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Li Z, Wen X, Li N, Zhong C, Chen L, Zhang F, Zhang G, Lyu A, Liu J. The roles of hepatokine and osteokine in liver-bone crosstalk: Advance in basic and clinical aspects. Front Endocrinol (Lausanne) 2023; 14:1149233. [PMID: 37091847 PMCID: PMC10117885 DOI: 10.3389/fendo.2023.1149233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/22/2023] [Indexed: 04/08/2023] Open
Abstract
Both the liver and bone are important secretory organs in the endocrine system. By secreting organ factors (hepatokines), the liver regulates the activity of other organs. Similarly, bone-derived factors, osteokines, are created during bone metabolism and act in an endocrine manner. Generally, the dysregulation of hepatokines is frequently accompanied by changes in bone mass, and osteokines can also disrupt liver metabolism. The crosstalk between the liver and bone, particularly the function and mechanism of hepatokines and osteokines, has increasingly gained notoriety as a topic of interest in recent years. Here, based on preclinical and clinical evidence, we summarize the potential roles of hepatokines and osteokines in liver-bone interaction, discuss the current shortcomings and contradictions, and make recommendations for future research.
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Affiliation(s)
- Zhanghao Li
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, Hong Kong SAR, China
| | - Xiaoxin Wen
- Department of Anatomy, Jinzhou Medical University, Jinzhou, China
| | - Nanxi Li
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, Hong Kong SAR, China
| | - Chuanxin Zhong
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, Hong Kong SAR, China
| | - Li Chen
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
| | - Feng Zhang
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ge Zhang
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, Hong Kong SAR, China
| | - Aiping Lyu
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, Hong Kong SAR, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China
- *Correspondence: Jin Liu, ; Aiping Lyu,
| | - Jin Liu
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University (HKBU), Hong Kong, Hong Kong SAR, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China
- *Correspondence: Jin Liu, ; Aiping Lyu,
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Polan C, Brenner C, Herten M, Hilken G, Grabellus F, Meyer HL, Burggraf M, Dudda M, Jahnen-Dechent W, Wedemeyer C, Kauther MD. Increased UHMWPE Particle-Induced Osteolysis in Fetuin-A-Deficient Mice. J Funct Biomater 2023; 14:jfb14010030. [PMID: 36662077 PMCID: PMC9865936 DOI: 10.3390/jfb14010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
Particle-induced osteolysis is a major cause of aseptic prosthetic loosening. Implant wear particles stimulate tissue macrophages inducing an aseptic inflammatory reaction, which ultimately results in bone loss. Fetuin-A is a key regulator of calcified matrix metabolism and an acute phase protein. We studied the influence of fetuin-A on particle-induced osteolysis in an established mouse model using fetuin-A-deficient mice. Ten fetuin-A-deficient (Ahsg−/−) mice and ten wild-type animals (Ahsg+/+) were assigned to test group receiving ultra-high molecular weight polyethylene (UHMWPE) particle implantation or to control group (sham surgery). After 14 days, bone metabolism parameters RANKL, osteoprotegerin (OPG), osteocalcin (OC), alkaline phosphatase (ALP), calcium, phosphate, and desoxypyridinoline (DPD) were examined. Bone volume was determined by microcomputed tomography (μCT); osteolytic regions and osteoclasts were histomorphometrically analyzed. After particle treatment, bone resorption was significantly increased in Ahsg−/− mice compared with corresponding Ahsg+/+ wild-type mice (p = 0.007). Eroded surface areas in Ahsg−/− mice were significantly increased (p = 0.002) compared with Ahsg+/+ mice, as well as the number of osteoclasts compared with control (p = 0.039). Fetuin-A deficiency revealed increased OPG (p = 0.002), and decreased levels of DPD (p = 0.038), OC (p = 0.036), ALP (p < 0.001), and Ca (p = 0.001) compared with wild-type animals. Under osteolytic conditions in Ahsg−/− mice, OPG was increased (p = 0.013), ALP (p = 0.015) and DPD (p = 0.012) were decreased compared with the Ahsg+/+ group. Osteolytic conditions lead to greater bone loss in fetuin-A-deficient mice compared with wild-type mice. Reduced fetuin-A serum levels may be a risk factor for particle-induced osteolysis while the protective effect of fetuin-A might be a future pathway for prophylaxis and treatment.
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Affiliation(s)
- Christina Polan
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Correspondence: ; Tel.: +49-201-723-1301
| | - Christina Brenner
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Monika Herten
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Gero Hilken
- Central Animal Laboratory, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Florian Grabellus
- Institute of Pathology and Neuropathology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Heinz-Lothar Meyer
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Manuel Burggraf
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Marcel Dudda
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Willi Jahnen-Dechent
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Christian Wedemeyer
- Department of Orthopaedic Surgery, St. Barbara Hospital Gladbeck, 45964 Gladbeck, Germany
| | - Max Daniel Kauther
- Department of Trauma Surgery and Orthopedics, Pediatric Orthopedics, Agaplesion Diakonieklinikum Rotenburg (Wümme), 27356 Rotenburg, Germany
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Evaluation of fetuin-A as a predictor of outcome after surgery for osteoporotic fracture of the proximal femur. Arch Orthop Trauma Surg 2020; 140:1359-1366. [PMID: 31858219 DOI: 10.1007/s00402-019-03329-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND In the elderly, osteoporotic fractures of the femur are associated with high morbidity and mortality. At the time of hospitalization and during pre-operative care identification of patients at risk for poor outcome despite an otherwise good clinical condition is challenging. We hypothesized that the serum concentration of fetuin-A during post-operative recovery might serve as a biomarker. METHODS During a 15 months period patients admitted to our hospital for treatment of a femur fracture were registered on a voluntary basis and irrespective of age, underlying diseases and therapy. For all patients enrolled in this registry, blood was sampled for additional laboratory analysis. Patients with osteoporotic fractures were invited for follow-up examination about 2 years later. At this time, the functional outcome and clinical performance together with the handgrip strength as a surrogate measure of overall strength were assessed and the occurrence of additional fractures was recorded. Results from these assessments and the absence or presence of subsequent fractures were combined as summary score of outcome (SSO) and overall physical performance (oPP), a score derived by principal component analysis and relying on normally distributed data, only. RESULTS 39 of 96 eligible patients were deceased during the follow-up period, while 45 consented to participate in the study. Patients with a SSO ≥ 17 pts were younger and had higher fetuin-A serum concentrations (each p < 0.05) during hospitalization compared to those with a SSO below 8 pts. Age at follow-up together with total serum protein and fetuin-A levels during post-operative recovery had significant influence on SSO and oPP. Fetuin-A at time of follow-up examination was not associated with outcome. CONCLUSIONS Our results are in favor of fetuin-A as an important factor for fracture healing but do not support an association between fetuin-A at time of follow-up examination and either SSO or oPP.
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Matias PJ, Laranjinha I, Azevedo A, Raimundo A, Navarro D, Jorge C, Aires I, Mendes M, Ferreira C, Amaral T, Gil C, Ferreira A. Bone fracture risk factors in prevalent hemodialysis patients. J Bone Miner Metab 2020; 38:205-212. [PMID: 31489503 DOI: 10.1007/s00774-019-01041-9] [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: 02/19/2019] [Accepted: 07/31/2019] [Indexed: 12/21/2022]
Abstract
Bone fractures are an important cause of morbidity and mortality in hemodialysis (HD) patients. The aim of this study was to quantify the incidence of fractures in a cohort of prevalent HD patients and evaluate its relationship with possible risk factors. We performed a retrospective analysis of 341 patients, since they started HD (median of 51 months). Demographic, clinical, and biochemical parameters as well as vascular calcifications (VC) were evaluated. Fifty-seven episodes of fracture were identified with a median HD vintage of 47 months (incidence rate of 31 per 1000 person-years). Age (p < 0.001), female gender (p < 0.001), lower albumin (p = 0.02), and higher VC score (p < 0.001) were independently associated with increased risk of fracture, while active vitamin D therapy (p = 0.03) was associated with decreased risk. A significantly higher risk of incident fracture was also associated with higher values of bone-specific alkaline phosphatase (bALP) (p = 0.01) and intact parathyroid hormone (iPTH) levels either < 300 pg/mL (p = 0.02) or > 800 pg/mL (p < 0.001) compared with 300-800 pg/mL. In conclusion, bone fracture incidence in HD patients is high and its risk increases with age, female gender, lower serum albumin, and with the presence of more VC. Prevalent HD patients with low or high iPTH levels or increased bALP also had a higher fracture risk. Therapy with active vitamin D seems to have a protective role. Assessment of fracture risk and management in dialysis patients at greatest risk requires further study.
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Affiliation(s)
- Patrícia João Matias
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal.
- Dialysis Unit, Dialverca, Forte da Casa, Portugal.
- NIDAN, Lisbon, Portugal.
- Faculdade de Ciências Médicas, NOVA Medical School, Lisbon, Portugal.
| | - Ivo Laranjinha
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
- Faculdade de Ciências Médicas, NOVA Medical School, Lisbon, Portugal
| | - Ana Azevedo
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
| | - Ana Raimundo
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal
- NIDAN, Lisbon, Portugal
| | - David Navarro
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal
- NIDAN, Lisbon, Portugal
| | - Cristina Jorge
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
| | - Inês Aires
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
- Faculdade de Ciências Médicas, NOVA Medical School, Lisbon, Portugal
| | - Marco Mendes
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal
- NIDAN, Lisbon, Portugal
| | - Carina Ferreira
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
- Faculdade de Ciências Médicas, NOVA Medical School, Lisbon, Portugal
| | - Tiago Amaral
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
| | - Célia Gil
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
| | - Aníbal Ferreira
- Dialysis Unit, Nephrocare Vila Franca de Xira, Praça Bartolomeu Dias, lote 3 r/c, 2600-063, Vila Franca de Xira, Portugal
- Dialysis Unit, Dialverca, Forte da Casa, Portugal
- NIDAN, Lisbon, Portugal
- Faculdade de Ciências Médicas, NOVA Medical School, Lisbon, Portugal
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Relationship between Fetuin A, Vascular Calcification and Fracture Risk in Dialysis Patients. PLoS One 2016; 11:e0158789. [PMID: 27398932 PMCID: PMC4939952 DOI: 10.1371/journal.pone.0158789] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/22/2016] [Indexed: 01/25/2023] Open
Abstract
Background Fractures are a common morbidity that lead to worse outcomes in dialysis patients. Fetuin A inhibits vascular calcification (VC), potentially promotes bone mineralization and its level positively correlates with bone mineral density in the general population. On the other hand, the presence of VC is associated with low bone volume in dialysis patients. Whether the fetuin A level and VC can predict the occurrence of fractures in dialysis patients remains unknown. Methods We performed this prospective, observational cohort study including 685 dialysis patients (629 hemodialysis and 56 peritoneal dialysis) from a single center in Taiwan for a median follow-up period of 3.4 years. The baseline fetuin A level and status of presence of aortic arch calcification (VC) and incidence of major fractures (hip, pelvis, humerus, proximal forearm, lower leg or vertebrae) were assessed using adjusted Cox proportional hazards models, recursive partitioning analysis and competing risk models. Results Overall, 177 of the patients had major fractures. The incidence rate of major fractures was 3.29 per 100 person-years. In adjusted analyses, the patients with higher baseline fetuin A levels had a lower incidence of fractures (adjusted hazard ratio (HR), 0.3; 95% CI, 0.18‒0.5, fetuin A tertile 3 vs. tertile 1 and HR, 0.52; 95% CI, 0.34‒0.78, tertile 2 vs. tertile 1). The presence of aortic arch calcification (VC) independently predicted the occurrence of fractures (adjusted HR, 1.95; 95% CI, 1.34‒2.84) as well. When accounting for death as an event in competing risk models, the patients with higher baseline fetuin A levels remained to have a lower incidence of fractures (SHR, 0.31; 95% CI, 0.17‒0.56, fetuin A tertile 3 vs. tertile 1 and 0.51; 95% CI, 0.32‒0.81, tertile 2 vs. tertile 1). Interpretations Lower baseline fetuin A levels and the presence of VC were independently linked to higher risk of incident fractures in prevalent dialysis patients.
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The role of fetuin-A in mineral trafficking and deposition. BONEKEY REPORTS 2015; 4:672. [PMID: 25987986 DOI: 10.1038/bonekey.2015.39] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/13/2015] [Indexed: 12/18/2022]
Abstract
Calcium and phosphate are the principle ions involved in the deposition of mineral in the human body. Inhibitors of mineralisation are essential for the prevention of ectopic mineral precipitation and deposition. In the past decade, through in vitro, in vivo and clinical observation studies, we have come to appreciate the importance of fetuin-A (Fet-A), a circulating glycoprotein, in preventing ectopic calcium phosphate mineralisation. Moreover, the detection of Fet-A-containing mineral complex, termed calciprotein particles (CPPs), has provided new ways to assess an individual's calcific risk. The pathophysiological significance of CPPs in disease states is yet to be defined, but it provides an exciting avenue to further our understanding of the development of ectopic mineralisation.
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