Osteoporosis: assessment of bone loss and remodeling

The Smad Dependent TGF-β and BMP Signaling Pathway in Bone Remodeling and Therapies

Bone remodeling is a continuous process that maintains the homeostasis of the skeletal system, and it depends on the homeostasis between bone-forming osteoblasts and bone-absorbing osteoclasts. A large number of studies have confirmed that the Smad signaling pathway is essential for the regulation of osteoblastic and osteoclastic differentiation during skeletal development, bone formation and bone homeostasis, suggesting a close relationship between Smad signaling and bone remodeling. It is known that Smads proteins are pivotal intracellular effectors for the members of the transforming growth factor-β (TGF-β) and bone morphogenetic proteins (BMP), acting as transcription factors. Smad mediates the signal transduction in TGF-β and BMP signaling pathway that affects both osteoblast and osteoclast functions, and therefore plays a critical role in the regulation of bone remodeling. Increasing studies have demonstrated that a number of Smad signaling regulators have potential functions in bone remodeling. Therefore, targeting Smad dependent TGF-β and BMP signaling pathway might be a novel and promising therapeutic strategy against osteoporosis. This article aims to review recent advances in this field, summarizing the influence of Smad on osteoblast and osteoclast function, together with Smad signaling regulators in bone remodeling. This will facilitate the understanding of Smad signaling pathway in bone biology and shed new light on the modulation and potential treatment for osteoporosis.

In Vivo Regeneration of Large Bone Defects by Cross-Linked Porous Hydrogel: A Pilot Study in Mice Combining Micro Tomography, Histological Analyses, Raman Spectroscopy and Synchrotron Infrared Imaging

The transplantation of engineered three-dimensional (3D) bone graft substitutes is a viable approach to the regeneration of severe bone defects. For large bone defects, an appropriate 3D scaffold may be necessary to support and stimulate bone regeneration, even when a sufficient number of cells and cell cytokines are available. In this study, we evaluated the in vivo performance of a nanogel tectonic 3D scaffold specifically developed for bone tissue engineering, referred to as nanogel cross-linked porous-freeze-dry (NanoCliP-FD) gel. Samples were characterized by a combination of micro-computed tomography scanning, Raman spectroscopy, histological analyses, and synchrotron radiation-based Fourier transform infrared spectroscopy. NanoCliP-FD gel is a modified version of a previously developed nanogel cross-linked porous (NanoCliP) gel and was designed to achieve highly improved functionality in bone mineralization. Spectroscopic imaging of the bone tissue grown in vivo upon application of NanoCliP-FD gel enables an evaluation of bone quality and can be employed to judge the feasibility of NanoCliP-FD gel scaffolding as a therapeutic modality for bone diseases associated with large bone defects.

Prevention of retinoic acid-induced osteoporosis in mice by isoflavone-enriched soy protein

BACKGROUND

A novel soy protein aggregate enriched with isoflavones (SPA-IS), a mixture of soy protein and isoflavones (Mix), isoflavones (IS), and the soy protein were obtained to investigate the preventive effects on osteoporosis induced by retinoic acid in Kunming mice.

RESULTS

The serum osteocalcin levels in the Mix and SPA-IS groups decreased compared with the model group (mice showing retinoic acid-induced osteoporosis) (P < 0.05). The trabecular analysis results showed an increased preventive effect of the SPA-IS group over the Mix group, the IS group, and the soy protein group. The results of both left tibial maximum load and the 4th lumbar structural strength differ between the IS and the SPA-IS groups.

CONCLUSION

The SPA-IS exhibited obvious oestrogenic activities on retinoic acid-induced osteoporosis in Kunming mice compared to Mix, IS, and soy protein. The results suggest that there is a potential use for SPA-IS in the treatment of osteoporosis induced by intake of retinoic acid. The improvement of bone indicators might be attributed to the formation of aggregate particles and the improvement of IS solubility.

A proposal for standardizing urine collections for bone resorption markers measurement

Diurnal variations in the excretion of bone resorption markers were assessed in order to identify the type of urine collection which provides the most information on bone resorption rate and its relation to measuring bone dynamics in a postmenopausal population. Sixty women, ages 43-67 and without disease or treatment known to affect bone mineral density, were divided into two groups on the basis of femoral mineral density T-score: <1.5 (Group I), >1.5 (Group II). Bone formation was assessed by measuring bone alkaline phosphatase activity and osteocalcin concentration, bone resorption by urinary hydroxyproline, pyridinoline and deoxypiridinoline, N-telopeptide, galactosyl hydroxylysine, and CrossLaps. To identify the more appropriate collection times, urine samples were collected from 7 am to 3 pm; from 3 pm to 11 pm; from 11 pm to 7 am. Twenty-four hour urine collection and first morning void urine samples were also measured. The findings suggest that nocturnal collection and first morning void samples provide the most reliable data on the rate of bone degradation, possibly showing bone loss not only in osteopenic patients but also in women with a low T-score. Nocturnal and first morning samples should therefore be recommended in order to standardize sample collection, as they enable an accurate assessment of bone resorption markers and improved comparability to results from different studies, as well as a less cumbersome collection modality.

Prevention of early postmenopausal bone loss with cyclical etidronate therapy (a double-blind, placebo-controlled study and 1-year follow-up)

The objective of the study was to evaluate the effects of cyclical therapy with etidronate and calcium on spinal and femoral bone loss in the early post menopausal period. Fifty-four women, 53 +/- 2.8 yr old (mean +/- SD) and 2.3 +/- 1.3 yr post menopause received oral doses of either 400 mg/day etidronate for 2 weeks followed by 500 mg/day elemental calcium for 11 weeks, or placebo for 14 days followed by calcium for 11 weeks, repeated over a total of 24 months. A statistically significant increase in spinal bone mineral density (BMD) was observed after 6 months in the etidronate group. At 2 yr, the mean treatment differences in spinal and femoral neck BMD were +2.93% (P < 0.02) and 2.02% (P < 0.03), respectively. Serum osteocalcin and urinary crossLaps/creatinine excretion were decreased significantly by etidronate. Etidronate was well tolerated with a safety profile similar to that of placebo. Thirty-seven women participated in a 1-yr open-label follow-up study. Twelve months after treatment withdrawal, spinal BMD in the former etidronate group decreased by 1.43% and serum osteocalcin and urinary crossLaps returned to pretreatment values. In conclusion, cyclical etidronate is an effective therapy for the prevention of both trabecular and cortical bone loss in the early menopause and has a good safety profile.

Elastic wave propagation in bone in vivo: methodology

The purpose of this study was to investigate the usefulness of elastic wave propagation (EWP) in estimating the mechanical properties (elasticity) of human tibia. The test group was composed of 78-yr-old women assigned to high (n = 19) and low (n = 17) bone mineral density (BMD) groups as measured at the calcaneus by the 125I-photon absorption method. The EWP apparatus consisted of an impact-producing hammer with a force strain gauge and two accelerometers positioned on the bone. Results for nylon and acrylic were used to calibrate the apparatus. Polyvinyl chloride (PVC) solid rods and tubes of various diameters were used to evaluate the relationship between the elastic wave velocity and cross-sectional area. The density and the cross-sectional area of tibia were measured by the computerized tomographic (CT) method at the same intersection points as velocity recordings. The velocities in tibia of bending waves produced by the mechanical hammer were found to depend on the density, area moment of inertia, and density-dependent elastic constants of bone. It is important to account for the changes of these quantities along the bone. It is suggested that the velocity of elastic waves and various indices derived there from provide inexpensive ways of evaluating the elastic properties of bone.