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Muniyasamy R, Manjubala I. Insights into the Mechanism of Osteoporosis and the Available Treatment Options. Curr Pharm Biotechnol 2024; 25:1538-1551. [PMID: 37936474 DOI: 10.2174/0113892010273783231027073117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 11/09/2023]
Abstract
Osteoporosis, one of the most prevalent bone illnesses, majorly affects postmenopausal women and men over 50 years of age. Osteoporosis is associated with an increased susceptibility to fragility fractures and can result in persistent pain and significant impairment in affected individuals. The primary method for diagnosing osteoporosis involves the assessment of bone mineral density (BMD) through the utilisation of dual energy x-ray absorptiometry (DEXA). The integration of a fracture risk assessment algorithm with bone mineral density (BMD) has led to significant progress in the diagnosis of osteoporosis. Given that osteoporosis is a chronic condition and multiple factors play an important role in maintaining bone mass, comprehending its underlying mechanism is crucial for developing more effective pharmaceutical interventions for the disease. The effective management of osteoporosis involves the utilisation of appropriate pharmacological agents in conjunction with suitable dietary interventions and lifestyle modifications. This review provides a comprehensive understanding of the types of osteoporosis and elucidates the currently available pharmacological treatment options and their related mechanism of action and usage.
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Affiliation(s)
- Rajeshwari Muniyasamy
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Inderchand Manjubala
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, India
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Hadjiargyrou M. Effects of bisphosphonates on appendicular fracture repair in rodents. Bone 2022; 164:116542. [PMID: 36041726 DOI: 10.1016/j.bone.2022.116542] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022]
Abstract
The balance between osteoclastic bone resorption and osteoblastic bone formation is ultimately responsible for maintaining a structural and functional skeleton. Despite their strength, bones do break and the main cause of fractures are trauma and decreased bone mineral density as a result of aging and/or pathology that weakens the bone's microarchitecture and subsequently, its material properties. Osteoporosis is a disease marked by increased osteoclast activity and decreased osteoblastic activity tipping the remodeling balance in favor of bone resorption and can be caused by aging, glucocorticoids, disuse and estrogen-deficiency. Ultimately, this leads to brittle and weaker bones which become more prone to trauma or stress-induced fractures. The current treatment for preventing and treating osteoporotic fractures is the use of antiresorptive drugs such as bisphosphonates (BPs) and denosumab, but unfortunately, their long-term use, especially with alendronate and ibandronate, has been associated with increased risk of atypical femoral fractures (AFFs); femoral diaphyseal fractures distal to the lesser trochanter but proximal to the supracondylar flare. The purpose of this review is to examine the information that exists in the literature examining the effects of BPs on fracture repair of long bones in rodent (rat and mouse) models. The focus on rodents stems from the scientific community's unresolved need to develop small animal models to examine the molecular, cellular, tissue and biomechanical mechanisms responsible for the development of AFFs and how best they can be treated.
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Affiliation(s)
- Michael Hadjiargyrou
- Department of Biological & Chemical Sciences, New York Institute of Technology, Old Westbury, NY 11568, United States of America.
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Zhang C, Zhu J, Jia J, Guan Z, Sun T, Zhang W, Yuan W, Wang H, Song C. Long-term pretreatment with alendronate inhibits calvarial defect healing in an osteoporotic rat model. J Bone Miner Metab 2021; 39:925-933. [PMID: 34091742 DOI: 10.1007/s00774-021-01235-0] [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: 10/28/2020] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed to observe the effects of long-term alendronate pretreatment on the healing of osteoporotic calvarial defects, and further investigate the effect of alendronate combined with once-weekly parathyroid hormone following 12 weeks of alendronate treatment in ovariectomized rats. MATERIALS AND METHODS Thirty 3-month-old female rats were ovariectomized, and 24 rats received alendronate for 12 weeks. Then, a critical defect was created in the calvaria of all animals. Immediately after osteotomy, the animals received one of five treatments for 8 weeks: (1) continuation of vehicle (group E), (2) alendronate followed by vehicle (group A), (3) continuation of alendronate (group B), (4) alendronate followed by once-weekly parathyroid hormone alone (group C), or (5) continuation of alendronate combined with once-weekly parathyroid hormone (group D). Calvarial defect healing was assessed using dual-energy X-ray absorptiometry, micro-computed tomography, histology, and sequential fluorescence labeling. RESULTS Group E showed a significantly higher volume of newly formed bone than groups A, B, C, and D. Evidence of new dense bone formation in group E was observed histologically. In addition, the immunohistochemical expression of runt-related transcription factor 2 was increased in group E but inhibited in groups A, B, C, and D. Sequential immunofluorescence also showed inhibited mineral apposition in groups A, B, C, and D compared with group E. CONCLUSION The present study shows that long-term pretreatment with alendronate inhibited calvarial defect healing in osteoporotic rats, and this effect could not be reversed by stopping alendronate, switching to parathyroid hormone, or combining with once-weekly parathyroid hormone.
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Affiliation(s)
- Chenggui Zhang
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Junxiong Zhu
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Jialin Jia
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Zhiyuan Guan
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Tiantong Sun
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Wang Zhang
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Wanqiong Yuan
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Hong Wang
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Chunli Song
- Department of Orthopedics, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China.
- Beijing Key Laboratory of Spinal Diseases, Beijing, China.
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Zhang C, Zhu J, Jia J, Guan Z, Sun T, Zhang W, Yuan W, Wang H, Leng H, Song C. Once-weekly parathyroid hormone combined with ongoing long-term alendronate treatment promotes osteoporotic fracture healing in ovariectomized rats. J Orthop Res 2021; 39:2103-2115. [PMID: 33325546 DOI: 10.1002/jor.24953] [Citation(s) in RCA: 3] [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: 08/28/2020] [Revised: 11/09/2020] [Accepted: 12/14/2020] [Indexed: 02/04/2023]
Abstract
This study examined the effect of once-weekly parathyroid hormone (PTH) combined with alendronate upon osteoporotic fracture healing after long-term alendronate anti-osteoporosis therapy. Seventy-six 12-week-old female Sprague-Dawley rats were either sham operated or bilaterally ovariectomized (OVX). Following confirmation of osteoporosis 3 months after OVX, the remaining 64 animals received alendronate therapy. After 3 months of alendronate treatment, all rats underwent unilateral transverse tibial osteotomy. Animals were immediately randomly assigned to one of four groups: (1) alendronate followed by vehicle (ALN-VEH), (2) continuation of alendronate (ALN-ALN), (3) alendronate followed by once-weekly PTH alone (ALN-PTH), (4) continuation of alendronate combined with once-weekly PTH (ALN-ALN + PTH) until collection at 4 or 8 weeks after osteotomy. The fractured tibia was assessed using x-ray, dual-energy x-ray absorptiometry, microcomputed tomography, biomechanical testing, histology, and sequential fluorescence labeling. The ALN-ALN + PTH treatment significantly increased total callus volume, mineralized callus volume, mineralized callus volume/total callus volume, and biomechanical strength of the callus relative to ALN-VEH and ALN-PTH treatments at both 4 and 8 weeks and produced more mature trabecular bone compared with ALN-ALN treatment at 8 weeks. RANKL/osteoprotegerin (OPG) are osteoclastogenesis markers, while cluster of differentiation 31 (CD31) is an important marker of angiogenesis. Qualitative immunohistochemical analysis revealed that CD31 and OPG expression was was strong after ALN-ALN + PTH compared with ALN-ALN treatment, whereas RANKL expression was weak after ALN-ALN + PTH versus ALN-PTH treatment. Our study showed that once-weekly PTH combined with alendronate was beneficial in promoting the healing of fractures acquired after long-term alendronate therapy in OVX-induced osteoporotic rats.
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Affiliation(s)
- Chenggui Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Junxiong Zhu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Jialin Jia
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Zhiyuan Guan
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Tiantong Sun
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Wang Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Wanqiong Yuan
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Hong Wang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Huijie Leng
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Chunli Song
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
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Eastman K, Gerlach M, Piec I, Greeves J, Fraser W. Effectiveness of parathyroid hormone (PTH) analogues on fracture healing: a meta-analysis. Osteoporos Int 2021; 32:1531-1546. [PMID: 33559713 DOI: 10.1007/s00198-021-05847-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 01/12/2021] [Indexed: 12/21/2022]
Abstract
UNLABELLED This meta-analysis evaluated the evidence for the use of parathyroid hormone (PTH) analogues to improve fracture healing. Eligible studies were prospective randomised controlled trials of adults with acute fractures treated with a PTH analogue. PTH improved functional outcomes but did not affect fracture healing rate or reduce pain. PURPOSE This meta-analysis evaluated the evidence of parathyroid hormone (PTH) analogues in fracture healing. The use of PTH analogues to prevent osteoporotic fractures is well investigated, and studies are emerging on extended indications. One such indication receiving increasing attention is the effect of PTH in fracture healing; however, the overall degree of efficacy remains inconclusive. METHODS A systematic electronic database search of MEDLINE, EMBASE and the Cochrane Library was conducted for relevant articles in August 2019 with no date restrictions. Randomised controlled trials of adults with acute fractures treated with a PTH analogue were included. PTH was compared with a comparator intervention, placebo or no treatment. RESULTS PTH analogue treatment improved functional outcomes in a range of fracture types but did not affect the fracture healing rate or reduce pain. Most trials included in this review were in elderly patients with osteoporosis. There was no evidence that PTH treatment caused harm or impeded fracture healing. CONCLUSIONS Meta-analysis of published data supports the use of PTH analogues to improve functional outcomes but not fracture healing rate or pain for different fracture types. The evidence for PTH analogue use in fracture healing is less clear in younger, non-osteoporotic patient populations. Trial design was heterogeneous and of limited quality, justifying further original trials.
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Affiliation(s)
- K Eastman
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | - M Gerlach
- Norfolk and Norwich University Hospital, Norwich, UK
| | - I Piec
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J Greeves
- Norwich Medical School, University of East Anglia, Norwich, UK
- Department of Army Health and Performance Research, Andover, Hampshire, UK
| | - W Fraser
- Norwich Medical School, University of East Anglia, Norwich, UK
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Li Z, Tian Y, Zhang L, Zhang T, Wang P, Wang J. Type II collagen from squid cartilage mediated myogenic IGF-I and irisin to activate the Ihh/PThrp and Wnt/β-catenin pathways to promote fracture healing in mice. Food Funct 2021; 12:6502-6512. [PMID: 34080588 DOI: 10.1039/d0fo03069d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Fractures are the most common large-organ, traumatic injury in humans. The fracture healing stage includes the inflammatory stage (0-5d), cartilage callus stage (5-14d) and hard callus stage (14-21d). All mice underwent open tibial fracture surgery and were treated with saline, Glu or SCII for 21d. Calluses were harvested 5d, 10d and 21d after fracture. Compared with the model group, SCII significantly decreased TNF-α and increased aggrecan serum levels by 5d. H&E results showed that fibrous calluses were already formed in the SCII group and that chondrocytes had begun to proliferate. By 10d, the chondrocytes in the SCII group became hypertrophic and mineralized, and the serum TGF-β and Col-Iα levels were significantly increased, which indicated that the mice with SCII treatment rapidly passed the cartilage repair period and new bone formation was accelerated. Skeletal muscle repaired bones through muscle paracrine factors. IGF-1 and irisin are the two major secretory cytokines. The results showed that the content of muscle homogenate IGF-1 in the SCII group reached the peak at 10d, followed by the up-regulation of Ihh, Patched, Gli1 and Col10α in the callus through the bone surface receptor IGF-1R. Besides, SCII also significantly elevated the muscle irisin level (10 and 21d), and then increased Wnt10b, LRP5, β-catenin and Runx2 expression in the callus by receptor αVβ5. These results suggest that SCII can accelerate the process of endochondral osteogenesis and promote fracture healing through activating the Ihh/PThrp and Wnt/β-catenin pathways by regulating muscle paracrine factors. To our knowledge, this is the first study to investigate the effect of marine-derived collagen on fracture healing. This study may provide a theoretical basis for the high-value application of the laryngeal cartilage of squid in the future.
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Affiliation(s)
- Zhuo Li
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, China.
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7
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Zhang C, Song C. Combination Therapy of PTH and Antiresorptive Drugs on Osteoporosis: A Review of Treatment Alternatives. Front Pharmacol 2021; 11:607017. [PMID: 33584284 PMCID: PMC7874063 DOI: 10.3389/fphar.2020.607017] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/21/2020] [Indexed: 12/04/2022] Open
Abstract
Antiresorptive drugs have been widely used for osteoporosis. Intermittent parathyroid hormone (PTH), an anabolic agent, increases osteoblast production rate and inhibits apoptosis of osteoblasts, thus increasing skeletal mass besides improving bone microarchitecture and strength. Combination therapy for osteoporosis produced great interests and controversies. Therefore, we performed a systematic literature search from PubMed, EMBASE, Scopus, Web of Science, CINDHL, and the Cochrane Database of Systematic Reviews using the search terms PTH or teriparatide combined with bisphosphonate, alendronate, ibandronate, risedronate, raloxifene, denosumab, and zoledronic acid with the limit osteoporosis. At last, 36 related articles were included for further analysis. Findings from previous studies revealed that combination therapy in different conditions of naive or previous bisphosphonate treatment might have different outcomes. The use of combination therapy, however, may be an alternative option among osteoporotic patients with a history of bisphosphonate use. Combined teriparatide with denosumab appear to show the most substantial and clinically relevant skeletal benefits to osteoporotic patients. Additional research is necessary to define optimal methods of developing sequential and/or cyclical combinations of PTH and antiresorptive agents.
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Affiliation(s)
- Chenggui Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Chunli Song
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Diseases, Beijing, China
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8
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Simpson CR, Kelly HM, Murphy CM. Synergistic use of biomaterials and licensed therapeutics to manipulate bone remodelling and promote non-union fracture repair. Adv Drug Deliv Rev 2020; 160:212-233. [PMID: 33122088 DOI: 10.1016/j.addr.2020.10.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022]
Abstract
Disrupted bone metabolism can lead to delayed fracture healing or non-union, often requiring intervention to correct. Although the current clinical gold standard bone graft implants and commercial bone graft substitutes are effective, they possess inherent drawbacks and are limited in their therapeutic capacity for delayed union and non-union repair. Research into advanced biomaterials and therapeutic biomolecules has shown great potential for driving bone regeneration, although few have achieved commercial success or clinical translation. There are a number of therapeutics, which influence bone remodelling, currently licensed for clinical use. Providing an alternative local delivery context for these therapies, can enhance their efficacy and is an emerging trend in bone regenerative therapeutic strategies. This review aims to provide an overview of how biomaterial design has advanced from currently available commercial bone graft substitutes to accommodate previously licensed therapeutics that target local bone restoration and healing in a synergistic manner, and the challenges faced in progressing this research towards clinical reality.
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Affiliation(s)
- Christopher R Simpson
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Helena M Kelly
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Ciara M Murphy
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin (TCD), Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland.
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Ross RD, Anderson K, Davison R, El-Masri BM, Andreasen CM, Andersen TL, Sumner DR. Osteoporosis Treatments Affect Bone Matrix Maturation in a Rat Model of Induced Cortical Remodeling. JBMR Plus 2020; 4:e10344. [PMID: 32258964 PMCID: PMC7117844 DOI: 10.1002/jbm4.10344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/19/2020] [Indexed: 11/20/2022] Open
Abstract
To test how osteoporosis drugs affect bone matrix maturation during cortical bone remodeling, 72 pregnant rats were switched from a 0.4% to a 0.01% calcium diet at parturition for a 23‐day lactation period. At weaning, eight dams were sacrificed to establish baseline values, while the remaining dams were returned to 0.4% calcium and treated with vehicle (saline), sodium fluoride (NaF), zoledronic acid (ZA), or sclerostin antibody (Scl‐Ab) for either 7 or 28 days (eight animals per group per time point). Femora were examined by μCT, dynamic histomorphometry, Fourier transform infrared imaging, and three‐point bending of notched specimens. Cortical porosity decreased in all groups from baseline to day 28. Intracortical mineralizing surface (MS/BS) and mineral apposition rate (MAR), as well as the mineral‐to‐matrix ratio were unaffected by treatment, but intracortical crystallinity was increased in the ZA group at day 10 compared with vehicle. Cortical area increased in all groups over 28 days mainly because of an addition of bone at the endocortical surface. Endocortical MS/BS did not vary among the groups, but endocortical MAR was suppressed in the NaF group at day 2 and elevated in the Scl‐Ab group at day 4 compared with vehicle. Endocortical mineral‐to‐matrix ratio was increased at days 5 and 10 following NaF treatment and endocortical crystallinity was increased at day 5 following ZA treatment compared with vehicle. Fracture toughness did not differ among the groups. Thus, the treatments affected matrix maturation more strongly at the endocortical then intracortical envelope. In this model of induced remodeling, the bone formation phase is synchronized at multiple sites, facilitating study of the effects of drugs or other bone‐targeting agents on matrix maturation independent of their effects on the initiation of remodeling. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Ryan D Ross
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA.,Department of Orthopedic Surgery Rush University Medical Center Chicago IL USA
| | - Kyle Anderson
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA
| | - Reid Davison
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA
| | - Bilal M El-Masri
- 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
| | - Christina M Andreasen
- 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
| | - Thomas L 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
| | - Dale R Sumner
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA.,Department of Orthopedic Surgery Rush University Medical Center Chicago IL USA
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Yamashita J, McCauley LK. Effects of Intermittent Administration of Parathyroid Hormone and Parathyroid Hormone-Related Protein on Fracture Healing: A Narrative Review of Animal and Human Studies. JBMR Plus 2019; 3:e10250. [PMID: 31844831 PMCID: PMC6894727 DOI: 10.1002/jbm4.10250] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/08/2019] [Accepted: 10/30/2019] [Indexed: 12/17/2022] Open
Abstract
Intermittent administration of parathyroid hormone (PTH) stimulates skeletal remodeling and is a potent anabolic agent in bone. PTH‐related protein (PTHrP) is anabolic acting on the same PTH1 receptor and is in therapeutic use for osteoporosis. The body of literature for PTH actions in fracture healing is emerging with promising yet not entirely consistent results. The objective of this review was to perform a literature analysis to extract up‐to‐date knowledge on the effects of intermittent PTH and PTHrP therapy in bone fracture healing. A literature search of the PubMed database was performed. Clinical case studies and articles related to “regeneration,” “implant,” and “distraction osteogenesis” were excluded. A narrative review was performed to deliberate the therapeutic potential of intermittent PTH administration on fracture healing. A smaller number of studies centered on the use of PTHrP or a PTHrP analog were also reviewed. Animal studies clearly show that intermittent PTH therapy promotes fracture healing and revealed the strong therapeutic potential of PTH. Human subject studies were fewer and not as consistent as the animal studies yet provide insight into the potential of intermittent PTH administration on fracture healing. Differences in outcomes for animal and human studies appear to be attributed partly to variable doses, fracture sites, age, remodeling patterns, and bone architectures, although other factors are involved. Future studies to examine the dose, timing, and duration of PTH administration will be necessary to further delineate the therapeutic potential of PTH for fracture healing in humans. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Junro Yamashita
- Center for Regenerative Medicine, Fukuoka Dental College Fukuoka Japan
| | - Laurie K McCauley
- Department of Periodontics and Oral Medicine, School of Dentistry University of Michigan Ann Arbor MI USA.,Department of Pathology, Medical School University of Michigan Ann Arbor MI USA
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11
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Li H, Zhou Q, Bai BL, Weng SJ, Wu ZY, Xie ZJ, Feng ZH, Cheng L, Boodhun V, Yang L. Effects of combined human parathyroid hormone (1-34) and menaquinone-4 treatment on the interface of hydroxyapatite-coated titanium implants in the femur of osteoporotic rats. J Bone Miner Metab 2018; 36:691-699. [PMID: 29280077 DOI: 10.1007/s00774-017-0893-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 11/26/2017] [Indexed: 01/22/2023]
Abstract
The objective of this study was to investigate the effects of human parathyroid hormone (1-34) (PTH1-34; PTH) plus menaquinone-4 (vitamin K2; MK) on the osseous integration of hydroxyapatite (HA)-coated implants in osteoporotic rats. Ovariectomized female Sprague-Dawley rats were used for the study. Twelve weeks after bilateral ovariectomy, HA-coated titanium implants were inserted bilaterally in the femoral medullary canal of the remaining 40 ovariectomized rats. All animals were then randomly assigned to four groups: Control, MK, PTH and PTH + MK. The rats from groups MK, PTH and PTH + MK received vitamin K2 (30 mg/kg/day), PTH1-34 (60 μg/kg, three times a week), or both for 12 weeks. Thereafter, serum levels of γ-carboxylated osteocalcin (Gla-OC) were quantitated by ELISA and the bilateral femurs of rats were harvested for evaluation. The combination of PTH and MK clearly increased the serum levels of Gla-OC (a specific marker for bone formation) compared to PTH or MK alone. The results of our study indicated that all treated groups had increased new bone formation around the surface of implants and increased push-out force compared to Control. In addition, PTH + MK treatment showed the strongest effects in histological, micro-computed tomography and biomechanical tests. In summary, our results confirm that treatment with PTH1-34 and MK together may have a therapeutic advantage over PTH or MK monotherapy on bone healing around HA-coated implants in osteoporotic rats.
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Affiliation(s)
- Hang Li
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiang Zhou
- Department of Orthopedics Surgery, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang, China
| | - Bing-Li Bai
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - She-Ji Weng
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zong-Yi Wu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhong-Jie Xie
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhen-Hua Feng
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liang Cheng
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Viraj Boodhun
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lei Yang
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Tsubouchi Y, Ikeda S, Kataoka M, Tsumura H. Combination therapy with low-dose teriparatide and zoledronate contributes to fracture healing on rat femoral fracture model. J Orthop Surg Res 2018; 13:267. [PMID: 30359257 PMCID: PMC6202815 DOI: 10.1186/s13018-018-0917-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/15/2018] [Indexed: 01/05/2023] Open
Abstract
Background Delay in fracture healing or non-union can be devastating complication. Recent studies have reported that teriparatide (TP) demonstrated effectively on callus formation and mechanical strength and zoledronate (ZA) increased the callus size and resistance at the fracture site in rat fracture model. In this study, the effects of combination therapy with low dose TP and ZA on fracture healing was evaluated. Methods From 1 week post-operation, TP (5 times a week administration) and ZA (0.1 mg/kg single administration) were administered by dividing the rats into the following five groups: TP 1 μg group {T(1): TP 1 μg/kg}, ZA group (ZA:0.1 mg/kg), TP1 μg+ZA group {T(1)+ZA: TP 1 μg/kg+ZA}, TP 10 μg+ZA group {T(10)+ZA: TP 10 μg/kg + ZA}, and control group (C: administered saline). Rt femurs were excised 7 weeks after the surgery; bone fusions were evaluated with soft X-ray images on a 4-point scale. And the histopathological examination was performed in demineralized and non-demineralized specimens. Furthermore, the Radiographic Union Scale was conducted in all specimens. Results About the bone fusions rates, C, T(1), ZA, T(1)+ZA, and T(10)+ZA groups demonstrated 20.0%, 55.6%, 70.0%, 70.0%, and 80.0%, respectively, and with 4-point scale, each group was 0.50, 1.56, 2.00, 2.60, and 2.80 points, respectively. The callus volume was significantly increased to 16.66 mm2 and 17.75 mm2 in the T(1)+ZA and T(10)+ZA groups, respectively, while 10.65 mm2 (p < 0.05) in the C group. Furthermore, the callus area in the T(10)+ZA group was also observed to have significantly increased to 78.78%, compared with 54.63% and 44.11% in the C and T(1)+ZA groups, respectively (p < 0.01). Histopathologically, cartilage tissue and immature callus formation were observed at the bone junction in the C group; however, the osseous bridge formation of mature callus was observed in the ZA, T(1)+ZA, and T(10)+ZA groups. Conclusion It is suggested that administration of low dose TP and ZA in combination may lead to the treatment of delayed union of fracture. We hope the combination treatment may become one of new therapeutic strategy.
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Affiliation(s)
- Yuta Tsubouchi
- Oita University Hospital Rehabilitation Center, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-city, Oita, 879-5593, Japan
| | - Shinichi Ikeda
- Department of Rehabilitation Medicine, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-city, Oita, 879-5593, Japan
| | - Masashi Kataoka
- Physical Therapy Course of Study, Faculty of Welfare and Health Sciences, Oita University, 700 Dannoharu, Oita, 870-1192, Japan.
| | - Hiroshi Tsumura
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-city, Oita, 879-5593, Japan
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13
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Wu Z, Weng S, Yan D, Xie Z, Zhou Q, Li H, Bai B, Boodhun V, Shen Z, Tang J, Zhou L, Tao Z, Yang L. Administration of cinnamaldehyde promotes osteogenesis in ovariectomized rats and differentiation of osteoblast in vitro. J Pharmacol Sci 2018; 138:63-70. [PMID: 30266553 DOI: 10.1016/j.jphs.2018.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/27/2018] [Accepted: 09/03/2018] [Indexed: 12/13/2022] Open
Abstract
To explore the effect of cinnamaldehyde on the distal femur in ovariectomized rats and its influence on osteoblast in vitro. Female Sprague-Dawley rats which underwent either bilateral ovariectomy or sham operation were divided into five groups randomly: group OVX (OVX, N = 10) and group sham (SHAM, N = 10) received normal saline (NS) by gavage at a dose of 50 ml/kg·d; group low dose, group middle dose and group high dose received cinnamaldehyde by gavage at a dose of 25 mg/kg·d (OLD, N = 10), 50 mg/kg·d (OMD, N = 10), and 75 mg/kg·d (OHD, N = 10) respectively. Distal femurs were harvested for hematoxylin and eosin (HE) staining, micro-ct scanning and immunohistochemical analysis. Murine mesenchymal stem cells were cultured and dealt with the presence of either cinnamaldehyde at a dose of 15ug/ml (OLD), 30ug/ml (OMD), 60ug/ml (OHD) or vehicle. ALP staining and western blot were performed to observe the influence of cinnamaldehyde on the differentiation of osteoblast. HE and micro-ct results indicated that osteogenesis were promoted with the treatment of cinnamaldehyde. Immunohistochemical results showed that cinnamaldehyde increased the number of osteoblast and decreased the number of osteoclast. In vitro studies indicated that cinnamaldehyde promoted expression of alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), osteocalcin (OCN) and collagen type Iɑ1 (COL1ɑ1). The treatment effect behaved as dose-dependently. Thus, cinnamaldehyde inhibits osteoclastogenesis and promotes osteoblastogenesis, and may plays an important role in the treatment of osteoporosis clinically.
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Affiliation(s)
- Zongyi Wu
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Sheji Weng
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Deyi Yan
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Zhongjie Xie
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Qiang Zhou
- Department of Orthopaedics Surgery, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, No. 75, Jingxiu Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Hang Li
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Bingli Bai
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Viraj Boodhun
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Zijian Shen
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Jiahao Tang
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Lingling Zhou
- Department of Pathology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China
| | - Zhoushan Tao
- Department of Orthopaedics Surgery, The First Affiliated Hospital of Wannan Medical College, No. 2, Zheshan West Road, Wuhu, 241000, Anhui Province, People's Republic of China
| | - Lei Yang
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang Province, People's Republic of China.
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Liu Y, Levack AE, Marty E, Or O, Samuels BP, Redko M, Lane JM. Anabolic agents: what is beyond osteoporosis? Osteoporos Int 2018; 29:1009-1022. [PMID: 29627891 PMCID: PMC5949085 DOI: 10.1007/s00198-018-4507-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 03/23/2018] [Indexed: 02/06/2023]
Abstract
Osteoporosis is a common skeletal disorder characterized by low bone mass, which leads to reduced bone strength and an increased risk of fractures. Anabolic agents have been shown to improve bone mass and decrease fracture risk in osteoporosis patients by directly stimulating osteoblasts to produce new bone. Currently, two anabolic agents are available in the USA: recombinantly produced teriparatide (TPTD), which is the fully active (1-34) amino active sequence of human parathyroid hormone (PTH), and abaloparatide (APTD), a synthetic analog of parathyroid hormone-related peptide (PTHrP). At present, both agents are approved only for treatment of patients with osteoporosis at high risk of fracture. Nonetheless, their anabolic properties have led to off-label application in additional settings which include spine fusion, osteonecrosis of the jaw, arthroplasty, and fracture healing. In this article, we summarize available scientific literature regarding the efficacy, effectiveness, and safety of TPTD in these off-label settings.
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Affiliation(s)
- Y Liu
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA
| | - A E Levack
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA
| | - E Marty
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA
| | - O Or
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA
- Department of Orthopedic Surgery, Hadassah Medical Center, 91120, Jerusalem, Israel
| | - B P Samuels
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA
| | - M Redko
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA
| | - J M Lane
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA.
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15
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Yang L, Yang M. Early initiation of zoledronic acid does not impact bone healing or clinical outcomes of hallux valgus orthomorphia. J Int Med Res 2018; 46:3251-3261. [PMID: 29658353 PMCID: PMC6134676 DOI: 10.1177/0300060518760128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This prospective randomized controlled study was performed to determine whether early drug use for osteoporosis impacts bone healing after orthomorphic surgery for hallux valgus (HV) in menopausal patients with osteoporosis. Methods This study included 113 consecutive patients with osteoporosis who underwent a combination of Lapidus arthrodesis and Akin osteotomy for treatment of HV. The patients were randomly divided into a zoledronic acid (ZOL) group (5-mg intravenous injection of ZOL, n = 56) and a placebo group (n = 57); both ZOL and placebo were administered 1 week postoperatively. Radiographs were taken preoperatively and at 1, 6, 8, 10, and 12 weeks postoperatively to record the time of the first tarsometatarsal joint (FTJ) fusion and Akin osteotomy site healing. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system 24 weeks after surgery. Results There were no statistically significant differences in the FTJ fusion time after Lapidus arthrodesis, healing time after Akin osteotomy, or postoperative AOFAS scores between the two groups. Conclusion Early initiation of ZOL does not impact the bone healing or clinical outcomes of orthomorphic surgery for HV in postmenopausal women diagnosed with osteoporosis after a combination of Lapidus arthrodesis and Akin osteotomy.
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Affiliation(s)
- Lei Yang
- 1 Department of Orthopedics, the First Hospital of China Medical University, Liaoning, China.,2 Department of Orthopedics, Shenjing Hospital of China Medical University, Shenyang, China
| | - Maowei Yang
- 1 Department of Orthopedics, the First Hospital of China Medical University, Liaoning, China
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16
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Wang F, Han L, Wang X, Li Y, Zhu Y, Wang J, Xue C. Sialoglycoprotein isolated from eggs of Carassius auratus promotes fracture healing in osteoporotic mice. J Food Drug Anal 2018; 26:716-724. [PMID: 29567242 PMCID: PMC9322214 DOI: 10.1016/j.jfda.2017.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 07/22/2017] [Accepted: 07/24/2017] [Indexed: 01/04/2023] Open
Abstract
In this study, open tibial fracture surgery was performed on mice with ovariectomy induced osteoporosis to investigate the effect of a treatment with sialoglycoprotein isolated from Carassius auratus eggs (Ca-SGP) on fracture healing. Dynamic histological analysis showed that Ca-SGP promoted the generation of cartilage callus on day 5 post-surgery, then facilitated the transformation of the cartilage callus to bony callus on days 11 and 24 post-surgery, and enhanced the remodeling of bony callus on 35 day post-surgery. Moreover, Ca-SGP significantly decreased the secretion of TNF-α and IL-1β in serum on day 5 post-surgery, thus inhibiting the negative spread of the inflammatory reaction. On day 11 post-surgery, Ca-SGP clearly decreased the serum level and the mRNA expression of Aggrecan but also increased the secretion and the expression of VEGF and MMP13, thus promoting the degradation of the cartilage matrix and vascular invasion. On day 24 post-surgery, Ca-SGP remarkably increased the mRNA expression of osteogenesis markers Col1a and OCN, and increased callus BV/TV and Tb.N, this facilitating the formation of woven bone. On day 35 post-surgery, Ca-SGP enhanced the transformation of woven bone into lamellar bone and improved the callus biomechanical property. In conclusion, Ca-SGP promoted fracture healing in osteoporotic mice by accelerating endochondral ossification.
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17
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Zhang W, Zhu J, Ma T, Liu C, Hai B, Du G, Wang H, Li N, Leng H, Xu Y, Song C. Comparison of the effects of once-weekly and once-daily rhPTH (1-34) injections on promoting fracture healing in rodents. J Orthop Res 2018; 36:1145-1152. [PMID: 28960481 DOI: 10.1002/jor.23750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/22/2017] [Indexed: 02/04/2023]
Abstract
To compare the efficacy of once-weekly and once-daily subcutaneous injections of teriparatide (recombinant human parathyroid hormone 1-34) on fracture healing, 50 adult male Sprague-Dawley rats were subjected to a unilateral tibia fracture and received internal fixation with a Kirschner needle. Based on the injection dose and frequency, the rats were randomly divided into five groups (n = 10 each): subcutaneous injections of saline or 10 µg/kg/w, 20 µg/kg/w, 10 µg/kg/d, and 20 µg/kg/d teriparatide. Four weeks later, the rats were euthanatized, and the fractured tibiae were assessed using X-rays, dual-energy X-ray absorptiometry, micro-computed tomography, the three-point bending biomechanics test, and histology. Compared to the saline control group, either daily or weekly subcutaneous injections of teriparatide significantly increased bone mass, improved the bone microarchitecture, and promoted fracture healing (p < 0.05). There were no significant differences in bone mineral density (BMD), bone microstructure or bone strength between the 20 µg/kg/w and 10 µg/kg/d groups (p > 0.05). Teriparatide 20 µg weekly injections promoted bone fracture healing to the same extent as teriparatide 10 µg daily injections, which can dramatically decrease the cumulative dosage of teriparatide injections. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1145-1152, 2018.
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Affiliation(s)
- Wen Zhang
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
| | - Junxiong Zhu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
| | - Teng Ma
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
| | - Can Liu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
| | - Bao Hai
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
| | - Guohong Du
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
| | - Hong Wang
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Huijie Leng
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
| | - Yingsheng Xu
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Chunli Song
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, 49 North Garden Rd Haidian District, Beijing, China
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Yishake M, Yasen M, Jiang L, Liu W, Xing R, Chen Q, Lin H, Dong J. Effects of combined teriparatide and zoledronic acid on posterior lumbar vertebral fusion in an aged ovariectomized rat model of osteopenia. J Orthop Res 2018; 36:937-944. [PMID: 28796280 DOI: 10.1002/jor.23682] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/29/2017] [Indexed: 02/04/2023]
Abstract
There has been no study regarding the effect of a combination of teriparatide (TPTD) and zoledronic acid (ZA) on vertebral fusion. In this study, we investigate the effect of single and combined TPTD and ZA treatment on lumbar vertebral fusion in aged ovariectomized (OVX) rats. Sixty two-month-old female Sprague-Dawley rats were ovariectomized and underwent bilateral L4-L5 posterolateral intertransverse fusion after 10 months. The OVX rats received vehicle (control) treatment, or ZA (100 µg/kg, once), or TPTD (60 µg/kg/2 d for 42 d), or ZA + TPTD until they were euthanized at 6 weeks following lumbar vertebral fusion. The lumbar spine was harvested. Bone mineral density (BMD), bone fusion, bone volume (BV), and bone formation rate (BFR)were analyzed by dual-energy X-ray absorptiometry (DXA), radiography, micro-computed tomography, and histomorphometry. Compared with vehicle (control) treatment, ZA and TPTD monotherapy increased bone volume (BV) at fusion site, and ZA + TPTD combined therapy had an additive effect. Treatment with TPTD and ZA + TPTD increased the bone fusion rate when compared with the control group. ZA monotherapy did not alter the rate of bone fusion. The TPTD and ZA + TPTD treatment groups had increased mineral apposition rate (MAR), mineralizing surfaces/bone surface ((MS/BS), and BFR/BS compared with the OVX group. Our experiment confirm that the monotherapy with TPTD and combination therapy with ZA + TPTD in an OVX rat model of osteopenia following lumbar vertebral fusion surgery increased bone fusion mass and bone fusion rate, and ZA + TPTD combined therapy had an additive effect on bone fusion mass. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:937-944, 2018.
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Affiliation(s)
- Mumingjiang Yishake
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Miersalijiang Yasen
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Libo Jiang
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Wangmi Liu
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Rong Xing
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Qian Chen
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Hong Lin
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Jian Dong
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
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Prevention of ovariectomy-induced osteoporosis in rats : Comparative study of zoledronic acid, parathyroid hormone (1-34) and strontium ranelate. Z Gerontol Geriatr 2018; 52:139-147. [PMID: 29476205 DOI: 10.1007/s00391-018-1376-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 12/14/2017] [Accepted: 01/31/2018] [Indexed: 02/08/2023]
Abstract
Recently, the use of the pharmacological agents strontium ranelate (SR), parathyroid hormone (1-34, PTH) and zoledronic acid (ZA) has come to prominence for the treatment of osteoporosis due to their ability to prevent bone loss in osteoporotic patients. Although much emphasis has been placed on using pharmacological agents for the prevention of disease, much less attention has been placed on which one is more effective. There is still no direct comparative study on these three drugs. The aim of the present study was to investigate the effect of SR, PTH, ZA on preventing ovariectomy-induced osteoporosis in rats. After bilateral ovariectomy the rats randomly received vehicle, SR (500 mg/kg body weight/day, orally), PTH (20 μg/kg/day, subcutaneously) or a single injection of ZA (0.1 mg/kg, i.v.) until death at 12 weeks. The distal femurs were harvested for evaluation of bone metabolism. The rats treated with ZA demonstrated the highest levels of new bone formation as assessed by microcomputed tomography (CT), biomechanical strength, histological analysis and bone metabolism. Furthermore, PTH and SR showed a stronger effect on improving trabecular bone mass at 12 weeks. The results from the present study demonstrate that systemic administration of PTH, SR and ZA could prevent bone loss, while a single dose of ZA has a better effect on preventing ovariectomy-induced osteoporosis than either PTH or SR.
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20
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Lou S, Lv H, Li Z, Tang P, Wang Y. Parathyroid hormone analogues for fracture healing: protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2018; 8:e019291. [PMID: 29362267 PMCID: PMC5988099 DOI: 10.1136/bmjopen-2017-019291] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Fracture healing is a complex physiological process. Impaired healing will increase the need for care and cause serious complications. Thus, identifying strategies to accelerate the rate of healing, preventing delayed unions and non-unions, is essential. Parathyroid hormone (PTH) is a key systemic regulator of calcium and phosphate metabolism. It has been determined that intermittent administration of PTH and its analogue can exert anabolic effect on bone, increase bone mass and reduce bone loss, leading to an increase in bone formation. Owing to their anabolic effect, there is an increasing interest in its potential in promoting the process of fracture healing. However, in clinical studies, the results are in conflict. This objective of this study is to determine the role of PTH analogues for fracture healing in adults. METHODS AND ANALYSIS MEDLINE, EMBASE and Cochrane databases will be searched to identify all randomised controlled trials (RCTs) and quasi-RCTs that compare the different effects between PTH analogues and any other treatments in adults with any type of fracture. The primary outcome is the functional recovery. And the secondary outcomes are fracture union and adverse events. The meta-analysis will be performed using a random effects model. Heterogeneity will be assessed by the P values and I² statistic. And subgroup analyses and sensitivity analyses will be used to explore the heterogeneity. Risk of bias will be assessed using the Cochrane tool and the quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION Ethical approval is not required because this proposed systematic review and meta-analysis is based on published data, without including confidential personal data or data on interventions on patients. The findings of this study will be published in a peer-reviewed journaland presented at a relevant conference. PROSPERO REGISTRATION NUMBER CRD42017062093.
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Affiliation(s)
- Shenghan Lou
- Department of Spine Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Houchen Lv
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Zhirui Li
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Peifu Tang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Yansong Wang
- Department of Spine Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
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21
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Li G, Zhang L, Wang L, Yuan G, Dai K, Pei J, Hao Y. Dual modulation of bone formation and resorption with zoledronic acid-loaded biodegradable magnesium alloy implants improves osteoporotic fracture healing: An in vitro and in vivo study. Acta Biomater 2018; 65:486-500. [PMID: 29079514 DOI: 10.1016/j.actbio.2017.10.033] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/02/2017] [Accepted: 10/23/2017] [Indexed: 01/08/2023]
Abstract
Osteoporotic fracture (OPF) remains a major clinical challenge for skeletal regeneration. Impaired osteogenesis and excessive remodeling result in prolonged and poor quality of fracture healing. To augment bone formation and inhibit excessive resorption simultaneously, we constructed a biodegradable magnesium-based implant integrated with the anti-catabolic drug zoledronic acid (ZA); this implant exhibits controllable, sustained release of magnesium degradation products and ZA in vitro. The extracts greatly stimulate the osteogenic differentiation of rat-bone marrow-derived mesenchymal stem cells (rBMSCs), while osteoclastogenesis is inhibited by ZA. Implantation of intramedullary nails to fix femur fracture in ovariectomy-induced osteoporotic rats for up to 12 weeks demonstrates magnesium implants alone can enhance OPF repair through promoting callus formation compared to conventional stainless steel, while the combinatory treatment with local ZA release from implant coating further increases bone regeneration rate and callus size, remarkably improves bone quality and mechanical strength and suppresses osteoclasts and bone remodeling, due to the synergistic effect of both agents. The slow and uniform degradation of the implant ensures a steady decrease in bending force, which meets clinical requirements. In summary, biodegradable magnesium-based implants can locally co-deliver magnesium degradation products and zoledronic acid in a controlled manner, and can be superior alternatives for the reconstruction of osteoporosis-related fracture. STATEMENT OF SIGNIFICANCE Management of osteoporotic fracture has posed a major challenge in orthopedics, as the imbalance between diminished osteogenesis and excessive bone remodeling often leads to delayed and compromised fracture repair. Among various efforts expended on augmenting osteoporotic fracture healing, herein we reported a new strategy by engineering and utilizing a biodegradable magnesium-based implant integrated with local drug delivery, specifically, zoledronic acid (ZA)-loaded polylactic acid/brushite bilayer coating on a biodegradable Mg-Nd-Zn-Zr alloy (denoted as Mg/ZA/CaP), aiming to combine the favorable properties of Mg and zoledronic acid for simultaneous modulation of bone formation and bone resorption. In vitro and in vivo studies demonstrated its superior treatment efficacy along with adequate degradation. It stimulated new bone formation while suppressing remodeling, ascribed to the local release of magnesium degradation products and zoledronic acid. To our knowledge, the enhanced fracture repair capability of Mg-based implants was for the first time demonstrated in an osteoporotic fracture animal model. This innovative biodegradable Mg-based orthopedic implant presents great potential as a superior alternative to current internal fixation devices for treating osteoporotic fracture.
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Affiliation(s)
- Guoyuan Li
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Lei Zhang
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai 200240, People's Republic of China
| | - Lei Wang
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Guangyin Yuan
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai 200240, People's Republic of China
| | - Kerong Dai
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Jia Pei
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai 200240, People's Republic of China.
| | - Yongqiang Hao
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China.
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22
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Chen H, Fu T, Ma Y, Wu X, Li X, Li X, Shen J, Wang H. Intermittent administration of parathyroid hormone ameliorated alveolar bone loss in experimental periodontitis in streptozotocin-induced diabetic rats. Arch Oral Biol 2017; 83:76-84. [DOI: 10.1016/j.archoralbio.2017.06.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 06/25/2017] [Accepted: 06/28/2017] [Indexed: 11/29/2022]
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23
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Liu GY, Cao GL, Tian FM, Song HP, Yuan LL, Geng LD, Zheng ZY, Zhang L. Parathyroid hormone (1-34) promotes fracture healing in ovariectomized rats with type 2 diabetes mellitus. Osteoporos Int 2017; 28:3043-3053. [PMID: 28808745 DOI: 10.1007/s00198-017-4148-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
UNLABELLED Ovariectomized (OVX) rats with type 2 diabetes mellitus (T2DM) with femur fracture received vehicle, insulin, or insulin plus parathyroid hormone (PTH) treatment for 2 and 3 weeks. Radiography, histomorphometry, histology, and immunohistochemistry in callus were evaluated. INTRODUCTION Reports about effects of PTH plus insulin on callus formation of osteoporotic fracture with T2DM were limited. This study was designed to investigate the effects of the combination of PTH and insulin on fracture healing in OVX rats with T2DM. METHODS Two-month-old female rats were randomly divided into five groups: normal fracture (F), OVX fracture (OF), T2DM + OVX fracture (DOF), insulin-treated (2-4 u/daylight, 4-6 u/night, DOFI), and treated with insulin and PTH (50 μg/kg/day, 5 days/week, DOFIP). A closed mid-shaft fracture was established in the right femurs of all rats after 6 weeks of OVX. Rats were euthanized at 2 and 3 weeks post-fracture according to the time schedule, respectively. RESULTS The administration of insulin alone or insulin combined with PTH significantly increased mineralized bone volume fraction (BV/TV) and connectivity density (Conn.D) compared with those of the DOF group at 3 weeks post-fracture and also increased cartilaginous callus area ratio in the DOFI and DOFIP groups at 2 weeks and bony callus area ratio in the DOFIP groups at both the 2 and 3 weeks post-fracture. CONCLUSIONS OVX rats with T2DM exhibited a marked delay in the fracture healing process; insulin treatment ameliorated these effects, and the healing process was enhanced following treatment with a combination of insulin and PTH.
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Affiliation(s)
- G Y Liu
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - G L Cao
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - F M Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, China
| | - H P Song
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L L Yuan
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L D Geng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Z Y Zheng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China.
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China.
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24
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Wang F, Wang X, Wang K, Han L, Wang J, Xue C. Phosphorylated peptides from Antarctic Krill (Euphausia superba
) improve fracture healing in mice with ovariectomy induced osteoporosis. J Food Biochem 2017. [DOI: 10.1111/jfbc.12408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Fei Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Xiaohong Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Kai Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Lihua Han
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Jingfeng Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Changhu Xue
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
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25
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Zhan Q, Gui X, Wang F, Yu P, Zhao M, Wang J, Xue C. Sialoglycoprotein isolated from the eggs of Gadus morhua enhances fracture healing in osteoporotic mice. Food Funct 2017; 8:1094-1104. [PMID: 28164198 DOI: 10.1039/c6fo01346e] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Osteoporosis is a common disease in the elderly, which is related to fracture healing delay. In this study, the effects of treatment with sialoglycoprotein isolated from the eggs of Gadus morhua (Gm-SGP) on tibial fracture healing in ovariectomized (OVX) osteoporotic female C57BL/6J mice for 56 days post-fracture were investigated. The result showed that Gm-SGP treatment significantly increased serum angiogenic factors and bone formation markers on day 5 and 11 post-fracture when compared with the OVX group. In addition, histological results in the Gm-SGP group showed a stronger endochondral ossification, a stronger bony consolidation and a stronger bony callus remodeling capability on day 11, 24 and 35 post-fracture, respectively, in comparison with the OVX group. Meanwhile, micro-computerized tomography revealed that the Gm-SGP group had stronger bony callus remodeling capability as evidenced by higher BV/TV and Tb.N but lower Tb.Sp and shorter lengths of callus maximum cross section than the OVX group on day 24 post-fracture. Besides, the tibial callus bending stiffness was significantly enhanced in the Gm-SGP group as compared with the OVX group on day 56 post-fracture. Moreover, gene expression suggested that Gm-SGP promoted vascular invasion and endochondral ossification on day 11 post-fracture as well as bone formation on day 11 and 24 post-fracture via up-regulating the expression of angiogenesis factors (including VEGF, PDGF and Ang1), entochondrostosis factors (including Col2a1, Aggrecan, Col10a1 and MMP-13) and osteogenesis markers (including Col1a1, BMP-2 and OCN). This research suggests that Gm-SGP significantly improve fracture healing which is delayed by OVX-induced osteoporosis. The present study may contribute to providing important implications for the utilization of Gm-SGP from fish eggs as a functional food to enhance fracture healing.
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Affiliation(s)
- Qiping Zhan
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266003, China.
| | - Xiong Gui
- School of Basic Medicine, Faculty of Medicine, Guangxi University of Science and Technology, Liuzhou, China
| | - Fei Wang
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266003, China.
| | - Peng Yu
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266003, China.
| | - Meihui Zhao
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266003, China.
| | - Jingfeng Wang
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266003, China.
| | - Changhu Xue
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266003, China.
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26
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Li WL, Yu X, Huang ZP, Pang QJ. Effect of parathyroid hormone on healing in osteoporotic fractures via a phospholipase C-independent pathway. J Int Med Res 2017; 45:1200-1207. [PMID: 28534698 PMCID: PMC5536420 DOI: 10.1177/0300060517707075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objective This study was performed to investigate the effect of parathyroid hormone (PTH) on healing in osteoporotic fractures via a phospholipase C (PLC)-independent pathway and explore the mechanism of PTH-mediated bone formation. Methods Ninety-six 12-week-old C57BL/6J female mice underwent bilateral ovariectomy. One month later, the lower third of the femur was fractured and the mice were treated using saline, PTH(1-28), PTH(1-34), zoledronic acid (ZA), PTH(1-28)+ZA, and PTH(1-34)+ZA. The mice were killed at weeks 2 and 4 in each group. Biomechanical testing and micro-computed tomography were performed. Results The formation and strength of the callus increased in all but the saline group. The mice treated with PTH(1-34) showed a significantly higher ultimate bending force, bending rigidity, bone mineral density, percent bone volume, and trabecular thickness than those treated with PTH(1-28). The PTH(1-34)+ZA group demonstrated the greatest improvements in the ultimate bending force, bending rigidity, bone mineral density, and relative bone volume. Conclusions PTH can promote fracture healing and callus hardness in ovariectomized mice by increasing callus formation and reconstructing trabecular bone via a PLC-independent pathway. PTH combined with ZA has a cumulative effect on the healing of fractures in ovariectomized mice.
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Affiliation(s)
- Wei-Long Li
- 1 Ningbo University School of Medicine, Ningbo, China
| | - Xiao Yu
- 2 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
| | - Zhi-Ping Huang
- 3 Department of Spinal Surgery, Nanfang Hospital, Southern University, Guangzhou, China
| | - Qing-Jiang Pang
- 2 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
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27
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Ma Y, Chu J, Ma J, Ning L, Zhou K, Fang X. Sanguinarine protects against ovariectomy‑induced osteoporosis in mice. Mol Med Rep 2017; 16:288-294. [PMID: 28498448 PMCID: PMC5482132 DOI: 10.3892/mmr.2017.6574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 03/14/2017] [Indexed: 01/06/2023] Open
Abstract
Natural compounds are alternative agents that have therapeutic potential for preventing and treating osteoporosis. Traditionally, sanguinarine has been used clinically due to its diverse biological properties, including antimicrobial, anti-inflammatory and anticancer effects. Recently, for the first time, it was reported that sanguinarine inhibits osteoclast differentiation and bone resorption by suppressing the tumor necrosis factor ligand superfamily member 11-induced nuclear factor-κB and extracellular signal-regulated kinase signaling pathways in vitro. Therefore, the present study further investigated the pharmacological effect of sanguinarine on osteoporosis in vivo. Micro-computed tomography and histomorphometry analysis demonstrated that sanguinarine, at low and high concentrations, prevents ovariectomy (OVX)-induced bone loss. In addition, further investigation of the cellular response in vivo revealed that sanguinarine inhibited osteoclastic bone resorption and promoted osteoblastic bone formation in a dose-dependent manner. Therefore, the present study demonstrated that sanguinarine protected mice from OVX-induced osteoporosis by modulating bone remodeling, indicating that sanguinarine may have potential in the treatment of osteoporosis.
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Affiliation(s)
- Yan Ma
- Department of Orthopedic Surgery, Sir Run Run Shaw Institute of Clinical Medicine, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Junjie Chu
- Department of Head and Neck Surgery, Sir Run Run Shaw Institute of Clinical Medicine, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Jianjun Ma
- Department of Orthopedic Surgery, Sir Run Run Shaw Institute of Clinical Medicine, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Lei Ning
- Department of Orthopedic Surgery, Sir Run Run Shaw Institute of Clinical Medicine, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Ke Zhou
- Department of Orthopedic Surgery, Sir Run Run Shaw Institute of Clinical Medicine, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Xiangqian Fang
- Department of Orthopedic Surgery, Sir Run Run Shaw Institute of Clinical Medicine, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
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28
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Sandberg O, Bernhardsson M, Aspenberg P. Earlier effect of alendronate in mouse metaphyseal versus diaphyseal bone healing. J Orthop Res 2017; 35:793-799. [PMID: 27233101 DOI: 10.1002/jor.23316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/19/2016] [Indexed: 02/04/2023]
Abstract
Healing of injured cancellous bone is characterized by a transient stage of rapid bone formation throughout the traumatized bone volume, often followed by similarly rapid resorption. This is different from the slower diaphyseal healing via an external callus. We, therefore, hypothesized that antiresorptive treatment might have an earlier positive effect in cancellous bone healing than in diaphyseal fractures. One hundred and twenty-three male C57bl6 mice received either an internally stabilized diaphyseal osteotomy of the femur or a screw inserted into the tibial metaphysis. The mice were randomized to daily alendronate injections (200 μg/kg/day), or control injections, and killed for mechanical testing after 14, 21, or 28 days. The hypothesis was tested by a three-way Anova (time, site, and drug). The ultimate force was increased by bisphosphonate treatment in both models. There was a significant interaction between time, site, and drug (p < 0.001) so that the full positive effect of alendronate was evident in the metaphysis at 14 days, but first after 28 days in the diaphysis. While the early effect in the metaphysis might be translated into earlier healing, the late effect in the diaphysis was due to delayed remodeling of the callus, which might have less clinical importance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:793-799, 2017.
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Affiliation(s)
- Olof Sandberg
- Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, 581 85, Sweden
| | - Magnus Bernhardsson
- Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, 581 85, Sweden
| | - Per Aspenberg
- Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, 581 85, Sweden
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29
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Wu J, Cai XH, Qin XX, Liu YX. The effects of sclerostin antibody plus parathyroid hormone (1-34) on bone formation in ovariectomized rats. Z Gerontol Geriatr 2017; 51:550-556. [PMID: 28364259 DOI: 10.1007/s00391-017-1219-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 12/26/2022]
Abstract
Previous studies have demonstrated the effects of sclerostin antibody (Scl-Ab) and parathyroid hormone (1-34, PTH) on healing in osteoporosis; however, reports about the combined effects of Scl-Ab plus PTH on osteoporosis are limited. This study was designed to investigate the impact of combined treatment with Scl-Ab and PTH on osteoporosis healing in ovariectomized (OVX) rats. After bilateral ovariectomy, 12 weeks were allowed to pass for the establishment of standard conditions for osteoporosis in animal models. The rats then randomly received a vehicle (control), Scl-Ab (25 mg/kg body weight, twice weekly), PTH (60 μg/kg, three times per week) or PTH plus Scl-Ab until death at 12 weeks. The blood and distal femurs of the rats were harvested for evaluation. The results of treatment for osteoporosis were evaluated by serum analysis, histology, microcomputed tomography (micro-CT) and biomechanical tests. Results from this study indicated that PTH + Scl-Ab had stronger effects on the prevention and treatment of osteoporosis than either of the monotherapies in OVX rats. The PTH + Scl-Ab produced the strongest effects on bone volume fraction (BV/TV), bone trabecular thickness (Tb.Th), trabecular number (Tb.N) and trabecular spacing (Tb.Sp), bone mineral density (BMD) and strength of distal femurs and increased the levels of procollagen type I N‑terminal propeptide (PINP) and osteocalcin. In contrast, monotherapy with PTH or Scl-Ab showed no differences between treated groups in the assessment of the metaphysis of contralateral femurs by histology, serum, biomechanical tests and micro-CT. These results seem to indicate that Scl-Ab plus PTH has an additive effect on osteoporosis in OVX rats.
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Affiliation(s)
- Jian Wu
- Southern Medical University, 510515, Guangzhou, Guangdong, China.,Department of orthopaedics, XianNing Central hospital, The First Affiliated Hospital of Hubei University of Science and Technology, 437100, XianNing, Hubei, China
| | - Xian-Hua Cai
- Southern Medical University, 510515, Guangzhou, Guangdong, China. .,Department of orthopaedics, Wuhan General Hospital of Guangzhou Military Area Commands affiliated Southern Medical University, 627 Wuluo Road, 437000, Wuhan, Hubei, China.
| | - Xing-Xing Qin
- Department of orthopaedics, XianNing Central hospital, The First Affiliated Hospital of Hubei University of Science and Technology, 437100, XianNing, Hubei, China
| | - Yan-Xi Liu
- Department of orthopaedics, XianNing Central hospital, The First Affiliated Hospital of Hubei University of Science and Technology, 437100, XianNing, Hubei, China
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30
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Wang X, Huang J, Huang F, Zong JC, Tang X, Liu Y, Zhang QF, Wang Y, Chen L, Yin LJ, He BC, Deng ZL. Bone morphogenetic protein 9 stimulates callus formation in osteoporotic rats during fracture healing. Mol Med Rep 2017; 15:2537-2545. [PMID: 28447742 PMCID: PMC5428899 DOI: 10.3892/mmr.2017.6302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 11/22/2016] [Indexed: 01/14/2023] Open
Abstract
Fracture healing involves the coordinated actions of multiple cytokines. Bone morphogenetic protein 9 (BMP9) is an important factor in bone formation. The present study aimed to investigate the osteogenic potential of bone marrow stem cells (BMSCs) in response to adenoviral (Ad)BMP9, and the early fracture repair properties of AdBMP9 in surgically-created fractures in osteoporotic rats. Alkaline phosphatase (ALP) activity was assayed and matrix mineralization was examined by Alizarin Red S staining. mRNA and protein expression levels of BMP9, runt-related transcription factor 2 (RUNX2) and type 1 collagen (COL-1) were detected in vitro and in vivo. Femoral bone mineral density was assessed for osteoporosis in ovariectomized rats. An open femora fracture was subsequently created, and gelatin sponges containing AdBMP9 were implanted. The femora were harvested for radiographical, micro-computed tomography, biomechanical and histological analysis 4 weeks later. BMP9 successfully increased ALP activity and induced mineralized nodule formation in BMSCs. BMP9 in gelatin sponges demonstrated marked effects on microstructural parameters and the biomechanical strength of bone callus. In addition, it upregulated the expression levels of RUNX2 and COL-1. AdBMP9 in gelatin sponges significantly mediated callus formation, and increased bone mass and strength in osteoporotic rats with femora fractures. The results of the present study suggested that BMP9 enhanced callus formation and maintained early mechanical stability during fracture healing in osteoporotic rats, implicating it as a potential novel therapeutic target for fracture healing.
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Affiliation(s)
- Xing Wang
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Jun Huang
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, Chongqing Medical University, Chongqing 400010, P.R. China
| | - Fan Huang
- Center for Musculoskeletal Surgery, Charité‑Universitätsmedizin, D‑13353 Berlin, Germany
| | - Jian-Chun Zong
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Xi Tang
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yang Liu
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Qiong-Fang Zhang
- Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Yang Wang
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Liang Chen
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Liang-Jun Yin
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Bai-Cheng He
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, Chongqing Medical University, Chongqing 400010, P.R. China
| | - Zhong-Liang Deng
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
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31
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Hoffmann DB, Sehmisch S, Hofmann AM, Eimer C, Komrakova M, Saul D, Wassmann M, Stürmer KM, Tezval M. Comparison of parathyroid hormone and strontium ranelate in combination with whole-body vibration in a rat model of osteoporosis. J Bone Miner Metab 2017; 35:31-39. [PMID: 26825660 DOI: 10.1007/s00774-016-0736-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/24/2015] [Indexed: 02/01/2023]
Abstract
We investigated the combinatorial effects of whole-body vertical vibration (WBVV) with the primarily osteoanabolic parathyroid hormone (PTH) and the mainly antiresorptive strontium ranelate (SR) in a rat model of osteoporosis. Ovariectomies were performed on 76 three-month-old Sprague-Dawley rats (OVX, n = 76; NON-OVX, n = 12). After 8 weeks, the ovariectomized rats were divided into 6 groups. One group (OVX + PTH) received daily injections of PTH (40 µg/kg body weight/day) for 6 weeks. Another group (OVX + SR) was fed SR-supplemented chow (600 mg/kg body weight/day). Three groups (OVX + VIB, OVX + PTH + VIB, and OVX + SR + VIB) were treated with WBVV twice a day at 70 Hz for 15 min. Two groups (OVX + PTH + VIB, OVX + SR + VIB) were treated additionally with PTH and SR, respectively. The rats were killed at 14 weeks post-ovariectomy. The lumbar vertebrae and femora were removed for biomechanical and morphological assessment. PTH produced statistically significant improvements in biomechanical and structural properties, including bone mineral density (BMD) and trabecular bone quality. In contrast, SR treatment exerted mild effects, with significant effects in cortical thickness only. SR produced no significant improvement in biomechanical properties. WBVV as a single or an adjunctive therapy produced no significant improvements. In conclusion, vibration therapy administered as a single or dual treatment had no significant impact on bones affected by osteoporosis. PTH considerably improved bone quality in osteoporosis cases and is superior to treatment with SR.
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Affiliation(s)
- D B Hoffmann
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany.
| | - S Sehmisch
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany
| | - A M Hofmann
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany
| | - C Eimer
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany
| | - M Komrakova
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany
| | - D Saul
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany
| | - M Wassmann
- Medical Institute of General Hygiene and Environmental Health, University of Goettingen, Kreuzbergring No. 57, 37075, Goettingen, Germany
| | - K M Stürmer
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany
| | - M Tezval
- Department of Trauma and Reconstructive Surgery, University of Goettingen, Robert Koch St. No. 40, 37075, Goettingen, Germany
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Casanova M, Herelle J, Thomas M, Softley R, Schindeler A, Little D, Schneider P, Müller R. Effect of combined treatment with zoledronic acid and parathyroid hormone on mouse bone callus structure and composition. Bone 2016; 92:70-78. [PMID: 27542660 DOI: 10.1016/j.bone.2016.08.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/12/2016] [Accepted: 08/14/2016] [Indexed: 11/20/2022]
Abstract
In recent years, great interest in combined treatment of parathyroid hormone (PTH) with anti-resorptive therapy has emerged. PTH has been suggested to aid bridging of atrophic fractures and improve strength in closed fracture models. Bisphosphonate treatments typically result in a larger woven bone callus that is slower to remodel. The combination of both drugs has been demonstrated to be effective for the treatment of osteoporotic bone loss in many preclinical studies. However, the effect of combined treatment on fracture repair is still largely unexplored. In this study, we aimed to compare these drugs as single-agent and in combination in a murine closed fracture model. We wanted to assess potential differences in material properties, morphometry and in the development of the lacuno-canalicular network. A total of 40 female, 11-week-old wild type mice underwent a closed fracture on the midshaft of the tibia and were assigned to four groups (n=8-10 per group). Beginning on post-operative day 8, animals received different subcutaneous injections. Group 1 received a single injection of saline solution and Group 2 of zoledronic acid (ZA). Group 3 received daily dosing of PTH. Group 4 received a dual treatment, starting with a single dose of ZA followed by daily injection of PTH. Three weeks after fracture, all animals were euthanized and tibiae were assessed using micro-computed tomography (micro-CT), high-resolution micro-CT (HR micro-CT), Raman spectroscopy, quantitative histomorphometry, and deconvolution microscopy (DV microscopy). Combined treatment showed a significant increase of 41% in bone volume fraction and a significant decrease of 61% in the standard deviation of the trabecular spacing compared to vehicle, both known to be strong predictors of callus strength. An analysis via HR micro-CT showed similar results on all groups for lacunar numerical density, whereas mean lacuna volume was found to be higher compared to vehicle in treated groups, but only PTH mono-treatment showed a significant increase compared to vehicle (+45%). Raman spectroscopy did not reveal detectable changes in material properties of the bone calluses. Sclerostin staining, tartrate resistant acid phosphatase (TRAP) staining and canalicular analysis with DV microscopy on a subset of samples did not display distinctive difference in any of the treatments. We therefore consider PTH+ZA treatment beneficial for bone healing. No clear negative effect on bone quality was detected during this study.
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Affiliation(s)
- Michele Casanova
- Institute for Biomechanics, HCP H 22.1, Leopold-Ruzicka-Weg 4, ETH Zurich, 8093 Zurich, Switzerland.
| | - Janelle Herelle
- Institute for Biomechanics, HCP H 22.1, Leopold-Ruzicka-Weg 4, ETH Zurich, 8093 Zurich, Switzerland.
| | - Marcel Thomas
- Institute for Biomechanics, HCP H 22.1, Leopold-Ruzicka-Weg 4, ETH Zurich, 8093 Zurich, Switzerland.
| | - Rowan Softley
- Institute for Biomechanics, HCP H 22.1, Leopold-Ruzicka-Weg 4, ETH Zurich, 8093 Zurich, Switzerland.
| | - Aaron Schindeler
- Orthopaedic Research and Biotechnology, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Discipline of Paediatrics and Child Health, University of Sydney, Camperdown, Australia.
| | - David Little
- Orthopaedic Research and Biotechnology, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Discipline of Paediatrics and Child Health, University of Sydney, Camperdown, Australia.
| | - Philipp Schneider
- Institute for Biomechanics, HCP H 22.1, Leopold-Ruzicka-Weg 4, ETH Zurich, 8093 Zurich, Switzerland; Bioengineering Science Research Group, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK.
| | - Ralph Müller
- Institute for Biomechanics, HCP H 22.1, Leopold-Ruzicka-Weg 4, ETH Zurich, 8093 Zurich, Switzerland.
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The Effect of Teriparatide on Fracture Healing of Osteoporotic Patients: A Meta-Analysis of Randomized Controlled Trials. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6040379. [PMID: 27429980 PMCID: PMC4939202 DOI: 10.1155/2016/6040379] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 05/30/2016] [Indexed: 12/28/2022]
Abstract
Purpose. This meta-analysis is to assess the effectiveness of teriparatide in fracture healing and clinical function improvement of the osteoporotic patients. Methods. We searched PubMed, Embase, Web of Science, and the Cochrane databases for randomized and quasi-randomized controlled trials comparing teriparatide to placebo, no treatment, or comparator interventions in the osteoporotic patients. Results. Five studies with 251 patients were included. Patients treated with teriparatide therapy had a significant shorter radiological fracture healing time compared with those in the control group (mean difference [MD] −4.54 days, 95% confidence interval [CI] −8.80 to −0.28). Stratified analysis showed that lower limb group had significant shorter healing time (MD −6.24 days, 95% CI −7.20 to −5.29), but upper limb group did not (MD −1 days, 95% CI −2.02 to 0.2). Patients treated with teriparatide therapy showed better functional outcome than those in the control group (standardized mean difference [SMD] −1.02, 95% CI −1.81 to −0.22). Patients with therapy duration over 4 weeks would have better functional outcome (SMD −1.68, 95% CI −2.07 to −1.29). Conclusions. Teriparatide is effective in accelerating fracture healing and improving functional outcome of osteoporotic women. However, more clinical studies are warranted in order to determine whether the results are applicable to males and the clinical indications for teriparatide after osteoporotic fractures.
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Combination Therapy with Zoledronic Acid and Parathyroid Hormone Improves Bone Architecture and Strength following a Clinically-Relevant Dose of Stereotactic Radiation Therapy for the Local Treatment of Canine Osteosarcoma in Athymic Rats. PLoS One 2016; 11:e0158005. [PMID: 27332712 PMCID: PMC4917251 DOI: 10.1371/journal.pone.0158005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/08/2016] [Indexed: 01/24/2023] Open
Abstract
Clinical studies using definitive-intent stereotactic radiation therapy (SRT) for the local treatment of canine osteosarcoma (OSA) have shown canine patients achieving similar median survival times as the current standard of care (amputation and adjuvant chemotherapy). Despite this, there remains an unacceptable high risk of pathologic fracture following radiation treatment. Zoledronic acid (ZA) and parathyroid hormone (PTH) are therapeutic candidates for decreasing this fracture risk post-irradiation. Due to differing mechanisms, we hypothesized that the combined treatment with ZA and PTH would significantly improve bone healing more than ZA or PTH treatment alone. Using an orthotopic model of canine osteosarcoma in athymic rats, we evaluated bone healing following clinically-relevant doses of radiation therapy (12 Gy x 3 fractions, 36 Gy total). Groups included 36 Gy SRT only, 36 Gy SRT plus ZA, 36 Gy SRT plus ZA and PTH, 36 Gy SRT plus PTH, and 36 Gy SRT plus localized PTH treatment. Our study showed significant increases in bone volume and increased polar moments of inertia (in the distal femoral metaphysis) 8 weeks after radiation in the combined (ZA/PTH) treatment group as compared to radiation treatment alone. Histomorphometric analysis revealed evidence of active mineralization at the study endpoint as well as successful tumor-cell kill across all treatment groups. This work provides further evidence for the expanding potential indications for ZA and PTH therapy, including post-irradiated bone disease due to osteosarcoma.
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E. Klontzas M, I. Kenanidis E, J. MacFarlane R, Michail T, E. Potoupnis M, Heliotis M, Mantalaris A, Tsiridis E. Investigational drugs for fracture healing: preclinical & clinical data. Expert Opin Investig Drugs 2016; 25:585-96. [DOI: 10.1517/13543784.2016.1161757] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Mansjur KQ, Kuroda S, Izawa T, Maeda Y, Sato M, Watanabe K, Horiuchi S, Tanaka E. The Effectiveness of Human Parathyroid Hormone and Low-Intensity Pulsed Ultrasound on the Fracture Healing in Osteoporotic Bones. Ann Biomed Eng 2016; 44:2480-2488. [PMID: 26795976 DOI: 10.1007/s10439-015-1533-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/04/2015] [Indexed: 12/12/2022]
Abstract
Osteoporotic fracture has become a major public health problem, and until today, the treatments available are not satisfactory. While there is growing evidence to support the individual treatment of parathyroid hormone (PTH) administration and low-intensity pulsed ultrasound (LIPUS) exposure as respectively systemic and local therapies during osteoporotic fracture healing, their effects have not yet been investigated when introduced concurrently. This study aimed to evaluate the effects of combined treatment with PTH (1-34) and LIPUS on fracture healing in ovariectomized (OVX) rats. Thirty-two, 12-week-old female Sprague-Dawley rats were OVX to induce osteoporosis. After 12 weeks, the rats underwent surgery to create bilateral mid-diaphyseal fractures of proximal tibiae. All animals were randomly divided into 4 groups (n = 8 for each): control group as placebo, PTH group, LIPUS group, and combined group. PTH group had PTH administration at a dose of 30 μg/kg/day for 3 days/week for 6 weeks. LIPUS group received ultrasound 5 days/week for 20 min/day for 6 weeks and combined group had both PTH administration and LIPUS exposure for 6 weeks. Fracture healing was observed weekly by anteroposterior radiography and micro-CT. Five weeks after the fracture, the tibia were harvested to permit histological assessments and at week 6, for mechanical property of the fracture callus. Micro-CT showed that the PTH and combined groups exhibited significantly higher BMD and trabecular bone integrity than control group at weeks 4-6. Radiography, fracture healing score and mean callus area indicated that the combined group revealed better healing processes than the individual groups. Mechanically, bending moment to failure was significantly higher in LIPUS, PTH and combined groups than in control group. These data suggest that the combined treatment of PTH and LIPUS have been shown to accelerate fracture bone healing and enhance bone properties rather than single agent therapy, and may be considered as a treatment remedy for fracture healing in postmenopausal osteoporosis.
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Affiliation(s)
- Karima Q Mansjur
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Shingo Kuroda
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Takashi Izawa
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Yuichi Maeda
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Minami Sato
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Keiichiro Watanabe
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Shinya Horiuchi
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
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The effects of combined human parathyroid hormone (1-34) and simvastatin treatment on osseous integration of hydroxyapatite-coated titanium implants in the femur of ovariectomized rats. Injury 2015; 46:2164-9. [PMID: 26404665 DOI: 10.1016/j.injury.2015.08.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/06/2015] [Accepted: 08/25/2015] [Indexed: 02/02/2023]
Abstract
The effect of human parathyroid hormone 1-34 (PTH) and simvastatin (SIM) alone could promote bone healing in osteoporotic osseous integration of the implant, but there are no reports about the combined use of PTH and SIM for promotion of bone healing around implant in osteoporotic settings still limited. This study aims to investigate effects of PTH+SIM on osseous integration of the implant in OVX rats. Female Sprague-Dawley rats were used for this study. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups: group control; group SIM; group PTH and group PTH+SIM. Afterwards, all OVX rats received hydroxyapatite (HA)-coated titanium rods (external diameter and length are 1.5mm and 20mm) in the femoral medullary canal. Subsequently, the animals from group SIM, group PTH and group PTH+SIM received human parathyroid hormone 1-34 (60μg/kg, three times a week), SIM (5mg/kg daily), or both for 12 weeks. Implants were inserted bilaterally in all animals until death at 12 weeks. The bilateral femurs of rats were harvested for evaluation. All groups increased new bone formation around the surface of titanium rods and push-out force; group PTH+SIM showed the strongest effects on new bone formation and biomechanical strength. Additionally, these are significant difference observed in bone formation and push-out force between groups SIM and PTH. This finding suggests that intermittent administration of PTH or SIM alone has an effect to increase new bone formation on the surface of HA-coated implants in the osteoporotic condition, and the additive effects of combination PTH and SIM on osseous integration of the implant in OVX rats.
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Combined treatment with parathyroid hormone (1–34) and beta-tricalcium phosphate had an additive effect on local bone formation in a rat defect model. Med Biol Eng Comput 2015; 54:1353-62. [DOI: 10.1007/s11517-015-1402-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/23/2015] [Indexed: 10/23/2022]
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Effect of teriparatide on repair of femoral metaphyseal defect in ovariectomized rats. Z Gerontol Geriatr 2015; 49:423-8. [PMID: 26358080 DOI: 10.1007/s00391-015-0949-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 07/13/2015] [Accepted: 08/07/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect exerted by teriparatide on the repair of femoral metaphyseal defect in ovariectomized rats. METHOD Female Sprague-Dawley rats were ovariectomized and after 3 months a critically sized defect of 3 mm in diameter-a through-hole bone defect-was drilled into each distal femur of the ovariectomized rats. The rats were injected with teriparatide (30 μg/kg) parathyroid hormone (PTH) in the peritoneum three times per week. After 4 and 8 weeks the animals were killed and the blood and bilateral femora were harvested for biochemical analysis, histopathological observation, and micro-computed tomography (CT) examination. RESULTS The PTH group and control group were compared 4 and 8 weeks after surgery. PTH increased bone formation in the defect area. Moreover, PTH showed the strongest effects on bone volume per total volume, trabecular number, trabecular thickness, trabecular separation, and total fluorescence-marked new bone area. Additionally, the PTH treatment group showed inhibited serum concentrations of C-terminal telopeptide of type I collagen and enhanced expression of calcium, phosphorus, and bone alkaline phosphatase. CONCLUSION Our findings suggest a positive effect of PTH on defect healing in ovariectomized rats.
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Salamanna F, Maglio M, Giavaresi G, Pagani S, Giardino R, Fini M. In vitro method for the screening and monitoring of estrogen-deficiency osteoporosis by targeting peripheral circulating monocytes. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9819. [PMID: 26250906 PMCID: PMC5005821 DOI: 10.1007/s11357-015-9819-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/20/2015] [Indexed: 06/04/2023]
Abstract
Bone loss occurs insidiously and initially asymptomatically; therefore, osteoporosis is frequently diagnosed only after the first clinical fracture. The aim of this study was to test the hypothesis is that by simply observing the behavior of cultured peripheral monocytes, it might be possible to diagnose altered bone remodeling and, therefore, limit the complications associated with osteoporosis, especially fractures. Monocytes isolated as mononuclear precursors from healthy and ovariectomized rats were cultured both in basal and differentiation medium for up to 3 weeks. Viability and differentiation capability towards the osteoclastic phenotype was checked by light microscopy at early times, whereas differentiation state and synthetic activity (tartrate-resistant acid phosphatase (TRAP) staining; phalloidin, fluorescin isothiocynate (FITC) staining, cathepsin K, metalloproteinase 7 and 9, MMP-7 and MMP-9) were measured at 1, 2, and 3 weeks. Compared to their controls, monocytes isolated from ovariectomized rats proliferate and lean toward the osteoclastic phenotype in the absence of differentiating factors. In both culture conditions, osteoclasts from ovariectomized rats showed significantly higher productions of cathepsin K, MMP-7, and MMP-9 than those of cells isolated from healthy rats, steadily over time. These results obtained in an animal osteoporotic model, if confirmed by clinical studies, open up the possibility to assess the presence of an alteration in bone remodeling with a simple in vitro diagnostic test requiring a small blood sample and less than 48 h. This might allow to early select patients with a spontaneous viability and differentiation of monocytes to osteoclasts for further diagnostic techniques.
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Affiliation(s)
- Francesca Salamanna
- Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, Rizzoli Research Innovation Technology, Via di Barbiano, 1/10, 40136, Bologna, Italy,
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Tokuyama N, Hirose J, Omata Y, Yasui T, Izawa N, Matsumoto T, Masuda H, Ohmiya T, Yasuda H, Saito T, Kadono Y, Tanaka S. Individual and combining effects of anti-RANKL monoclonal antibody and teriparatide in ovariectomized mice. Bone Rep 2015; 2:1-7. [PMID: 28377948 PMCID: PMC5365172 DOI: 10.1016/j.bonr.2014.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 11/16/2014] [Accepted: 12/03/2014] [Indexed: 01/22/2023] Open
Abstract
We examined the individual and combined effects of teriparatide and anti-RANKL (receptor activator of nuclear factor κB ligand) monoclonal antibody in ovariectomized mice. Three-month-old female C57BL/6 mice were ovariectomized (OVX) or sham operated. Four weeks after OVX, they were assigned to 3 different groups to receive anti-RANKL monoclonal antibody (Ab) alone (5 mg/kg single injection at 4 weeks after OVX, Ab group), teriparatide alone (80 μg/kg daily injection for 4 weeks from 4 weeks after OVX, PTH group), or mAb plus teriparatide (Ab + PTH group). Mice were sacrificed 8 weeks after OVX. Bone mineral density (BMD) was measured at the femur and lumbar spine. Hind limbs were subjected to histological and histomorphometric analysis. Serum osteocalcin and CTX-I levels were measured to investigate the bone turnover. Compared with Ab group, Ab + PTH group showed a significant increase in BMD at distal femur and femoral shaft. Cortical bone volume was significantly increased in PTH and Ab + PTH groups compared with Ab group. Bone turnover in Ab + PTH group was suppressed to the same degree as in Ab group. The number of TRAP-positive multinucleated cells was markedly reduced in Ab and Ab + PTH groups. These results suggest that combined treatment of teriparatide with anti-RANKL antibody has additive effects on BMD in OVX mice compared with individual treatment. The effects of anti-RANKL antibody and teriparitide in ovariectomized mice was studied. Anti-RANKL antibody and teriparatide increased bone mass at the distinct regions. Combination of anti-RANKL antibody and teriparatide had additive effects. Teriparitide, but not anti-RANKL antibody, increased periosteal bone formation.
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Affiliation(s)
- Naoto Tokuyama
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Jun Hirose
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Yasunori Omata
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Tetsuro Yasui
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Naohiro Izawa
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Takumi Matsumoto
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Hironari Masuda
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Toshinobu Ohmiya
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Hisataka Yasuda
- Bioindustry Division, Oriental Yeast Co., Ltd., Azusawa 3-6-10, Itabashi-ku, Tokyo 174-8505, Japan
| | - Taku Saito
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Yuho Kadono
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655,Japan
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Campbell EJ, Campbell GM, Hanley DA. The effect of parathyroid hormone and teriparatide on fracture healing. Expert Opin Biol Ther 2014; 15:119-29. [PMID: 25363308 DOI: 10.1517/14712598.2015.977249] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Daily subcutaneous injections of parathyroid hormone (PTH), and its synthetic peptide fragment, teriparatide (PTH 1-34, TPTD), have a net anabolic effect on bone and prevent osteoporotic fractures. TPTD is currently approved for this indication worldwide. Because of the anabolic effect, there is an interest in a role for TPTD (and, where available, human PTH 1-84) in improving bone healing after a fracture. PTH has been studied in animal fracture healing models and in a limited number of human trials. We have reviewed current literature regarding possible mechanisms and efficacy for PTH and TPTD to improve the healing process in the setting of various types of fractures. AREAS COVERED Our review focuses first on the role of PTH in normal bone. We then discuss mechanisms of normal bone healing as well as delayed and impaired fracture healing. We summarize pertinent animal data and then review human studies utilizing PTH or TPTD for fracture healing. In particular, we examine unique situations including osteoporotic fractures, diabetes, stress fractures, delayed or poor healing and combination with bisphosphonate therapy. EXPERT OPINION Available data indicate there is likely an important role for TPTD and PTH in promoting fracture healing in selected patients, but more clinical trial data are needed.
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Affiliation(s)
- Eric J Campbell
- University of Calgary, Cumming School of Medicine , 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1 , Canada
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Shimizu T, Takahata M, Kameda Y, Hamano H, Ito T, Kimura-Suda H, Todoh M, Tadano S, Iwasaki N. Vitamin K-dependent carboxylation of osteocalcin affects the efficacy of teriparatide (PTH(1-34)) for skeletal repair. Bone 2014; 64:95-101. [PMID: 24731926 DOI: 10.1016/j.bone.2014.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 03/16/2014] [Accepted: 04/04/2014] [Indexed: 01/02/2023]
Abstract
Teriparatide (PTH1-34) promotes skeletal repair and increases bone mass. Vitamin K is involved in bone mineralization as a coenzyme of γ-carboxylase for Gla proteins, and therefore vitamin K insufficiency caused by malnutrition or therapeutic intake of the vitamin K antagonist warfarin could affect the efficacy of PTH1-34 therapy for bone repair. In the present study, we investigated whether vitamin K influences the efficacy of PTH1-34 therapy for bone repair in a rat osteotomy model. Female 12-week-old Sprague-Dawley rats were subjected to a closed midshaft osteotomy of the femur and randomized into four groups (n=10 per group): vehicle, PTH1-34 (daily 30 μg/kg/day subcutaneous injection)+solvent (orally, three times a week), PTH1-34+warfarin (0.4 mg/kg/day orally, three times a week), and PTH1-34+vitamin K2 (menatetrenone, 30 mg/kg/day orally, three times a week). Serum γ-carboxylated and uncarboxylated osteocalcin (Gla-OC and Glu-OC) levels and radiographic healing were monitored every 2 weeks. Skeletal repair was assessed by micro-computed tomography, mechanical testing, and histology at 8weeks after surgery. PTH1-34 amplified the osteotomy-induced increase in Gla-OC and improved the mechanical properties as well as the volumetric bone mineral tissue density of the fracture callus. Concurrent use of warfarin decreased the response to PTH1-34 therapy in terms of mechanical recovery, probably by impairing mineralization due to the lack of Gla-OC. Although the effects of combination therapy with PTH1-34 and vitamin K2 on bone repair did not significantly exceed those of PTH1-34 monotherapy in rats fed sufficient dietary vitamin K, postoperative Gla-OC levels were correlated with the mechanical properties of the osteotomized femur in PTH1-34-treated rats regardless of the use of warfarin or vitamin K2. These findings suggest the importance of vitamin K dependent γ-carboxylation of OC for realizing the full effects of PTH1-34 on skeletal repair.
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Affiliation(s)
- Tomohiro Shimizu
- Hokkaido University, Department of Orthopedic Surgery, School of Medicine, Sapporo, Japan
| | - Masahiko Takahata
- Hokkaido University, Department of Orthopedic Surgery, School of Medicine, Sapporo, Japan.
| | - Yusuke Kameda
- Hokkaido University, Department of Orthopedic Surgery, School of Medicine, Sapporo, Japan
| | - Hiroki Hamano
- Hokkaido University, Department of Orthopedic Surgery, School of Medicine, Sapporo, Japan
| | - Teppei Ito
- Chitose Institute of Science of Technology, Chitose, Japan
| | | | - Masahiro Todoh
- Division of Human Mechanical Systems and Design, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Shigeru Tadano
- Division of Human Mechanical Systems and Design, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Norimasa Iwasaki
- Hokkaido University, Department of Orthopedic Surgery, School of Medicine, Sapporo, Japan
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Abstract
INTRODUCTION Fracture healing is a complex process that leads to the restoration of tissue integrity through bone repair and represents a unique physiological characteristic of bone. Developing a better understanding of a fracture is essential to plan best noninvasive treatment for the patient. In osteoporosis, the patient who suffers of a fragility fracture is recommended to initiate a treatment with compounds active in preventing other low-energy skeletal trauma. Pharmaceutical industries are developing controlled clinical trials aiming to evaluate the capability of osteoporosis drugs to accelerate fracture healing. AREAS COVERED In preparing this review, a search was made with key words encompassing 'osteoporosis anti-fracture drugs and bone repair/healing', 'antiresorptives and bone repair/healing', 'bone-forming agents and bone repair/healing', and 'osteoporosis/anti-fracture drugs in fractures'. The results published in the area of the use of registered anti-fracture drugs to improve fracture repair and the efforts made to recommend measures for clinical outcomes in fracture healing acceleration are described in this report. EXPERT OPINION At present, the use of systemic pharmacological agents active to improve fracture healing by the clinicians is controversial and clinicians and scientists must do a better job in determining the methods of assessment for fracture healing.
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Affiliation(s)
- Maria Luisa Brandi
- University of Florence, Bone Metabolic Diseases Unit, Department of Surgery and Translational Medicine, Florence, Italy.
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Corrigan RA, Miller A, McNally MA, Javaid MK. Treatment of fracture non-union in a young adult with combination anabolic and anti-resorptive bone therapy. Rheumatology (Oxford) 2012; 52:1147-9. [DOI: 10.1093/rheumatology/kes319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zhao Y, Wang L, Liu Y, Akiyama K, Chen C, Atsuta I, Zhou T, Duan X, Jin Y, Shi S. Technetium-99 conjugated with methylene diphosphonate ameliorates ovariectomy-induced osteoporotic phenotype without causing osteonecrosis in the jaw. Calcif Tissue Int 2012; 91:400-8. [PMID: 23064899 PMCID: PMC3850783 DOI: 10.1007/s00223-012-9649-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 09/04/2012] [Indexed: 12/20/2022]
Abstract
Technetium-99 conjugated with methylene diphosphonate ((99)Tc-MDP) is a novel bisphosphonate derivative without radioactivity and has been successfully used to treat arthritis in China for years. Since bisphosphonate therapy has the potential to induce bisphosphonate-related osteonecrosis of the jaw (BRONJ), we examined whether (99)Tc-MDP represents a new class of bisphosphonate for antiresorptive therapy to ameliorate estrogen deficiency-induced bone resorption with less risk of causing BRONJ. We showed that (99)Tc-MDP-treated, ovariectomized (OVX) mice had significantly improved bone mineral density and trabecular bone volume in comparison to the untreated OVX group by inhibiting osteoclasts and enhancing osteogenic differentiation of bone marrow mesenchymal stem cells. To determine the potential of inducing BRONJ, (99)Tc-MDP/dexamethasone (Dex) or zoledronate/Dex was administered into C57BL/6J mice via the tail vein, followed by extraction of maxillary first molars. Interestingly, (99)Tc-MDP treatment showed less risk to induce osteonecrosis in the maxillary bones compared to zoledronate treatment group, partially because (99)Tc-MDP neither suppressed adaptive regulatory T cells nor activated the inflammatory T-helper-producing interleukin-17 cells. Taken together, our findings demonstrate that (99)Tc-MDP therapy may be a promising approach in the treatment of osteoporosis with less risk of causing BRONJ.
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Affiliation(s)
- Yinghua Zhao
- Center for Craniofacial Molecular Biology, Herman School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA
- Stomatology Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Lei Wang
- Center for Craniofacial Molecular Biology, Herman School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA
- Fourth Military Medical University School of Stomatology, Xi'an, Shaanxi 710032, China
| | - Yi Liu
- Center for Craniofacial Molecular Biology, Herman School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA
| | - Kentaro Akiyama
- Center for Craniofacial Molecular Biology, Herman School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA
| | - Chider Chen
- Center for Craniofacial Molecular Biology, Herman School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA
| | - Ikiru Atsuta
- Center for Craniofacial Molecular Biology, Herman School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA
| | - Tao Zhou
- Fourth Military Medical University School of Stomatology, Xi'an, Shaanxi 710032, China
| | - Xiaohong Duan
- Fourth Military Medical University School of Stomatology, Xi'an, Shaanxi 710032, China
| | - Yan Jin
- Fourth Military Medical University School of Stomatology, Xi'an, Shaanxi 710032, China
- Corresponding Author: Dr. Songtao Shi, Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA., Tel: 323-442-3038 Fax:323-442-2981, , Or, Dr. Yan Jin, Dept. of Oral Histology and Patholog, Fourth Military Medical University School of Stomatology, Director, Engineering Technology Center for Tissue Engineering of Xi'an, 145 West Changle Road, Xi'an, 710032, P. R. China, Tel: +29-84776472 Fax: +29-83218039,
| | - Songtao Shi
- Center for Craniofacial Molecular Biology, Herman School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA
- Corresponding Author: Dr. Songtao Shi, Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, 2250 Alcazar Street, CSA 103, Los Angeles, CA 90033, USA., Tel: 323-442-3038 Fax:323-442-2981, , Or, Dr. Yan Jin, Dept. of Oral Histology and Patholog, Fourth Military Medical University School of Stomatology, Director, Engineering Technology Center for Tissue Engineering of Xi'an, 145 West Changle Road, Xi'an, 710032, P. R. China, Tel: +29-84776472 Fax: +29-83218039,
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Cho JH, Cho DC, Yu SH, Jeon YH, Sung JK, Kim KT. Effect of dietary calcium on spinal bone fusion in an ovariectomized rat model. J Korean Neurosurg Soc 2012; 52:281-7. [PMID: 23133713 PMCID: PMC3488633 DOI: 10.3340/jkns.2012.52.4.281] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 07/25/2012] [Accepted: 10/04/2012] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats. METHODS Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography. RESULTS The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group (71.80±8.06 mm(3)) than in controls (35.34±8.24 mm(3)) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks (610.08±10.41 vs. 551.61±12.34 ng/mL) and 8 weeks (552.05±19.67 vs. 502.98±22.76 ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks (77.07±12.57 vs. 101.75±7.20 ng/mL) and 8 weeks (69.58±2.45 vs. 77.15±4.10 ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01). CONCLUSION Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.
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Affiliation(s)
- Jae-Hoon Cho
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
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