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Bevers MSAM, Harsevoort AGJ, Gooijer K, Wyers CE, Feenstra J, van Rietbergen B, Boomsma MF, van den Bergh JP, Janus GJM. Bone microarchitecture and strength assessment in adults with osteogenesis imperfecta using HR-pQCT: normative comparison and challenges. J Bone Miner Res 2024; 39:271-286. [PMID: 38477754 DOI: 10.1093/jbmr/zjae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/12/2023] [Accepted: 01/12/2024] [Indexed: 03/14/2024]
Abstract
Data on bone microarchitecture in osteogenesis imperfecta (OI) are scarce. The aim of this cross-sectional study was to assess bone microarchitecture and strength in a large cohort of adults with OI using high-resolution peripheral quantitative computed tomography (HR-pQCT) and to evaluate challenges of using HR-pQCT in this cohort. Second-generation HR-pQCT scans were obtained at the distal radius and tibia in 118 men and women with Sillence OI type I, III, or IV using an extremity-length-dependent scan protocol. In total, 102 radius and 105 tibia scans of sufficient quality could be obtained, of which 11 radius scans (11%) and 14 tibia scans (13%) had a deviated axial scan angle as compared with axial angle data of 13 young women. In the scans without a deviated axial angle and compared with normative HR-pQCT data, Z-scores at the radius for trabecular bone mineral density (BMD), number, and separation were -1.6 ± 1.3, -2.5 ± 1.4, and -2.7 (IQR: 2.7), respectively. They were -1.4 ± 1.5 and -1.1 ± 1.2 for stiffness and failure load and between ±1 for trabecular thickness and cortical bone parameters. Z-scores were significantly lower for total and trabecular BMD, stiffness, failure load, and cortical area and thickness at the tibia. Additionally, local microarchitectural inhomogeneities were observed, most pronounced being trabecular void volumes. In the scans with a deviated axial angle, the proportion of Z-scores <-4 or >4 was significantly higher for trabecular BMD and separation (radius) or most total and trabecular bone parameters (tibia). To conclude, especially trabecular bone microarchitecture and bone strength were impaired in adults with OI. HR-pQCT may be used without challenges in most adults with OI, but approximately 12% of the scans may have a deviated axial angle in OI due to bone deformities or scan positioning limitations. Furthermore, standard HR-pQCT parameters may not always be reliable due to microarchitectural inhomogeneities nor fully reflect all inhomogeneities.
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Affiliation(s)
- M S A M Bevers
- Department of Internal Medicine, VieCuri Medical Center, Tegelseweg 210, 5912 BL Venlo, The Netherlands
- NUTRIM School for Nutrition and Translational Research In Metabolism, Maastricht University Medical Center, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Groene Loper 3, 5612 AE, Eindhoven, The Netherlands
| | - A G J Harsevoort
- Expert Center for adults with Osteogenesis Imperfecta, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - K Gooijer
- Expert Center for adults with Osteogenesis Imperfecta, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - C E Wyers
- Department of Internal Medicine, VieCuri Medical Center, Tegelseweg 210, 5912 BL Venlo, The Netherlands
- NUTRIM School for Nutrition and Translational Research In Metabolism, Maastricht University Medical Center, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands
- Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - J Feenstra
- Expert Center for adults with Osteogenesis Imperfecta, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - B van Rietbergen
- Department of Biomedical Engineering, Eindhoven University of Technology, Groene Loper 3, 5612 AE, Eindhoven, The Netherlands
- Department of Orthopedic Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - M F Boomsma
- Department of Radiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - J P van den Bergh
- Department of Internal Medicine, VieCuri Medical Center, Tegelseweg 210, 5912 BL Venlo, The Netherlands
- NUTRIM School for Nutrition and Translational Research In Metabolism, Maastricht University Medical Center, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands
- Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - G J M Janus
- Expert Center for adults with Osteogenesis Imperfecta, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
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Raimann A, Misof BM, Fratzl P, Fratzl-Zelman N. Bone Material Properties in Bone Diseases Affecting Children. Curr Osteoporos Rep 2023; 21:787-805. [PMID: 37897675 DOI: 10.1007/s11914-023-00822-6] [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] [Accepted: 09/12/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE OF REVIEW Metabolic and genetic bone disorders affect not only bone mass but often also the bone material, including degree of mineralization, matrix organization, and lacunar porosity. The quality of juvenile bone is moreover highly influenced by skeletal growth. This review aims to provide a compact summary of the present knowledge on the complex interplay between bone modeling and remodeling during skeletal growth and to alert the reader to the complexity of bone tissue characteristics in children with bone disorders. RECENT FINDINGS We describe cellular events together with the characteristics of the different tissues and organic matrix organization (cartilage, woven and lamellar bone) occurring during linear growth. Subsequently, we present typical alterations thereof in disorders leading to over-mineralized bone matrix compared to those associated with low or normal mineral content based on bone biopsy studies. Growth spurts or growth retardation might amplify or mask disease-related alterations in bone material, which makes the interpretation of bone tissue findings in children complex and challenging.
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Affiliation(s)
- Adalbert Raimann
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna, Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria
| | - Barbara M Misof
- Vienna Bone and Growth Center, Vienna, Austria
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Center Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - Peter Fratzl
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Research Campus Golm, Potsdam, Germany
| | - Nadja Fratzl-Zelman
- Vienna Bone and Growth Center, Vienna, Austria.
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Center Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria.
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3
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Banerjee M, Venkatesh P, Azad SV, Verma S. Retinal manifestations in osteogenesis imperfecta. BMJ Case Rep 2023; 16:e256366. [PMID: 37918942 PMCID: PMC10626894 DOI: 10.1136/bcr-2023-256366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Affiliation(s)
- Mousumi Banerjee
- Dr R.P.Centre for Ophthalmic Sciences, AIIMS, New Delhi, Delhi, India
| | - Pradeep Venkatesh
- Dr R.P.Centre for Ophthalmic Sciences, AIIMS, New Delhi, Delhi, India
| | | | - Saurabh Verma
- Dr R.P.Centre for Ophthalmic Sciences, AIIMS, New Delhi, Delhi, India
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Fratzl-Zelman N, Linglart A, Bin K, Rauch F, Blouin S, Coutant R, Donzeau A. Combination of osteogenesis imperfecta and hypophosphatasia in three children with multiple fractures, low bone mass and severe osteomalacia, a challenge for therapeutic management. Eur J Med Genet 2023; 66:104856. [PMID: 37758163 DOI: 10.1016/j.ejmg.2023.104856] [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: 06/16/2023] [Revised: 09/05/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
Osteogenesis imperfecta (OI) and hypophosphatasia (HPP) are rare skeletal disorders caused by mutations in the genes encoding collagen type I (COL1A, COL1A2) and tissue-non-specific isoenzyme of alkaline phosphatase (ALPL), respectively. Both conditions result in skeletal deformities and bone fragility although bone tissue abnormalities differ considerably. Children with OI have low bone mass and hypermineralized matrix, whereas HPP children develop rickets and osteomalacia. We report a family, father and three children, affected with growth retardation, low bone mass and recurrent fractures. None of them had rickets, blue sclera or dentinogenesis imperfecta. ALP serum levels were low and genetics revealed in the four probands heterozygous pathogenic mutations in COL1A2 c.838G > A (p.Gly280Ser) and in ALPL c.1333T > C (p.Ser445Pro). After multidisciplinary meeting, a diagnostic transiliac bone biopsy was indicated for each sibling for therapeutic decision. Bone histology and histomorphometry, as compared to reference values of children with OI type I as well as, to a control pediatric patient harboring the same COL1A2 mutation, revealed similarly decreased trabecular bone volume, increased osteocyte lacunae, but additionally severe osteomalacia. Quantitative backscattered electron imaging demonstrated that bone matrix mineralization was not as decreased as expected for osteomalacia. In summary, we observed within each biopsy samples classical features of OI and classical features of HPP. The apparent nearly normal bone mineralization density distribution results presumably from divergent effects of OI and HPP on matrix mineralization. A combination therapy was initiated with ALP enzyme-replacement and one month later with bisphosphonates. The ongoing treatment led to improved skeletal growth, increased BMD and markedly reduced fracture incidence.
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Affiliation(s)
- Nadja Fratzl-Zelman
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Department Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria.
| | - Agnès Linglart
- AP-HP, Paris Saclay University, INSERM, Reference Center for Rare Diseases of the Calcium and Phosphate Metabolism, Platform of Expertise for Rare Diseases, OSCAR Filière, EndoERN and BOND ERN Center, Endocrinology and Diabetes for Children, Bicêtre Paris Saclay Hospital, France
| | - Kim Bin
- Pediatric Orthopedic Surgery Angers University Hospital, Angers, France
| | - Frank Rauch
- Shriners Hospital for Children, Canada, Montreal, QC, Canada
| | - Stéphane Blouin
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Department Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Régis Coutant
- AP-HP, Paris Saclay University, INSERM, Reference Center for Rare Diseases of the Calcium and Phosphate Metabolism, Platform of Expertise for Rare Diseases, OSCAR Filière, EndoERN and BOND ERN Center, Endocrinology and Diabetes for Children, Bicêtre Paris Saclay Hospital, France; Department of Pediatric Endocrinology and Diabetology, Competence Center for Rare Diseases of the Calcium and Phosphate Metabolism, Angers University Hospital, Angers, France
| | - Aurélie Donzeau
- Department of Pediatric Endocrinology and Diabetology, Competence Center for Rare Diseases of the Calcium and Phosphate Metabolism, Angers University Hospital, Angers, France
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Majdoub F, Ferjani HL, Nessib DB, Kaffel D, Maatallah K, Hamdi W. Denosumab use in osteogenesis imperfecta: an update on therapeutic approaches. Ann Pediatr Endocrinol Metab 2023; 28:98-106. [PMID: 37401056 DOI: 10.6065/apem.2346058.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/05/2023] [Indexed: 07/05/2023] Open
Abstract
Osteogenesis imperfecta (OI) is an inherited skeletal disorder that leads to bone fragility and multiple fractures. Given advances in the genetic understanding of existing phenotypes and newly discovered mutations, therapeutic management of OI has become challenging. Denosumab, a monoclonal antibody that inhibits the interaction between the receptor activator of nuclear factor kappa B ligand (RANKL) and its receptor RANK, has been approved to treat postmenopausal osteoporosis and emerged as an important therapy for malignancies and other skeletal disorders, including pediatric skeletal conditions such as OI. This review summarizes information about denosumab therapy in OI by exploring its mechanisms of action, main indications, and safety and efficacy. Several case reports and small series have been published about the short-term use of denosumab in children with OI. Denosumab was considered a strong drug candidate for OI patients with bone fragility and a high risk of fracture, particularly for patients with the bisphosphonate (BP)-unresponsive OI-VI subtype. The evidence for denosumab's effects in children with OI indicates that it effectively improves bone mineral density but not fracture rates. A decrease in bone resorption markers was observed after each treatment. Safety was assessed by tracking the effects on calcium homeostasis and reporting side effects. No severe adverse effects were reported. Hypercalciuria and moderate hypercalcemia were reported, suggesting that BPs be used to prevent the bone rebound effect. In other words, denosumab can be used as a targeted intervention in children with OI. The posology and administration protocol require more investigation to achieve secure efficiency.
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Affiliation(s)
- Fatma Majdoub
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
- Research unit UR17SP04, 2010, Ksar Said 2010, Tunis, Tunisia
| | - Hanene Lassoued Ferjani
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
- Research unit UR17SP04, 2010, Ksar Said 2010, Tunis, Tunisia
| | - Dorra Ben Nessib
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
- Research unit UR17SP04, 2010, Ksar Said 2010, Tunis, Tunisia
| | - Dhia Kaffel
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
- Research unit UR17SP04, 2010, Ksar Said 2010, Tunis, Tunisia
| | - Kaouther Maatallah
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
- Research unit UR17SP04, 2010, Ksar Said 2010, Tunis, Tunisia
| | - Wafa Hamdi
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
- Research unit UR17SP04, 2010, Ksar Said 2010, Tunis, Tunisia
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Misof BM, Roschger P, Mähr M, Fratzl-Zelman N, Glorieux FH, Hartmann MA, Rauch F, Blouin S. Accelerated mineralization kinetics in children with osteogenesis imperfecta type 1. Bone 2023; 166:116580. [PMID: 36210024 DOI: 10.1016/j.bone.2022.116580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/24/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Barbara M Misof
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria.
| | - Paul Roschger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Matthias Mähr
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Nadja Fratzl-Zelman
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Francis H Glorieux
- Shriners Hospital for Children and McGill University, Montreal, QC H4A 0A9, Canada
| | - Markus A Hartmann
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Frank Rauch
- Shriners Hospital for Children and McGill University, Montreal, QC H4A 0A9, Canada
| | - Stéphane Blouin
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
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7
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Coussens M, Lapauw B, Verroken C, Goemaere S, De Wandele I, Malfait F, Banica T, Calders P. Bone Mass, Density, Geometry, and Stress-Strain Index in Adults With Osteogenesis Imperfecta Type I and Their Associations With Physical Activity and Muscle Function Parameters. J Bone Miner Res 2022; 37:2456-2465. [PMID: 36239015 DOI: 10.1002/jbmr.4722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 11/09/2022]
Abstract
Osteogenesis imperfecta (OI) is a clinically and genetically heterogeneous heritable connective tissue disorder mainly characterized by bone fragility and increased fracture risk. This study investigated bone parameters in adults with OI type I and their relationship with physical activity and muscle function parameters in comparison with controls. A total of 27 (15 women, 12 men) adults with OI type I and 27 healthy age- and sex-matched controls, with mean age 45 years (range 18-72 years), were included. Peripheral quantitative computed tomography was performed at the lower leg and forearm to assess muscle density, muscle and fat cross-sectional area (CSA) (66% site), and trabecular (4% site) and cortical bone parameters (66% site) at radius and tibia. Physical activity (step count and moderate-to-vigorous physical activity [MVPA]) was assessed by accelerometry, muscle function parameters by Leonardo mechanography (single two-legged jump - peak power), and hand grip dynamometry (maximal hand grip strength). Overall, the OI type I group had significantly lower muscle CSA at the lower leg and forearm, lower trabecular and cortical bone mineral content, lower polar stress-strain index (SSIp), and smaller cortices but higher cortical bone mineral density and lower step count and MVPA in comparison with controls. Maximal hand grip strength was positively associated with SSIp at radius (p = 0.012) in the control group but not in the OI type I group (p = 0.338) (difference in associations: p = 0.012). No other significantly different associations between bone and muscle function parameters or physical activity (step count or MVPA) were found in the OI type I versus control group. We conclude that adults with OI type I have smaller bones, lower trabecular bone mass, lower estimates of bone strength, and higher cortical density in comparison with controls and that there are some indications of a disturbed biomechanical muscle-bone relationship in adults with OI type I. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Marie Coussens
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium
| | - Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium
| | - Inge De Wandele
- Centre for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Fransiska Malfait
- Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium.,Centre for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Thiberiu Banica
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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Hofstaetter JG, Atkins GJ, Kato H, Kogawa M, Blouin S, Misof BM, Roschger P, Evdokiou A, Yang D, Solomon LB, Findlay DM, Ito N. A Mild Case of Autosomal Recessive Osteopetrosis Masquerading as the Dominant Form Involving Homozygous Deep Intronic Variations in the CLCN7 Gene. Calcif Tissue Int 2022; 111:430-444. [PMID: 35618777 PMCID: PMC9474465 DOI: 10.1007/s00223-022-00988-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/06/2022] [Indexed: 11/28/2022]
Abstract
Osteopetrosis is a heterogeneous group of rare hereditary diseases characterized by increased bone mass of poor quality. Autosomal-dominant osteopetrosis type II (ADOII) is most often caused by mutation of the CLCN7 gene leading to impaired bone resorption. Autosomal recessive osteopetrosis (ARO) is a more severe form and is frequently accompanied by additional morbidities. We report an adult male presenting with classical clinical and radiological features of ADOII. Genetic analyses showed no amino-acid-converting mutation in CLCN7 but an apparent haploinsufficiency and suppression of CLCN7 mRNA levels in peripheral blood mononuclear cells. Next generation sequencing revealed low-frequency intronic homozygous variations in CLCN7, suggesting recessive inheritance. In silico analysis of an intronic duplication c.595-120_595-86dup revealed additional binding sites for Serine- and Arginine-rich Splicing Factors (SRSF), which is predicted to impair CLCN7 expression. Quantitative backscattered electron imaging and histomorphometric analyses revealed bone tissue and material abnormalities. Giant osteoclasts were present and additionally to lamellar bone, and abundant woven bone and mineralized cartilage were observed, together with increased frequency and thickness of cement lines. Bone mineralization density distribution (BMDD) analysis revealed markedly increased average mineral content of the dense bone (CaMean T-score + 10.1) and frequency of bone with highest mineral content (CaHigh T-score + 19.6), suggesting continued mineral accumulation and lack of bone remodelling. Osteocyte lacunae sections (OLS) characteristics were unremarkable except for an unusually circular shape. Together, our findings suggest that the reduced expression of CLCN7 mRNA in osteoclasts, and possibly also osteocytes, causes poorly remodelled bone with abnormal bone matrix with high mineral content. This together with the lack of adequate bone repair mechanisms makes the material brittle and prone to fracture. While the skeletal phenotype and medical history were suggestive of ADOII, genetic analysis revealed that this is a possible mild case of ARO due to deep intronic mutation.
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Affiliation(s)
- Jochen G Hofstaetter
- 1st Medical Dept., Hanusch Hospital, Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, Vienna, Austria
- Michael Ogon Laboratory, Orthopaedic Hospital Vienna-Speising, Vienna, Austria
| | - Gerald J Atkins
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia.
| | - Hajime Kato
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan
- Osteoporosis Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Masakazu Kogawa
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia
| | - Stéphane Blouin
- 1st Medical Dept., Hanusch Hospital, Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, Vienna, Austria
| | - Barbara M Misof
- 1st Medical Dept., Hanusch Hospital, Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, Vienna, Austria
| | - Paul Roschger
- 1st Medical Dept., Hanusch Hospital, Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, Vienna, Austria
| | - Andreas Evdokiou
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia
| | - Dongqing Yang
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia
| | - Lucian B Solomon
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
| | - David M Findlay
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia
| | - Nobuaki Ito
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan
- Osteoporosis Center, The University of Tokyo Hospital, Tokyo, Japan
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Hedjazi G, Guterman-Ram G, Blouin S, Schemenz V, Wagermaier W, Fratzl P, Hartmann MA, Zwerina J, Fratzl-Zelman N, Marini JC. Alterations of bone material properties in growing Ifitm5/BRIL p.S42 knock-in mice, a new model for atypical type VI osteogenesis imperfecta. Bone 2022; 162:116451. [PMID: 35654352 PMCID: PMC11162744 DOI: 10.1016/j.bone.2022.116451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Osteogenesis imperfecta (OI) is a heterogenous group of heritable connective tissue disorders characterized by high bone fragility due to low bone mass and impaired bone material properties. Atypical type VI OI is an extremely rare and severe form of bone dysplasia resulting from a loss-of-function mutation (p.S40L) in IFITM5/BRIL,the causative gene of OI type V and decreased osteoblast secretion of pigment epithelium-derived factor (PEDF), as in OI type VI. It is not yet known which alterations at the material level might lead to such a severe phenotype. We therefore characterized bone tissue at the micrometer level in a novel heterozygous Ifitm5/BRIL p.S42L knock-in murine model at 4 and 8 weeks of age. METHODS We evaluated in female mice, total body size, femoral and lumbar bone mineral density (BMD) by dual-energy X-ray absorptiometry. In the femoral bone we examined osteoid deposition by light microscopy, assessed bone histomorphometry and mineralization density distribution by quantitative backscattered electron imaging (qBEI). Osteocyte lacunae were examined by qBEI and the osteocyte lacuno-canalicular network by confocal laser scanning microscopy. Vasculature was examined indirectly by qBEI as 2D porosity in cortex, and as 3D porosity by micro-CT in third trochanter. Collagen orientation was examined by second harmonic generation microscopy. Two-way ANOVA was used to discriminate the effect of age and genotype. RESULTS Ifitm5/BRIL p.S42L female mice are viable, do not differ in body size, fat and lean mass from wild type (WT) littermates but have lower whole-body, lumbar and femoral BMD and multiple fractures. The average and most frequent calcium concentration, CaMean and CaPeak, increased with age in metaphyseal and cortical bone in both genotypes and were always higher in Ifitm5/BRIL p.S42L than in WT, except CaMean in metaphysis at 4 weeks of age. The fraction of highly mineralized bone area, CaHigh, was also increased in Ifitm5/BRIL p.S42L metaphyseal bone at 8 weeks of age and at both ages in cortical bone. The fraction of lowly mineralized bone area, CaLow, decreased with age and was not higher in Ifitm5/BRIL p.S42L, consistent with lack of hyperosteoidosis on histological sections by visual exam. Osteocyte lacunae density was higher in Ifitm5/BRIL p.S42L than WT, whereas canalicular density was decreased. Indirect measurements of vascularity revealed a higher pore density at 4 weeks in cortical bone of Ifitm5/BRIL p.S42L than in WT and at both ages in the third trochanter. Importantly, the proportion of bone area with disordered collagen fibrils was highly increased in Ifitm5/BRIL p.S42L at both ages. CONCLUSIONS Despite normal skeletal growth and the lack of a collagen gene mutation, the Ifitm5/BRIL p.S42L mouse shows major OI-related bone tissue alterations such as hypermineralization of the matrix and elevated osteocyte porosity. Together with the disordered lacuno-canalicular network and the disordered collagen fibril orientation, these abnormalities likely contribute to overall bone fragility.
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Affiliation(s)
- Ghazal Hedjazi
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich Collin Strasse 30, 1140 Vienna, Austria
| | - Gali Guterman-Ram
- Section on Heritable Disorders of Bone and Extracellular Matrix, NICHD, NIH, Bethesda, USA
| | - Stéphane Blouin
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich Collin Strasse 30, 1140 Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Victoria Schemenz
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Am Mühlenberg 1, 14476 Potsdam, Germany
| | - Wolfgang Wagermaier
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Am Mühlenberg 1, 14476 Potsdam, Germany
| | - Peter Fratzl
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Am Mühlenberg 1, 14476 Potsdam, Germany
| | - Markus A Hartmann
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich Collin Strasse 30, 1140 Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Jochen Zwerina
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich Collin Strasse 30, 1140 Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Nadja Fratzl-Zelman
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich Collin Strasse 30, 1140 Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Joan C Marini
- Section on Heritable Disorders of Bone and Extracellular Matrix, NICHD, NIH, Bethesda, USA.
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10
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Wanna SBC, Basaruddin KS, Mat F, Mat Som MH, Sulaiman AR. Finite Element Prediction on Fracture Load of Femur with Osteogenesis Imperfecta under Various Loading Conditions. Appl Bionics Biomech 2022; 2022:8722333. [PMID: 35096140 PMCID: PMC8799369 DOI: 10.1155/2022/8722333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 11/26/2021] [Accepted: 12/27/2021] [Indexed: 11/21/2022] Open
Abstract
Osteogenesis Imperfecta (OI) is an inherited disorder characterized by extreme bone fragility due to collagen defects. It is an incurable disease. Bone fractures can occur frequently without prior notice, especially among children. Early quantitative prediction of fracture loads due to OI tends to alert patients to avoid unnecessary situations or dangerous conditions. This study is aimed at investigating the fracture loads of femur with OI under various types of loading. Ten finite element models of an OI-affected bone were reconstructed from the normal femur with different bowing angles ranging from 7.5 to 30.0°. The boundary conditions were assigned on an OI-affected femoral head under three types of load: medial-lateral impacts, compression-tension, and internal-external torsions, and various loading direction cases that reflect the stance condition. The fracture load was examined based on the load that can cause bone fracture for each case. The results show that the loads bearable by the femur before fracture were decreased with respect to the increase of OI bowing angles in most of the loading cases. The risk of fracture for the femur with OI was directly proportional to the increase of bowing angles in the frontal plane. This study provides new insights on fracture load prediction in OI-affected bone with respect to various loading types, which could help medical personnel for surgical intervention judgement.
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Affiliation(s)
- Soh Bua Chai Wanna
- Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, 02600 Pauh Putra, Perlis, Malaysia
| | - Khairul Salleh Basaruddin
- Faculty of Mechanical Engineering Technology, Universiti Malaysia Perlis, 02600 Pauh Putra, Perlis, Malaysia
- Sport Engineering Research Center, Universiti Malaysia Perlis, 02600 Pauh Putra, Perlis, Malaysia
| | - Fauziah Mat
- Faculty of Mechanical Engineering Technology, Universiti Malaysia Perlis, 02600 Pauh Putra, Perlis, Malaysia
| | - Mohd Hanafi Mat Som
- Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, 02600 Pauh Putra, Perlis, Malaysia
- Faculty of Mechanical Engineering Technology, Universiti Malaysia Perlis, 02600 Pauh Putra, Perlis, Malaysia
| | - Abdul Razak Sulaiman
- Department of Orthopaedics, School of Medical Science, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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11
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Zeng Y, Pan Y, Mo J, Ling Z, Jiang L, Xiong F, Yan W. Case Report: A Novel COL1A1 Missense Mutation Associated With Dentineogenesis Imperfecta Type I. Front Genet 2021; 12:699278. [PMID: 34249109 PMCID: PMC8260930 DOI: 10.3389/fgene.2021.699278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 05/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Osteogenesis imperfecta (OI) is a clinical and genetic disorder that results in bone fragility, blue sclerae and dentineogenesis imperfecta (DGI), which is mainly caused by a mutation in the COL1A1 or COL1A2 genes, which encode type I procollagen. Case Report: A missense mutation (c.1463G > C) in exon 22 of the COL1A1 gene was found using whole-exome sequencing. However, the cases reported herein only exhibited a clinical DGI-I phenotype. There were no cases of bone disease or any other common abnormal symptom caused by a COL1A1 mutation. In addition, the ultrastructural analysis of the tooth affected with non-syndromic DGI-I showed that the abnormal dentine was accompanied by the disruption of odontoblast polarization, a reduced number of odontoblasts, a reduction in hardness and elasticity, and the loss of dentinal tubules, suggesting a severe developmental disorder. We also investigated the odontoblast differentiation ability using dental pulp stem cells (DPSCs) that were isolated from a patient with DGI-I and cultured. Stem cells isolated from patients with DGI-I are important to elucidate their pathogenesis and underlying mechanisms to develop regenerative therapies. Conclusion: This study can provide new insights into the phenotype-genotype association in collagen-associated diseases and improve the clinical diagnosis of OI/DGI-I.
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Affiliation(s)
- Yuting Zeng
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuhua Pan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiayao Mo
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiting Ling
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lifang Jiang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fu Xiong
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Guangzhou, Guangdong, China
| | - Wenjuan Yan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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12
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Mähr M, Blouin S, Misof BM, Paschalis EP, Hartmann MA, Zwerina J, Fratzl-Zelman N. Bone properties in osteogenesis imperfecta: what can we learn from a bone biopsy beyond histology? Wien Med Wochenschr 2021; 171:111-119. [PMID: 33616798 DOI: 10.1007/s10354-021-00818-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
Transiliac bone biopsy samples are used to evaluate histology and bone cell activity in unclear pathological conditions. However, much additional information can be obtained from such bone samples. Using the example of osteogenesis imperfecta (OI), the current article describes how biopsy samples can be further used to study bone material characteristics including the degree of matrix mineralization, organic matrix properties, mineral particle size and bone nanoporosity. OI is a heritable collagen-related disorder that is phenotypically and genetically extremely heterogeneous. One essential finding was that OI bone is hypermineralized independently of clinical severity. Moreover, mineral particles in OI bone are of normal size or even smaller, but more densely packed than normally. Another recent finding was that in some forms of OI, collagen orientation is highly disorganized, indicating that the collagen-mineral particle network is profoundly altered in OI. These findings have contributed to the understanding of impaired bone strength in OI.
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Affiliation(s)
- Matthias Mähr
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich-Collin-Str. 30, 1140, Vienna, Austria
| | - Stéphane Blouin
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich-Collin-Str. 30, 1140, Vienna, Austria.,Vienna Bone and Growth Center, Vienna, Austria
| | - Barbara M Misof
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich-Collin-Str. 30, 1140, Vienna, Austria.,Vienna Bone and Growth Center, Vienna, Austria
| | - Eleftherios P Paschalis
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich-Collin-Str. 30, 1140, Vienna, Austria.,Vienna Bone and Growth Center, Vienna, Austria
| | - Markus A Hartmann
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich-Collin-Str. 30, 1140, Vienna, Austria.,Vienna Bone and Growth Center, Vienna, Austria
| | - Jochen Zwerina
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich-Collin-Str. 30, 1140, Vienna, Austria.,Vienna Bone and Growth Center, Vienna, Austria
| | - Nadja Fratzl-Zelman
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich-Collin-Str. 30, 1140, Vienna, Austria. .,Vienna Bone and Growth Center, Vienna, Austria.
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13
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Lee CL, Liu SC, Yang CY, Chuang CK, Lin HY, Lin SP. Incidence and treatment of adult femoral fractures with osteogenesis imperfecta: An analysis of a center of 72 patients in Taiwan. Int J Med Sci 2021; 18:1240-1246. [PMID: 33526985 PMCID: PMC7847618 DOI: 10.7150/ijms.53286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/18/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Osteogenesis imperfecta (OI) is a rare disease characterized by increased bone fragility and susceptibility for fractures. Only few studies have compared the management for femoral fractures in children with OI. Nevertheless, no cohort studies have described the treatment for femoral fractures in adults with OI in Taiwan. This study aimed to investigate and compare the incidence of union and non-union femoral fractures and the best treatment options to avoid non-union fractures. Methods: We enrolled 72 patients with OI who were older than 18 years at MacKay Memorial Hospital between January 2010 and December 2018. Femoral fracture incidence, non-union rate, and treatment modality were analyzed. Results: Of 72 patients with OI, 11 patients had femoral fractures and 4 patients of them had >1 femoral fracture. The incidence for all types of femoral fractures was 651 fractures per 100,000 person-years annually. In 15 total fractures, 4 fractures resulted in non-union, and patients with type 4 OI mostly had shaft fractures. The best outcomes for non-union shaft fracture is achieved by surgical treatment. Conclusion: Adults with OI tended to develop femoral fractures and non-unions. Adults with type 4 OI were particularly at high risk for non-unions in shaft fractures with conservative treatment.
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Affiliation(s)
- Chung-Lin Lee
- Department of Pediatrics, MacKay Memorial Hospital, Hsinchu, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Chia Liu
- Department of Orthopedics, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Chen-Yu Yang
- Department of Orthopedics, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Chih-Kuang Chuang
- Division of Genetics and Metabolism, Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Hsiang-Yu Lin
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Division of Genetics and Metabolism, Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Rare Disease Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shuan-Pei Lin
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,Division of Genetics and Metabolism, Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Rare Disease Center, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Infant and Child Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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14
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15
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Treurniet S, Eekhoff EMW, Schmidt FN, Micha D, Busse B, Bravenboer N. A Clinical Perspective on Advanced Developments in Bone Biopsy Assessment in Rare Bone Disorders. Front Endocrinol (Lausanne) 2020; 11:399. [PMID: 32714279 PMCID: PMC7344330 DOI: 10.3389/fendo.2020.00399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/18/2020] [Indexed: 01/22/2023] Open
Abstract
Introduction: Bone biopsies have been obtained for many centuries and are one of the oldest known medical procedures in history. Despite the introduction of new noninvasive radiographic imaging techniques and genetic analyses, bone biopsies are still valuable in the diagnosis of bone diseases. Advanced techniques for the assessment of bone quality in bone biopsies, which have emerged during the last decades, allows in-depth tissue analyses beyond structural changes visible in bone histology. In this review, we give an overview of the application and advantages of the advanced techniques for the analysis of bone biopsies in the clinical setting of various rare metabolic bone diseases. Method: A systematic literature search on rare metabolic bone diseases and analyzing techniques of bone biopsies was performed in PubMed up to 2019 week 34. Results: Advanced techniques for the analysis of bone biopsies were described for rare metabolic bone disorders including Paget's disease of bone, osteogenesis imperfecta, fibrous dysplasia, Fibrodysplasia ossificans progressiva, PLS3 X-linked osteoporosis, Loeys-Diets syndrome, osteopetrosis, Erdheim-Chester disease, and Cherubism. A variety of advanced available analytical techniques were identified that may help to provide additional detail on cellular, structural, and compositional characteristics in rare bone diseases complementing classical histopathology. Discussion: To date, these techniques have only been used in research and not in daily clinical practice. Clinical application of bone quality assessment techniques depends upon several aspects such as availability of the technique in hospitals, the existence of reference data, and a cooperative network of researchers and clinicians. The evaluation of rare metabolic bone disorders requires a repertoire of different methods, owing to their distinct bone tissue characteristics. The broader use of bone material obtained from biopsies could provide much more information about pathophysiology or treatment options and establish bone biopsies as a valuable tool in rare metabolic bone diseases.
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Affiliation(s)
- Sanne Treurniet
- Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Elisabeth M. W. Eekhoff
- Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Felix N. Schmidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dimitra Micha
- Department of Clinical Genetics, Amsterdam University Medical Center, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nathalie Bravenboer
- Bone and Calcium Metabolism Lab, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
- *Correspondence: Nathalie Bravenboer
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16
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Ibrahim S, Strange AP, Aguayo S, Shinawi A, Harith N, Mohamed-Ibrahim N, Siddiqui S, Parekh S, Bozec L. Phenotypic Properties of Collagen in Dentinogenesis Imperfecta Associated with Osteogenesis Imperfecta. Int J Nanomedicine 2019; 14:9423-9435. [PMID: 31819441 PMCID: PMC6897053 DOI: 10.2147/ijn.s217420] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/04/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Dentinogenesis imperfecta type 1 (OIDI) is considered a relatively rare genetic disorder (1:5000 to 1:45,000) associated with osteogenesis imperfecta. OIDI impacts the formation of collagen fibrils in dentin, leading to morphological and structural changes that affect the strength and appearance of teeth. However, there is still a lack of understanding regarding the nanoscale characterization of the disease, in terms of collagen ultrastructure and mechanical properties. Therefore, this research presents a qualitative and quantitative report into the phenotype and characterization of OIDI in dentin, by using a combination of imaging, nanomechanical approaches. Methods For this study, 8 primary molars from OIDI patients and 8 primary control molars were collected, embedded in acrylic resin and cut into longitudinal sections. Sections were then demineralized in 37% phosphoric acid using a protocol developed in-house. Initial experiments demonstrated the effectiveness of the demineralization protocol, as the ATR-FTIR spectral fingerprints showed an increase in the amide bands together with a decrease in phosphate content. Structural and mechanical analyses were performed directly on both the mineralized and demineralized samples using a combination of scanning electron microscopy, atomic force microscopy, and Wallace indentation. Results Mesoscale imaging showed alterations in dentinal tubule morphology in OIDI patients, with a reduced number of tubules and a decreased tubule diameter compared to healthy controls. Nanoscale collagen ultrastructure presented a similar D-banding periodicity between OIDI and controls. Reduced collagen fibrils diameter was also recorded for the OIDI group. The hardness of the (mineralized) control dentin was found to be significantly higher (p<0.05) than that of the OIDI (mineralized) dentine. Both the exposed peri- and intratubular dentinal collagen presented bimodal elastic behaviors (Young’s moduli). The control samples presented a stiffening of the intratubular collagen when compared to the peritubular collagen. In case of the OIDI, this stiffening in the collagen between peri- and intratubular dentinal collagen was not observed and the exposed collagen presented overall a lower elasticity than the control samples. Conclusion This study presents a systematic approach to the characterization of collagen structure and properties in OIDI as diagnosed in dentin. Structural markers for OIDI at the mesoscale and nanoscale were found and correlated with an observed lack of increased elastic moduli of the collagen fibrils in the intratubular OIDI dentin. These findings offer an explanation of how structural changes in the dentin could be responsible for the failure of some adhesive restorative materials as observed in patients affected by OIDI.
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Affiliation(s)
- Salwa Ibrahim
- Department of Paediatric Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| | - Adam P Strange
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - Sebastian Aguayo
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK.,School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Albatool Shinawi
- Department of Paediatric Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| | - Nabilah Harith
- Department of Paediatric Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| | - Nurjehan Mohamed-Ibrahim
- Department of Paediatric Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| | - Samera Siddiqui
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - Susan Parekh
- Department of Paediatric Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| | - Laurent Bozec
- Faculty of Dentistry, University of Toronto, Toronto, Canada
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17
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Goudriaan WA, Harsevoort GJ, van Leeuwen M, Franken AA, Janus GJM. Incidence and treatment of femur fractures in adults with osteogenesis imperfecta: an analysis of an expert clinic of 216 patients. Eur J Trauma Emerg Surg 2018; 46:165-171. [PMID: 30244374 PMCID: PMC7026263 DOI: 10.1007/s00068-018-1005-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 09/11/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE Osteogenesis imperfecta (OI) is characterized by increased bone fragility and susceptibility for fractures. A few studies described and compared treatment modalities for femur fractures in children with OI. However, no cohort studies on adults with OI have been published. This study on adult OI patients aims to give insight into the incidence of femur fractures and non-unions and its best treatment options to avert non-union. METHODS In this retrospective, descriptive study of the OI expert clinic in The Netherlands, all medical charts of patients 16 years or older were analyzed for femur fracture incidence, non-union rate and treatment modality. RESULTS Of 216 OI patients, 34 patients suffered a femur fracture with 12 patients having more than 1 femur fracture. For all types of femur fractures, the incidence was 651 fractures per 100,000 person-years annually. In 49 total fractures, 10 fractures resulted in a non-union, mostly shaft fractures of type 4 OI patients. Surgically treated shaft fractures had the best outcomes for non-union. CONCLUSIONS OI adults were prone to developing femur fractures and non-unions. Especially type 4 OI adults, with conservatively treated shaft fractures, were at high risk for non-unions.
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18
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Misof BM, Roschger P, Klaushofer K, Rauch F, Ma J, Mack DR, Ward LM. Increased bone matrix mineralization in treatment-naïve children with inflammatory bowel disease. Bone 2017; 105:50-56. [PMID: 28705682 DOI: 10.1016/j.bone.2017.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/05/2017] [Accepted: 07/09/2017] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel disease (IBD) affects many organ systems including the skeleton. In children with IBD, bone mineral density (BMD) and bone turnover are frequently low. Disturbances in bone mineralization density distribution (BMDD) are linked to alterations in bone material strength; however, BMDD has not previously been reported in children with chronic inflammatory disorders. The aim of this study was to characterize BMDD based on quantitative backscatter electron imaging in cancellous (Cn.) and cortical (Ct.) compartments from trans-iliac biopsy samples from a cohort of 20 treatment-naïve children at the time of their IBD diagnosis (12 males, mean age 14.5±2.3years). The outcomes were compared to pediatric reference BMDD data and correlation with revisited biochemical and histomorphometric outcomes was analyzed. BMDD in treatment-naïve children with IBD was shifted toward higher calcium concentrations compared to reference: (i) In cancellous bone, the most frequent calcium concentration (Cn.CaPeak+2.8%, p=0.004) and the portion of highly mineralized bone (Cn.CaHigh+52%, p=0.009) were increased. (ii) In cortical bone, the mineralization heterogeneity (Ct.CaWidth+17.0%, p=0.001) and Ct.CaHigh (+30.4%, p=0.006) were increased. (iii) Furthermore, significant correlations with serum alkaline phosphatase (ALP), bone-specific alkaline phosphatase (bsALP), and urinary crosslinked N-telopeptide of type I collagen (uNTX) were observed: the higher CaMean (the average calcium concentration), CaPeak and CaHigh, the lower were ALP, bsALP, and uNTX (p-value from <0.001 to 0.05). Children with treatment-naïve IBD have decreased bone turnover leading to a higher bone matrix mineralization density, findings which may contribute to compromised bone strength.
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Affiliation(s)
- Barbara M Misof
- Ludwig Boltzmann-Institute of Osteology at Hanusch-Hospital of WGKK & Trauma Centre Meidling of AUVA, 1st Medical Department, Hanusch-Hospital, Vienna, Austria.
| | - Paul Roschger
- Ludwig Boltzmann-Institute of Osteology at Hanusch-Hospital of WGKK & Trauma Centre Meidling of AUVA, 1st Medical Department, Hanusch-Hospital, Vienna, Austria
| | - Klaus Klaushofer
- Ludwig Boltzmann-Institute of Osteology at Hanusch-Hospital of WGKK & Trauma Centre Meidling of AUVA, 1st Medical Department, Hanusch-Hospital, Vienna, Austria
| | - Frank Rauch
- Department of Pediatrics, McGill University, Shriners Hospital of Montréal, Montréal, Canada
| | - Jinhui Ma
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - David R Mack
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Inflammatory Bowel Disease Centre, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Canada
| | - Leanne M Ward
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Canada
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19
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Blouin S, Fratzl-Zelman N, Glorieux FH, Roschger P, Klaushofer K, Marini JC, Rauch F. Hypermineralization and High Osteocyte Lacunar Density in Osteogenesis Imperfecta Type V Bone Indicate Exuberant Primary Bone Formation. J Bone Miner Res 2017; 32:1884-1892. [PMID: 28548288 PMCID: PMC5555797 DOI: 10.1002/jbmr.3180] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/10/2017] [Accepted: 05/25/2017] [Indexed: 01/03/2023]
Abstract
In contrast to "classical" forms of osteogenesis imperfecta (OI) types I to IV, caused by a mutation in COL1A1/A2, OI type V is due to a gain-of-function mutation in the IFITM5 gene, encoding the interferon-induced transmembrane protein 5, or bone-restricted interferon-inducible transmembrane (IFITM)-like protein (BRIL). Its phenotype distinctly differs from OI types I to IV by absence of blue sclerae and dentinogenesis imperfecta, by the occurrence of ossification disorders such as hyperplastic callus and forearm interosseous membrane ossification. Little is known about the impact of the mutation on bone tissue/material level in untreated and bisphosphonate-treated patients. Therefore, investigations of transiliac bone biopsy samples from a cohort of OI type V children (n = 15, 8.7 ± 4 years old) untreated at baseline and a subset (n = 8) after pamidronate treatment (2.6 years in average) were performed. Quantitative backscattered electron imaging (qBEI) was used to determine bone mineralization density distribution (BMDD) as well as osteocyte lacunar density. The BMDD of type V OI bone was distinctly shifted toward a higher degree of mineralization. The most frequently occurring calcium concentration (CaPeak) in cortical (Ct) and cancellous (Cn) bone was markedly increased (+11.5%, +10.4%, respectively, p < 0.0001) compared to healthy reference values. Treatment with pamidronate resulted in only a slight enhancement of mineralization. The osteocyte lacunar density derived from sectioned bone area was elevated in OI type V Ct and Cn bone (+171%, p < 0.0001; +183.3%, p < 0.01; respectively) versus controls. The high osteocyte density was associated with an overall immature primary bone structure ("mesh-like") as visualized by polarized light microscopy. In summary, the bone material from OI type V patients is hypermineralized, similar to other forms of OI. The elevated osteocyte lacunar density in connection with lack of regular bone lamellation points to an exuberant primary bone formation and an alteration of the bone remodeling process in OI type V. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Stéphane Blouin
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria
| | - Nadja Fratzl-Zelman
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria
| | | | - Paul Roschger
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria
| | - Klaus Klaushofer
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria
| | - Joan C Marini
- Bone and Extracellular Matrix Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Frank Rauch
- Shriners Hospital for Children, Montreal, Quebec, Canada
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20
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Suh KS, Chon S, Choi EM. Limonene attenuates methylglyoxal-induced dysfunction in MC3T3-E1 osteoblastic cells. FOOD AGR IMMUNOL 2017. [DOI: 10.1080/09540105.2017.1337082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Kwang Sik Suh
- Department of Endocrinology & Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Suk Chon
- Department of Endocrinology & Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Eun Mi Choi
- Department of Endocrinology & Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
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21
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Fratzl-Zelman N, Valta H, Pereira RC, Misof BM, Roschger P, Jalanko H, Wesseling-Perry K, Klaushofer K, Mäkitie O. Abnormally High and Heterogeneous Bone Matrix Mineralization After Childhood Solid Organ Transplantation: A Complex Pathology of Low Bone Turnover and Local Defects in Mineralization. J Bone Miner Res 2017; 32:1116-1125. [PMID: 28214296 DOI: 10.1002/jbmr.3087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 01/20/2023]
Abstract
Chronic renal, liver, and heart failure in children associates with multiple skeletal complications. Increased fracture incidence often persists after transplantation and could be related to alterations in bone material properties. In the present cohort study we evaluated bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in 23 pediatric solid organ allograft recipients with suspected osteoporosis. We measured BMDD in the entire cross-sectional area of transiliac bone biopsies obtained from kidney (n = 9), liver (n = 9), and heart (n = 5) transplant recipients (aged 7.6 to 19.7 years; 6.0 ± 5.6 years posttransplantation, patients with a history of clinical fractures: n = 14). The BMDD findings were compared with age-appropriate references and with a previously presented cohort of children with chronic kidney disease on dialysis (CKD5D, n = 18). Furthermore, we related the BMDD parameters with patients' clinical and bone histomorphometric outcomes. Compared to healthy children, qBEI results for cancellous and cortical bone in transplant recipients revealed an increase in the most frequently occurring calcium concentration (+2.9%, p = 0.001; +3.5%, p = 0.014), in the portion of fully mineralized bone (fivefold; 10-fold, both p < 0.0001) and in heterogeneity of mineralization (+26,5% and +27.8%, both p < 0.0001), respectively. Moreover, the BMDD parameters were nonsignificantly distinct from CKD5D cohort except that the heterogeneity in mineralization was higher posttransplantation. There was a strong inverse correlation between the average calcium content of the bone matrix and patients' biochemical ALP levels, histomorphometric indices of bone formation and resorption. The abnormally high bone matrix mineralization in transplant recipients, consistent with serum and histomorphometric outcomes, suggests a history of low bone turnover with accumulation of fully mineralized bone packets. Additionally, the increased heterogeneity of mineralization suggests local alterations in mineralization kinetics, which may be linked to dysfunctional osteocytes that were recently shown to accumulate within the bone matrix during organ failure and concomitant glucocorticoid and immunosuppressive medication. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Nadja Fratzl-Zelman
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Helena Valta
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Renata C Pereira
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Barbara M Misof
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Paul Roschger
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Hannu Jalanko
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | | | - Klaus Klaushofer
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre, Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Outi Mäkitie
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.,Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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22
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Folkestad L, Hald JD, Ersbøll AK, Gram J, Hermann AP, Langdahl B, Abrahamsen B, Brixen K. Fracture Rates and Fracture Sites in Patients With Osteogenesis Imperfecta: A Nationwide Register-Based Cohort Study. J Bone Miner Res 2017; 32:125-134. [PMID: 27448250 DOI: 10.1002/jbmr.2920] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/14/2016] [Accepted: 07/20/2016] [Indexed: 11/08/2022]
Abstract
Osteogenesis imperfecta (OI) is a hereditary, clinically heterogeneous, connective tissue disorder. The population prevalence of OI in Denmark is 10.6 in 100,000. A hallmark of the disease is frequent fractures that are often precipitated by minimal trauma. The aim of the current study was to compare the fracture rates across the lifespan of patients with OI with that of a reference population from the general population. The present study was a Danish nationwide, population-based, cohort study using register data. We identified 644 (55.6% females) patients in the OI cohort through the Danish National Patient Register and 3361 (55.2% females) persons, randomly selected from the Civil Registry System. A total of 416 patients with OI experienced a total of 1566 fractures during the observation period of median 17.9 years (interquartile range [IQR], 12.4 to 18.0 years), summing to 10137 person years. In comparison, 709 persons in the reference population experienced a total of 1018 fractures during follow-up. Both male and female patients with OI had an increased fracture rate throughout their life. The fracture rate ratio for participants aged 0 to 19 years was 10.7, for participants aged 20 to 54 years 17.2, and for participants aged 55 years and over 4.1 when compared to the reference population. The highest fracture rate was seen in males with OI aged 0 to 19 years (257 fractures per 1000 person-years). The fractures appear to follow the same pattern as in the general population, with a peak during the toddler and adolescent years (incidence rate [IR] 233.9 per 1000 person years), fewer fractures during adulthood (IR 84.5 per 1000 person years), and increased fracture rates in older women (IR 111.9 per 1000 person years). This is the largest register-based nationwide study on the fracture epidemiology of patients with OI. The risk of fractures seems largest in the childhood and adolescent years, and the relative risk of fracture declines with age in patients with OI compared to the general population. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Lars Folkestad
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Endocrinology, Hospital of Southwest Denmark, Esbjerg, Denmark
| | - Jannie Dahl Hald
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Annette Kjaer Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jeppe Gram
- Department of Endocrinology, Hospital of Southwest Denmark, Esbjerg, Denmark
| | | | - Bente Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Bo Abrahamsen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark.,Odense Exploratory Patient Network (OPEN), Holbaek, Denmark
| | - Kim Brixen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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24
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Rocha B, Ruiz-Romero C, Blanco FJ. Mass spectrometry imaging: a novel technology in rheumatology. Nat Rev Rheumatol 2016; 13:52-63. [DOI: 10.1038/nrrheum.2016.184] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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25
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Rocha B, Cillero-Pastor B, Blanco FJ, Ruiz-Romero C. MALDI mass spectrometry imaging in rheumatic diseases. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2016; 1865:784-794. [PMID: 27742553 DOI: 10.1016/j.bbapap.2016.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 01/15/2023]
Abstract
Mass spectrometry imaging (MSI) is a technique used to visualize the spatial distribution of biomolecules such as peptides, proteins, lipids or other organic compounds by their molecular masses. Among the different MSI strategies, MALDI-MSI provides a sensitive and label-free approach for imaging of a wide variety of protein or peptide biomarkers from the surface of tissue sections, being currently used in an increasing number of biomedical applications such as biomarker discovery and tissue classification. In the field of rheumatology, MALDI-MSI has been applied to date for the analysis of joint tissues such as synovial membrane or cartilage. This review summarizes the studies and key achievements obtained using MALDI-MSI to increase understanding on rheumatic pathologies and to describe potential diagnostic or prognostic biomarkers of these diseases. This article is part of a Special Issue entitled: MALDI Imaging, edited by Dr. Corinna Henkel and Prof. Peter Hoffmann.
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Affiliation(s)
- Beatriz Rocha
- Proteomics Unit-ProteoRed/ISCIII, Rheumatology Group, INIBIC - Hospital Universitario de A Coruña, SERGAS, A Coruña, Spain
| | | | - Francisco J Blanco
- Proteomics Unit-ProteoRed/ISCIII, Rheumatology Group, INIBIC - Hospital Universitario de A Coruña, SERGAS, A Coruña, Spain; RIER-RED de Inflamación y Enfermedades Reumáticas, INIBIC-CHUAC, A Coruña, Spain.
| | - Cristina Ruiz-Romero
- Proteomics Unit-ProteoRed/ISCIII, Rheumatology Group, INIBIC - Hospital Universitario de A Coruña, SERGAS, A Coruña, Spain; CIBER-BBN Instituto de Salud Carlos III, INIBIC-CHUAC, A Coruña, Spain.
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26
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Mertz EL, Makareeva E, Mirigian LS, Koon KY, Perosky JE, Kozloff KM, Leikin S. Makings of a brittle bone: Unexpected lessons from a low protein diet study of a mouse OI model. Matrix Biol 2016; 52-54:29-42. [PMID: 27039252 DOI: 10.1016/j.matbio.2016.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/09/2016] [Accepted: 03/09/2016] [Indexed: 12/19/2022]
Abstract
Glycine substitutions in type I collagen appear to cause osteogenesis imperfecta (OI) by disrupting folding of the triple helix, the structure of which requires Gly in every third position. It is less clear, however, whether the resulting bone malformations and fragility are caused by effects of intracellular accumulation of misfolded collagen on differentiation and function of osteoblasts, effects of secreted misfolded collagen on the function of bone matrix, or both. Here we describe a study originally conceived for testing how reducing intracellular accumulation of misfolded collagen would affect mice with a Gly610 to Cys substitution in the triple helical region of the α2(I) chain. To stimulate degradation of misfolded collagen by autophagy, we utilized a low protein diet. The diet had beneficial effects on osteoblast differentiation and bone matrix mineralization, but also affected bone modeling and suppressed overall animal growth. Our more important observations, however, were not related to the diet. They revealed how altered osteoblast function and deficient bone formation by each cell caused by the G610C mutation combined with increased osteoblastogenesis might make the bone more brittle, all of which are common OI features. In G610C mice, increased bone formation surface compensated for reduced mineral apposition rate, resulting in normal cortical area and thickness at the cost of altering cortical modeling process, retaining woven bone, and reducing the ability of bone to absorb energy through plastic deformation. Reduced collagen and increased mineral density in extracellular matrix of lamellar bone compounded the problem, further reducing bone toughness. The latter observations might have particularly important implications for understanding OI pathophysiology and designing more effective therapeutic interventions.
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Affiliation(s)
- E L Mertz
- Section on Physical Biochemistry, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - E Makareeva
- Section on Physical Biochemistry, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - L S Mirigian
- Section on Physical Biochemistry, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - K Y Koon
- Section on Physical Biochemistry, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - J E Perosky
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - K M Kozloff
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - S Leikin
- Section on Physical Biochemistry, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
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