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Koh NYY, Miszkiewicz JJ, Fac ML, Wee NKY, Sims NA. Preclinical Rodent Models for Human Bone Disease, Including a Focus on Cortical Bone. Endocr Rev 2024; 45:493-520. [PMID: 38315213 PMCID: PMC11244217 DOI: 10.1210/endrev/bnae004] [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: 06/15/2023] [Revised: 11/22/2023] [Accepted: 02/02/2024] [Indexed: 02/07/2024]
Abstract
Preclinical models (typically ovariectomized rats and genetically altered mice) have underpinned much of what we know about skeletal biology. They have been pivotal for developing therapies for osteoporosis and monogenic skeletal conditions, including osteogenesis imperfecta, achondroplasia, hypophosphatasia, and craniodysplasias. Further therapeutic advances, particularly to improve cortical strength, require improved understanding and more rigorous use and reporting. We describe here how trabecular and cortical bone structure develop, are maintained, and degenerate with aging in mice, rats, and humans, and how cortical bone structure is changed in some preclinical models of endocrine conditions (eg, postmenopausal osteoporosis, chronic kidney disease, hyperparathyroidism, diabetes). We provide examples of preclinical models used to identify and test current therapies for osteoporosis, and discuss common concerns raised when comparing rodent preclinical models to the human skeleton. We focus especially on cortical bone, because it differs between small and larger mammals in its organizational structure. We discuss mechanisms common to mouse and human controlling cortical bone strength and structure, including recent examples revealing genetic contributors to cortical porosity and osteocyte network configurations during growth, maturity, and aging. We conclude with guidelines for clear reporting on mouse models with a goal for better consistency in the use and interpretation of these models.
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Affiliation(s)
- Natalie Y Y Koh
- Bone Cell Biology & Disease Unit, St. Vincent's Institute of Medical Research, Fitzroy, VIC 3065, Australia
- Department of Medicine at St. Vincent's Hospital, The University of Melbourne, Fitzroy, VIC 3065, Australia
| | - Justyna J Miszkiewicz
- School of Social Science, The University of Queensland, Brisbane, QLD 4072, Australia
- Vertebrate Evolution Development and Ecology, Naturalis Biodiversity Center, 2333 CR Leiden, The Netherlands
| | - Mary Louise Fac
- Bone Cell Biology & Disease Unit, St. Vincent's Institute of Medical Research, Fitzroy, VIC 3065, Australia
- Department of Medicine at St. Vincent's Hospital, The University of Melbourne, Fitzroy, VIC 3065, Australia
| | - Natalie K Y Wee
- Bone Cell Biology & Disease Unit, St. Vincent's Institute of Medical Research, Fitzroy, VIC 3065, Australia
- Department of Medicine at St. Vincent's Hospital, The University of Melbourne, Fitzroy, VIC 3065, Australia
| | - Natalie A Sims
- Bone Cell Biology & Disease Unit, St. Vincent's Institute of Medical Research, Fitzroy, VIC 3065, Australia
- Department of Medicine at St. Vincent's Hospital, The University of Melbourne, Fitzroy, VIC 3065, Australia
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2
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Hegarty-Cremer SGD, Borggaard XG, Andreasen CM, van der Eerden BCJ, Simpson MJ, Andersen TL, Buenzli PR. How osteons form: A quantitative hypothesis-testing analysis of cortical pore filling and wall asymmetry. Bone 2024; 180:116998. [PMID: 38184100 DOI: 10.1016/j.bone.2023.116998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/08/2024]
Abstract
Osteon morphology provides valuable information about the interplay between different processes involved in bone remodelling. The correct quantitative interpretation of these morphological features is challenging due to the complexity of interactions between osteoblast behaviour, and the evolving geometry of cortical pores during pore closing. We present a combined experimental and mathematical modelling study to provide insights into bone formation mechanisms during cortical bone remodelling based on histological cross-sections of quiescent human osteons and hypothesis-testing analyses. We introduce wall thickness asymmetry as a measure of the local asymmetry of bone formation within an osteon and examine the frequency distribution of wall thickness asymmetry in cortical osteons from human iliac crest bone samples from women 16-78 years old. Our measurements show that most osteons possess some degree of asymmetry, and that the average degree of osteon asymmetry in cortical bone evolves with age. We then propose a comprehensive mathematical model of cortical pore filling that includes osteoblast secretory activity, osteoblast elimination, osteoblast embedment as osteocytes, and osteoblast crowding and redistribution along the bone surface. The mathematical model is first calibrated to symmetric osteon data, and then used to test three mechanisms of asymmetric wall formation against osteon data: (i) delays in the onset of infilling around the cement line; (ii) heterogeneous osteoblastogenesis around the bone perimeter; and (iii) heterogeneous osteoblast secretory rate around the bone perimeter. Our results suggest that wall thickness asymmetry due to off-centred Haversian pores within osteons, and that nonuniform lamellar thicknesses within osteons are important morphological features that can indicate the prevalence of specific asymmetry-generating mechanisms. This has significant implications for the study of disruptions of bone formation as it could indicate what biological bone formation processes may become disrupted with age or disease.
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Affiliation(s)
- Solene G D Hegarty-Cremer
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia; Department of Mathematics and Statistics, The University of Montreal, Montreal, Canada
| | - Xenia G Borggaard
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | - Christina M Andreasen
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | | | - Matthew J Simpson
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Thomas L Andersen
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark; Dept. of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Pascal R Buenzli
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia.
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3
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Costa da Silva RG, Sun TC, Mishra AP, Boyde A, Doube M, Riggs CM. Intracortical remodelling increases in highly loaded bone after exercise cessation. J Anat 2024; 244:424-437. [PMID: 37953410 PMCID: PMC10862154 DOI: 10.1111/joa.13969] [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: 06/16/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023] Open
Abstract
Resorption within cortices of long bones removes excess mass and damaged tissue and increases during periods of reduced mechanical loading. Returning to high-intensity exercise may place bones at risk of failure due to increased porosity caused by bone resorption. We used point-projection X-ray microscopy images of bone slices from highly loaded (metacarpal, tibia) and minimally loaded (rib) bones from 12 racehorses, 6 that died during a period of high-intensity exercise and 6 that had a period of intense exercise followed by at least 35 days of rest prior to death, and measured intracortical canal cross-sectional area (Ca.Ar) and number (N.Ca) to infer remodelling activity across sites and exercise groups. Large canals that are the consequence of bone resorption (Ca.Ar >0.04 mm2 ) were 1.4× to 18.7× greater in number and area in the third metacarpal bone from rested than exercised animals (p = 0.005-0.008), but were similar in number and area in ribs from rested and exercised animals (p = 0.575-0.688). An intermediate relationship was present in the tibia, and when large canals and smaller canals that result from partial bony infilling (Ca.Ar >0.002 mm2 ) were considered together. The mechanostat may override targeted remodelling during periods of high mechanical load by enhancing bone formation, reducing resorption and suppressing turnover. Both systems may work synergistically in rest periods to remove excess and damaged tissue.
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Affiliation(s)
| | - Tsim Christopher Sun
- Sydney School of Veterinary ScienceUniversity of SydneyCamperdownNew South WalesAustralia
| | - Ambika Prasad Mishra
- Department of Infectious Diseases and Public HealthCity University of Hong KongKowloonHong Kong
| | - Alan Boyde
- Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Michael Doube
- Department of Infectious Diseases and Public HealthCity University of Hong KongKowloonHong Kong
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4
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Mertens TF, Liebheit AT, Ehl J, Köhler R, Rakhymzhan A, Woehler A, Katthän L, Ebel G, Liublin W, Kasapi A, Triantafyllopoulou A, Schulz TJ, Niesner RA, Hauser AE. MarShie: a clearing protocol for 3D analysis of single cells throughout the bone marrow at subcellular resolution. Nat Commun 2024; 15:1764. [PMID: 38409121 PMCID: PMC10897183 DOI: 10.1038/s41467-024-45827-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 02/01/2024] [Indexed: 02/28/2024] Open
Abstract
Analyzing immune cell interactions in the bone marrow is vital for understanding hematopoiesis and bone homeostasis. Three-dimensional analysis of the complete, intact bone marrow within the cortex of whole long bones remains a challenge, especially at subcellular resolution. We present a method that stabilizes the marrow and provides subcellular resolution of fluorescent signals throughout the murine femur, enabling identification and spatial characterization of hematopoietic and stromal cell subsets. By combining a pre-processing algorithm for stripe artifact removal with a machine-learning approach, we demonstrate reliable cell segmentation down to the deepest bone marrow regions. This reveals age-related changes in the marrow. It highlights the interaction between CX3CR1+ cells and the vascular system in homeostasis, in contrast to other myeloid cell types, and reveals their spatial characteristics after injury. The broad applicability of this method will contribute to a better understanding of bone marrow biology.
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Affiliation(s)
- Till Fabian Mertens
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Immune Dynamics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Alina Tabea Liebheit
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Immune Dynamics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
- Institute of Chemistry and Biochemistry, Department of Biology, Chemistry and Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Johanna Ehl
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Immune Dynamics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Ralf Köhler
- Immune Dynamics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Asylkhan Rakhymzhan
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Biophysical Analytics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Andrew Woehler
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, 10115, Berlin, Germany
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA, 20147, USA
| | - Lukas Katthän
- Miltenyi Biotec B.V. and Co. Bertha-von-Suttner-Straße 5, 37085, Göttingen, Germany
| | - Gernot Ebel
- Miltenyi Biotec B.V. and Co. Bertha-von-Suttner-Straße 5, 37085, Göttingen, Germany
| | - Wjatscheslaw Liublin
- Biophysical Analytics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Ana Kasapi
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Innate Immunity in Rheumatic Diseases, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Antigoni Triantafyllopoulou
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Innate Immunity in Rheumatic Diseases, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
| | - Tim Julius Schulz
- Department of Adipocyte Development and Nutrition, German Institute of Human Nutrition (DIfE) Potsdam-Rehbruecke, 14558, Nuthetal, Germany
- German Center for Diabetes Research (DZD), 85764, Munich-Neuherberg, Germany
| | - Raluca Aura Niesner
- Biophysical Analytics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany
- Dynamic and Functional in vivo Imaging, Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Anja Erika Hauser
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany.
- Immune Dynamics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Charitéplatz 1, 10117, Berlin, Germany.
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5
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Loundagin LL, Harrison KD, Wei X, Cooper DML. Understanding basic multicellular unit activity in cortical bone through 3D morphological analysis: New methods to define zones of the remodeling space. Bone 2024; 179:116960. [PMID: 37972746 DOI: 10.1016/j.bone.2023.116960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/27/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
The activity of basic multicellular units (BMU) in cortical bone is classically described as a sequential order of events- resorption, reversal and formation. This simplified portrayal of the remodeling process is pervasive despite the reported variability in remodeling space morphology. These variations may reflect meaningful nuances in BMU activity but methods to quantify 3D remodeling space morphology within the context of the cellular activity are currently lacking. This study developed new techniques to define zones of BMU activity based on the 3D morphology of remodeling spaces in rabbit cortical bone and integrated morphological data with the BMU longitudinal erosion rate (LER) to elucidate the spatial-temporal coordination of BMUs and estimate mineral apposition rate (MAR). The tibiae of New Zealand white rabbits (n = 5) were imaged in vivo using synchrotron radiation and two weeks later ex vivo with desktop microCT. The in vivo and ex vivo datasets were co-registered, and 27 remodeling spaces were identified at both timepoints. A radial profile representing the 3D morphology was the platform for partitioning the remodeling spaces into resorption, reversal and formation zones. Manual, automated and semi-automated partitioning approaches were compared, and the zone-segmentations were used to calculate the length, change in radius and slope of each zone. The manual approach most accurately defined the zones of idealized remodeling spaces with known dimensions (relative error = 0.9-9.2 %) while the semi-automated method reliably defined the zones in rabbit remodeling spaces (ICC = 0.85-1.00). Combining LER and the manually derived zone dimensions indicated that a BMU passes through a cross-section in approximately 18.8 days with resorption, reversal and formation taking 4.1, 2.2, and 12.5 days, respectively. MAR estimated by the 3D analysis was not significantly different than that determined with classic histomorphometry (p = 0.48). These techniques have the potential to assess dynamic parameters of bone resorption and formation, eliminate the need for fluorochrome labeling and provide a more comprehensive perspective of the remodeling process.
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Affiliation(s)
- Lindsay L Loundagin
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
| | - Kim D Harrison
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Xuan Wei
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - David M L Cooper
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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6
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Hoshi-Numahata M, Takakura A, Nakanishi-Kimura A, Watanabe H, Takada K, Nishiura M, Sato Y, Takao-Kawabata R, Iimura T. Evaluation of cortical bone remodeling in canines treated with daily and weekly administrations of teriparatide by establishing AI-driven morphometric analyses and GIS-based spatial mapping. Bone Rep 2023; 19:101720. [PMID: 37915737 PMCID: PMC10616120 DOI: 10.1016/j.bonr.2023.101720] [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: 09/03/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023] Open
Abstract
Larger animal models with a well-developed Haversian system, as observed in humans, are ideal to analyze cortical bone remodeling in pharmacological studies of anti-osteoporosis drugs, although they have some limitations in controlling individual variability in size, weight, age, and number. This study aimed to morphometrically analyze cortical bone remodeling focusing on Haversian canals in dogs using four regimens of TPTD with daily and weekly administrations at lower and higher weekly doses (4.9 μg/kg/week and 19.8 μg/kg/week, respectively) for 9 months. A micro-computed tomography-based analysis showed no significant differences among regimen groups. By establishing artificial intelligence (AI)-driven morphometric analyses and geographical information system (GIS)-based spatial mapping of Haversian canals that does not require confocal microscopy but is possible with more commonly used wide field microscopes, we successfully observed significant morphometric distinctions among regimens applied even in dogs. Our analytical results suggested that the daily higher regimen specifically increased the number of eroded pores creating spaces between existing canals, thus stimulating cortical bone remodeling.
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Affiliation(s)
- Marie Hoshi-Numahata
- Department of Pharmacology, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
- Department of Orthodontics, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
| | - Aya Takakura
- Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation, 632-1 Mifuku, Izunokuni, Shizuoka 410-2321, Japan
| | - Atsuko Nakanishi-Kimura
- Department of Pharmacology, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
- Department of Orthodontics, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
| | - Haruhisa Watanabe
- Department of Pharmacology, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
- Department of Oral Medicine and Diagnostics, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
| | - Kentaro Takada
- Department of Natural History Sciences, Graduate School of Science, Hokkaido University, N10 W8, Sapporo 060-8010, Japan
| | - Mai Nishiura
- Department of Pharmacology, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
- Department of Dentistry for Children and Disabled Persons, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
| | - Yoshiaki Sato
- Department of Orthodontics, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
| | - Ryoko Takao-Kawabata
- Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation, 632-1 Mifuku, Izunokuni, Shizuoka 410-2321, Japan
| | - Tadahiro Iimura
- Department of Pharmacology, Faculty and Graduate School of Dental Medicine, Hokkaido University, N13 W7, Sapporo 060-8586, Japan
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7
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van Dijk Christiansen P, Andreasen CM, El-Masri BM, Laursen KS, Delaisse JM, Andersen TL. Osteoprogenitor recruitment and differentiation during intracortical bone remodeling of adolescent humans. Bone 2023; 177:116896. [PMID: 37699496 DOI: 10.1016/j.bone.2023.116896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 08/17/2023] [Accepted: 09/08/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Recruitment and proliferation of osteoprogenitors during the reversal-resorption phase, and their differentiation into mature bone-forming osteoblasts is crucial for initiation of bone formation during bone remodeling. This study investigates the osteoprogenitors' gradual recruitment, proliferation, and differentiation into bone-forming osteoblasts within intracortical remodeling events of healthy adolescent humans. METHODS The study was conducted on cortical bone specimens from 11 adolescent human controls - patients undergoing surgery due to coxa valga. The osteoprogenitor recruitment route and differentiation into osteoblasts were backtracked using immunostainings and in situ hybridizations with osteoblastic markers (CD271/NGFR, osterix/SP7, COL3A1 and COL1A1). The osteoblastic cell populations were defined based on the pore surfaces, and their proliferation index (Ki67), density and number/circumference were estimated in multiplex-immunofluorescence (Ki67, TRAcP, CD34) stained sections. RESULTS During the reversal-resorption phase, osteoclasts are intermixed with (COL3A1+NFGR+) osteoblastic reversal cells, which are considered to be osteoprogenitors of (COL1A1+SP7+) bone-forming osteoblasts. Initiation of bone formation requires a critical density of these osteoprogenitors (43 ± 9 cells/mm), which is reached though proliferation (4.4 ± 0.5 % proliferative) and even more so through recruitment of osteoprogenitors, but challenged by the ongoing expansion of the canal circumference. These osteoprogenitors most likely originate from osteoblastic bone lining cells and mainly lumen osteoprogenitors, which expand their population though proliferation (4.6 ± 0.3 %) and vascular recruitment. These lumen osteoprogenitors resemble canopy cells above trabecular remodeling sites, and like canopy cells they extend above bone-forming osteoblasts where they may rejuvenate the osteoblast population during bone formation. CONCLUSION Initiation of bone formation during intracortical remodeling requires a critical density of osteoprogenitors on eroded surfaces, which is reached though proliferation and recruitment of local osteoprogenitors: bone lining cells and lumen osteoprogenitors.
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Affiliation(s)
- Pernille van Dijk Christiansen
- Clinical Cell Biology, Research Unit of Pathology, Department of Pathology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Christina Møller Andreasen
- Clinical Cell Biology, Research Unit of Pathology, Department of Pathology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Danish Spatial Imaging Consortium (DanSIC).
| | - Bilal Mohamad El-Masri
- Clinical Cell Biology, Research Unit of Pathology, Department of Pathology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Danish Spatial Imaging Consortium (DanSIC).
| | - Kaja Søndergaard Laursen
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark; Danish Spatial Imaging Consortium (DanSIC).
| | - Jean-Marie Delaisse
- Clinical Cell Biology, Research Unit of Pathology, Department of Pathology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
| | - Thomas Levin Andersen
- Clinical Cell Biology, Research Unit of Pathology, Department of Pathology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Department of Forensic Medicine, Aarhus University, Aarhus, Denmark; Danish Spatial Imaging Consortium (DanSIC).
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8
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Syahruddin MH, Anggraeni R, Ana ID. A microfluidic organ-on-a-chip: into the next decade of bone tissue engineering applied in dentistry. Future Sci OA 2023; 9:FSO902. [PMID: 37753360 PMCID: PMC10518836 DOI: 10.2144/fsoa-2023-0061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
A comprehensive understanding of the complex physiological and pathological processes associated with alveolar bones, their responses to different therapeutics strategies, and cell interactions with biomaterial becomes necessary in precisely treating patients with severe progressive periodontitis, as a bone-related issue in dentistry. However, existing monolayer cell culture or pre-clinical models have been unable to mimic the complex physiological, pathological and regeneration processes in the bone microenvironment in response to different therapeutic strategies. In this point, 'organ-on-a-chip' (OOAC) technology, specifically 'alveolar-bone-on-a-chip', is expected to resolve the problems by better imitating infection site microenvironment and microphysiology within the oral tissues. The OOAC technology is assessed in this study toward better approaches in disease modeling and better therapeutics strategy for bone tissue engineering applied in dentistry.
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Affiliation(s)
- Muhammad Hidayat Syahruddin
- Postgraduate Student, Dental Science Doctoral Study Program, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Rahmi Anggraeni
- Research Center for Preclinical & Clinical Medicine, National Research & Innovation Agency of the Republic of Indonesia, Cibinong Science Center, Bogor, 16915, Indonesia
- Research Collaboration Center for Biomedical Scaffolds, National Research & Innovation Agency (BRIN) – Universitas Gadjah Mada (UGM), Yogyakarta, 55281, Indonesia
| | - Ika Dewi Ana
- Department of Dental Biomedical Sciences, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
- Research Collaboration Center for Biomedical Scaffolds, National Research & Innovation Agency (BRIN) – Universitas Gadjah Mada (UGM), Yogyakarta, 55281, Indonesia
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9
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Drejer LA, El-Masri BM, Ejersted C, Andreasen CM, Thomsen LK, Thomsen JS, Andersen TL, Hansen S. Trabecular bone deterioration in a postmenopausal female suffering multiple spontaneous vertebral fractures due to a delayed denosumab injection - A post-treatment re-initiation bone biopsy-based case study. Bone Rep 2023; 19:101703. [PMID: 37576928 PMCID: PMC10412862 DOI: 10.1016/j.bonr.2023.101703] [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: 03/16/2023] [Revised: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background Denosumab, is a potent anti-resorptive that, increases bone mineral density, and reduces fracture risk in osteoporotic patients. However, several case studies have reported multiple vertebral fractures in patients discontinuing denosumab. Case presentation This case report describes a 64-year-old female with postmenopausal osteoporosis treated with denosumab, who had her 11th injection delayed by 4 months. The patient suffered eight spontaneous vertebral fractures. After consent, an iliac crest bone biopsy was obtained following re-initiation of the denosumab treatment and analyzed by micro-computed tomography and histomorphometry. Results micro-computed tomography analysis revealed a low trabecular bone volume of 10 %, a low trabecular thickness of 97 μm, a low trabecular spacing of 546 μm, a high trabecular number of 1.8/mm, and a high structure model index of 2.2, suggesting trabecular thinning and loss of trabecular plates. Histomorphometric trabecular bone analysis revealed an eroded perimeter per bone perimeter of 33 % and an osteoid perimeter per bone perimeter of 62 %. Importantly, 88 % of the osteoid perimeter was immediately above an eroded-scalloped cement line with no sign of mineralization, and often with no clear bone-forming osteoblasts on the surface. Moreover, only 5 % of the bone perimeter was mineralizing, reflecting that only 8 % of the osteoid perimeter underwent mineralization, resulting in a mineralization lag time of 545 days. Taken together, this indicates limited bone formation and delayed mineralization. Conclusion We present a case report of multiple vertebral fractures after denosumab discontinuation with histomorphometric evidence that denosumab discontinuation leads to extensive trabecular bone resorption followed by a limited bone formation and delayed mineralization if the denosumab treatment is reinitiated. This highlights the importance of developing optimal discontinuation strategies for patients that are to discontinue treatment.
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Affiliation(s)
- Louise Alstrup Drejer
- Department of Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Bilal Mohamad El-Masri
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Charlotte Ejersted
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Christina Møller Andreasen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Lisbeth Koch Thomsen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | | | - Thomas Levin Andersen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Stinus Hansen
- Department of Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
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10
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van Dijk Christiansen P, Sikjær T, Andreasen CM, Thomsen JS, Brüel A, Hauge EM, Delaisse J, Rejnmark L, Andersen TL. Transitory Activation and Improved Transition from Erosion to Formation within Intracortical Bone Remodeling in Hypoparathyroid Patients Treated with rhPTH(1-84). JBMR Plus 2023; 7:e10829. [PMID: 38130746 PMCID: PMC10731115 DOI: 10.1002/jbm4.10829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 12/23/2023] Open
Abstract
In hypoparathyroidism, lack of parathyroid hormone (PTH) leads to low calcium levels and decreased bone remodeling. Treatment with recombinant human PTH (rhPTH) may normalize bone turnover. This study aimed to investigate whether rhPTH(1-84) continued to activate intracortical bone remodeling after 30 months and promoted the transition from erosion to formation and whether this effect was transitory when rhPTH(1-84) was discontinued. Cortical histomorphometry was performed on 60 bone biopsies from patients (aged 31 to 78 years) with chronic hypoparathyroidism randomized to either 100 μg rhPTH(1-84) a day (n = 21) (PTH) or similar placebo (n = 21) (PLB) for 6 months as add-on to conventional therapy. This was followed by an open-label extension, where patients extended their rhPTH(1-84) (PTH) (n = 5), continued conventional treatment (CON) (n = 5), or withdrew from rhPTH(1-84) and resumed conventional therapy (PTHw) for an additional 24 months (n = 8). Bone biopsies were collected at months 6 (n = 42) and 30 (n = 18). After 6 and 30 months, the overall cortical microarchitecture (cortical porosity, thickness, pore density, and mean pore diameter) in the PTH group did not differ from that of the PLB/CON and PTHw groups. Still, the PTH group had a significantly and persistently higher percentage of pores undergoing remodeling than the PLB/CON groups. A significantly higher percentage of these pores was undergoing bone formation in the PTH compared with the PLB/CON groups, whereas the percentage of pores with erosion only was not different. This resulted in a shift in the ratio between formative and eroded pores, reflecting a faster transition from erosion to formation in the PTH-treated patients. In the rhPTH(1-84) withdrawal group PTHw, the latter effects of PTH were completely reversed in comparison to those of the PLB/CON groups. In conclusion, rhPTH(1-84) replacement therapy in hypoparathyroidism patients promotes intracortical remodeling and its transition from erosion to formation without affecting the overall cortical microstructure. The effect persists for at least 30 months and is reversible when treatment is withdrawn. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Pernille van Dijk Christiansen
- Department of PathologyOdense University HospitalOdenseDenmark
- Molecular Bone Histology (MBH) Lab, Research Unit of Pathology, Department of Clinical Research and Department of Molecular MedicineUniversity of Southern DenmarkOdenseDenmark
| | - Tanja Sikjær
- Department of Endocrinology and Internal MedicineAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Christina Møller Andreasen
- Department of PathologyOdense University HospitalOdenseDenmark
- Molecular Bone Histology (MBH) Lab, Research Unit of Pathology, Department of Clinical Research and Department of Molecular MedicineUniversity of Southern DenmarkOdenseDenmark
| | | | | | - Ellen Margrethe Hauge
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
- Department of RheumatologyAarhus University HospitalAarhusDenmark
| | - Jean‐Marie Delaisse
- Department of PathologyOdense University HospitalOdenseDenmark
- Molecular Bone Histology (MBH) Lab, Research Unit of Pathology, Department of Clinical Research and Department of Molecular MedicineUniversity of Southern DenmarkOdenseDenmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal MedicineAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Thomas Levin Andersen
- Department of PathologyOdense University HospitalOdenseDenmark
- Molecular Bone Histology (MBH) Lab, Research Unit of Pathology, Department of Clinical Research and Department of Molecular MedicineUniversity of Southern DenmarkOdenseDenmark
- Molecular Bone Histology (MBH) Lab, Department of Forensic MedicineAarhus UniversityAarhusDenmark
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11
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Cooper DML, Harrison KD, Hiebert BD, King GA, Panahifar A, Zhu N, Swekla KJ, Pivonka P, Chapman LD, Arnason T. Daily administration of parathyroid hormone slows the progression of basic multicellular units in the cortical bone of the rabbit distal tibia. Bone 2023; 176:116864. [PMID: 37574096 DOI: 10.1016/j.bone.2023.116864] [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: 06/09/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
Basic Multicellular Units (BMUs) conduct bone remodeling, a critical process of tissue turnover which, if imbalanced, can lead to disease, including osteoporosis. Parathyroid hormone (PTH 1-34; Teriparatide) is an osteoanabolic treatment for osteoporosis; however, it elevates the rate of intra-cortical remodeling (activation frequency) leading, at least transiently, to increased porosity. The purpose of this study was to test the hypothesis that PTH not only increases the rate at which cortical BMUs are initiated but also increases their progression (Longitudinal Erosion Rate; LER). Two groups (n = 7 each) of six-month old female New Zealand white rabbits were both administered 30 μg/kg of PTH once daily for a period of two weeks to induce remodeling. Their distal right tibiae were then imaged in vivo by in-line phase contrast micro-CT at the Canadian Light Source synchrotron. Over the following two weeks the first group (PTH) received continued daily PTH while the second withdrawal group (PTHW) was administrated 0.9 % saline. At four weeks all animals were euthanized, their distal tibiae were imaged by conventional micro-CT ex vivo and histomorphometry was performed. Matching micro-CT datasets (in vivo and ex vivo) were co-registered in 3D and LER was measured from 612 BMUs. Counter to our hypothesis, mean LER was lower (p < 0.001) in the PTH group (30.19 ± 3.01 μm/day) versus the PTHW group (37.20 ± 2.77 μm/day). Despite the difference in LER, osteonal mineral apposition rate (On.MAR) did not differ between groups indicating the anabolic effect of PTH was sustained after withdrawal. The slowing of BMU progression by PTH warrants further investigation; slowed resorption combined with elevated bone formation rate, may play an important role in how PTH enhances coupling between resorption and formation within the BMU. Finally, the prolonged anabolic response following withdrawal may have utility in terms of optimizing clinical dosing regimens.
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Affiliation(s)
- David M L Cooper
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Kim D Harrison
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Beverly D Hiebert
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gavin A King
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Arash Panahifar
- BioMedical Imaging and Therapy Beamline, Canadian Light Source, Saskatoon, Saskatchewan, Canada; Department of Medical Imaging, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ning Zhu
- BioMedical Imaging and Therapy Beamline, Canadian Light Source, Saskatoon, Saskatchewan, Canada
| | - Kurtis J Swekla
- Animal Care and Research Support Office, Office of the Vice-President of Research, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Peter Pivonka
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, Australia
| | - L Dean Chapman
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Terra Arnason
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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12
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Andreasen CM, El-Masri BM, MacDonald B, Laursen KS, Nielsen MH, Thomsen JS, Delaisse JM, Andersen TL. Local coordination between intracortical bone remodeling and vascular development in human juvenile bone. Bone 2023; 173:116787. [PMID: 37150243 DOI: 10.1016/j.bone.2023.116787] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 05/09/2023]
Abstract
Although failure to establish a vascular network has been associated with many skeletal disorders, little is known about what drives development of vasculature in the intracortical bone compartments. Here, we show that intracortical bone resorption events are coordinated with development of the vasculature. We investigated the prevalence of vascular structures at different remodeling stages as well as their 3D organization using proximal femoral cortical bone from 5 girls and 6 boys (aged 6-15 years). A 2D analysis revealed that non-quiescent intracortical pores contained more vascular structures than quiescent pores (p < 0.0001). Type 2 pores, i.e., remodeling of existing pores, had a higher density of vascular structures than type 1 pores, i.e., de novo created pores (p < 0.05). Furthermore, pores at the eroded-formative remodeling stage, had more vascular structures than pores at any other remodeling stage (p < 0.05). A 3D reconstruction of an intracortical remodeling event showed that osteoclasts in the advancing tip of the cutting cone as well as preosteoclasts in the lumen expressed vascular endothelial growth factor-A (VEGFA), while VEGFA-receptors 1 and 2 mainly were expressed in endothelial cells in the adjacent vasculature. Consequently, we propose that the progression of the vascular network in intracortical remodeling events is driven by osteoclasts expressing VEGFA. Moreover, the vasculature is continuously reconfigured according to the demands of the remodeling events at the surrounding bone surfaces.
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Affiliation(s)
- Christina Møller Andreasen
- Department of Pathology, Odense University Hospital, Odense, Denmark; Molecular Bone Histology lab, Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark; Department of Molecular Medicine, University of Southern Denmark, Denmark.
| | - Bilal Mohamad El-Masri
- Department of Pathology, Odense University Hospital, Odense, Denmark; Molecular Bone Histology lab, Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark; Department of Molecular Medicine, University of Southern Denmark, Denmark.
| | - Birgit MacDonald
- Department of Pathology, Odense University Hospital, Odense, Denmark; Molecular Bone Histology lab, Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark; Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Kaja Søndergaard Laursen
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Denmark; Molecular Bone Histology lab, Department of Forensic Medicine, Aarhus University, Aarhus, Denmark.
| | - Malene Hykkelbjerg Nielsen
- Department of Pathology, Odense University Hospital, Odense, Denmark; Molecular Bone Histology lab, Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark; Department of Molecular Medicine, University of Southern Denmark, Denmark.
| | | | - Jean-Marie Delaisse
- Department of Pathology, Odense University Hospital, Odense, Denmark; Molecular Bone Histology lab, Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark; Department of Molecular Medicine, University of Southern Denmark, Denmark; Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Denmark.
| | - Thomas Levin Andersen
- Department of Pathology, Odense University Hospital, Odense, Denmark; Molecular Bone Histology lab, Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark; Department of Molecular Medicine, University of Southern Denmark, Denmark; Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Denmark; Molecular Bone Histology lab, Department of Forensic Medicine, Aarhus University, Aarhus, Denmark.
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13
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Diaz-delCastillo M, Gundesen MT, Andersen CW, Nielsen AL, Møller HEH, Vinholt PJ, Asmussen JT, Kristensen IB, Nyvold CG, Abildgaard N, Levin Andersen T, Lund T. Increased Bone Volume by Ixazomib in Multiple Myeloma: 3-Month Results from an Open Label Phase 2 Study. J Bone Miner Res 2023; 38:639-649. [PMID: 36970780 DOI: 10.1002/jbmr.4807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
Multiple myeloma (MM) is an incurable bone marrow cancer characterized by the development of osteolytic lesions due to the myeloma-induced increase in osteoclastogenesis and decrease in osteoblastic activity. The standard treatment of MM often involves proteasome inhibitors (PIs), which can also have a beneficial off-target bone anabolic effect. However, long-term treatment with PIs is unadvised due to their high side-effect burden and inconvenient route of administration. Ixazomib is a new-generation, oral PI that is generally well tolerated; however, its bone effect remains unknown. Here, we describe the 3-month results of a single-center phase II clinical trial investigating the effect of ixazomib treatment on bone formation and bone microstructure. Thirty patients with MM in stable disease not receiving antimyeloma treatment for ≥3 months and presenting ≥2 osteolytic lesions received monthly ixazomib treatment cycles. Serum and plasma samples were collected at baseline and monthly thereafter. Sodium 18 F-Fluoride positron emission tomography (NaF-PET) whole-body scans and trephine iliac crest bone biopsies were collected before and after three treatment cycles. The serum levels of bone remodeling biomarkers suggested an early ixazomib-induced decrease in bone resorption. NaF-PET scans indicated unchanged bone formation ratios; however, histological analyses of bone biopsies revealed a significant increase in bone volume per total volume after treatment. Further analyses of bone biopsies showed unchanged osteoclast number and COLL1A1High -expressing osteoblasts on bone surfaces. Next, we analyzed the superficial bone structural units (BSUs), which represent each recent microscopic bone remodeling event. Osteopontin staining revealed that following treatment, significantly more BSUs were enlarged (>200,000 μm2 ), and the distribution frequency of their shape was significantly different from baseline. Overall, our data suggest that ixazomib induces overflow remodeling-based bone formation by decreasing the level of bone resorption and promoting longer bone formation events, making it a potentially valuable candidate for future maintenance treatment. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | - Michael Tveden Gundesen
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | | | | | - Jon Thor Asmussen
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Ida Bruun Kristensen
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Hematology-Pathology Research Laboratory, Research Unit for Hematology & Research Unit for Pathology, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| | - Charlotte Guldborg Nyvold
- Hematology-Pathology Research Laboratory, Research Unit for Hematology & Research Unit for Pathology, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| | - Niels Abildgaard
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Levin Andersen
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Thomas Lund
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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14
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Welsh H, Brickley MB. Pathology or expected morphology? Investigating patterns of cortical porosity and trabecularization during infancy and early childhood. Anat Rec (Hoboken) 2023; 306:354-365. [PMID: 36116138 DOI: 10.1002/ar.25081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/15/2022] [Accepted: 09/08/2022] [Indexed: 01/25/2023]
Abstract
Increased cortical porosity is associated with a heightened risk of skeletal fragility due to bone loss and structural decay in adults. However, few studies have examined the etiology of cortical porosity in infants and children. This study examines whether age-related changes in femoral growth and locomotor development influence femoral midshaft cortical porosity in a sample of 48 individuals (fetal to 3.99 years) from the 10th-13th century cemetery of St. Étienne de Toulouse, France. Histological sections were prepared and imaged using light microscopy. Midshaft geometric variables such as total area, cortical area, and pore area were calculated using BoneJ. Increased porosity and cortical trabecularization were found to be significantly associated with age, being almost exclusively present in individuals aged 0.5-1.99 years. At approximately 6 months of age infants typically begin engaging in regular femoral loading and experience an acceleration in growth. The observed increase in midshaft porosity and trabecularization, therefore, likely results from the reorganization and redistribution of cortical bone, stimulated by increased growth velocity and the onset of weight-bearing activities. The reduction in cortical porosity and trabecularization in individuals aged 2.0-3.99 years indicates that children are approaching some sort of homeostasis as growth velocity slows and their femora adapt to consistent loading. Understanding what expected skeletal development looks like is necessary when conducting bioarcheological studies and this study provides evidence for a pattern of transient midshaft porosity during infancy and early childhood.
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Affiliation(s)
- Hayley Welsh
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | - Megan B Brickley
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada
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15
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Dia AS, Renaud G, Nooghabi AH, Grimal Q. The influence of intra-cortical microstructure on the contrast in ultrasound images of the cortex of long bones: A 2D simulation study. ULTRASONICS 2023; 127:106831. [PMID: 36084514 DOI: 10.1016/j.ultras.2022.106831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Decreased thickness of the bone cortex due to bone loss in the course of ageing and osteoporosis is associated with reduced bone strength. Cortical thickness measurement from ultrasound images was recently demonstrated in young adults. This requires the identification of both the outer (periosteum) and inner (endosteum) surfaces of the bone cortex. However, with bone loss, the cortical porosity and the size of the vascular pores increase resulting in enhanced ultrasound scattering which may prevent the detection of the endosteum. The aim of this work was to study the influence of cortical bone microstructure variables, such as porosity and pore size, on the contrast of the endosteum in ultrasound images. We wanted to estimate the range of these variables for which ultrasound imaging of the endosteum is feasible. We generated synthetic data using a two-dimensional time-domain code to simulate the propagation of elastodynamic waves. A synthetic aperture imaging sequence with an array transducer operating at a center frequency of 2.5 MHz was used. The numerical simulations were conducted for 105 cortical microstructures obtained from high resolution X-ray computed tomography images of ex vivo bone samples with a porosity ranging from 2% to 24 %. Images were reconstructed using a delay-and-sum (DAS) algorithm with optimized f-number, correction of refraction at the periosteum, and sample-specific wave-speed. We observed a range variation of 18 dB of endosteum contrast in our data set depending on the bone microstructure. We found that as porosity increases, speckle intensity inside the bone cortex increases whereas the intensity of the signal from the endosteum decreases. Also, a microstructure with large pores (diameter >250 μm) was associated with poor endosteum visibility, compared with a microstructure with equal porosity but a more narrow distribution of pore sizes. These findings suggest that ultrasound imaging of the bone cortex with a probe operating at a central frequency of 2.5 MHz using refraction-corrected DAS is capable of detecting the endosteum of a cortex with moderate porosity (less than about 10%) if the largest pores remain smaller than about 200 μm.
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Affiliation(s)
- Amadou Sall Dia
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France.
| | - Guillaume Renaud
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France; Department of Imaging Physics, Delft University of Technology, The Netherlands
| | - Aida Hejazi Nooghabi
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France
| | - Quentin Grimal
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France
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16
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Xie F, Li J, Song W, Liu Q, Jiang S, Chen ZY, Shu Q. Long-term Care Facility and its Elderly Chronic Diseases in Jishou: Insights into Underdeveloped Area of China. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221128735. [PMID: 36217738 PMCID: PMC9557860 DOI: 10.1177/00469580221128735] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Insight into the current status of long-term care facilities (LTCFs) and chronic diseases in underdeveloped areas in China is scant. Using a census method to survey older adults ≥60 years old (154 older adult residents) in all LTCFs in Jishou area. The International Resident Assessment Instrument for Long-Term Care Facilities (interRAI-LTCF) was used to collect information and analyze the current status of chronic diseases among older adult residents. There were 62 187 residents ≥60 years old in Jishou area. According to the survey, there were only 154 older adult residents living in the LTCFs of Jishou, with a ratio was 0.3% of all older adult residents, which was much lower than China's 3.0%. Of respondents (109 older adult residents), the prevalence of chronic diseases was 70.6%. The prevalence increases with age, as well as in the female is higher than in the male. The top 3 chronic diseases were hypertension (41.3%), bone and joint disease (12.8%) and cerebrovascular disease (12.8%). It was found that different age groups and genders lead to differences in the prevalence and the order of chronic diseases. The prevalence of older adults with impaired balance ability, sleep disturbance and swallowing disturbance was higher than that of normal older adults. The results of the one-way analysis of variance showed that the age and balance ability of the older adults with chronic diseases were statistically significant (P < .05). In addition, the prevalence of chronic diseases in the LTCFs older adult was higher than the home care (HC) older adults in Jishou. The age and the prevalence of chronic diseases of LTCFs in older adults with professional nursing staff were higher than in those without. This study provides a theoretical basis for the healthcare distribution, prevention and treatment of chronic diseases in underdeveloped areas. The undeveloped area has lower LTCFs staying rate and chronic disease prevalence of older adults than relatively developed areas. More public health attention and capital investment are needed to increase the LTCFs number and strengthen disease testing and screening. As well as, the proportion of professional nursing staff and specialist doctors in LTCFs and improve the quality of care and medical treatment for older adults.
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Affiliation(s)
- Fen Xie
- Jishou University School of Medicine,
Jishou, P. R. China
- The Fourth Affiliated Hospital of
Jishou University (The First People’s Hospital of Huaihua), Huaihua, P. R.
China
| | - Jinxiu Li
- Jishou University School of Medicine,
Jishou, P. R. China
| | - Wenkai Song
- Jishou University School of Medicine,
Jishou, P. R. China
| | - Quanlong Liu
- Jishou University School of Medicine,
Jishou, P. R. China
| | - Siping Jiang
- Jishou University School of Medicine,
Jishou, P. R. China
| | | | - Qingxia Shu
- Jishou University School of Medicine,
Jishou, P. R. China
- The Fourth Affiliated Hospital of
Jishou University (The First People’s Hospital of Huaihua), Huaihua, P. R.
China
- Qingxia Shu, The Fourth Affiliated Hospital
of Jishou University (The First People’s Hospital of Huaihua), Huaihua 418000,
P. R. China.
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17
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Lamarche BA, Thomsen JS, Andreasen CM, Lievers WB, Andersen TL. 2D size of trabecular bone structure units (BSU) correlate more strongly with 3D architectural parameters than age in human vertebrae. Bone 2022; 160:116399. [PMID: 35364343 DOI: 10.1016/j.bone.2022.116399] [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: 11/02/2021] [Revised: 03/14/2022] [Accepted: 03/25/2022] [Indexed: 11/22/2022]
Abstract
Bone tissue is continuously remodeled. In trabecular bone, each remodeling transaction forms a microscopic bone structural unit (BSU), also known as a hemiosteon or a trabecular packet, which is bonded to existing tissue by osteopontin-rich cement lines. The size and shape of the BSUs are determined by the size and shape of the resorption cavity, and whether the cavity is potentially over- or under-filled by the subsequent bone formation. The present study focuses on the recently formed trabecular BSUs, and how their 2D size and shape changes with age and trabecular microstructure. The study was performed using osteopontin-immunostained frontal sections of L2 vertebrae from 8 young (aged 18.5-37.6 years) and 8 old (aged 69.1-96.4 years) control females, which underwent microcomputed tomography (μCT) imaging prior to sectioning. The contour of 4230 BSU profiles (181-385 per vertebra) within 1024 trabecular profiles were outlined, and their 2D width, length, area, and shape were assessed. Of these BSUs, 22 (0.5%) were generated by modeling-based bone formation (i.e. without prior resorption), while 99.5% were generated by remodeling-based bone formation (i.e. with prior resorption). The distributions of BSU profile width, length, and area were significantly smaller in the old versus young females (p < 0.005), and the median profile width, length, and area were negative correlated with age (p < 0.018). Importantly, these BSU profile size parameters were more strongly correlated with trabecular bone volume (BV/TV, p < 0.002) and structure model index (SMI, p < 0.008) assessed by μCT, than age. Moreover, the 2D BSU size parameters were positively correlated to the area of the individual trabecular profiles (p < 0.0001), which were significantly smaller in the old versus young females (p < 0.024). The BSU shape parameters (aspect ratio, circularity, and solidity) were not correlated with age, BV/TV, or SMI. Collectively, the study supports the notion that not only the BSU profile width, but also its length and area, are more influenced by the age-related bone loss and shift from plates to rods (SMI), than age itself. This implies that BSU profile size is mainly driven by changes in the trabecular microstructure, which affect the size of the resorption cavity that the BSU refills.
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Affiliation(s)
- Britney Alexi Lamarche
- Bharti School of Engineering and Computer Science, Laurentian University, Sudbury, Ontario, Canada
| | | | - Christina Møller Andreasen
- Clinical Cell Biology, Dept. of Pathology, Odense University Hospital, Odense, Denmark; Pathology Research Unit, Dept. of Molecular Medicine & Dept. of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - W Brent Lievers
- Bharti School of Engineering and Computer Science, Laurentian University, Sudbury, Ontario, Canada.
| | - Thomas Levin Andersen
- Clinical Cell Biology, Dept. of Pathology, Odense University Hospital, Odense, Denmark; Pathology Research Unit, Dept. of Molecular Medicine & Dept. of Clinical Research, University of Southern Denmark, Odense, Denmark; Dept. of Forensic Medicine, Aarhus University, Aarhus, Denmark.
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18
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Borggaard XG, Roux JP, Delaisse JM, Chavassieux P, Andreasen CM, Andersen TL. Alendronate prolongs the reversal-resorption phase in human cortical bone remodeling. Bone 2022; 160:116419. [PMID: 35413490 DOI: 10.1016/j.bone.2022.116419] [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: 12/01/2021] [Revised: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 01/18/2023]
Abstract
Despite their ability to reduce fracture-risk and increase Bone Mineral Density (BMD) in osteoporotic women, bisphosphonates are reported to reduce formation of new bone. Reduced bone formation has been suggested to lead to accumulation of microfractures and contribute to rare side effects in cortical bone such as atypical femur fractures. However, most studies are limited to trabecular bone. In this study, the cortical bone remodeling in human iliac bone specimens of 65 non-treated and 24 alendronate-treated osteoporotic women was investigated using a new histomorphometric classification of intracortical pores. The study showed that only 12.4 ± 11% of the cortical pore area reflected quiescent pores/osteons in alendronate-treated patients versus 8.5 ± 5% in placebo, highlighting that new cortical remodeling events remain to be activated. The percent and size of eroded pores (events in resorption-reversal phase) remained unchanged, but their contribution to total pore area was 1.4-fold higher in alendronate versus placebo treated patients (66 ± 22% vs 48 ± 22%, p < 0.001). On the other hand, the mixed eroded-formative pores (events with mixed resorption-reversal-formation phases) was 2-fold lower in alendronate versus placebo treated patients (19 ± 14% vs 39 ± 23% of total pore area, p < 0.001), and formative pores (event in formation phase) was 2.2-fold lower in alendronate versus placebo treated patients (2.1 ± 2.4% vs 4.6 ± 3.6%, p < 0.01), and their contribution to total pore area was 2.4-fold lower (1.3 ± 2.1% vs 3.1 ± 4.4%, p < 0.05). Importantly, these differences between alendronate and placebo treated patients were significant in patients after 3 years of treatment, not after 2 years of treatment. Collectively, the results support that cortical remodeling events activated during alendronate treatment has a prolonged reversal-resorption phase with a delayed transition to formation, becoming increasingly evident after 3-years of treatment. A potential contributor to atypical femur fractures associated with long-term bisphosphonate treatment.
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Affiliation(s)
- Xenia G Borggaard
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark.
| | | | - Jean-Marie Delaisse
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | | | - Christina M Andreasen
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | - Thomas L Andersen
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark; Dept. of Forensic Medicine, Aarhus University, Aarhus, Denmark.
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19
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Figeac F, Tencerova M, Ali D, Andersen TL, Appadoo DRC, Kerckhofs G, Ditzel N, Kowal JM, Rauch A, Kassem M. Impaired bone fracture healing in type 2 diabetes is caused by defective functions of skeletal progenitor cells. Stem Cells 2022; 40:149-164. [DOI: 10.1093/stmcls/sxab011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/17/2021] [Indexed: 11/12/2022]
Abstract
Abstract
The mechanisms of obesity and type 2 diabetes (T2D)-associated impaired fracture healing are poorly studied. In a murine model of T2D reflecting both hyperinsulinemia induced by high fat diet (HFD) and insulinopenia induced by treatment with streptozotocin (STZ), we examined bone healing in a tibia cortical bone defect. A delayed bone healing was observed during hyperinsulinemia as newly formed bone was reduced by – 28.4±7.7% and was associated with accumulation of marrow adipocytes at the defect site +124.06±38.71%, and increased density of SCA1+ (+74.99± 29.19%) but not Runx2 +osteoprogenitor cells. We also observed increased in reactive oxygen species production (+101.82± 33.05%), senescence gene signature (≈106.66± 34.03%) and LAMIN B1 - senescent cell density (+225.18± 43.15%), suggesting accelerated senescence phenotype. During insulinopenia, a more pronounced delayed bone healing was observed with decreased newly formed bone to -34.9± 6.2% which was inversely correlated with glucose levels (R 2=0.48, p<0.004) and callus adipose tissue area (R 2=0.3711, p<0.01). Finally, to investigate the relevance to human physiology, we observed that sera from obese and T2D subjects had disease state-specific inhibitory effects on osteoblast related gene signatures in human bone marrow stromal cells which resulted in inhibition of osteoblast and enhanced adipocyte differentiation. Our data demonstrate that T2D exerts negative effects on bone healing through inhibition of osteoblast differentiation of skeletal stem cells and induction of accelerated bone senescence and that the hyperglycaemia per se and not just insulin levels is detrimental for bone healing.
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Affiliation(s)
- Florence Figeac
- Department of Molecular Endocrinology, KMEB, University of Southern Denmark and Odense University Hospital, Denmark
| | - Michaela Tencerova
- Department of Molecular Endocrinology, KMEB, University of Southern Denmark and Odense University Hospital, Denmark
- Current Molecular Physiology of Bone, Institute of Physiology, the Czech Academy of Sciences, Prague, Czech Republic
| | - Dalia Ali
- Department of Molecular Endocrinology, KMEB, University of Southern Denmark and Odense University Hospital, Denmark
| | - Thomas L Andersen
- Department of Pathology, Odense University Hospital, Odense
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Denmark
| | | | - Greet Kerckhofs
- Biomechanics lab, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Institute for Experimental and Clinical Research, UCLouvain, Woluwe, Belgium
- Department of Material Science and Engineering, KU Leuven, Leuven, Belgium
| | - Nicholas Ditzel
- Department of Molecular Endocrinology, KMEB, University of Southern Denmark and Odense University Hospital, Denmark
| | - Justyna M Kowal
- Department of Molecular Endocrinology, KMEB, University of Southern Denmark and Odense University Hospital, Denmark
| | - Alexander Rauch
- Department of Molecular Endocrinology, KMEB, University of Southern Denmark and Odense University Hospital, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Moustapha Kassem
- Department of Molecular Endocrinology, KMEB, University of Southern Denmark and Odense University Hospital, Denmark
- Department of Cellular and Molecular Medicine, Danish Stem Cell Center (DanStem), University of Copenhagen, Copenhagen, Denmark
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20
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Tippen SP, Metzger CE, Swallow EA, Sacks SA, Wallace JM, Allen MR. The combination of aging and chronic kidney disease leads to an exacerbated cortical porosity phenotype. Bone 2022; 154:116228. [PMID: 34624561 PMCID: PMC8671241 DOI: 10.1016/j.bone.2021.116228] [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: 08/23/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Chronic kidney disease (CKD) and aging are each independently associated with higher fracture risk. Although CKD is highly prevalent in the aging population, the interaction between these two conditions with respect to bone structure and mechanics is not well understood. The purpose of this study was to examine cortical porosity and mechanical properties in skeletally mature young and aging mice with CKD. METHODS CKD was induced by feeding 16-week and 78-week male mice 0.2% adenine (AD) for six weeks followed by two weeks of maintenance on a control diet for a total study duration of eight weeks of CKD; control (CON) animals of each age were fed a standard diet. Serum biochemistries, μCT imaging, and mechanical properties via four-point bending were assessed at the endpoint. RESULTS Phosphorus, parathyroid hormone, and blood urea nitrogen were elevated in both ages of AD mice compared to age-matched CON; aging AD mice had PTH and BUN values higher than all other groups. Femoral cortical porosity was more than four-fold higher in aging AD mice compared to young AD mice and more than two-fold higher compared to age-matched controls. Structural and estimated material mechanical properties were both lower in aging mice, but there were no significant interactions between AD treatment and age. CONCLUSION These data show an interaction between CKD and aging that produces a more severe biochemical and cortical bone phenotype. This highlights the importance of studying mechanisms and potential interventions in both young and aged animals to translate to a broader spectrum of CKD patients.
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Affiliation(s)
- Samantha P Tippen
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Corinne E Metzger
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Elizabeth A Swallow
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Spencer A Sacks
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Joseph M Wallace
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN 46202, USA
| | - Matthew R Allen
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Medicine/Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 4620, USA; Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN 46202, USA; Roudebush Veterans Administration Medical Center, Indianapolis, IN 46202, USA.
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21
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Armbrecht G, Nguyen Minh H, Massmann J, Raum K. Pore-Size Distribution and Frequency-Dependent Attenuation in Human Cortical Tibia Bone Discriminate Fragility Fractures in Postmenopausal Women With Low Bone Mineral Density. JBMR Plus 2021; 5:e10536. [PMID: 34761144 PMCID: PMC8567489 DOI: 10.1002/jbm4.10536] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/03/2021] [Indexed: 11/21/2022] Open
Abstract
Osteoporosis is a disorder of bone remodeling leading to reduced bone mass, structural deterioration, and increased bone fragility. The established diagnosis is based on the measurement of areal bone mineral density by dual‐energy X‐ray absorptiometry (DXA), which poorly captures individual bone loss and structural decay. Enlarged cortical pores in the tibia have been proposed to indicate structural deterioration and reduced bone strength in the hip. Here, we report for the first time the in vivo assessment of the cortical pore‐size distribution together with frequency‐dependent attenuation at the anteromedial tibia midshaft by means of a novel ultrasonic cortical backscatter (CortBS) technology. We hypothesized that the CortBS parameters are associated with the occurrence of fragility fractures in postmenopausal women (n = 55). The discrimination performance was compared with those of DXA and high‐resolution peripheral computed tomography (HR‐pQCT). The results suggest a superior discrimination performance of CortBS (area under the receiver operating characteristic curve [AUC]: 0.69 ≤ AUC ≤ 0.75) compared with DXA (0.54 ≤ AUC ≤ 0.55) and a similar performance compared with HR‐pQCT (0.66 ≤ AUC ≤ 0.73). CortBS is the first quantitative bone imaging modality that can quantify microstructural tissue deteriorations in cortical bone, which occur during normal aging and the development of osteoporosis. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Gabriele Armbrecht
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Center for Muscle and Bone Research Berlin Germany
| | - Huong Nguyen Minh
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Regenerative Therapies Berlin Germany
| | - Jonas Massmann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Regenerative Therapies Berlin Germany
| | - Kay Raum
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Regenerative Therapies Berlin Germany
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22
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Liang W, Wu X, Dong Y, Chen X, Zhou P, Xu F. Mechanical stimuli-mediated modulation of bone cell function-implications for bone remodeling and angiogenesis. Cell Tissue Res 2021; 386:445-454. [PMID: 34665321 DOI: 10.1007/s00441-021-03532-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 09/21/2021] [Indexed: 12/20/2022]
Abstract
Bone remodeling, expressed as bone formation and turnover, is a complex and dynamic process closely related to its form and function. Different events, such as development, aging, and function, play a critical role in bone remodeling and metabolism. The ability of the bone to adapt to new loads and forces has been well known and has proven useful in orthopedics and insightful for research in bone and cell biology. Mechanical stimulation is one of the most important drivers of bone metabolism. Interestingly, different types of forces will have specific consequences in bone remodeling, and their beneficial effects can be traced using different biomarkers. In this narrative review, we summarize the major mediators and events in bone remodeling, focusing on the effects of mechanical stimulation on bone metabolism, cell populations, and ultimately, bone health.
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Affiliation(s)
- Wenqing Liang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan 316000, Zhejiang Province, People's Republic of China.
| | - Xudong Wu
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan 316000, Zhejiang Province, People's Republic of China
| | - Yongqiang Dong
- Department of Orthopaedics, Xinchang People's Hospital, Shaoxing, 312500, Zhejiang Province, People's Republic of China
| | - Xuerong Chen
- Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing, 312000, Zhejiang Province, People's Republic of China
| | - Ping Zhou
- Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing, 312000, Zhejiang Province, People's Republic of China
| | - Fangming Xu
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan 316000, Zhejiang Province, People's Republic of China.
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23
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Shrivas NV, Tiwari AK, Kumar R, Patil S, Tripathi D, Badhyal S. Physiological Loading-Induced Interstitial Fluid Dynamics in Osteon of Osteogenesis Imperfecta Bone. J Biomech Eng 2021; 143:081011. [PMID: 33834233 DOI: 10.1115/1.4050818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Indexed: 11/08/2022]
Abstract
Osteogenesis imperfecta (OI), also known as "brittle bone disease," is a genetic bone disorder. OI bones experience frequent fractures. Surgical procedures are usually followed by clinicians in the management of OI. It has been observed physical activity is equally beneficial in reducing OI bone fractures in both children and adults as mechanical stimulation improves bone mass and strength. Loading-induced mechanical strain and interstitial fluid flow stimulate bone remodeling activities. Several studies have characterized strain environment in OI bones, whereas very few studies attempted to characterize the interstitial fluid flow. OI significantly affects bone micro-architecture. Thus, this study anticipates that canalicular fluid flow reduces in OI bone in comparison to the healthy bone in response to physiological loading due to altered poromechanical properties. This work attempts to understand the canalicular fluid distribution in single osteon models of OI and healthy bone. A poromechanical model of osteon is developed to compute pore-pressure and interstitial fluid flow as a function of gait loading pattern reported for OI and healthy subjects. Fluid distribution patterns are compared at different time-points of the stance phase of the gait cycle. It is observed that fluid flow significantly reduces in OI bone. Additionally, flow is more static than dynamic in OI osteon in comparison to healthy subjects. This work attempts to identify the plausible explanation behind the diminished mechanotransduction capability of OI bone. This work may further be extended for designing better biomechanical therapies to enhance the fluid flow in order to improve osteogenic activities in OI bone.
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Affiliation(s)
- Nikhil Vivek Shrivas
- Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India; Department of Mechatronics Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India
| | - Abhishek Kumar Tiwari
- Department of Applied Mechanics, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, Uttar Pradesh 211004, India
| | - Rakesh Kumar
- Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India
| | - Santosh Patil
- Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India
| | - Dharmendra Tripathi
- Department of Mathematics, National Institute of Technology Uttarakhand, Srinagar, Uttarakhand 246174, India
| | - Subham Badhyal
- Sports Authority of India, Jawahar Lal Nehru Stadium, Lodhi Road, New Delhi 110003, India; MYAS-GNDU Department of Sports Sciences and Medicine, Guru Nanak Dev University, Amritsar, Punjab 143005, India
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24
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Brunauer R, Xia IG, Asrar SN, Dawson LA, Dolan CP, Muneoka K. Aging delays epimorphic regeneration in mice. J Gerontol A Biol Sci Med Sci 2021; 76:1726-1733. [PMID: 33970250 DOI: 10.1093/gerona/glab131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Indexed: 11/14/2022] Open
Abstract
Epimorphic regeneration is a multi-tissue regeneration process where amputation does not lead to scarring, but blastema formation and patterned morphogenesis for which cell plasticity and concerted cell-cell interactions are pivotal. Tissue regeneration declines with aging, yet if and how aging impairs epimorphic regeneration is unknown. Here we show for the first time that aging derails the spatiotemporal regulation of epimorphic regeneration in mammals, first, by exacerbating tissue histolysis and delaying wound closure, and second, by impairing blastema differentiation and skeletal regrowth. Surprisingly, aging did not limit stem cell availability in the blastema, but reduced osteoblast-dependent bone formation. Our data suggest that aging delays regeneration not by stem cell exhaustion, but functional defects of differentiated cells that may be driven by an aged wound environment and alterations in the spatiotemporal regulation of regeneration events. Our findings emphasize the importance of accurate timing of signaling events for regeneration, and highlight the need for carefully timed interventions in regenerative medicine.
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Affiliation(s)
- Regina Brunauer
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Ian G Xia
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Shabistan N Asrar
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Lindsay A Dawson
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Connor P Dolan
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.,Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD
| | - Ken Muneoka
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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25
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Hirano F, Okuma KF, Zenke Y, Menuki K, Ohnishi H, Fukuda F, Sakai A, Yamamoto N, Shimakura T, Sano H, Tokunaga Y, Takahashi HE. Disturbance of osteonal bone remodeling and high tensile stresses on the lateral cortex in atypical femoral fracture after long-term treatment with Risedronate and Alfacalcidol for osteoporosis. Bone Rep 2021; 14:101091. [PMID: 34036125 PMCID: PMC8138479 DOI: 10.1016/j.bonr.2021.101091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/11/2021] [Accepted: 05/01/2021] [Indexed: 12/23/2022] Open
Abstract
An 83 year-old Japanese woman complained of left lateral thigh pain following a low-energy fall 4 months prior to admission. She had been treated for osteoporosis with Risedronate and Alfacalcidol for the previous five years. She was diagnosed with an atypical femoral fracture (AFF) according to the American Society for Bone and Mineral Research (ASBMR) Task Force revised criteria. Radiographs revealed cortical thickening and a transverse radiolucent fracture line in the lateral cortex of the shaft. MRI showed a high intensity signal on the T2WI image 1 cm long in the lateral cortex. The patient had normal levels of bone resorption and formation biomarkers except for low 25(OH) Vitamin D. Double fluorescent labeling was done preoperatively. Due to significant bowing, a corrective osteotomy and intramedullary nailing were performed, and the resected bone wedge was analyzed by bone histomorphometry. Three ground sections of the lateral cortex at the fracture site showed many and large pores, with or without tetracycline labeling. Histomorphometric assessment was done on intracortical pores, classified by a novel criteria, only to assess size of the pores to know prolonged osteoclastic activity and its characteristics of inner surfaces to assess whether bone formation has been occurring or not in labeling period in remodeling cycle, and coalition of multi-pores. Increased size with widespread variation of pores suggested prolonged osteoclastic activity in the reversal/resorptive phase. Bone labeling showed lamellar bone on the endocortical surface. We hypothesize that the case had developed from a regional disturbance of osteonal remodeling in the lateral cortex, in which accumulated microcracks might have initiated a resorption process resulting in resorption cavities, i.e., pores, which became larger due to prolonged activity of secondary osteoclasts. Various sized pores could form lamellar bone, still forming at the time of biopsy, some had formed lamellar bone, but stopped to form before labeling and not to start to form at all, probably due to incomplete coupling. Endocortical lamellar bone might had started to resorbed to smooth off endocortical surface, followed by formation of lamellar bone. The endocortical bone formation was assessed and its formation period is about 2.7 years. A finite element analysis using preoperative CT data revealed high tensile stresses on the lateral aspect of the femur. Histomorphometric results suggest that there might be more pores in the tensile area than the compressive area. These findings may subsequently connect accumulation of microcracks, an increase of size and number of pores and coalition and subsequent fracture in the lateral cortex. The lateral cortex of the fracture site of atypical femoral fracture was assessed by bone histomorphometry and FEA. Many enlarged pores may suggest a prolonged resorptive phase, resulting in excessive resorption by secondary osteoclasts. There is large variation in size of pores, which is much more than that of osteons, normally observed. Pores were classified as types with/without label, and with/without parallel lamellae to inner surface of the pores. More pores in size and number were observed in the lateral cortex under tensile force than compressive force by FEA.
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Affiliation(s)
- Fumitaka Hirano
- University of Occupational and Environmental Health, School of Medicine Department of Orthopaedic Surgery, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan.,Moji Medical Center, 3-1 Higashiminatomachi Moji-ku, Kitakyushu-shi, Fukuoka 801-8502, Japan
| | - Kayoko Furukawa Okuma
- University of Occupational and Environmental Health, School of Medicine Department of Orthopaedic Surgery, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Yukichi Zenke
- University of Occupational and Environmental Health, School of Medicine Department of Orthopaedic Surgery, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Kunitaka Menuki
- University of Occupational and Environmental Health, School of Medicine Department of Orthopaedic Surgery, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Hideo Ohnishi
- Moji Medical Center, 3-1 Higashiminatomachi Moji-ku, Kitakyushu-shi, Fukuoka 801-8502, Japan
| | - Fumio Fukuda
- Kitakyushu General Hospital, 1-1 Higashijonocho Kokurakita-ku, Kitakyushu-shi, Fukuoka 802-8517, Japan
| | - Akinori Sakai
- University of Occupational and Environmental Health, School of Medicine Department of Orthopaedic Surgery, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Noriaki Yamamoto
- Niigata Rehabilitation Hospital, 761 Kizaki, Kita-ku, Niigata-shi, Niigata 950-3304, Japan.,Niigata Bone Science Institute, 761 Kizaki, Kita-ku, Niigata-shi, Niigata 950-3304, Japan
| | - Taketoshi Shimakura
- Niigata Bone Science Institute, 761 Kizaki, Kita-ku, Niigata-shi, Niigata 950-3304, Japan
| | - Hiroshige Sano
- Niigata Bone Science Institute, 761 Kizaki, Kita-ku, Niigata-shi, Niigata 950-3304, Japan.,Niigata University Graduate School of Medical and Dental Sciences Division of Orthopaedic Surgery, 757 Asahimachidoriichibancho, Chuo-ku, Niigata-shi, Niigata 951-8510, Japan
| | - Yuta Tokunaga
- Niigata Bone Science Institute, 761 Kizaki, Kita-ku, Niigata-shi, Niigata 950-3304, Japan.,Niigata University of Health and Welfare Graduate School, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata 950-3198, Japan
| | - Hideaki E Takahashi
- Niigata Rehabilitation Hospital, 761 Kizaki, Kita-ku, Niigata-shi, Niigata 950-3304, Japan.,Niigata Bone Science Institute, 761 Kizaki, Kita-ku, Niigata-shi, Niigata 950-3304, Japan
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26
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Iori G, Du J, Hackenbeck J, Kilappa V, Raum K. Estimation of Cortical Bone Microstructure From Ultrasound Backscatter. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:1081-1095. [PMID: 33104498 DOI: 10.1109/tuffc.2020.3033050] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Multichannel pulse-echo ultrasound using linear arrays and single-channel data acquisition systems opens new perspectives for the evaluation of cortical bone. In combination with spectral backscatter analysis, it can provide quantitative information about cortical microstructural properties. We present a numerical study, based on the finite-difference time-domain method, to estimate the backscatter cross section of randomly distributed circular pores in a bone matrix. A model that predicts the backscatter coefficient using arbitrary pore diameter distributions was derived. In an ex vivo study on 19 human tibia bones (six males, 13 females, 83.7 ± 8.4 years), multidirectional ultrasound backscatter measurements were performed using an ultrasound scanner equipped with a 6-MHz 128-element linear array with sweep motor control. A normalized depth-dependent spectral analysis was performed to derive backscatter and attenuation coefficients. Site-matched reference values of tissue acoustic impedance Z , cortical thickness (Ct.Th), pore density (Ct.Po.Dn), porosity (Ct.Po), and characteristic parameters of the pore diameter (Ct.Po.Dm) distribution were obtained from 100-MHz scanning-acoustic microscopy images. Proximal femur areal bone mineral density (aBMD), stiffness S , and ultimate force Fu from the same donors were available from a previous study. All pore structure and material properties could be predicted using linear combinations of backscatter parameters with a median to high accuracy (0.28 ≤ adjusted R2 ≤ 0.59). The combination of cortical thickness and backscatter parameter provided similar or better prediction accuracies than aBMD. For the first time, a method for the noninvasive assessment of the pore diameter distribution in cortical bone by ultrasound is proposed. The combined assessment of cortical thickness, sound velocity, and pore size distribution in a mobile, nonionizing measurement system could have a major impact on preventing osteoporotic fractures.
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Hegarty-Cremer SGD, Simpson MJ, Andersen TL, Buenzli PR. Modelling cell guidance and curvature control in evolving biological tissues. J Theor Biol 2021; 520:110658. [PMID: 33667542 DOI: 10.1016/j.jtbi.2021.110658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/20/2021] [Accepted: 02/26/2021] [Indexed: 12/22/2022]
Abstract
Tissue geometry is an important influence on the evolution of many biological tissues. The local curvature of an evolving tissue induces tissue crowding or spreading, which leads to differential tissue growth rates, and to changes in cellular tension, which can influence cell behaviour. Here, we investigate how directed cell motion interacts with curvature control in evolving biological tissues. Directed cell motion is involved in the generation of angled tissue growth and anisotropic tissue material properties, such as tissue fibre orientation. We develop a new cell-based mathematical model of tissue growth that includes both curvature control and cell guidance mechanisms to investigate their interplay. The model is based on conservation principles applied to the density of tissue synthesising cells at or near the tissue's moving boundary. The resulting mathematical model is a partial differential equation for cell density on a moving boundary, which is solved numerically using a hybrid front-tracking method called the cell-based particle method. The inclusion of directed cell motion allows us to model new types of biological growth, where tangential cell motion is important for the evolution of the interface, or for the generation of anisotropic tissue properties. We illustrate such situations by applying the model to simulate both the resorption and infilling components of the bone remodelling process, and to simulate root hair growth. We also provide user-friendly MATLAB code to implement the algorithms.
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Affiliation(s)
| | - Matthew J Simpson
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Thomas L Andersen
- Clinical Cell Biology, Department of Pathology, Odense University Hospital, Odense, Denmark; Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Pascal R Buenzli
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia.
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Yousefian O, Karbalaeisadegh Y, Muller M. Frequency-dependent analysis of ultrasound apparent absorption coefficient in multiple scattering porous media: application to cortical bone. Phys Med Biol 2021; 66:035026. [PMID: 32937603 PMCID: PMC10851310 DOI: 10.1088/1361-6560/abb934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The effect of matrix viscoelastic absorption on frequency-dependent attenuation in porous structures mimicking simplified cortical bone is addressed in this numerical study. An apparent absorption is defined to quantify the difference between total attenuation (resulting from both absorption and scattering) and attenuation exclusively due to scattering. A power-law model is then used to describe the frequency-dependent apparent absorption as a function of pore diameter and density. The frequency response of the porous structures to a Gaussian pulse is studied to determine the frequency range over which the system can be considered linear. The results show that for low scattering regimes (normalized frequency [Formula: see text]0.80), the system and its apparent absorption can be considered linear. Hence, the total attenuation coefficient results from the summation of scattering and absorption coefficients. However, for highly scattering regimes, the system can no longer be considered linear, as the apparent absorption vs. frequency deviates from a linear trend. As the pore density increases, the apparent absorption coefficient increases as well.
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Affiliation(s)
- Omid Yousefian
- Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27606, United States of America
| | - Yasamin Karbalaeisadegh
- Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27606, United States of America
| | - Marie Muller
- Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27606, United States of America
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Delaisse JM, Andersen TL, Kristensen HB, Jensen PR, Andreasen CM, Søe K. Re-thinking the bone remodeling cycle mechanism and the origin of bone loss. Bone 2020; 141:115628. [PMID: 32919109 DOI: 10.1016/j.bone.2020.115628] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 02/06/2023]
Abstract
Proper bone remodeling necessarily requires that osteoblasts reconstruct the bone that osteoclasts have resorbed. However, the cellular events connecting resorption to reconstruction have remained poorly known. The consequence is a fragmentary understanding of the remodeling cycle where only the resorption and formation steps are taken into account. New tools have recently made possible to elucidate how resorption shifts to formation, thereby allowing to comprehend the remodeling cycle as a whole. This new knowledge is reviewed herein. It shows how teams of osteoclasts and osteoblast lineage cells are progressively established and how they are subjected therein to reciprocal interactions. Contrary to the common view, osteoclasts and osteoprogenitors are intermingled on the eroded surfaces. The analysis of the resorption and cell population dynamics shows that osteoprogenitor cell expansion and resorption proceed as an integrated mechanism; that a threshold cell density of osteoprogenitors on the eroded surface is mandatory for onset of bone formation; that the cell initiating osteoprogenitor cell expansion is the osteoclast; and that the osteoclast therefore triggers putative osteoprogenitor reservoirs positioned at proximity of the eroded bone surface (bone lining cells, canopy cells, pericytes). The interplay between magnitude of resorption and rate of cell expansion governs how soon bone reconstruction is initiated and may determine uncoupling and permanent bone loss if a threshold cell density is not reached. The clinical perspectives opened by these findings are discussed.
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Affiliation(s)
- Jean-Marie Delaisse
- Clinical Cell Biology, Department of Pathology, Odense University Hospital, Department of Clinical Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
| | - Thomas Levin Andersen
- Clinical Cell Biology, Department of Pathology, Odense University Hospital, Department of Clinical Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Department of Forensic Medicine, Aarhus University, Aarhus, Denmark.
| | - Helene Bjoerg Kristensen
- Clinical Cell Biology, Lillebælt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
| | - Pia Rosgaard Jensen
- Clinical Cell Biology, Lillebælt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
| | - Christina Møller Andreasen
- Clinical Cell Biology, Department of Pathology, Odense University Hospital, Department of Clinical Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
| | - Kent Søe
- Clinical Cell Biology, Department of Pathology, Odense University Hospital, Department of Clinical Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
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30
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Harrison KD, Hiebert BD, Panahifar A, Andronowski JM, Ashique AM, King GA, Arnason T, Swekla KJ, Pivonka P, Cooper DM. Cortical Bone Porosity in Rabbit Models of Osteoporosis. J Bone Miner Res 2020; 35:2211-2228. [PMID: 32614975 PMCID: PMC7702175 DOI: 10.1002/jbmr.4124] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 06/17/2020] [Accepted: 06/21/2020] [Indexed: 12/20/2022]
Abstract
Cortical bone porosity is intimately linked with remodeling, is of growing clinical interest, and is increasingly accessible by imaging. Thus, the potential of animal models of osteoporosis (OP) to provide a platform for studying how porosity develops and responds to interventions is tremendous. To date, rabbit models of OP have largely focused on trabecular microarchitecture or bone density; some such as ovariectomy (OVX) have uncertain efficacy and cortical porosity has not been extensively reported. Our primary objective was to characterize tibial cortical porosity in rabbit-based models of OP, including OVX, glucocorticoids (GC), and OVX + GC relative to controls (SHAM). We sought to: (i) test the hypothesis that intracortical remodeling is elevated in these models; (ii) contrast cortical remodeling and porosity in these models with that induced by parathyroid hormone (1-34; PTH); and (iii) contrast trabecular morphology in the proximal tibia across all groups. Evidence that an increase in cortical porosity occurred in all groups was observed, although this was the least robust for GC. Histomorphometric measures supported the hypothesis that remodeling rate was elevated in all groups and also revealed evidence of uncoupling of bone resorption and formation in the GC and OVX + GC groups. For trabecular bone, a pattern of loss was observed for OVX, GC, and OVX + GC groups, whereas the opposite was observed for PTH. Change in trabecular number best explained these patterns. Taken together, the findings indicated rabbit models provide a viable and varied platform for the study of OP and associated changes in cortical remodeling and porosity. Intriguingly, the evidence revealed differing effects on the cortical and trabecular envelopes for the PTH model. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR)..
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Affiliation(s)
- Kim D Harrison
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Beverly D Hiebert
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Arash Panahifar
- BioMedical Imaging and Therapy Beamline, Canadian Light Source, Saskatoon, Canada.,Department of Medical Imaging, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | | | - Gavin A King
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Terra Arnason
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Kurtis J Swekla
- Research Services and Ethics Office, Office of the Vice President of Research, University of Saskatchewan, Saskatoon, Canada
| | - Peter Pivonka
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, Australia
| | - David Ml Cooper
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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31
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Iori G, Schneider J, Reisinger A, Heyer F, Peralta L, Wyers C, Glüer CC, van den Bergh JP, Pahr D, Raum K. Cortical thinning and accumulation of large cortical pores in the tibia reflect local structural deterioration of the femoral neck. Bone 2020; 137:115446. [PMID: 32450342 DOI: 10.1016/j.bone.2020.115446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 05/03/2020] [Accepted: 05/19/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Cortical bone thinning and a rarefaction of the trabecular architecture represent possible causes of increased femoral neck (FN) fracture risk. Due to X-ray exposure limits, the bone microstructure is rarely measurable in the FN of subjects but can be assessed at the tibia. Here, we studied whether changes of the tibial cortical microstructure, which were previously reported to be associated with femur strength, are also associated with structural deteriorations of the femoral neck. METHODS The cortical and trabecular architectures in the FN of 19 humans were analyzed ex vivo on 3D microcomputed tomography images with 30.3 μm voxel size. Cortical thickness (Ct.Thtibia), porosity (Ct.Potibia) and pore size distribution in the tibiae of the same subjects were measured using scanning acoustic microscopy (12 μm pixel size). Femur strength during sideways falls was simulated with homogenized voxel finite element models. RESULTS Femur strength was associated with the total (vBMDtot; R2 = 0.23, p < 0.01) and trabecular (vBMDtrab; R2 = 0.26, p < 0.01) volumetric bone mineral density (vBMD), with the cortical thickness (Ct.ThFN; R2 = 0.29, p < 0.001) and with the trabecular bone volume fraction (Tb.BV/TVFN; R2 = 0.34, p < 0.001), separation (Tb.SpFN; R2 = 0.25, p < 0.01) and number (Tb.NFN; R2 = 0.32, p < 0.001) of the femoral neck. Moreover, smaller Ct.Thtibia was associated with smaller Ct.ThFN (R2 = 0.31, p < 0.05), lower Tb.BV/TVFN (R2 = 0.29, p < 0.05), higher Tb.SpFN (R2 = 0.33, p < 0.05) and lower Tb.NFN (R2 = 0.42, p < 0.01). A higher prevalence of pores with diameter > 100 μm in tibial cortical bone (relCt.Po100μm-tibia) indicated higher Tb.SpFN (R2 = 0.36, p < 0.01) and lower Tb.NFN (R2 = 0.45, p < 0.01). CONCLUSION Bone resorption and structural decline of the femoral neck may be identified in vivo by measuring cortical bone thickness and large pores in the tibia.
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Affiliation(s)
- Gianluca Iori
- Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Schneider
- Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Reisinger
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Frans Heyer
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Laura Peralta
- Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, INSERM UMR S 1146, CNRS UMR 7371, Paris, France; Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Caroline Wyers
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Claus C Glüer
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - J P van den Bergh
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Dieter Pahr
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria; Institute for Lightweight Design and Structural Biomechanics, TU Wien, Vienna, Austria
| | - Kay Raum
- Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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32
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Iori G, Peralta L, Reisinger A, Heyer F, Wyers C, van den Bergh J, Pahr D, Raum K. Femur strength predictions by nonlinear homogenized voxel finite element models reflect the microarchitecture of the femoral neck. Med Eng Phys 2020; 79:60-66. [PMID: 32291201 DOI: 10.1016/j.medengphy.2020.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 03/10/2020] [Accepted: 03/17/2020] [Indexed: 12/16/2022]
Abstract
In the human femoral neck, the contribution of the cortical and trabecular architecture to mechanical strength is known to depend on the load direction. In this work, we investigate if QCT-derived homogenized voxel finite element (hvFE) simulations of varying hip loading conditions can be used to study the architecture of the femoral neck. The strength of 19 pairs of human femora was measured ex vivo using nonlinear hvFE models derived from high-resolution peripheral QCT scans (voxel size: 30.3 µm). Standing and side-backwards falling loads were modeled. Quasi-static mechanical tests were performed on 20 bones for comparison. Associations of femur strength with volumetric bone mineral density (vBMD) or microstructural parameters of the femoral neck obtained from high-resolution QCT were compared between mechanical tests and simulations and between standing and falling loads. Proximal femur strength predictions by hvFE models were positively associated with the vBMD of the femoral neck (R² > 0.61, p < 0.001), as well as with its cortical thickness (R² > 0.27, p < 0.001), trabecular bone volume fraction (R² = 0.42, p < 0.001) and with the first two principal components of the femoral neck architecture (R² > 0.38, p < 0.001). Associations between femur strength and femoral neck microarchitecture were stronger for one-legged standing than for side-backwards falling. For both loading directions, associations between structural parameters and femur strength from hvFE models were in good agreement with those from mechanical tests. This suggests that hvFE models can reflect the load-direction-specific contribution of the femoral neck microarchitecture to femur strength.
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Affiliation(s)
- Gianluca Iori
- Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Laura Peralta
- Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, INSERM UMR S 1146, CNRS UMR, 7371, Paris, France; Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Andreas Reisinger
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Frans Heyer
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Caroline Wyers
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Joop van den Bergh
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Dieter Pahr
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria; Institute for Lightweight Design and Structural Biomechanics, TU Wien, Vienna, Austria
| | - Kay Raum
- Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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Seeman E, Martin TJ. Antiresorptive and anabolic agents in the prevention and reversal of bone fragility. Nat Rev Rheumatol 2020; 15:225-236. [PMID: 30755735 DOI: 10.1038/s41584-019-0172-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Bone volume, microstructure and its material composition are maintained by bone remodelling, a cellular activity carried out by bone multicellular units (BMUs). BMUs are focally transient teams of osteoclasts and osteoblasts that respectively resorb a volume of old bone and then deposit an equal volume of new bone at the same location. Around the time of menopause, bone remodelling becomes unbalanced and rapid, and an increased number of BMUs deposit less bone than they resorb, resulting in bone loss, a reduction in bone volume and microstructural deterioration. Cortices become porous and thin, and trabeculae become thin, perforated and disconnected, causing bone fragility. Antiresorptive agents reduce fracture risk by reducing the rate of bone remodelling so that fewer BMUs are available to remodel bone. Bone fragility is not abolished by these drugs because existing microstructural deterioration is not reversed, unsuppressed remodelling continues producing microstructural deterioration and unremodelled bone that becomes more mineralized can become brittle. Anabolic agents reduce fracture risk by stimulating new bone formation, which partly restores bone volume and microstructure. To guide fracture prevention, this Review provides an overview of the structural basis of bone fragility, the mechanisms of remodelling and how anabolic and antiresorptive agents target remodelling defects.
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Affiliation(s)
- Ego Seeman
- Departments of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia. .,Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - T J Martin
- Department of Medicine and St Vincent's Institute, University of Melbourne, Melbourne, Victoria, Australia
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Andreasen CM, Bakalova LP, Brüel A, Hauge EM, Kiil BJ, Delaisse JM, Kersh ME, Thomsen JS, Andersen TL. The generation of enlarged eroded pores upon existing intracortical canals is a major contributor to endocortical trabecularization. Bone 2020; 130:115127. [PMID: 31689525 DOI: 10.1016/j.bone.2019.115127] [Citation(s) in RCA: 8] [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: 06/19/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 02/04/2023]
Abstract
The gradual conversion of cortical bone into trabecular bone on the endocortical surface contributes substantially to thinning of the cortical bone. The purpose of the present study was to characterize the intracortical canals (3D) and pores (2D) in human fibular bone, to identify the intracortical remodeling events leading to this endocortical trabecularization. The analysis was conducted in fibular diaphyseal bone specimens obtained from 20 patients (6 women and 14 men, age range 41-75 years). μCT revealed that endosteal bone had a higher cortical porosity (p< 0.05) and canals with a larger diameter (p< 0.05) than periosteal bone, while the canal spacing and number were similar in the endosteal and periosteal half. Histological analysis showed that the endosteal half versus the periosteal half: (i) had a higher likelihood of being non-quiescent type 2 pores (i.e. remodeling of existing pores) than other pore types (OR = 1.6, p< 0.01); (ii) that the non-quiescent type 2 pores contributed to a higher porosity (p< 0.001); and that (iii) amongst these pores especially eroded type 2 pores contributed to the elevated cortical porosity (p< 0.001). In conclusion, we propose that endocortical trabecularization results from the accumulation of eroded cavities upon existing intracortical canals, favored by delayed initiation of bone formation.
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Affiliation(s)
- Christina Møller Andreasen
- Department of Orthopedic Surgery & Traumatology, Odense University Hospital, Odense, Denmark; Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark and Department of Pathology, Odense University Hospital, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
| | - Lydia Peteva Bakalova
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, IL, USA.
| | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Ellen Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Birgitte Jul Kiil
- Department of Plastic Surgery, Aarhus University Hospital, Aarhus, Denmark.
| | - Jean-Marie Delaisse
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark and Department of Pathology, Odense University Hospital, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Clinical Cell Biology, Vejle Hospital - Lillebælt Hospital, University of Southern Denmark, Vejle, Denmark.
| | - Mariana Elizabeth Kersh
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, IL, USA.
| | | | - Thomas Levin Andersen
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark and Department of Pathology, Odense University Hospital, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Clinical Cell Biology, Vejle Hospital - Lillebælt Hospital, University of Southern Denmark, Vejle, Denmark; Department of Forensic Medicine, Aarhus University, Aarhus, Denmark.
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Creecy A, Uppuganti S, Girard MR, Schlunk SG, Amah C, Granke M, Unal M, Does MD, Nyman JS. The age-related decrease in material properties of BALB/c mouse long bones involves alterations to the extracellular matrix. Bone 2020; 130:115126. [PMID: 31678497 PMCID: PMC6885131 DOI: 10.1016/j.bone.2019.115126] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/28/2022]
Abstract
One possibility for the disproportionate increase in fracture risk with aging relative to the decrease in bone mass is an accumulation of changes to the bone matrix which deleteriously affect fracture resistance. In order to effectively develop new targets for osteoporosis, a preclinical model of the age-related loss in fracture resistance needs to be established beyond known age-related decreases in bone mineral density and bone volume fraction. To that end, we examined long bones of male and female BALB/c mice at 6-mo. and 20-mo. of age and assessed whether material and matrix properties of cortical bone significantly differed between the age groups. The second moment of area of the diaphysis (minimum and maximum principals for femur and radius, respectively) as measured by ex vivo micro-computed tomography (μCT) was higher at 20-mo. than at 6-mo. for both males and females, but ultimate moment as measured by three-point bending tests did not decrease with age. Cortical thickness was lower with age for males, but higher for old females. Partially accounting for differences in structure, material estimates of yield, ultimate stress, and toughness (left femur) were 12.6%, 11.1%, and 40.9% lower, respectively, with age for both sexes. The ability of the cortical bone to resist crack growth (right femur) was also 18.1% less for the old than for the young adult mice. These decreases in material properties were not due to changes in intracortical porosity as pore number decreased with age. Rather, age-related alterations in the matrix were observed for both sexes: enzymatic and non-enzymatic crosslinks by high performance liquid chromatography increased (femur), volume fraction of bound water by 1H-nuclear magnetic resonance relaxometry decreased (femur), cortical tissue mineral density by μCT increased (femur and radius), and an Amide I sub-peak ratio I1670/I1640 by Raman spectroscopy increased (tibia). Overall, there are multiple matrix changes to potentially target that could prevent the age-related decrease in fracture resistance observed in BALB/c mouse.
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Affiliation(s)
- Amy Creecy
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Madeline R Girard
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States
| | - Siegfried G Schlunk
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States
| | - Chidi Amah
- Meharry Medical College, Nashville, TN 37208, United States
| | - Mathilde Granke
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Mustafa Unal
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Department of Mechanical Engineering, Karamanoglu Mehmetbey University, Karaman, 70100, Turkey
| | - Mark D Does
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States
| | - Jeffry S Nyman
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, United States.
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36
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van Tol AF, Roschger A, Repp F, Chen J, Roschger P, Berzlanovich A, Gruber GM, Fratzl P, Weinkamer R. Network architecture strongly influences the fluid flow pattern through the lacunocanalicular network in human osteons. Biomech Model Mechanobiol 2019; 19:823-840. [PMID: 31782029 PMCID: PMC7203595 DOI: 10.1007/s10237-019-01250-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 11/04/2019] [Indexed: 12/24/2022]
Abstract
A popular hypothesis explains the mechanosensitivity of bone due to osteocytes sensing the load-induced flow of interstitial fluid squeezed through the lacunocanalicular network (LCN). However, the way in which the intricate structure of the LCN influences fluid flow through the network is largely unexplored. We therefore aimed to quantify fluid flow through real LCNs from human osteons using a combination of experimental and computational techniques. Bone samples were stained with rhodamine to image the LCN with 3D confocal microscopy. Image analysis was then performed to convert image stacks into mathematical network structures, in order to estimate the intrinsic permeability of the osteons as well as the load-induced fluid flow using hydraulic circuit theory. Fluid flow was studied in both ordinary osteons with a rather homogeneous LCN as well as a frequent subtype of osteons-so-called osteon-in-osteons-which are characterized by a ring-like zone of low network connectivity between the inner and the outer parts of these osteons. We analyzed 8 ordinary osteons and 9 osteon-in-osteons from the femur midshaft of a 57-year-old woman without any known disease. While the intrinsic permeability was 2.7 times smaller in osteon-in-osteons compared to ordinary osteons, the load-induced fluid velocity was 2.3 times higher. This increased fluid velocity in osteon-in-osteons can be explained by the longer path length, needed to cross the osteon from the cement line to the Haversian canal, including more fluid-filled lacunae and canaliculi. This explanation was corroborated by the observation that a purely structural parameter-the mean path length to the Haversian canal-is an excellent predictor for the average fluid flow velocity. We conclude that osteon-in-osteons may be particularly significant contributors to the mechanosensitivity of cortical bone, due to the higher fluid flow in this type of osteons.
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Affiliation(s)
- Alexander F van Tol
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, 14476, Potsdam, Germany. .,Berlin-Brandenburg School of Regenerative Therapies (BSRT), Föhrer Str. 15, 13353, Berlin, Germany.
| | - A Roschger
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, 14476, Potsdam, Germany.,Chemistry and Physics of Materials, Paris Lodron University of Salzburg, Jakrob-Haringer Straße 2a, 5020, Salzburg, Austria
| | - F Repp
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, 14476, Potsdam, Germany
| | - J Chen
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, 14476, Potsdam, Germany.,College of Engineering, Mathematics, and Physical Science, University of Exeter, Exeter, EX4 4QF, UK
| | - P Roschger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, 1140, Vienna, Austria
| | - A Berzlanovich
- Center of Forensic Science, Medical University of Vienna, Sensengasse 2, 1090, Vienna, Austria
| | - G M Gruber
- Department of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, 1090, Vienna, Austria
| | - P Fratzl
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, 14476, Potsdam, Germany
| | - Richard Weinkamer
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, 14476, Potsdam, Germany
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37
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Zebaze R, Osima M, Bui M, Lukic M, Wang X, Ghasem-Zadeh A, Eriksen EF, Vais A, Shore-Lorenti C, Ebeling PR, Seeman E, Bjørnerem Å. Adding Marrow Adiposity and Cortical Porosity to Femoral Neck Areal Bone Mineral Density Improves the Discrimination of Women With Nonvertebral Fractures From Controls. J Bone Miner Res 2019; 34:1451-1460. [PMID: 30883870 DOI: 10.1002/jbmr.3721] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 02/24/2019] [Accepted: 03/01/2019] [Indexed: 11/08/2022]
Abstract
Advancing age is accompanied by a reduction in bone formation and remodeling imbalance, which produces microstructural deterioration. This may be partly caused by a diversion of mesenchymal cells towards adipocytes rather than osteoblast lineage cells. We hypothesized that microstructural deterioration would be associated with an increased marrow adiposity, and each of these traits would be independently associated with nonvertebral fractures and improve discrimination of women with fractures from controls over that achieved by femoral neck (FN) areal bone mineral density (aBMD) alone. The marrow adiposity and bone microstructure were quantified from HR-pQCT images of the distal tibia and distal radius in 77 women aged 40 to 70 years with a recent nonvertebral fracture and 226 controls in Melbourne, Australia. Marrow fat measurement from HR-pQCT images was validated using direct histologic measurement as the gold standard, at the distal radius of 15 sheep, with an agreement (R2 = 0.86, p < 0.0001). Each SD higher distal tibia marrow adiposity was associated with 0.33 SD higher cortical porosity, and 0.60 SD fewer, 0.24 SD thinner, and 0.72 SD more-separated trabeculae (all p < 0.05). Adjusted for age and FN aBMD, odds ratios (ORs) (95% CI) for fracture per SD higher marrow adiposity and cortical porosity were OR, 3.39 (95% CI, 2.14 to 5.38) and OR, 1.79 (95% CI, 1.14 to 2.80), respectively. Discrimination of women with fracture from controls improved when cortical porosity was added to FN aBMD and age (area under the receiver-operating characteristic curve [AUC] 0.778 versus 0.751, p = 0.006) or marrow adiposity was added to FN aBMD and age (AUC 0.825 versus 0.751, p = 0.002). The model including FN aBMD, age, cortical porosity, trabecular thickness, and marrow adiposity had an AUC = 0.888. Results were similar for the distal radius. Whether marrow adiposity and cortical porosity indices improve the identification of women at risk for fractures requires validation in prospective studies. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Roger Zebaze
- Department of Medicine, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia.,Departments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia
| | - Marit Osima
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Orthopaedic Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Minh Bui
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Marko Lukic
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Xiaofang Wang
- Departments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia
| | - Ali Ghasem-Zadeh
- Departments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia
| | - Erik F Eriksen
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Angela Vais
- Hudson Institute for Medical Research, Monash University, Melbourne, Australia
| | - Catherine Shore-Lorenti
- Department of Medicine, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia
| | - Ego Seeman
- Departments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Åshild Bjørnerem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
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38
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Liu G, Xie Y, Su J, Qin H, Wu H, Li K, Yu B, Zhang X. The role of EGFR signaling in age-related osteoporosis in mouse cortical bone. FASEB J 2019; 33:11137-11147. [PMID: 31298955 DOI: 10.1096/fj.201900436rr] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
So far, there has been no effective cure for osteoporotic cortical bone, the most significant change in long bone structure during aging and the main cause of bone fragility fractures, because its underlying molecular and cellular mechanisms remain largely unknown. We used 3- and 15-mo-old mice as well as 15-mo-old mice treated with vehicle and gefitinib to evaluate structural, cellular, and molecular changes in cortical bone. We found that the senescence of osteoprogenitors was increased, whereas the expression of phosphorylated epidermal growth factor receptor (EGFR) on the endosteal surface of cortical bone down-regulated in middle-aged 15-mo-old mice compared with young 3-mo-old mice. Further decreasing EGFR signaling by gefitinib treatment in middle-aged mice resulted in promoted senescence of osteoprogenitors and accelerated cortical bone degeneration. Moreover, inhibiting EGFR signaling suppressed the expression of enhancer of zeste homolog 2 (Ezh2), the repressor of cell senescence-inducer genes, through ERK1/2 pathway, thereby promoting senescence in osteoprogenitors. Down-regulated EGFR signaling plays a physiologically significant role during aging by reducing Ezh2 expression, leading to the senescence of osteoprogenitors and the decline in bone formation on the endosteal surface of cortical bone.-Liu, G., Xie, Y., Su, J., Qin, H., Wu, H., Li, K., Yu, B., Zhang, X. The role of EGFR signaling in age-related osteoporosis in mouse cortical bone.
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Affiliation(s)
- Guanqiao Liu
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yongheng Xie
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianwen Su
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hanjun Qin
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hangtian Wu
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Kaiqun Li
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bin Yu
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xianrong Zhang
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Grote C, Reinhardt D, Zhang M, Wang J. Regulatory mechanisms and clinical manifestations of musculoskeletal aging. J Orthop Res 2019; 37:1475-1488. [PMID: 30919498 PMCID: PMC9202363 DOI: 10.1002/jor.24292] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/13/2019] [Indexed: 02/04/2023]
Abstract
Aging is the strongest risk factor for degenerative bone and joint diseases. Clinical therapies for age-related musculoskeletal disorders face significant challenges as their pathogenic mechanisms remain largely unclear. This review article focuses on the recent advances in the understanding of regulatory mechanisms of musculoskeletal aging and their clinical relevance. We begin with the prevalence and socioeconomic impacts of major age-related musculoskeletal disorders such as sarcopenia, osteoporosis, osteoarthritis, and degenerative tendinopathy. The current understanding of responsible biological mechanisms involved in general aging is then summarized. Proposed molecular, cellular, and biomechanical mechanisms relevant to the clinical manifestations of aging in the musculoskeletal system are discussed in detail, with a focus on the disorders affecting muscle, bone, articular cartilage, and tendon. Although musculoskeletal aging processes share many common pathways with the aging of other body systems, unique molecular and cellular mechanisms may be involved in the aging processes of musculoskeletal tissues. Advancements in the understanding of regulatory mechanisms of musculoskeletal aging may promote the development of novel treatments for age-related musculoskeletal disorders. Finally, future research directions for major musculoskeletal tissues including functional interaction between the tissues and their clinical relevance to age-related musculoskeletal disorders are highlighted in the Future Prospects section. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1475-1488, 2019.
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Affiliation(s)
- Caleb Grote
- Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Daniel Reinhardt
- Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mingcai Zhang
- Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jinxi Wang
- Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA,Department of Biochemistry & Molecular Biology, University of Kansas Medical Center, Kansas City, Kansas, USA,Correspondence to: Jinxi Wang, MD, PhD, Department of Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS #3017, Kansas City, KS 66160, USA, Tel: 913-588-0870; Fax: 913-945-7773,
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40
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Bigelow EM, Patton DM, Ward FS, Ciarelli A, Casden M, Clark A, Goulet RW, Morris MD, Schlecht SH, Mandair GS, Bredbenner TL, Kohn DH, Jepsen KJ. External Bone Size Is a Key Determinant of Strength-Decline Trajectories of Aging Male Radii. J Bone Miner Res 2019; 34:825-837. [PMID: 30715752 PMCID: PMC6536328 DOI: 10.1002/jbmr.3661] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/06/2018] [Accepted: 12/19/2018] [Indexed: 12/13/2022]
Abstract
Given prior work showing associations between remodeling and external bone size, we tested the hypothesis that wide bones would show a greater negative correlation between whole-bone strength and age compared with narrow bones. Cadaveric male radii (n = 37 pairs, 18 to 89 years old) were evaluated biomechanically, and samples were sorted into narrow and wide subgroups using height-adjusted robustness (total area/bone length). Strength was 54% greater (p < 0.0001) in wide compared with narrow radii for young adults (<40 years old). However, the greater strength of young-adult wide radii was not observed for older wide radii, as the wide (R2 = 0.565, p = 0.001), but not narrow (R2 = 0.0004, p = 0.944) subgroup showed a significant negative correlation between strength and age. Significant positive correlations between age and robustness (R2 = 0.269, p = 0.048), cortical area (Ct.Ar; R2 = 0.356, p = 0.019), and the mineral/matrix ratio (MMR; R2 = 0.293, p = 0.037) were observed for narrow, but not wide radii (robustness: R2 = 0.015, p = 0.217; Ct.Ar: R2 = 0.095, p = 0.245; MMR: R2 = 0.086, p = 0.271). Porosity increased with age for the narrow (R2 = 0.556, p = 0.001) and wide (R2 = 0.321, p = 0.022) subgroups. The wide subgroup (p < 0.0001) showed a significantly greater elevation of a new measure called the Cortical Pore Score, which quantifies the cumulative effect of pore size and location, indicating that porosity had a more deleterious effect on strength for wide compared with narrow radii. Thus, the divergent strength-age regressions implied that narrow radii maintained a low strength with aging by increasing external size and mineral content to mechanically offset increases in porosity. In contrast, the significant negative strength-age correlation for wide radii implied that the deleterious effect of greater porosity further from the centroid was not offset by changes in outer bone size or mineral content. Thus, the low strength of elderly male radii arose through different biomechanical mechanisms. Consideration of different strength-age regressions (trajectories) may inform clinical decisions on how best to treat individuals to reduce fracture risk. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Erin Mr Bigelow
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Daniella M Patton
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.,Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Ferrous S Ward
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.,Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Antonio Ciarelli
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.,Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Michael Casden
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Andrea Clark
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Robert W Goulet
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Michael D Morris
- College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | | | - Gurjit S Mandair
- Biological and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Todd L Bredbenner
- Department of Mechanical and Aerospace Engineering, University of Colorado-Colorado Springs, Colorado Springs, CO, USA
| | - David H Kohn
- Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.,Biological and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Karl J Jepsen
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.,Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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41
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Iori G, Schneider J, Reisinger A, Heyer F, Peralta L, Wyers C, Gräsel M, Barkmann R, Glüer CC, van den Bergh JP, Pahr D, Raum K. Large cortical bone pores in the tibia are associated with proximal femur strength. PLoS One 2019; 14:e0215405. [PMID: 30995279 PMCID: PMC6469812 DOI: 10.1371/journal.pone.0215405] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/01/2019] [Indexed: 11/23/2022] Open
Abstract
Alterations of structure and density of cortical bone are associated with fragility fractures and can be assessed in vivo in humans at the tibia. Bone remodeling deficits in aging women have been recently linked to an increase in size of cortical pores. In this ex vivo study, we characterized the cortical microarchitecture of 19 tibiae from human donors (aged 69 to 94 years) to address, whether this can reflect impairments of the mechanical competence of the proximal femur, i.e., a major fracture site in osteoporosis. Scanning acoustic microscopy (12 μm pixel size) provided reference microstructural measurements at the left tibia, while the bone vBMD at this site was obtained using microcomputed tomography (microCT). The areal bone mineral density of both left and right femoral necks (aBMDneck) was measured by dual‐energy X‐ray absorptiometry (DXA), while homogenized nonlinear finite element models based on high-resolution peripheral quantitative computed tomography provided hip stiffness and strength for one-legged standing and sideways falling loads. Hip strength was associated with aBMDneck (r = 0.74 to 0.78), with tibial cortical thickness (r = 0.81) and with measurements of the tibial cross-sectional geometry (r = 0.48 to 0.73) of the same leg. Tibial vBMD was associated with hip strength only for standing loads (r = 0.59 to 0.65). Cortical porosity (Ct.Po) of the tibia was not associated with any of the femoral parameters. However, the proportion of Ct.Po attributable to large pores (diameter > 100 μm) was associated with hip strength in both standing (r = -0.61) and falling (r = 0.48) conditions. When added to aBMDneck, the prevalence of large pores could explain up to 17% of the femur ultimate force. In conclusion, microstructural characteristics of the tibia reflect hip strength as well as femoral DXA, but it remains to be tested whether such properties can be measured in vivo.
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Affiliation(s)
- Gianluca Iori
- Berlin-Brandenburg Center for Regenerative Therapies, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Schneider
- Berlin-Brandenburg Center for Regenerative Therapies, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Reisinger
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Frans Heyer
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - Laura Peralta
- Laboratoire d’Imagerie Biomédicale, Sorbonne Universités, INSERM UMR S 1146, CNRS UMR 7371, Paris, France
- Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Caroline Wyers
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - Melanie Gräsel
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Reinhard Barkmann
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Claus C. Glüer
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - J. P. van den Bergh
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - Dieter Pahr
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
- Institute for Lightweight Design and Structural Biomechanics, TU Wien, Vienna, Austria
| | - Kay Raum
- Berlin-Brandenburg Center for Regenerative Therapies, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- * E-mail:
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42
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Sayilekshmy M, Hansen RB, Delaissé JM, Rolighed L, Andersen TL, Heegaard AM. Innervation is higher above Bone Remodeling Surfaces and in Cortical Pores in Human Bone: Lessons from patients with primary hyperparathyroidism. Sci Rep 2019; 9:5361. [PMID: 30926835 PMCID: PMC6441095 DOI: 10.1038/s41598-019-41779-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 03/13/2019] [Indexed: 01/07/2023] Open
Abstract
Mounting evidence from animal studies suggests a role of the nervous system in bone physiology. However, little is known about the nerve fiber localization to human bone compartments and bone surface events. This study reveals the density and distribution of nerves in human bone and the association of nerve profiles to bone remodeling events and vascular structures in iliac crest biopsies isolated from patients diagnosed with primary hyperparathyroidism (PHPT). Bone sections were sequentially double-immunostained for tyrosine hydroxylase (TH), a marker for sympathetic nerves, followed by protein gene product 9.5 (PGP9.5), a pan-neuronal marker, or double-immunostained for either PGP9.5 or TH in combination with CD34, an endothelial marker. In the bone marrow, the nerve profile density was significantly higher above remodeling surfaces as compared to quiescent bone surfaces. Ninety-five percentages of all nerve profiles were associated with vascular structures with the highest association to capillaries and arterioles. Moreover, vasculature with innervation was denser above bone remodeling surfaces. Finally, the nerve profiles density was 5-fold higher in the intracortical pores compared to bone marrow and periosteum. In conclusion, the study shows an anatomical link between innervation and bone remodeling in human bone.
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Affiliation(s)
- Manasi Sayilekshmy
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Rie Bager Hansen
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Jean-Marie Delaissé
- Department of Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark.,Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark.,Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Lars Rolighed
- Department of Surgery and Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Levin Andersen
- Department of Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark. .,Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark. .,Department of Forensic Medicine, Aarhus University, Aarhus, Denmark.
| | - Anne-Marie Heegaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
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43
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Bakalova LP, Andreasen CM, Thomsen JS, Brüel A, Hauge EM, Kiil BJ, Delaisse JM, Andersen TL, Kersh ME. Intracortical Bone Mechanics Are Related to Pore Morphology and Remodeling in Human Bone. J Bone Miner Res 2018; 33:2177-2185. [PMID: 30048570 DOI: 10.1002/jbmr.3561] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/11/2018] [Accepted: 07/20/2018] [Indexed: 01/06/2023]
Abstract
During aging and in osteoporosis, cortical bone becomes more porous, making it more fragile and susceptible to fractures. The aim of this study was to investigate the intracortical compression- induced strain energy distribution, and determine whether intracortical pores associated with high strain energy density (SED) in the surrounding bone matrix have a different morphology and distribution, as well as different remodeling characteristics than matrix with normal SED. Fibular diaphyseal specimens from 20 patients undergoing a jaw reconstruction (age range 41 to 75 years; 14 men and 6 women) were studied. Bone specimens were µCT-scanned, plastic embedded, and sectioned for histology. Three-dimensional microfinite element models of each specimen were tested in compression, and the SED of the bone immediately surrounding the intracortical pores was calculated within a plane of interest corresponding to the histological sections. The SED of a pore, relative to the distribution of the SED of all pores in each specimen, was used to classify pores as either a high or normal SED pore. Pores with high SED were larger, less circular, and were located closer to the endosteal surface of the cortex than normal SED pores (p < 0.001). Histological analysis of the remodeling events generating the pores revealed that the high SED pores compared with normal SED pores had 13.3-fold higher odds of being an erosive (70%) or formative (7%) pore versus a quiescent pore (p < 0.001), 5.9-fold higher odds of resulting from remodeling upon existing pores (type 2 pore) versus remodeling generating new pores (type 1 pore) (p < 0.001), and 3.2-fold higher odds of being a coalescing type 2 pore versus a noncoalescing type 2 pore (p < 0.001). Overall, the study demonstrates a strong relationship between cortical bone mechanics and pore morphology, distribution, and remodeling characteristics in human fibular bone. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Lydia P Bakalova
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Christina M Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Denmark
| | | | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Birgitte Jul Kiil
- Department of Plastic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Jean-Marie Delaisse
- Department of Clinical Cell Biology (KCB), Vejle Hospital-Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Thomas Levin Andersen
- Department of Clinical Cell Biology (KCB), Vejle Hospital-Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Andreasen CM, Delaisse JM, van der Eerden BCJ, van Leeuwen JPTM, Ding M, Andersen TL. Understanding age-induced cortical porosity in women: Is a negative BMU balance in quiescent osteons a major contributor? Bone 2018; 117:70-82. [PMID: 30240959 DOI: 10.1016/j.bone.2018.09.011] [Citation(s) in RCA: 12] [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: 07/04/2018] [Revised: 09/10/2018] [Accepted: 09/16/2018] [Indexed: 01/18/2023]
Abstract
Cortical bone is remodeled by intracortical basic multicellular units (BMUs), whose end result can be observed as quiescent osteons in histological sections. These osteons offer a unique opportunity to investigate the BMU balance between the magnitude of bone resorption and subsequent bone formation at the BMU level. Our main objective was to investigate whether the latter parameters change between defined categories of osteons and with age, and to which extend these changes contribute to age-induced cortical porosity. Cortices of iliac bone specimens from 35 women (aged 16-78 years) with a higher porosity with age were investigated. A total of 3084 quiescent osteons reflecting 75% of the intracortical pores were histological examined. The osteons diameter, pore diameter, wall thickness, prevalence and contribution to the porosity were highly variable, but unchanged with age. Next, the osteons were categorized according to whether they reflected the remodeling of existing canals (type 2Q osteons) or the generation of new canals (type 1Q osteons). Type 2Q osteons versus type 1Q osteons: (i) had more frequently a pore diameter > 75 μm (7.4 vs. 1.3%; p < 0.001); (ii) had a larger mean pore diameter (40 ± 10 vs. 25 ± 4 μm; p < 0.001), osteon diameter (120 ± 21 vs. 94 ± 21 μm; p < 0.001) and wall thickness (40 ± 10 vs. 35 ± 9; p < 0.05); (iii) had a larger contribution to the cortical porosity (29 ± 18 vs. 8 ± 8%; p < 0.001); (iv) were more prevalent (44 ± 10 vs. 31 ± 11%; p < 0.001); and (v) were more prevalent with age. Collectively, this study demonstrates that quiescent osteons with age more frequently result from remodeling of existing canals, which in some cases had a more negative BMU balance. Still, the osteons showed no overall age-related change in their pore diameter i.e. BMU balance. In contrast to conventional wisdom, these data show that non-quiescent pores, not pores of quiescent osteons, were the main contributor to a higher cortical porosity.
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Affiliation(s)
- Christina M Andreasen
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark; Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Jean-Marie Delaisse
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
| | - Bram C J van der Eerden
- Laboratory for Calcium and Bone Metabolism, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | - Johannes P T M van Leeuwen
- Laboratory for Calcium and Bone Metabolism, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Thomas L Andersen
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
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Ramchand SK, Seeman E. The Influence of Cortical Porosity on the Strength of Bone During Growth and Advancing Age. Curr Osteoporos Rep 2018; 16:561-572. [PMID: 30187285 DOI: 10.1007/s11914-018-0478-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Bone densitometry provides a two-dimensional projected areal apparent bone mineral density that fails to capture the heterogeneity of bone's material composition and macro-, micro-, and nano-structures critical to its material and structural strength. Assessment of the structural basis of bone fragility has focused largely on trabecular bone based on the common occurrence of fragility fractures at sites with substantial amounts of trabecular bone. This review focuses on the contribution of cortical bone to bone fragility throughout life. RECENT FINDINGS Accurately differentiating cortical and trabecular bone loss has important implications in quantifying bone fragility as these compartments have differing effects on bone strength. Recent advances in imaging methodology have improved distinction of these two compartments by (i) recognition of a cortico-trabecular transitional zone and (ii) quantifying bone microstructure in a region of interest that is a percentage of bone length rather than a fixed point. Additionally, non-invasive three-dimensional imaging methods allow more accurate quantification of changes in the cortical, trabecular, and cortico-trabecular compartments during growth, aging, disease, and treatment. Over 75% of the skeleton is assembled as cortical bone. Of all fragility fractures, ~ 80% are appendicular and involve regions rich in cortical bone and ~ 70% of all age-related appendicular bone loss is cortical and is mainly due to unbalanced intracortical remodeling which increases cortical porosity. The failure to achieve the optimal peak bone microstructure during growth due to disease and the deterioration in cortical and trabecular bone produced by bone loss compromise bone strength. The loss of strength produced by microstructural deterioration is disproportionate to the bone loss producing this deterioration. The reason for this is that the loss of strength increases as a 7th power function of the rise in cortical porosity and a 3rd power function of the fall in trabecular density (Schaffler and Burr in J Biomech. 21(1):13-6, 1988), hence the need to quantify bone microstructure.
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Affiliation(s)
- Sabashini K Ramchand
- Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia.
- Department of Endocrinology, Level 2 Centaur Wing, Austin Health Repatriation Campus, 300 Waterdale Road, Heidelberg Heights, Melbourne, Victoria, 3081, Australia.
| | - Ego Seeman
- Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
- Department of Endocrinology, Level 2 Centaur Wing, Austin Health Repatriation Campus, 300 Waterdale Road, Heidelberg Heights, Melbourne, Victoria, 3081, Australia
- Australian Catholic University, Melbourne, Australia
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Osteoblasts infill irregular pores under curvature and porosity controls: a hypothesis-testing analysis of cell behaviours. Biomech Model Mechanobiol 2018; 17:1357-1371. [DOI: 10.1007/s10237-018-1031-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/12/2018] [Indexed: 01/11/2023]
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