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Meyer C, Brockmueller A, Ruiz de Porras V, Shakibaei M. Microbiota and Resveratrol: How Are They Linked to Osteoporosis? Cells 2024; 13:1145. [PMID: 38994996 PMCID: PMC11240679 DOI: 10.3390/cells13131145] [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: 05/28/2024] [Revised: 06/18/2024] [Accepted: 06/30/2024] [Indexed: 07/13/2024] Open
Abstract
Osteoporosis (OP), which is characterized by a decrease in bone density and increased susceptibility to fractures, is closely linked to the gut microbiota (GM). It is increasingly realized that the GM plays a key role in the maintenance of the functioning of multiple organs, including bone, by producing bioactive metabolites such as short-chain fatty acids (SCFA). Consequently, imbalances in the GM, referred to as dysbiosis, have been identified with a significant reduction in beneficial metabolites, such as decreased SCFA associated with increased chronic inflammatory processes, including the activation of NF-κB at the epigenetic level, which is recognized as the main cause of many chronic diseases, including OP. Furthermore, regular or long-term medications such as antibiotics and many non-antibiotics such as proton pump inhibitors, chemotherapy, and NSAIDs, have been found to contribute to the development of dysbiosis, highlighting an urgent need for new treatment approaches. A promising preventive and adjuvant approach is to combat dysbiosis with natural polyphenols such as resveratrol, which have prebiotic functions and ensure an optimal microenvironment for beneficial GM. Resveratrol offers a range of benefits, including anti-inflammatory, anti-oxidant, analgesic, and prebiotic effects. In particular, the GM has been shown to convert resveratrol, into highly metabolically active molecules with even more potent beneficial properties, supporting a synergistic polyphenol-GM axis. This review addresses the question of how the GM can enhance the effects of resveratrol and how resveratrol, as an epigenetic modulator, can promote the growth and diversity of beneficial GM, thus providing important insights for the prevention and co-treatment of OP.
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Affiliation(s)
- Christine Meyer
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, Ludwig-Maximilians-University Munich, Pettenkoferstr. 11, D-80336 Munich, Germany
| | - Aranka Brockmueller
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, Ludwig-Maximilians-University Munich, Pettenkoferstr. 11, D-80336 Munich, Germany
| | - Vicenç Ruiz de Porras
- CARE Program, Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, Badalona, 08916 Barcelona, Spain
- Badalona Applied Research Group in Oncology (B⋅ARGO), Catalan Institute of Oncology, Camí de les Escoles, s/n, Badalona, 08916 Barcelona, Spain
- GRET and Toxicology Unit, Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Mehdi Shakibaei
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, Ludwig-Maximilians-University Munich, Pettenkoferstr. 11, D-80336 Munich, Germany
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Ding W, Huang Y, Li G, Dong Y, Li X, Wu M, Song K, Li F. Higher risk of osteoporosis in adult-onset asthma than childhood-onset asthma: from genetic and prospective evidence. Osteoporos Int 2024; 35:659-668. [PMID: 38141141 DOI: 10.1007/s00198-023-07004-1] [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: 02/06/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Both COA and AOA have a genetically causal effect on osteoporosis. COA and AOA were independently associated with incident osteoporosis, and the risk was greatly higher in AOA. Besides corticosteroids, the increased risk of osteoporosis among asthma patients should be attributed to genetic susceptibility and other asthma medications. PURPOSE/INTRODUCTION Childhood-onset asthma (COA) differs with adult-onset asthma (AOA) on genetic susceptibility, severity, and co-morbidities. Whether COA or AOA is independently associated with osteoporosis is unexplored. We aimed to determine the effects of COA and AOA on osteoporosis at genetic and individual level. METHODS We used two-sample Mendelian randomization analysis to explore the causal effects of COA and AOA on osteoporosis. In the UK Biobank cohort, we included 478,289 osteoporosis-free participants at baseline (2006-2010). Participants were classified as non-asthma, COA, and AOA at recruitment. Multivariate Cox regression analysis was used to evaluate the effects of COA, AOA, and multiple asthma medications on incident osteoporosis risk. RESULTS COA and AOA were causally related to osteoporosis, with odds ratio of 1.007 (95% confidence interval (CI), 1.0003-1.0132) and 1.012 (95% CI, 1.002-1.023), respectively. Multivariate Cox regression analysis suggested that COA (hazard ratio (HR), 1.46; 95% CI, 1.32-1.61) and AOA (HR, 1.70; 95% CI, 1.61-1.80) were independently associated with incident osteoporosis, and the risk was greatly higher in AOA (HR, 1.51; 95% CI, 1.34-1.70). In addition to corticosteroids, monotherapy with leukotriene modifiers (HR, 1.70; 95% CI, 1.20-2.42), long-acting beta agonists (HR, 1.49; 95% CI, 1.18-1.87), and short-acting beta agonists (HR, 1.72; 95% CI1.01-2.93) were independently associated with a higher risk of osteoporosis. CONCLUSIONS Both COA and AOA have a genetically causal effect on osteoporosis, and the risk of osteoporosis is greatly higher in AOA. Besides corticosteroids, the increased risk of osteoporosis among asthma patients should be attributed to genetic susceptibility and other asthma medications.
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Affiliation(s)
- Weizhong Ding
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yong Huang
- Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Guanghui Li
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yimin Dong
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiaochen Li
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minglong Wu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Kehan Song
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
| | - Feng Li
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
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Fleishman NR, Richardson T, Attard TM. A multicenter cohort analysis of fractures in histamine-2-receptor antagonist treated pediatric patients. Curr Med Res Opin 2022; 38:565-570. [PMID: 35112645 DOI: 10.1080/03007995.2022.2037847] [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] [Indexed: 11/03/2022]
Abstract
BACKGROUND Histamine 2 receptor antagonists (H2RA) are amongst the most entrenched antacid therapies available including over-the-counter. They have an excellent safety profile including no known teratogenic risk. Fracture risk is generally recognized with chronic proton pump inhibitor (PPI) therapy in adults and children although the related mechanism is poorly understood. The analogous risk in H2RAs, including in children, is unclear. We studied the fracture risk and characteristics among hospitalized pediatric patients exposed to H2RA compared to an untreated cohort. METHODS The Pediatric Health Information System (PHIS) multicenter database was queried for hospital encounters of children aged 6 months - 15.5 years and between 7/2016 and 8/2017. Patients with comorbidities and medications including PPI that predispose for fractures were excluded from the cohort and a propensity-matched control was identified. The subjects and controls were followed for 2 years for hospitalization with fracture diagnoses. RESULTS Our cohort included 3526 patients with exposure to H2RA and matched controls. Fractures were reported in 1% of patients (67) with no statistical difference between the groups. Upper, then lower extremity fractures were the most common in both groups. Axial skeleton fractures were the least frequently encountered fractures among both groups. CONCLUSION H2RA exposure is not associated with an increased risk of fracture in hospitalized children exposed to H2RA when compared with a matched untreated cohort, further studies are needed to determine if long-term exposure to H2RA may be associated with fracture risk in both those with and without comorbidities or on fracture predisposing medication.
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Affiliation(s)
- Nathan R Fleishman
- Department of Gastroenterology, Levine Children's Hospital, Charlotte, North Carolina, USA
| | | | - Thomas M Attard
- Department of Gastroenterology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
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Antihistamines Potentiate Dexamethasone Anti-Inflammatory Effects. Impact on Glucocorticoid Receptor-Mediated Expression of Inflammation-Related Genes. Cells 2021; 10:cells10113026. [PMID: 34831249 PMCID: PMC8617649 DOI: 10.3390/cells10113026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 12/20/2022] Open
Abstract
Antihistamines and glucocorticoids (GCs) are often used together in the clinic to treat several inflammation-related situations. Although there is no rationale for this association, clinical practice has assumed that, due to their concomitant anti-inflammatory effects, there should be an intrinsic benefit to their co-administration. In this work, we evaluated the effects of the co-treatment of several antihistamines on dexamethasone-induced glucocorticoid receptor transcriptional activity on the expression of various inflammation-related genes in A549 and U937 cell lines. Our results show that all antihistamines potentiate GCs' anti-inflammatory effects, presenting ligand-, cell- and gene-dependent effects. Given that treatment with GCs has strong adverse effects, particularly on bone metabolism, we also examined the impact of antihistamine co-treatment on the expression of bone metabolism markers. Using MC3T3-E1 pre-osteoblastic cells, we observed that, though the antihistamine azelastine reduces the expression of dexamethasone-induced bone loss molecular markers, it potentiates osteoblast apoptosis. Our results suggest that the synergistic effect could contribute to reducing GC clinical doses, ineffective by itself but effective in combination with an antihistamine. This could result in a therapeutic advantage, as the addition of an antihistamine may reinforce the wanted effects of GCs, while related adverse effects could be diminished or at least mitigated. By modulating the patterns of gene activation/repression mediated by GR, antihistamines could enhance only the desired effects of GCs, allowing their effective dose to be reduced. Further research is needed to correctly determine the clinical scope, benefits, and potential risks of this therapeutic strategy.
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Leone A, Criscuolo M, Gullì C, Petrosino A, Carlo Bianco N, Colosimo C. Systemic mastocytosis revisited with an emphasis on skeletal manifestations. Radiol Med 2020; 126:585-598. [PMID: 33242205 DOI: 10.1007/s11547-020-01306-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 11/15/2020] [Indexed: 12/12/2022]
Abstract
Systemic mastocytosis (SM) is a rare form of mastocytosis that can affect various organ systems. Bone involvement is the most common and prominent imaging feature in patients with SM regardless of the subtype. Furthermore, bone involvement is a prognostic factor as it may entail an aggressive course of the disease. Diagnosis is established by bone marrow biopsy complemented by imaging modalities such as radiography, CT, and magnetic resonance (MR) imaging. The radiographic and CT appearances are that of sclerotic, lytic, or mixed patterns with focal or diffuse distribution, involving primarily the axial skeleton and the ends of the long bones. Bone marrow infiltration is best recognized on MR imaging. Osteoporosis is common in SM; thus, a bone mineral density measurement at lumbar spine and proximal femur by dual-energy X-ray absorptiometry should be obtained. Imaging plays a huge part in the diagnostic process; when skeletal imaging findings are carefully interpreted and correlated with clinical features, they can lead to the suspicion of SM. The primary aims of this review article were to focus on the role of imaging in detection and characterization of skeletal patterns of SM and to discuss relevant clinical features that could facilitate prompt and correct diagnosis.
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Affiliation(s)
- Antonio Leone
- Department of Radiological and Hematological Sciences Fondazione, Policlinico Universitario A. Gemelli, IRCCS Università Cattolica del Sacro Cuore, Largo A. Gemelli, 100168, Rome, Italy.
| | - Marianna Criscuolo
- Department of Radiological and Hematological Sciences Fondazione, Policlinico Universitario A. Gemelli, IRCCS Università Cattolica del Sacro Cuore, Largo A. Gemelli, 100168, Rome, Italy
| | - Consolato Gullì
- Department of Radiological and Hematological Sciences Fondazione, Policlinico Universitario A. Gemelli, IRCCS Università Cattolica del Sacro Cuore, Largo A. Gemelli, 100168, Rome, Italy
| | - Antonella Petrosino
- Department of Radiological and Hematological Sciences Fondazione, Policlinico Universitario A. Gemelli, IRCCS Università Cattolica del Sacro Cuore, Largo A. Gemelli, 100168, Rome, Italy
| | - Nicola Carlo Bianco
- Department of Radiological and Hematological Sciences Fondazione, Policlinico Universitario A. Gemelli, IRCCS Università Cattolica del Sacro Cuore, Largo A. Gemelli, 100168, Rome, Italy
| | - Cesare Colosimo
- Department of Radiological and Hematological Sciences Fondazione, Policlinico Universitario A. Gemelli, IRCCS Università Cattolica del Sacro Cuore, Largo A. Gemelli, 100168, Rome, Italy
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Fisher L, Fisher A, Smith PN. Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review). J Clin Med 2020; 9:E3253. [PMID: 33053671 PMCID: PMC7600664 DOI: 10.3390/jcm9103253] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis (OP) and osteoporotic fractures (OFs) are common multifactorial and heterogenic disorders of increasing incidence. Helicobacter pylori (H.p.) colonizes the stomach approximately in half of the world's population, causes gastroduodenal diseases and is prevalent in numerous extra-digestive diseases known to be associated with OP/OF. The studies regarding relationship between H.p. infection (HPI) and OP/OFs are inconsistent. The current review summarizes the relevant literature on the potential role of HPI in OP, falls and OFs and highlights the reasons for controversies in the publications. In the first section, after a brief overview of HPI biological features, we analyze the studies evaluating the association of HPI and bone status. The second part includes data on the prevalence of OP/OFs in HPI-induced gastroduodenal diseases (peptic ulcer, chronic/atrophic gastritis and cancer) and the effects of acid-suppressive drugs. In the next section, we discuss the possible contribution of HPI-associated extra-digestive diseases and medications to OP/OF, focusing on conditions affecting both bone homeostasis and predisposing to falls. In the last section, we describe clinical implications of accumulated data on HPI as a co-factor of OP/OF and present a feasible five-step algorithm for OP/OF risk assessment and management in regard to HPI, emphasizing the importance of an integrative (but differentiated) holistic approach. Increased awareness about the consequences of HPI linked to OP/OF can aid early detection and management. Further research on the HPI-OP/OF relationship is needed to close current knowledge gaps and improve clinical management of both OP/OF and HPI-related disorders.
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Affiliation(s)
- Leon Fisher
- Department of Gastroenterology, Frankston Hospital, Peninsula Health, Melbourne 3199, Australia
| | - Alexander Fisher
- Department of Geriatric Medicine, The Canberra Hospital, ACT Health, Canberra 2605, Australia;
- Department of Orthopedic Surgery, The Canberra Hospital, ACT Health, Canberra 2605, Australia;
- Australian National University Medical School, Canberra 2605, Australia
| | - Paul N Smith
- Department of Orthopedic Surgery, The Canberra Hospital, ACT Health, Canberra 2605, Australia;
- Australian National University Medical School, Canberra 2605, Australia
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Alshahrani NS, Abu-Nada L, Ramirez Garcia-Luna JL, Al-Hamed FS, Alamri A, Makhoul NM, Tamimi F. Ranitidine Impairs Bone Healing and Implant Osseointegration in Rats' Tibiae. J Oral Maxillofac Surg 2020; 78:1943-1952. [PMID: 32687794 DOI: 10.1016/j.joms.2020.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/18/2020] [Accepted: 06/18/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Ranitidine has been found to have an impact on bone metabolism by suppressing osteoclastogenesis. We hypothesized that the use of ranitidine would impair bone healing and implant osseointegration. This study investigated the effect of postoperative administration of ranitidine on bone healing and osseointegration in rats. MATERIALS AND METHODS Twenty-two Sprague-Dawley rats underwent surgery to create a unicortical bone defect in each tibia. A titanium implant was placed on the right tibial defect, whereas the contralateral defect was left unfilled. After surgery, the rats were randomly divided into 2 groups receiving a daily dose of ranitidine or saline solution for 14 days and then euthanized for assessment of bone healing and osseointegration using micro-computed tomography (CT) and histomorphometry. RESULTS Micro-CT analysis of the bone defect showed a larger bone defect volume in the ranitidine group (0.82 ± 0.13 μL vs 0.66 ± 0.16 μL, P = .034), thinner cortical thickness (0.54 ± 0.07 mm vs 0.63 ± 0.11 mm, P = .026), and less bone regeneration at the defect site (40% ± 12% vs 57% ± 11%, P = .003). Implant-site micro-CT analysis showed less osseointegration in the ranitidine group (34.1% ± 2.7% vs 43.5% ± 2.1%, P = .014), and implant-site histologic analysis showed less medullary (P = .021), cortical (P = .001), and total (P = .003) bone-implant contact and less peri-implant bone volume-tissue volume (P = .002) in the ranitidine group. Histologic analysis for osteoclastic activity showed a lower number of osteoclasts in the ranitidine group (4.8 ± 2.4 mm-2 vs 9.1 ± 2.1 mm-2, P = .026). CONCLUSIONS The postoperative use of ranitidine impaired bone healing and osseointegration.
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Affiliation(s)
- Nasser S Alshahrani
- Resident in Oral and Maxillofacial Surgery, Biomedical Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; and Department of Dentistry and Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lina Abu-Nada
- PhD Candidate, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Jose Luis Ramirez Garcia-Luna
- PhD Candidate, The Bone Engineering Labs, Injury Recovery Repair Program, Research Institute, McGill University Health Center, Montreal, Quebec, Canada; and Department of Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Faez Saleh Al-Hamed
- PhD Candidate, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Abdulaziz Alamri
- Assistant Professor, Preventive Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nicholas M Makhoul
- Head of Department, Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; and Associate Professor, Department of Dentistry and Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Faleh Tamimi
- Associate Professor, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; and Professor, College of Dental Medicine, Health Cluster, Qatar University, Doha, Qatar.
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He J, Xu S, Zhang B, Xiao C, Chen Z, Si F, Fu J, Lin X, Zheng G, Yu G, Chen J. Gut microbiota and metabolite alterations associated with reduced bone mineral density or bone metabolic indexes in postmenopausal osteoporosis. Aging (Albany NY) 2020; 12:8583-8604. [PMID: 32392181 PMCID: PMC7244073 DOI: 10.18632/aging.103168] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/31/2020] [Indexed: 04/16/2023]
Abstract
Reduced bone mineral density (BMD) is associated with an altered microbiota in senile osteoporosis. However, the relationship among gut microbiota, BMD and bone metabolic indexes remains unknown in postmenopausal osteoporosis. In this study, fecal microbiota profiles for 106 postmenopausal individuals with osteopenia (n=33) or osteoporosis (n=42) or with normal BMD (n=31) were determined. An integrated 16S rRNA gene sequencing and LC-MS-based metabolomics approach was applied to explore the association of estrogen-reduced osteoporosis with the gut microbiota and fecal metabolic phenotype. Adjustments were made using several statistical models for potential confounding variables identified from the literature. The results demonstrated decreased bacterial richness and diversity in postmenopausal osteoporosis. Additionally, showed significant differences in abundance levels among phyla and genera in the gut microbial community were found. Moreover, postmenopausal osteopenia-enriched N-acetylmannosamine correlated negatively with BMD, and distinguishing metabolites were closely associated with gut bacterial variation. Both serum procollagen type I N propeptide (P1NP) and C-terminal telopeptide of type I collagen (CTX-1) correlated positively with osteopenia-enriched Allisonella, Klebsiella and Megasphaera. However, we did not find a significant correlation between bacterial diversity and estrogen. These observations will lead to a better understanding of the relationship between bone homeostasis and the microbiota in postmenopausal osteoporosis.
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Affiliation(s)
- Jianquan He
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation, Zhongshan Hospital Xiamen University, Xiamen 361004, China
| | - Shuangbin Xu
- Department of Bioinformatics, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Bangzhou Zhang
- Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Chuanxing Xiao
- Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Zhangran Chen
- Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Fuyou Si
- Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Jifan Fu
- Department of Rehabilitation, Xinyu People's Hospital, Xinyu 338000, China
| | - Xiaomei Lin
- Department of Rehabilitation, Zhongshan Hospital Xiamen University, Xiamen 361004, China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Guangchuang Yu
- Department of Bioinformatics, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Jian Chen
- Department of Rehabilitation, Zhongshan Hospital Xiamen University, Xiamen 361004, China
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Sirufo MM, Suppa M, Ginaldi L, De Martinis M. Does Allergy Break Bones? Osteoporosis and Its Connection to Allergy. Int J Mol Sci 2020; 21:E712. [PMID: 31973226 PMCID: PMC7037724 DOI: 10.3390/ijms21030712] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/11/2020] [Accepted: 01/16/2020] [Indexed: 12/13/2022] Open
Abstract
: Osteoporosis and allergic diseases are important causes of morbidity, and traditionally their coexistence has been attributed to causality, to independent processes, and they were considered unrelated. However, the increasing knowledge in the field of osteoimmunology and an increasing number of epidemiological and biological studies have provided support to a correlation between bone and allergy that share pathways, cells, cytokines and mediators. If the link between allergic pathology and bone alterations appears more subtle, there are conditions such as mastocytosis and hypereosinophilic or hyper-IgE syndromes characterized by the proliferation of cells or hyper-production of molecules that play a key role in allergies, in which this link is at least clinically more evident, and the diseases are accompanied by frank skeletal involvement, offering multiple speculation cues. The pathophysiological connection of allergy and osteoporosis is currently an intriguing area of research. The aim of this review is to summarize and bring together the current knowledge and pursue an opportunity to stimulate further investigation.
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Affiliation(s)
- Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
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Folwarczna J, Konarek N, Freier K, Karbowniczek D, Londzin P, Janas A. Effects of loratadine, a histamine H 1 receptor antagonist, on the skeletal system of young male rats. DRUG DESIGN DEVELOPMENT AND THERAPY 2019; 13:3357-3367. [PMID: 31576110 PMCID: PMC6767469 DOI: 10.2147/dddt.s215337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 07/26/2019] [Indexed: 01/03/2023]
Abstract
Background Histamine H1 receptor antagonists are widely used in the treatment of allergic diseases. H1 receptors are expressed on bone cells and histamine takes part in regulation of bone metabolism. Loratadine is often prescribed to children. Purpose The aim of the present study was to investigate the effects of loratadine on the skeletal system of young rats. Material and methods Loratadine (0.5, 5, and 50 mg/kg p.o. daily) was administered for 4 weeks to male Wistar rats, 6-week-old at the start of the experiment. Bone mass, mass of bone mineral, calcium, and phosphorus content in the bone mineral of the tibia, femur, and L-4 vertebra, histomorphometric parameters of the femur, mechanical properties of the proximal tibial metaphysis, femoral diaphysis and femoral neck, and serum levels of bone turnover markers were examined. Results Loratadine at 0.5 and 5 mg/kg did not significantly affect the skeletal system of young rats. At 50 mg/kg, loratadine decreased the femoral length, increased content of calcium and phosphorus in the bone mineral of the vertebra, and tended to improve mechanical properties of the tibial metaphysis. Conclusion High-dose loratadine slightly but significantly affected development of the skeletal system in rapidly growing rats.
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Affiliation(s)
- Joanna Folwarczna
- Department of Pharmacology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Sosnowiec 41-200, Poland
| | - Natalia Konarek
- Department of Pharmacology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Sosnowiec 41-200, Poland
| | - Karolina Freier
- Department of Pharmacology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Sosnowiec 41-200, Poland
| | - Dawid Karbowniczek
- Department of Pharmacology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Sosnowiec 41-200, Poland
| | - Piotr Londzin
- Department of Pharmacology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Sosnowiec 41-200, Poland
| | - Aleksandra Janas
- Department of Pharmacology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Sosnowiec 41-200, Poland
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Malchodi L, Wagner K, Susi A, Gorman G, Hisle-Gorman E. Early Acid Suppression Therapy Exposure and Fracture in Young Children. Pediatrics 2019; 144:peds.2018-2625. [PMID: 31175146 DOI: 10.1542/peds.2018-2625] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acid suppression therapy (AST), including proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs), is frequently prescribed to treat symptomatic gastroesophageal reflux in otherwise healthy infants. PPI use has been associated with increased fracture risk in older adults; 2 preliminary studies in children have conflicting results. METHODS A retrospective cohort of children born 2001 to 2013 who were followed for ≥2 years was formed. Those with osteogenesis imperfecta, cholestasis, or child maltreatment were excluded. Prescription data were used to identify AST prescription before age 1 year. International Classification of Diseases, Ninth Revision, Clinical Modification codes identified fractures after age 1 year. A Cox proportional hazard analysis assessed fracture hazard and was adjusted for sex, prematurity, low birth weight, previous fracture, anti-epileptics, and overweight or obesity. RESULTS Of 851 631 included children, 97 286 (11%) were prescribed AST in the first year of life; 7998 (0.9%) children were prescribed PPI, 71 578 (8%) were prescribed H2RA, and 17 710 (2%) were prescribed both a PPI and H2RA. Infants prescribed AST had an earlier median first fracture age (3.9 vs 4.5 years). After adjustment, increased fracture hazard was associated with PPI use (21%) and PPI and H2RA use (30%), but not H2RA use alone. Longer duration of AST treatment and earlier age of first AST use was associated with increased fracture hazard. CONCLUSIONS Infant PPI use alone and together with H2RAs is associated with an increased childhood fracture hazard, which appears amplified by days of use and earlier initiation of ASTs. Use of AST in infants should be weighed carefully against possible fracture.
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Affiliation(s)
- Laura Malchodi
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland.,Pediatrics, D 35th Medical Group, Misawa Air Force Base, Misawa, Japan; and
| | - Kari Wagner
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland.,Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Gregory Gorman
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland.,Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Elizabeth Hisle-Gorman
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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12
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Yoshida K, Yu Z, Greendale GA, Ruppert K, Lian Y, Tedeschi SK, Lin TC, Haneuse S, Glynn RJ, Hernández-Díaz S, Solomon DH. Effects of analgesics on bone mineral density: A longitudinal analysis of the prospective SWAN cohort with three-group matching weights. Pharmacoepidemiol Drug Saf 2017; 27:182-190. [PMID: 29230890 DOI: 10.1002/pds.4362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/19/2017] [Accepted: 10/26/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE To examine the effects of analgesics on bone mineral density (BMD), which have not been examined in a longitudinal study with multiple measurements. METHODS We investigated changes in BMD associated with new use of analgesics in a prospective longitudinal cohort of mid-life women. BMD and medication use were measured annually. We compared BMD among new users of acetaminophen, NSAIDs, and opioids. Adjustment for baseline covariates was conducted through propensity score matching weights. On-treatment analysis was conducted with inverse probability of censoring weights. Analysis based on the initial treatment group was also conducted to provide insights into selection bias. Repeated BMD measurements were examined with generalized estimating equations. RESULTS We identified 71 acetaminophen new users, 659 NSAID new users, and 84 opioid new users among 2365 participants. In the on-treatment analysis, the opioid group in comparison to the acetaminophen group had an additional average BMD decline of -0.06% [-1.24, 1.11] per year in the spine and -0.45% [-1.51, 0.61] per year in the femoral neck. BMD mean trajectories over time suggested a fifth-year decline in the opioid persistent users compared with other 2 groups. In the initial treatment group analysis, all 3 groups showed similar trajectories. CONCLUSION The BMD decline over time was similar among the 3 groups. However, 5 years of continuous opioid use may be associated with a greater BMD decline than 5 years on other analgesics. Further studies examining the relationship between very long-term persistent opioid use and BMD are warranted.
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Affiliation(s)
- Kazuki Yoshida
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, USA
| | - Zhi Yu
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gail A Greendale
- Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kristine Ruppert
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yinjuan Lian
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sara K Tedeschi
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, USA
| | - Tzu-Chieh Lin
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert J Glynn
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sonia Hernández-Díaz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Daniel H Solomon
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, USA.,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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13
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Aasarød KM, Mosti MP, Stunes AK, Reseland JE, Basso T, Syversen U, Fossmark R. Impaired skeletal health in patients with chronic atrophic gastritis. Scand J Gastroenterol 2016; 51:774-81. [PMID: 26854332 DOI: 10.3109/00365521.2016.1141317] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE In chronic atrophic gastritis (CAG), destruction of gastric parietal cells causes anacidity and hypergastrinemia. Use of proton pump inhibitors, which also induces gastric anacidity, is associated with increased fracture rates. Our objectives were to study possible differences in bone mineral density (BMD) and bone quality in patients with CAG compared to controls. MATERIAL AND METHODS We performed a cross-sectional study on 17 CAG patients aged 54 ± 13 years and 41 sex- and age-matched controls. Lumbar and femoral BMD and bone quality assessed by lumbar trabecular bone score (TBS) were measured by DXA, and bone material strength (BMS) by microindentation of the tibia. Serum bone markers (CTX, P1NP, sclerostin, osteocalcin, OPG, RANKL) were analyzed. RESULTS We found lower lumbar BMD Z-score (-0.324 ± 1.096 versus 0.456 ± 1.262, p = 0.030), as well as a higher frequency of osteoporosis at the lumbar spine (p = 0.046) and osteopenia at total hip (p = 0.019) in patients compared to controls. In a post hoc subgroup analysis, we observed that the differences were confined to the male patients. TBS also tended to be lower in male patients (p = 0.059), while BMS did not differ between the groups. Osteocalcin, sclerostin, OPG, and OPG/RANKL ratio were lower in patients compared to controls, while CTX and P1NP did not differ between the groups. CONCLUSIONS We observed lower lumbar BMD, increased frequency of osteopenia and osteoporosis in male, but not female patients with CAG. Bone markers suggest a decrease in bone formation and increased bone resorption in CAG patients compared to controls.
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Affiliation(s)
- Kristin Matre Aasarød
- a Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway ;,b Department of Gastroenterology and Hepatology , St Olav's Hospital , Trondheim , Norway
| | - Mats Peder Mosti
- a Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Astrid Kamilla Stunes
- a Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Janne Elin Reseland
- c Department of Biomaterials , Institute of Clinical Dentistry, University of Oslo , Norway
| | - Trude Basso
- d Department of Orthopedics , St. Olav's Hospital , Trondheim , Norway ;,e Department of Neuroscience , NTNU , Trondheim , Norway
| | - Unni Syversen
- a Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway ;,f Department of Endocrinology , St. Olav's Hospital , Trondheim , Norway
| | - Reidar Fossmark
- a Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway ;,b Department of Gastroenterology and Hepatology , St Olav's Hospital , Trondheim , Norway
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14
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Aasarød KM, Stunes AK, Mosti MP, Ramezanzadehkoldeh M, Viggaklev BI, Reseland JE, Skallerud BH, Fossmark R, Syversen U. Effects of the Histamine 1 Receptor Antagonist Cetirizine on the Osteoporotic Phenotype in H(+) /K(+) ATPase Beta Subunit KO Mice. J Cell Biochem 2016; 117:2089-96. [PMID: 26869358 DOI: 10.1002/jcb.25514] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/09/2016] [Indexed: 12/14/2022]
Abstract
Epidemiological studies suggest increased fracture risk in patients using proton pump inhibitors (PPIs). We have previously shown that the H(+) /K(+) ATPase beta subunit knockout (KO) mouse, which is a model of PPI-use, have lower bone mineral density (BMD) and impaired bone quality compared to wild type (WT) mice. Like PPI users, these KO mice display elevated gastric pH and hypergastrinemia, which in turn stimulates gastric histamine release. Previous studies have suggested a negative effect of histamine on bone, thus, we wanted to study whether a histamine 1 receptor (H1R) antagonist could improve bone quality in KO mice. Female KO and WT mice aged 8 weeks received either an H1R antagonist (cetirizine) or polyethylene glycol (PEG) for 6 months. At the end of the study, KO mice displayed elevated plasma histamine levels compared to WT. As demonstrated previously, the KO mice also exhibited lower whole body BMD, reduced mechanical bone strength, and impaired bone quality assessed by μCT. No significant differences, however, were found between the KO groups receiving cetirizine or PEG for any of the measured bone parameters. In vitro gene expression analyses of histamine receptors revealed the presence of H1R and H2R both in osteoblasts and osteoclasts, and H3R in late stage osteoblasts. In conclusion, administration of the H1R antagonist cetirizine in a concentration of 3 mg/kg did not rescue the osteoporotic phenotype in H(+) /K(+) ATPase beta subunit KO mice. It can, however, not be ruled out that histamine may influence bone via other receptors. J. Cell. Biochem. 117: 2089-2096, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Kristin M Aasarød
- Department of Cancer Research and Molecular Medicine, NTNU, Trondheim, Norway
| | - Astrid K Stunes
- Department of Cancer Research and Molecular Medicine, NTNU, Trondheim, Norway
| | - Mats P Mosti
- Department of Cancer Research and Molecular Medicine, NTNU, Trondheim, Norway
| | | | - Bjørn I Viggaklev
- Department of Cancer Research and Molecular Medicine, NTNU, Trondheim, Norway
| | - Janne E Reseland
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, Oslo, Norway
| | | | - Reidar Fossmark
- Department of Cancer Research and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Gastroenterology and Hepatology, St. Olav's Hospital, Trondheim, Norway
| | - Unni Syversen
- Department of Cancer Research and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Endocrinology, St. Olav's Hospital, Trondheim, Norway
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15
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Folwarczna J, Janas A, Pytlik M, Śliwiński L, Wiercigroch M, Brzęczek A. Modifications of histamine receptor signaling affect bone mechanical properties in rats. Pharmacol Rep 2014; 66:93-9. [PMID: 24905313 DOI: 10.1016/j.pharep.2013.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 08/01/2013] [Accepted: 08/13/2013] [Indexed: 12/31/2022]
Abstract
Histamine receptors are expressed on bone cells and histamine may be involved in regulation of bone metabolism. The aim of the present study was to investigate the effects of loratadine (an H(1) receptor antagonist), ranitidine (an H(2) receptor antagonist) and betahistine (an H(3) receptor antagonist and H(1) receptor agonist) on bone mechanical properties in rats. Loratadine (5 mg/kg/day, po), ranitidine (50 mg/kg/day, po), or betahistine dihydrochloride (5 mg/kg/day, po), were administered for 4 weeks to non-ovariectomized and bilaterally ovariectomized (estrogen-deficient) 3-month-old rats, and their effects were compared with appropriate controls. Serum levels of bone turnover markers, bone mineralization and mechanical properties of the proximal tibial metaphysis, femoral diaphysis and femoral neck were studied. In rats with normal estrogen level, administration of loratadine slightly favorably affected mechanical properties of compact bone, significantly increasing the strength of the femoral neck (p < 0.05), and tending to increase the strength of the femoral diaphysis. Ranitidine did not significantly affect the investigated parameters, and betahistine decreased the strength of the tibial metaphysis (cancellous bone, p < 0.01). There were no significant effects of the drugs on serum bone turnover markers. In estrogen-deficient rats, the drugs did not significantly affect the investigated skeletal parameters. In conclusion, the effects of histamine H(1), H(2) and H(3) receptor antagonists on the skeletal system in rats were differential and dependent on estrogen status.
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Affiliation(s)
- Joanna Folwarczna
- Department of Pharmacology, Medical University of Silesia, Katowice, Sosnowiec, Poland.
| | - Aleksandra Janas
- Department of Pharmacology, Medical University of Silesia, Katowice, Sosnowiec, Poland
| | - Maria Pytlik
- Department of Pharmacology, Medical University of Silesia, Katowice, Sosnowiec, Poland
| | - Leszek Śliwiński
- Department of Pharmacology, Medical University of Silesia, Katowice, Sosnowiec, Poland
| | - Marek Wiercigroch
- Department of Pharmacology, Medical University of Silesia, Katowice, Sosnowiec, Poland
| | - Anna Brzęczek
- Department of Pharmacology, Medical University of Silesia, Katowice, Sosnowiec, Poland
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16
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Alshbool FZ, Alarcon C, Wergedal J, Mohan S. A high-calcium diet failed to rescue an osteopenia phenotype in claudin-18 knockout mice. Physiol Rep 2014; 2:e00200. [PMID: 24744879 PMCID: PMC3967683 DOI: 10.1002/phy2.200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 12/03/2013] [Indexed: 12/14/2022] Open
Abstract
We have recently demonstrated that mice with disruption of claudin‐18 (Cldn‐18) gene exhibited osteopenia due to increased bone resorption (BR). In this study, we found that gastric pH was significantly higher in Cldn‐18 knockout (KO) mice compared to heterozygous control mice at 10 weeks of age. To test the possibility that the increased BR in the Cldn‐18 KO mice fed a normal‐Ca diet is a consequence of decreased Ca absorption caused by increased stomach pH, we subjected KO and control mice to a normal‐Ca and high‐Ca diet at birth. Serum Ca levels were significantly lower in Cldn‐18 KO mice compared to control mice at a normal‐Ca diet but not at high‐Ca diet. Dual energy X‐ray absorptiometry revealed that a high‐Ca diet significantly increased lumbar bone mineral density (BMD), but had no effect on femur/tibia BMD in both Cldn‐18 KO and control mice compared to a normal‐Ca diet. While a high‐Ca diet did not affect volumetric BMD, trabecular, and cortical parameters of the lumbar vertebra (LV) as measured by μCT, the size of the LV did increase, in both genotypes due to reduced BR. Comparison of the skeletal phenotype of high‐Ca Cldn‐18 KO and control mice revealed that an osteopenia phenotype seen at a normal‐Ca diet was still maintained at different skeletal sites in the KO mice till 10 weeks of age. In conclusion, our findings suggest that increased BR is likely caused by direct effects of a lack of Cldn‐18 on osteoclasts rather than gastric pH changes. In this study, we examined if calcium deficiency caused by low‐gastric acidity was the cause of osteopenia phenotype observed in claudin‐18 (Cldn‐18) knockout (KO) mice. Our findings that high‐calcium diet did not rescue the osteopenia phenotype in Cldn‐18 KO mice suggest that increased bone resorption is likely caused by direct effects of a lack of Cldn‐18 on osteoclasts rather than gastric pH changes.
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Affiliation(s)
- Fatima Z Alshbool
- Musculoskeletal Disease Center, Jerry L Pettis VA Medical Center, Loma Linda, 92357, California ; Department of Pharmacology, Loma Linda University, Loma Linda, 92354, California
| | - Catrina Alarcon
- Musculoskeletal Disease Center, Jerry L Pettis VA Medical Center, Loma Linda, 92357, California
| | - Jon Wergedal
- Musculoskeletal Disease Center, Jerry L Pettis VA Medical Center, Loma Linda, 92357, California ; Department of Medicine, Loma Linda University, Loma Linda, 92354, California
| | - Subburaman Mohan
- Musculoskeletal Disease Center, Jerry L Pettis VA Medical Center, Loma Linda, 92357, California ; Department of Medicine, Loma Linda University, Loma Linda, 92354, California ; Department of Biochemistry, Loma Linda University, Loma Linda, 92354, California ; Department of Physiology, Loma Linda University, Loma Linda, 92354, California
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17
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Abrahamsen B, Vestergaard P. Proton pump inhibitor use and fracture risk - effect modification by histamine H1 receptor blockade. Observational case-control study using National Prescription Data. Bone 2013; 57:269-71. [PMID: 23973557 DOI: 10.1016/j.bone.2013.08.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 07/14/2013] [Accepted: 08/15/2013] [Indexed: 12/20/2022]
Abstract
It remains unknown why proton pump inhibitor (PPI) use may be associated with risk of osteoporotic fractures; evidence of direct effects on calcium absorption or on the osteoclast in humans is weak or absent. However, the ensuing increased gastrin levels may cause histamine production through hypertrophy of gastric enterochromaffin like cells, which could lead to bone loss. We speculated that H1 receptor antagonists (H1RA) used for allergies would then reduce the effect of PPI on bone. We therefore conducted a register-based case-control study comprising 124,655 patients with hospital treated fractures, who were matched 3:1 with non fracture control subjects of the same age and gender. Use of prescription medications was retrieved from the National Prescription Database and data was analyzed using conditional logistic regression analysis. We observed a significant interaction between PPI and H1RA use on fracture risk in general (adjusted OR 0.92, 95% CI 0.87-0.98) though not on hip fracture risk (adjusted OR 0.99, 95% CI 0.85-1.16). There was a significant modification of the interaction by age (p<0.05 for both fracture categories). As previously shown, fracture risk was higher in PPI users both for fractures in general and for hip fractures. Irrespective of PPI use, H1RA users had lower risk of hip fractures than non-users (adjusted OR 0.86, 95% CI 0.79-0.93). This short report suggests that the effects of PPI on bone could be driven by in part by increased histamine release as the increased fracture risk can be modified by H1RA.
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Affiliation(s)
- Bo Abrahamsen
- Department of Medicine F, Gentofte Hospital, Copenhagen, Denmark; OPEN, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
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18
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Gatti D, Senna G, Viapiana O, Rossini M, Passalacqua G, Adami S. Allergy and the bone: unexpected relationships. Ann Allergy Asthma Immunol 2011; 107:202-6. [PMID: 21875537 DOI: 10.1016/j.anai.2011.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 03/09/2011] [Accepted: 03/28/2011] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine the relationships between allergy and bone metabolism as represented by the effects of antihistamines and leukotriene modifiers on bone resorption and formation. DATA SOURCES The major databases MEDLINE and Scopus were searched using the keywords bone metabolism, bone resorption, bone formation, antihistamines, h1 antagonist, leukotriene antagonist, and leukotriene modifier. STUDY SELECTION The studies were independently evaluated by all the coauthors, who judged their pertinence to this review. RESULTS Two of the most intriguing aspects in the field are the possible effects of leukotriene modifiers on fracture repair and the hypothesized role of antihistamines in contrasting osteoporosis. Another rapidly expanding field of research is that related to the immune-modulating effects of vitamin D because serum levels of vitamin D have been shown to correlate with pulmonary function, asthma onset, and the development of allergic diseases. CONCLUSION Although unexpected, data are now available suggesting a strict connection among allergy, its treatments, and bone metabolism.
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Affiliation(s)
- Davide Gatti
- Rheumatologic Department, University of Verona, Verona, Italy
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19
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Sipponen P, Härkönen M. Hypochlorhydric stomach: a risk condition for calcium malabsorption and osteoporosis? Scand J Gastroenterol 2010; 45:133-8. [PMID: 19958055 DOI: 10.3109/00365520903434117] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Malabsorption of dietary calcium is a cause of osteoporosis. Dissolution of calcium salts (e.g. calcium carbonate) in the stomach is one step in the proper active and passive absorption of calcium as a calcium ion (Ca(2+)) in the proximal small intestine. Stomach acid markedly increases dissolution and ionization of poorly soluble calcium salts. If acid is not properly secreted, calcium salts are minimally dissolved (ionized) and, subsequently, may not be properly and effectively absorbed. Atrophic gastritis, gastric surgery, and high-dose, long-term use of antisecretory drugs markedly reduce acid secretion and may, therefore, be risk conditions for malabsorption of dietary and supplementary calcium, and may thereby increase the risk of osteoporosis in the long term.
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