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Robin M, Djediat C, Bardouil A, Baccile N, Chareyron C, Zizak I, Fratzl P, Selmane M, Haye B, Genois I, Krafft J, Costentin G, Azaïs T, Artzner F, Giraud‐Guille M, Zaslansky P, Nassif N. Acidic Osteoid Templates the Plywood Structure of Bone Tissue. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2304454. [PMID: 38115757 PMCID: PMC10916609 DOI: 10.1002/advs.202304454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/18/2023] [Indexed: 12/21/2023]
Abstract
Bone is created by osteoblasts that secrete osteoid after which an ordered texture emerges, followed by mineralization. Plywood geometries are a hallmark of many trabecular and cortical bones, yet the origin of this texturing in vivo has never been shown. Nevertheless, extensive in vitro work revealed how plywood textures of fibrils can emerge from acidic molecular cholesteric collagen mesophases. This study demonstrates in sheep, which is the preferred model for skeletal orthopaedic research, that the deeper non-fibrillar osteoid is organized in a liquid-crystal cholesteric geometry. This basophilic domain, rich in acidic glycosaminoglycans, exhibits low pH which presumably fosters mesoscale collagen molecule ordering in vivo. The results suggest that the collagen fibril motif of twisted plywood matures slowly through self-assembly thermodynamically driven processes as proposed by the Bouligand theory of biological analogues of liquid crystals. Understanding the steps of collagen patterning in osteoid-maturation processes may shed new light on bone pathologies that emerge from collagen physico-chemical maturation imbalances.
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Affiliation(s)
- Marc Robin
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
| | - Chakib Djediat
- Muséum National d'Histoire NaturelleUMR CNRS 7245, Bâtiment 39, CP 39, 57 rue CuvierParis75231France
| | - Arnaud Bardouil
- Université de Rennes, CNRSInstitut de Physique de Rennes (IPR)RennesF‐35000France
| | - Niki Baccile
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
| | - Camille Chareyron
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
| | - Ivo Zizak
- Helmholtz‐Zentrum Berlin für Materialien und Energie – Speicherring BESSY IIAlbert‐Einstein Str. 15D‐12349BerlinGermany
| | - Peter Fratzl
- Department of BiomaterialsMax Planck Institute of Colloids and Interfacesam Mühlenberg 114476PotsdamGermany
| | - Mohamed Selmane
- Institut des Matériaux de Paris CentreSorbonne UniversitéParisF‐75005France
| | - Bernard Haye
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
| | - Isabelle Genois
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
| | - Jean‐Marc Krafft
- Sorbonne Université, CNRSLaboratoire Réactivité de Surface (LRS)ParisF‐75005France
| | - Guylène Costentin
- Sorbonne Université, CNRSLaboratoire Réactivité de Surface (LRS)ParisF‐75005France
| | - Thierry Azaïs
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
| | - Franck Artzner
- Université de Rennes, CNRSInstitut de Physique de Rennes (IPR)RennesF‐35000France
| | - Marie‐Madeleine Giraud‐Guille
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
| | - Paul Zaslansky
- Department for OperativePreventive and Pediatric DentistryCharité – Universitätsmedizin BerlinAßmannshauser Str. 4–614197BerlinGermany
| | - Nadine Nassif
- CNRS, Sorbonne Université, Collège de FranceLaboratoire Chimie de la Matière Condensée de Paris (LCMCP)ParisF‐75005France
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2
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Gheorghe AM, Stanescu LS, Petrova E, Carsote M, Nistor C, Ghemigian A. Paget's Disease of the Bone and Lynch Syndrome: An Exceptional Finding. Diagnostics (Basel) 2023; 13:2101. [PMID: 37370996 DOI: 10.3390/diagnostics13122101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Our objective is to present an exceptional case of a patient diagnosed with Paget's disease of the bone (PDB) while being confirmed with Lynch syndrome (LS). A 44-year-old woman was admitted for progressive pain in the left forearm 2 years ago, and was partially relieved since admission by non-steroidal anti-inflammatory drugs. Suggestive imaging findings and increased blood bone turnover markers helped the diagnosis of PDB. She was offered zoledronate 5 mg. She had two more episodes of relapse, and a decision of new medication was taken within the following years (a second dose of zoledronate, as well as denosumab 60 mg). Her family history showed PDB (mother) and colorectal cancer (father). Whole exome sequencing was performed according to the manufacturer's standard procedure (Ion AmpliSeq™ Exome RDY S5 Kit). A heterozygous pathogenic variant in the SQSTM1 gene (c.1175C>T, p.Pro392Leu) was confirmed, consistent with the diagnosis of PDB. Additionally, a heterozygous pathogenic variant of MSH2 gene (c.2634+1G>T) was associated with LS. The patient's first-degree relatives (her brother, one of her two sisters, and her only daughter) underwent specific genetic screening and found negative results, except for her daughter, who tested positive for both pathogenic variants while being clinically asymptomatic. The phenotype influence of either mutation is still an open issue. To our current knowledge, no similar case has been published before. Both genetic defects that led to the two conditions appeared highly transmissible in the patient's family. The patient might have an increased risk of osteosarcoma and chondrosarcoma, both due to PDB and LS, and a review of the literature was introduced in this particular matter. The phenotypic expression of the daughter remains uncertain and is yet to be a lifelong follow-up as the second patient harbouring this unique combination of gene anomalies.
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Affiliation(s)
- Ana-Maria Gheorghe
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
| | - Laura-Semonia Stanescu
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- PhD Doctoral School, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Eugenia Petrova
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mara Carsote
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Claudiu Nistor
- Department 4-Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Carol Davila University of Medicine and Pharmacy & Thoracic Surgery Department, Dr. Carol Davila Central Emergency University Military Hospital, 050474 Bucharest, Romania
| | - Adina Ghemigian
- C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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3
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Iannuzzo G, De Filippo G, Merlotti D, Abate V, Buonaiuto A, Evangelista M, Gentile M, Giaquinto A, Picchioni T, Di Minno MND, Strazzullo P, Gennari L, Rendina D. Effects of Bisphosphonate Treatment on Circulating Lipid and Glucose Levels in Patients with Metabolic Bone Disorders. Calcif Tissue Int 2021; 108:757-763. [PMID: 33559705 PMCID: PMC8166716 DOI: 10.1007/s00223-021-00811-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 01/15/2021] [Indexed: 12/11/2022]
Abstract
Bisphosphonates are the first-choice treatment of osteoporosis and Paget's disease of bone. Among the bisphosphonates, the non-amino-bisphosphonates, such as clodronic acid, are intracellular converted into toxic analogues of ATP and induce cellular apoptosis whereas the amino-bisphosphonates, such as zoledronic acid, inhibit the farnesyl-diphosphate-synthase, an enzyme of the mevalonate pathway. This pathway regulates cholesterol and glucose homeostasis and is a target for statins. In this retrospective cohort study, we evaluated the effects of an intravenous infusion of zoledronic acid (5 mg) or clodronic acid (1500 mg) on blood lipid (i.e. total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol and triglycerides) and glucose levels in patients with osteoporosis and Paget's disease of bone. All patients were evaluated before, 1 and 6 months after bisphosphonate treatment. Pagetic and osteoporotic patients treated with zoledronic acid showed a significant reduction in glucose and atherogenic lipids during follow-up whereas these phenomena were not observed after clodronic treatment. The effect on circulating lipid levels was similar in naïve and re-treated Pagetic patients. Zoledronic acid treatment was associated with a reduction in blood glucose and atherogenic lipids in patients with metabolic bone disorders. The extent of change was similar to that obtained with the regular assumption of a low-intensity statin. Further studies are warranted to better evaluate the clinical implications of these observations.
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Affiliation(s)
- Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert-Debré, Service d'Endocrinologie et Diabétologie Pédiatrique, Paris, France
| | - Daniela Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Veronica Abate
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy
| | - Alessio Buonaiuto
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy
| | - Marco Evangelista
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy
| | - Marco Gentile
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy
| | - Alfonso Giaquinto
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy
| | - Tommaso Picchioni
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | | | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy
| | - Luigi Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy, 5, Via Pansini, 80131, Naples, Italy.
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Rendina D, De Filippo G, Merlotti D, Di Stefano M, Mingiano C, Giaquinto A, Evangelista M, Bo M, Arpino S, Faraonio R, Strazzullo P, Gennari L. Increased Prevalence of Nephrolithiasis and Hyperoxaluria in Paget Disease of Bone. J Clin Endocrinol Metab 2020; 105:5896000. [PMID: 32827434 DOI: 10.1210/clinem/dgaa576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT Nephrolithiasis (NL) and primary hyperparathyroidism (HPTH) are metabolic complications of Paget disease of bone (PDB), but recent data regarding their prevalence in PDB patients are lacking. OBJECTIVES Study 1: To compare the prevalence of primary HPTH and NL in 708 patients with PDB and in 1803 controls. Study 2: To evaluate the prevalence of NL-metabolic risk factors in 97 patients with PDB and NL, 219 PDB patients without NL, 364 NL patients without PDB, and 219 controls, all of them without HPTH. DESIGN Cross-sectional multicentric study. SETTING Italian referral centers for metabolic bone disorders. PARTICIPANTS Patients with PDB from the Associazione Italiana malati di osteodistrofia di Paget registry. Participants in the Olivetti Heart and the Siena Osteoporosis studies. MAIN OUTCOME MEASURES HPTH; NL; NL-metabolic risk factors. RESULTS Patients with PDB showed higher prevalence of primary HPTH and NL compared with controls (P < 0.01). The NL recurrence occurs more frequently in patients with polyostotic PDB. About one-half of patients with PDB but without NL showed 1 or more NL-related metabolic risk factors. The hyperoxaluria (HyperOx) prevalence was higher in patients with PDB and NL compared with patients with NL but without PDB and in patients with PDB without NL compared with controls (P = 0.01). Patients with PDB and HyperOx showed a longer lapse of time from the last aminobisphosphonate treatment. CONCLUSIONS NL and HPTH are frequent metabolic complication of PDB. The NL occurrence should be evaluated in patients with PDB, particularly in those with polyostotic disease and/or after aminobisphosphonate treatment to apply an adequate prevention strategy.
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Affiliation(s)
- Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Service d'Endocrinologie et Diabétologie Pédiatrique, Paris, France
| | - Daniela Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Marco Di Stefano
- Department of Medical Science, Gerontology and Bone Metabolic Diseases, University of Torino, Torino, Italy
| | - Christian Mingiano
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Alfonso Giaquinto
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marco Evangelista
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Mario Bo
- Department of Medical Science, Gerontology and Bone Metabolic Diseases, University of Torino, Torino, Italy
| | - Sergio Arpino
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Raffaella Faraonio
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Luigi Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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5
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Abstract
PURPOSE OF REVIEW To provide clinicians an overview to the diagnosis, treatment, and management of Paget's disease, including recent guideline recommendations, with comparison of the Endocrine Society Clinical Practice Guideline (JCEM 2014) with the new Clinical Guideline review endorsed by the International Osteoporosis Foundation, the American Society of Bone and Mineral Research, the European Calcified Tissues Society, and the United Kingdom Bone Research Society (JBMR 2019). RECENT FINDINGS Radionuclide bone scans are recommended for assessing the extent of Paget's disease. Bisphosphonates remain the mainstay for therapy with evidence of reducing symptomatic bone pain. One 5 mg intravenous dose of zoledronic acid is the current standard therapy for Paget's disease. SUMMARY Paget's disease of the bone is characterized by focal increased bone remodeling activity, resulting in sclerotic or lytic lesions and poor bone quality at one or more sites. Patients may be symptomatic with bone pain, or may be asymptomatic, and identified through unexplained elevations in serum alkaline phosphatase. Diagnosis is through plain film imaging, with radionuclide bone scan to determine the extent. A single dose of IV zoledronic acid typically results in extended suppression of bone turnover and amelioration of bone pain. There remains a lack of evidence regarding efficacy of this treatment with regards to other complications of Paget's, but in general, bisphosphonate treatment is recommended.
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Affiliation(s)
- Emory Hsu
- Division of Endocrinology, Santa Clara Valley Medical Center, California, USA
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6
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Rendina D, De Filippo G, Merlotti D, Di Stefano M, Succoio M, Muggianu SM, Bianciardi S, D'Elia L, Coppo E, Faraonio R, Nuti R, Strazzullo P, Gennari L. Vitamin D Status in Paget Disease of Bone and Efficacy-Safety Profile of Cholecalciferol Treatment in Pagetic Patients with Hypovitaminosis D. Calcif Tissue Int 2019; 105:412-422. [PMID: 31236621 DOI: 10.1007/s00223-019-00578-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 06/18/2019] [Indexed: 01/03/2023]
Abstract
Adequate vitamin D status is essential for skeletal health. Paget's disease of bone (PDB) is a common metabolic skeletal disorder, but data regarding the vitamin D status in PDB patients are lacking. We performed a case-control study to estimate vitamin D status in 708 PDB patients and in 1803 healthy controls from Italy and an observational prospective study to evaluate the efficacy-safety profile of oral cholecalciferol treatment [400.000 International Units (UI) of cholecalciferol administered in cycles of 8 weeks until 25OHD levels reaches 70 nmol/L as primary therapy and 50.000 UI of cholecalciferol administered every 2 weeks for 52 weeks for the maintenance therapy] in 82 PDB patients with hypovitaminosis D, i.e., 25OHD < 50 nmol/L. The main outcome measures for the prospective study were 25OHD levels, metabolic risk factors (RF) for nephrolithiasis, bone pain score (BPS), and pain medication score (PMS). Over half of PDB patients had hypovitaminosis D. Among PDB patients treated with cholecalciferol, 76 patients reached 25OHD levels ≥ 70 nmol/L after the first cycle of primary therapy and the remaining six patients after a second cycle. The maintenance therapy guaranteed 25OHD levels ≥ 70 nmol/L during the entire follow-up. The increase in 25OHD levels reduced PTH, BPS, and PMS levels, without changes in RF for nephrolithiasis. We can conclude that (i) hypovitaminosis D is frequent in PDB patients, (ii) cholecalciferol significantly increased 25OHD levels in PDB patients, and (iii) the correction of hypovitaminosis D improves the quality of life of PDB patients without inducing significant changes in RF for nephrolithiasis.
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Affiliation(s)
- Domenico Rendina
- Department of Medicine and Surgery, Federico II University, 5, via Pansini, 80131, Naples, Italy.
| | - Gianpaolo De Filippo
- Service de Médecine des Adolescents, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Daniela Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Marco Di Stefano
- Department of Medical Science, Gerontology and Bone Metabolic Diseases, University of Torino, Turin, Italy
| | - Mariangela Succoio
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Simona Maria Muggianu
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Simone Bianciardi
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Lanfranco D'Elia
- Department of Medicine and Surgery, Federico II University, 5, via Pansini, 80131, Naples, Italy
| | - Eleonora Coppo
- Department of Medical Science, Gerontology and Bone Metabolic Diseases, University of Torino, Turin, Italy
| | - Raffaella Faraonio
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Ranuccio Nuti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Pasquale Strazzullo
- Department of Medicine and Surgery, Federico II University, 5, via Pansini, 80131, Naples, Italy
| | - Luigi Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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7
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Sharaf A, Mensching L, Keller C, Rading S, Scheffold M, Palkowitsch L, Djogo N, Rezgaoui M, Kestler HA, Moepps B, Failla AV, Karsak M. Systematic Affinity Purification Coupled to Mass Spectrometry Identified p62 as Part of the Cannabinoid Receptor CB2 Interactome. Front Mol Neurosci 2019; 12:224. [PMID: 31616248 PMCID: PMC6763791 DOI: 10.3389/fnmol.2019.00224] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/03/2019] [Indexed: 01/29/2023] Open
Abstract
The endocannabinoid system (ECS) consists particularly of cannabinoid receptors 1 and 2 (CB1 and CB2), their endogenous ligands, and enzymes that synthesize and degrade their ligands. It acts in a variety of organs and disease states ranging from cancer progression over neuropathic pain to neurodegeneration. Protein components engaged in the signaling, trafficking, and homeostasis machinery of the G-protein coupled CB2, are however largely unknown. It is therefore important to identify further interaction partners to better understand CB2 receptor functions in physiology and pathophysiology. For this purpose, we used an affinity purification and mass spectrometry-based proteomics approach of Strep-HA-CB2 receptor in HEK293 cells. After subtraction of background interactions and protein frequency library assessment we could identify 83 proteins that were classified by the identification of minimally 2 unique peptides as highly probable interactors. A functional protein association network analysis obtained an interaction network with a significant enrichment of proteins functionally involved in protein metabolic process, in endoplasmic reticulum, response to stress but also in lipid metabolism and membrane organization. The network especially contains proteins involved in biosynthesis and trafficking like calnexin, Sec61A, tubulin chains TUBA1C and TUBB2B, TMED2, and TMED10. Six proteins that were only expressed in stable CB2 expressing cells were DHC24, DHRS7, GGT7, HECD3, KIAA2013, and PLS1. To exemplify the validity of our approach, we chose a candidate having a relatively low number of edges in the network to increase the likelihood of a direct protein interaction with CB2 and focused on the scaffold/phagosomal protein p62/SQSTM1. Indeed, we independently confirmed the interaction by co-immunoprecipitation and immunocytochemical colocalization studies. 3D reconstruction of confocal images furthermore showed CB2 localization in close proximity to p62 positive vesicles at the cell membrane. In summary, we provide a comprehensive repository of the CB2 interactome in HEK293 cells identified by a systematic unbiased approach, which can be used in future experiments to decipher the signaling and trafficking complex of this cannabinoid receptor. Future studies will have to analyze the exact mechanism of the p62-CB2 interaction as well as its putative role in disease pathophysiology.
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Affiliation(s)
- Ahmed Sharaf
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leonore Mensching
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Keller
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Rading
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marina Scheffold
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Pharmacology and Toxicology, Ulm University, Ulm, Germany
| | | | - Nevena Djogo
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Meriem Rezgaoui
- Institute for Biochemistry and Molecular Biology, University of Hamburg, Hamburg, Germany
| | - Hans A Kestler
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
| | - Barbara Moepps
- Institute of Pharmacology and Toxicology, Ulm University, Ulm, Germany
| | | | - Meliha Karsak
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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8
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Nebot E, Heimel P, Tangl S, Dockner M, Patsch J, Weber GW, Pretterklieber M, Teschler-Nicola M, Pietschmann P. Paget's Disease of Long Bones: Microstructural Analyses of Historical Bone Samples. Calcif Tissue Int 2019; 105:15-25. [PMID: 30850857 DOI: 10.1007/s00223-019-00539-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/03/2019] [Indexed: 11/28/2022]
Abstract
Although Paget's disease of bone (PDB) is the second most common metabolic bone disease, there is only limited information about the microarchitecture of affected bones. Therefore, the aim of this study was to determine cortical and trabecular bone properties in clinically relevant locations by microcomputed tomography (µCT). Ten femora and ten tibiae affected by Paget's disease taken from the Natural History Museum Vienna were compared to 13 femora and 10 tibiae of non-affected body donors. Digitization of the cortical and trabecular bone microarchitecture was performed with an X-ray-based µCT scanner. Additionally, semi-quantitative gradings of trabecular and cortical architectural parameters of the femora and the tibiae were generated. Microcomputed tomography images showed changes in the thickness of cortices, cortical porosity, and trabecularization of cortical structures. Moreover, severe disorganization of trabecular structures, trabecular defects, and thickening of (remaining) trabeculae were detected. Numerical cortical analyses showed lower total bone volume (BV) and lower BV in the outer region (66-100%) (- 36%, p = 0.004, and - 50%, p < 0.001, respectively), lower total volume (TV) in the outer region (66-100%) (- 42%, p < 0.001), lower total bone volume fraction (BV/TV) and BV/TV in the outer region (66-100%) (- 23%, and - 12%, p < 0.001, respectively), higher BV and TV in the middle region (33-66%) and higher BV/TV in the inner region (0-33%) (123%, p = 0.011, 147%, p = 0.010, and 33%, p = 0.025, respectively) in Pagetic compared to non-affected bones. Trabecular analyses showed higher BV/TV (96%, p = 0.008) and Tb.Th (43%, p = 0.004) in Pagetic compared to non-affected bones. There is a major and consistent structural alteration of PDB at cortical and trabecular sites in weight-bearing long bones. Our findings are relevant for the differential diagnosis of PDB and for the pathogenesis of associated complications, since the disorder produces abnormalities in the structure that might lead to bone fragility.
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Affiliation(s)
- Elena Nebot
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090, Vienna, Austria
- Department of Physiology, School of Pharmacy, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
- Department of Preventive Medicine and Public Health, School of Pharmacy, University of Granada, Granada, Spain
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology - Austrian Cluster for Tissue Regeneration, AUVA Research Center, Vienna, Austria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Martin Dockner
- Department of Anthropology, and Core Facility for Micro-Computed Tomography, University of Vienna, Vienna, Austria
| | - Janina Patsch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gerhard W Weber
- Department of Anthropology, and Core Facility for Micro-Computed Tomography, University of Vienna, Vienna, Austria
| | - Michael Pretterklieber
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Maria Teschler-Nicola
- Pathological-Anatomical Collection in the Fool's Tower, Department of Anthropology, Natural History Museum Vienna, Vienna, Austria
| | - Peter Pietschmann
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090, Vienna, Austria.
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Lee YK, Kim HS, Cho HS, Koo KH. Subtrochanteric femoral stress fracture with features of atypical femoral fracture in patient with Paget's disease: a case report. ACTA ACUST UNITED AC 2018; 14:368-371. [PMID: 29354170 DOI: 10.11138/ccmbm/2017.14.3.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Atypical femoral fracture (AFF) has been widely issued since the American Society for Bone and Mineral Research (ASBMR) taskforce stated a possible association with long-term use of bisphosphonate in 2010. ASBMR taskforce recommended to include Paget's disease as one of variables to investigate the AFF in 2010. On the other hand, the ASBMR taskforce in 2014 excluded Paget's disease in the definition of AFF. Still, any rationale has been barely documented about this change. We described the rationale by reporting an 85-year-old man who had a subtrochanteric fracture with features of atypical femoral fracture which turned out to be Paget's disease of bone in the pathology.
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Affiliation(s)
- Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hong Seok Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hwan Seong Cho
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Rolvien T, Butscheidt S, Zustin J, Amling M. Skeletal dissemination in Paget's disease of the spine. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:453-457. [PMID: 29344730 DOI: 10.1007/s00586-018-5477-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 11/29/2017] [Accepted: 01/13/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Paget's disease of bone (PDB) is a common skeletal disorder that is associated with locally increased bone turnover, skeletal deformity and pain. We report a case of skeletal dissemination in PDB of the spine. METHODS Case report. RESULTS A 46-year-old former professional athlete suffered from disseminated PDB throughout the spine and hips after various surgical interventions including spondylodesis, bone grafting and bone morphogenetic protein (rhBMP-2) administration. Only intravenous zoledronic acid prevented the further progression of skeletal dissemination, which was expressed by a normalization of (bone-specific) alkaline phosphatase levels. The biopsy obtained from the lumbar spine confirmed the diagnosis of PDB in the absence of malignant transformation. CONCLUSIONS We outline skeletal dissemination as a possibly surgery-related complication in a patient with PDB in the lumbar spine. Bisphosphonates remain the treatment of first choice in PDB and surgical interventions should be considered very carefully.
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Affiliation(s)
- Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany.,Department of Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Sebastian Butscheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany
| | - Jozef Zustin
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany.,Pathologie Hamburg, Lademannbogen 61-63, 22339, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany.
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Alaya R, Alaya Z, Nang M, Bouajina E. [Paget's disease of bone: Diagnostic and therapeutic updates]. Rev Med Interne 2017; 39:185-191. [PMID: 28690091 DOI: 10.1016/j.revmed.2017.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 03/09/2017] [Accepted: 05/30/2017] [Indexed: 11/15/2022]
Abstract
Paget's disease of bone is the second most common metabolic bone disease after osteoporosis. Its pathogenesis is not yet clearly understood. Geographic distribution and epidemiological variations suggest a role of genetic and environmental factors in its pathophysiology. The frequency of the Paget's disease of bone increases with age. Its discovery can be fortuitous. Prognosis mainly depends on the occurrence of complications involving bones and joints, neurological, cardiovascular or metabolic systems. Treatment of symptomatic forms currently relies on bisphosphonates that have transformed its prognosis.
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Affiliation(s)
- R Alaya
- Service de rhumatologie, centre hospitalier Sud Francilien, 91100 Corbeil-Essonnes, France
| | - Z Alaya
- Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
| | - M Nang
- Service de rhumatologie, centre hospitalier Sud Francilien, 91100 Corbeil-Essonnes, France
| | - E Bouajina
- Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
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Zimmermann EA, Köhne T, Bale HA, Panganiban B, Gludovatz B, Zustin J, Hahn M, Amling M, Ritchie RO, Busse B. Modifications to nano- and microstructural quality and the effects on mechanical integrity in Paget's disease of bone. J Bone Miner Res 2015; 30:264-73. [PMID: 25112610 DOI: 10.1002/jbmr.2340] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/04/2014] [Accepted: 08/07/2014] [Indexed: 12/28/2022]
Abstract
Paget's disease of bone (PDB) is the second most common bone disease mostly developing after 50 years of age at one or more localized skeletal sites; it is associated with severely high bone turnover, bone enlargement, bowing/deformity, cracking, and pain. Here, to specifically address the origins of the deteriorated mechanical integrity, we use a cohort of control and PDB human biopsies to investigate multiscale architectural and compositional modifications to the bone structure (ie, bone quality) and relate these changes to mechanical property measurements to provide further insight into the clinical manifestations (ie, deformities and bowing) and fracture risk caused by PDB. Here, at the level of the collagen and mineral (ie, nanometer-length scale), we find a 19% lower mineral content and lower carbonate-to-phosphate ratio in PDB, which accounts for the 14% lower stiffness and 19% lower hardness promoting plastic deformation in pathological bone. At the microstructural scale, trabecular regions are known to become densified, whereas cortical bone loses its characteristic parallel-aligned osteonal pattern, which is replaced with a mosaic of lamellar and woven bone. Although we find this loss of anisotropic alignment produces a straighter crack path in mechanically-loaded PDB cases, cortical fracture toughness appears to be maintained due to increased plastic deformation. Clearly, the altered quality of the bone structure in PDB affects the mechanical integrity leading to complications such as bowing, deformities, and stable cracks called fissure fractures associated with this disease. Although the lower mineralization and loss of aligned Haversian structures do produce a lower modulus tissue, which is susceptible to deformities, our results indicate that the higher levels of plasticity may compensate for the lost microstructural features and maintain the resistance to crack growth.
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Affiliation(s)
- Elizabeth A Zimmermann
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
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Wolfovitz A, Shihada R, Shpak T, Braun J, Luntz M. Cochlear implantation in a patient with paget's disease. Laryngoscope 2011; 121:358-60. [DOI: 10.1002/lary.21281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 08/13/2010] [Indexed: 11/06/2022]
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Focus on Skeletal Bone Diseases - Osteoporosis and Paget's Disease of Bone. Eur J Trauma Emerg Surg 2008; 34:525. [PMID: 26816274 DOI: 10.1007/s00068-008-1006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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