Determination of hydroxyl content of calcified tissue mineral

Evolution of bone mineral density in patients with idiopathic hypercalciuria: a 20-year longitudinal study

BACKGROUND

Several recent studies reported bone mineral density (BMD) reduction in pediatric patients with idiopathic hypercalciuria (IH). This longitudinal study aimed to evaluate BMD evolution in IH patients through three bone densitometry studies conducted over 20 years on average. A second objective was to evaluate urine calcium and citrate excretion during this period.

METHODS

Case notes of 34 patients diagnosed with IH at age 7.9 ± 3, alongside results of two bone densitometry studies, performed at 10.5 ± 2.7 (BMD1) and 14.5 ± 2.7 (BMD2) years of age, were reviewed. Patients underwent a third densitometry study in adulthood (BMD3) aged 28.3 ± 2.9. Mean follow-up duration (time-lapse between BMD1 and BMD3) was 17.7 ± 1.4 years.

RESULTS

Statistically significant differences were found between z-BMD3 (- 0.85 ± 1.10) and z-BMD1 (- 1.47 ± 0.99) (P = 0.001) as well as between z-BMD3 and z-BMD2 (- 1.33 ± 1.20) (P = 0.016). At the end of follow-up, z-BMD3 was superior to z-BMD2 in 23 adult patients (67.6%) and lower in 11 patients (5M, 6F; 32.3%). Both men and women showed increased bone mass over time, although such increases were significant only for women. The gradual decrease observed in calcium/creatinine and citrate/creatinine ratios could be related to improvement in osteoblastic activity and especially reduction in osteoclastic activity.

CONCLUSIONS

In patients with IH, BMD improves, which may be related especially to female sex, increment of body mass, and reduction in bone resorption. Upon reaching adulthood, urine calcium and citrate excretion tend to decrease so lithogenic risk still remains. The cause of the latter is unknown, although it likely relates to changes in bone activity.

The idiopathic hypercalciuria reviewed. Metabolic abnormality or disease?

Idiopathic hypercalciuria (IH) is defined as that clinical situation in which an increase in urinary calcium excretion is observed, in the absence of hypercalcemia and other known causes of hypercalciuria. In recent years, its diagnosis in pediatric age has been more frequent because it has been known that it can debut with very different symptoms, in the absence of kidney stone formation. The discovery of genetic hypercalciuric stone-forming rats has allowed us to glimpse the pathophysiological mechanism of IH since they show many data in common with humans with IH as normal levels of blood calcium, intestinal calcium hyperabsorption, increased bone resorption and a defect in the renal tubular calcium reabsorption. In 1993, it was shown that in these animals there is an increase in the number of vitamin D receptors (VDR) in the intestine, which favors an increase in the functional capacity of calcitriol-VDR complexes that explains the increase in intestinal transport of calcium. The same happens at the bone level producing a greater resorption. In our opinion, IH is a 'metabolic anomaly' or, better, an inheritable constitutive metabolic characteristic. In this sense, what patients with IH would inherit is the availability of having a greater number of VDRs in their cells than those with normal urinary calcium excretion. IH cannot be considered a sensu stricto disease, so pharmacological treatment must be individualized.

High mineral affinity of polyphosphoester ionomer-phospholipid vesicles

Bone-specific drug delivery is important for the treatment of osteoporosis and osseous metastases. However, there have been limitations in the design of drug carriers having bone affinity. We synthesized amphiphilic polyphosphoester ionomers (CH-PHE) and modified them to 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) vesicles. The ζ-potential of the vesicles was decreased by immobilization of CH-PHE; the amount was influenced by the structure and fraction of CH-PHE. The release rate of 5-carboxyfluorescein from the vesicles could be controlled by changing the fraction of DOPC and CH-PHE. In particular, the release of CF from DOPC vesicles containing 3% CH-PHE was most reduced. In addition, the enzymatic degradation of DOPC was reduced by immobilization with polyphosphoester ionomers; enzyme tolerance was increased with an increase in the molar fraction of polyphosphoester ionomers. Hemolytic activity of the phospholipid vesicles bearing CH-PHE was infrequently observed and was similar to that of the DOPC vesicles. Although a decrease in the viability of mouse osteoblastic cells (MC3T3-E1) in contact with the vesicles bearing CH-PHE was observed when the DOPC concentration of the vesicles bearing 20 mol % CH-PHE with highly ionized units was greater than 200 μM, the cytotoxicity was diminished by sodium salt formation of the CH-PHE. The affinity of the vesicles to calcium deposits generated by MC3T3-E1 cells was significantly improved by the immobilization polyphosphoesters.

Thermal Treatments Modulate Bacterial Adhesion to Dental Enamel

Numerous studies have demonstrated the effects of laser-induced heat on demineralization of enamel; however, no studies have investigated the link between heat/laser-induced changes in physicochemical properties and bacterial adhesion. In this study, we investigated the effects of thermal treatment on surface properties of enamel such as hydrophobicity and zeta potential. Bacterial adhesion to treated surfaces was characterized by confocal laser scanning microscopy, and adhesion force was quantified by atomic force microscopy. The hydrophobicity of enamel increased after heating (p < 0.05), and the zeta potential of heated enamel became more negative than that of the control (p < 0.01). Streptococcus oralis and S. mitis were more hydrophilic than S. sanguis, with more negative zeta potential (all p < 0.01). S. mitis and S. oralis occupied significantly less area on enamel after being heated (p < 0.05). Heating reduced the adhesion force of both S. mitis and S. oralis to enamel with or without saliva coating. Reduction of adhesion force was statistically significant for S. mitis (p < 0.01), whereas that of S. oralis was not statistically significant (p > 0.05). Heating did not affect the adhesion of S. sanguis with or without saliva coating. In conclusion, thermal treatment and photothermal/laser treatments may modulate the physicochemical properties of enamel, preventing the adhesion of some bacterial species.

Detection of hydroxyl ions in bone mineral by solid-state NMR spectroscopy

Previous measurements of the hydroxyl (OH-) ion content of the calcium phosphate crystals of bone mineral have indicated a substantial depletion or near-absence of OH-, despite its presumed status as a constituent of the hydroxyapatite lattice. Analytical methods for determining bone crystal OH- content have depended on procedures or assumptions that may have biased the results, such as chemical pretreatment to eliminate interference from the organic matrix. We demonstrate a two-dimensional solid-state nuclear magnetic resonance (NMR) spectroscopy technique that detects the proton spectrum of bone crystals while suppressing the interfering matrix signals, eliminating the need for specimen pretreatment other than cryogenic grinding. Results on fresh-frozen and ground whole bone of several mammalian species show that the bone crystal OH- is readily detectable; a rough estimate yields an OH- content of human cortical bone of about 20% of the amount expected in stoichiometric hydroxyapatite. This finding sheds light on the biochemical processes underlying normal and abnormal bone mineral metabolism.

Evidence of hydroxyl-ion deficiency in bone apatites: an inelastic neutron-scattering study

The novelty of very large neutron-scattering intensity from the nuclear-spin incoherence in hydrogen has permitted the determination of atomic motion of hydrogen in synthetic hydroxyapatite and in deproteinated isolated apatite crystals of bovine and rat bone without the interference of vibrational modes from other structural units. From an inelastic neutron-scattering experiment, we found no sharp excitations characteristic of the vibrational mode and stretch vibrations of OH ions around 80 and 450 meV (645 and 3630 cm(-1)), respectively, in the isolated, deproteinated crystals of bone apatites; such salient features were clearly seen in micron- and nanometer-size crystals of pure hydroxyapatite powders. Thus, the data provide additional definitive evidence for the lack of OH(-) ions in the crystals of bone apatite. Weak features at 160-180 and 376 meV, which are clearly observed in the apatite crystals of rat bone and possibly in adult mature bovine bone, but to a much lesser degree, but not in the synthetic hydroxyapatite, are assigned to the deformation and stretch modes of OH ions belonging to HPO(4)-like species.

Hydroxyl groups in bone mineral

The question of whether the apatite crystals of bone contain hydroxyl groups was explored using magic angle spinning, proton nuclear magnetic resonance spectroscopy, and resolution enhanced Fourier transform infrared spectroscopy. The powdered bone samples were heated at 300 degrees C in air, in CO2 at 4 bar atmosphere, and at 300 degrees C in air and subsequently at 300 degrees C in CO2, to eliminate the effects of water tightly bound to the crystals and to prevent the degradation of carbonate groups and the elimination of potentially present OH groups. Results confirm earlier findings that bone apatite crystals do not contain detectable amounts of hydroxyl ions.

Quantification of free water in human dental enamel

The amount of free water in 50 samples of air-dried enamel from permanent and deciduous teeth was measured by the Karl Fischer method. Samples included both contemporary and burial specimens. The mean values obtained showed that free water constituted about 1% of enamel mass. However, the range of individual values varied considerably, from 0.56 to 1.48%. The proportion of free water did not seem to depend on the patient's age, the type of tooth, or the relationship between the tooth and its oral environment. On the other hand, the deciduous enamel tested displayed a mean free water content that was three times the mean for the permanent teeth (3.01 vs. 1.00%) and the five burial teeth, a mean content of 1.68%.

Hydroxyl content of solution-precipitated calcium phosphates

A method is described for determination of the titratable hydroxide ion in calcium phosphate precipitates. The procedure requires accurate analysis of the other titratable species in the crystal lattice but is unaffected by the presence of other lattice constituents or impurities. The method was applied to precipitates that had been previously analyzed by solution thermodynamic techniques, and the results were consistent with the earlier observations. The hydroxide content of the precipitates increased with crystal maturity and with increasing pH of the precipitation medium. The hydroxide content of the amorphous phase and the immediate postamorphous-crystalline transformation phase was shown to be nearly zero. After 3 to 4 days' maturation, the hydroxide content of precipitates prepared at pH values of 7, 8, and 9 was shown to increase to approximately 23, 40, 56% of that required for pure hydroxyapatite.

An x-ray study of the paracrystalline nature of bone apatite

X-ray diffraction from oriented bone sections show that the crystalline apatite content of untreated mature cortical bovine bone has, in fact, a paracrystalline structure (i.e., no long range order). There is anisotropy in both lattice distortions and the sizes of the coherently diffracting domains. The paracrystalline mean distance fluctuations (g) were found to be 1.5 (+/- 0.1)% and 2.9 (+/- 0.2)% for the basal and prism planes respectively, the corresponding paracrystalline sizes being 220 (+/- 20) and 70 (+/- 10) A. The paracrystalline structure became more ordered above 600 degrees C, suggesting the association of hydroxyl and possibly carbonate and other ions with the paracrystalline structure. The paracrystalline model for bone apatite helps explain anomalies between X-ray and electron microscope measurements of crystal size and also more of the biological functions of the crystalline apatite.