1
|
Feng C, Zhang K, Zhan S, Gan Y, Xiang X, Niu W. Mechanical impact of regional structural deterioration and tissue-level compensation on proximal femur trabecular bone. Front Bioeng Biotechnol 2024; 12:1448708. [PMID: 39315313 PMCID: PMC11416999 DOI: 10.3389/fbioe.2024.1448708] [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: 06/13/2024] [Accepted: 08/27/2024] [Indexed: 09/25/2024] Open
Abstract
Introduction Osteoporosis-induced changes in bone structure and composition significantly reduce bone strength, particularly in the human proximal femur. This study examines how these changes affect the mechanical performance of trabecular bone to enhance diagnosis, prevention, and treatment strategies. Methods A proximal femur sample was scanned using micro-CT at 40 μm resolution. Five regions of interest were selected within the femoral head, femoral neck, and greater trochanter. Structural models simulating various stages of osteoporosis were created using image processing software. Micro-finite element analysis evaluated the mechanical properties of trabecular bone under different conditions of structural deterioration and tissue-level elastic modulus variations. The combined effects of structural deterioration and tissue-level mechanical properties on trabecular bone mechanical performance were further analyzed. Results The mechanical performance of trabecular bone generally follows a power-law relationship with its microstructural characteristics. However, in any specific region, the apparent mechanical properties linearly decrease with structural deterioration. The femoral neck and greater trochanter are more sensitive to structural deterioration than the femoral head. A 5% bone mass loss in the femoral head led to a 7% reduction in mechanical performance, while the femoral neck experienced a 12% loss. Increasing tissue-level elastic modulus improved mechanical performance, partially offsetting bone mass reduction effects. Conclusion Trabecular bone in low bone mass regions is more affected by bone mass loss. Structural deterioration primarily reduces bone strength, but improvements in tissue-level properties can mitigate this effect, especially in early osteoporosis. Targeted assessments and interventions are crucial for effective management. Future research should explore heterogeneous deterioration models to better understand osteoporosis progression.
Collapse
Affiliation(s)
- Chenglong Feng
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Ke Zhang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Shi Zhan
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
- Biomechanical Laboratory of Orthopedic Surgery Department, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yuxiong Gan
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Xinhao Xiang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Wenxin Niu
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| |
Collapse
|
2
|
Raimann A, Misof BM, Fratzl P, Fratzl-Zelman N. Bone Material Properties in Bone Diseases Affecting Children. Curr Osteoporos Rep 2023; 21:787-805. [PMID: 37897675 DOI: 10.1007/s11914-023-00822-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE OF REVIEW Metabolic and genetic bone disorders affect not only bone mass but often also the bone material, including degree of mineralization, matrix organization, and lacunar porosity. The quality of juvenile bone is moreover highly influenced by skeletal growth. This review aims to provide a compact summary of the present knowledge on the complex interplay between bone modeling and remodeling during skeletal growth and to alert the reader to the complexity of bone tissue characteristics in children with bone disorders. RECENT FINDINGS We describe cellular events together with the characteristics of the different tissues and organic matrix organization (cartilage, woven and lamellar bone) occurring during linear growth. Subsequently, we present typical alterations thereof in disorders leading to over-mineralized bone matrix compared to those associated with low or normal mineral content based on bone biopsy studies. Growth spurts or growth retardation might amplify or mask disease-related alterations in bone material, which makes the interpretation of bone tissue findings in children complex and challenging.
Collapse
Affiliation(s)
- Adalbert Raimann
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna, Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria
| | - Barbara M Misof
- Vienna Bone and Growth Center, Vienna, Austria
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Center Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - Peter Fratzl
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Research Campus Golm, Potsdam, Germany
| | - Nadja Fratzl-Zelman
- Vienna Bone and Growth Center, Vienna, Austria.
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Center Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria.
| |
Collapse
|
3
|
Iolascon G, Paoletta M, Liguori S, Gimigliano F, Moretti A. Bone fragility: conceptual framework, therapeutic implications, and COVID-19-related issues. Ther Adv Musculoskelet Dis 2022; 14:1759720X221133429. [PMID: 36317067 PMCID: PMC9614590 DOI: 10.1177/1759720x221133429] [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: 06/29/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Bone fragility is the susceptibility to fracture even for common loads because of structural, architectural, or material alterations of bone tissue that result in poor bone strength. In osteoporosis, quantitative and qualitative changes in density, geometry, and micro-architecture modify the internal stress state predisposing to fragility fractures. Bone fragility substantially depends on the structural behavior related to the size and shape of the bone characterized by different responses in the load-deformation curve and on the material behavior that reflects the intrinsic material properties of the bone itself, such as yield and fatigue. From a clinical perspective, the measurement of bone density by DXA remains the gold standard for defining the risk of fragility fracture in all population groups. However, non-quantitative parameters, such as macro-architecture, geometry, tissue material properties, and microcracks accumulation can modify the bone's mechanical strength. This review provides an overview of the role of different contributors to bone fragility and how these factors might be influenced by the use of anti-osteoporotic drugs and by the COVID-19 pandemic.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, 80138 Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| |
Collapse
|
4
|
Paschalis EP, Gamsjaeger S, Burr DB. Bone quality in an ovariectomized monkey animal model treated with two doses of teriparatide for either 18 months, or 12 months followed by withdrawal for 6 months. Bone 2022; 158:116366. [PMID: 35167989 DOI: 10.1016/j.bone.2022.116366] [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: 12/14/2021] [Revised: 01/27/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Previous studies of ovariectomized (OVX) monkeys, treated with recombinant human parathyroid hormone (PTH) (1-34) at 1 or 5 μg/kg/day for 18 months or for 12 months followed by 6 months withdrawal from treatment, displayed significant changes in geometry, histomorphometry, and bone quality, but without strict tissue age criteria, of the midshaft humerus. Since bone quality significantly depends on tissue age among other factors, the aim of the present study was to establish the bone-turnover independent effects of two doses of PTH, as well as the effects of treatment withdrawal on bone quality by measuring bone material composition at precisely known tissue ages ranging from osteoid, to mineralized tissue older than 373 days. Raman microspectroscopic analysis of bone tissue from the mid-shaft humerus of OVX monkeys demonstrated that the clinically relevant dose of PTH administered for 18 months reverses the effects of ovariectomy on bone quality when compared against SHAM. Both doses investigated in this study restore the mineralization regulation mechanisms to SHAM levels. The study also showed that the beneficial effects induced by 12 months of clinically relevant PTH therapy were sustained after six months of therapy withdrawal.
Collapse
Affiliation(s)
- E P Paschalis
- Ludwig Boltzmann Institute for Osteology, at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria.
| | - S Gamsjaeger
- Ludwig Boltzmann Institute for Osteology, at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - D B Burr
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Biomedical Engineering, Indiana University-Purdue University, Indianapolis (IUPUI), Indianapolis, IN 46202, USA
| |
Collapse
|
5
|
Falgayrac G, Farlay D, Ponçon C, Béhal H, Gardegaront M, Ammann P, Boivin G, Cortet B. Bone matrix quality in paired iliac bone biopsies from postmenopausal women treated for 12 months with strontium ranelate or alendronate. Bone 2021; 153:116107. [PMID: 34260980 DOI: 10.1016/j.bone.2021.116107] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023]
Abstract
Bone quality is altered mainly by osteoporosis, which is treated with modulators of bone quality. Knowledge of their mechanisms of action is crucial to understand their effects on bone quality. The goal of our study was to compare the action of alendronate (ALN) and strontium ranelate (SrRan) on the determinants of bone quality. The investigation was performed on over 60 paired human iliac biopsies. Paired samples correspond to biopsies obtained from the same patient, one before treatment (baseline) and one after 12 months of treatment, in postmenopausal women with osteoporosis. Vibrational spectroscopy (Raman and FTIRM) and nanoindentation were used to evaluate the effect of both drugs on bone quality at the ultrastructural level. Outcomes measured by vibrational spectroscopy and nanoindentation are sensitive to bone age. New bone packets are distinguished from old bone packets. Thus, the effect of bone age is distinguished from the treatment effect. Both drugs modify the mineral and organic composition in new and old bone in different fashions after 12 months of administration. The new bone formed during ALN administration is characterized by an increased mineral content, carbonation and apatite crystal size/perfection compared to baseline. Post-translational modifications of collagen are observed through an increase in the hydroxyproline/proline ratio in new bone. The proteoglycan content is also increased in new bone. SrRan directly modulates bone quality through its physicochemical actions, independent of an effect on bone remodeling. Strontium cations are captured by the hydrated layer of the mineral matrix. The mineral matrix formed during SrRan administration has a lower carbonate content and crystallinity after 12 months than at baseline. Strontium might create bonds (crosslinks) with collagen and noncollagenous proteins in new and old bone. The nanomechanical properties of bone were not modified with either ALN or SrRan, probably due to the short duration of administration. Our results show that ALN and SrRan have differential effects on bone quality in relation to their mechanism of action.
Collapse
Affiliation(s)
- Guillaume Falgayrac
- Univ. Lille, CHU Lille, Univ. Littoral Côte d'Opale, ULR 4490 - MABLab, F-59000 Lille, France.
| | - Delphine Farlay
- INSERM, UMR1033, Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Camille Ponçon
- INSERM, UMR1033, Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Hélène Béhal
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - Marc Gardegaront
- INSERM, UMR1033, Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Patrick Ammann
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospital, 4, rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland
| | - Georges Boivin
- INSERM, UMR1033, Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Bernard Cortet
- Univ. Lille, CHU Lille, Univ. Littoral Côte d'Opale, ULR 4490 - MABLab, F-59000 Lille, France
| |
Collapse
|
6
|
Woźniczka M, Błaszczak-Świątkiewicz K. New Generation of Meso and Antiprogestins (SPRMs) into the Osteoporosis Approach. Molecules 2021; 26:6491. [PMID: 34770897 PMCID: PMC8588216 DOI: 10.3390/molecules26216491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/04/2021] [Accepted: 10/19/2021] [Indexed: 01/09/2023] Open
Abstract
Receptor activator of nuclear factor κB (RANK) and its ligand (RANKL) play key roles in bone metabolism and the immune system. The RANK/RANKL complex has also been shown to be critical in the formation of mammary epithelia cells. The female hormones estradiol and progesterone closely control the action of RANKL with RANK. Blood concentration of these sex hormones in the postmenopausal period leads to an increase in RANK/RANKL signaling and are a major cause of women's osteoporosis, characterized by altered bone mineralization. Knowledge of the biochemical relationships between hormones and RANK/RANKL signaling provides the opportunity to design novel therapeutic agents to inhibit bone loss, based on the anti-RANKL treatment and inhibition of its interaction with the RANK receptor. The new generation of both anti- and mesoprogestins that inhibit the NF-κB-cyclin D1 axis and blocks the binding of RANKL to RANK can be considered as a potential source of new RANK receptor ligands with anti-RANKL function, which may provide a new perspective into osteoporosis treatment itself as well as limit the osteoporosis rise during breast cancer metastasis to the bone.
Collapse
Affiliation(s)
| | - Katarzyna Błaszczak-Świątkiewicz
- Department of Physical and Biocoordination Chemistry, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland;
| |
Collapse
|
7
|
Abdul Halim NA, Hussein MZ, Kandar MK. Nanomaterials-Upconverted Hydroxyapatite for Bone Tissue Engineering and a Platform for Drug Delivery. Int J Nanomedicine 2021; 16:6477-6496. [PMID: 34584412 PMCID: PMC8464594 DOI: 10.2147/ijn.s298936] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/30/2021] [Indexed: 01/03/2023] Open
Abstract
Hydroxyapatite is a basic mineral that is very important to the human body framework. Recently, synthetic hydroxyapatite (SHA) and its nanocomposites (HANs) are the subject of intense research for bone tissue engineering and drug loading system applications, due to their unique, tailor-made characteristics, as well as their similarities with the bone mineral component in the human body. Although hydroxyapatite has good biocompatibility and osteoconductive characteristics, the poor mechanical strength restricts its use in non-load-bearing applications. Consequently, a rapid increase in reinforcing of other nanomaterials into hydroxyapatite for the formation of HANs could improve the mechanical properties. Most of the research reported on the success of other nanomaterials such as metals, ceramics and natural/synthetic polymers as additions into hydroxyapatite is reviewed. In addition, this review also focuses on the addition of various substances into hydroxyapatite for the formation of various HANs and at the same time to try to minimize the limitations so that various bone tissue engineering and drug loading system applications can be exploited.
Collapse
Affiliation(s)
- Nur Akma Abdul Halim
- Materials Synthesis and Characterization Laboratory, Institute of Advanced Technology, Seri Kembangan, Selangor Darul Ehsan, 43400, Malaysia
| | - Mohd Zobir Hussein
- Materials Synthesis and Characterization Laboratory, Institute of Advanced Technology, Seri Kembangan, Selangor Darul Ehsan, 43400, Malaysia
| | - Mohd Khairuddin Kandar
- Department of Orthopedics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Selangor Darul Ehsan, 43400, Malaysia
| |
Collapse
|