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Metzger CE, Olayooye P, Tak LY, Culpepper O, LaPlant AN, Jalaie P, Andoh PM, Bandara W, Reul ON, Tomaschke AA, Surowiec RK. Estrogen deficiency induces changes in bone matrix bound water that do not closely correspond with bone turnover. Bone 2024; 186:117173. [PMID: 38906519 DOI: 10.1016/j.bone.2024.117173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024]
Abstract
Postmenopausal osteoporosis, marked by estrogen deficiency, is a major contributor to osteoporotic fractures, yet early prediction of fractures in this population remains challenging. Our goal was to explore the temporal changes in bone-specific inflammation, oxidative stress, bone turnover, and bone-matrix water, and their relationship with estrogen deficiency-induced modifications in bone structure and mechanical properties. Additionally, we sought to determine if emerging clinically translatable imaging techniques could capture early bone modifications prior to standard clinical imaging. Two-month-old female Sprague Dawley rats (n = 48) underwent ovariectomy (OVX, n = 24) or sham operations (n = 24). A subgroup of n = 8 rats per group was sacrificed at 2-, 5-, and 10-weeks post-surgery to assess the temporal relationships of inflammation, oxidative stress, bone turnover, bone matrix water, mechanics, and imaging outcomes. OVX rats exhibited higher body weight compared to sham rats at all time points. By 5-weeks, OVX animals showed elevated markers of inflammation and oxidative stress in cortical bone, which persisted throughout the study, while cortical bone formation rate did not differ from sham until 10-weeks. DXA outcomes did not reveal differences between OVX and sham at any time point. Bound water, assessed using ultrashort echo time magnetic resonance imaging (UTE MRI), was lower in OVX at the earliest time point (2-weeks) and reduced again at 10-weeks with no difference at 5-weeks. These data demonstrate that bound water assessment using novel UTE MRI technology was lower at the earliest time point following OVX. However, no temporal relationship with bone turnover, inflammation, or oxidative stress was observed at the time points assessed in this study. These findings underscore both the increased need to understand bone hydration changes and highlight the usefulness of UTE MRI for non-invasive bone hydration measurements.
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Affiliation(s)
- Corinne E Metzger
- Dept. of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Peter Olayooye
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Landon Y Tak
- Dept. of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Oli Culpepper
- Dept. of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Alec N LaPlant
- Dept. of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA; Dept. of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Peter Jalaie
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Pearl-Marie Andoh
- Dept. of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Wikum Bandara
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Olivia N Reul
- Dept. of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Andrew A Tomaschke
- Dept. of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Rachel K Surowiec
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Dept. of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA; Dept. of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
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2
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Creecy A, Segvich D, Metzger C, Kohler R, Wallace JM. Combining anabolic loading and raloxifene improves bone quantity and some quality measures in a mouse model of osteogenesis imperfecta. Bone 2024; 184:117106. [PMID: 38641232 PMCID: PMC11130993 DOI: 10.1016/j.bone.2024.117106] [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: 01/25/2024] [Revised: 03/20/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
Osteogenesis imperfecta (OI) increases fracture risk due to changes in bone quantity and quality caused by mutations in collagen and its processing proteins. Current therapeutics improve bone quantity, but do not treat the underlying quality deficiencies. Male and female G610C+/- mice, a murine model of OI, were treated with a combination of raloxifene and in vivo axial tibial compressive loading starting at 10 weeks of age and continuing for 6 weeks to improve bone quantity and quality. Bone geometry and mechanical properties were measured to determine whole bone and tissue-level material properties. A colocalized Raman/nanoindentation system was used to measure chemical composition and nanomechanical properties in newly formed bone compared to old bone to determine if bone formed during the treatment regimen differed in quality compared to bone formed prior to treatment. Lastly, lacunar geometry and osteocyte apoptosis were assessed. OI mice were able to build bone in response to the loading, but this response was less robust than in control mice. Raloxifene improved some bone material properties in female but not male OI mice. Raloxifene did not alter nanomechanical properties, but loading did. Lacunar geometry was largely unchanged with raloxifene and loading. However, osteocyte apoptosis was increased with loading in raloxifene treated female mice. Overall, combination treatment with raloxifene and loading resulted in positive but subtle changes to bone quality.
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Affiliation(s)
- Amy Creecy
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, United States of America.
| | - Dyann Segvich
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, United States of America
| | - Corinne Metzger
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Rachel Kohler
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, United States of America
| | - Joseph M Wallace
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, United States of America
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Williams DR, Taylor L, Miter GA, Sheiman JL, Wallace JM, Allen MR, Kohler R, Medeiros C. Synthesis Studies and the Evaluation of C 6 Raloxifene Derivatives. ACS Med Chem Lett 2024; 15:879-884. [PMID: 38894928 PMCID: PMC11181480 DOI: 10.1021/acsmedchemlett.4c00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Methodology is described for the synthesis of C6 derivatives of raloxifene, a prescribed drug for the treatment and prevention of osteoporosis. Studies have explored the incorporation of electron-withdrawing substituents at C6 of the benzothiophene core. Efficient processes are also examined to introduce hydrogen bond donor and acceptor functionality. Raloxifene derivatives are evaluated with in vitro testing to determine estrogen receptor (ER) binding affinity and gene expression in MC3T3 cells.
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Affiliation(s)
- David R. Williams
- Department
of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Levin Taylor
- Department
of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Gabriel A. Miter
- Department
of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Johnathan L. Sheiman
- Department
of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Joseph M. Wallace
- Department
of Biomedical Engineering, Indiana University-Purdue
University, Indianapolis, Indiana 46202, United States
| | - Matthew R. Allen
- Department
of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana 46202 United States
| | - Rachel Kohler
- Department
of Biomedical Engineering, Indiana University-Purdue
University, Indianapolis, Indiana 46202, United States
| | - Claudia Medeiros
- Department
of Biomedical Engineering, Indiana University-Purdue
University, Indianapolis, Indiana 46202, United States
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Bhadouria N, Holguin N. Osteoporosis treatments for intervertebral disc degeneration and back pain: a perspective. JBMR Plus 2024; 8:ziae048. [PMID: 38706880 PMCID: PMC11066806 DOI: 10.1093/jbmrpl/ziae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 05/07/2024] Open
Abstract
Low back pain derived from intervertebral disc (IVD) degeneration is a debilitating spinal condition that, despite its prevalence, does not have any intermediary guidelines for pharmacological treatment between palliative care and invasive surgery. The development of treatments for the IVD is complicated by the variety of resident cell types needed to maintain the regionally distinct structural properties of the IVD that permit the safe, complex motions of the spine. Osteoporosis of the spine increases the risk of vertebral bone fracture that can increase the incidence of back pain. Fortunately, there are a variety of pharmacological treatments for osteoporosis that target osteoblasts, osteoclasts and/or osteocytes to build bone and prevent vertebral fracture. Of particular note, clinical and preclinical studies suggest that commonly prescribed osteoporosis drugs like bisphosphonates, intermittent parathyroid hormone, anti-sclerostin antibody, selective estrogen receptor modulators and anti-receptor activator of nuclear factor-kappa B ligand inhibitor denosumab may also relieve back pain. Here, we cite clinical and preclinical studies and include unpublished data to support the argument that a subset of these therapeutics for osteoporosis may alleviate low back pain by also targeting the IVD.
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Affiliation(s)
- Neharika Bhadouria
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, United States
| | - Nilsson Holguin
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
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Surowiec RK, Reul ON, Chowdhury NN, Rai RK, Segvich D, Tomaschke AA, Damrath J, Jacobson AM, Allen MR, Wallace JM. Combining raloxifene and mechanical loading improves bone composition and mechanical properties in a murine model of chronic kidney disease (CKD). Bone 2024; 183:117089. [PMID: 38575047 PMCID: PMC11210703 DOI: 10.1016/j.bone.2024.117089] [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: 01/26/2024] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Patients with chronic kidney disease (CKD) are at an alarming risk of fracture compared to age and sex-matched non-CKD individuals. Clinical and preclinical data highlight two key factors in CKD-induced skeletal fragility: cortical porosity and reduced matrix-level properties including bone hydration. Thus, strategies are needed to address these concerns to improve mechanical properties and ultimately lower fracture risk in CKD. We sought to evaluate the singular and combined effects of mechanical and pharmacological interventions on modulating porosity, bone hydration, and mechanical properties in CKD. METHODS Sixteen-week-old male C57BL/6J mice underwent a 10-week CKD induction period via a 0.2 % adenine-laced casein-based diet (n = 48) or remained as non-CKD littermate controls (Con, n = 48). Following disease induction (26 weeks of age), n = 7 CKD and n = 7 Con were sacrificed (baseline cohort) to confirm a steady-state CKD state was achieved prior to the initiation of treatment. At 27 weeks of age, all remaining mice underwent right tibial loading to a maximum tensile strain of 2050 μƐ 3× a week for five weeks with the contralateral limb as a non-loaded control. Half of the mice (equal number CKD and Con) received subcutaneous injections of 0.5 mg/kg raloxifene (RAL) 5× a week, and the other half remained untreated (UN). Mice were sacrificed at 31 weeks of age. Serum biochemistries were performed, and bi-lateral tibiae were assessed for microarchitecture, whole bone and tissue level mechanical properties, and composition including bone hydration. RESULTS Regardless of intervention, BUN and PTH were higher in CKD animals throughout the study. In CKD, the combined effects of loading and RAL were quantified as lower cortical porosity and improved mechanical, material, and compositional properties, including higher matrix-bound water. Loading was generally responsible for positive impacts in cortical geometry and structural mechanical properties, while RAL treatment improved some trabecular outcomes and material-level mechanical properties and was responsible for improvements in several compositional parameters. While control animals responded positively to loading, their bones were less impacted by the RAL treatment, showing no deformation, toughness, or bound water improvements which were all evident in CKD. Serum PTH levels were negatively correlated with matrix-bound water. DISCUSSION An effective treatment program to improve fracture risk in CKD ideally focuses on the cortical bone and considers both cortical porosity and matrix properties. Loading-induced bone formation and mechanical improvements were observed across groups, and in the CKD cohort, this included lower cortical porosity. This study highlights that RAL treatment superimposed on active bone formation may be ideal for reducing skeletal complications in CKD by forming new bone with enhanced matrix properties.
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Affiliation(s)
- Rachel K Surowiec
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America; Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States of America.
| | - Olivia N Reul
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States of America.
| | - Nusaiba N Chowdhury
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States of America.
| | - Ratan K Rai
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States of America.
| | - Dyann Segvich
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States of America.
| | - Andrew A Tomaschke
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States of America.
| | - John Damrath
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America.
| | - Andrea M Jacobson
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States of America.
| | - Matthew R Allen
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, United States of America; Roudebush Veterans Administration Medical Center, Indianapolis, IN, United States of America.
| | - Joseph M Wallace
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States of America.
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Giubertoni G, Feng L, Klein K, Giannetti G, Rutten L, Choi Y, van der Net A, Castro-Linares G, Caporaletti F, Micha D, Hunger J, Deblais A, Bonn D, Sommerdijk N, Šarić A, Ilie IM, Koenderink GH, Woutersen S. Elucidating the role of water in collagen self-assembly by isotopically modulating collagen hydration. Proc Natl Acad Sci U S A 2024; 121:e2313162121. [PMID: 38451946 PMCID: PMC10945838 DOI: 10.1073/pnas.2313162121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/30/2023] [Indexed: 03/09/2024] Open
Abstract
Water is known to play an important role in collagen self-assembly, but it is still largely unclear how water-collagen interactions influence the assembly process and determine the fibril network properties. Here, we use the H[Formula: see text]O/D[Formula: see text]O isotope effect on the hydrogen-bond strength in water to investigate the role of hydration in collagen self-assembly. We dissolve collagen in H[Formula: see text]O and D[Formula: see text]O and compare the growth kinetics and the structure of the collagen assemblies formed in these water isotopomers. Surprisingly, collagen assembly occurs ten times faster in D[Formula: see text]O than in H[Formula: see text]O, and collagen in D[Formula: see text]O self-assembles into much thinner fibrils, that form a more inhomogeneous and softer network, with a fourfold reduction in elastic modulus when compared to H[Formula: see text]O. Combining spectroscopic measurements with atomistic simulations, we show that collagen in D[Formula: see text]O is less hydrated than in H[Formula: see text]O. This partial dehydration lowers the enthalpic penalty for water removal and reorganization at the collagen-water interface, increasing the self-assembly rate and the number of nucleation centers, leading to thinner fibrils and a softer network. Coarse-grained simulations show that the acceleration in the initial nucleation rate can be reproduced by the enhancement of electrostatic interactions. These results show that water acts as a mediator between collagen monomers, by modulating their interactions so as to optimize the assembly process and, thus, the final network properties. We believe that isotopically modulating the hydration of proteins can be a valuable method to investigate the role of water in protein structural dynamics and protein self-assembly.
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Affiliation(s)
- Giulia Giubertoni
- Van ’t Hoff Institute for Molecular Sciences, Department of Molecular Photonics, University of Amsterdam, Amsterdam1090 GD, The Netherlands
| | - Liru Feng
- Van ’t Hoff Institute for Molecular Sciences, Department of Molecular Photonics, University of Amsterdam, Amsterdam1090 GD, The Netherlands
| | - Kevin Klein
- Institute of Science and Technology Austria, Division of Mathematical and Physical Sciences, Klosterneuburg3400, Austria
- University College London, Division of Physics and Astronomy, LondonWC1E 6BT, United Kingdom
| | - Guido Giannetti
- Van ’t Hoff Institute for Molecular Sciences, Department of Molecular Photonics, University of Amsterdam, Amsterdam1090 GD, The Netherlands
| | - Luco Rutten
- Electron Microscopy Center, Radboud Technology Center Microscopy, Department of Medical BioSciences, Radboud University Medical Center, Nijmegen6525 GA, The Netherlands
| | - Yeji Choi
- Max Planck Institute for Polymer Research, Molecular Spectroscopy Department, Mainz55128, Germany
| | - Anouk van der Net
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft2628 HZ, The Netherlands
| | - Gerard Castro-Linares
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft2628 HZ, The Netherlands
| | - Federico Caporaletti
- Van ’t Hoff Institute for Molecular Sciences, Department of Molecular Photonics, University of Amsterdam, Amsterdam1090 GD, The Netherlands
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, Amsterdam1090 GL, The Netherlands
| | - Dimitra Micha
- Amsterdam University Medical Centers, Human Genetics Department, Vrije Universiteit, Amsterdam1007 MB, The Netherlands
| | - Johannes Hunger
- Max Planck Institute for Polymer Research, Molecular Spectroscopy Department, Mainz55128, Germany
| | - Antoine Deblais
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, Amsterdam1090 GL, The Netherlands
| | - Daniel Bonn
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, Amsterdam1090 GL, The Netherlands
| | - Nico Sommerdijk
- Electron Microscopy Center, Radboud Technology Center Microscopy, Department of Medical BioSciences, Radboud University Medical Center, Nijmegen6525 GA, The Netherlands
| | - Andela Šarić
- Institute of Science and Technology Austria, Division of Mathematical and Physical Sciences, Klosterneuburg3400, Austria
| | - Ioana M. Ilie
- Van ’t Hoff Institute for Molecular Sciences, Department of Molecular Photonics, University of Amsterdam, Amsterdam1090 GD, The Netherlands
- Amsterdam Center for Multiscale Modeling, University of Amsterdam, Amsterdam1090 GD, The Netherlands
| | - Gijsje H. Koenderink
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft2628 HZ, The Netherlands
| | - Sander Woutersen
- Van ’t Hoff Institute for Molecular Sciences, Department of Molecular Photonics, University of Amsterdam, Amsterdam1090 GD, The Netherlands
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Dewangan VK, Sampath Kumar TS, Doble M, Daniel Varghese V. Injectable macroporous naturally-derived apatite bone cement as a potential trabecular bone substitute. J Biomed Mater Res B Appl Biomater 2024; 112:e35397. [PMID: 38456309 DOI: 10.1002/jbm.b.35397] [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: 10/28/2023] [Revised: 01/17/2024] [Accepted: 02/18/2024] [Indexed: 03/09/2024]
Abstract
In this study, we have formulated a novel apatite bone cements derived from natural sources (i.e. eggshell and fishbone) with improved qualities that is, porosity, resorbability, biological activity, and so forth. The naturally-derived apatite bone cement (i.e. FBDEAp) was prepared by mixing hydroxyapatite (synthesized from fishbone) and tricalcium phosphate (synthesized from eggshell) as a solid phase with a liquid phase (a dilute acidic blend of cement binding accelerator and biopolymers like gelatin and chitosan) with polysorbate (as liquid porogen) to get a desired bone cement paste. The prepared cement paste sets within the clinically acceptable setting time (≤20 min), easily injectable (>85%) through hands and exhibits physiological pH stability (7.3-7.4). The pure apatite phased bone cement was confirmed by x-ray diffraction and Fourier transform infrared spectroscopy analyses. The FBDEAp bone cement possesses acceptable compressive strength (i.e. 5-7 MPa) within trabecular bone range and is resorbable up to 28% in simulated body fluid solution within 12 weeks of incubation at physiological conditions. The FBDEAp is macroporous in nature (average pore size ~50-400 μm) with interconnected pores verified by SEM and micro-CT analyses. The FBDEAp showed significantly increased MG63 cell viability (>125% after 72 h), cell adhesion, proliferation, and key osteogenic genes expression levels (up to 5-13 folds) compared to the synthetically derived, synthetic and eggshell derived as well as synthetic and fishbone derived bone cements. Thus, we strongly believe that our prepared FBDEAp bone cement can be used as potential trabecular bone substitute in orthopedics.
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Affiliation(s)
- Vimal Kumar Dewangan
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai, India
- Department of Biotechnology, Indian Institute of Technology Madras, Chennai, India
| | - T S Sampath Kumar
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Mukesh Doble
- Department of Biotechnology, Indian Institute of Technology Madras, Chennai, India
- Department of Cariology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Ramchand SK, Tsai JN, Lee H, Sassana-Khadka G, Jordan M, Ryan S, Leder BZ. The comparison of alendronate and raloxifene after denosumab (CARD) study: A comparative efficacy trial. Osteoporos Int 2024; 35:255-263. [PMID: 37798320 DOI: 10.1007/s00198-023-06932-2] [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: 07/27/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023]
Abstract
Denosumab discontinuation results in accelerated bone remodeling, decreased bone mineral density (BMD), and an increased risk of multiple vertebral fractures. Bisphosphonates are at least partially effective at inhibiting these consequences but there have been no randomized clinical trials assessing the efficacy of alternative antiresorptives. PURPOSE The aim of this study was to evaluate the comparative efficacy of alendronate and the SERM, raloxifene, in preventing the post-denosumab high-turnover bone loss. METHODS We conducted an open-label randomized controlled trial in which 51 postmenopausal women at increased risk of fracture were randomized with equal probability to receive 12-months of denosumab 60-mg 6-monthly followed by 12-months of either alendronate 70-mg weekly or raloxifene 60-mg daily. Serum bone remodeling markers were measured at 0,6,12,15,18, and 24 and areal BMD of the distal radius, spine, and hip were measured at 0,12,18 and 24 months. RESULTS After denosumab discontinuation, serum markers of bone remodeling remained suppressed when followed by alendronate, but gradually increased to baseline when followed by raloxifene. In the denosumab-to-alendronate group, denosumab-induced BMD gains were maintained at all sites whereas in the denosumab-to-raloxifene group, BMD decreased at the spine by 2.0% (95% CI -3.2 to -0.8, P = 0.003) and at the total hip by 1.2% (-2.1 to -0.4%, P = 0.008), but remained stable at the femoral neck and distal radius and above the original baseline at all sites. The decreases in spine and total hip BMD in the denosumab-to-raloxifene group (but not the femoral neck or distal radius) were significant when compared to the denosumab-to-alendronate group. CONCLUSIONS These results suggest that after one year of denosumab, one year of alendronate is better able to maintain the inhibition of bone remodeling and BMD gains than raloxifene.
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Affiliation(s)
- Sabashini K Ramchand
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
| | - Joy N Tsai
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Grace Sassana-Khadka
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Mackenzie Jordan
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Savannah Ryan
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Benjamin Z Leder
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA
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9
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Surowiec RK, Saldivar R, Rai RK, Metzger CE, Jacobson AM, Allen MR, Wallace JM. Ex vivo exposure to calcitonin or raloxifene improves mechanical properties of diseased bone through non-cell mediated mechanisms. Bone 2023; 173:116805. [PMID: 37196853 PMCID: PMC10330631 DOI: 10.1016/j.bone.2023.116805] [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: 03/15/2023] [Revised: 05/01/2023] [Accepted: 05/12/2023] [Indexed: 05/19/2023]
Abstract
Raloxifene (RAL) reduces clinical fracture risk despite modest effects on bone mass and density. This reduction in fracture risk may be due to improved material level-mechanical properties through a non-cell mediated increase in bone hydration. Synthetic salmon calcitonin (CAL) has also demonstrated efficacy in reducing fracture risk with only modest bone mass and density improvements. This study aimed to determine if CAL could modify healthy and diseased bone through cell-independent mechanisms that alter hydration similar to RAL. 26-week-old male C57BL/6 mice induced with chronic kidney disease (CKD) beginning at 16 weeks of age via 0.2 % adenine-laced casein-based (0.9 % P, 0.6 % C) chow, and their non-CKD control littermates (Con), were utilized. Upon sacrifice, right femora were randomly assigned to the following ex vivo experimental groups: RAL (2 μM, n = 10 CKD, n = 10 Con), CAL (100 nM, n = 10 CKD, n = 10 Con), or Vehicle (VEH; n = 9 CKD, n = 9 Con). Bones were incubated in PBS + drug solution at 37 °C for 14 days using an established ex vivo soaking methodology. Cortical geometry (μCT) was used to confirm a CKD bone phenotype, including porosity and cortical thinning, at sacrifice. Femora were assessed for mechanical properties (3-point bending) and bone hydration (via solid state nuclear magnetic resonance spectroscopy with magic angle spinning (ssNMR)). Data were analyzed by two-tailed t-tests (μCT) or 2-way ANOVA for main effects of disease, treatment, and their interaction. Tukey's post hoc analyses followed a significant main effect of treatment to determine the source of the effect. Imaging confirmed a cortical phenotype reflective of CKD, including lower cortical thickness (p < 0.0001) and increased cortical porosity (p = 0.02) compared to Con. In addition, CKD resulted in weaker, less deformable bones. In CKD bones, ex vivo exposure to RAL or CAL improved total work (+120 % and +107 %, respectively; p < 0.05), post-yield work (+143 % and +133 %), total displacement (+197 % and +229 %), total strain (+225 % and +243 %), and toughness (+158 % and +119 %) vs. CKD VEH soaked bones. Ex vivo exposure to RAL or CAL did not impact any mechanical properties in Con bone. Matrix-bound water by ssNMR showed CAL treated bones had significantly higher bound water compared to VEH treated bones in both CKD and Con cohorts (p = 0.001 and p = 0.01, respectively). RAL positively modulated bound water in CKD bone compared to VEH (p = 0.002) but not in Con bone. There were no significant differences between bones soaked with CAL vs. RAL for any outcomes measured. RAL and CAL improve important post-yield properties and toughness in a non-cell mediated manner in CKD bone but not in Con bones. While RAL treated CKD bones had higher matrix-bound water content in line with previous reports, both Con and CKD bones exposed to CAL had higher matrix-bound water. Therapeutic modulation of water, specifically the bound water fraction, represents a novel approach to improving mechanical properties and potentially reducing fracture risk.
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Affiliation(s)
- Rachel K Surowiec
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA; Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Rosario Saldivar
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Epidemiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ratan K Rai
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Corinne E Metzger
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Andrea M Jacobson
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA.
| | - Matthew R Allen
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA; Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA.
| | - Joseph M Wallace
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA.
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10
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McGuire BD, Dees A, Hao L, Buckendahl P, Ogilvie AR, Sun H, Rezaee T, Barrett LO, Karim L, Dominguez-Bello MG, Bello NT, Shapses SA. A vitamin D deficient diet increases weight gain and compromises bone biomechanical properties without a reduction in BMD in adult female mice. J Steroid Biochem Mol Biol 2023; 231:106314. [PMID: 37088440 DOI: 10.1016/j.jsbmb.2023.106314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/27/2023] [Accepted: 04/20/2023] [Indexed: 04/25/2023]
Abstract
Vitamin D contributes to the development and maintenance of bone. Evidence suggests vitamin D status can also alter energy balance and gut health. In young animals, vitamin D deficiency (VDD) negatively affects bone mineral density (BMD) and bone microarchitecture, and these effects may also occur due to chronic ethanol intake. However, evidence is limited in mature models, and addressing this was a goal of the current study. Seven-month-old female C57BL/6 mice (n = 40) were weight-matched and randomized to one of four ad libitum diets: control, alcohol (Alc), vitamin D deficient (0 IU/d), or Alc+VDD for 8 weeks. A purified (AIN-93) diet was provided with water or alcohol (10 %) ad libitum. Body weight and food intake were recorded weekly, and feces were collected at 0, 4, and 8 weeks. At the age of 9 months, intestinal permeability was assessed by oral gavage of fluorescein isothiocyanate-dextran. Thereafter, bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. The microarchitecture of the distal femur was assessed by micro-computed tomography and biomechanical properties were evaluated by cyclic reference point indentation. VDD did not affect BMD or most bone microarchitecture parameters, however, the polar moment of inertia (p < 0.05) was higher in the VDD groups compared to vitamin D sufficient groups. VDD mice also had lower whole bone water content (p < 0.05) and a greater average unloading slope (p < 0.01), and energy dissipated (p < 0.01), indicating the femur displayed a brittle phenotype. In addition, VDD caused a greater increase in energy intake (p < 0.05), weight gain (p < 0.05), and a trend for higher intestinal permeability (p = 0.08). The gut microbiota of the VDD group had a reduction in alpha diversity (p < 0.05) and a lower abundance of ASVs from Rikenellaceae, Clostridia_UCG-014, Oscillospiraceae, and Lachnospiraceae (p < 0.01). There was little to no effect of alcohol supplementation on outcomes. Overall, these findings suggest that vitamin D deficiency causes excess weight gain and reduces the biomechanical strength of the femur as indicated by the higher average unloading slope and energy dissipated without an effect on BMD in a mature murine model.
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Affiliation(s)
- Brandon D McGuire
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Azra Dees
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Lihong Hao
- Department of Animal Sciences, Rutgers University, New Brunswick, NJ, USA
| | | | - Anna R Ogilvie
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Haipeng Sun
- Department of Microbiology and Biochemistry, New Brunswick, NJ, USA
| | - Taraneh Rezaee
- Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA
| | - Leland O Barrett
- Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA
| | - Lamya Karim
- Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA
| | - Maria Gloria Dominguez-Bello
- Department of Microbiology and Biochemistry, New Brunswick, NJ, USA; NJ Institute of Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, USA
| | - Nicholas T Bello
- Department of Animal Sciences, Rutgers University, New Brunswick, NJ, USA; NJ Institute of Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, USA
| | - Sue A Shapses
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA; NJ Institute of Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, USA; Department of Medicine, Rutgers-Robert Wood Johnson Univ. Hospital, New Brunswick, NJ, USA.
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11
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Park JS, Chen H, James KC, Natanson LJ, Stock SR. Three-dimensional mapping of mineral in intact shark centra with energy dispersive x-ray diffraction. J Mech Behav Biomed Mater 2022; 136:105506. [PMID: 36228402 DOI: 10.1016/j.jmbbm.2022.105506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 06/20/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
The centra of shark vertebrae consist of cartilage mineralized by a bioapatite similar to bone's carbonated hydroxyapatite, and, without a repair mechanism analogous to remodeling in bone, these structures still survive millions of cycles of high-strain loading. The main structures of the centrum are an hourglass-shaped double cone and the intermedialia which supports the cones. Little is known about the nanostructure of shark centra, specifically the relationship between bioapatite and cartilage fibers, and this study uses energy dispersive diffraction (EDD) with polychromatic synchrotron x-radiation to study the spatial organization of the mineral phase and its crystallographic texture. The unique energy-sensitive detector array at beamline 6-BM-B, the Advanced Photon Source, enables EDD to quantify the texture within each sampling volume with one exposure while constructing 3D maps via specimen translation across the sampling volume. This study maps a centrum from two shark orders, a carcharhiniform and a lamniform, with different intermedialia structures. In the blue shark (Prionace glauca, Carcharhiniformes), the bioapatite's c-axes are oriented laterally within the centrum's cone walls but axially within the wide wedges of the intermedialia; the former is interpreted to resist lateral deformation, the latter to support axial loads. In the shortfin mako (Isurus oxyrinchus, Lamniformes), there is some tendency for c-axis variation with position, but the situation is unclear because one dimension of the sampling volume is considerably larger than the thickness and spacing of the intermedialia's radially-oriented lamellae. Because elastic modulus in collagen plus bioapatite mineralized tissues varies significantly with both volume fraction of bioapatite and crystallographic texture, the present 3D EDD-derived maps should inform future 3D numerical models of shark centra under applied load.
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Affiliation(s)
- J S Park
- The Advanced Photon Source, Argonne National Laboratory, Lemont, IL, USA.
| | - H Chen
- Mineral Physics Inst, Stony Brook Univ., Stony Brook, NY, USA.
| | - K C James
- Southwest Fisheries Science Center, National Marine Fisheries Service, NOAA, La Jolla, CA, USA.
| | - L J Natanson
- (retired) Northeast Fisheries Science Center, National Marine Fisheries Service, NOAA, Narragansett, RI, USA.
| | - S R Stock
- Dept. of Cell and Developmental Biology, Feinberg School of Medicine and Simpson Querrey Inst., Northwestern University, Chicago, IL, USA.
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12
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Ma Y, Jang H, Jerban S, Chang EY, Chung CB, Bydder GM, Du J. Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications. APPLIED PHYSICS REVIEWS 2022; 9:041303. [PMID: 36467869 PMCID: PMC9677812 DOI: 10.1063/5.0086459] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/12/2022] [Indexed: 05/25/2023]
Abstract
Magnetic resonance imaging (MRI) uses a large magnetic field and radio waves to generate images of tissues in the body. Conventional MRI techniques have been developed to image and quantify tissues and fluids with long transverse relaxation times (T2s), such as muscle, cartilage, liver, white matter, gray matter, spinal cord, and cerebrospinal fluid. However, the body also contains many tissues and tissue components such as the osteochondral junction, menisci, ligaments, tendons, bone, lung parenchyma, and myelin, which have short or ultrashort T2s. After radio frequency excitation, their transverse magnetizations typically decay to zero or near zero before the receiving mode is enabled for spatial encoding with conventional MR imaging. As a result, these tissues appear dark, and their MR properties are inaccessible. However, when ultrashort echo times (UTEs) are used, signals can be detected from these tissues before they decay to zero. This review summarizes recent technical developments in UTE MRI of tissues with short and ultrashort T2 relaxation times. A series of UTE MRI techniques for high-resolution morphological and quantitative imaging of these short-T2 tissues are discussed. Applications of UTE imaging in the musculoskeletal, nervous, respiratory, gastrointestinal, and cardiovascular systems of the body are included.
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Affiliation(s)
- Yajun Ma
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California 92037, USA
| | | | | | - Graeme M Bydder
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Jiang Du
- Author to whom correspondence should be addressed:. Tel.: (858) 246-2248, Fax: (858) 246-2221
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13
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Niem T, Frankenberger R, Amend S, Wöstmann B, Krämer N. Damping Behaviour and Mechanical Properties of Restorative Materials for Primary Teeth. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7698. [PMID: 36363290 PMCID: PMC9656603 DOI: 10.3390/ma15217698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The energy dissipation capacity and damping ability of restorative materials used to restore deciduous teeth were assessed compared to common mechanical properties. Mechanical properties (flexural strength, modulus of elasticity, modulus of toughness) for Compoglass F, Dyract eXtra, SDR flow, Tetric Evo Ceram, Tetric Evo Ceram Bulk Fill, and Venus Diamond were determined using a 4-point bending test. Vickers hardness and Martens hardness, together with its plastic index (ηITdis), were recorded using instrumented indentation testing. Leeb hardness (HLD) and its deduced energy dissipation data (HLDdis) were likewise determined. The reliability of materials was assessed using Weibull analysis. For common mechanical properties, Venus Diamond always exhibited the significantly highest results and SDR flow the lowest, except for flexural strength. Independently determined damping parameters (modulus of toughness, HLDdis, ηITdis) invariably disclosed the highest values for SDR flow. Composite materials, including SDR flow, showed markedly higher reliabilities (Weibull modulus) than Compoglass F and Dyract eXtra. SDR flow showed pronounced energy dissipation and damping characteristics, making it the most promising material for a biomimetic restoration of viscoelastic dentin structures in deciduous teeth. Future developments in composite technology should implement improved resin structures that facilitate damping effects in artificial restorative materials.
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Affiliation(s)
- Thomas Niem
- Department of Prosthodontics, Medical Center for Dentistry, Justus Liebig University Giessen and University Hospital Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392 Giessen, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Medical Center for Dentistry, University of Marburg and University Hospital Giessen and Marburg, Campus Marburg, Georg Voigt Strasse 3, 35039 Marburg, Germany
| | - Stefanie Amend
- Department of Paediatric Dentistry, Medical Centre for Dentistry, Justus Liebig University Giessen and University Hospital Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392 Giessen, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics, Medical Center for Dentistry, Justus Liebig University Giessen and University Hospital Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392 Giessen, Germany
| | - Norbert Krämer
- Department of Paediatric Dentistry, Medical Centre for Dentistry, Justus Liebig University Giessen and University Hospital Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392 Giessen, Germany
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14
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Bhadouria N, Berman AG, Wallace JM, Holguin N. Raloxifene Stimulates Estrogen Signaling to Protect Against Age- and Sex-Related Intervertebral Disc Degeneration in Mice. Front Bioeng Biotechnol 2022; 10:924918. [PMID: 36032728 PMCID: PMC9404526 DOI: 10.3389/fbioe.2022.924918] [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: 04/22/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Estrogen agonist raloxifene is an FDA-approved treatment of osteoporosis in postmenopausal women, which may also be a promising prophylactic for painful intervertebral disc (IVD) degeneration. Here, we hypothesized that 1) aging and biological sex contribute to IVD degeneration by reducing estrogen signaling and that 2) raloxifene stimulates estrogen signaling to protect against age- and sex-related IVD degeneration in mice. 2.5-month-old (male and female) and 22.5-month-old (female) C57Bl/6J mice were subcutaneously injected with raloxifene hydrochloride 5x/week for 6 weeks (n = 7-9/grp). Next, female mice were ovariectomized (OVX) or sham operated at 4 months of age and tissues harvested at 6 months (n = 5-6/grp). Advanced aging and OVX increased IVD degeneration score, weakened IVD strength, reduced estrogen receptor-α (ER-α) protein expression, and increased neurotransmitter substance P (SP) expression. Similar to aging and compared with male IVDs, female IVDs were more degenerated, mechanically less viscoelastic, and expressed less ER-α protein, but unlike the effect induced by aging or OVX, IVD mechanical force was greater in females than in males. Therapeutically, systemic injection of raloxifene promoted ER-α protein to quell these dysregulations by enlarging IVD height, alleviating IVD degeneration score, increasing the strength and viscoelastic properties of the IVD, and reducing IVD cell expression of SP in young-adult and old female mice. Transcriptionally, injection of raloxifene upregulated the gene expression of ER-α and extracellular matrix-related anabolism in young-adult and old IVD. In vertebra, advanced aging and OVX reduced trabecular BV/TV, whereas injection of raloxifene increased trabecular BV/TV in young-adult and old female mice, but not in young-adult male mice. In vertebra, advanced aging, OVX, and biological sex (females > males) increased the number of SP-expressing osteocytes, whereas injection of raloxifene reduced the number of SP-expressing osteocytes in young-adult female and male mice and old female mice. Overall, injection of estrogen agonist raloxifene in mice normalized dysregulation of IVD structure, IVD mechanics, and pain-related SP expression in IVD cells and osteocytes induced by aging and biological sex. These data suggest that, in addition to bone loss, raloxifene may relieve painful IVD degeneration in postmenopausal women induced by advanced age, biological sex, and estrogen depletion.
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Affiliation(s)
- Neharika Bhadouria
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, United States,Department of Mechanical and Energy Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Alycia G. Berman
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Joseph M. Wallace
- Department of Biomedical Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States,Indiana Center of Musculoskeletal Health, Indianapolis, IN, United States
| | - Nilsson Holguin
- Department of Mechanical and Energy Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States,Indiana Center of Musculoskeletal Health, Indianapolis, IN, United States,Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, United States,*Correspondence: Nilsson Holguin,
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15
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Surowiec RK, Allen MR, Wallace JM. Bone hydration: How we can evaluate it, what can it tell us, and is it an effective therapeutic target? Bone Rep 2022; 16:101161. [PMID: 35005101 PMCID: PMC8718737 DOI: 10.1016/j.bonr.2021.101161] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 12/22/2022] Open
Abstract
Water constitutes roughly a quarter of the cortical bone by volume yet can greatly influence mechanical properties and tissue quality. There is a growing appreciation for how water can dynamically change due to age, disease, and treatment. A key emerging area related to bone mechanical and tissue properties lies in differentiating the role of water in its four different compartments, including free/pore water, water loosely bound at the collagen/mineral interfaces, water tightly bound within collagen triple helices, and structural water within the mineral. This review summarizes our current knowledge of bone water across the four functional compartments and discusses how alterations in each compartment relate to mechanical changes. It provides an overview on the advent of- and improvements to- imaging and spectroscopic techniques able to probe nano-and molecular scales of bone water. These technical advances have led to an emerging understanding of how bone water changes in various conditions, of which aging, chronic kidney disease, diabetes, osteoporosis, and osteogenesis imperfecta are reviewed. Finally, it summarizes work focused on therapeutically targeting water to improve mechanical properties.
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Affiliation(s)
- Rachel K. Surowiec
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, United States
| | - Matthew R. Allen
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, United States
- Roudebush Veterans Administration Medical Center, Indianapolis, IN, United States
| | - Joseph M. Wallace
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, United States
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16
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Berman AG, Damrath JG, Hatch J, Pulliam AN, Powell KM, Hinton M, Wallace JM. Effects of Raloxifene and tibial loading on bone mass and mechanics in male and female mice. Connect Tissue Res 2022; 63:3-15. [PMID: 33427519 PMCID: PMC8272732 DOI: 10.1080/03008207.2020.1865938] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose: Raloxifene (RAL) is a selective estrogen receptor modulator (SERM) that has previously been shown to cause acellular benefits to bone tissue. Due to these improvements, RAL was combined with targeted tibial loading to assess if RAL treatment during periods of active bone formation would allow for further mechanical enhancements.Methods: Structural, mechanical, and microstructural effects were assessed in bone from C57BL/6 mice that were treated with RAL (0.5 mg/kg), tibial loading, or both for 6 weeks, beginning at 10 weeks of age.Results:Ex vivo microcomputed tomography (CT) images indicated RAL and loading work together to improve bone mass and architecture, especially within the cancellous region of males. Increases in cancellous bone volume fraction were heavily driven by increases in trabecular thickness, though there were some effects on trabecular spacing and number. In the cortical regions, RAL and loading both increased cross-sectional area, cortical area, and cortical thickness. Whole-bone mechanical testing primarily indicated the effects of loading. Further characterization through Raman spectroscopy and nanoindentation showed load-based changes in mineralization and micromechanics, while both loading and RAL caused changes in the secondary collagen structure. In contrast to males, in females, there were large load-based effects in the cancellous and cortical regions, resulting in increased whole-bone mechanical properties. RAL had less of an effect on cancellous and cortical architecture, though some effects were still present.Conclusion: RAL and loading work together to impact bone architecture and mechanical integrity, leading to greater improvements than either treatment individually.
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Affiliation(s)
- Alycia G. Berman
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - John G. Damrath
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Jennifer Hatch
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Alexis N. Pulliam
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Katherine M. Powell
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Madicyn Hinton
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Joseph M. Wallace
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA,Corresponding Author Joseph M. Wallace, Ph.D., Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA, , +1-317-274-2448
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17
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Frank M, Grabos A, Reisinger AG, Burr DB, Pahr DH, Allen MR, Thurner PJ. Effects of anti-resorptive treatment on the material properties of individual canine trabeculae in cyclic tensile tests. Bone 2021; 150:115995. [PMID: 33940224 DOI: 10.1016/j.bone.2021.115995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/25/2021] [Accepted: 04/28/2021] [Indexed: 01/22/2023]
Abstract
Osteoporosis is defined as a decrease of bone mass and strength, as well as an increase in fracture risk. It is conventionally treated with antiresorptive drugs, such as bisphosphonates (BPs) and selective estrogen receptor modulators (SERMs). Although both drug types successfully decrease the risk of bone fractures, their effect on bone mass and strength is different. For instance, BP treatment causes an increase of bone mass, stiffness and strength of whole bones, whereas SERM treatment causes only small (4%) increases of bone mass, but increased bone toughness. Such improved mechanical behavior of whole bones can be potentially related to the bone mass, bone structure or material changes. While bone mass and architecture have already been investigated previously, little is known about the mechanical behavior at the tissue/material level, especially of trabecular bone. As such, the goal of the work presented here was to fill this gap by performing cyclic tensile tests in a wet, close to physiologic environment of individual trabeculae retrieved from the vertebrae of beagle dogs treated with alendronate (a BP), raloxifene (a SERM) or without treatments. Identification of material properties was performed with a previously developed rheological model and of mechanical properties via fitting of envelope curves. Additionally, tissue mineral density (TMD) and microdamage formation were analyzed. Alendronate treatment resulted in a higher trabecular tissue stiffness and strength, associated with higher levels of TMD. In contrast, raloxifene treatment caused a higher trabecular toughness, pre-dominantly in the post-yield region. Microdamage formation during testing was not affected by either anti-resorptive treatment regimens. These findings highlight that the improved mechanical behavior of whole bones after anti-resorptive treatment is at least partly caused by improved material properties, with different mechanisms for alendronate and raloxifene. This study further shows the power of performing a mechanical characterization of trabecular bone at the level of individual trabeculae for better understanding of clinically relevant mechanical behavior of bone.
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Affiliation(s)
- Martin Frank
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Gumpendorfer Straße 7, 1060 Vienna, Austria.
| | - Andreas Grabos
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Gumpendorfer Straße 7, 1060 Vienna, Austria; Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, 340 West 10th Street Fairbanks Hall, Suite 6200, Indianapolis, USA
| | - Andreas G Reisinger
- Department of Anatomy and Biomechanics, Division Biomechanics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria.
| | - David B Burr
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, 340 West 10th Street Fairbanks Hall, Suite 6200, Indianapolis, USA.
| | - Dieter H Pahr
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Gumpendorfer Straße 7, 1060 Vienna, Austria; Department of Anatomy and Biomechanics, Division Biomechanics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria.
| | - Matthew R Allen
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, 340 West 10th Street Fairbanks Hall, Suite 6200, Indianapolis, USA.
| | - Philipp J Thurner
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Gumpendorfer Straße 7, 1060 Vienna, Austria.
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Eby MR, Cristino DM, Counihan M, Masada KM, Ahn J, Hast MW. Immersion in Raloxifene does not significantly improve bone toughness or screw pull-out strength in multiple in vitro models. BMC Musculoskelet Disord 2021; 22:468. [PMID: 34022860 PMCID: PMC8141119 DOI: 10.1186/s12891-021-04342-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Failure of surgical fixation in orthopaedic fractures occurs at a significantly higher rate in osteoporotic patients due to weakened osteoporotic bone. A therapy to acutely improve the mechanical properties of bone during fracture repair would have profound clinical impact. A previous study has demonstrated an increase in mechanical properties of acellular cortical canine bone after immersion in raloxifene. The goal of this study was to determine if similar treatment yields the same results in cancellous fetal bovine bone and whether this translates into a difference in screw pull-out strength in human cadaveric tissue. METHODS Cancellous bone from fetal bovine distal femora underwent quasi-static four-point bending tests after being immersed in either raloxifene (20 μM) or phosphate-buffered saline as a control for 7 days (n = 10). Separately, 5 matched pairs of human osteoporotic cadaveric humeral heads underwent the same procedure. Five 3.5 mm unicortical cancellous screws were then inserted at standard surgical fixation locations to a depth of 30 mm and quasi-static screw pull-out tests were performed. RESULTS In the four-point bending tests, there were no significant differences between the raloxifene and control groups for any of the mechanical properties - including stiffness (p = 0.333) and toughness (p = 0.546). In the screw pull-out tests, the raloxifene soaked samples and control samples had pullout strengths of 122 ± 74.3 N and 89.5 ± 63.8 N, respectively. CONCLUSIONS Results from this study indicate that cancellous fetal bovine samples did not demonstrate an increase in toughness with raloxifene treatment, which is in contrast to previously published data that studied canine cortical bone. In vivo experiments are likely required to determine whether raloxifene will improve implant fixation.
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Affiliation(s)
- Michael R Eby
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Danielle M Cristino
- Biedermann Lab for Orthopaedic Research, University of Pennsylvania, 3450 Hamilton Walk, 373A Stemmler Hall, Philadelphia, PA, 19104, USA
| | - Matthew Counihan
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Kendall M Masada
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jaimo Ahn
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Michael W Hast
- Biedermann Lab for Orthopaedic Research, University of Pennsylvania, 3450 Hamilton Walk, 373A Stemmler Hall, Philadelphia, PA, 19104, USA.
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19
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Tastad CA, Kohler R, Wallace JM. Limited impacts of thermoneutral housing on bone morphology and mechanical properties in growing female mice exposed to external loading and raloxifene treatment. Bone 2021; 146:115889. [PMID: 33618075 PMCID: PMC8009860 DOI: 10.1016/j.bone.2021.115889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/29/2022]
Abstract
Thermoregulation is an important factor that could have physiological consequences on pre-clinical research outcomes. Simply housing mice at thermoneutral temperature has been shown to prevent the well-established loss of cancellous bone that is typical in growing mice. In this study, active tissue formation was induced by non-invasive tibial loading in female mice and combined with raloxifene treatment to assess whether temperature could enhance their combined effects on bone morphology and mechanical properties. It was hypothesized that by removing the cold stress under which normal lab mice are housed, a metabolic boost would allow for further architectural and mechanical improvements in mice exposed to a combination of tibial loading and raloxifene. Ten-week old female C57BL/6J mice were treated with raloxifene, underwent tibial loading to a maximum tensile stress of 2050 με, and were housed in thermoneutral conditions (32 °C) for 6 weeks. We investigated bone morphology through microcomputed tomography (μCT), mechanical properties via four-point bending, and fracture toughness testing. Results confirmed previous work showing a combined effect of external loading and raloxifene which led to greater improvements in most properties than either individual treatment. Counter to the hypothesis, temperature had modest effects on body weight, overall bone size, and trabecular architecture, and most effects were detrimental. Thermoneutrality had no impact on mechanical integrity or fracture toughness. In most cases, the magnitude of temperature-based effects were less robust than either RAL treatment or loading.
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Affiliation(s)
- Carli A Tastad
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Rachel Kohler
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Joseph M Wallace
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA.
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20
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Abstract
PURPOSE OF REVIEW Osteoporosis is commonly diagnosed through the clinical assessment of bone quantity using bone mineral density; however, the primary clinical concern is bone fragility. Bone fragility is determined by both bone quantity and bone quality. Over the past decade, the gut microbiome has emerged as a factor that can regulate diseases throughout the body. This review discusses how microbial organisms and their genetic products that inhabit the gastrointestinal tract influence bone quantity, bone quality, and bone strength. RECENT FINDINGS Recent studies have shown that the gut microbiome regulates bone loss during estrogen depletion and glucocorticoid treatment. A series of studies has also shown that the gut microbiome influences whole bone strength by modifying bone tissue quality. The possible links between the gut microbiome and bone tissue quality are discussed focusing on the effects of microbiome-derived vitamin K. We provide a brief introduction to the gut microbiome and how modifications to the gut microbiome may lead to changes in bone. The gut microbiome is a promising target for new therapeutic approaches that address bone quality in ways not possible with current interventions.
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Affiliation(s)
- Macy Castaneda
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, 124 Hoy Road, 355 Upson Hall, Ithaca, NY, 14850, USA
| | - Jasmin M Strong
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, 124 Hoy Road, 355 Upson Hall, Ithaca, NY, 14850, USA
| | - Denise A Alabi
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, 124 Hoy Road, 355 Upson Hall, Ithaca, NY, 14850, USA
| | - Christopher J Hernandez
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, 124 Hoy Road, 355 Upson Hall, Ithaca, NY, 14850, USA.
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21
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Du T, Sun R, Li L, Ebuzoeme C, Bui D, Zheng Z, Yin T, Liang D, Hu M, Gao S. Development and validation of ultra-high-performance liquid chromatography-mass spectrometry method for the determination of raloxifene and its phase II metabolites in plasma: Application to pharmacokinetic studies in rats. J Sep Sci 2020; 43:4414-4423. [PMID: 33119204 DOI: 10.1002/jssc.202000835] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/06/2020] [Accepted: 10/16/2020] [Indexed: 12/11/2022]
Abstract
The aim of this study is to establish a reliable liquid chromatography-mass spectrometry method to simultaneously quantitate raloxifene, and its major metabolites, raloxifene-6-glucuronide, raloxifene-4'-glucuronide, and raloxifene-6-sulfate in rat plasma samples for pharmacokinetic studies. The separation of the analytes was achieved on a Waters BEH C18 column. Water (0.1% formic acid) and acetonitrile were used as the mobile phases for elution. A one-step protein precipitation using a mixture solvent was applied for plasma sample preparation. The method was validated following the FDA guidance. The results showed that the linear range were 1.95-1000 nM for raloxifene-6-glucuronide, and raloxifene-4'-glucuronide, 0.195-100 nM for raloxifene-6-sulfate, and 0.195-200 nM for raloxifene, respectively. The lower limit of quantification was 1.95, 1.95, 0.195, and 0.195 nM for raloxifene-6-glucuronide, raloxifene-4'-glucuronide, raloxifene-6-sulfate, and raloxifene, respectively. Only 20 µl of plasma sample was required since the method is sensitive. The intra- and interday variance is <15% and the accuracy is within 85-115%. The variance of matrix effect and recovery were <15%. The method was successfully applied in a pharmacokinetic study in rats with oral administration of raloxifene.
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Affiliation(s)
- Ting Du
- Department of Pharmaceutical and Environmental Health Sciences, College of Pharmacy and Health sciences, Texas Southern University, Houston, Texas, USA
| | - Rongjin Sun
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, The University of Houston, Houston, Texas, USA
| | - Li Li
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, The University of Houston, Houston, Texas, USA
| | - Christabel Ebuzoeme
- Department of Pharmaceutical and Environmental Health Sciences, College of Pharmacy and Health sciences, Texas Southern University, Houston, Texas, USA
| | - Dinh Bui
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, The University of Houston, Houston, Texas, USA
| | - Zicong Zheng
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, The University of Houston, Houston, Texas, USA
| | - Taijun Yin
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, The University of Houston, Houston, Texas, USA
| | - Dong Liang
- Department of Pharmaceutical and Environmental Health Sciences, College of Pharmacy and Health sciences, Texas Southern University, Houston, Texas, USA
| | - Ming Hu
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, The University of Houston, Houston, Texas, USA
| | - Song Gao
- Department of Pharmaceutical and Environmental Health Sciences, College of Pharmacy and Health sciences, Texas Southern University, Houston, Texas, USA
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22
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Luo P, Shi W, Wang Y, Ma H, Liu T, Yan D, Huo S, Guo J, Wang M, Li C, Lin J, Zhang C, Li S, Lv J, Lin L. Raloxifene inhibits IL-6/STAT3 signaling pathway and protects against high-fat-induced atherosclerosis in ApoE -/- mice. Life Sci 2020; 261:118304. [PMID: 32828944 DOI: 10.1016/j.lfs.2020.118304] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 08/06/2020] [Accepted: 08/17/2020] [Indexed: 12/11/2022]
Abstract
AIMS The signal transducer and activator of transcription 3 (STAT3) pathway plays an important role in inflammatory cascade process. Our previous studies found that Raloxifene targeted against IL-6/GP130 protein-protein interface and inhibited STAT3 phosphorylation induced by IL-6 in cancer cells. However, whether Raloxifene could suppress IL-6/STAT3 signaling pathway and attenuate atherosclerosis in high-fat diet (HFD)-induced mice remains unknown. The objective of this study was to explore the potential effect of Raloxifene on the prevention of atherosclerosis. MAIN METHODS HFD-induced atherosclerosis was established in apoliprotein E-deficient (ApoE -/-) mice. Mice by daily intragastric gavage with Raloxifene or vehicle as controls were provided. The human umbilical vein endothelial cells (HUVEC), Rat VSMC and RAW264.7 cell lines were used to evaluate the effect of Raloxifene in vitro. KEY FINDINGS We demonstrated that Raloxifene was effective in ameliorating HFD- induced atherosclerosis plaque burden and size. Histological analysis showed that the expression of IL-6, P-STAT3, ICAM-1, VCAM-1, CD68 and α-SMA were significantly decreased in the Raloxifene intervention group compared to HFD group. Moreover, we observed that IL-6 increased migration and cell viability of VSMCs and RAW264.7 cells, while Raloxifene treatment decreased migration and reduced cell viability of VSMCs and RAW264.7 cells stimulated by IL-6. Furthermore, this effect was related to blocking IL-6/STAT3 pathway. SIGNIFICANCE Raloxifene has effects on inhibiting atherosclerosis development, the underlying mechanisms might involve in inhibiting inflammation-related IL-6/STAT3 signaling pathway.
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Affiliation(s)
- Pengcheng Luo
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yina Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haiyan Ma
- Division of Cardiology, Department of Internal Medicine, First People's Hospital of ShangQiu, Shangqiu, China
| | - Tianshu Liu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Yan
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shengqi Huo
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junyi Guo
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Moran Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chenglong Li
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Jiayuh Lin
- Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Li
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiagao Lv
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Li Lin
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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23
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6'-Methoxy Raloxifene-analog enhances mouse bone properties with reduced estrogen receptor binding. Bone Rep 2020; 12:100246. [PMID: 32016137 PMCID: PMC6992940 DOI: 10.1016/j.bonr.2020.100246] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 02/08/2023] Open
Abstract
Raloxifene (RAL) is an FDA-approved drug used to treat osteoporosis in postmenopausal women. RAL suppresses bone loss primarily through its role as a selective estrogen receptor modulator (SERM). This hormonal estrogen therapy promotes unintended side effects, such as hot flashes and increased thrombosis risk, and prevents the drug from being used in some patient populations at-risk for fracture, including children with bone disorders. It has recently been demonstrated that RAL can have significant positive effects on overall bone mechanical properties by binding to collagen and increasing bone tissue hydration in a cell-independent manner. A Raloxifene-Analog (RAL-A) was synthesized by replacing the 6-hydroxyl substituent with 6-methoxy in effort to reduce the compound's binding affinity for estrogen receptors (ER) while maintaining its collagen-binding ability. It was hypothesized that RAL-A would improve the mechanical integrity of bone in a manner similar to RAL, but with reduced estrogen receptor binding. Molecular assessment showed that while RAL-A did reduce ER binding, downstream ER signaling was not completely abolished. In-vitro, RAL-A performed similarly to RAL and had an identical concentration threshold on osteocyte cell proliferation, differentiation, and function. To assess treatment effect in-vivo, wildtype (WT) and heterozygous (OIM+/−) female mice from the Osteogenesis Imperfecta (OI) murine model were treated with either RAL or RAL-A from 8 weeks to 16 weeks of age. There was an untreated control group for each genotype as well. Bone microarchitecture was assessed using microCT, and mechanical behavior was assessed using 3-point bending. Results indicate that both compounds produced analogous gains in tibial trabecular and cortical microarchitecture. While WT mechanical properties were not drastically altered with either treatment, OIM+/− mechanical properties were significantly enhanced, most notably, in post-yield properties including bone toughness. This proof-of-concept study shows promising results and warrants the exploration of additional analog iterations to further reduce ER binding and improve fracture resistance.
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24
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Creecy A, Uppuganti S, Girard MR, Schlunk SG, Amah C, Granke M, Unal M, Does MD, Nyman JS. The age-related decrease in material properties of BALB/c mouse long bones involves alterations to the extracellular matrix. Bone 2020; 130:115126. [PMID: 31678497 PMCID: PMC6885131 DOI: 10.1016/j.bone.2019.115126] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/28/2022]
Abstract
One possibility for the disproportionate increase in fracture risk with aging relative to the decrease in bone mass is an accumulation of changes to the bone matrix which deleteriously affect fracture resistance. In order to effectively develop new targets for osteoporosis, a preclinical model of the age-related loss in fracture resistance needs to be established beyond known age-related decreases in bone mineral density and bone volume fraction. To that end, we examined long bones of male and female BALB/c mice at 6-mo. and 20-mo. of age and assessed whether material and matrix properties of cortical bone significantly differed between the age groups. The second moment of area of the diaphysis (minimum and maximum principals for femur and radius, respectively) as measured by ex vivo micro-computed tomography (μCT) was higher at 20-mo. than at 6-mo. for both males and females, but ultimate moment as measured by three-point bending tests did not decrease with age. Cortical thickness was lower with age for males, but higher for old females. Partially accounting for differences in structure, material estimates of yield, ultimate stress, and toughness (left femur) were 12.6%, 11.1%, and 40.9% lower, respectively, with age for both sexes. The ability of the cortical bone to resist crack growth (right femur) was also 18.1% less for the old than for the young adult mice. These decreases in material properties were not due to changes in intracortical porosity as pore number decreased with age. Rather, age-related alterations in the matrix were observed for both sexes: enzymatic and non-enzymatic crosslinks by high performance liquid chromatography increased (femur), volume fraction of bound water by 1H-nuclear magnetic resonance relaxometry decreased (femur), cortical tissue mineral density by μCT increased (femur and radius), and an Amide I sub-peak ratio I1670/I1640 by Raman spectroscopy increased (tibia). Overall, there are multiple matrix changes to potentially target that could prevent the age-related decrease in fracture resistance observed in BALB/c mouse.
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Affiliation(s)
- Amy Creecy
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Madeline R Girard
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States
| | - Siegfried G Schlunk
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States
| | - Chidi Amah
- Meharry Medical College, Nashville, TN 37208, United States
| | - Mathilde Granke
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Mustafa Unal
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Department of Mechanical Engineering, Karamanoglu Mehmetbey University, Karaman, 70100, Turkey
| | - Mark D Does
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States
| | - Jeffry S Nyman
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, United States; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, United States.
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25
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Burr DB. Stress concentrations and bone microdamage: John Currey's contributions to understanding the initiation and arrest of cracks in bone. Bone 2019; 127:517-525. [PMID: 31344476 DOI: 10.1016/j.bone.2019.07.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/10/2019] [Accepted: 07/13/2019] [Indexed: 12/28/2022]
Abstract
The microarchitecture of bone tissue presents many features that could act as stress concentrators for the initiation of bone microdamage. This was first identified by John Currey in a seminal paper in 1962 in which he presented the mechanical and biological evidence for stress concentrations at the bone surface, within the bone through the action of stiffness differentials between architectural features including between lamellae, and at the level of the lacunar and canalicular walls. Those early observations set the stage to consider how microscopic damage to bone tissue might affect the properties of bone at a time when most in the scientific community dismissed microcracks in bone as artifact. Evidence collected in the nearly 60 years since those important initial observations suggest that some of these architectural features in bone tissue are more effective as crack arrestors than as crack initiators. Sites of higher mineralization in the bone matrix, particularly interstitial sites in both cortical and trabecular bone, may serve preferentially as locations for crack initiation, whereas those boundaries identified by Currey as both stress concentrators and stress arrestors are more effective at stopping cracks than at initiating them.
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Affiliation(s)
- David B Burr
- Dept. of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America; Dept. of Biomedical Engineering, Indiana University-Purdue University, Indianapolis (IUPUI), Indianapolis, IN 46202, United States of America.
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26
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Powell KM, Skaggs C, Pulliam A, Berman A, Allen MR, Wallace JM. Zoledronate and Raloxifene combination therapy enhances material and mechanical properties of diseased mouse bone. Bone 2019; 127:199-206. [PMID: 31233931 PMCID: PMC7036744 DOI: 10.1016/j.bone.2019.06.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 01/15/2023]
Abstract
Current interventions to reduce skeletal fragility are insufficient at enhancing both the quantity and quality of bone when attempting to improve overall mechanical integrity. Bisphosphonates, such as Zoledronate (ZOL), are used to treat a variety of bone disorders by increasing bone mass to decrease fracture risk, but long-term use has been shown in some settings to compromise bone quality. Alternatively, Raloxifene (RAL) has recently been demonstrated to improve tissue quality and overall mechanical properties in a cell-independent manner by binding to collagen and increasing tissue hydration. We hypothesized that a combination of RAL and ZOL would improve mechanical and material properties of bone more than either monotherapy alone by enhancing both quantity and quality. In this study, wildtype (WT) and heterozygous (OIM+/-) male mice from the Osteogenesis Imperfecta (OI) murine model were treated with either RAL, ZOL, or both from 8 weeks to 16 weeks of age. Using the OIM model allows for investigation of therapeutic effects on a quality-based bone disease. Combination treatment resulted in higher trabecular architecture, cortical mechanical properties, and cortical fracture toughness in diseased mouse bone. Two fracture toughness properties, which are direct measures of the tissue's ability to resist the initiation and propagation of a crack, were significantly improved with combination treatment in OIM+/- compared to control. There was no significant effect on fracture toughness with either monotherapy alone in either genotype. Following the mass-based effects of ZOL, trabecular bone volume fraction was significantly higher with combination treatment in both genotypes. Combination treatment resulted in higher ultimate stress in both genotypes. RAL and combination treatment in OIM+/- also increased resilience compared to the control. In conclusion, this study demonstrates the beneficial effects of using combination drug treatments to increase bone mass while simultaneously improving tissue quality, especially to enhance the mechanical integrity of diseased bone. Combination therapies could be a potential method to improve bone health and combat skeletal fragility on both the microscopic and macroscopic levels.
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Affiliation(s)
- Katherine M Powell
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Cayla Skaggs
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Alexis Pulliam
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Alycia Berman
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Matthew R Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Joseph M Wallace
- Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA.
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27
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Environmentally-Controlled Near Infrared Spectroscopic Imaging of Bone Water. Sci Rep 2019; 9:10199. [PMID: 31308386 PMCID: PMC6629628 DOI: 10.1038/s41598-019-45897-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/13/2019] [Indexed: 12/17/2022] Open
Abstract
We have designed an environmentally-controlled chamber for near infrared spectroscopic imaging (NIRSI) to monitor changes in cortical bone water content, an emerging biomarker related to bone quality assessment. The chamber is required to ensure repeatable spectroscopic measurements of tissues without the influence of atmospheric moisture. A calibration curve to predict gravimetric water content from human cadaveric cortical bone was created using NIRSI data obtained at six different lyophilization time points. Partial least squares (PLS) models successfully predicted bone water content that ranged from 0–10% (R = 0.96, p < 0.05, root mean square error of prediction (RMSEP) = 7.39%), as well as in the physiologic range of 4–10% of wet tissue weight (R = 0.87, p < 0.05, RMSEP = 14.5%). Similar results were obtained with univariate and bivariate regression models for prediction of water in the 0–10% range. Further, we identified two new NIR bone absorbances, at 6560 cm−1 and 6688 cm−1, associated with water and collagen respectively. Such data will be useful in pre-clinical studies that investigate changes in bone quality with disease, aging and with therapeutic use.
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28
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Park J, Fertala A, Tomlinson RE. Naproxen impairs load-induced bone formation, reduces bone toughness, and diminishes woven bone formation following stress fracture in mice. Bone 2019; 124:22-32. [PMID: 30998998 DOI: 10.1016/j.bone.2019.04.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/01/2019] [Accepted: 04/14/2019] [Indexed: 01/17/2023]
Abstract
Debilitating stress fractures are surprisingly common in physically active individuals, including athletes, military recruits, and dancers. These individuals are overrepresented in the 30 million daily users of non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesized that regular use of NSAIDs would predispose habitually loaded bones to stress fracture and delay the repair of these injuries. In this project, we used repetitive axial forelimb compression in mice as a model to test these hypotheses. First, adult mice were subjected to six bouts of forelimb compression over a period of two weeks, with aspirin, naproxen, or vehicle continuously administered through drinking water. Naproxen-treated mice had diminished load-induced bone formation as well as a significant loss in toughness in non-loaded bone, which were not observed in aspirin-treated mice. Furthermore, there were no differences in RANKL/OPG ratio or cortical bone parameters. Picrosirius red staining and second harmonic generation imaging revealed that alterations in bone collagen fibril size and organization were driving the loss of toughness in naproxen-treated mice. Separately, adult mice were subjected to an ulnar stress fracture generated by a single bout of fatigue loading, with NSAIDs provided 24 h before injury. Both aspirin-treated and naproxen-treated mice had normal forelimb use in the week after injury, whereas control mice favored the injured forelimb until day 7. However, woven bone volume was only significantly impaired by naproxen. Both NSAIDs were found to significantly inhibit Ptgs2 and Ngf expression following stress fracture, but only naproxen significantly affected serum PGE2 concentration. Overall, our results suggest that naproxen, but not aspirin, may increase the risk of stress fracture and extend the healing time of these injuries, warranting further clinical evaluation for patients at risk for fatigue injuries.
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Affiliation(s)
- Jino Park
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Andrzej Fertala
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Ryan E Tomlinson
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Groetsch A, Gourrier A, Schwiedrzik J, Sztucki M, Beck RJ, Shephard JD, Michler J, Zysset PK, Wolfram U. Compressive behaviour of uniaxially aligned individual mineralised collagen fibres at the micro- and nanoscale. Acta Biomater 2019; 89:313-329. [PMID: 30858052 DOI: 10.1016/j.actbio.2019.02.053] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/21/2019] [Accepted: 02/28/2019] [Indexed: 12/17/2022]
Abstract
The increasing incidence of osteoporotic bone fractures makes fracture risk prediction an important clinical challenge. Computational models can be utilised to facilitate such analyses. However, they critically depend on bone's underlying hierarchical material description. To understand bone's irreversible behaviour at the micro- and nanoscale, we developed an in situ testing protocol that allows us to directly relate the experimental data to the mechanical behaviour of individual mineralised collagen fibres and its main constitutive phases, the mineralised collagen fibrils and the mineral nanocrystals, by combining micropillar compression of single fibres with small angle X-ray scattering (SAXS) and X-ray diffraction (XRD). Failure modes were assessed by SEM. Strain ratios in the elastic region at fibre, fibril and mineral levels were found to be approximately 22:5:2 with strain ratios at the point of compressive strength of 0.23 ± 0.11 for fibril-to-fibre and 0.07 ± 0.01 for mineral-to-fibre levels. Mineral-to-fibre levels showed highest strain ratios around the apparent yield point, fibril-to-fibre around apparent strength. The mineralised collagen fibrils showed a delayed mechanical response, contrary to the mineral phase, which points towards preceding deformations of mineral nanocrystals in the extrafibrillar matrix. No damage was measured at the level of the mineralised collagen fibre which indicates an incomplete separation of the mineral and collagen, and an extrafibrillar interface failure. The formation of kink bands and the gradual recruitment of fibrils upon compressive loading presumably led to localised strains. Our results from a well-controlled fibrillar architecture provide valuable input for micromechanical models and computational non-linear bone strength analyses that may provide further insights for personalised diagnosis and treatment as well as bio-inspired implants for patients with bone diseases. STATEMENT OF SIGNIFICANCE: Musculoskeletal diseases such as osteoporosis, osteoarthritis or bone cancer significantly challenge health care systems and make fracture risk prediction and treatment optimisation important clinical goals. Computational methods such as finite element models have the potential to optimise analyses but highly depend on underlying material descriptions. We developed an in situ testing set-up to directly relate experimental data to the mechanical behaviour of bone's fundamental building block, the individual mineralised collagen fibre and its main constituents. Low multilevel strain ratios suggest high deformations in the extrafibrillar matrix and energy dissipation at the interfaces, the absence of damage indicates both an incomplete separation between mineral and collagen and an extrafibrillar interface failure. The formation of kink bands in the fibril-reinforced composite presumably led to localised strains. The deformation behaviour of a well-controlled fibrillar architecture provides valuable input for non-linear bone strength analyses.
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Affiliation(s)
- Alexander Groetsch
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | | | - Jakob Schwiedrzik
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory of Mechanics of Materials and Nanostructures, Thun, Switzerland
| | - Michael Sztucki
- European Synchrotron Radiation Facility (ESRF), F-38043 Grenoble Cedex, France
| | - Rainer J Beck
- Institute of Photonics and Quantum Sciences, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | - Jonathan D Shephard
- Institute of Photonics and Quantum Sciences, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | - Johann Michler
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory of Mechanics of Materials and Nanostructures, Thun, Switzerland
| | - Philippe K Zysset
- Institute for Surgical Technology and Biomechanics, University of Bern, Switzerland
| | - Uwe Wolfram
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK.
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Ramchand SK, Seeman E. Advances and Unmet Needs in the Therapeutics of Bone Fragility. Front Endocrinol (Lausanne) 2018; 9:505. [PMID: 30237785 PMCID: PMC6135909 DOI: 10.3389/fendo.2018.00505] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/10/2018] [Indexed: 01/22/2023] Open
Abstract
The prevalence of fragility fractures increases as longevity increases the proportion of the elderly in the community. Until recently, the majority of studies have targeted women with osteoporosis defined as a bone mineral density (BMD) T score of < -2.5 SD, despite evidence that the population burden of fractures arises from women with osteopenia. Antiresorptive agents reduce vertebral and hip fracture risk by ~50 percent during 3 years but efficacy against non-vertebral fractures, 80% of all fractures in the community, is reported in few studies, and of those, the risk reduction is only 20-30%. Recent advances in the use of antiresorptives and anabolic agents has addressed some of these unmet needs. Zoledronic acid is now reported to reduce vertebral and non-vertebral fractures rates in women with osteopenia. Studies using teriparatide demonstrate better vertebral and clinical (symptomatic vertebral and non-vertebral) antifracture efficacy than risedronate. Abaloparatide, a peptide sharing amino acid sequences with teriparatide, reduces vertebral and non-vertebral fractures. Romosozumab, a monoclonal antibody suppressing sclerostin, reduces vertebral and non-vertebral fractures within a year of starting treatment, and does so more greatly than alendronate. Some recent studies signal undesirable effects of therapy but provide essential cautionary insights into long term management. Cessation of denosumab is associated with a rapid increase in bone remodeling and the uncommon but clinically important observation of increased multiple vertebral fractures suggesting the need to start alternative anti-resorptive therapy around the time of stopping denosumab. Antiresorptives like bisphosphonates and denosumab suppress remodeling but not completely. Antifracture efficacy may be limited, in part, as a consequence of continued unsuppressed remodeling, particularly in cortical bone. Bisphosphonates may not distribute in deeper cortical bone, so unbalanced intracortical remodeling continues to cause microstructural deterioration. In addition, suppressed remodeling may compromise the material composition by increasing matrix mineral density and glycosylation of collagen. As antiresorptive agents do not restore microstructural deterioration existing at the time of starting treatment, under some circumstances, anabolic therapy may be more appropriate first line treatment. Combining antiresorptive and anabolic therapy is an alternative but whether anti-fracture efficacy is greater than that achieved by either treatment alone is not known.
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Affiliation(s)
- Sabashini K. Ramchand
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
- Department of Endocrinology, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Ego Seeman
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
- Department of Endocrinology, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
- Mary Mackillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia
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Xi L, De Falco P, Barbieri E, Karunaratne A, Bentley L, Esapa CT, Terrill NJ, Brown SDM, Cox RD, Davis GR, Pugno NM, Thakker RV, Gupta HS. Bone matrix development in steroid-induced osteoporosis is associated with a consistently reduced fibrillar stiffness linked to altered bone mineral quality. Acta Biomater 2018; 76:295-307. [PMID: 29902593 PMCID: PMC6084282 DOI: 10.1016/j.actbio.2018.05.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/14/2018] [Accepted: 05/31/2018] [Indexed: 01/24/2023]
Abstract
Glucocorticoid-induced osteoporosis (GIOP) is a major secondary form of osteoporosis, with the fracture risk significantly elevated - at similar levels of bone mineral density - in patients taking glucocorticoids compared with non-users. The adverse bone structural changes at multiple hierarchical levels in GIOP, and their mechanistic consequences leading to reduced load-bearing capacity, are not clearly understood. Here we combine experimental X-ray nanoscale mechanical imaging with analytical modelling of the bone matrix mechanics to determine mechanisms causing bone material quality deterioration during development of GIOP. In situ synchrotron small-angle X-ray diffraction combined with tensile testing was used to measure nanoscale deformation mechanisms in a murine model of GIOP, due to a corticotrophin-releasing hormone promoter mutation, at multiple ages (8-, 12-, 24- and 36 weeks), complemented by quantitative micro-computed tomography and backscattered electron imaging to determine mineral concentrations. We develop a two-level hierarchical model of the bone matrix (mineralized fibril and lamella) to predict fibrillar mechanical response as a function of architectural parameters of the mineralized matrix. The fibrillar elastic modulus of GIOP-bone is lower than healthy bone throughout development, and nearly constant in time, in contrast to the progressively increasing stiffness in healthy bone. The lower mineral platelet aspect ratio value for GIOP compared to healthy bone in the multiscale model can explain the fibrillar deformation. Consistent with this result, independent measurement of mineral platelet lengths from wide-angle X-ray diffraction finds a shorter mineral platelet length in GIOP. Our results show how lowered mineralization combined with altered mineral nanostructure in GIOP leads to lowered mechanical competence. SIGNIFICANCE STATEMENT Increased fragility in musculoskeletal disorders like osteoporosis are believed to arise due to alterations in bone structure at multiple length-scales from the organ down to the supramolecular-level, where collagen molecules and elongated mineral nanoparticles form stiff fibrils. However, the nature of these molecular-level alterations are not known. Here we used X-ray scattering to determine both how bone fibrils deform in secondary osteoporosis, as well as how the fibril orientation and mineral nanoparticle structure changes. We found that osteoporotic fibrils become less stiff both because the mineral nanoparticles became shorter and less efficient at transferring load from collagen, and because the fibrils are more randomly oriented. These results will help in the design of new composite musculoskeletal implants for bone repair.
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Affiliation(s)
- L Xi
- School of Engineering and Material Sciences, Queen Mary University of London, London E1 4NS, UK; Department of Nuclear Engineering, North Carolina State University, Raleigh, NC 27607, USA
| | - P De Falco
- School of Engineering and Material Sciences, Queen Mary University of London, London E1 4NS, UK; Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, D-14424 Potsdam-Golm, Germany.
| | - E Barbieri
- School of Engineering and Material Sciences, Queen Mary University of London, London E1 4NS, UK; Department of Mathematical Science and Advanced Technology (MAT), Yokohama Institute for Earth Sciences (YES) 3173-25, Showa-machi, Kanazawa-ku, Yokohama-city, Japan.
| | - A Karunaratne
- Department of Mechanical Engineering, University of Moratuwa, Sri Lanka
| | - L Bentley
- MRC Mammalian Genetics Unit and Mary Lyon Centre, MRC Harwell, Harwell Science and Innovation Campus, OX11 0RD, UK.
| | - C T Esapa
- MRC Mammalian Genetics Unit and Mary Lyon Centre, MRC Harwell, Harwell Science and Innovation Campus, OX11 0RD, UK; Academic Endocrine Unit, Nuffield Department of Clinical Medicine, Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Churchill Hospital, Headington, Oxford OX3 7JL, UK.
| | - N J Terrill
- Beamline I22, Diamond Light Source Ltd., Diamond House, Harwell Science and Innovation Campus, Chilton, Didcot, Oxfordshire OX11 0DE, UK.
| | - S D M Brown
- MRC Mammalian Genetics Unit and Mary Lyon Centre, MRC Harwell, Harwell Science and Innovation Campus, OX11 0RD, UK.
| | - R D Cox
- MRC Mammalian Genetics Unit and Mary Lyon Centre, MRC Harwell, Harwell Science and Innovation Campus, OX11 0RD, UK.
| | - G R Davis
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Institute of Dentistry, E1 2AD, UK.
| | - N M Pugno
- Laboratory of Bio-Inspired & Graphene Nanomechanics, Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano, 77, 38123 Trento, Italy; School of Engineering and Material Sciences, Queen Mary University of London, London E1 4NS, UK; Ket Lab, Edoardo Amaldi Foundation, Italian Space Agency, Via del Politecnico snc, 00133 Rome, Italy.
| | - R V Thakker
- MRC Mammalian Genetics Unit and Mary Lyon Centre, MRC Harwell, Harwell Science and Innovation Campus, OX11 0RD, UK; Academic Endocrine Unit, Nuffield Department of Clinical Medicine, Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Churchill Hospital, Headington, Oxford OX3 7JL, UK.
| | - H S Gupta
- School of Engineering and Material Sciences, Queen Mary University of London, London E1 4NS, UK.
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Abstract
PURPOSE OF REVIEW While thinning of the cortices or trabeculae weakens bone, age-related changes in matrix composition also lower fracture resistance. This review summarizes how the organic matrix, mineral phase, and water compartments influence the mechanical behavior of bone, thereby identifying characteristics important to fracture risk. RECENT FINDINGS In the synthesis of the organic matrix, tropocollagen experiences various post-translational modifications that facilitate a highly organized fibril of collagen I with a preferred orientation giving bone extensibility and several toughening mechanisms. Being a ceramic, mineral is brittle but increases the strength of bone as its content within the organic matrix increases. With time, hydroxyapatite-like crystals experience carbonate substitutions, the consequence of which remains to be understood. Water participates in hydrogen bonding with organic matrix and in electrostatic attractions with mineral phase, thereby providing stability to collagen-mineral interface and ductility to bone. Clinical tools sensitive to age- and disease-related changes in matrix composition that the affect mechanical behavior of bone could potentially improve fracture risk assessment.
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Affiliation(s)
- Mustafa Unal
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37232, USA
| | - Amy Creecy
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA
| | - Jeffry S Nyman
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
- Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37232, USA.
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA.
- Vanderbilt Orthopedic Institute, Medical Center East, South Tower, Suite 4200, Nashville, TN, 37232, USA.
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33
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Shi P, Liu M, Fan F, Yu C, Lu W, Du M. Characterization of natural hydroxyapatite originated from fish bone and its biocompatibility with osteoblasts. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 90:706-712. [PMID: 29853142 DOI: 10.1016/j.msec.2018.04.026] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/23/2018] [Accepted: 04/12/2018] [Indexed: 02/07/2023]
Abstract
Hydroxyapatite (HAP) was very attractive for using as bone implant material for a long period due to the close similarity with natural bone in composition and osteoconductive properties. In this study, three kinds of natural HAP (nHAP) derived from rainbow trout (Onchorynchus mkiss), cod (Gadus) and salmon (Oncorhynchus keta) bones were prepared using thermal calcination method for the first time. Resultant nHAPs were characterized by fourier transform infrared spectroscopy (FT-IR), x-ray diffraction analysis (XRD), field-emission scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) analysis. Biocompatibility of calcined nHAP was evaluated through MTT cell viability assay and alkaline phosphatase activity experiment using mouse preosteoblast MC3T3-E1. Results of cell experiment indicated that the nHAP originated from rainbow trout and salmon bones showed better biological compatibility compared with the nHAP originated from cod bone and chemical synthetic HAP (cHAP). This is most likely attributed to the different element composition in nHAP, i.e., the nHAP derived from rainbow trout and salmon bones showed the presence of CO32- and Mg2+. Therefore, the nHAP originated from rainbow trout and salmon bones have a great potential for application as implant material substitute in bone tissue engineering and the natural waste fish bone product can be used for hydroxyapatite synthesis as a part of bio-waste management.
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Affiliation(s)
- Pujie Shi
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China; School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150090, China
| | - Meng Liu
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150090, China
| | - Fengjiao Fan
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China; School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150090, China
| | - Cuiping Yu
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China
| | - Weihong Lu
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150090, China
| | - Ming Du
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China.
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Odegard DT, Sonnenfelt MA, Bledsoe JG, Keenan SW, Hill CA, Warren DE. Changes in the material properties of the shell during simulated aquatic hibernation in the anoxia-tolerant painted turtle. J Exp Biol 2018; 221:jeb.176990. [DOI: 10.1242/jeb.176990] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/25/2018] [Indexed: 11/20/2022]
Abstract
Western painted turtles (Chrysemys picta bellii) tolerate anoxic submergence longer than any other tetrapod, surviving more than 170 days at 3°C. This ability is due, in part, to the shell and skeleton simultaneously releasing calcium and magnesium carbonates, and sequestering lactate and H+ to prevent lethal decreases in body fluid pH. We evaluated the effects of anoxic submergence at 3°C on various material properties of painted turtle bone after 60, 130, and 167-170 days, and compared them to normoxic turtles held at the same temperature for the same time periods. To assess changes in the mechanical properties, beams (4×25 mm) were milled from the plastron and broken in a three-point flexural test. Bone mineral density, CO2 concentration (a measure of total bone HCO3−/CO32-), and elemental composition were measured using microCT, HCO3−/CO32- titration, and inductively coupled plasma mass spectrometry (ICP-MS), respectively. Tissue mineral density of the sampled bone beams were not significantly altered by 167-170 days of aquatic overwintering in anoxic or normoxic water, but bone CO2 and Mg were depleted in anoxic compared normoxic turtles. At this time point, the plastron beams from anoxic turtles yielded at stresses that were significantly smaller and strains significantly greater than the plastron beams of normoxic turtles. When data from anoxic and normoxic turtles were pooled, plastron beams had a diminished elastic modulus after 167-170 days compared to control turtles sampled on Day 1, indicating an effect of prolonged housing of the turtles in 3°C water without access to basking sites. There were no changes in the mechanical properties of the plastron beams at any of the earlier time points in either group. We conclude that anoxic hibernation can weaken the painted turtle's plastron, but likely only after durations that exceed what it might naturally experience. The duration of aquatic overwintering, regardless of oxygenation state, is likely to be an important factor determining the mechanical properties of the turtle shell during spring emergence.
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Affiliation(s)
- Dean T. Odegard
- Department of Biology, Saint Louis University, St. Louis, MO 63103, USA
| | - Michael A. Sonnenfelt
- Department of Biomedical Engineering, Saint Louis University, St. Louis, MO 63103, USA
| | - J. Gary Bledsoe
- Department of Biomedical Engineering, Saint Louis University, St. Louis, MO 63103, USA
| | - Sarah W. Keenan
- Department of Biology, Saint Louis University, St. Louis, MO 63103, USA
| | - Craig A. Hill
- Department of Biology, Saint Louis University, St. Louis, MO 63103, USA
| | - Daniel E. Warren
- Department of Biology, Saint Louis University, St. Louis, MO 63103, USA
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Chen J, Ahn T, Colón-Bernal ID, Kim J, Banaszak Holl MM. The Relationship of Collagen Structural and Compositional Heterogeneity to Tissue Mechanical Properties: A Chemical Perspective. ACS NANO 2017; 11:10665-10671. [PMID: 29112404 DOI: 10.1021/acsnano.7b06826] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Collagen is the primary protein component in mammalian connective tissues. Over the last 20 years, evidence has mounted that collagen matrices exhibit substantial heterogeneity in their hierarchical structures and that this heterogeneity plays important roles in both structure and function. Herein, an overview of studies addressing the nanoscale compositional and structural heterogeneity is provided and connected to work exploring the mechanical implications for a number of tissues.
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Affiliation(s)
- Junjie Chen
- Department of Chemistry, ‡Macromolecular Science and Engineering, and §Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Taeyong Ahn
- Department of Chemistry, ‡Macromolecular Science and Engineering, and §Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Isabel D Colón-Bernal
- Department of Chemistry, ‡Macromolecular Science and Engineering, and §Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Jinhee Kim
- Department of Chemistry, ‡Macromolecular Science and Engineering, and §Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Mark M Banaszak Holl
- Department of Chemistry, ‡Macromolecular Science and Engineering, and §Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States
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Georgiadis M, Müller R, Schneider P. Techniques to assess bone ultrastructure organization: orientation and arrangement of mineralized collagen fibrils. J R Soc Interface 2017; 13:rsif.2016.0088. [PMID: 27335222 DOI: 10.1098/rsif.2016.0088] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/18/2016] [Indexed: 12/13/2022] Open
Abstract
Bone's remarkable mechanical properties are a result of its hierarchical structure. The mineralized collagen fibrils, made up of collagen fibrils and crystal platelets, are bone's building blocks at an ultrastructural level. The organization of bone's ultrastructure with respect to the orientation and arrangement of mineralized collagen fibrils has been the matter of numerous studies based on a variety of imaging techniques in the past decades. These techniques either exploit physical principles, such as polarization, diffraction or scattering to examine bone ultrastructure orientation and arrangement, or directly image the fibrils at the sub-micrometre scale. They make use of diverse probes such as visible light, X-rays and electrons at different scales, from centimetres down to nanometres. They allow imaging of bone sections or surfaces in two dimensions or investigating bone tissue truly in three dimensions, in vivo or ex vivo, and sometimes in combination with in situ mechanical experiments. The purpose of this review is to summarize and discuss this broad range of imaging techniques and the different modalities of their use, in order to discuss their advantages and limitations for the assessment of bone ultrastructure organization with respect to the orientation and arrangement of mineralized collagen fibrils.
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Affiliation(s)
| | - Ralph Müller
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Philipp Schneider
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland Bioengineering Science Research Group, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
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Raloxifene reduces the risk of local alveolar bone destruction in a mouse model of periodontitis combined with systemic postmenopausal osteoporosis. Arch Oral Biol 2017; 85:98-103. [PMID: 29035723 DOI: 10.1016/j.archoralbio.2017.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/22/2017] [Accepted: 09/24/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Periodontitis is characterized by local inflammation leading to tooth loss and severe destruction of alveolar bone. Raloxifene is a selective estrogen receptor modulator (SERM) that halts estrogen deficiency-induced systemic bone loss in postmenopausal osteoporosis without the side effects of cancer in breast and uterus. In this study, we examined the effects of raloxifene on alveolar bone mass in a mouse model with estrogen deficiency-induced periodontitis. METHODS Periodontitis was induced by the injection of lipopolysaccharide (LPS) into the lower gingiva in ovariectomized (OVX) mice, and the alveolar bone and femur bone mineral density (BMD) were analyzed by dual-energy X-ray absorptiometry. To explore the direct osteoclast inhibitory effect of raloxifene, a co-culture system for osteoclast formation and organ culture of alveolar bone was established. RESULTS When OVX mice were treated with raloxifene, the bone loss in both alveolar bone and femur were abrogated. Interleukin 1 and/or LPS stimulated the osteoclast formation and bone-resorbing activity; however, raloxifene did not show any inhibitory effect on the osteoclast formation or function. In vivo local injection of raloxifene also did not prevent bone resorption in a mouse model of periodontitis. However, the systemic treatment of raloxifene using a mini-osmotic pump did prevent the loss of BMD of alveolar bone induced by LPS. CONCLUSION These results suggest that the SERM raloxifene systemically maintain alveolar bone mass in a mouse model of periodontitis with osteoporosis. Increasing the alveolar bone mass by SERMs treatment in patients with postmenopausal osteoporosis may be a useful approach to preventing the destruction of alveolar bone in late-onset periodontitis.
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Allen MR. Preclinical Models for Skeletal Research: How Commonly Used Species Mimic (or Don’t) Aspects of Human Bone. Toxicol Pathol 2017; 45:851-854. [DOI: 10.1177/0192623317733925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Preclinical studies play an indispensable role in exploring the biological regulation of the musculoskeletal system. They are required in all drug development pipelines where both small and large animal models are needed to understand efficacy and side effects. This brief review highlights 4 aspects of human bone, longitudinal bone growth, intracortical remodeling, collagen/mineral interface, and age-related changes, and discusses how various animal models recapitulate (or don’t) these aspects of human skeletal physiology.
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Affiliation(s)
- Matthew R. Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, Indiana, USA
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Mu C, Hu Y, Huang L, Shen X, Li M, Li L, Gu H, Yu Y, Xia Z, Cai K. Sustained raloxifene release from hyaluronan-alendronate-functionalized titanium nanotube arrays capable of enhancing osseointegration in osteoporotic rabbits. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 82:345-353. [PMID: 29025668 DOI: 10.1016/j.msec.2017.08.056] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 07/25/2017] [Accepted: 08/10/2017] [Indexed: 02/05/2023]
Abstract
To enhance the localized bone remodeling at titanium-based implants under osteoporotic conditions, TiO2 nanotube arrays (TNT) were used as nanoreserviors for raloxifene (Ral) and then covered with the hybrid multilayered coating of chitosan and alendronate grafted hyaluronic acid (HA-Aln) via a spin-assisted layer-by-layer technique. The fabrication of this system (TNT/Ral/LBL-Aln) was characterized by field emission scanning electron microscopy (SEM), atomic force microscope (AFM) and X-ray photoelectron spectroscopy (XPS), respectively. The release test showed that the composited multilayers onto Ral-loaded TiO2 nanotube substrate (TNT/Ral) could prevent the burst release of Ral from TiO2 nanotube arrays and maintain stable Ral concentration at the implant site even after 192h. The TNT/Ral/LBL-Aln system demonstrated higher alkaline phosphatase (ALP) activity, mineralization capability in osteoblasts as well as lower tartrate-resistant acid phosphatase (TRAP) activity in osteoclasts compared to both bare TiO2 nanotube and TNT/Ral substrate, respectively. Moreover, the in vivo tests of micro-CT, histological staining and push-out testing showed that TNT/Ral/LBL-Aln implant could efficiently enhance the formation of new bone around the implant and promote bone binding in osteoporotic rabbits. The study indicated the potential application of TNT/Ral/LBL-Aln system for bone remodeling under osteoporotic condition.
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Affiliation(s)
- Caiyun Mu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China
| | - Yan Hu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China.
| | - Ling Huang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China
| | - Xinkun Shen
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China
| | - Menghuan Li
- School of Life Science, Chongqing University, Chongqing 400044, China
| | - Liqi Li
- Department of General Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Hao Gu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China
| | - Yonglin Yu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China
| | - Zhining Xia
- School of Chemistry and Chemical Engineering, Chongqing University, Chongqing 400044, China
| | - Kaiyong Cai
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China
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Allen MR, McNerny E, Aref M, Organ JM, Newman CL, McGowan B, Jang T, Burr DB, Brown DM, Hammond M, Territo PR, Lin C, Persohn S, Jiang L, Riley AA, McCarthy BP, Hutchins GD, Wallace JM. Effects of combination treatment with alendronate and raloxifene on skeletal properties in a beagle dog model. PLoS One 2017; 12:e0181750. [PMID: 28793321 PMCID: PMC5549927 DOI: 10.1371/journal.pone.0181750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 07/06/2017] [Indexed: 12/18/2022] Open
Abstract
A growing number of studies have investigated combination treatment as an approach to treat bone disease. The goal of this study was to investigate the combination of alendronate and raloxifene with a particular focus on mechanical properties. To achieve this goal we utilized a large animal model, the beagle dog, used previously by our laboratory to study both alendronate and raloxifene monotherapies. Forty-eight skeletally mature female beagles (1–2 years old) received daily oral treatment: saline vehicle (VEH), alendronate (ALN), raloxifene (RAL) or both ALN and RAL. After 6 and 12 months of treatment, all animals underwent assessment of bone material properties using in vivo reference point indentation (RPI) and skeletal hydration using ultra-short echo magnetic resonance imaging (UTE-MRI). End point measures include imaging, histomorphometry, and mechanical properties. Bone formation rate was significantly lower in iliac crest trabecular bone of animals treated with ALN (-71%) and ALN+RAL (-81%) compared to VEH. In vivo assessment of properties by RPI yielded minimal differences between groups while UTE-MRI showed a RAL and RAL+ALN treatment regimens resulted in significantly higher bound water compared to VEH (+23 and +18%, respectively). There was no significant difference among groups for DXA- or CT-based measures lumbar vertebra, or femoral diaphysis. Ribs of RAL-treated animals were smaller and less dense compared to VEH and although mechanical properties were lower the material-level properties were equivalent to normal. In conclusion, we present a suite of data in a beagle dog model treated for one year with clinically-relevant doses of alendronate and raloxifene monotherapies or combination treatment with both agents. Despite the expected effects on bone remodeling, our study did not find the expected benefit of ALN to BMD or structural mechanical properties, and thus the viability of the combination therapy remains unclear.
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Affiliation(s)
- Matthew R. Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Orthopedics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, Indiana, United States of America
- * E-mail:
| | - Erin McNerny
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Mohammad Aref
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Jason M. Organ
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, Indiana, United States of America
| | - Christopher L. Newman
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Brian McGowan
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Tim Jang
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - David B. Burr
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Orthopedics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, Indiana, United States of America
| | - Drew M. Brown
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Max Hammond
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, Indiana, United States of America
| | - Paul R. Territo
- Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Chen Lin
- Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Scott Persohn
- Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Lei Jiang
- Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Amanda A. Riley
- Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Brian P. McCarthy
- Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Gary D. Hutchins
- Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Joseph M. Wallace
- Department of Orthopedics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, Indiana, United States of America
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New treatment paradigm of combined raloxifene and conjugated estrogen for postmenopausal symptoms in VCD-induced menopausal rats. ALEXANDRIA JOURNAL OF MEDICINE 2017. [DOI: 10.1016/j.ajme.2016.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Meixner CN, Aref MW, Gupta A, McNerny EMB, Brown D, Wallace JM, Allen MR. Raloxifene Improves Bone Mechanical Properties in Mice Previously Treated with Zoledronate. Calcif Tissue Int 2017; 101:75-81. [PMID: 28246928 PMCID: PMC5459622 DOI: 10.1007/s00223-017-0257-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/16/2017] [Indexed: 12/18/2022]
Abstract
Bisphosphonates represent the gold-standard pharmaceutical agent for reducing fracture risk. Long-term treatment with bisphosphonates can result in tissue brittleness which in rare clinical cases manifests as atypical femoral fracture. Although this has led to an increasing call for bisphosphonate cessation, few studies have investigated therapeutic options for follow-up treatment. The goal of this study was to test the hypothesis that treatment with raloxifene, a drug that has cell-independent effects on bone mechanical material properties, could reverse the compromised mechanical properties that occur following zoledronate treatment. Skeletally mature male C57Bl/6J mice were treated with vehicle (VEH), zoledronate (ZOL), or ZOL followed by raloxifene (RAL; 2 different doses). At the conclusion of 8 weeks of treatment, femora were collected and assessed with microCT and mechanical testing. Trabecular BV/TV was significantly higher in all treated animals compared to VEH with both RAL groups having significantly higher BV/TV compared to ZOL (+21%). All three drug-treated groups had significantly more cortical bone area, higher cortical thickness, and greater moment of inertia at the femoral mid-diaphysis compared to VEH with no difference among the three treated groups. All three drug-treated groups had significantly higher ultimate load compared to VEH-treated animals (+14 to 18%). Both doses of RAL resulted in significantly higher displacement values compared to ZOL-treated animals (+25 to +50%). In conclusion, the current work shows beneficial effects of raloxifene in animals previously treated with zoledronate. The higher mechanical properties of raloxifene-treated animals, combined with similar cortical bone geometry compared to animals treated with zoledronate, suggest that the raloxifene treatment is enhancing mechanical material properties of the tissue.
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Affiliation(s)
- Cory N Meixner
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, MS 5035, 635 Barnhill Dr., Indianapolis, IN, 46202, USA
| | - Mohammad W Aref
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, MS 5035, 635 Barnhill Dr., Indianapolis, IN, 46202, USA
| | - Aryaman Gupta
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, MS 5035, 635 Barnhill Dr., Indianapolis, IN, 46202, USA
| | - Erin M B McNerny
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, MS 5035, 635 Barnhill Dr., Indianapolis, IN, 46202, USA
| | - Drew Brown
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, MS 5035, 635 Barnhill Dr., Indianapolis, IN, 46202, USA
| | - Joseph M Wallace
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, USA
| | - Matthew R Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, MS 5035, 635 Barnhill Dr., Indianapolis, IN, 46202, USA.
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, USA.
- Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA.
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Kimura S, Saito M, Kida Y, Seki A, Isaka Y, Marumo K. Effects of raloxifene and alendronate on non-enzymatic collagen cross-links and bone strength in ovariectomized rabbits in sequential treatments after daily human parathyroid hormone (1-34) administration. Osteoporos Int 2017; 28:1109-1119. [PMID: 27796444 DOI: 10.1007/s00198-016-3812-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 10/17/2016] [Indexed: 01/22/2023]
Abstract
UNLABELLED This study investigated the effects of raloxifene and alendronate to follow parathyroid hormone (PTH) on bone collagen and biomechanical properties in ovariectomized rabbits. Sequential treatments of raloxifene and alendronate after hPTH(1-34) treatment improved biomechanical properties with and without bone collagen improvement, respectively. INTRODUCTION The standard sequential treatment to follow human parathyroid hormone (hPTH) (1-34) therapy for osteoporosis has yet to be determined. The objective of this study was to compare the effects of raloxifene and alendronate treatments to follow daily hPTH(1-34) treatment on non-enzymatic collagen cross-links, bone mass, and bone strength in ovariectomized (OVX) rabbits. METHODS From 3 months after ovariectomy, seven month-old female New Zealand white rabbits were given either vehicle or hPTH(1-34) (8 μg/kg/day), once daily for 5 months. After hPTH(1-34) treatment, the hPTH(1-34)-treated animals were divided into two groups, and given raloxifene (10 mg/kg, daily) orally or alendronate (100 μg/kg, twice weekly) subcutaneously for 5 months. We evaluated bone mineral density (BMD), bone structural parameters, advanced glycation end product (AGE) content in collagen, and bone mechanical parameters including intrinsic parameters in the femur. RESULTS Raloxifene (hPTH/RLX) and alendronate (hPTH/ALN) to follow hPTH(1-34) increased cortical thickness, maximum load, and maximum stress and decreased endocortical surface in the diaphysis, in addition to increasing total BMD in the distal metaphysis. Decreased trabecular AGE, pentosidine, and homocysteine contents and increased toughness and breaking energy were noted with hPTH/RLX treatment only. With hPTH/ALN treatment, no effects on non-enzymatic collagen cross-link AGEs were noted although increases in stiffness and elastic modulus were observed. CONCLUSION These results suggest that sequential treatments with hPTH(1-34) and antiresorptive drugs (raloxifene and alendronate) have a beneficial effect on bone mass and biomechanical properties in OVX rabbits.
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Affiliation(s)
- S Kimura
- Medical Science, Medicines Development Unit Japan, Eli Lilly Japan KK, Sannomiya Plaza Building 7-1-5 Isogami-dori, Chuo-ku, Kobe, 651-0086, Japan.
| | - M Saito
- Department of Orthopaedic Surgery, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Y Kida
- Department of Orthopaedic Surgery, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - A Seki
- Hamri Co., Ltd., 2638-2, Osaki, Koga, Ibaraki, 306-0101, Japan
| | - Y Isaka
- Medical Science, Medicines Development Unit Japan, Eli Lilly Japan KK, Sannomiya Plaza Building 7-1-5 Isogami-dori, Chuo-ku, Kobe, 651-0086, Japan
| | - K Marumo
- Department of Orthopaedic Surgery, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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Paschalis EP, Gamsjaeger S, Hassler N, Klaushofer K, Burr D. Ovarian hormone depletion affects cortical bone quality differently on different skeletal envelopes. Bone 2017; 95:55-64. [PMID: 27826024 DOI: 10.1016/j.bone.2016.10.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 10/17/2016] [Accepted: 10/25/2016] [Indexed: 12/31/2022]
Abstract
The physical properties of bone tissue are determined by the organic and mineral matrix, and are one aspect of bone quality. As such, the properties of mineral and matrix are a major contributor to bone strength, independent of bone mass. Cortical bone quality may differ regionally on the three skeletal envelopes that compose it. Each of these envelopes may be affected differently by ovarian hormone depletion. Identifying how these regions vary in their tissue adaptive response to ovarian hormones can inform our understanding of how tissue quality contributes to overall bone strength in postmenopausal women. We analyzed humeri from monkeys that were either SHAM-operated or ovariectomized. Raman microspectroscopic analysis was performed as a function of tissue age based on the presence of multiple fluorescent double labels, to determine whether bone compositional properties (mineral/matrix ratio, tissue water, glycosaminoglycan, lipid, and pyridinoline contents, and mineral maturity/crystallinity) are similar between periosteal, osteonal, and endosteal surfaces, as well as to determine the effects of ovarian hormone depletion on them. The results indicate that mineral and organic matrix characteristics, and kinetics of mineral and organic matrix modifications as a function of tissue age are different at periosteal vs. osteonal and endosteal surfaces. Ovarian hormone depletion affects the three cortical surfaces (periosteal, osteonal, endosteal) differently. While ovarian hormone depletion does not significantly affect the quality of either the osteoid or the most recently mineralized tissue, it significantly affects the rate of subsequent mineral accumulation, as well as the kinetics of organic matrix modifications, culminating in significant differences within interstitial bone. These results highlight the complexity of the cortical bone compartments, add to existing knowledge on the effects of ovarian hormone depletion on local cortical bone properties, and may contribute to a better understanding of the location specific action of drugs used in the management of postmenopausal osteoporosis.
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Affiliation(s)
- E P Paschalis
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, A-1140 Vienna, Austria.
| | - S Gamsjaeger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, A-1140 Vienna, Austria
| | - N Hassler
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, A-1140 Vienna, Austria
| | - K Klaushofer
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, A-1140 Vienna, Austria
| | - D Burr
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Biomedical Engineering, Indiana University-Purdue University, Indianapolis (IUPUI), Indianapolis, IN 46202, USA
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Sato M, Ye W, Sugihara T, Isaka Y. Fracture risk and healthcare resource utilization and costs among osteoporosis patients with type 2 diabetes mellitus and without diabetes mellitus in Japan: retrospective analysis of a hospital claims database. BMC Musculoskelet Disord 2016; 17:489. [PMID: 27887655 PMCID: PMC5124298 DOI: 10.1186/s12891-016-1344-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/18/2016] [Indexed: 12/18/2022] Open
Abstract
Background Osteoporosis, osteoporosis-related fractures, and diabetes are considerable health burdens in Japan. Diabetes in patients with osteoporosis has been reported to be associated with increased fracture risk. This retrospective analysis of a Japanese hospital claims database investigated the real-world effect of type 2 diabetes mellitus (T2DM) on the incidence of clinical fractures, costs, and healthcare resource utilization in patients with osteoporosis and a subgroup of patients prescribed raloxifene. Methods Women aged ≥50 years diagnosed with osteoporosis who had a first prescription claim for osteoporosis treatment with a pre-index period ≥12 months and a post-index period of 30 months were selected from a database extract (April 2008-July 2013). Patients prescribed raloxifene were classed as a subgroup. Patients diagnosed with T2DM constituted the T2DM group; all other patients (excluding patients with type 1 diabetes mellitus) constituted the non-diabetes mellitus (non-DM) group. Groups were matched by exact matching, using selected baseline characteristics. Patient demographic and clinical characteristics were compared using chi-squared tests, t-tests, or Wilcoxon rank sum tests. Time to first fracture was examined using Kaplan-Meier survival analysis. Results Overall, the T2DM and non-DM groups had 7580 and 7979 patients, respectively; following matching, there were 3273 patients per group. In the raloxifene subgroup, the T2DM and non-DM groups had 668 and 699 patients, respectively; following matching, there were 239 patients per group. At baseline, the T2DM group (overall and raloxifene subgroup) had significantly higher healthcare resource utilization and comorbidities. During the post-index period, a similar pattern was observed in the overall group, even after matching; the T2DM group also had a higher incidence of fracture. In the raloxifene subgroup, after matching, there were no significant differences in fracture incidence or costs and fewer differences in healthcare resource utilization between the T2DM and non-DM groups. Conclusions These findings suggest that comorbid T2DM increases fracture incidence in patients with osteoporosis, compared with patients without DM. Increases in fracture incidence were accompanied by greater costs and healthcare resource utilization, which are important considerations for clinical practice in Japan. Further research investigating the use of raloxifene for treatment of osteoporosis with comorbid T2DM may also be warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1344-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masayo Sato
- Medical Development Unit Japan, Eli Lilly Japan K.K, 7-1-5 Isogamidori, Chuo-ku, Kobe, Hyogo, 651-0086, Japan.
| | - Wenyu Ye
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Yoshitaka Isaka
- Medical Development Unit Japan, Eli Lilly Japan K.K, 7-1-5 Isogamidori, Chuo-ku, Kobe, Hyogo, 651-0086, Japan
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Ross RD, Mashiatulla M, Acerbo AS, Almer JD, Miller LM, Johnson ML, Sumner DR. HBM Mice Have Altered Bone Matrix Composition and Improved Material Toughness. Calcif Tissue Int 2016; 99:384-95. [PMID: 27230741 PMCID: PMC7376697 DOI: 10.1007/s00223-016-0154-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/12/2016] [Indexed: 01/22/2023]
Abstract
The G171V mutation in the low-density lipoprotein receptor-related protein 5 (LRP5) leads to a high bone mass (HBM) phenotype. Studies using HBM transgenic mouse models have consistently found increased bone mass and whole-bone strength, but little attention has been paid to the composition of the bone matrix. The current study sought to determine if the cortical bone matrix composition differs in HBM and wild-type mice and to determine how much of the variance in bone material properties is explained by variance in matrix composition. Consistent with previous studies, HBM mice had greater cortical area, moment of inertia, ultimate force, bending stiffness, and energy to failure than wild-type animals. The increased energy to failure was primarily caused by a large increase in post-yield behavior, with no difference in pre-yield behavior. The HBM mice had increased mineral-to-matrix and collagen cross-link ratios, and decreased crystallinity, carbonate, and acid phosphate substitution as measured by Fourier transform infrared microspectroscopy, but no differences in crystal length, intra-fibular strains, and mineral spacing compared to wild-type controls, as measured by X-ray scattering. The largest between genotype difference in material properties was a twofold increase in the modulus of toughness in HBM mice. Step-wise regression analyses showed that the specific matrix compositional parameters most closely associated with material properties varied between the wild-type and HBM genotypes. Although the mechanisms controlling the paradoxical combination of more mineralized yet tougher bone in HBM mice remain to be fully explained, the findings suggest that LRP5 represents a target to not only build bone mass but also to improve bone quality.
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Affiliation(s)
- Ryan D Ross
- Department of Anatomy & Cell Biology, Rush University Medical Center, 600 South Paulina, Suite 507, Chicago, IL, 60612, USA.
| | - Maleeha Mashiatulla
- Department of Anatomy & Cell Biology, Rush University Medical Center, 600 South Paulina, Suite 507, Chicago, IL, 60612, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Alvin S Acerbo
- Center for Advanced Radiation Sources, The University of Chicago, Chicago, IL, USA
- National Synchrotron Light Source, Brookhaven National Laboratory, Upton, NY, USA
| | - Jonathan D Almer
- X-ray Science Division, Argonne National Laboratory, Argonne, IL, USA
| | - Lisa M Miller
- National Synchrotron Light Source, Brookhaven National Laboratory, Upton, NY, USA
| | - Mark L Johnson
- Department of Oral Biology, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - D Rick Sumner
- Department of Anatomy & Cell Biology, Rush University Medical Center, 600 South Paulina, Suite 507, Chicago, IL, 60612, USA
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
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48
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Burr DB. Bone Biomechanics and Bone Quality: Effects of Pharmaceutical Agents Used to Treat Osteoporosis. Clin Rev Bone Miner Metab 2016. [DOI: 10.1007/s12018-016-9217-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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49
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Krege JB, Aref MW, McNerny E, Wallace JM, Organ JM, Allen MR. Reference point indentation is insufficient for detecting alterations in traditional mechanical properties of bone under common experimental conditions. Bone 2016; 87:97-101. [PMID: 27072518 PMCID: PMC4862890 DOI: 10.1016/j.bone.2016.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/21/2016] [Accepted: 04/04/2016] [Indexed: 12/28/2022]
Abstract
Reference point indentation (RPI) was developed as a novel method to assess mechanical properties of bone in vivo, yet it remains unclear what aspects of bone dictate changes/differences in RPI-based parameters. The main RPI parameter, indentation distance increase (IDI), has been proposed to be inversely related to the ability of bone to form/tolerate damage. The goal of this work was to explore the relationshipre-intervention RPI measurebetween RPI parameters and traditional mechanical properties under varying experimental conditions (drying and ashing bones to increase brittleness, demineralizing bones and soaking in raloxifene to decrease brittleness). Beams were machined from cadaveric bone, pre-tested with RPI, subjected to experimental manipulation, post-tested with RPI, and then subjected to four-point bending to failure. Drying and ashing significantly reduced RPI's IDI, as well as ultimate load (UL), and energy absorption measured from bending tests. Demineralization increased IDI with minimal change to bending properties. Ex vivo soaking in raloxifene had no effect on IDI but tended to enhance post-yield behavior at the structural level. These data challenge the paradigm of an inverse relationship between IDI and bone toughness, both through correlation analyses and in the individual experiments where divergent patterns of altered IDI and mechanical properties were noted. Based on these results, we conclude that RPI measurements alone, as compared to bending tests, are insufficient to reach conclusions regarding mechanical properties of bone. This proves problematic for the potential clinical use of RPI measurements in determining fracture risk for a single patient, as it is not currently clear that there is an IDI, or even a trend of IDI, that can determine clinically relevant changes in tissue properties that may contribute to whole bone fracture resistance.
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Affiliation(s)
- John B Krege
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Mohammad W Aref
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Erin McNerny
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Joseph M Wallace
- Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, United States
| | - Jason M Organ
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Matthew R Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, United States.
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Ramchand SK, Chiang CY, Zebaze RM, Seeman E. Recurrence of bilateral atypical femoral fractures associated with the sequential use of teriparatide and denosumab: a case report. Osteoporos Int 2016; 27:821-5. [PMID: 26458389 DOI: 10.1007/s00198-015-3354-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 09/29/2015] [Indexed: 01/23/2023]
Abstract
We report that a postmenopausal woman with osteoporosis developed bilateral incomplete atypical femoral fractures (AFFs) after seven years of bisphosphonate therapy. Cessation of the bisphosphonate and treatment with teriparatide was associated with near complete radiological resolution of the AFFs. After 12 months without treatment, denosumab was commenced to prevent structural deterioration. Six months later she developed recurrent bilateral AFFs. This case highlights the management dilemma in patients with ongoing bone loss but prone to stress fractures associated with antiresorptive therapy. Stopping the antiresorptive is recommended but structural decay will recur predisposing to fragility fractures. If the antiresorptive is continued, bone material composition will be further compromised predisposing to atypical fractures. Teriparatide may assist healing of stress fractures and improvement in bone matrix composition. Later antiresosrptive therapy to preserve bone microstructure may compromise material composition.
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Affiliation(s)
- S K Ramchand
- Department of Endocrinology, Austin Health, Level 2 Centaur Building Repatriation Campus, Heidelberg, Melbourne, VIC, 3084, Australia.
| | - C Y Chiang
- Department of Endocrinology, Austin Health, Level 2 Centaur Building Repatriation Campus, Heidelberg, Melbourne, VIC, 3084, Australia
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - R M Zebaze
- Department of Endocrinology, Austin Health, Level 2 Centaur Building Repatriation Campus, Heidelberg, Melbourne, VIC, 3084, Australia
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - E Seeman
- Department of Endocrinology, Austin Health, Level 2 Centaur Building Repatriation Campus, Heidelberg, Melbourne, VIC, 3084, Australia
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
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