrotron small-angle x-ray scattering (SAXS) at low and high strain rates. The lower modulus, strength and fibril deformation measured at low strain rates reflects susceptibility for osteoporotic low-energy fragility fractures. Independent of age, disease and treatment status, SAXS revealed reduced fibril plasticity at high strain rates, characteristic of traumatic fracture. The significantly reduced mechanical integrity in osteoporosis may originate from porosity and alterations to the intra/extrafibrillar structure, while the fibril deformation under treatment indicates improved nano-scale characteristics. In conclusion, losses in strength and fibril deformation at low strain rates correlate with the occurrence of fragility fractures in osteoporosis, while improvements in structural and mechanical properties following bisphosphonate treatment may foster resistance to fracture during physiological strain rates.
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Affiliation(s)
- Elizabeth A Zimmermann
- Department of Osteology and Biomechanics, University Medical Center Hamburg, D-22529 Hamburg, Germany
| | - Eric Schaible
- Experimental Systems Group, Advanced Light Source, Berkeley, California, 94720, USA
| | - Bernd Gludovatz
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, 94720, USA
| | - Felix N Schmidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg, D-22529 Hamburg, Germany
| | - Christoph Riedel
- Department of Osteology and Biomechanics, University Medical Center Hamburg, D-22529 Hamburg, Germany
| | - Matthias Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg, D-22529 Hamburg, Germany
| | - Eik Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Claire Acevedo
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, 94720, USA
| | - Michael Hahn
- Department of Osteology and Biomechanics, University Medical Center Hamburg, D-22529 Hamburg, Germany
| | - Klaus Püschel
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Simon Tang
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St Louis, MO 63110, USA
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg, D-22529 Hamburg, Germany
| | - Robert O Ritchie
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, 94720, USA.,Department of Materials Science and Engineering, University of California, Berkeley, California, 94720, USA
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg, D-22529 Hamburg, Germany.,Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, 94720, USA
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Zimmermann EA, Busse B, Ritchie RO. The fracture mechanics of human bone: influence of disease and treatment. BONEKEY REPORTS 2015; 4:743. [PMID: 26380080 PMCID: PMC4562496 DOI: 10.1038/bonekey.2015.112] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 01/09/2023]
Abstract
Aging and bone diseases are associated with increased fracture risk. It is therefore pertinent to seek an understanding of the origins of such disease-related deterioration in bone's mechanical properties. The mechanical integrity of bone derives from its hierarchical structure, which in healthy tissue is able to resist complex physiological loading patterns and tolerate damage. Indeed, the mechanisms through which bone derives its mechanical properties make fracture mechanics an ideal framework to study bone's mechanical resistance, where crack-growth resistance curves give a measure of the intrinsic resistance to the initiation of cracks and the extrinsic resistance to the growth of cracks. Recent research on healthy cortical bone has demonstrated how this hierarchical structure can develop intrinsic toughness at the collagen fibril scale mainly through sliding and sacrificial bonding mechanisms that promote plasticity. Furthermore, the bone-matrix structure develops extrinsic toughness at much larger micrometer length-scales, where the structural features are large enough to resist crack growth through crack-tip shielding mechanisms. Although healthy bone tissue can generally resist physiological loading environments, certain conditions such as aging and disease can significantly increase fracture risk. In simple terms, the reduced mechanical integrity originates from alterations to the hierarchical structure. Here, we review how human cortical bone resists fracture in healthy bone and how changes to the bone structure due to aging, osteoporosis, vitamin D deficiency and Paget's disease can affect the mechanical integrity of bone tissue.
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Affiliation(s)
- Elizabeth A Zimmermann
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert O Ritchie
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
- Department of Materials Science & Engineering, University of California, Berkeley, CA, USA
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Bala Y, Seeman E. Bone's Material Constituents and their Contribution to Bone Strength in Health, Disease, and Treatment. Calcif Tissue Int 2015; 97:308-26. [PMID: 25712256 DOI: 10.1007/s00223-015-9971-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 02/11/2015] [Indexed: 12/24/2022]
Abstract
Type 1 collagen matrix volume, its degree of completeness of its mineralization, the extent of collagen crosslinking and water content, and the non-collagenous proteins like osteopontin and osteocalcin comprise the main constituents of bone's material composition. Each influences material strength and change in different ways during advancing age, health, disease, and drug therapy. These traits are not quantifiable using bone densitometry and their plurality is better captured by the term bone 'qualities' than 'quality'. These qualities are the subject of this manuscript.
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Affiliation(s)
- Y Bala
- Laboratoire Vibrations Acoustique, Institut National des Sciences Appliquées de Lyon, Campus LyonTech la Doua, Villeurbanne, France
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Zimmermann EA, Ritchie RO. Bone as a Structural Material. Adv Healthc Mater 2015; 4:1287-304. [PMID: 25865873 DOI: 10.1002/adhm.201500070] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/12/2015] [Indexed: 01/02/2023]
Abstract
As one of the most important natural materials, cortical bone is a composite material comprising assemblies of tropocollagen molecules and nanoscale hydroxyapatite mineral crystals, forming an extremely tough, yet lightweight, adaptive and multi-functional material. Bone has evolved to provide structural support to organisms, and therefore its mechanical properties are vital physiologically. Like many mineralized tissues, bone can resist deformation and fracture from the nature of its hierarchical structure, which spans molecular to macroscopic length-scales. In fact, bone derives its fracture resistance with a multitude of deformation and toughening mechanisms that are active at most of these dimensions. It is shown that bone's strength and ductility originate primarily at the scale of the nano to submicrometer structure of its mineralized collagen fibrils and fibers, whereas bone toughness is additionally generated at much larger, micro- to near-millimeter, scales from crack-tip shielding associated with interactions between the crack path and the microstructure. It is further shown how the effectiveness with which bone's structural features can resist fracture at small to large length-scales can become degraded by biological factors such as aging and disease, which affect such features as the collagen cross-linking environment, the homogeneity of mineralization, and the density of the osteonal structures.
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Affiliation(s)
| | - Robert O. Ritchie
- Materials Sciences Division; Lawrence Berkeley National Laboratory; Berkeley CA 94720 USA
- Department of Materials Science & Engineering; University of California; Berkeley CA 94720 USA
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