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Kuo CC, Soliman MAR, Baig RA, Aguirre AO, Ruggiero N, Donnelly BM, Siddiqi M, Khan A, Quiceno E, Mullin JP, Pollina J. Vertebral Bone Quality Score as a Predictor of Adjacent Segment Disease After Lumbar Interbody Fusion. Neurosurgery 2024; 95:284-296. [PMID: 38334396 DOI: 10.1227/neu.0000000000002864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/20/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVE With lumbar spine fusion being one of the most commonly performed spinal surgeries, investigating common complications such as adjacent segment disease (ASD) is a high priority. To the authors' knowledge, there are no previous studies investigating the utility of the preoperative magnetic resonance imaging-based vertebral bone quality (VBQ) score in predicting radiographic and surgical ASD after lumbar spine fusion. We aimed to investigate the predictive factors for radiographic and surgical ASD, focusing on the predictive potential of the VBQ score. METHODS A single-center retrospective analysis was conducted of all patients who underwent 1-3 level lumbar or lumbosacral interbody fusion for lumbar spine degenerative disease between 2014 and 2021 with a minimum 12 months of clinical and radiographic follow-up. Demographic data were collected, along with patient medical, and surgical data. Preoperative MRI was assessed in the included patients using the VBQ scoring system to identify whether radiographic ASD or surgical ASD could be predicted. RESULTS A total of 417 patients were identified (mean age, 59.8 ± 12.4 years; women, 54.0%). Eighty-two (19.7%) patients developed radiographic ASD, and 58 (13.9%) developed surgical ASD. A higher VBQ score was a significant predictor of radiographic ASD in univariate analysis (2.4 ± 0.5 vs 3.3 ± 0.4; P < .001) and multivariate analysis (odds ratio, 1.601; 95% CI, 1.453-1.763; P < .001). For surgical ASD, a significantly higher VBQ score was seen in univariate analysis (2.3 ± 0.5 vs 3.3 ± 0.4; P < .001) and served as an independent risk factor in multivariate analysis (odds ratio, 1.509; 95% CI, 1.324-1.720; P < .001). We also identified preoperative disk bulge and preoperative existence of adjacent segment disk degeneration to be significant predictors of both radiographic and surgical ASD. Furthermore, 3-level fusion was also a significant predictor for surgical ASD. CONCLUSION The VBQ scoring system might be a useful adjunct for predicting radiographic and surgical ASD.
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Affiliation(s)
- Cathleen C Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Mohamed A R Soliman
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo , New York , USA
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo , Egypt
| | - Rehman Ali Baig
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo , New York , USA
| | - Alexander O Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Nicco Ruggiero
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Brianna M Donnelly
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo , New York , USA
| | - Manhal Siddiqi
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Asham Khan
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo , New York , USA
| | - Esteban Quiceno
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo , New York , USA
| | - Jeffrey P Mullin
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo , New York , USA
| | - John Pollina
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo , New York , USA
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Gou Y, Li H, Sun X, Chen D, Tian F. Parathyroid hormone (1-34) retards the lumbar facet joint degeneration and activates Wnt/β-catenin signaling pathway in ovariectomized rats. J Orthop Surg Res 2024; 19:352. [PMID: 38877549 PMCID: PMC11177467 DOI: 10.1186/s13018-024-04817-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/28/2024] [Indexed: 06/16/2024] Open
Abstract
PURPOSE Facet joint degeneration (FJD) is a major cause of low back pain. Parathyroid hormone (PTH) (1-34) is commonly used to treat osteoporosis. However, little is known about its effects on FJD induced by estrogen deficiency. This study aims to investigate the effects of PTH (1-34) on FJD induced by estrogen deficiency and the underlying pathogenesis of the disease. METHODS Forty 3-month-old female Sprague-Dawley rats were randomly divided into four groups: 30 received bilateral ovariectomy (OVX) followed by 12 weeks of treatment with normal saline, PTH (1-34) or 17β-estradiol (E2), and 10 received sham surgery followed by administration of normal saline. Status and Wnt/β-catenin signaling activity in the cartilage and subchondral bone of the L4-L5 FJs and serum biomarkers were analyzed. RESULTS Administration of PTH (1-34) and E2 ameliorated cartilage lesions, and significantly decreased MMP-13 and caspase-3 levels and chondrocyte apoptosis. PTH (1-34) but not E2 significantly increased cartilage thickness, number of chondrocytes, and the expression of aggrecan. PTH (1-34) significantly improved microarchitecture parameters of subchondral bone, increased the expression of collagen I and osteocalcin, and decreased RANKL/OPG ratio. E2 treatment significantly increased the OPG level and decreased the RANKL/OPG ratio in the subchondral bone of ovariectomized rats, but it did not significantly improve the microarchitecture parameters of subchondral bone. Wnt3a and β-catenin expression was significantly reduced in the articular cartilage and subchondral bone in OVX rats, but PTH (1-34) could increase the expression of these proteins. E2 significantly increased the activity of Wnt/β-catenin pathway only in cartilage, but not in subchondral bone. The restoration of Wnt/β-catenin signaling had an obvious correlation with the improvement of some parameters associated with the FJs status. CONCLUSION Wnt/β-catenin signaling may be a potential therapeutic target for FJD induced by estrogen deficiency. PTH (1-34) is effective in treating this disease with better efficacy than 17β-estradiol, and the efficacy may be attributed to its restoration of Wnt/β-catenin signaling.
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Affiliation(s)
- Yu Gou
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Hetong Li
- Department of Orthopaedics, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Xun Sun
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Desheng Chen
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, China.
| | - Faming Tian
- School of Public Health, North China University of Science and Technology, Tangshan, China.
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He Y, Liu S, Lin H, Ding F, Shao Z, Xiong L. Roles of organokines in intervertebral disc homeostasis and degeneration. Front Endocrinol (Lausanne) 2024; 15:1340625. [PMID: 38532900 PMCID: PMC10963452 DOI: 10.3389/fendo.2024.1340625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
The intervertebral disc is not isolated from other tissues. Recently, abundant research has linked intervertebral disc homeostasis and degeneration to various systemic diseases, including obesity, metabolic syndrome, and diabetes. Organokines are a group of diverse factors named for the tissue of origin, including adipokines, osteokines, myokines, cardiokines, gastrointestinal hormones, and hepatokines. Through endocrine, paracrine, and autocrine mechanisms, organokines modulate energy homeostasis, oxidative stress, and metabolic balance in various tissues to mediate cross-organ communication. These molecules are involved in the regulation of cellular behavior, inflammation, and matrix metabolism under physiological and pathological conditions. In this review, we aimed to summarize the impact of organokines on disc homeostasis and degeneration and the underlying signaling mechanism. We focused on the regulatory mechanisms of organokines to provide a basis for the development of early diagnostic and therapeutic strategies for disc degeneration.
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Affiliation(s)
- Yuxin He
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Lin
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Ding
- Department of Orthopaedics, JingMen Central Hospital, Jingmen, China
- Hubei Minzu University, Enshi, China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liming Xiong
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sun Q, Liu F, Fang J, Lian Q, Hu Y, Nan X, Tian FM, Zhang G, Qi D, Zhang L, Zhang J, Luo Y, Zhang Z, Zhou Z. Strontium ranelate retards disc degradation and improves endplate and bone micro-architecture in ovariectomized rats with lumbar fusion induced - Adjacent segment disc degeneration. Bone Rep 2024; 20:101744. [PMID: 38404727 PMCID: PMC10884424 DOI: 10.1016/j.bonr.2024.101744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/02/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024] Open
Abstract
Objectives Adjacent segment disc degeneration (ASDD) is one of the long-term sequelae of spinal fusion, which is more susceptible with osteoporosis. As an anti-osteoporosis drug, strontium ranelate (SR) has been reported to not only regulate bone metabolism but also cartilage matrix formation. However, it is not yet clear whether SR has a reversal or delaying effect on fusion-induced ASDD in a model of osteoporosis. Materials and methods Fifth three-month-old female Sprague-Dawley rats that underwent L4-L5 posterolateral lumbar fusion (PLF) with spinous-process wire fixation 4 weeks after bilateral ovariectomy (OVX) surgery. Animals were administered vehicle (V) or SR (900 mg/kg/d) orally for 12 weeks post-PLF as follows: Sham+V, OVX + V, PLF + V, OVX + PLF + V, and OVX + PLF + SR. Manual palpation and X-ray were used to evaluate the state of lumbar fusion. Adjacent-segment disc was assessed by histological (VG staining and Scoring), histomorphometry (Disc Height, MVD, Calcification rate and Vascular Bud rate), immunohistochemical (Col-II, Aggrecan, MMP-13, ADAMTS-4 and Caspase-3), and mRNA analysis (Col-I, Col-II, Aggrecan, MMP-13 and ADAMTS-4). Adjacent L6 vertebrae microstructures were evaluated by microcomputed tomography. Results Manual palpation and radiographs showed clear evidence of the fused segment's immobility. After 12 weeks of PLF surgery, a fusion-induced ASDD model was established. Low bone mass caused by ovariectomy can significantly exacerbate ASDD progression. SR exerted a protective effect on adjacent segment intervertebral disc with the underlying mechanism possibly being associated with preserving bone mass to prevent spinal instability, maintaining the functional integrity of endplate vascular microstructure, and regulating matrix metabolism in the nucleus pulposus and annulus fibrosus. Discussion Anti-osteoporosis medication SR treatments not only maintain bone mass and prevent fractures, but early intervention could also potentially delay degenerative conditions linked to osteoporosis. Taken together, our results suggested that SR might be a promising approach for the intervention of fusion-induced ASDD with osteoporosis.
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Affiliation(s)
- Qi Sun
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Fang Liu
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Jiakang Fang
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, People's Republic of China
| | - Qiangqiang Lian
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, People's Republic of China
| | - Yunpeng Hu
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, People's Republic of China
| | - Xinyu Nan
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, People's Republic of China
| | - Fa-Ming Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Guochuan Zhang
- Department of Musculoskeletal Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Dianwen Qi
- Department of Musculoskeletal Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Liu Zhang
- Department of Orthopedic Surgery, Emergency General Hospital, Beijing, People's Republic of China
| | - Jingwen Zhang
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yang Luo
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Zuzhuo Zhang
- Department of Radiology, the Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Zhuang Zhou
- Department of Musculoskeletal Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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5
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Tan Q, Li F, Zhang K, Liu Z, Tian Y, Zhu T. Proteomics Analysis of Knee Subchondral Bone Identifies Differentially Expressed Proteins Associated with Osteoarthritis. J Proteome Res 2024; 23:738-748. [PMID: 38206579 PMCID: PMC10846524 DOI: 10.1021/acs.jproteome.3c00584] [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: 09/10/2023] [Revised: 12/16/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024]
Abstract
Osteoarthritis (OA) is a prevalent debilitating whole-joint disorder. Currently, a growing number of proteomic studies have been performed to evaluate molecular biomarkers in several tissues from OA patients; however, little is known about the protein profiles in subchondral bone of OA. In this study, proteomic analysis was performed on subchondral bone from patients with OA to identify differentially expressed proteins (DEPs). Bioinformatics tools were used to further investigate these DEPs. Thereafter, DEPs were validated in the samples from patients with OA, as well as in bilateral ovariectomy-induced OA (OVX-OA) rats using immunohistochemistry. A comprehensive subchondral bone proteome profile of patients with OA was constructed. Additionally, biological information analysis showed that a majority of DEPs participated in the dysregulation of the complement and coagulation cascades. The validation experiments suggested that SerpinA5, the protein involved in the complement and coagulation cascades, was significantly increased in severely damaged subchondral bone of patients with OA compared to the control group. Furthermore, the increase of SerpinA5 in OVX-OA rats compared to control rats was also confirmed. Our results indicated that the dysregulation of coagulation and complement pathways plays a role in the progression of OA, and it provides a promising therapeutic target of OA.
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Affiliation(s)
- Qizhao Tan
- Department
of Orthopaedics, Peking University Third
Hospital, Beijing 100191, China
- Engineering
Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
| | - Feng Li
- Department
of Orthopaedics, Peking University Third
Hospital, Beijing 100191, China
- Engineering
Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
| | - Ke Zhang
- Department
of Orthopaedics, Peking University Third
Hospital, Beijing 100191, China
- Department
of Orthopaedics, Peking University International
Hospital, Beijing 102206, China
| | - Zhongjun Liu
- Department
of Orthopaedics, Peking University Third
Hospital, Beijing 100191, China
| | - Yun Tian
- Department
of Orthopaedics, Peking University Third
Hospital, Beijing 100191, China
- Engineering
Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
| | - Tengjiao Zhu
- Department
of Orthopaedics, Peking University Third
Hospital, Beijing 100191, China
- Engineering
Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
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Broussolle T, Roux JP, Chapurlat R, Barrey C. Murine models of posterolateral spinal fusion: A systematic review. Neurochirurgie 2023; 69:101428. [PMID: 36871885 DOI: 10.1016/j.neuchi.2023.101428] [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: 12/22/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Rodent models are commonly used experimentally to assess treatment effectiveness in spinal fusion. Certain factors are associated with better fusion rates. The objectives of the present study were to report the protocols most frequently used, to evaluate factors known to positively influence fusion rate, and to identify new factors. METHOD A systematic literature search of PubMed and Web of Science found 139 experimental studies of posterolateral lumbar spinal fusion in rodent models. Data for level and location of fusion, animal strain, sex, weight and age, graft, decortication, fusion assessment and fusion and mortality rates were collected and analyzed. RESULTS The standard murine model for spinal fusion was male Sprague Dawley rats of 295g weight and 13 weeks' age, using decortication, with L4-L5 as fusion level. The last two criteria were associated with significantly better fusion rates. On manual palpation, the overall mean fusion rate in rats was 58% and the autograft mean fusion rate was 61%. Most studies evaluated fusion as a binary on manual palpation, and only a few used CT and histology. Average mortality was 3.03% in rats and 1.56% in mice. CONCLUSIONS These results suggest using a rat model, younger than 10 weeks and weighing more than 300 grams on the day of surgery, to optimize fusion rates, with decortication before grafting and fusing the L4-L5 level.
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Affiliation(s)
- T Broussolle
- Department of Spine Surgery, P. Wertheimer University Hospital, GHE, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France; Inserm UMR 1033, université Claude-Bernard Lyon 1, Lyon, France.
| | - Jean-Paul Roux
- Inserm UMR 1033, université Claude-Bernard Lyon 1, Lyon, France
| | - R Chapurlat
- Inserm UMR 1033, université Claude-Bernard Lyon 1, Lyon, France
| | - C Barrey
- Department of Spine Surgery, P. Wertheimer University Hospital, GHE, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France; Arts et métiers ParisTech, ENSAM, 151, boulevard de l'Hôpital, 75013 Paris, France
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Zhang H, Bei M, Zheng Z, Liu N, Cao X, Xiao Y, Lian Q, Wang Y, Hou X, Tian F. Parathyroid Hormone (1-34) Attenuates Cartilage Degradation and Preserves Subchondral Bone Micro-architecture in Rats with Patella Baja-Induced-Patellofemoral Joint Osteoarthritis. Calcif Tissue Int 2022; 111:87-95. [PMID: 35179619 DOI: 10.1007/s00223-022-00958-0] [Citation(s) in RCA: 4] [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] [Received: 11/26/2021] [Accepted: 02/04/2022] [Indexed: 11/28/2022]
Abstract
Several studies have revealed that PTH1-34 may possess the potential for treating osteoarthritis (OA) and osteoporosis. However, no study has yet determined whether PTH1-34 can be used for the treatment of patella baja-induced patellofemoral joint OA (PFJOA). Thus, this study sought to assess the efficacy of PTH1-34 for the treatment of PFJOA in a rat model. Patella baja was induced in 3-month-old female Sprague-Dawley (SD) rats by patellar ligament shortening (PLS), after which the rats were randomly divided into three groups (n = 12): Sham, PLS, and PTH group (PTH + PLS, PTH1-34, 30 µg/kg/d, 5 days per week for 10 weeks). Thereafter, radiographic imaging, macroscopic and microscopic analyses, immunohistochemistry, and microcomputed tomography (CT) analysis were performed. The appearance of PLS-induced PFJOA promoted obvious changes in the patellar position and structure in the PLS group, which were characterized by cartilage degeneration, subchondral bone microstructure deterioration, patella baja, and increasing patella length. However, these negative characteristics were markedly ameliorated by PTH1-34, which not only inhibited cartilage catabolism by decreasing MMP-13 and ADAMTS-4 but also enhanced anabolism by increasing Col-II and Aggrecan. Furthermore, the micro-CT results showed a marked improvement in subchondral bone microarchitecture. The findings presented herein demonstrated that early treatment with PTH1-34 could improve cartilage metabolism and subchondral bone health in this PFJOA model.
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Affiliation(s)
- Hongfei Zhang
- School of Public Health, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis., Tangshan, 063210, Hebei, People's Republic of China
| | - Mingjian Bei
- Department of Orthopedic Surgery, Beijing Ji Shui Tan Hospital, Xinjiekoudongjie 31, Xicheng Dis., Beijing, 100035, People's Republic of China
| | - Zhiyuan Zheng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, People's Republic of China
| | - Ning Liu
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, People's Republic of China
| | - Xuehui Cao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, People's Republic of China
| | - Yaping Xiao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, People's Republic of China
| | - Qiangqiang Lian
- School of Public Health, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis., Tangshan, 063210, Hebei, People's Republic of China
| | - Yudan Wang
- School of Public Health, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis., Tangshan, 063210, Hebei, People's Republic of China
| | - Xiaoli Hou
- School of Public Health, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis., Tangshan, 063210, Hebei, People's Republic of China
| | - Faming Tian
- School of Public Health, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis., Tangshan, 063210, Hebei, People's Republic of China.
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Exogenous Parathyroid Hormone Alleviates Intervertebral Disc Degeneration through the Sonic Hedgehog Signalling Pathway Mediated by CREB. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9955677. [PMID: 35265269 PMCID: PMC8898813 DOI: 10.1155/2022/9955677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/19/2022]
Abstract
As an important hormone that regulates the balance of calcium and phosphorus, parathyroid hormone (PTH) has also been found to have an important function in intervertebral disc degeneration (IVDD). Our aim was to investigate the mechanism by which PTH alleviates IVDD. In this study, the PTH 1 receptor was found to be highly expressed in severely degenerated human nucleus pulposus (NP) cells. We found in the mouse model of IVDD that supplementation with exogenous PTH alleviated the narrowing of the intervertebral space and the degradation of the extracellular matrix (ECM) caused by tail suspension (TS). In addition, inflammation, oxidative stress, and apoptosis levels were significantly increased in the intervertebral disc tissues of TS-induced mice, and the activity of NP cells was decreased. TS also led to the downregulation of Sonic hedgehog (SHH) signalling pathway-related signal molecules in NP cells such as SHH, Smoothened, and GLI1. However, supplementation with exogenous PTH can reverse these changes. In vitro, PTH also promotes the activity of NP cells and the secretion of ECM. However, the antagonist of the SHH signalling pathway can inhibit the therapeutic effect of PTH on NP cells. In addition, a cAMP-response element-binding protein, as an important transcription factor, was found to mediate the promotion of PTH on the SHH signalling pathway. Our results revealed that PTH can alleviate IVDD by inhibiting inflammation, oxidative stress, and apoptosis and improving the activity of NP cells via activating the SHH signalling pathway.
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Zhu T, Tan Q, Xin X, Li F, Zhang K, Liu Z, Tian Y. Proteomic analysis of human articular cartilage unravels the dyscoagulation in osteoarthritis and the potential value of serpinA5 as a biomarker for osteoarthritis. Proteomics Clin Appl 2021; 16:e2100117. [PMID: 34964303 DOI: 10.1002/prca.202100117] [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: 11/22/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 11/08/2022]
Abstract
PURPOSE Nowadays, there is no clinically applicable biomarker for osteoarthritis (OA). Therefore, the aim of the study is to discover a potential biomarker for OA. EXPERIMENTAL DESIGN We performed a proteomics of eight cartilage samples (four damaged cartilage and four macroscopically intact cartilage) from four OA patients without any comorbidities to search for valuable OA biomarkers. Four rats underwent bilateral ovariectomy to induce the OA (OVX-OA) model, while another four underwent a sham procedure wherein the ovaries were exteriorized but not removed (SHAM). Selected candidate proteins were further verified in the patients and the OVX-OA animal model. RESULTS A comprehensive cartilage proteome profile of patients with OA was constructed. Additionally, the complement and coagulation cascades were found to be significantly altered, and serpinA5 was chosen as a protein of interest based on biological information analysis. The reduction of serpinA5 in locally damaged cartilage and serum of patients with OA compared to the control group was determined. Furthermore, we found that serpinA5 was decreased in OVX-OA rats compared to that in SHAM rats. CONCLUSIONS AND CLINICAL RELEVANCE Our results suggest that there is dyscoagulation in the OA process and that serpinA5 can serve as a potentially valuable OA biomarker.
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Affiliation(s)
- Tengjiao Zhu
- Department of Orthopedic, Peking University Third Hospital, Beijing, P.R. China.,Department of Orthopedic, Peking University International Hospital, Beijing, P.R. China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, P.R. China
| | - Qizhao Tan
- Department of Orthopedic, Peking University Third Hospital, Beijing, P.R. China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, P.R. China
| | - Xing Xin
- Department of Orthopedic, Peking University International Hospital, Beijing, P.R. China
| | - Feng Li
- Department of Orthopedic, Peking University Third Hospital, Beijing, P.R. China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, P.R. China
| | - Ke Zhang
- Department of Orthopedic, Peking University Third Hospital, Beijing, P.R. China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, P.R. China
| | - Zhongjun Liu
- Department of Orthopedic, Peking University Third Hospital, Beijing, P.R. China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, P.R. China
| | - Yun Tian
- Department of Orthopedic, Peking University Third Hospital, Beijing, P.R. China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, P.R. China
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Shih TY, Wu YC, Tseng SC, Chen KH, Pan CC, Lee CH. Correlation between Preoperative Serum Levels of Calcium, Phosphate, and Intact Parathyroid Hormone and Radiological Outcomes in Spinal Interbody Fusion among End-Stage Renal Disease Patients. J Clin Med 2021; 10:jcm10225447. [PMID: 34830729 PMCID: PMC8619249 DOI: 10.3390/jcm10225447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 11/29/2022] Open
Abstract
Spinal fusion surgery for end-stage renal disease (ESRD) patients is a clinical challenge. This study aimed to investigate whether postoperative radiological outcomes are related to preoperative serum calcium, phosphate, or intact parathyroid hormone (iPTH) levels in patients with ESRD who underwent spinal interbody fusion surgery. This study included 62-consecutive patients with ESRD who underwent anterior cervical discectomy and fusion (ACDF) or transforaminal lumbar interbody fusion (TLIF) surgery for symptomatic spinal disorder. The most recent preoperative serum calcium, phosphate, and iPTH levels were recorded, and the postoperative radiographic outcomes were assessed. A significant correlation was found between the occurrence of cage subsidence and higher blood phosphate, calcium–phosphate product (Ca × P), and iPTH levels in the TLIF group. The occurrence of pedicle screw loosening was related to higher blood phosphate and Ca × P product in the TLIF group. However, no correlation was found between the fusion grades and the serum levels in either the TLIF or ACDF groups. These results indicated that higher preoperative serum phosphate and Ca × P product are risk factors for both cage subsidence and screw loosening in patients with ESRD who underwent TLIF surgery. Higher iPTH levels are also a possible risk factor for cage subsidence.
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Affiliation(s)
- Ting-Yu Shih
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (T.-Y.S.); (Y.-C.W.); (S.-C.T.); (K.-H.C.); (C.-C.P.)
| | - Yun-Che Wu
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (T.-Y.S.); (Y.-C.W.); (S.-C.T.); (K.-H.C.); (C.-C.P.)
| | - Sheng-Chieh Tseng
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (T.-Y.S.); (Y.-C.W.); (S.-C.T.); (K.-H.C.); (C.-C.P.)
| | - Kun-Hui Chen
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (T.-Y.S.); (Y.-C.W.); (S.-C.T.); (K.-H.C.); (C.-C.P.)
| | - Chien-Chou Pan
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (T.-Y.S.); (Y.-C.W.); (S.-C.T.); (K.-H.C.); (C.-C.P.)
| | - Cheng-Hung Lee
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (T.-Y.S.); (Y.-C.W.); (S.-C.T.); (K.-H.C.); (C.-C.P.)
- Department of Food Science and Technology, Hung Kuang University, Taichung 43302, Taiwan
- College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Correspondence: ; Tel.: +886-4-23592525 (ext. 5101)
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11
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Jin L, Yin Y, Chen W, Zhang R, Guo J, Tao S, Guo Z, Hou Z, Zhang Y. Role of the Lumbosacral Transition Vertebra and Vertebral Lamina in the Pathogenesis of Lumbar Disc Herniation. Orthop Surg 2021; 13:2355-2362. [PMID: 34791784 PMCID: PMC8654657 DOI: 10.1111/os.13122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/30/2021] [Accepted: 06/02/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of lumbosacral transition vertebrae (LSTVs) in both the normal population and the lumbar disc herniation (LDH) population and to determine the risk factors for LDH. METHODS Between January 2019 and September 2020, all patients aged 18-39 years and underwent an anteroposterior (AP) X-ray of the lumbar vertebrae were retrospective reviewed in our institution. Those patients who were diagnosed with LDH were eligible for inclusion in the LDH group. During the same period, those patients admitted to our hospital who underwent an anteroposterior X-ray of the lumbar spine and had not been diagnosed with LDH were included in the control group. Those patients with disease that might affect the lumbar anatomy were excluded from both groups. The type of LSTV was classified according to the Castellvi classification. The height of the lumbar vertebral lamina was evaluated through the h/H index. The inter- and intra-observer reliability was evaluated by one senior radiologist and one senior orthopedist using intraclass correlation coefficient (ICC). The association between the LSTV and the herniation level was also investigated. Binary logistic regression was used to explore the association of different factors between the LDH group and the control group. RESULTS Two hundred LDH patients (115 male and 85 female) and 200 individuals (108 male and 92 female) were investigated retrospectively. The prevalence of LSTVs was 71.5% (n = 143) in the LDH group and 34.0% (n = 68) in the control group. The most frequent LSTV types were type Ib and type IIa. The inter- and intra-observer ICCs of the measurement of "h/H" index and the classification of LSTV were all "excellent" (ICC > 0.90). The median h/H index in the control group was significantly higher than that in the LDH group (0.28 (0.26, 0.31) vs 0.34 (0.31, 0.37), P = 0.000). The distribution of the Castellvi classification in the L4/5 and L5/S1 herniation patients was significantly different (P = 0.048). LSTVs, BMI and the h/H index were closely associated with LDH, with odds ratios of 3.06 (95% CI: 2.12-4.43), 1.23 (95% CI: 1.13-1.33) and 0.09 (95% CI: 0.05-0.15), respectively. The incidence of L4/5 disc herniation in patients with an LSTV was significantly more common than that in patients with L5/S1 disc herniation (P = 0.048). CONCLUSION The prevalence of LSTVs was 34.0% in the control group and 71.5% in the LDH group; LSTVs and BMI were positively correlated with LDH, and h/H was negatively correlated with LDH.
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Affiliation(s)
- Lin Jin
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Yingchao Yin
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Wei Chen
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Ruipeng Zhang
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Jialiang Guo
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Shiwu Tao
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Zheming Guo
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Zhiyong Hou
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
| | - Yingze Zhang
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (Third Hospital of Hebei Medical University), Shijiazhuang, China
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12
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Dutra EH, O’Brien MH, Chen PJ, Wei M, Yadav S. Intermittent Parathyroid Hormone [1-34] Augments Chondrogenesis of the Mandibular Condylar Cartilage of the Temporomandibular Joint. Cartilage 2021; 12:475-483. [PMID: 30897936 PMCID: PMC8461153 DOI: 10.1177/1947603519833146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To characterize the long-term effects of intermittent parathyroid hormone (I-PTH) on the mandibular condylar cartilage (MCC) and subchondral bone of the temporomandibular joint, in vivo and in vitro. MATERIALS AND METHODS For the in vivo experiments, sixteen 10-week-old mice were divided into 2 groups: (1) I-PTH (n = 8)-subcutaneous daily injection of PTH; (2) control group (n = 8)-subcutaneous daily injection of saline solution. Experiments were carried out for 4 weeks. Mice were injected with calcein, alizarin complexone, and cell proliferation marker before euthanasia. For the in vitro experiments, primary chondrocyte cultures from the MCC of eight 10-week-old mice were treated with I-PTH for 14 days. RESULTS There was a significant increase in bone volume, tissue density, mineral deposition, osteoclastic activity, cell proliferation in the cartilage, and cartilage thickness in the I-PTH-treated mice when compared with the control group. In addition, immunohistochemistry in cartilage revealed that I-PTH administration led to an increase in expression of vascular endothelial growth factor and to a decreased expression of sclerostin, matrix metallopeptidase 13, and aggreganase-1 (ADAM-TS4). Quantitative polymerase chain reaction analysis of the I-PTH-treated chondrocytes revealed significantly decreased relative expression of collagen type X (Col10a1), alkaline phosphatase (Alp), and Indian Hedgehog (Ihh) and remarkable increased expression of Sox9, fibroblast growth factor 2 (Fgf2), and proteoglycan 4 (Prg4). CONCLUSION I-PTH administration causes anabolic effects at the subchondral region of the mandibular condyle while triggers anabolic and protective effects at the MCC.
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Affiliation(s)
- Eliane H. Dutra
- Division of Orthodontics, University of Connecticut Health Center, Farmington, CT, USA
| | - Mara H. O’Brien
- Division of Orthodontics, University of Connecticut Health Center, Farmington, CT, USA
| | - Po-Jung Chen
- Division of Orthodontics, University of Connecticut Health Center, Farmington, CT, USA
| | - Mei Wei
- UCONN School of Engineering, University of Connecticut, Storrs, CT, USA
| | - Sumit Yadav
- Division of Orthodontics, University of Connecticut Health Center, Farmington, CT, USA,Sumit Yadav, Department of Orthodontics, University of Connecticut Health Center 263 Farmington Avenue, MC1725, Farmington, CT 06030, USA.
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13
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Ping SH, Tian FM, Liu H, Sun Q, Shao LT, Lian QQ, Zhang L. Raloxifene inhibits the overexpression of TGF-β1 in cartilage and regulates the metabolism of subchondral bone in rats with osteoporotic osteoarthritis. Bosn J Basic Med Sci 2021; 21:284-293. [PMID: 33259777 PMCID: PMC8112563 DOI: 10.17305/bjbms.2020.5142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/16/2020] [Indexed: 01/18/2023] Open
Abstract
Overexpression of transforming growth factor-beta 1 (TGF-β1) and subchondral bone remodelling play key roles in osteoarthritis (OA). Raloxifene (RAL) reduces the serum level of TGF-β1 in postmenopausal women. However, the effect of RAL on TGF-β1 expression in articular cartilage is still unclear. Therefore, we aimed to investigate the protective effect of RAL on osteoporotic osteoarthritis via affecting TGF-β1 expression in cartilage and the metabolism of subchondral bone. Osteoporotic osteoarthritis was induced by a combination of anterior cruciate transection (ACLT) and ovariectomy (OVX). Rats were divided into five groups (n = 12): The sham group, the ACLT group, the OVX group, the ACLT + OVX group, and the RAL group (ACLT + OVX + RAL, 6.25 mg/kg/day for 12 weeks). Assessment was performed by histomorphology, microcomputed tomography (micro-CT) scan, immunohistochemistry, and tartrate-resistant acid phosphatase (TRAP) staining. We found that severe cartilage degeneration was shown in the ACLT + OVX group. The histomorphological scores, the levels of TGF-β1, and its related catabolic enzymes and osteoclasts numbers in the ACLT + OVX group were higher than those in other groups (p < 0.05). Furthermore, structure model index (SMI) and trabecular spacing (Tb.Sp) were decreased (p < 0.05), while bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular number (Tb.N) were increased by RAL compared with the ACLT + OVX group (p < 0.05). Our findings demonstrated that RAL in clinical doses retards the development of osteoporotic osteoarthritis by inhibiting the overexpression of TGF-β1 in cartilage and regulating the metabolism of subchondral bone. These results provide support for RAL in the expansion of clinical indication for prevention and treatment in postmenopausal osteoarthritis.
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Affiliation(s)
- Shao-Hua Ping
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - Fa-Ming Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, China
| | - Hao Liu
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Qi Sun
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - Li-Tao Shao
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - Qiang-Qiang Lian
- Department of Orthopedic Surgery, the Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Liu Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China; Department of Orthopedic Surgery, Emergency General Hospital, Beijing, China
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14
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Sun Q, Tian FM, Liu F, Fang JK, Hu YP, Lian QQ, Zhou Z, Zhang L. Denosumab alleviates intervertebral disc degeneration adjacent to lumbar fusion by inhibiting endplate osteochondral remodeling and vertebral osteoporosis in ovariectomized rats. Arthritis Res Ther 2021; 23:152. [PMID: 34049577 PMCID: PMC8161944 DOI: 10.1186/s13075-021-02525-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 05/05/2021] [Indexed: 01/22/2023] Open
Abstract
Background Although adjacent segmental intervertebral disc degeneration (ASDD) is one of the most common complications after lumbar fusion, its exact mechanism remains unclear. As an antibody to RANKL, denosumab (Dmab) effectively reduces bone resorption and stimulates bone formation, which can increase bone mineral density (BMD) and improve osteoporosis. However, it has not been confirmed whether Dmab has a reversing or retarding effect on ASDD. Methods Three-month-old female Sprague-Dawley rats that underwent L4–L5 posterolateral lumbar fusion (PLF) with spinous-process wire fixation 4 weeks after bilateral ovariectomy (OVX) surgery were given Dmab 4 weeks after PLF surgery (OVX+PLF+Dmab group). In addition, the following control groups were defined: Sham, OVX, PLF, and OVX+PLF (n=12 each). Next, manual palpation and X-ray were used to evaluate the state of lumbar fusion. The bone microstructure in the lumbar vertebra and endplate as well as the disc height index (DHI) of L5/6 was evaluated by microcomputed tomography (μCT). The characteristic alterations of ASDD were identified via Safranin-O green staining. Osteoclasts were detected using tartrate-resistant acid phosphatase (TRAP) staining, and the biomechanical properties of vertebrae were evaluated. Aggrecan (Agg), metalloproteinase-13 (MMP-13), and a disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4) expression in the intervertebral disc were detected by immunohistochemistry and real-time polymerase chain reaction (RT-PCR) analysis. In addition, the expression of CD24 and Sox-9 was assessed by immunohistochemistry. Results Manual palpation showed clear evidence of the fused segment’s immobility. Compared to the OVX+PLF group, more new bone formation was observed by X-ray examination in the OVX+PLF+Dmab group. Dmab significantly alleviated ASDD by retaining disc height index (DHI), decreasing endplate porosity, and increasing vertebral biomechanical properties and BMD. TRAP staining results showed a significantly decreased number of active osteoclasts after Dmab treatment, especially in subchondral bone and cartilaginous endplates. Moreover, the protein and mRNA expression results in discs (IVDs) showed that Dmab not only inhibited matrix degradation by decreasing MMP-13 and ADAMTS-4 but also promoted matrix synthesis by increasing Agg. Dmab maintained the number of notochord cells by increasing CD24 but reducing Sox-9. Conclusions These results suggest that Dmab may be a novel therapeutic target for ASDD treatment.
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Affiliation(s)
- Qi Sun
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Fa-Ming Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Fang Liu
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Jia-Kang Fang
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Yun-Peng Hu
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Qiang-Qiang Lian
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Zhuang Zhou
- Department of Bone and Soft Tissue Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Liu Zhang
- Department of Orthopedic Surgery, Hebei Medical University, 361 Zhongshan ERoad, Hebei, 050000, Shijiazhuang, People's Republic of China.
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15
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Zhang C, Chang M, Zhang R, Tang S. Biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion: A finite element study. Pak J Med Sci 2021; 37:403-408. [PMID: 33679922 PMCID: PMC7931299 DOI: 10.12669/pjms.37.2.3223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: To investigate the biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion (PLIF). Methods: This study was designed and conducted in the Traumatology and Orthopedics Laboratory, School of Chinese Medicine, Jinan University, Guangzhou, China, between December 2019 and February 2020. A healthy finite element model of L3-S1 was developed along with one PLIF model and one PLIF with osteoporosis model. Based on a hybrid test method, the inferior surface of S1 was entirely fixed, and a preload of 400N combined with an adjusted moment was imposed on the superior surface of L3 in each model to simulate flexion, extension, lateral bending and axial rotation. The intradiscal pressure (IDP), shear stress on annulus fibrosus, and the range of motion (ROM) of L3-L4 and L5-S1 were calculated and compared. Results: In each direction, the highest value of IDP and shear stress on annulus fibrosus at L3-L4 and L5-S1 was found in the PLIF model, and the lowest value in the healthy model. The largest ROM at L4-L5 appeared in the healthy model, and the smallest value in the PLIF model in each direction. At L3-L4 and L5-S1, the highest ROM in most directions was found in the PLIF model, followed by the PLIF with osteoporosis model, and the lowest value in the healthy model. Conclusions: Osteoporosis can decrease IDP, shear stress on annulus fibrosus, and ROM at adjacent levels, and slow down the development of ASD after PLIF.
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Affiliation(s)
- Chenchen Zhang
- Chenchen Zhang, School of Chinese Medicine, Jinan University, Guangzhou, 510630, China
| | - Minmin Chang
- Minmin Chang, School of Chinese Medicine, Jinan University, Guangzhou, 510630, China
| | - Renwen Zhang
- Renwen Zhang, School of Chinese Medicine, Jinan University, Guangzhou, 510630, China
| | - Shujie Tang
- Shujie Tang, School of Chinese Medicine, Jinan University, Guangzhou, 510630, China
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16
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Negri S, Wang Y, Sono T, Lee S, Hsu GC, Xu J, Meyers CA, Qin Q, Broderick K, Witwer KW, Peault B, James AW. Human perivascular stem cells prevent bone graft resorption in osteoporotic contexts by inhibiting osteoclast formation. Stem Cells Transl Med 2020; 9:1617-1630. [PMID: 32697440 PMCID: PMC7695633 DOI: 10.1002/sctm.20-0152] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/24/2020] [Accepted: 06/15/2020] [Indexed: 12/15/2022] Open
Abstract
The vascular wall stores mesenchymal progenitor cells which are able to induce bone regeneration, via direct and paracrine mechanisms. Although much is known regarding perivascular cell regulation of osteoblasts, their regulation of osteoclasts, and by extension utility in states of high bone resorption, is not known. Here, human perivascular stem cells (PSCs) were used as a means to prevent autograft resorption in a gonadectomy-induced osteoporotic spine fusion model. Furthermore, the paracrine regulation by PSCs of osteoclast formation was evaluated, using coculture, conditioned medium, and purified extracellular vesicles. Results showed that PSCs when mixed with autograft bone induce an increase in osteoblast:osteoclast ratio, promote bone matrix formation, and prevent bone graft resorption. The confluence of these factors resulted in high rates of fusion in an ovariectomized rat lumbar spine fusion model. Application of PSCs was superior across metrics to either the use of unpurified, culture-defined adipose-derived stromal cells or autograft bone alone. Under coculture conditions, PSCs negatively regulated osteoclast formation and did so via secreted, nonvesicular paracrine factors. Total RNA sequencing identified secreted factors overexpressed by PSCs which may explain their negative regulation of graft resorption. In summary, PSCs reduce osteoclast formation and prevent bone graft resorption in high turnover states such as gonadectomy-induced osteoporosis.
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Affiliation(s)
- Stefano Negri
- Department of PathologyJohns Hopkins UniversityBaltimoreMarylandUSA
- Orthopaedic and Trauma Surgery Unit, Department of Surgery, DentistryPaediatrics and Gynaecology of the University of VeronaVeronaItaly
| | - Yiyun Wang
- Department of PathologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Takashi Sono
- Department of PathologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Seungyong Lee
- Department of PathologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Jiajia Xu
- Department of PathologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Qizhi Qin
- Department of PathologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Kristen Broderick
- Department of Plastic SurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Kenneth W. Witwer
- Departments of Molecular and Comparative Pathobiology and NeurologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Bruno Peault
- UCLA and Orthopaedic Hospital Department of Orthopaedic Surgery and the Orthopaedic Hospital Research CenterLos AngelesCaliforniaUSA
- Center for Cardiovascular Science and MRC Center for Regenerative MedicineUniversity of EdinburghEdinburghUK
| | - Aaron W. James
- Department of PathologyJohns Hopkins UniversityBaltimoreMarylandUSA
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17
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Wang Y, Huang L, Qin Z, Yuan H, Li B, Pan Y, Wang X, Du X, Hao S, Du Y, Wang R, Shen Y. Parathyroid hormone ameliorates osteogenesis of human bone marrow mesenchymal stem cells against glucolipotoxicity through p38 MAPK signaling. IUBMB Life 2020; 73:213-222. [PMID: 33249758 DOI: 10.1002/iub.2420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 01/13/2023]
Abstract
Diabetes mellitus (DM)-induced glucolipotoxicity is a factor strongly contributing to alveolar bone deficiency. Parathyroid hormone (PTH) has been identified as a main systemic mediator to balance physiological calcium in bone. This study aimed to uncover PTH's potential role in ameliorating the osteogenic capacity of human bone marrow mesenchymal stem cells (HBMSCs) against glucolipotoxicity. Optimal PTH concentrations and high glucose and palmitic acid (GP) were administered to cells, followed by alkaline phosphatase (ALP) staining and ALP activity assay. Quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR) and Immunoblot were carried out for assessing mRNA and protein amounts, respectively. Cell counting kit-8 (CCK-8) and flow cytometry were performed for quantitating cell proliferation. Osteogenesis and oxidative stress were determined, and the involvement of mitogen-activated protein kinase (MAPK) signaling was further verified. About 1-50 mmol/ml GP significantly inhibited the osteogenic differentiation of HBMSCs. 10-9 mol/L PTH was found to be the optimal concentration for HBMSC induction. PTH had no effects on HBMSC proliferation, with or without GP treatment. PTH reversed inadequate osteogenesis and excessive oxidative stress in GP-treated HBMSCs. Mechanistically, PTH activated p38 MAPK signaling, while inhibiting p38 MAPK-suppressed PTH's beneficial impacts on HBMSCs. Collectively, PTH promotes osteogenic differentiation in HBMSCs against glucolipotoxicity via p38 MAPK signaling.
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Affiliation(s)
- Yuli Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Lintong Huang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Ziyue Qin
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Hua Yuan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Bing Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Yongchu Pan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Xiaoqian Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontist, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Xin Du
- State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China
| | - Shushu Hao
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Yifei Du
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Ruixia Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Dental Implant, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Yi Shen
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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18
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Zhang C, Shi J, Chang M, Yuan X, Zhang R, Huang H, Tang S. Does Osteoporosis Affect the Adjacent Segments Following Anterior Lumbar Interbody Fusion? A Finite Element Study. World Neurosurg 2020; 146:e739-e746. [PMID: 33171324 DOI: 10.1016/j.wneu.2020.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adjacent segment degeneration is a common complication following anterior lumbar interbody fusion (ALIF). Osteoporosis is becoming increasingly prevalent in the elderly population and thus patients undergoing ALIF may experience osteoporosis with age. However, the influence of osteoporosis on adjacent segment degeneration after ALIF remains unclear. METHODS Three finite element models of the L3-S1 segment, including a healthy model, an ALIF model, and an ALIF with osteoporosis model, were used for analysis. ALIF was simulated at the L4-L5 segment. Based on a hybrid test method, the models were imposed with a preload of 400 N and an adjusted moment in flexion, extension, lateral bending, and axial torsion. Intradiscal pressure, shear stress on anulus fibrosus, and range of motion at L3-L4 and L5-S1 were calculated and compared. RESULTS In each direction, the maximal values of intradiscal pressure and shear stress on anulus fibrosus at L3-L4 and L5-S1 were found in the ALIF model, and the minimal values were found in the healthy model. At L3-L4 and L5-S1, the maximal values of range of motion in most directions were found in the ALIF model followed by the ALIF with osteoporosis model, and the minimal values were found in the healthy model. However, the maximal value of range of motion at L5-S1 in axial torsion was found in the ALIF with osteoporosis model. CONCLUSIONS Osteoporosis may mitigate the adverse influence of ALIF on adjacent segments.
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Affiliation(s)
- Chenchen Zhang
- School of Chinese Medicine, Jinan University, Guangzhou, China
| | - Jing Shi
- School of Chinese Medicine, Jinan University, Guangzhou, China
| | - Minmin Chang
- School of Chinese Medicine, Jinan University, Guangzhou, China
| | - Xin Yuan
- School of Chinese Medicine, Jinan University, Guangzhou, China
| | - Renwen Zhang
- School of Chinese Medicine, Jinan University, Guangzhou, China
| | - Honghao Huang
- School of Chinese Medicine, Jinan University, Guangzhou, China
| | - Shujie Tang
- School of Chinese Medicine, Jinan University, Guangzhou, China.
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Sheinberg DL, Perez-Roman RJ, Lugo-Pico JG, Cajigas I, Madhavan KH, Green BA, Gjolaj JP. Effects of menopausal state on lumbar decompression and fusion surgery. J Clin Neurosci 2020; 77:157-162. [PMID: 32387254 DOI: 10.1016/j.jocn.2020.04.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/06/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
Menopause leads to fluctuations in androgenic hormones which directly affect bone metabolism. Bone resorption, mineralization, and remodeling at fusion sites are essential in order to obtain a solid and biomechanically stable fusion mass. Bone metabolic imbalance seen in the postmenopausal state may predispose to fusion related complications. The aim of this study was to investigate fusion outcomes in lumbar spinal fusion surgery in women based on menopausal status. A retrospective analysis of all female patients who underwent posterior lumbar decompression and fusion at a single institution from 2013 to 2017 was performed. A total of 112 patients were identified and stratified into premenopausal (n = 25) and postmenopausal (n = 87) groups. Clinical and radiographic data was assessed at 1 year follow up. Postmenopausal patients had a higher rates of pseudarthrosis (11.63% vs 0%, p = 0.08), PJK (15.1% vs 4%, p = 0.14), and revision surgery (3.5% vs 0%, p = 0.35). The number of levels fused was associated with increased risk of pseudarthrosis (OR 1.4, p = 0.02); however, there was no association between age, hormonal use, prior tobacco use, or T-score. Age was associated with increased risk of developing PJK (OR = 1.11, p = 0.01); however, PJK was not associated with menopause, hormonal use, prior tobacco use, or T-score. Revision surgery was not associated with age, hormonal use, prior tobacco use, or T-score. This study suggests that postmenopausal women may be prone to have higher rates of pseudarthrosis, PJK and revision surgery, although our results were not statistically significant. Larger studies with longer follow up will help elucidate the true effects of menopause in spine surgery.
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Affiliation(s)
- Dallas L Sheinberg
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Roberto J Perez-Roman
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Julian G Lugo-Pico
- Department of Orthopedics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Iahn Cajigas
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Karthik H Madhavan
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Barth A Green
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joseph P Gjolaj
- Department of Orthopedics, University of Miami Miller School of Medicine, Miami, FL, USA
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20
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Bei MJ, Tian FM, Xiao YP, Cao XH, Liu N, Zheng ZY, Dai MW, Wang WY, Song HP, Zhang L. Raloxifene retards cartilage degradation and improves subchondral bone micro-architecture in ovariectomized rats with patella baja-induced - patellofemoral joint osteoarthritis. Osteoarthritis Cartilage 2020; 28:344-355. [PMID: 31326553 DOI: 10.1016/j.joca.2019.06.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 06/04/2019] [Accepted: 06/10/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Abnormal remodeling of subchondral bone (SB) induced by estrogen deficiency has been shown to be involved in osteoarthritis (OA). Raloxifene (RAL) is commonly used to treat postmenopausal osteoporosis (OP). However, little is known about its effects on OA combined with estrogen deficiency. This study was performed to evaluate the efficacy of RAL on patella baja-induced patellofemoral joint OA (PFJOA) in an ovariectomized rat model. DESIGN Patellar ligament shortening (PLS) and ovariectomy (OVX) were performed simultaneously in 3-month-old female Sprague-Dawley rats, which were treated with RAL (10 mg/kg/day) or vehicle at 72 h postoperatively for 10 weeks. PFJOA was assessed by immunohistochemistry (IHC), real-time polymerase chain reaction (PCR), tartrate-resistant acid phosphatase (TRAP) staining, enzyme-linked immunosorbent assay (ELISA), micro-computed tomography (μCT), histomorphology and behavioral analyses. RESULTS X-ray examinations showed that patella baja was successfully established by PLS. Histomorphological analysis revealed that PFJOA was significantly exacerbated by OVX and markedly alleviated by RAL. Moreover, RAL improved cartilage metabolism by decreasing MMP-13, ADAMTS-4, and caspase-3 and increasing Col-II and aggrecan at both the protein and mRNA levels. Furthermore, RAL markedly improved bone mass and SB microarchitecture and reduced osteoclast numbers and the serum osteocalcin and CTX-I levels. Although RAL showed a trend toward reducing pain sensitivity based on mechanical allodynia testing, this result was not statistically significant. CONCLUSION These findings demonstrate that RAL treatment retards PFJOA progression in an ovariectomized rat model, suggesting that it may be a potential candidate for amelioration of the progression of PFJOA accompanied by postmenopausal OP.
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Affiliation(s)
- M-J Bei
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, PR China.
| | - F-M Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, Hebei, PR China.
| | - Y-P Xiao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, PR China.
| | - X-H Cao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, PR China.
| | - N Liu
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, PR China.
| | - Z-Y Zheng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, PR China.
| | - M-W Dai
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, PR China.
| | - W-Y Wang
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, PR China.
| | - H-P Song
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, PR China.
| | - L Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, PR China.
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21
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Ge X, Li Z, Jing S, Wang Y, Li N, Lu J, Yu J. Parathyroid hormone enhances the osteo/odontogenic differentiation of dental pulp stem cells via ERK and P38 MAPK pathways. J Cell Physiol 2019; 235:1209-1221. [PMID: 31276209 DOI: 10.1002/jcp.29034] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/12/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Parathyroid hormone (PTH) is a main systemic mediator of calcium and phosphate homeostasis in the bone. Dental pulp stem cells (DPSCs) have been extensively studied in the regeneration of bone and tooth tissues. This paper aims to uncover the influences of PTH on the proliferative ability and osteo/odontogenic differentiation of DPSCs, as well as the underlying mechanisms. MATERIALS AND METHODS The optimal concentration of PTH on DPSCs was determined by alkaline phosphatase (ALP) activity assay, ALP staining and western blot analysis. Proliferative ability and cell cycle distribution of DPSCs were analyzed by Cell counting kit-8, 5-ethynyl-20-deoxyuridine assay, and flow cytometry. Osteo/odontogenic capacity of DPSCs was evaluated and finally, the involvement of mitogen-activated protein kinase (MAPK) pathway was assessed. RESULTS Purified DPSCs were obtained by enzymatic digestion, which presented a typical fibroblast-like morphology. 10-9 mol/L PTH was concerned as the optimal concentration for DPSCs induction. 10-9 mol/L PTH treatment did not change the proliferative rate of DPSCs (p > .05). Relative expressions of DSPP/DSPP, RUNX2/RUNX2, OSX/OSX, and ALP/ALP were upregulated in PTH-treated DPSCs relative to control group. Particularly, their mRNA/protein levels at Day 7 were markedly higher relative to those at Day 3 (p < .05 or p < .01). Mineralized nodules were formed after PTH induction, and calcium content increased by cetylpyridinium chloride quantitative analysis. Mechanistically, the protein levels of p-ERK and p-P38 significantly increased after PTH treatment, and the inhibitors targeting MAPK were identified that weakened the effects of PTH on the committed differentiation of DPSCs. CONCLUSIONS PTH enhances the osteo/odontogenic differentiation capacity of DPSCs via ERK and P38 signaling pathways.
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Affiliation(s)
- Xingyun Ge
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zehan Li
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shuanglin Jing
- Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yanqiu Wang
- Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Na Li
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiamin Lu
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jinhua Yu
- Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
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22
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Hashimoto K, Aizawa T, Kanno H, Itoi E. Adjacent segment degeneration after fusion spinal surgery—a systematic review. INTERNATIONAL ORTHOPAEDICS 2018; 43:987-993. [DOI: 10.1007/s00264-018-4241-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
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23
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Ciliary parathyroid hormone signaling activates transforming growth factor-β to maintain intervertebral disc homeostasis during aging. Bone Res 2018; 6:21. [PMID: 30038820 PMCID: PMC6050246 DOI: 10.1038/s41413-018-0022-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 05/25/2018] [Indexed: 02/05/2023] Open
Abstract
Degenerative disc disease (DDD) is associated with intervertebral disc degeneration of spinal instability. Here, we report that the cilia of nucleus pulposus (NP) cells mediate mechanotransduction to maintain anabolic activity in the discs. We found that mechanical stress promotes transport of parathyroid hormone 1 receptor (PTH1R) to the cilia and enhances parathyroid hormone (PTH) signaling in NP cells. PTH induces transcription of integrin αvβ6 to activate the transforming growth factor (TGF)-β-connective tissue growth factor (CCN2)-matrix proteins signaling cascade. Intermittent injection of PTH (iPTH) effectively attenuates disc degeneration of aged mice by direct signaling through NP cells, specifically improving intervertebral disc height and volume by increasing levels of TGF-β activity, CCN2, and aggrecan. PTH1R is expressed in both mouse and human NP cells. Importantly, knockout PTH1R or cilia in the NP cells results in significant disc degeneration and blunts the effect of PTH on attenuation of aged discs. Thus, mechanical stress-induced transport of PTH1R to the cilia enhances PTH signaling, which helps maintain intervertebral disc homeostasis, particularly during aging, indicating therapeutic potential of iPTH for DDD. Sensory structures found in the jelly-like space between spinal discs release a hormone that helps preserve back health in aging mice. Xu Cao from Johns Hopkins University in Baltimore, Maryland, USA, and colleagues observed that levels of a critical growth factor declined in the space between adjacent vertebrae as mice aged, and that injecting a naturally occurring hormone that activates this growth factor could attenuate disc degeneration in older animals. The researchers showed, in response to mechanical stresses, receptor proteins that respond to this hormone relocate themselves to particular sensory organelles known as cilia that found within cells of the intervertebral core. That results in elevated hormone signaling—and drugs designed to have the same effect could help treat degenerative disc disease, one of the most common causes of chronic back pain.
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24
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Abstract
PURPOSE In patients undergoing lumbar fusion, osteoporosis has been shown to lead to poorer outcomes and greater incidence of fusion-related complications. Given the undesirable effect of osteoporosis on lumbar fusion surgery, a number of medications have been proposed for use in the peri- and postoperative period to mitigate risks and enhance outcomes. The purpose of this review was to summarize and synthesize the current literature regarding medical management of osteoporosis in the context of lumbar fusion surgery. METHODS A literature search of PubMed, Embase, and Web of Science was conducted in October 2016, using permutations of various search terms related to osteoporosis, medications, and lumbar fusion. RESULTS Teriparatide injections may lead to faster, more successful fusion, and may reduce fusion-related complications. Bisphosphonate therapy likely does not hinder fusion outcomes and may be useful in reducing certain complications of fusion in osteoporotic patients. Calcitonin and selective estrogen receptor modulator therapy show mixed results, but more research is necessary to make a recommendation. Vitamin D deficiency is associated with poor fusion outcomes, but evidence for supplementation in patients with normal serum levels is weak. CONCLUSIONS Overall, the current body of research appears to support the use of teriparatide therapy to enhance lumbar fusion outcomes in the osteoporotic patient, although the extent of research on this topic is limited. Additionally, very little evidence exists to cease any of the mentioned osteoporosis treatments prior to lumbar fusion.
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Affiliation(s)
| | | | - Vafa Tabatabaie
- Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Endocrinology, Montefiore Medical Center, Bronx, NY, USA
| | - Woojin Cho
- Albert Einstein College of Medicine, Bronx, NY, USA. .,Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA.
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25
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Luo Y, Li SY, Tian FM, Song HP, Zhang YZ, Zhang L. Effects of human parathyroid hormone 1-34 on bone loss and lumbar intervertebral disc degeneration in ovariectomized rats. INTERNATIONAL ORTHOPAEDICS 2018; 42:1183-1190. [PMID: 29442158 DOI: 10.1007/s00264-018-3821-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 01/29/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Lumbar intervertebral disc degeneration is a common cause of lower back pain that affects the physical and mental health of patients and increases social burden. Parathyroid hormone has been reported to be effective at inhibiting disc degeneration; however, these effects have not been fully established in vivo in ovariectomized (OVX) rats. Thus, in this study, we aimed to address this issue and examine the effects of parathyroid hormone treatment in OVX rats. METHODS Thirty female Sprague-Dawley rats, three months-old, were subjected to sham or ovariectomy surgery. Twelve weeks postsurgery, OVX rats were treated with either human parathyroid hormone [hPTH(1-34), 30 μg/kg/day] or vehicle (normal saline (NS)) treatment. The L3-6 spinal segments were harvested after 12 weeks treatment. Bone mineral density (BMD), micro-architectural parameters, and biomechanical assessment were measured at the lumbar vertebral bodies. Histology and immunohistochemistry were performed to analyze the characteristics of the lumbar intervertebral discs. RESULTS OVX + PTH rats had significantly higher BMD, percentage bone volume density, trabecular thickness, and biomechanical strength compared with those in Sham and OVX + NS rats. Histology and immunostaining revealed that disc degeneration was not significantly different between the OVX + NS rats and the OVX + PTH rats, compared with the Sham group; the structure of nucleus pulposus was disordered, the expression of collagen I was increased, and collagen II and aggrecan were decreased. CONCLUSIONS These findings confirmed that hPTH(1-34) treatment has substantial anabolic effects on bone mass and trabecular micro-architecture, while the excessively enhanced bone mass and strength were coupled with a non-significant effect on the disc degeneration in ovariectomized rats.
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Affiliation(s)
- Yang Luo
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, No. 73 Jianshe South Rd, Tangshan, 063000, Hebei, People's Republic of China.,Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Shu-Yang Li
- College of Traditional Chinese Medicine, Inner Mongolia Medical University, Huhehaote, People's Republic of China
| | - Fa-Ming Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Hui-Ping Song
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, No. 73 Jianshe South Rd, Tangshan, 063000, Hebei, People's Republic of China
| | - Ying-Ze Zhang
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Liu Zhang
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, No. 73 Jianshe South Rd, Tangshan, 063000, Hebei, People's Republic of China.
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26
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Sittadjody S, Saul JM, McQuilling JP, Joo S, Register TC, Yoo JJ, Atala A, Opara EC. In vivo transplantation of 3D encapsulated ovarian constructs in rats corrects abnormalities of ovarian failure. Nat Commun 2017; 8:1858. [PMID: 29208899 PMCID: PMC5717171 DOI: 10.1038/s41467-017-01851-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 10/20/2017] [Indexed: 01/07/2023] Open
Abstract
Safe clinical hormone replacement (HR) will likely become increasingly important in the growing populations of aged women and cancer patients undergoing treatments that ablate the ovaries. Cell-based HRT (cHRT) is an alternative approach that may allow certain physiological outcomes to be achieved with lower circulating hormone levels than pharmacological means due to participation of cells in the hypothalamus-pituitary-ovary feedback control loop. Here we describe the in vivo performance of 3D bioengineered ovarian constructs that recapitulate native cell-cell interactions between ovarian granulosa and theca cells as an approach to cHRT. The constructs are fabricated using either Ca++ or Sr++ to crosslink alginate. Following implantation in ovariectomized (ovx) rats, the Sr++-cross-linked constructs achieve stable secretion of hormones during 90 days of study. Further, we show these constructs with isogeneic cells to be effective in ameliorating adverse effects of hormone deficiency, including bone health, uterine health, and body composition in this rat model.
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Affiliation(s)
- Sivanandane Sittadjody
- Wake Forest Institute for Regenerative Medicine, Wake Forest School for Medicine, Winston-Salem, NC, 27157, USA
| | - Justin M Saul
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, OH, 45056, USA
| | - John P McQuilling
- Wake Forest Institute for Regenerative Medicine, Wake Forest School for Medicine, Winston-Salem, NC, 27157, USA
- School of Biomedical Engineering and Sciences (SBES), Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Sunyoung Joo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School for Medicine, Winston-Salem, NC, 27157, USA
| | - Thomas C Register
- Department of Pathology, Section on Comparative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School for Medicine, Winston-Salem, NC, 27157, USA
- School of Biomedical Engineering and Sciences (SBES), Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Anthony Atala
- Wake Forest Institute for Regenerative Medicine, Wake Forest School for Medicine, Winston-Salem, NC, 27157, USA
- School of Biomedical Engineering and Sciences (SBES), Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Emmanuel C Opara
- Wake Forest Institute for Regenerative Medicine, Wake Forest School for Medicine, Winston-Salem, NC, 27157, USA.
- School of Biomedical Engineering and Sciences (SBES), Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
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27
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Liu GY, Cao GL, Tian FM, Song HP, Yuan LL, Geng LD, Zheng ZY, Zhang L. Parathyroid hormone (1-34) promotes fracture healing in ovariectomized rats with type 2 diabetes mellitus. Osteoporos Int 2017; 28:3043-3053. [PMID: 28808745 DOI: 10.1007/s00198-017-4148-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
UNLABELLED Ovariectomized (OVX) rats with type 2 diabetes mellitus (T2DM) with femur fracture received vehicle, insulin, or insulin plus parathyroid hormone (PTH) treatment for 2 and 3 weeks. Radiography, histomorphometry, histology, and immunohistochemistry in callus were evaluated. INTRODUCTION Reports about effects of PTH plus insulin on callus formation of osteoporotic fracture with T2DM were limited. This study was designed to investigate the effects of the combination of PTH and insulin on fracture healing in OVX rats with T2DM. METHODS Two-month-old female rats were randomly divided into five groups: normal fracture (F), OVX fracture (OF), T2DM + OVX fracture (DOF), insulin-treated (2-4 u/daylight, 4-6 u/night, DOFI), and treated with insulin and PTH (50 μg/kg/day, 5 days/week, DOFIP). A closed mid-shaft fracture was established in the right femurs of all rats after 6 weeks of OVX. Rats were euthanized at 2 and 3 weeks post-fracture according to the time schedule, respectively. RESULTS The administration of insulin alone or insulin combined with PTH significantly increased mineralized bone volume fraction (BV/TV) and connectivity density (Conn.D) compared with those of the DOF group at 3 weeks post-fracture and also increased cartilaginous callus area ratio in the DOFI and DOFIP groups at 2 weeks and bony callus area ratio in the DOFIP groups at both the 2 and 3 weeks post-fracture. CONCLUSIONS OVX rats with T2DM exhibited a marked delay in the fracture healing process; insulin treatment ameliorated these effects, and the healing process was enhanced following treatment with a combination of insulin and PTH.
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Affiliation(s)
- G Y Liu
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - G L Cao
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - F M Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, China
| | - H P Song
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L L Yuan
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L D Geng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Z Y Zheng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China.
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China.
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