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Williams JA, Campsie P, Gibson R, Johnson-Love O, Werner A, Sprott M, Meechan R, Huesa C, Windmill JFC, Purcell M, Coupaud S, Dalby MJ, Childs P, Riddell JS, Reid S. Developing and Investigating a Nanovibration Intervention for the Prevention/Reversal of Bone Loss Following Spinal Cord Injury. ACS NANO 2024; 18:17630-17641. [PMID: 38924391 PMCID: PMC11238619 DOI: 10.1021/acsnano.4c02104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Osteoporosis disrupts the fine-tuned balance between bone formation and resorption, leading to reductions in bone quantity and quality and ultimately increasing fracture risk. Prevention and treatment of osteoporotic fractures is essential for reductions in mortality, morbidity, and the economic burden, particularly considering the aging global population. Extreme bone loss that mimics time-accelerated osteoporosis develops in the paralyzed limbs following complete spinal cord injury (SCI). In vitro nanoscale vibration (1 kHz, 30 or 90 nm amplitude) has been shown to drive differentiation of mesenchymal stem cells toward osteoblast-like phenotypes, enhancing osteogenesis and inhibiting osteoclastogenesis simultaneously. Here, we develop and characterize a wearable device designed to deliver and monitor continuous nanoamplitude vibration to the hindlimb long bones of rats with complete SCI. We investigate whether a clinically feasible dose of nanovibration (two 2 h/day, 5 days/week for 6 weeks) is effective at reversing the established SCI-induced osteoporosis. Laser interferometry and finite element analysis confirmed transmission of nanovibration into the bone, and microcomputed tomography and serum bone formation and resorption markers assessed effectiveness. The intervention did not reverse SCI-induced osteoporosis. However, serum analysis indicated an elevated concentration of the bone formation marker procollagen type 1 N-terminal propeptide (P1NP) in rats receiving 40 nm amplitude nanovibration, suggesting increased synthesis of type 1 collagen, the major organic component of bone. Therefore, enhanced doses of nanovibrational stimulus may yet prove beneficial in attenuating/reversing osteoporosis, particularly in less severe forms of osteoporosis.
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Affiliation(s)
- Jonathan A. Williams
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
- School
of Psychology and Neuroscience, College of Medical, Veterinary and
Life Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
- Scottish
Centre for Innovation in Spinal Cord Injury, Queen Elizabeth National
Spinal Injuries Unit, Queen Elizabeth University
Hospital, Glasgow G51 4TF, U.K.
| | - Paul Campsie
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
| | - Richard Gibson
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
| | - Olivia Johnson-Love
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
| | - Anna Werner
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
| | - Mark Sprott
- Centre
for the Cellular Microenvironment, Institute of Molecular, Cell and
Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
| | - Ryan Meechan
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
| | - Carmen Huesa
- Institute
of Infection, Immunity and Inflammation, College of Medical, Veterinary
and Life Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
| | - James F. C. Windmill
- Department
of Electronic and Electrical Engineering, Royal College Building, University of Strathclyde, Glasgow G1 1XW, U.K.
| | - Mariel Purcell
- Scottish
Centre for Innovation in Spinal Cord Injury, Queen Elizabeth National
Spinal Injuries Unit, Queen Elizabeth University
Hospital, Glasgow G51 4TF, U.K.
| | - Sylvie Coupaud
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
- Scottish
Centre for Innovation in Spinal Cord Injury, Queen Elizabeth National
Spinal Injuries Unit, Queen Elizabeth University
Hospital, Glasgow G51 4TF, U.K.
| | - Matthew J. Dalby
- Centre
for the Cellular Microenvironment, Institute of Molecular, Cell and
Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
| | - Peter Childs
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
| | - John S. Riddell
- School
of Psychology and Neuroscience, College of Medical, Veterinary and
Life Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
| | - Stuart Reid
- Centre
for the Cellular Microenvironment, Department of Biomedical Engineering,
Wolfson Centre, University of Strathclyde, Glasgow G4 0NW, U.K.
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Roberts BC, Cheong VS, Oliviero S, Arredondo Carrera HM, Wang N, Gartland A, Dall'Ara E. Combining PTH(1-34) and mechanical loading has increased benefit to tibia bone mechanics in ovariectomised mice. J Orthop Res 2024; 42:1254-1266. [PMID: 38151816 DOI: 10.1002/jor.25777] [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: 04/18/2023] [Revised: 11/29/2023] [Accepted: 12/24/2023] [Indexed: 12/29/2023]
Abstract
Combined treatment with PTH(1-34) and mechanical loading confers increased structural benefits to bone than monotherapies. However, it remains unclear how this longitudinal adaptation affects the bone mechanics. This study quantified the individual and combined longitudinal effects of PTH(1-34) and mechanical loading on the bone stiffness and strength evaluated in vivo with validated micro-finite element (microFE) models. C57BL/6 mice were ovariectomised at 14-week-old and treated either with injections of PTH(1-34), compressive tibia loading or both interventions concurrently. Right tibiae were in vivo microCT-scanned every 2 weeks from 14 until 24-week-old. MicroCT images were rigidly registered to reference tibia and the cortical organ level (whole bone) and tissue level (midshaft) morphometric properties and bone mineral content were quantified. MicroCT images were converted into voxel-based homogeneous, linear elastic microFE models to estimate the bone stiffness and strength. This approach allowed us for the first time to quantify the longitudinal changes in mechanical properties induced by combined treatments in a model of accelerated bone resorption. Both changes of stiffness and strength were higher with co-treatment than with individual therapies, consistent with increased benefits with the tibia bone mineral content and cortical area, properties strongly associated with the tibia mechanics. The longitudinal data shows that the two bone anabolics, both individually and combined, had persistent benefit on estimated mechanical properties, and that benefits (increased stiffness and strength) remained after treatment was withdrawn.
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Affiliation(s)
- Bryant C Roberts
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
- Adelaide Microscopy, Division of Research and Innovation, The University of Adelaide, Adelaide, South Australia, Australia
| | - Vee San Cheong
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Sara Oliviero
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | | | - Ning Wang
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
| | - Alison Gartland
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
| | - Enrico Dall'Ara
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
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Farage-O’Reilly SM, Cheong VS, Pickering E, Pivonka P, Bellantuono I, Kadirkamanathan V, Dall’Ara E. The loading direction dramatically affects the mechanical properties of the mouse tibia. Front Bioeng Biotechnol 2024; 12:1335955. [PMID: 38380263 PMCID: PMC10877372 DOI: 10.3389/fbioe.2024.1335955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
Introduction: The in vivo tibial loading mouse model has been extensively used to evaluate bone adaptation in the tibia after mechanical loading treatment. However, there is a prevailing assumption that the load is applied axially to the tibia. The aim of this in silico study was to evaluate how much the apparent mechanical properties of the mouse tibia are affected by the loading direction, by using a validated micro-finite element (micro-FE) model of mice which have been ovariectomized and exposed to external mechanical loading over a two-week period. Methods: Longitudinal micro-computed tomography (micro-CT) images were taken of the tibiae of eleven ovariectomized mice at ages 18 and 20 weeks. Six of the mice underwent a mechanical loading treatment at age 19 weeks. Micro-FE models were generated, based on the segmented micro-CT images. Three models using unitary loads were linearly combined to simulate a range of loading directions, generated as a function of the angle from the inferior-superior axis (θ, 0°-30° range, 5° steps) and the angle from the anterior-posterior axis (ϕ, 0°: anterior axis, positive anticlockwise, 0°-355° range, 5° steps). The minimum principal strain was calculated and used to estimate the failure load, by linearly scaling the strain until 10% of the nodes reached the critical strain level of -14,420 με. The apparent bone stiffness was calculated as the ratio between the axial applied force and the average displacement along the longitudinal direction, for the loaded nodes. Results: The results demonstrated a high sensitivity of the mouse tibia to the loading direction across all groups and time points. Higher failure loads were found for several loading directions (θ = 10°, ϕ 205°-210°) than for the nominal axial case (θ = 0°, ϕ = 0°), highlighting adaptation of the bone for loading directions far from the nominal axial one. Conclusion: These results suggest that in studies which use mouse tibia, the loading direction can significantly impact the failure load. Thus, the magnitude and direction of the applied load should be well controlled during the experiments.
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Affiliation(s)
- Saira Mary Farage-O’Reilly
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- Division of Clinical Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Vee San Cheong
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Edmund Pickering
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, Australia
| | - Peter Pivonka
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ilaria Bellantuono
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- Division of Clinical Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Visakan Kadirkamanathan
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Enrico Dall’Ara
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- Division of Clinical Medicine, University of Sheffield, Sheffield, United Kingdom
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Venkatesh VS, Nie T, Zajac JD, Grossmann M, Davey RA. The Utility of Preclinical Models in Understanding the Bone Health of Transgender Individuals Undergoing Gender-Affirming Hormone Therapy. Curr Osteoporos Rep 2023; 21:825-841. [PMID: 37707757 PMCID: PMC10724092 DOI: 10.1007/s11914-023-00818-2] [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] [Accepted: 08/16/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE OF REVIEW To summarise the evidence regarding the effects of gender-affirming hormone therapy (GAHT) on bone health in transgender people, to identify key knowledge gaps and how these gaps can be addressed using preclinical rodent models. RECENT FINDINGS Sex hormones play a critical role in bone physiology, yet there is a paucity of research regarding the effects of GAHT on bone microstructure and fracture risk in transgender individuals. The controlled clinical studies required to yield fracture data are unethical to conduct making clinically translatable preclinical research of the utmost importance. Novel genetic and surgical preclinical models have yielded significant mechanistic insight into the roles of sex steroids on skeletal integrity. Preclinical models of GAHT have the potential inform clinical approaches to preserve skeletal integrity and prevent fractures in transgender people undergoing GAHT. This review highlights the key considerations required to ensure the information gained from preclinical models of GAHT are informative.
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Affiliation(s)
- Varun S Venkatesh
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, 3084, Australia
| | - Tian Nie
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, 3084, Australia
| | - Jeffrey D Zajac
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, 3084, Australia
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, 3084, Australia
| | - Mathis Grossmann
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, 3084, Australia
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, 3084, Australia
| | - Rachel A Davey
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, 3084, Australia.
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Jin BH, Woo J, Lee M, Ku S, Moon HS, Ryu SJ, Hyun YM, Park JY, Kuh SU, Cho YE. Optimization of the optical transparency of bones by PACT-based passive tissue clearing. Exp Mol Med 2023; 55:2190-2204. [PMID: 37779150 PMCID: PMC10618275 DOI: 10.1038/s12276-023-01089-8] [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: 11/04/2022] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 10/03/2023] Open
Abstract
Recent developments in tissue clearing methods such as the passive clearing technique (PACT) have allowed three-dimensional analysis of biological structures in whole, intact tissues, thereby providing a greater understanding of spatial relationships and biological circuits. Nonetheless, the issues that remain in maintaining structural integrity and preventing tissue expansion/shrinkage with rapid clearing still inhibit the wide application of these techniques in hard bone tissues, such as femurs and tibias. Here, we present an optimized PACT-based bone-clearing method, Bone-mPACT+, that protects biological structures. Bone-mPACT+ and four different decalcifying procedures were tested for their ability to improve bone tissue clearing efficiency without sacrificing optical transparency; they rendered nearly all types of bone tissues transparent. Both mouse and rat bones were nearly transparent after the clearing process. We also present a further modification, the Bone-mPACT+ Advance protocol, which is specifically optimized for processing the largest and hardest rat bones for easy clearing and imaging using established tissue clearing methods.
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Affiliation(s)
- Byung-Ho Jin
- The Spine and Spinal Cord Institute, Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
- College of Medicine, Yonsei University Graduate School, Seoul, 03722, Republic of Korea
- Department of Neurosurgery, International ST Mary´s Hospital, College of Medicine, Catholic Kwandong University, Incheon, 22711, Republic of Korea
| | - Jiwon Woo
- The Spine and Spinal Cord Institute, Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
- Department of Neurosurgery, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Biomedical Research Institute, Biohedron, Seoul, 06230, Republic of Korea
- Biomedical Research Center, Gangnam Severance Hospital, Seoul, 06230, Republic of Korea
| | - Mirae Lee
- The Spine and Spinal Cord Institute, Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
- Department of Neurosurgery, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Biomedical Research Center, Gangnam Severance Hospital, Seoul, 06230, Republic of Korea
| | - Seockmo Ku
- Department of Food Science and Technology, Texas A&M University, College Station, TX, 77843, USA
| | - Hyung Seok Moon
- Biomedical Research Center, Gangnam Severance Hospital, Seoul, 06230, Republic of Korea
| | - Seung Jun Ryu
- The Spine and Spinal Cord Institute, Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
- Department of Neurosurgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, 35233, Republic of Korea
| | - Young-Min Hyun
- Department of Anatomy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jeong-Yoon Park
- The Spine and Spinal Cord Institute, Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
- College of Medicine, Yonsei University Graduate School, Seoul, 03722, Republic of Korea
- Department of Neurosurgery, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Sung Uk Kuh
- The Spine and Spinal Cord Institute, Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
- College of Medicine, Yonsei University Graduate School, Seoul, 03722, Republic of Korea
- Biomedical Research Center, Gangnam Severance Hospital, Seoul, 06230, Republic of Korea
- Department of Medical Device Engineering and Management, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Yong Eun Cho
- The Spine and Spinal Cord Institute, Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea.
- College of Medicine, Yonsei University Graduate School, Seoul, 03722, Republic of Korea.
- Department of Neurosurgery, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
- Department of Neurosurgery, Wiltse Memorial Hospital, Suwon-si, Gyeonggi-do, 16480, Republic of Korea.
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Marques FC, Boaretti D, Walle M, Scheuren AC, Schulte FA, Müller R. Mechanostat parameters estimated from time-lapsed in vivo micro-computed tomography data of mechanically driven bone adaptation are logarithmically dependent on loading frequency. Front Bioeng Biotechnol 2023; 11:1140673. [PMID: 37113673 PMCID: PMC10126906 DOI: 10.3389/fbioe.2023.1140673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
Mechanical loading is a key factor governing bone adaptation. Both preclinical and clinical studies have demonstrated its effects on bone tissue, which were also notably predicted in the mechanostat theory. Indeed, existing methods to quantify bone mechanoregulation have successfully associated the frequency of (re)modeling events with local mechanical signals, combining time-lapsed in vivo micro-computed tomography (micro-CT) imaging and micro-finite element (micro-FE) analysis. However, a correlation between the local surface velocity of (re)modeling events and mechanical signals has not been shown. As many degenerative bone diseases have also been linked to impaired bone (re)modeling, this relationship could provide an advantage in detecting the effects of such conditions and advance our understanding of the underlying mechanisms. Therefore, in this study, we introduce a novel method to estimate (re)modeling velocity curves from time-lapsed in vivo mouse caudal vertebrae data under static and cyclic mechanical loading. These curves can be fitted with piecewise linear functions as proposed in the mechanostat theory. Accordingly, new (re)modeling parameters can be derived from such data, including formation saturation levels, resorption velocity moduli, and (re)modeling thresholds. Our results revealed that the norm of the gradient of strain energy density yielded the highest accuracy in quantifying mechanoregulation data using micro-finite element analysis with homogeneous material properties, while effective strain was the best predictor for micro-finite element analysis with heterogeneous material properties. Furthermore, (re)modeling velocity curves could be accurately described with piecewise linear and hyperbola functions (root mean square error below 0.2 µm/day for weekly analysis), and several (re)modeling parameters determined from these curves followed a logarithmic relationship with loading frequency. Crucially, (re)modeling velocity curves and derived parameters could detect differences in mechanically driven bone adaptation, which complemented previous results showing a logarithmic relationship between loading frequency and net change in bone volume fraction over 4 weeks. Together, we expect this data to support the calibration of in silico models of bone adaptation and the characterization of the effects of mechanical loading and pharmaceutical treatment interventions in vivo.
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van As C, Koedam M, McLuskey A, Kramer P, Lahlou N, van der Eerden BCJ, Visser JA. Loss of Anti-Müllerian Hormone Signaling in Mice Affects Trabecular Bone Mass in a Sex- and Age-Dependent Manner. Endocrinology 2022; 163:6717957. [PMID: 36155779 PMCID: PMC9576916 DOI: 10.1210/endocr/bqac157] [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: 02/28/2022] [Indexed: 11/19/2022]
Abstract
Ovariectomy-induced osteoporosis in mice results from an abrupt loss of ovarian sex steroids. Anti-Müllerian hormone knockout (AMHKO) mice show a gradual but accelerated ovarian aging, and therefore may better resemble osteoporosis following natural menopause. To study the impact of AMH signaling deficiency on bone, we compared trabecular and cortical bone parameters in 2-, 4-, 10-, and 16-month-old male and female wild-type (WT), AMHKO, and AMH type II receptor knockout (MRKI) mice using micro computed tomography (microCT). Goldner's staining was performed to confirm the observed bone phenotype. Both male and female AMHKO and MRKI mice showed age-dependent loss of trabecular bone (P < 0.001). However, reproductive-aged female AMHKO and MRKI mice had higher BV/TV compared with WT (P < 0.001), coinciding with increased growing follicle numbers (P < 0.05) and increased estrus inhibin B levels (AMHKO: P < 0.001; MRKI: P < 0.05) but normal inhibin A, estrogen, and progesterone levels. In aged female AMHKO and MRKI mice BV/TV did not differ from WT mice due to greater trabecular bone loss between 10 and 16 months compared with WT mice. At these ages, AMHKO and MRKI mice had reduced growing follicle numbers (P < 0.05) and reduced inhibin B levels (P < 0.001). At age 10 months, female MRKI mice had increased cortical bone parameters compared with WT mice (P < 0.01). Bone parameters of male AMHKO and MRKI mice did not differ from male WT mice. In conclusion, AMH signaling deficiency results in a sex- and age-dependent effect on predominantly trabecular bone. Our results further suggest that reproductive hormones beyond estrogen may contribute to bone homeostasis.
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Affiliation(s)
- Christiane van As
- Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Marijke Koedam
- Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Anke McLuskey
- Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Piet Kramer
- Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Najiba Lahlou
- Department of Hormone Biology and Metabolic Disorders, BPR-AS, 45700 Pannes, France
| | | | - Jenny A Visser
- Correspondence: Jenny A. Visser, PhD, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Shar A, Aboutalebianaraki N, Misiti K, Sip YYL, Zhai L, Razavi M. A novel ultrasound-mediated nanodroplet-based gene delivery system for osteoporosis treatment. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2022; 41:102530. [PMID: 35104672 DOI: 10.1016/j.nano.2022.102530] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/30/2021] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
This project aimed to develop, optimize, and test an ultrasound-responsive targeted nanodroplet system for the delivery of osteoporosis-related silencing gene Cathepsin K small interfering RNA (CTSK siRNA) for osteoporosis treatment. The nanodroplet (ND) is composed of a gas core made from perfluorocarbon, stabilized with albumin, encapsulated with CTSK siRNA, and embedded with alendronate (AL) for bone targeting (CTSK siRNA-ND-AL). Following the development, the responsiveness of CTSK siRNA-ND-AL to a therapeutic ultrasound probe was examined. The results of biocompatibility tests with human bone marrow-derived mesenchymal stem cells proved no significant cell death (P > 0.05). When the CTSK siRNA-ND-AL was supplemented with human osteoclast precursors, they suppressed osteoclastogenesis. Thus, this project establishes the potential of nanotechnology and ultrasound to deliver genes into the osteoclasts. This research also presents a novel ultrasound responsive and targeted nanodroplet platform that can be used as a gene and drug delivery system for various diseases including cancer.
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Affiliation(s)
- Angela Shar
- Biionix™ (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA; Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Nadia Aboutalebianaraki
- Biionix™ (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA; Department of Material Sciences and Engineering, University of Central Florida, Orlando, Florida, USA
| | - Kaylee Misiti
- Biionix™ (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Yuen Yee Li Sip
- Department of Material Sciences and Engineering, University of Central Florida, Orlando, Florida, USA; Nanoscience Technology Center, University of Central Florida, Orlando, Florida, USA
| | - Lei Zhai
- Nanoscience Technology Center, University of Central Florida, Orlando, Florida, USA; Department of Chemistry, University of Central Florida, Orlando, Florida, USA
| | - Mehdi Razavi
- Biionix™ (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA; Department of Material Sciences and Engineering, University of Central Florida, Orlando, Florida, USA.
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9
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A mouse model of disuse osteoporosis based on a movable noninvasive 3D-printed unloading device. J Orthop Translat 2022; 33:1-12. [PMID: 35070713 PMCID: PMC8753063 DOI: 10.1016/j.jot.2021.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/02/2021] [Accepted: 11/22/2021] [Indexed: 01/16/2023] Open
Abstract
Objective Disuse osteoporosis is a major type of bone loss disease characterized by regional bone loss and microstructure alterations. The condition is induced by a marked decrease in weight bearing over time, which usually occurs due to limb immobilization, therapeutic bed rest or space flight. To date, the most commonly used mouse model of disuse osteoporosis is constructed using the classical tail suspension method, which causes tail injury, movement inconvenience and mental stress. This study aimed to propose a noninvasive and effective method for the establishment of a mouse model of disuse osteoporosis and compared this method with the tail suspension method. Methods 3D printing technology was applied to construct a movable unloading device. A movable noninvasive 3D-printed unloading device (3D-ULD) was used to unload the hindlimbs of the mice. The bone microstructure and bone volume of unloaded femurs were analysed through micro-CT and H&E staining, and von Kossa staining was performed for the detection of bone mineralization in the femurs. TRAP staining, IHC-CTSK and Q-PCR were performed for evaluation of the bone resorption ability, and double labelling, IHC-DMP1, ALP staining and Q-PCR assays were conducted to assess the osteogenic ability. The mechanical properties of disused bone were detected using the three-point bending test. The body, thymus and spleen weights of the mice were recorded, and the serum corticosterone level of the mice was assayed by enzyme-linked immunosorbent assay (ELISA). Results The micro-CT results showed significant trabecular bone loss, and 3D-ULD induced cortical bone loss in disused femurs as well as a decrease in the bone mineral density in the unloaded mice. TRAP staining and IHC-CTSK staining results indicated increases in the osteoclast number per bone perimeter (Oc.N/B.Pm) and the osteoclast surface per bone surface (Oc.S/BS) in the unloaded mice. The Ctsk, Trap and Mmp9 expression levels were significantly increased in the unloaded mice. Decreases in the ratio of the mineral surface to bone surface (MS/BS), mineral apposition rate (MAR) and bone formation rate per bone surface (BFR/BS) were found in unloaded mice in the 3D-ULD by double labelling. The IHC-DMP1 and ALP staining results showed decreases in the osteoblast number per bone perimeter (Ob.N/B.Pm) and osteoblast surface per bone surface (Ob. S/BS) in the mice unloaded in the 3D-ULD, and these mice also showed decreased Runx2, Alp and Dmp1 expression levels. Three-point bending test results showed that the mechanical properties were attenuated in the disused femurs of the unloaded mice. Less skin rupture and rare alterations in the thymus and spleen weights were found in the unloaded mice in the 3D-ULD. The ELISA results indicated the serum corticosterone level of the mice unloaded in the 3D-ULD was significantly lower than that of mice suspended by their tail. Conclusion This new disuse osteoporosis mouse model based on 3D-ULD could induce effective disuse bone loss with significantly alleviated side effects. Translational potential of this article This study proposes a new disuse osteoporosis mouse model based on 3D-ULD that can be used to better understand disuse bone loss in the future.
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Oliviero S, Millard E, Chen Z, Rayson A, Roberts B, Ismail H, Bellantuono I, Dall’Ara E. Accuracy of in vivo microCT imaging in assessing the microstructural properties of the mouse tibia subchondral bone. Front Endocrinol (Lausanne) 2022; 13:1016321. [PMID: 36714558 PMCID: PMC9874301 DOI: 10.3389/fendo.2022.1016321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Osteoarthritis (OA) is one of the most common musculoskeletal diseases. OA is characterized by degeneration of the articular cartilage as well as the underlying subchondral bone. Post-traumatic osteoarthritis (PTOA) is a subset of OA caused by mechanical trauma. Mouse models, such as destabilization of the medial meniscus (DMM), are useful to study PTOA. Ex vivo micro-Computed Tomography (microCT) imaging is the predominant technique used to scan the mouse knee in OA studies. Nevertheless, in vivo microCT enables the longitudinal assessment of bone microstructure, reducing measurement variability and number of animals required. The effect of image resolution in measuring subchondral bone parameters was previously evaluated only for a limited number of parameters. The aim of this study was to evaluate the ability of in vivo microCT imaging in measuring the microstructural properties of the mouse tibia trabecular and cortical subchondral bone, with respect to ex vivo high resolution imaging, in a DMM model of PTOA. Sixteen male C57BL/6J mice received DMM surgery or sham operation at 14 weeks of age (N=8 per group). The right knee of each mouse was microCT scanned in vivo (10.4μm voxel size) and ex vivo (4.35μm voxel size) at the age of 26 weeks. Each image was aligned to a reference image using rigid registration. The subchondral cortical bone plate thickness was measured at the lateral and medial condyles. Standard morphometric parameters were measured in the subchondral trabecular bone. In vivo microCT imaging led to significant underestimation of bone volume fraction (-14%), bone surface density (-3%) and trabecular number (-16%), whereas trabecular thickness (+3%) and separation (+5%) were significantly overestimated. Nevertheless, most trabecular parameters measured in vivo were well correlated with ex vivo measurements (R2 = 0.69-0.81). Degree of anisotropy, structure model index and connectivity density were measured in vivo with lower accuracy. Excellent accuracy was found for cortical thickness measurements. In conclusion, this study identified what bone morphological parameters can be reliably measured by in vivo microCT imaging of the subchondral bone in the mouse tibia. It highlights that this approach can be used to study longitudinal effects of diseases and treatments on the subchondral cortical bone and on most subchondral trabecular bone parameters, but systematic over- or under-estimations should be considered when interpreting the results.
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Affiliation(s)
- S. Oliviero
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Department of Industrial Engineering, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - E. Millard
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Z. Chen
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - A. Rayson
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - B.C. Roberts
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - H.M.S. Ismail
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
| | - I. Bellantuono
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
| | - E. Dall’Ara
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- *Correspondence: E. Dall’Ara,
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11
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Oliviero S, Cheong VS, Roberts BC, Orozco Diaz CA, Griffiths W, Bellantuono I, Dall’Ara E. Reproducibility of Densitometric and Biomechanical Assessment of the Mouse Tibia From In Vivo Micro-CT Images. Front Endocrinol (Lausanne) 2022; 13:915938. [PMID: 35846342 PMCID: PMC9282377 DOI: 10.3389/fendo.2022.915938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
Interventions for bone diseases (e.g. osteoporosis) require testing in animal models before clinical translation and the mouse tibia is among the most common tested anatomical sites. In vivo micro-Computed Tomography (microCT) based measurements of the geometrical and densitometric properties are non-invasive and therefore constitute an important tool in preclinical studies. Moreover, validated micro-Finite Element (microFE) models can be used for predicting the bone mechanical properties non-invasively. However, considering that the image processing pipeline requires operator-dependant steps, the reproducibility of these measurements has to be assessed. The aim of this study was to evaluate the intra- and inter-operator reproducibility of several bone parameters measured from microCT images. Ten in vivo microCT images of the right tibia of five mice (at 18 and 22 weeks of age) were processed. One experienced operator (intra-operator analysis) and three different operators (inter-operator) aligned each image to a reference through a rigid registration and selected a volume of interest below the growth plate. From each image the following parameters were measured: total bone mineral content (BMC) and density (BMD), BMC in 40 subregions (ten longitudinal sections, four quadrants), microFE-based stiffness and failure load. Intra-operator reproducibility was acceptable for all parameters (precision error, PE < 3.71%), with lowest reproducibility for stiffness (3.06% at week 18, 3.71% at week 22). The inter-operator reproducibility was slightly lower (PE < 4.25%), although still acceptable for assessing the properties of most interventions. The lowest reproducibility was found for BMC in the lateral sector at the midshaft (PE = 4.25%). Densitometric parameters were more reproducible than most standard morphometric parameters calculated in the proximal trabecular bone. In conclusion, microCT and microFE models provide reproducible measurements for non-invasive assessment of the mouse tibia properties.
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Affiliation(s)
- Sara Oliviero
- Department of Oncology and Metabolism, Mellanby Centre for bone Research, University of Sheffield, Sheffield, United Kingdom
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Industrial Engineering, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Vee San Cheong
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Bryant C. Roberts
- Department of Oncology and Metabolism, Mellanby Centre for bone Research, University of Sheffield, Sheffield, United Kingdom
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Carlos Amnael Orozco Diaz
- Department of Oncology and Metabolism, Mellanby Centre for bone Research, University of Sheffield, Sheffield, United Kingdom
| | - William Griffiths
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Ilaria Bellantuono
- Department of Oncology and Metabolism, Mellanby Centre for bone Research, University of Sheffield, Sheffield, United Kingdom
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
| | - Enrico Dall’Ara
- Department of Oncology and Metabolism, Mellanby Centre for bone Research, University of Sheffield, Sheffield, United Kingdom
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- *Correspondence: Enrico Dall’Ara,
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12
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Cheong VS, Roberts BC, Kadirkamanathan V, Dall'Ara E. Positive interactions of mechanical loading and PTH treatments on spatio-temporal bone remodelling. Acta Biomater 2021; 136:291-305. [PMID: 34563722 DOI: 10.1016/j.actbio.2021.09.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/03/2021] [Accepted: 09/17/2021] [Indexed: 11/26/2022]
Abstract
Osteoporosis is one of the most common skeletal diseases, but current therapies are limited to generalized antiresorptive or anabolic interventions, which do not target regions that would benefit from improvements to skeletal health. To improve the evaluation of treatment plans, we used a spatio-temporal multiscale approach that combines longitudinal in vivo micro-computed tomography (micro-CT) and in silico subject-specific finite element modeling to quantitatively map bone adaptation changes due to disease and treatment at high resolution. Our findings show time and region-dependent modifications in bone remodelling following one and two sets of mechanical loading and/or pharmacological interventions. The multiscale results highlighted that the distal section was unaffected by mechanical loading alone but the proximal tibia had the greatest gain from positive interactions of combined therapies. Mechanical loading abated the catabolic effect of PTH, but the main benefit of combined treatments occurred from the additive interactions of the two therapies in periosteal apposition. These results provide detailed insight into the efficacy of combined treatments, facilitating the optimisation of dosage and treatment duration in preclinical mouse studies, and the development of novel interventions for skeletal diseases. STATEMENT OF SIGNIFICANCE: Combined mechanical loading and pharmacotherapy have the potential to slow osteoporosis-induced bone loss but current therapies do not target the regions in need of strengthening. We show for the first time spatial region-dependant interactions between PTH and mechanical loading treatment in OVX mouse tibiae, highlighting local regions in the tibia that benefitted from separate and combined treatments. Combined experimental-computational analysis also detailed the lasting period of each treatment per location in the tibia, the extent of positive (or negative) interactions of the combined therapies, and the impact of each treatment on the regulation of bone adaptation spatio-temporally. This approach can be used to create hypothesis about the interactions of different treatments to optimise the design of biomaterials and medical interventions.
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13
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Freid R, Hussein AI, Schlezinger JJ. Tributyltin protects against ovariectomy-induced trabecular bone loss in C57BL/6J mice with an attenuated effect in high fat fed mice. Toxicol Appl Pharmacol 2021; 431:115736. [PMID: 34619157 PMCID: PMC8545923 DOI: 10.1016/j.taap.2021.115736] [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: 07/02/2021] [Revised: 09/25/2021] [Accepted: 09/29/2021] [Indexed: 11/27/2022]
Abstract
Risk factors for poor bone quality include estrogen loss at menopause, a high fat diet and exposures to drugs/chemicals that activate peroxisome proliferator activated receptor gamma (PPARγ). We previously reported that the PPARγ and retinoid X receptor dual ligand, tributyltin (TBT), repressed periosteal bone formation but enhanced trabecular bone formation in vivo. Here, we examined the interaction of diet, ovariectomy (OVX) and TBT exposure on bone structure. C57BL/6J mice underwent either sham surgery or OVX at 10 weeks of age. At 12 weeks of age, they were placed on a low (10% kcal) or high (45% kcal) fat, sucrose-matched diet and treated with vehicle or TBT (1 or 5 mg/kg) for 14 weeks. OVX increased body weight gain in mice on either diet. TBT enhanced body weight gain in intact mice fed a high fat diet, but decreased weight gain in OVX mice. Elemental tin concentrations increased dose-dependently in bone. TBT had marginal effects on cortical and trabecular bone in intact mice fed either diet. OVX caused a reduction in cortical and trabecular bone, regardless of diet. In high fat fed OVX mice, TBT further reduced cortical thickness, bone area and total area. Interestingly, TBT protected against OVX-induced trabecular bone loss in low fat fed mice. The protective effect of TBT was nullified by the high fat. These results show that TBT protects against trabecular bone loss, even in the presence of a strongly resorptive environment, at an even lower level of exposure than we showed repressed homeostatic resorption.
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Affiliation(s)
- Rachel Freid
- Environmental Health, Boston University School of Public Health, USA
| | - Amira I Hussein
- Orthopaedic Surgery, Boston University School of Medicine, Boston, MA 02118, USA
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14
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Batoon L, Millard SM, Raggatt LJ, Wu AC, Kaur S, Sun LWH, Williams K, Sandrock C, Ng PY, Irvine KM, Bartnikowski M, Glatt V, Pavlos NJ, Pettit AR. Osteal macrophages support osteoclast-mediated resorption and contribute to bone pathology in a postmenopausal osteoporosis mouse model. J Bone Miner Res 2021; 36:2214-2228. [PMID: 34278602 DOI: 10.1002/jbmr.4413] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/29/2021] [Accepted: 07/14/2021] [Indexed: 11/08/2022]
Abstract
Osteal macrophages (osteomacs) support osteoblast function and promote bone anabolism, but their contribution to osteoporosis has not been explored. Although mouse ovariectomy (OVX) models have been repeatedly used, variation in strain, experimental design and assessment modalities have contributed to no single model being confirmed as comprehensively replicating the full gamut of osteoporosis pathological manifestations. We validated an OVX model in adult C3H/HeJ mice and demonstrated that it presents with human postmenopausal osteoporosis features with reduced bone volume in axial and appendicular bone and bone loss in both trabecular and cortical bone including increased cortical porosity. Bone loss was associated with increased osteoclasts on trabecular and endocortical bone and decreased osteoblasts on trabecular bone. Importantly, this OVX model was characterized by delayed fracture healing. Using this validated model, we demonstrated that osteomacs are increased post-OVX on both trabecular and endocortical bone. Dual F4/80 (pan-macrophage marker) and tartrate-resistant acid phosphatase (TRAP) staining revealed osteomacs frequently located near TRAP+ osteoclasts and contained TRAP+ intracellular vesicles. Using an in vivo inducible macrophage depletion model that does not simultaneously deplete osteoclasts, we observed that osteomac loss was associated with elevated extracellular TRAP in bone marrow interstitium and increased serum TRAP. Using in vitro high-resolution confocal imaging of mixed osteoclast-macrophage cultures on bone substrate, we observed macrophages juxtaposed to osteoclast basolateral functional secretory domains scavenging degraded bone byproducts. These data demonstrate a role for osteomacs in supporting osteoclastic bone resorption through phagocytosis and sequestration of resorption byproducts. Overall, our data expose a novel role for osteomacs in supporting osteoclast function and provide the first evidence of their involvement in osteoporosis pathogenesis. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Lena Batoon
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Susan M Millard
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Liza J Raggatt
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Andy C Wu
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Simranpreet Kaur
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Lucas W H Sun
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Kyle Williams
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Cheyenne Sandrock
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Pei Ying Ng
- Bone Biology and Disease Laboratory, School of Biomedical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Katharine M Irvine
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Michal Bartnikowski
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Vaida Glatt
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Orthopaedic Surgery Department, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Nathan J Pavlos
- Bone Biology and Disease Laboratory, School of Biomedical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Allison R Pettit
- Mater Research Institute-The University of Queensland, Translational Research Institute, Woolloongabba, Queensland, Australia
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15
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Cheong VS, Kadirkamanathan V, Dall'Ara E. The Role of the Loading Condition in Predictions of Bone Adaptation in a Mouse Tibial Loading Model. Front Bioeng Biotechnol 2021; 9:676867. [PMID: 34178966 PMCID: PMC8225949 DOI: 10.3389/fbioe.2021.676867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
The in vivo mouse tibial loading model is used to evaluate the effectiveness of mechanical loading treatment against skeletal diseases. Although studies have correlated bone adaptation with the induced mechanical stimulus, predictions of bone remodeling remained poor, and the interaction between external and physiological loading in engendering bone changes have not been determined. The aim of this study was to determine the effect of passive mechanical loading on the strain distribution in the mouse tibia and its predictions of bone adaptation. Longitudinal micro-computed tomography (micro-CT) imaging was performed over 2 weeks of cyclic loading from weeks 18 to 22 of age, to quantify the shape change, remodeling, and changes in densitometric properties. Micro-CT based finite element analysis coupled with an optimization algorithm for bone remodeling was used to predict bone adaptation under physiological loads, nominal 12N axial load and combined nominal 12N axial load superimposed to the physiological load. The results showed that despite large differences in the strain energy density magnitudes and distributions across the tibial length, the overall accuracy of the model and the spatial match were similar for all evaluated loading conditions. Predictions of densitometric properties were most similar to the experimental data for combined loading, followed closely by physiological loading conditions, despite no significant difference between these two predicted groups. However, all predicted densitometric properties were significantly different for the 12N and the combined loading conditions. The results suggest that computational modeling of bone's adaptive response to passive mechanical loading should include the contribution of daily physiological load.
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Affiliation(s)
- Vee San Cheong
- Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom.,Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Visakan Kadirkamanathan
- Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom.,Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Enrico Dall'Ara
- Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
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16
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Lu Q, Jiang C, Hou J, Qian H, Chu F, Zhang W, Ye M, Chen Z, Liu J, Yao H, Zhang J, Xu J, Wang T, Fan S, Wang Q. Patchouli Alcohol Modulates the Pregnancy X Receptor/Toll-like Receptor 4/Nuclear Factor Kappa B Axis to Suppress Osteoclastogenesis. Front Pharmacol 2021; 12:684976. [PMID: 34177594 PMCID: PMC8227438 DOI: 10.3389/fphar.2021.684976] [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: 03/24/2021] [Accepted: 05/17/2021] [Indexed: 11/23/2022] Open
Abstract
The incidence of osteoporosis, which is primarily characterized by plethoric osteoclast (OC) formation and severe bone loss, has increased in recent years. Millions of people worldwide, especially postmenopausal women, suffer from osteoporosis. The drugs commonly used to treat osteoporosis still exist many disadvantages, but natural extracts provide options for the treatment of osteoporosis. Therefore, the identification of cost-effective natural compounds is important. Patchouli alcohol (PA), a natural compound extracted from Pogostemon cablin that exerts anti-inflammatory effects, is used as a treatment for gastroenteritis. However, no research on the use of Patchouli alcohol in osteoporosis has been reported. We found that PA dose-dependently inhibited the receptor activator of nuclear factor kappa-B ligand (RANKL)-induced formation and function of OCs without cytotoxicity. Furthermore, these inhibitory effects were reflected in the significant effect of PA on the NF-κB signaling pathway, as PA suppressed the transcription factors NFATc1 and c-Fos. We also determined that PA activated expression of the nuclear receptor pregnane X receptor (PXR) and promoted the PXR/Toll-like receptor 4 (TLR4) axis to inhibit the nuclear import of NF-κB (p50 and p65). Additionally, PA exerted therapeutic effects against osteoporosis in ovariectomized (OVX) mice, supporting the use of PA as a treatment for osteoporosis in the future.
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Affiliation(s)
- Qian Lu
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Orthopaedics, Huzhou Central Hospital, Huzhou, China
| | - Chao Jiang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jialong Hou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hao Qian
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Feifan Chu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weiqi Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengke Ye
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziyi Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jian Liu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hanbing Yao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jianfeng Zhang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiake Xu
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Te Wang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shunwu Fan
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qingqing Wang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Oliviero S, Roberts M, Owen R, Reilly GC, Bellantuono I, Dall'Ara E. Non-invasive prediction of the mouse tibia mechanical properties from microCT images: comparison between different finite element models. Biomech Model Mechanobiol 2021; 20:941-955. [PMID: 33523337 PMCID: PMC8154847 DOI: 10.1007/s10237-021-01422-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/07/2021] [Indexed: 01/01/2023]
Abstract
New treatments for bone diseases require testing in animal models before clinical translation, and the mouse tibia is among the most common models. In vivo micro-Computed Tomography (microCT)-based micro-Finite Element (microFE) models can be used for predicting the bone strength non-invasively, after proper validation against experimental data. Different modelling techniques can be used to estimate the bone properties, and the accuracy associated with each is unclear. The aim of this study was to evaluate the ability of different microCT-based microFE models to predict the mechanical properties of the mouse tibia under compressive load. Twenty tibiae were microCT scanned at 10.4 µm voxel size and subsequently compressed at 0.03 mm/s until failure. Stiffness and failure load were measured from the load-displacement curves. Different microFE models were generated from each microCT image, with hexahedral or tetrahedral mesh, and homogeneous or heterogeneous material properties. Prediction accuracy was comparable among models. The best correlations between experimental and predicted mechanical properties, as well as lower errors, were obtained for hexahedral models with homogeneous material properties. Experimental stiffness and predicted stiffness were reasonably well correlated (R2 = 0.53-0.65, average error of 13-17%). A lower correlation was found for failure load (R2 = 0.21-0.48, average error of 9-15%). Experimental and predicted mechanical properties normalized by the total bone mass were strongly correlated (R2 = 0.75-0.80 for stiffness, R2 = 0.55-0.81 for failure load). In conclusion, hexahedral models with homogeneous material properties based on in vivo microCT images were shown to best predict the mechanical properties of the mouse tibia.
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Affiliation(s)
- S Oliviero
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
- INSIGNEO Institute for in Silico Medicine, University of Sheffield, Sheffield, UK
| | - M Roberts
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | - R Owen
- INSIGNEO Institute for in Silico Medicine, University of Sheffield, Sheffield, UK
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK
- Regenerative Medicine and Cellular Therapies, School of Pharmacy, University of Nottingham Biodiscovery Institute, University Park, UK
| | - G C Reilly
- INSIGNEO Institute for in Silico Medicine, University of Sheffield, Sheffield, UK
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK
| | - I Bellantuono
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
- INSIGNEO Institute for in Silico Medicine, University of Sheffield, Sheffield, UK
- Healthy Lifespan Institute, The Medical School, University of Sheffield, Sheffield, UK
| | - E Dall'Ara
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK.
- INSIGNEO Institute for in Silico Medicine, University of Sheffield, Sheffield, UK.
- Healthy Lifespan Institute, The Medical School, University of Sheffield, Sheffield, UK.
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18
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Li Y, Tseng WJ, de Bakker CMJ, Zhao H, Chung R, Liu XS. Peak trabecular bone microstructure predicts rate of estrogen-deficiency-induced bone loss in rats. Bone 2021; 145:115862. [PMID: 33493654 PMCID: PMC7920939 DOI: 10.1016/j.bone.2021.115862] [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: 10/09/2020] [Revised: 12/31/2020] [Accepted: 01/19/2021] [Indexed: 01/11/2023]
Abstract
Postmenopausal osteoporosis affects a large number of women worldwide. Reduced estrogen levels during menopause lead to accelerated bone remodeling, resulting in low bone mass and increased fracture risk. Both peak bone mass and the rate of bone loss are important predictors of postmenopausal osteoporosis risk. However, whether peak bone mass and/or bone microstructure directly influence the rate of bone loss following menopause remains unclear. Our study aimed to establish the relationship between peak bone mass/microstructure and the rate of bone loss in response to estrogen deficiency following ovariectomy (OVX) surgery in rats of homogeneous background by tracking the skeletal changes using in vivo micro-computed tomography (μCT) and three-dimensional (3D) image registrations. Linear regression analyses demonstrated that the peak bone microstructure, but not peak bone mass, was highly predictive of the rate of OVX-induced bone loss. In particular, the baseline trabecular thickness was found to have the highest correlation with the degree of OVX-induced bone loss and trabecular stiffness reduction. Given the same bone mass, the rats with thicker baseline trabeculae had a lower rate of trabecular microstructure and stiffness deterioration after OVX. Moreover, further evaluation to track the changes within each individual trabecula via our novel individual trabecular dynamics (ITD) analysis suggested that a trabecular network with thicker trabeculae is less likely to disconnect or perforate in response to estrogen deficiency, resulting a lower degree of bone loss. Taken together, these findings indicate that the rate of estrogen-deficiency-induced bone loss could be predicted by peak bone microstructure, most notably the trabecular thickness. Given the same bone mass, a trabecular bone phenotype with thin trabeculae may be a risk factor toward accelerated postmenopausal bone loss.
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Affiliation(s)
- Yihan Li
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Wei-Ju Tseng
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Chantal M J de Bakker
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.
| | - Hongbo Zhao
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Rebecca Chung
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - X Sherry Liu
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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19
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Improved prediction of femoral fracture toughness in mice by combining standard medical imaging with Raman spectroscopy. J Biomech 2021; 116:110243. [PMID: 33485148 DOI: 10.1016/j.jbiomech.2021.110243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/13/2020] [Accepted: 01/03/2021] [Indexed: 12/12/2022]
Abstract
Bone fragility and fracture risk are assessed by measuring the areal bone mineral density (aBMD) using dual-energy X-ray absorptiometry (DXA). While aBMD correlates with bone strength, it is a poor predictor of fragility fracture risk. Alternatively, fracture toughness assesses the bone's resistance to crack propagation and fracture, making it a suitable bone quality metric. Here, we explored how femoral midshaft measurements from DXA, micro-computed tomography (µCT), and Raman spectroscopy could predict fracture toughness. We hypothesized that ovariectomy (OVX) decreases aBMD and fracture toughness compared to controls and we can optimize a multivariate assessment of bone quality by combining results from X-ray and Raman spectroscopy. Female mice underwent an OVX (n = 5) or sham (n = 5) surgery at 3 months of age. Femurs were excised 3 months after ovariectomy and assessed with Raman spectroscopy, µCT, and DXA. Subsequently, a notch was created on the anterior side of the mid-diaphysis of the femurs. Three-point bending induced a controlled fracture that initiated at the notch. The OVX mice had a significantly lower aBMD, cortical thickness, and fracture toughness when compared to controls (p < 0.05). A leave one out cross-validated (LOOCV) partial least squares regression (PLSR) model based only on the combination of aBMD and cortical thickness showed no significant predictive correlations with fracture toughness, whereas a PLSR model based on principal components derived from the full Raman spectra yielded significant prediction (r2 = 0.71, p < 0.05). Further, the PLSR model was improved by incorporating aBMD, cortical thickness, and principal components from Raman spectra (r2 = 0.92, p < 0.001). This exploratory study demonstrates combining X-ray with Raman spectroscopy leads to a more accurate assessment of bone fracture toughness and could be a useful diagnostic tool for the assessment of fragility fracture risk.
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20
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Fok JA, Mayer C. Genetic-Code-Expansion Strategies for Vaccine Development. Chembiochem 2020; 21:3291-3300. [PMID: 32608153 PMCID: PMC7361271 DOI: 10.1002/cbic.202000343] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/29/2020] [Indexed: 12/16/2022]
Abstract
By providing long-term protection against infectious diseases, vaccinations have significantly reduced death and morbidity worldwide. In the 21st century, (bio)technological advances have paved the way for developing prophylactic vaccines that are safer and more effective as well as enabling the use of vaccines as therapeutics to treat human diseases. Here, we provide a focused review of the utility of genetic code expansion as an emerging tool for the development of vaccines. Specifically, we discuss how the incorporation of immunogenic noncanonical amino acids can aid in eliciting immune responses against adverse self-proteins and highlight the potential of an expanded genetic code for the construction of replication-incompetent viruses. We close the review by discussing the future prospects and remaining challenges for the application of these approaches in the development of both prophylactic and therapeutic vaccines in the near future.
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Affiliation(s)
- Jelle A. Fok
- Stratingh Institute for ChemistryUniversity of GroningenNijenborgh 49474 AGGroningen (TheNetherlands
| | - Clemens Mayer
- Stratingh Institute for ChemistryUniversity of GroningenNijenborgh 49474 AGGroningen (TheNetherlands
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21
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Oliviero S, Owen R, Reilly GC, Bellantuono I, Dall'Ara E. Optimization of the failure criterion in micro-Finite Element models of the mouse tibia for the non-invasive prediction of its failure load in preclinical applications. J Mech Behav Biomed Mater 2020; 113:104190. [PMID: 33191174 DOI: 10.1016/j.jmbbm.2020.104190] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/23/2020] [Accepted: 10/27/2020] [Indexed: 01/21/2023]
Abstract
New treatments against osteoporosis require testing in animal models and the mouse tibia is among the most common studied anatomical sites. In vivo micro-Computed Tomography (microCT) based micro-Finite Element (microFE) models can be used for predicting the bone strength non-invasively, after proper validation against experiments. The aim of this study was to evaluate the ability of different microCT-based bone parameters and microFE models to predict tibial structural mechanical properties in compression. Twenty tibiae were scanned at 10.4 μm voxel size and subsequently tested in uniaxial compression at 0.03 mm/s until failure. Stiffness and failure load were measured from the load-displacement curves. Standard morphometric parameters were measured from the microCT images. The spatial distribution of bone mineral content (BMC) was evaluated by dividing the tibia into 40 regions. MicroFE models were generated by converting each microCT image into a voxel-based mesh with homogeneous isotropic material properties. Failure load was estimated by using different failure criteria, and the optimized parameters were selected by minimising the errors with respect to experimental measurements. Experimental and predicted stiffness were moderately correlated (R2 = 0.65, error = 14% ± 8%). Normalized failure load was best predicted by microFE models (R2 = 0.81, error = 9% ± 6%). Failure load was not correlated to the morphometric parameters and weakly correlated with some geometrical parameters (R2 < 0.37). In conclusion, microFE models can improve the current estimation of the mouse tibia structural properties and in this study an optimal failure criterion has been defined. Since it is a non-invasive method, this approach can be applied longitudinally for evaluating temporal changes in the bone strength.
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Affiliation(s)
- S Oliviero
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, UK; INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK
| | - R Owen
- INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK; Department of Materials Science and Engineering, University of Sheffield, UK; Regenerative Medicine and Cellular Therapies, School of Pharmacy, University of Nottingham Biodiscovery Institute, University Park, UK
| | - G C Reilly
- INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK; Department of Materials Science and Engineering, University of Sheffield, UK
| | - I Bellantuono
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, UK; INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK; Healthy Lifespan Institute, Department of Oncology and Metabolism, The Medical School, University of Sheffield, UK
| | - E Dall'Ara
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, UK; INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK.
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22
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Cheong VS, Roberts BC, Kadirkamanathan V, Dall'Ara E. Bone remodelling in the mouse tibia is spatio-temporally modulated by oestrogen deficiency and external mechanical loading: A combined in vivo/in silico study. Acta Biomater 2020; 116:302-317. [PMID: 32911105 DOI: 10.1016/j.actbio.2020.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 12/17/2022]
Abstract
Osteoporosis disrupts the healthy remodelling process in bone and affects its mechanical properties. Mechanical loading has been shown to be effective in stimulating bone formation to mitigate initial bone loss. However, no study has investigated the effects of repeated mechanical loading, with a pause of one week in between, in the mouse tibia with oestrogen deficiency. This study uses a combined experimental and computational approach, through longitudinal monitoring with micro-computed tomography, to evaluate the effects of loading on bone adaptation in the tibiae of ovariectomised (OVX) C57BL/6 mice from 14 to 22 weeks of age. Micro-FE models coupled with bone adaptation algorithms were used to estimate changes in local tissue strains due to OVX and mechanical loading, and to quantify the relationship between local strain and remodelling. The first in vivo mechanical loading increased apposition, by 50-150%, while resorption decreased by 50-60%. Both endosteal and periosteal resorption increased despite the second mechanical loading, and periosteal resorption was up to 70% higher than that after the first loading. This was found to correlate with an initial decrease in average strain energy density after the first loading, which was lower and more localised after the second loading. Predictions of bone adaptation showed that between 50 and 90% of the load-induced bone apposition is linearly strain driven at the organ-level, but resorption is more biologically driven at the local level. The results imply that a systematic increase in peak load or loading rate may be required to achieve a similar bone adaptation rate in specific regions of interests.
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23
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Roberts BC, Arredondo Carrera HM, Zanjani-Pour S, Boudiffa M, Wang N, Gartland A, Dall'Ara E. PTH(1-34) treatment and/or mechanical loading have different osteogenic effects on the trabecular and cortical bone in the ovariectomized C57BL/6 mouse. Sci Rep 2020; 10:8889. [PMID: 32483372 PMCID: PMC7264307 DOI: 10.1038/s41598-020-65921-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/12/2020] [Indexed: 12/18/2022] Open
Abstract
In preclinical mouse models, a synergistic anabolic response to PTH(1–34) and tibia loading was shown. Whether combined treatment improves bone properties with oestrogen deficiency, a cardinal feature of osteoporosis, remains unknown. This study quantified the individual and combined longitudinal effects of PTH(1–34) and loading on the bone morphometric and densitometric properties in ovariectomised mice. C57BL/6 mice were ovariectomised at 14-weeks-old and treated either with injections of PTH(1–34); compressive loading of the right tibia; both interventions concurrently; or both interventions on alternating weeks. Right tibiae were microCT-scanned from 14 until 24-weeks-old. Trabecular metaphyseal and cortical midshaft morphometric properties, and bone mineral content (BMC) in 40 different regions of the tibia were measured. Mice treated only with loading showed the highest trabecular bone volume fraction at week 22. Cortical thickness was higher with co-treatment than in the mice treated with PTH alone. In the mid-diaphysis, increases in BMC were significantly higher with loading than PTH. In ovariectomised mice, the osteogenic benefits of co-treatment on the trabecular bone were lower than loading alone. However, combined interventions had increased, albeit regionally-dependent, benefits to cortical bone. Increased benefits were largest in the mid-diaphysis and postero-laterally, regions subjected to higher strains under compressive loads.
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Affiliation(s)
- Bryant C Roberts
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom. .,Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom.
| | - Hector M Arredondo Carrera
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom.,MRC Arthritis Research UK, Centre for Integrated Research into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
| | - Sahand Zanjani-Pour
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom.,Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Maya Boudiffa
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom.,MRC Arthritis Research UK, Centre for Integrated Research into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
| | - Ning Wang
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom.,MRC Arthritis Research UK, Centre for Integrated Research into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
| | - Alison Gartland
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom.,MRC Arthritis Research UK, Centre for Integrated Research into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
| | - Enrico Dall'Ara
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom.,Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom.,MRC Arthritis Research UK, Centre for Integrated Research into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
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24
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Proanthocyanidin-rich grape seed extract improves bone loss, bone healing, and implant osseointegration in ovariectomized animals. Sci Rep 2020; 10:8812. [PMID: 32483182 PMCID: PMC7264202 DOI: 10.1038/s41598-020-65403-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/04/2020] [Indexed: 01/21/2023] Open
Abstract
The purpose of the present study was to confirm if proanthocyanidin-rich grape seed extract (GSE) had the ability to improve bone health such as bone loss, bone healing, and implant osseointegration (defined as the direct connection between bone tissue and an implant) in ovariectomized (OVX) animals. We demonstrated that daily oral administration of GSE prevented bone loss in the lumbar vertebrae and femur in OVX mice. In addition, osteoclastogenesis in the lumbar spine bone of OVX mice, as assessed by histological and histomorphometric analyses, was accelerated but GSE prevented this dynamization, suggesting that GSE could counteract OVX-induced accelerated osteoclastogenic activity. In rats, OVX clearly impaired the healing of defects created on the calvaria, and GSE overcame this OVX-impaired healing. In the same way, osseointegration of a tibial implant in rats was retarded by OVX, and GSE counteracted the OVX-induced poor osseointegration, likely promoting bone healing by preventing imbalanced bone turnover. These results suggest that orally administered GSE improved implant osseointegration by mitigating the impaired bone health induced by OVX as a model of estrogen deficiency.
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25
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Chen D, Ye Z, Wang C, Wang Q, Wang H, Kuek V, Wang Z, Qiu H, Yuan J, Kenny J, Yang F, He J, Liu Y, Wang G, Zhang M, Zhang G, Wang J, Chen P, Xu J. Arctiin abrogates osteoclastogenesis and bone resorption via suppressing RANKL-induced ROS and NFATc1 activation. Pharmacol Res 2020; 159:104944. [PMID: 32454224 DOI: 10.1016/j.phrs.2020.104944] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 12/30/2022]
Abstract
Osteoporosis, characterized by disrupted bone resorption and formation, is viewed as a global health challenge. Arctiin (ARC) is a main component of Arctium lappa L, which exerts chemopreventive effects against various tumor cells. However, the role of ARC in bone remodeling is still unclear. Here, we first demonstrated that ARC inhibits osteoclast formation and bone resorption function induced by the receptor activator of nuclear factor-κB ligand (RANKL) in a dose- and time-dependent manner without exerting cytotoxic effects. Mechanistic analysis revealed that ARC not only suppresses RANKL-induced mitogen-activated protein kinase (MAPK) and calcium signaling pathways, but also enhances the expression of cytoprotective enzymes that are involved in scavenging reactive oxygen species (ROS). Further, ARC inhibits the activation of the major transcription factor nuclear factor of activated T cells 1 (NFATc1) during RANKL-induced osteoclast formation. Preclinical studies showed that ARC protects bone loss in an ovariectomy (OVX) mouse model. Conclusively, our data confirmed that ARC could potentially inhibit osteoclastogenesis by abrogating RANKL-induced MAPK, calcium, and NFATc1 signaling pathway, as well as by promoting the expression of ROS scavenging enzymes in Nrf2/Keap1/ARE signaling pathway, thereby2 preventing OVX-induced bone loss. Thus, ARC may serve as a novel therapeutic agent for the treatment of osteoporosis.
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Affiliation(s)
- Delong Chen
- Department of Orthopaedic Surgery, Clifford Hospital, Jinan University, Guangzhou 510006, China; School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Zhen Ye
- The First Affiliated Hospital, Wenzhou Medical University, Wenzhou 325000, China
| | - Chao Wang
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Qingqing Wang
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia; Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China
| | - Haibin Wang
- Department of Orthopaedic Surgery, First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Vincent Kuek
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Ziyi Wang
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Heng Qiu
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Jinbo Yuan
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Jacob Kenny
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Fan Yang
- The MOE Key Laboratory for Standardization of Chinese Medicines and the SHTCM Key Laboratory for New Resources and Quality Evaluation of Chinese Medicines, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jianbo He
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia; Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Yun Liu
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia; Department of Spine Osteopathy Surgery, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China
| | - Gang Wang
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia; Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Meng Zhang
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Gangyu Zhang
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Junjian Wang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Peng Chen
- Department of Orthopaedic Surgery, First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
| | - Jiake Xu
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia 6009, Australia.
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26
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Pepe V, Oliviero S, Cristofolini L, Dall'Ara E. Regional Nanoindentation Properties in Different Locations on the Mouse Tibia From C57BL/6 and Balb/C Female Mice. Front Bioeng Biotechnol 2020; 8:478. [PMID: 32500069 PMCID: PMC7243342 DOI: 10.3389/fbioe.2020.00478] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/24/2020] [Indexed: 01/03/2023] Open
Abstract
The local spatial heterogeneity of the material properties of the cortical and trabecular bone extracted from the mouse tibia is not well-known. Nevertheless, its characterization is fundamental to be able to study comprehensively the effect of interventions and to generate computational models to predict the bone strength preclinically. The goal of this study was to evaluate the nanoindentation properties of bone tissue extracted from two different mouse strains across the tibia length and in different sectors. Left tibiae were collected from four female mice, two C57BL/6, and two Balb/C mice. Nanoindentations with maximum 6 mN load were performed on different microstructures, regions along the axis of the tibiae, and sectors (379 in total). Reduced modulus (Er) and hardness (H) were computed for each indentation. Trabecular bone of Balb/C mice was 21% stiffer than that of C57BL/6 mice (20.8 ± 4.1 GPa vs. 16.5 ± 7.1 GPa). Moreover, the proximal regions of the bones were 13-36% less stiff than the mid-shaft and distal regions of the same bones. No significant differences were found for the different sectors for E r and H for Balb/C mice. The bone in the medial sector was found to be 8-14% harder and stiffer than the bone in the anterior or posterior sectors for C57BL/6 mice. In conclusion, this study showed that the nanoindentation properties of the mouse tibia are heterogeneous across the tibia length and the trabecular bone properties are different between Balb/C and C57BL/6 mice. These results will help the research community to identify regions where to characterize the mechanical properties of the bone during preclinical optimisation of treatments for skeletal diseases.
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Affiliation(s)
- Valentina Pepe
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom.,INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom.,Department of Industrial Engineering, Alma Mater Studiorum - Università di Bologna, Bologna, Italy
| | - Sara Oliviero
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom.,INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Luca Cristofolini
- Department of Industrial Engineering, Alma Mater Studiorum - Università di Bologna, Bologna, Italy
| | - Enrico Dall'Ara
- Department of Oncology and Metabolism, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom.,INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
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27
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Martínez-Martínez A, Muñoz-Islas E, Ramírez-Rosas MB, Acosta-González RI, Torres-Rodríguez HF, Jiménez-Andrade JM. Blockade of the colony-stimulating factor-1 receptor reverses bone loss in osteoporosis mouse models. Pharmacol Rep 2020; 72:1614-1626. [PMID: 32222915 DOI: 10.1007/s43440-020-00091-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Mice lacking either colony-stimulating factor-1 (CSF-1) or its receptor, CSF-1R, display osteopetrosis. Accordingly, genetic deletion or pharmacological blockade of CSF-1 prevents the bone loss associated with estrogen deficiency. However, the role of CSF-1R in osteoporosis models of type-1 diabetes (T1D) and ovariectomy (OVX) has not been examined. Thus, we evaluated whether CSF-1R blockade would relieve the bone loss in a model of primary osteoporosis (female mice with OVX) and a model of secondary osteoporosis (female with T1D) using micro-computed tomography. METHODS Female ICR mice at 10 weeks underwent OVX or received five daily administrations of streptozotocin (ip, 50 mg/kg) to induce T1D. Four weeks after OVX and 14 weeks after first injection of streptozotocin, mice received an anti-CSF-1R (2G2) antibody (10 mg/kg, ip; once/week for 6 weeks) or vehicle. At the last day of antibody administration, mice were sacrificed and femur and tibia were harvested for micro-computed tomography analysis. RESULTS Mice with OVX had a significant loss of trabecular bone at the distal femoral and proximal tibial metaphysis. Chronic treatment with anti-CSF-1R significantly reversed the trabecular bone loss at these anatomical sites. Streptozotocin-induced T1D resulted in significant loss of trabecular bone at the femoral neck and cortical bone at the femoral mid-diaphysis. Chronic treatment with anti-CSF-1R antibody significantly reversed the bone loss observed in mice with T1D. CONCLUSION Our results demonstrate that blockade of CSF-1R signaling reverses bone loss in two different mouse models of osteoporosis.
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Affiliation(s)
- Arisaí Martínez-Martínez
- Laboratorio de Farmacología, Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, 88740, Reynosa, TAMPS, México
| | - Enriqueta Muñoz-Islas
- Laboratorio de Farmacología, Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, 88740, Reynosa, TAMPS, México
| | - Martha B Ramírez-Rosas
- Laboratorio de Farmacología, Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, 88740, Reynosa, TAMPS, México
| | - Rosa I Acosta-González
- Laboratorio de Farmacología, Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, 88740, Reynosa, TAMPS, México
| | - Héctor F Torres-Rodríguez
- Laboratorio de Farmacología, Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, 88740, Reynosa, TAMPS, México
| | - Juan M Jiménez-Andrade
- Laboratorio de Farmacología, Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, 88740, Reynosa, TAMPS, México.
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Rakowski AG, Veličković P, Dall’Ara E, Liò P. ChronoMID-Cross-modal neural networks for 3-D temporal medical imaging data. PLoS One 2020; 15:e0228962. [PMID: 32084166 PMCID: PMC7034884 DOI: 10.1371/journal.pone.0228962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 01/27/2020] [Indexed: 11/19/2022] Open
Abstract
ChronoMID-neural networks for temporally-varying, hence Chrono, Medical Imaging Data-makes the novel application of cross-modal convolutional neural networks (X-CNNs) to the medical domain. In this paper, we present multiple approaches for incorporating temporal information into X-CNNs and compare their performance in a case study on the classification of abnormal bone remodelling in mice. Previous work developing medical models has predominantly focused on either spatial or temporal aspects, but rarely both. Our models seek to unify these complementary sources of information and derive insights in a bottom-up, data-driven approach. As with many medical datasets, the case study herein exhibits deep rather than wide data; we apply various techniques, including extensive regularisation, to account for this. After training on a balanced set of approximately 70000 images, two of the models-those using difference maps from known reference points-outperformed a state-of-the-art convolutional neural network baseline by over 30pp (> 99% vs. 68.26%) on an unseen, balanced validation set comprising around 20000 images. These models are expected to perform well with sparse data sets based on both previous findings with X-CNNs and the representations of time used, which permit arbitrarily large and irregular gaps between data points. Our results highlight the importance of identifying a suitable description of time for a problem domain, as unsuitable descriptors may not only fail to improve a model, they may in fact confound it.
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Affiliation(s)
- Alexander G. Rakowski
- Computer Laboratory, University of Cambridge, Cambridge, Cambs, England, United Kingdom
| | - Petar Veličković
- Computer Laboratory, University of Cambridge, Cambridge, Cambs, England, United Kingdom
| | - Enrico Dall’Ara
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, South Yorkshire, England, United Kingdom
| | - Pietro Liò
- Computer Laboratory, University of Cambridge, Cambridge, Cambs, England, United Kingdom
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Oliviero S, Giorgi M, Laud PJ, Dall’Ara E. Effect of repeated in vivo microCT imaging on the properties of the mouse tibia. PLoS One 2019; 14:e0225127. [PMID: 31751367 PMCID: PMC6874075 DOI: 10.1371/journal.pone.0225127] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/29/2019] [Indexed: 01/01/2023] Open
Abstract
In longitudinal studies, in vivo micro-Computed Tomography (microCT) imaging is used to investigate bone changes over time due to interventions in mice. However, ionising radiation can provoke significant variations in bone morphometric parameters. In a previous study, we evaluated the effect of reducing the integration time on the properties of the mouse tibia measured from microCT images. A scanning procedure (100 ms integration time, 256 mGy nominal radiation dose) was selected as the best compromise between image quality and radiation dose induced on the animal. In this work, the effect of repeated in vivo scans has been evaluated using the selected procedure. The right tibia of twelve female C57BL/6 (six wild type, WT, six ovariectomised, OVX) and twelve BALB/c (six WT, six OVX) mice was scanned every two weeks, starting at week 14 of age. At week 24, mice were sacrificed and both tibiae were scanned. Standard trabecular and cortical morphometric parameters were calculated. The spatial distribution of densitometric parameters (e.g. bone mineral content) was obtained by dividing each tibia in 40 partitions. Stiffness and strength in compression were estimated using homogeneous linear elastic microCT-based micro-Finite Element models. Differences between right (irradiated) and left (non-irradiated control) tibiae were evaluated for each parameter. The irradiated tibiae had higher Tb.Th (+3.3%) and Tb.Sp (+11.6%), and lower Tb.N (-14.2%) compared to non-irradiated tibiae, consistently across both strains and intervention groups. A reduction in Tb.BV/TV (-14.9%) was also observed in the C57BL/6 strain. In the OVX group, a small reduction was also observed in Tt.Ar (-5.0%). In conclusion, repeated microCT scans (at 256 mGy, 5 scans, every two weeks) had limited effects on the mouse tibia, compared to the expected changes induced by bone treatments. Therefore, the selected scanning protocol is acceptable for measuring the effect of bone interventions in vivo.
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Affiliation(s)
- Sara Oliviero
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- * E-mail:
| | - Mario Giorgi
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Certara QSP, Certara UK Ltd., Simcyp Division, Sheffield, United Kingdom
| | - Peter J. Laud
- Statistical Services Unit, University of Sheffield, Sheffield, United Kingdom
| | - Enrico Dall’Ara
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- MRC Arthritis Research UK Centre for Integrated research into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
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