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Li S, Zhao X. Anatomical and biomechanical characteristics of basivertebral foramen and its clinical significance. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024; 53:443-449. [PMID: 39183068 PMCID: PMC11375485 DOI: 10.3724/zdxbyxb-2024-0220] [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] [Indexed: 08/27/2024]
Abstract
Basivertebral foramen is a natural orifice in the posterior wall of the vertebral body existing in humans and mammals, through which the basal vertebral vein, branch of lumbar artery and recurrent branch of spinal nerve enter and exit the vertebral body. Basivertebral foramen changes the local microstructure of the vertebral body, resulting in cortical defect and sparse trabecular bone in the central region of the vertebral body, thus affecting its biomechanical characteristics and making its central region a "weak" area of the vertebra. Some characteristic injuries of the vertebra are related to basivertebral foramen, such as vertebral compression fracture and intervertebral cleft, vertebral burst fracture and posterior upper vertebral fracture fragment, and cement leakage during treatment. In this article, the anatomical and developmental biological characteristics of basivertebral foramen, the impact of basivertebral foramen on biomechanical characteristics, and the treatment of basivertebral foramen related vertebral diseases are reviewed, in order to provide references for the clinical diagnosis and treatment of vertebral injuries.
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Affiliation(s)
- Shengyun Li
- Department of Orthopedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
| | - Xing Zhao
- Department of Orthopedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
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2
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Yang Y, Liao F, Xing X, Liao N, Wang D, Yin X, Liu Y, Guo J, Li L, Wang H, Li C, Zheng Y. The reduced cortical bone density in vertebral bodies: risk for osteoporotic fractures? Insights from CT analysis. J Orthop Surg Res 2024; 19:486. [PMID: 39152470 PMCID: PMC11329995 DOI: 10.1186/s13018-024-04896-5] [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: 03/08/2024] [Accepted: 07/03/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND There is a corresponding increase in the prevalence of osteoporosis and related fractures with the aging population on the rise. Furthermore, osteoporotic vertebral compression fractures (OVCF) may contribute to higher patient mortality rates. It is essential to conduct research on risk factors for OVCF and provide a theoretical basis for preventing such fractures. METHODS We retrospectively recruited patients who had spine CT for OVCF or back pain. Demographic and CT data were collected. Quantitative computed tomography (QCT) software analyzed the CT data, using subcutaneous fat and paraspinal muscles as reference standards for BMD processing. BMD of cortical and cancellous bones in each patient's vertebral body was determined. RESULTS In this study, 144 patients were divided into non-OVCF (96) and OVCF (48) groups. Non-OVCF patients had higher cortical BMD of 382.5 ± 52.4 to 444.6 ± 70.1 mg/cm3, with T12 having the lowest BMD (p < 0.001, T12 vs. L2). Cancellous BMD ranged from 128.5 ± 58.4 to 140.9 ± 58.9 mg/cm3, with L3 having the lowest BMD. OVCF patients had lower cortical BMD of 365.0 ± 78.9 to 429.3 ± 156.7 mg/cm3, with a further decrease in T12 BMD. Cancellous BMD ranged from 71.68 ± 52.07 to 123.9 ± 126.2 mg/cm3, with L3 still having the lowest BMD. Fractured vertebrae in OVCF patients (T12, L1, and L2) had lower cortical bone density compared to their corresponding vertebrae without fractures (p < 0.05). CONCLUSIONS T12 had the lowest cortical BMD and L3 had the lowest cancellous BMD in OVCF patients, with T12 also having the highest incidence of osteoporotic fractures. These findings suggest that reduction in cortical BMD has a greater impact on OVCF than reduction in cancellous BMD, along with biomechanical factors.
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Affiliation(s)
- Yong Yang
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610083, PR China
| | - Feng Liao
- Department of Orthopaedics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, PR China
| | - Xingbo Xing
- Department of Radiology, Fourth Medical Center of PLA General Hospital, Beijing, 10048, PR China
| | - Nianxi Liao
- Yizhun medical AI Co.Ltd, No.7, Zhichun road, Haidian district, Beijing, 100088, PR China
| | - Dawei Wang
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
| | - Xin Yin
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
| | - Yihao Liu
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
| | - Jidong Guo
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
| | - Li Li
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
| | - Huadong Wang
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China.
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China.
| | - Chunyan Li
- Department of Clinical Laboratory, Beijing Jishuitan Hospital, Xicheng District, Beijing, 100035, PR China.
| | - Yang Zheng
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China.
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China.
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610083, PR China.
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Lim DZ, Macbain M, Kok M, Wiggins G, Abbouchie H, Lee ST, Lau E, Lim RP, Chiang C, Kutaiba N. Opportunistic screening for osteoporosis using routine clinical care computed tomography brain studies. Skeletal Radiol 2024:10.1007/s00256-024-04703-6. [PMID: 38755335 DOI: 10.1007/s00256-024-04703-6] [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: 02/22/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Osteoporosis and falls are both prevalent in the elderly, and CT brain (CTB) is frequently performed post head-strike. We aim to validate the relationship between frontal bone density (Hounsfield unit) from routine CTB and bone mineral density from dual-energy X-ray absorptiometry (DEXA) scan for opportunistic osteoporosis screening. MATERIALS AND METHODS Patients who had a non-contrast CTB followed by a DEXA scan in the subsequent year were included in this multi-center retrospective study. The relationship between frontal bone density on CT and femoral neck T-score on DEXA was examined using ANOVA, Pearson's correlation, and receiver operating curve (ROC) analysis. Sensitivity, specificity, negative and positive predictive values, and area under the curve (AUC) were calculated. RESULTS Three hundred twenty-six patients (205 females and 121 males) were analyzed. ANOVA analysis showed that frontal bone density was lower in patients with DEXA-defined osteoporosis (p < 0.001), while Pearson's correlation analysis demonstrated a fair correlation with femoral neck T-score (r = 0.3, p < 0.001). On subgroup analysis, these were true in females but not in males. On ROC analysis, frontal bone density weakly predicted osteoporosis (AUC 0.6, 95% CI 0.5-0.7) with no optimal threshold identified. HU < 610 was highly specific (87.5%) but poorly sensitive (18.9%). HU > 1200 in females had a strong negative predictive value for osteoporosis (92.6%, 95% CI 87.1-98.1%). CONCLUSION Frontal bone density from routine CTB is significantly different between females with and without osteoporosis, but not between males. However, frontal bone density was a weak predictor for DEXA-defined osteoporosis. Further research is required to determine the role of CTB in opportunistic osteoporosis screening.
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Affiliation(s)
- Dee Zhen Lim
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia.
| | - Milo Macbain
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Marcus Kok
- Department of Radiology, Eastern Health, 8 Arnold Street, Box Hill, VIC, 3128, Australia
| | - Ghanda Wiggins
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Hussein Abbouchie
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Sze Ting Lee
- Department of Molecular Imaging and Therapy, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
- University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Eddie Lau
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
- Department of Molecular Imaging and Therapy, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
- University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Ruth P Lim
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
- University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Cherie Chiang
- University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
- Department of Endocrinology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Numan Kutaiba
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
- Department of Radiology, Eastern Health, 8 Arnold Street, Box Hill, VIC, 3128, Australia
- University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
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Löffler MT, Wu PH, Pirmoazen AM, Joseph GB, Stewart JM, Saeed I, Liu J, Schafer AL, Schwartz AV, Link TM, Kazakia GJ. Microvascular disease not type 2 diabetes is associated with increased cortical porosity: A study of cortical bone microstructure and intracortical vessel characteristics. Bone Rep 2024; 20:101745. [PMID: 38444830 PMCID: PMC10912053 DOI: 10.1016/j.bonr.2024.101745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/05/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Fracture risk is elevated in type 2 diabetes (T2D) despite normal or even high bone mineral density (BMD). Microvascular disease (MVD) is a diabetic complication, but also associated with other diseases, for example chronic kidney disease. We hypothesize that increased fracture risk in T2D could be due to increased cortical porosity (Ct.Po) driven by expansion of the vascular network in MVD. The purpose of this study was to investigate associations of T2D and MVD with cortical microstructure and intracortical vessel parameters. Methods The study group consisted of 75 participants (38 with T2D and 37 without T2D). High-resolution peripheral quantitative CT (HR-pQCT) and dynamic contrast-enhanced MRI (DCE-MRI) of the ultra-distal tibia were performed to assess cortical bone and intracortical vessels (outcomes). MVD was defined as ≥1 manifestation including neuropathy, nephropathy, or retinopathy based on clinical exams in all participants. Adjusted means of outcomes were compared between groups with/without T2D or between participants with/without MVD in both groups using linear regression models adjusting for age, sex, BMI, and T2D as applicable. Results MVD was found in 21 (55 %) participants with T2D and in 9 (24 %) participants without T2D. In T2D, cortical pore diameter (Ct.Po.Dm) and diameter distribution (Ct.Po.Dm.SD) were significantly higher by 14.6 μm (3.6 %, 95 % confidence interval [CI]: 2.70, 26.5 μm, p = 0.017) and by 8.73 μm (4.8 %, CI: 0.79, 16.7 μm, p = 0.032), respectively. In MVD, but not in T2D, cortical porosity was significantly higher by 2.25 % (relative increase = 12.9 %, CI: 0.53, 3.97 %, p = 0.011) and cortical BMD (Ct.BMD) was significantly lower by -43.6 mg/cm3 (2.6 %, CI: -77.4, -9.81 mg/cm3, p = 0.012). In T2D, vessel volume and vessel diameter were significantly higher by 0.02 mm3 (13.3 %, CI: 0.004, 0.04 mm3, p = 0.017) and 15.4 μm (2.9 %, CI: 0.42, 30.4 μm, p = 0.044), respectively. In MVD, vessel density was significantly higher by 0.11 mm-3 (17.8 %, CI: 0.01, 0.21 mm-3, p = 0.033) and vessel volume and diameter were significantly lower by -0.02 mm3 (13.7 %, CI: -0.04, -0.004 mm3, p = 0.015) and - 14.6 μm (2.8 %, CI: -29.1, -0.11 μm, p = 0.048), respectively. Conclusions The presence of MVD, rather than T2D, was associated with increased cortical porosity. Increased porosity in MVD was coupled with a larger number of smaller vessels, which could indicate upregulation of neovascularization triggered by ischemia. It is unclear why higher variability and average diameters of pores in T2D were accompanied by larger vessels.
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Affiliation(s)
- Maximilian T. Löffler
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg im Breisgau, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Po-hung Wu
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Amir M. Pirmoazen
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Gabby B. Joseph
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Jay M. Stewart
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Isra Saeed
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Jing Liu
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Anne L. Schafer
- Department of Medicine, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Ann V. Schwartz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Galateia J. Kazakia
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
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Rubitschung K, Sherwood A, Kapadia R, Xi Y, Hajibeigi A, Rubinow KB, Zerwekh JE, Öz OK. Aromatase deficiency in transplanted bone marrow cells improves vertebral trabecular bone quantity, connectivity, and mineralization and decreases cortical porosity in murine bone marrow transplant recipients. PLoS One 2024; 19:e0296390. [PMID: 38315701 PMCID: PMC10843046 DOI: 10.1371/journal.pone.0296390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024] Open
Abstract
Estradiol is an important regulator of bone accumulation and maintenance. Circulating estrogens are primarily produced by the gonads. Aromatase, the enzyme responsible for the conversion of androgens to estrogen, is expressed by bone marrow cells (BMCs) of both hematopoietic and nonhematopoietic origin. While the significance of gonad-derived estradiol to bone health has been investigated, there is limited understanding regarding the relative contribution of BMC derived estrogens to bone metabolism. To elucidate the role of BMC derived estrogens in male bone, irradiated wild-type C57BL/6J mice received bone marrow cells transplanted from either WT (WT(WT)) or aromatase-deficient (WT(ArKO)) mice. MicroCT was acquired on lumbar vertebra to assess bone quantity and quality. WT(ArKO) animals had greater trabecular bone volume (BV/TV p = 0.002), with a higher trabecular number (p = 0.008), connectivity density (p = 0.017), and bone mineral content (p = 0.004). In cortical bone, WT(ArKO) animals exhibited smaller cortical pores and lower cortical porosity (p = 0.02). Static histomorphometry revealed fewer osteoclasts per bone surface (Oc.S/BS%), osteoclasts on the erosion surface (ES(Oc+)/BS, p = 0.04) and low number of osteoclasts per bone perimeter (N.Oc/B.Pm, p = 0.01) in WT(ArKO). Osteoblast-associated parameters in WT(ArKO) were lower but not statistically different from WT(WT). Dynamic histomorphometry suggested similar bone formation indices' patterns with lower mean values in mineral apposition rate, label separation, and BFR/BS in WT(ArKO) animals. Ex vivo bone cell differentiation assays demonstrated relative decreased osteoblast differentiation and ability to form mineralized nodules. This study demonstrates a role of local 17β-estradiol production by BMCs for regulating the quantity and quality of bone in male mice. Underlying in vivo cellular and molecular mechanisms require further study.
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Affiliation(s)
- Katie Rubitschung
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Amber Sherwood
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Rasesh Kapadia
- Scanco USA Incorporated, Wayne, Pennsylvania, United States of America
| | - Yin Xi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Asghar Hajibeigi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Katya B. Rubinow
- Division of Metabolism, Endocrinology, and Nutrition, University of Washington Medicine Diabetes Institute, Seattle, Washington, United States of America
| | - Joseph E. Zerwekh
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Orhan K. Öz
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, Texas, United States of America
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Arun Raj AC, Roy S, Datta S. Informatics guided FE design of bioactive titanium alloy/composite multi-layered dental implants. Comput Methods Biomech Biomed Engin 2024; 27:431-442. [PMID: 37771233 DOI: 10.1080/10255842.2023.2263124] [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: 06/20/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
A dental implant with three distinct layers, of titanium alloy at core, porous titanium alloy at the intermediate layer and titanium alloy hydroxyapatite composite at the outer layer, is designed to achieve low elastic modulus and adequate strength with bioactive surface. Artificial Neural Network (ANN) along with Rule of Mixture (ROM) is used to generate the objective functions for the Genetic Algorithm (GA) based multi-objective optimization for achieving the optimal designs, which are validated using Finite Element Analysis (FEA) simulations. The composition and processing parameters are correlated with the yield strength and elastic modulus of titanium alloy using ANN. The ANN models are generated to express the strength and effective modulus of the implant using ROM. To determine the optimal composition of titanium alloys, porous layers, and composite layers for a three-layer dental implant, multi-objective genetic algorithm is employed. The Pareto optimal solutions provide the guidelines for designing the implant. A few selected non-dominated solutions are used for studying the actual stress distribution at the bone-implant interface using FEA, and showed significant improvements compared to conventional implants.
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Affiliation(s)
- A C Arun Raj
- Department of Mechanical Engineering, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Sandipan Roy
- Department of Mechanical Engineering, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Shubhabrata Datta
- Department of Mechanical Engineering, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
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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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Galefi A, Nourany M, Hosseini S, Alipour A, Azari S, Jahanfar M, Farrokhi N, Homaeigohar S, Shahsavarani H. Enhanced osteogenesis on proantocyanidin-loaded date palm endocarp cellulosic matrices: A novel sustainable approach for guided bone regeneration. Int J Biol Macromol 2023; 242:124857. [PMID: 37187421 DOI: 10.1016/j.ijbiomac.2023.124857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023]
Abstract
Developing inexpensive, biocompatible natural scaffolds that can support the differentiation and proliferation of stem cells has been recently emphasized by the research community to faster obtain the FDA approvals for regenerative medicine. In this regard, plant-derived cellulose materials are a novel class of sustainable scaffolding materials with high potentials for bone tissue engineering (BTE). However, low bioactivity of the plant-derived cellulose scaffolds restricts cell proliferation and cell differentiation. This limitation can be addressed though surface-functionalization of cellulose scaffolds with natural antioxidant polyphenols, e.g., grape seed proanthocyanidin (PCA)-rich extract (GSPE). Despite the various merits of GSPE as a natural antioxidant, its impact on the proliferation and adhesion of osteoblast precursor cells, and on their osteogenic differentiation is an as-yet unknown issue. Here, we investigated the effects of GSPE surface functionalization on the physicochemical properties of decellularized date (Phoenix dactyliferous) fruit inner layer (endocarp) (DE) scaffold. In this regard, various physiochemical characteristics of the DE-GSPE scaffold such as hydrophilicity, surface roughness, mechanical stiffness, porosity, and swelling, and biodegradation behavior were compared with those of the DE scaffold. Additionally, the impact of the GSPE treatment of the DE scaffold on the osteogenic response of human mesenchymal stem cells (hMSCs) was thoroughly studied. For this purpose, cellular activities including cell adhesion, calcium deposition and mineralization, alkaline phosphatase (ALP) activity, and expression levels of bone-related genes were monitored. Taken together, the GSPE treatment enhanced the physicochemical and biological properties of the DE-GSPE scaffold, thereby raising its potentials as a promising candidate for guided bone regeneration.
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Affiliation(s)
- Atena Galefi
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran 19839-69411, Iran; Laboratory of Regenerative Medicine and Biomedical Innovations, Pasteur Institute of Iran, National Cell Bank, Tehran 13169-43551, Iran
| | - Mohammad Nourany
- Amirkabir University of Technology, Polymer Engineering and Color Technology, Tehran, Iran; Laboratory of Regenerative Medicine and Biomedical Innovations, Pasteur Institute of Iran, National Cell Bank, Tehran 13169-43551, Iran
| | - Saadi Hosseini
- Laboratory of Regenerative Medicine and Biomedical Innovations, Pasteur Institute of Iran, National Cell Bank, Tehran 13169-43551, Iran
| | - Atefeh Alipour
- Department of Nanobiotechnology, Pasteur Institute of Iran, Tehran 13169-43551, Iran.
| | - Shahram Azari
- Laboratory of Regenerative Medicine and Biomedical Innovations, Pasteur Institute of Iran, National Cell Bank, Tehran 13169-43551, Iran
| | - Mehdi Jahanfar
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran 19839-69411, Iran
| | - Naser Farrokhi
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran 19839-69411, Iran
| | - Shahin Homaeigohar
- School of Science & Engineering, University of Dundee, Dundee DD1 4HN, UK
| | - Hosein Shahsavarani
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran 19839-69411, Iran; Laboratory of Regenerative Medicine and Biomedical Innovations, Pasteur Institute of Iran, National Cell Bank, Tehran 13169-43551, Iran.
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9
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Hamamoto A, Ogami-Takamura K, Saiki K, Endo D, Murai K, Tsurumoto T. Evaluation of cortical bone density using clinical computed tomography images: Detection of cortical porosity areas or transitional zones in human femoral diaphyses. Clin Anat 2023. [PMID: 36883194 DOI: 10.1002/ca.24038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023]
Abstract
Age-related changes in human trabecular bone and cortical bone are known to vary. Although the porosity of cortical bone has been suggested to increase the risk of bone fracture, most of the currently available instruments for osteoporosis testing target trabecular bone. In this study, we evaluated cortical bone density using clinical computed tomography (CT) and compared the reliability of the cortical bone density index (CDI) with that of a polished male femoral bone from the same region. CDI images revealed that the porous area of cortical bone was extended in low CDI values. Moreover, this method was used to semi-quantitatively evaluate the cortical bones of the diaphysis of male femur specimens (n = 46). We found that there was a significant relationship (r = 0.70, p < 0.01) between the value of the cortical index (the ratio of cortical bone area to the cross-sectional area of the femoral diaphysis) and the average of CDI in the low signal area. Our findings suggest that the smaller the cortical bone occupancy, the more areas of consequential bone density loss were present. This may be the first step toward using clinical CT to assess cortical bone density.
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Affiliation(s)
- Ayami Hamamoto
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keiko Ogami-Takamura
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,Center of Cadaver Surgical Training, School of Medicine, Nagasaki University, Nagasaki, Japan
| | - Kazunobu Saiki
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Daisuke Endo
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,Center of Cadaver Surgical Training, School of Medicine, Nagasaki University, Nagasaki, Japan
| | - Kiyohito Murai
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Toshiyuki Tsurumoto
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,Center of Cadaver Surgical Training, School of Medicine, Nagasaki University, Nagasaki, Japan
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10
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Tsurumoto T, Endo D, Saiki K, Imamura T, Murai K, Nishi K, Manabe Y, Oyamada J, Sakamoto J, Ogami-Takamura K. Cross-sectional geometry of the femoral diaphyseal cortical bones: analysis of central mass distribution. Anat Sci Int 2023; 98:77-88. [PMID: 35718803 DOI: 10.1007/s12565-022-00676-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 05/25/2022] [Indexed: 01/20/2023]
Abstract
A detailed analysis of differences in skeletal shape among many individuals is expected to reveal the mechanical significance behind various morphological features. To confirm the distribution of the cortical bone region in cross sections, the relative position of the central mass distribution (CMD) of the cortical bone region to the CMD of the entire cross section was examined. A total of 90 right human femoral skeletons were examined using clinical multi-slice computed tomography. For nine cross sections of each femur, we determined the CMD of the whole area, including both cortical bone and medullary areas, as CMD-W, and that of the cortical bone region in the same cross section as CMD-C, and they were compared. The medial and anterior portion of the cortex was relatively thick just below the lesser trochanter. The posterior cortical bone tended to be relatively thick in the region from the center to the distal part of the diaphysis. Females had a significantly more medially deviated CMD than males throughout the entire diaphysis. These results suggest that femurs with advanced cortical bone thinning tend to have a concentration of cortical bone in their medial portion. CMD-C was located farther from the diaphysis axis as the degree of medial bending increased. Conversely, the greater the lateral bending of the diaphysis, the closer CMD-C was to the diaphysis axis. As the amount of bone decreases with age, self-adjustment could occur so that the cortical bone's critical area remains to prevent a decrease in mechanical strength.
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Affiliation(s)
- Toshiyuki Tsurumoto
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan. .,Center of Cadaver Surgical Training, School of Medicine, Nagasaki University, Nagasaki, 852-8523, Japan.
| | - Daisuke Endo
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan.,Center of Cadaver Surgical Training, School of Medicine, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Kazunobu Saiki
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Takeshi Imamura
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Kiyohito Murai
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Keita Nishi
- Department of Oral Anatomy and Dental Anthropology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Yoshitaka Manabe
- Department of Oral Anatomy and Dental Anthropology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Joichi Oyamada
- Department of Oral Anatomy and Dental Anthropology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Junya Sakamoto
- Department of Physical Therapy Science, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8520, Japan
| | - Keiko Ogami-Takamura
- Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan.,Center of Cadaver Surgical Training, School of Medicine, Nagasaki University, Nagasaki, 852-8523, Japan
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11
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Koushik TM, Miller CM, Antunes E. Bone Tissue Engineering Scaffolds: Function of Multi-Material Hierarchically Structured Scaffolds. Adv Healthc Mater 2022; 12:e2202766. [PMID: 36512599 DOI: 10.1002/adhm.202202766] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/29/2022] [Indexed: 12/15/2022]
Abstract
Bone tissue engineering (BTE) is a topic of interest for the last decade, and advances in materials, processing techniques, and the understanding of bone healing pathways have opened new avenues of research. The dual responsibility of BTE scaffolds in providing load-bearing capability and interaction with the local extracellular matrix to promote bone healing is a challenge in synthetic scaffolds. This article describes the usage and processing of multi-materials and hierarchical structures to mimic the structure of natural bone tissues to function as bioactive and load-bearing synthetic scaffolds. The first part of this literature review describes the physiology of bone healing responses and the interactions at different stages of bone repair. The following section reviews the available literature on biomaterials used for BTE scaffolds followed by some multi-material approaches. The next section discusses the impact of the scaffold's structural features on bone healing and the necessity of a hierarchical distribution in the scaffold structure. Finally, the last section of this review highlights the emerging trends in BTE scaffold developments that can inspire new tissue engineering strategies and truly develop the next generation of synthetic scaffolds.
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Affiliation(s)
- Tejas M Koushik
- College of Science and Engineering, James Cook University, Townsville, Queensland, 4811, Australia
| | - Catherine M Miller
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, 4878, Australia
| | - Elsa Antunes
- College of Science and Engineering, James Cook University, Townsville, Queensland, 4811, Australia
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12
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Daphnetin Alleviates Senile and Disuse Osteoporosis by Distinct Modulations of Bone Formation and Resorption. Antioxidants (Basel) 2022; 11:antiox11122365. [PMID: 36552574 PMCID: PMC9774389 DOI: 10.3390/antiox11122365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Senile and disuse osteoporosis have distinct bone turnover status and lack effective treatments. In this study, senescence-accelerated mouse prone 8 (SAMP8) and hindlimb unloading mouse models were used to explore the protective effects of daphnetin on these two types of osteoporosis, and primary osteoblasts and bone marrow monocyte-derived osteoclasts, as well as pre-osteoblast MC3T3-E1, and osteoclast precursor RAW264.7 cells were used to investigate the underlying mechanisms. The results showed that daphnetin administration effectively improved bone remodeling in both senile and disuse osteoporosis, but with different mechanisms. In senile osteoporosis with low bone turnover, daphnetin inhibited NOX2-mediated ROS production in osteoblasts, resulting in accelerated osteogenic differentiation and bone formation, while in disuse osteoporosis with high bone turnover, daphnetin restored SIRT3 expression, maintained mitochondrial homeostasis, and additionally upregulated SOD2 to eliminate ROS in osteoclasts, resulting in attenuation of osteoclast differentiation and bone resorption. These findings illuminated that daphnetin has promising potential for the prevention and treatment of senile and disuse osteoporosis. The different mechanisms may provide clues and basis for targeted prevention and treatment of osteoporosis according to distinct bone turnover status.
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13
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Williams KA, Gostling NJ, Oreffo ROC, Schneider P. Ontogenetic changes in cortical bone vascular microstructure in the domestic duck (Anas platyrhynchos) and ring-necked pheasant (Phasianus colchicus). J Anat 2022; 241:1371-1386. [PMID: 36000871 PMCID: PMC9644950 DOI: 10.1111/joa.13741] [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] [Received: 04/04/2022] [Revised: 07/01/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022] Open
Abstract
Age‐related changes in bone microstructure can inform our understanding the biology of both extant and fossil birds, but to date, histological work in birds, and particularly work using high‐resolution 3D imaging, has largely been restricted to limited growth stages. We used minimally destructive synchrotron radiation‐based X‐ray computed tomography to visualise and measure key morphological and histological traits in 3D across development in the domestic duck and ring‐necked pheasant. We use these measurements to build on the database of key reference material for interpreting bone histology. We found that growth patterns differed between the two species, with the ducks showing rapid growth in their lower limbs and early lower limb maturation, while pheasants grew more slowly, reflecting their later age at maturity. In the pheasant, both walking and flight occur early and their upper and lower limbs grew at similar rates. In the duck, flight and wing development are delayed until the bird is almost at full body mass. Through juvenile development, the second moment of area for the duck wing was low but increased rapidly towards the age of flight, at which point it became significantly greater than that of the lower limb, or the pheasant. On a microstructural level, both cortical porosity and canal diameter were related to cortical bone deposition rate. In terms of orientation, vascular canals in the bone cortex were more laminar in the humerus and femur compared with the tibiotarsus, and laminarity increased through juvenile development in the humerus, but not the tibiotarsus, possibly reflecting torsional vs compressive loading. These age‐related changes in cortical bone vascular microstructure of the domestic duck and pheasant will help understanding the biology of both extant and fossil birds, including age estimation, growth rate and growth patterns, and limb function.
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Affiliation(s)
- Katherine A Williams
- School of Biological Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK.,Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Neil J Gostling
- Institute for Life Sciences, University of Southampton, Southampton, UK.,School of Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Richard O C Oreffo
- Institute for Life Sciences, University of Southampton, Southampton, UK.,Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Philipp Schneider
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK.,High-Performance Vision Systems, Center for Vision, Automation & Control, AIT Austrian Institute of Technology, Vienna, Austria
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14
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Biomechanical performance of Ti-PEEK dental implants in bone: An in-silico analysis. J Mech Behav Biomed Mater 2022; 134:105422. [PMID: 36037710 DOI: 10.1016/j.jmbbm.2022.105422] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/20/2022]
Abstract
Stress-shielding is caused by a significant mismatch in stiffness between bone tissue and Ti alloy dental implants. Therefore, in this study, a Ti-PEEK composite implant was examined and compared with conventional titanium, to determine the behavior of the host bone. Twelve 3D finite element models were modeled with two conditions of marginal cortical bone (with and without marginal bone loss). Six implant designs were constructed. Implant (A) was made with a conventional design (dense titanium), implants (B), (C) and (D) are designed with Ti-PEEK composite (outer layer made of PEEK and inner structures made of Ti with hexagonal, cylindrical, and cross shapes for implants (B), (C) and (D), respectively), the implant (E) is designed with Ti at the upper half section and PEEK at the bottom half section, and the implant (F) is designed with PEEK at the upper half section and Ti at the bottom half section. An axial load of 200 N was applied to the buccal cusp and central fossa of the occlusal surface. The displacements, stress, and equivalent strain were analyzed at the level of bone tissue. The mechanostat of Frost was used to determine the behavior of the cancellous bone under these biomechanical conditions. Results showed that strains were greater in cancellous bone with marginal bone loss than in healthy bone (w/o MBL). When compared to implants (B)-(F), conventional implant (A) did not produce as much strain. Thus, results and analyses suggest that the Ti-PEEK implants outperform compared with the implant (A) in the case of no marginal bone loss. However, the implants (A) and (E) perform equally in terms of bone loss.
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15
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Mandair GS, Bigelow EMR, Viswanathan G, Ward FS, Patton DM, Schlecht SH, Jepsen KJ, Kohn DH. Region-specific associations among tissue-level mechanical properties, porosity, and composition in human male femora. J Biomech 2022; 139:111144. [PMID: 35623287 DOI: 10.1016/j.jbiomech.2022.111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022]
Abstract
Region-specific differences in age-related bone remodeling are known to exist. We therefore hypothesized that the decline in tissue-level strength and post-yield strain (PYS) with age is not uniform within the femur, but is driven by region-specific differences in porosity and composition. Four-point bending was conducted on anterior, posterior, medial, and lateral beams from male cadaveric femora (n = 33, 18-89 yrs of age). Mid-cortical porosity, composition, and mineralization were assessed using nano-computed tomography (nanoCT), Raman spectroscopy, and ashing assays. Traits between bones from young and elderly groups were compared, while multivariate analyses were used to identify traits that predicted strength and PYS at the regional level. We show that age-related decline in porosity and mechanical properties varied regionally, with highest positive slope of age vs. Log(porosity) found in posterior and anterior bone, and steepest negative slopes of age vs. strength and age vs. PYS found in anterior bone. Multivariate analyses show that Log(porosity) and/or Raman 1246/1269 ratio explained 46-51% of the variance in strength in anterior and posterior bone. Three out of five traits related to Log(porosity), mineral crystallinity, 1246/1269, mineral/matrix ratio, and/or hydroxyproline/proline (Hyp/Pro) ratio, explained 35-50% of the variance in PYS in anterior, posterior and lateral bones. Log(porosity) and Hyp/Pro ratio alone explained 13% and 19% of the variance in strength and PYS in medial bone, respectively. The predictive performance of multivariate analyses was negatively impacted by pooling data across all bone regions, underscoring the complexity of the femur and that the use of pooled analyses may obscure underlying region-specific differences.
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Affiliation(s)
- Gurjit S Mandair
- Biological and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Erin M R Bigelow
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Gowri Viswanathan
- Biological and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Ferrous S Ward
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA; Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Daniella M Patton
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA; Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Stephen H Schlecht
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA; Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Karl J Jepsen
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA; Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - David H Kohn
- Biological and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
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16
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Sewing L, Potasso L, Baumann S, Schenk D, Gazozcu F, Lippuner K, Kraenzlin M, Zysset P, Meier C. Bone Microarchitecture and Strength in Long-Standing Type 1 Diabetes. J Bone Miner Res 2022; 37:837-847. [PMID: 35094426 PMCID: PMC9313576 DOI: 10.1002/jbmr.4517] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/09/2022] [Accepted: 01/21/2022] [Indexed: 11/22/2022]
Abstract
Type 1 diabetes (T1DM) is associated with an increased fracture risk, specifically at nonvertebral sites. The influence of glycemic control and microvascular disease on skeletal health in long-standing T1DM remains largely unknown. We aimed to assess areal (aBMD) and volumetric bone mineral density (vBMD), bone microarchitecture, bone turnover, and estimated bone strength in patients with long-standing T1DM, defined as disease duration ≥25 years. We recruited 59 patients with T1DM (disease duration 37.7 ± 9.0 years; age 59.9 ± 9.9 years.; body mass index [BMI] 25.5 ± 3.7 kg/m2 ; 5-year median glycated hemoglobin [HbA1c] 7.1% [IQR 6.82-7.40]) and 77 nondiabetic controls. Dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HRpQCT) at the ultradistal radius and tibia, and biochemical markers of bone turnover were assessed. Group comparisons were performed after adjustment for age, gender, and BMI. Patients with T1DM had lower aBMD at the hip (p < 0.001), distal radius (p = 0.01), lumbar spine (p = 0.04), and femoral neck (p = 0.05) as compared to controls. Cross-linked C-telopeptide (CTX), a marker of bone resorption, was significantly lower in T1DM (p = 0.005). At the distal radius there were no significant differences in vBMD and bone microarchitecture between both groups. In contrast, patients with T1DM had lower cortical thickness (estimate [95% confidence interval]: -0.14 [-0.24, -0.05], p < 0.01) and lower cortical vBMD (-28.66 [-54.38, -2.93], p = 0.03) at the ultradistal tibia. Bone strength and bone stiffness at the tibia, determined by homogenized finite element modeling, were significantly reduced in T1DM compared to controls. Both the altered cortical microarchitecture and decreased bone strength and stiffness were dependent on the presence of diabetic peripheral neuropathy. In addition to a reduced aBMD and decreased bone resorption, long-standing, well-controlled T1DM is associated with a cortical bone deficit at the ultradistal tibia with reduced bone strength and stiffness. Diabetic neuropathy was found to be a determinant of cortical bone structure and bone strength at the tibia, potentially contributing to the increased nonvertebral fracture risk. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Lilian Sewing
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland
| | - Laura Potasso
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Sandra Baumann
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland
| | - Denis Schenk
- ARTORG Center, University of Bern, Bern, Switzerland
| | - Furkan Gazozcu
- Department of Osteoporosis, University Hospital Bern, Bern, Switzerland
| | - Kurt Lippuner
- Department of Osteoporosis, University Hospital Bern, Bern, Switzerland
| | | | | | - Christian Meier
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland.,Endocrine Clinic and Laboratory, Basel, Switzerland
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17
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Cui J, Shibata Y, Zhu T, Zhou J, Zhang J. Osteocytes in bone aging: Advances, challenges, and future perspectives. Ageing Res Rev 2022; 77:101608. [PMID: 35283289 DOI: 10.1016/j.arr.2022.101608] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 02/08/2023]
Abstract
Osteocytes play a critical role in maintaining bone homeostasis and in regulating skeletal response to hormones and mechanical loading. Substantial evidence have demonstrated that osteocytes and their lacunae exhibit morphological changes in aged bone, indicating the underlying involvement of osteocytes in bone aging. Notably, recent studies have deciphered aged osteocytes to have characteristics such as impaired mechanosensitivity, accumulated cellular senescence, dysfunctional perilacunar/canalicular remodeling, and degenerated lacuna-canalicular network. However, detailed molecular mechanisms of osteocytes remain unclear. Nonetheless, osteocyte transcriptomes analyzed via advanced RNA sequencing (RNA-seq) techniques have identified several bone aging-related genes and signaling pathways, such as Wnt, Bmp/TGF, and Jak-STAT. Moreover, inflammation, immune dysfunction, energy shortage, and impaired hormone responses possibly affect osteocytes in age-related bone deterioration. In this review, we summarize the hallmarks of aging bone and osteocytes and discuss osteocytic mechanisms in age-related bone loss and impaired bone quality. Furthermore, we provide insights into the challenges faced and their possible solutions when investigating osteocyte transcriptomes. We also highlight that single-cell RNA-seq can decode transcriptomic messages in aged osteocytes; therefore, this technique can promote novel single cell-based investigations in osteocytes once a well-established standardized protocol specific for osteocytes is developed. Interestingly, improved understanding of osteocytic mechanisms have helped identify promising targets and effective therapies for aging-related osteoporosis and fragile fractures.
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18
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Jin X, Li Y, Yang Y, Shen H, Chen J, Xu B, Xu J. Thioacetamide promotes osteoclast transformation of bone marrow macrophages by influencing PI3K/AKT pathways. J Orthop Surg Res 2022; 17:53. [PMID: 35093114 PMCID: PMC8800259 DOI: 10.1186/s13018-022-02938-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Osteoclast cell increase is a major risk factor for osteoporosis and degenerative bone and joint diseases. At present, RANKL and M-CSF are commonly used to induce osteoclastogenesis. Thioacetamide (TAA) can lead to many types of liver and kidney damage, but less attention has been paid to the association of TAA with bone damage. In this work, we investigated the effects of TAA on the osteoclastogenesis and differentiation of bone marrow macrophages (BMMs).
Methods
BMMs of SD rat suckling mice were taken for primary culture. CCK-8 was used to detect the toxic effects of TAA on BMMs, and flow cytometry was used to detect the effects of TAA on the cell cycle, cell viability, apoptosis and intracytoplasmic Ca2+ concentration of BMMs. TRAP staining was used to detect the effect of RANKL and M-CSF and TAA on osteoclast differentiation of BMMs. Western Blot was used to detect the expression level of PI3K/AKT pathway and osteoclast-specific proteins (TRAP and cathepsin K).
Results
The results suggested that TAA inhibited the proliferation of BMMs, while enhancing osteoclastogenesis at 0.5 mg/mL and 1 mg/mL as assayed by TRAP staining. Exposed to TAA, BMMs could differentiate into osteoclast-like cells with overexpression of cathepsin K and TRAP proteins. Western blot results showed that TAA can activate the expression levels of P-PI3K, P-AKT, P-P38, and P-JNK, accompanied by apoptosis of BMMs and increase in intracellular Ca2+.
Conclusion
TAA may induce osteoclast formation in BMMs by activating the expression of PI3K/AKT pathway proteins, which is comparable to the classic osteoclast differentiation inducer RANKL and M-CSF. This suggests that we may find a cheap osteoclast inducer.
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19
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Wang W, Wang Y, Tang Z, Chen Y, Liu Z, Duan H, Zhong Z, He F. Mesenchymal stem cells prevent ovariectomy-induced osteoporosis formation in mice through intraosseous vascular remodeling. Biochem Biophys Res Commun 2021; 582:64-71. [PMID: 34689107 DOI: 10.1016/j.bbrc.2021.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022]
Abstract
Mesenchymal stem cells (MSCs) can promote osteogenesis and are a promising therapy for postmenopausal osteoporosis. However, the relationship between improved intraosseous microcirculation and increased bone mass induced by MSCs in postmenopausal osteoporosis remains unclear. After the primary MSCs were characterized, they were transplanted into ovariectomized mice. MSCs transplantation enhanced the trabecular number, trabecular bone volume/total volume, and trabecular bone mineral density in ovariectomized mice. To determine the role of MSCs in vascular repair, mice were subjected to femoral artery ligation. Through laser speckle flowmetry, vascular perfusion and femoral trabecular bone and cortical bone analyses, we determined the effects of MSCs in promoting intraosseous angiogenesis and preventing osteoporosis in mice. MSCs effectively prevented postmenopausal osteoporosis development, which is associated with the involvement of MSCs in reestablishment of microcirculation within the skeleton.
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Affiliation(s)
- Weizhou Wang
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Yunnan, China; Kunming Medical University, Yunnan, China
| | - Yanghao Wang
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Yunnan, China; Kunming Medical University, Yunnan, China
| | - Zhihong Tang
- Department of orthopaedics, People's Hospital of Guang'an City, Sichuan, China
| | - Yongcheng Chen
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Yunnan, China; Kunming Medical University, Yunnan, China
| | - Zhui Liu
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Yunnan, China; Kunming Medical University, Yunnan, China
| | - Hao Duan
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Zongyu Zhong
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Fei He
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Yunnan, China; Yunnan Province Stem Cell Technology Application Research Center, Yunnan, China; Yunnan Provincial Clinical Medical Center for Bone and Joint Diseases, Yunnan, China.
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20
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McCarthy A, Shah R, John JV, Brown D, Xie J. Understanding and utilizing textile-based electrostatic flocking for biomedical applications. APPLIED PHYSICS REVIEWS 2021; 8:041326. [PMID: 35003482 PMCID: PMC8715800 DOI: 10.1063/5.0070658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/23/2021] [Indexed: 05/10/2023]
Abstract
Electrostatic flocking immobilizes electrical charges to the surface of microfibers from a high voltage-connected electrode and utilizes Coulombic forces to propel microfibers toward an adhesive-coated substrate, leaving a forest of aligned fibers. This traditional textile engineering technique has been used to modify surfaces or to create standalone anisotropic structures. Notably, a small body of evidence validating the use of electrostatic flocking for biomedical applications has emerged over the past several years. Noting the growing interest in utilizing electrostatic flocking in biomedical research, we aim to provide an overview of electrostatic flocking, including the principle, setups, and general and biomedical considerations, and propose a variety of biomedical applications. We begin with an introduction to the development and general applications of electrostatic flocking. Additionally, we introduce and review some of the flocking physics and mathematical considerations. We then discuss how to select, synthesize, and tune the main components (flocking fibers, adhesives, substrates) of electrostatic flocking for biomedical applications. After reviewing the considerations necessary for applying flocking toward biomedical research, we introduce a variety of proposed use cases including bone and skin tissue engineering, wound healing and wound management, and specimen swabbing. Finally, we presented the industrial comments followed by conclusions and future directions. We hope this review article inspires a broad audience of biomedical, material, and physics researchers to apply electrostatic flocking technology to solve a variety of biomedical and materials science problems.
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Affiliation(s)
- Alec McCarthy
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 668198, USA
| | - Rajesh Shah
- Spectro Coating Corporation, Leominster, Massachusetts 01453, USA
| | - Johnson V. John
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 668198, USA
| | - Demi Brown
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 668198, USA
| | - Jingwei Xie
- Author to whom correspondence should be addressed:
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21
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Chen Y, Zhong Z, Chen W, Lv X, Luo SY. Glucocorticoid-induced dose-related and site-specific bone remodelling, microstructure, and mechanical changes in cancellous and cortical bones. Clin Exp Pharmacol Physiol 2021; 48:1421-1429. [PMID: 34214197 DOI: 10.1111/1440-1681.13548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 11/29/2022]
Abstract
The study investigated the effects of long-term glucocorticoid (GC) administration on bone remodelling, microstructure, and biomechanical strength in cortical and cancellous (trabecular) bones. Thirty-one female Sprague-Dawley rats were randomly divided into three dexamethasone (Dex) dosage groups, 1.0, 2.5, and 5.0 mg/kg twice a week for 8 weeks, and one control group treated with saline. At the end of the experiment, the tibia of one side and the fourth lumbar vertebrae were processed into sections for a histomorphometric analysis, while the femur of the same side and the fifth vertebrae were isolated for a biomechanical test. A dose-dependent decline in bone formation was observed in both trabecular and cortical (periosteal and endosteal) bones. In contrast, bone resorption was inhibited only in cancellous bone in the two higher dose groups and not dose-related. The ratio of Node/Termini increased, while marrow star volume (MSV) decreased in all Dex groups in metaphyseal trabecular bones, both of which were dose-dependent. Subendosteal cortex porosity increased in parallel with non-uniform trabecular distribution, but cortical thickness remained unchanged. Interestingly, there were no significant changes in microstructure or mechanical strength in lumbar trabecular bone. The cortical elastic load was dose-independently reduced in all three Dex groups when compared with the control group. In summary, bone remodelling was dose-dependently inhibited in cancellous bones but enhanced in intracortical bones. The non-uniform distribution of trabecular bone and increased porosity in the inner edge of cortical bone were both in parallel with GC dosage, and the porosity increase was more likely to occur, leading to reduced cortical mechanical strength.
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Affiliation(s)
- Yan Chen
- Guangdong Key Laboratory for R&D of Natural Drug, Department of Pharmacology, Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
| | - Zhiguo Zhong
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wenshuang Chen
- Guangdong Key Laboratory for R&D of Natural Drug, Department of Pharmacology, Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
| | - Xiaohua Lv
- Guangdong Key Laboratory for R&D of Natural Drug, Department of Pharmacology, Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
| | - Shi-Ying Luo
- Guangdong Key Laboratory for R&D of Natural Drug, Department of Pharmacology, Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
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22
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van Rietbergen B, Biver E, Chevalley T, Ito K, Chapurlat R, Ferrari S. A Novel HR-pQCT Image Registration Approach Reveals Sex-Specific Changes in Cortical Bone Retraction With Aging. J Bone Miner Res 2021; 36:1351-1363. [PMID: 33724532 PMCID: PMC8360120 DOI: 10.1002/jbmr.4285] [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: 10/08/2020] [Revised: 02/26/2021] [Accepted: 03/07/2021] [Indexed: 11/11/2022]
Abstract
During aging, changes in endosteal and periosteal boundaries of cortical bone occur that differ between men and women. We here develop a new procedure that uses high-resolution peripheral quantitative CT (HR-pQCT) imaging and 3D registration to identify such changes within the timescale of longitudinal studies. A first goal was to test the sensitivity of the approach. A second goal was to assess differences in periosteal/endosteal expansion over time between men and women. Rigid 3D registration was used to transform baseline and all follow-up (FU) images to a common reference configuration for which the region consisting of complete slices (largest common height) was determined. Periosteal and endosteal contours were transformed to the reference position to determine the net periosteal and endosteal expansion distances. To test the sensitivity, images from a short-term reproducibility study were used (15 female, aged 21 to 47 years, scanned three times). To test differences between men and women, images from a subset of the Geneva Retirees Cohort were used (248 female, 61 male, average age 65 years, 3.5 and 7 years FU). The sensitivity study indicated a least significant change for detecting periosteal/endosteal expansion of 41/31 microns for the radius and 17/26 microns for the tibia. Results of the cohort study showed significant net endosteal retraction only in females at the radius and tibia after 3.5 years (38.0 and 38.4 microns, respectively) that further increased at 7 years FU (70.4 and 70.8 microns, respectively). No significant net periosteal changes were found for males or females at 7 years. The results demonstrate that it is possible to measure changes in endosteal contours in longitudinal studies within several years. For the investigated cohort, significant endosteal retraction was found in females but not in males. Whether these changes in cortical geometry are related to fracture risk remains to be investigated in larger cohorts © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Bert van Rietbergen
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Emmanuel Biver
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Thierry Chevalley
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Serge Ferrari
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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23
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Schmidutz F, Milz S, Schiuma D, Richards RG, Windolf M, Sprecher CM. Cortical parameters predict bone strength at the tibial diaphysis, but are underestimated by HR-pQCT and μCT compared to histomorphometry. J Anat 2020; 238:669-678. [PMID: 33084063 PMCID: PMC7855080 DOI: 10.1111/joa.13337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/05/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022] Open
Abstract
Cortical bone and its microstructure are crucial for bone strength, especially at the long bone diaphysis. However, it is still not well‐defined how imaging procedures can be used as predictive tools for mechanical bone properties. This study evaluated the capability of several high‐resolution imaging techniques to capture cortical bone morphology and assessed the correlation with the bone's mechanical properties. The microstructural properties (cortical thickness [Ct.Th], porosity [Ct.Po], area [Ct.Ar]) of 11 female tibial diaphysis (40–90 years) were evaluated by dual‐energy X‐ray absorptiometry (DXA), high‐resolution peripheral‐quantitative‐computed‐tomography (HR‐pQCT), micro‐CT (μCT) and histomorphometry. Stiffness and maximal torque to failure were determined by mechanical testing. T‐Scores determined by DXA ranged from 0.6 to −5.6 and a lower T‐Score was associated with a decrease in Ct.Th (p ≤ 0.001) while the Ct.Po (p ≤ 0.007) increased, and this relationship was independent of the imaging method. With decreasing T‐Score, histology showed an increase in Ct.Po from the endosteal to the periosteal side (p = 0.001) and an exponential increase in the ratio of osteons at rest to those after remodelling. However, compared to histomorphometry, HR‐pQCT and μCT underestimated Ct.Po and Ct.Th. A lower T‐Score was also associated with significantly reduced stiffness (p = 0.031) and maximal torque (p = 0.006). Improving the accuracy of Ct.Po and Ct.Th did not improve prediction of the mechanical properties, which was most closely related to geometry (Ct.Ar). The ex‐vivo evaluation of mechanical properties correlated with all imaging modalities, with Ct.Th and Ct.Po highly correlated with the T‐Score of the tibial diaphysis. Cortical microstructural changes were underestimated with the lower resolution of HR‐pQCT and μCT compared to the histological ‘gold standard’. The increased accuracy did not result in an improved prediction for local bone strength in this study, which however might be related to the limited number of specimens and thus needs to be evaluated in a larger collective.
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Affiliation(s)
- Florian Schmidutz
- AO Research Institute Davos, Davos, Switzerland.,Department of Orthopaedic Surgery, University of Munich (LMU), Munich, Germany.,University of Tübingen, BG Trauma Center, Tübingen, Germany
| | - Stefan Milz
- Department of Anatomy II, University of Munich (LMU), Munich, Germany
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24
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Rampersad C, Whitlock RH, Leslie WD, Rigatto C, Komenda P, Bohm C, Hans D, Tangri N. Trabecular bone score in patients with chronic kidney disease. Osteoporos Int 2020; 31:1905-1912. [PMID: 32440892 DOI: 10.1007/s00198-020-05458-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/07/2020] [Indexed: 01/09/2023]
Abstract
UNLABELLED Patients with chronic kidney disease have high risk of osteoporotic fractures. Lower trabecular bone score (TBS) was associated with poorer kidney function and higher fracture risk when kidney function was normal. Addition of TBS to The Fracture Risk Assessment Tool with bone mineral density did not improve fracture risk prediction. INTRODUCTION We sought to determine whether trabecular bone score (TBS) either independently or adjusted for The Fracture Risk Assessment Tool (FRAX) could predict risk of major osteoporotic fractures (MOFs) in a large population-based sample of patients with all stages of chronic kidney disease (CKD). METHODS We used population-based administrative databases to identify patients above age 20 years who had dual-energy X-ray absorptiometry (DXA) scan and serum creatinine measured within 1 year, during the years 2005 to 2010. Patients were excluded if they were on dialysis or had a functioning renal transplant. We stratified patients by estimated glomerular filtration rate (eGFR). We collected femoral neck bone mineral density (BMD), lumbar spine TBS, incident major osteoporotic fractures (MOF) and hip fractures, and other clinical characteristics. RESULTS Among 8289 patients, there were 6224 (75.1%) with eGFR ≥ 60 mL/min/1.73 m2, 1624 (19.6%) with eGFR 30-60 mL/min/1.73 m2, and 441 (5.3%) with eGFR < 30 mL/min/1.73 m2. There were 593 patients (7.2%) with MOFs and 163 (2.0%) with hip fractures. Lower TBS score was associated with increased risk of MOF and hip fractures across all eGFR strata in unadjusted Cox proportional hazards models but after adjusting for FRAX with BMD, lower TBS was only statistically significant for MOF prediction for eGFR ≥ 60 mL/min/1.73 m2. CONCLUSION Lower TBS scores were associated with lower eGFR and increased fracture risk in patients with eGFR ≥ 60 mL/min/1.73 m2. However, the addition of TBS to the FRAX score with BMD did not significantly improve fracture risk prediction in patients with CKD.
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Affiliation(s)
- C Rampersad
- Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
| | - R H Whitlock
- Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada
- Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - W D Leslie
- Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada
| | - C Rigatto
- Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada
- Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - P Komenda
- Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada
- Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - C Bohm
- Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada
- Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - D Hans
- Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - N Tangri
- Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada
- Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
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25
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Mitchell DM, Caksa S, Joseph T, Bouxsein ML, Misra M. Elevated HbA1c Is Associated with Altered Cortical and Trabecular Microarchitecture in Girls with Type 1 Diabetes. J Clin Endocrinol Metab 2020; 105:5639696. [PMID: 31761940 PMCID: PMC7064304 DOI: 10.1210/clinem/dgz221] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/22/2019] [Indexed: 12/27/2022]
Abstract
CONTEXT Skeletal fragility is a significant complication of type 1 diabetes (T1D), with an increased risk of fracture observed starting in childhood. Altered bone accrual and microarchitectural development during the critical peripubertal years may contribute to this fragility. OBJECTIVE To evaluate differences in skeletal microarchitecture between girls with T1D and controls and to assess factors associated with these differences. DESIGN Cross-sectional comparison. PARTICIPANTS Girls ages 10-16 years, 62 with T1D and 61 controls. RESULTS Areal bone mineral density (BMD) measured by dual-energy x-ray absorptiometry did not differ between girls with and without T1D. At the distal tibia, trabecular BMD was 7.3 ± 2.9% lower in T1D (P = 0.013), with fewer plate-like and axially-aligned trabeculae. Cortical porosity was 21.5 ± 10.5% higher, while the estimated failure load was 4.7 ± 2.2% lower in T1D (P = 0.043 and P = 0.037, respectively). At the distal radius, BMD and microarchitecture showed similar differences between the groups but did not reach statistical significance. After stratifying by HbA1c, only those girls with T1D and HbA1c > 8.5% differed significantly from controls. P1NP, a marker of bone formation, was lower in T1D while CTX and TRAcP5b, markers of bone resorption and osteoclast number, respectively, did not differ. The insulin-like growth factor 1 (IGF-1) Z-score was lower in T1D, and after adjustment for the IGF-1 Z-score, associations between T1D status and trabecular microarchitecture were largely attenuated. CONCLUSIONS Skeletal microarchitecture is altered in T1D early in the course of disease and among those with higher average glycemia. Suppressed bone formation and lower circulating IGF-1 likely contribute to this phenotype.
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Affiliation(s)
- Deborah M Mitchell
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Correspondence and Reprint Requests: Deborah Mitchell, MD, Endocrine Unit, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114. Phone: 617-724-2034; Fax: 617-726-1703. E-mail:
| | - Signe Caksa
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Taïsha Joseph
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconness Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Madhusmita Misra
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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26
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Abstract
PURPOSE OF REVIEW This review updates readers on recent developments in the assessment of cortical bone fragility in vivo. The review explains the clinical need that motivated the development of Cortical Bone Mechanics Technology™ (CBMT) as a scientific instrument, its unique capabilities, and its necessary further development as a medical device. RECENT FINDINGS Clinical experience with dual-energy X-ray absorptiometry has led to calls for new clinical methods for assessing bone health. CBMT is a noninvasive, dynamic 3-point bending test that makes direct, functional measurements of the mechanical properties of cortical bone in ulnas of living people. Its technical validity in accurate measurements of ulna flexural rigidity and its clinical validity in accurate estimations of quasistatic ulna bending strength have been demonstrated. Because CBMT is a whole bone test, its measurements reflect the influences of bone quantity and bone quality at all hierarchical levels.
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Affiliation(s)
- Lyn Bowman
- Department of Biological Sciences and the Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, 45701, USA
- AEIOU Scientific, LLC, Ohio University, Athens, OH, 45701, USA
| | - Anne B Loucks
- Department of Biological Sciences and the Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, 45701, USA.
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27
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Cesar R, Bravo-Castillero J, Ramos RR, Pereira CAM, Zanin H, Rollo JMDA. Relating mechanical properties of vertebral trabecular bones to osteoporosis. Comput Methods Biomech Biomed Engin 2019; 23:54-68. [DOI: 10.1080/10255842.2019.1699542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- R. Cesar
- Department of Mechanical Engineering, São Carlos School of Engineering, University of São Paulo, São Carlos, Brazil
| | - J. Bravo-Castillero
- Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas (IIMAS), Universidad Nacional Autónoma de México (UNAM), Mexico City, México
- IIMAS UNAM Mérida, Unidad Académica de Yucatán, Parque Científico Tecnológico de Yucatán, Mérida, México
| | - R. R. Ramos
- Facultad de Matemática y Computación, Universidad de La Habana, Havana, Cuba
| | - C. A. M. Pereira
- Orthopedics and Traumatology Institute at the Clinical Hospital, University of São Paulo (USP), São Paulo, Brazil
| | - H. Zanin
- Carbon Sci-Tech labs, School of Electrical and Computer Engineering, University of Campinas, Campinas, Brazil
| | - J. M. D. A. Rollo
- Department of Materials Engineering, São Carlos School of Engineering, University of São Paulo, São Carlos, Brazil
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28
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Youlten SE, Baldock PA. Using mouse genetics to understand human skeletal disease. Bone 2019; 126:27-36. [PMID: 30776501 DOI: 10.1016/j.bone.2019.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/25/2019] [Accepted: 02/13/2019] [Indexed: 02/06/2023]
Abstract
Technological advances have enabled the study of the human genome in incredible detail with relative ease. However, our ability to interpret the functional significance of the millions of genetic variants present within each individual is limited. As a result, the confident assignment of disease-causing variant calls remains a significant challenge. Here we explore how mouse genetics can help address this deficit in functional genomic understanding. Underpinned by marked genetic correspondence, skeletal biology shows inter-species similarities which provide important opportunities to use data from mouse models to direct research into the genetic basis of skeletal pathophysiology. In this article we outline critical resources that may be used to establish genotype/phenotype relationships in skeletal tissue, identify genes with established skeletal effects and define the transcriptome of critical skeletal cell types. Finally, we outline how these mouse resources might be utilized to progress from a list of human sequence variants toward plausible gene candidates that contribute to skeletal disease.
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Affiliation(s)
- Scott E Youlten
- Division of Bone Biology, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia; St Vincent's Clinical School, Faculty of Medicine, UNSW Australia, Sydney, NSW, 2010, Australia.
| | - Paul A Baldock
- Division of Bone Biology, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia; St Vincent's Clinical School, Faculty of Medicine, UNSW Australia, Sydney, NSW, 2010, Australia; University of Notre Dame Australia, Sydney, NSW, 2010, Australia
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29
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Liu G, Xie Y, Su J, Qin H, Wu H, Li K, Yu B, Zhang X. The role of EGFR signaling in age-related osteoporosis in mouse cortical bone. FASEB J 2019; 33:11137-11147. [PMID: 31298955 DOI: 10.1096/fj.201900436rr] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
So far, there has been no effective cure for osteoporotic cortical bone, the most significant change in long bone structure during aging and the main cause of bone fragility fractures, because its underlying molecular and cellular mechanisms remain largely unknown. We used 3- and 15-mo-old mice as well as 15-mo-old mice treated with vehicle and gefitinib to evaluate structural, cellular, and molecular changes in cortical bone. We found that the senescence of osteoprogenitors was increased, whereas the expression of phosphorylated epidermal growth factor receptor (EGFR) on the endosteal surface of cortical bone down-regulated in middle-aged 15-mo-old mice compared with young 3-mo-old mice. Further decreasing EGFR signaling by gefitinib treatment in middle-aged mice resulted in promoted senescence of osteoprogenitors and accelerated cortical bone degeneration. Moreover, inhibiting EGFR signaling suppressed the expression of enhancer of zeste homolog 2 (Ezh2), the repressor of cell senescence-inducer genes, through ERK1/2 pathway, thereby promoting senescence in osteoprogenitors. Down-regulated EGFR signaling plays a physiologically significant role during aging by reducing Ezh2 expression, leading to the senescence of osteoprogenitors and the decline in bone formation on the endosteal surface of cortical bone.-Liu, G., Xie, Y., Su, J., Qin, H., Wu, H., Li, K., Yu, B., Zhang, X. The role of EGFR signaling in age-related osteoporosis in mouse cortical bone.
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Affiliation(s)
- Guanqiao Liu
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yongheng Xie
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianwen Su
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hanjun Qin
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hangtian Wu
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Kaiqun Li
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bin Yu
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xianrong Zhang
- Department of Orthopaedics and Traumatology Nanfang Hospital, Southern Medical University, Guangzhou, China.,Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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