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Columbres RCA, Din S, Gibbs L, Kimonis V. Bone scan findings of Paget's disease of bone in patients with VCP Multisystem Proteinopathy 1. Sci Rep 2024; 14:5917. [PMID: 38467645 PMCID: PMC10928154 DOI: 10.1038/s41598-024-54526-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024] Open
Abstract
Multisystem Proteinopathy 1 (MSP1) disease is a rare genetic disorder caused by mutations in the Valosin-Containing Protein (VCP) gene with clinical features of inclusion body myopathy (IBM), frontotemporal dementia (FTD), and Paget's disease of bone (PDB). We performed bone scan imaging in twelve patients (6 females, 6 males) with confirmed VCP gene mutation six (50%) of which has myopathy alone, four (33%) with both PDB and myopathy, and two (15%) were presymptomatic carriers. We aim to characterize the PDB in diagnosed individuals, and potentially identify PDB in the myopathy and presymptomatic groups. Interestingly, two patients with previously undiagnosed PDB had positive diagnostic findings on the bone scan and subsequent radiograph imaging. Among the individuals with PDB, increased radiotracer uptake of the affected bones were of typical distribution as seen in conventional PDB and those reported in other MSP1 cohorts which are the thoracic spine and ribs (75%), pelvis (75%), shoulder (75%) and calvarium (15%). Overall, we show that technetium-99m bone scans done at regular intervals are a sensitive screening tool in patients with MSP1 associated VCP variants at risk for PDB. However, diagnostic confirmation should be coupled with clinical history, biochemical analysis, and skeletal radiographs to facilitate early treatment and prevention complications, acknowledging its limited specificity.
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Affiliation(s)
- Rod Carlo Agram Columbres
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, CA, USA
- College of Osteopathic Medicine, William Carey University, Hattiesburg, MS, USA
| | - Sarosh Din
- College of Osteopathic Medicine, William Carey University, Hattiesburg, MS, USA
| | - Liliane Gibbs
- Department of Radiology, University of California, Irvine, CA, USA
| | - Virginia Kimonis
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, CA, USA.
- Department of Pathology, University of California, Irvine, CA, USA.
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Michou L, Gamache P, Guertin JR, Tarride JE, Brown JP, Jean S. Prevalence and incidence of Paget's disease of bone: Temporal trend over 20 years in the province of Quebec, Canada. Bone 2023; 176:116895. [PMID: 37683713 DOI: 10.1016/j.bone.2023.116895] [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: 06/14/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Paget's disease of bone (PDB) is a focal bone disorder characterized by an increased bone remodeling and an anarchic bone structure. A decline of prevalence and incidence of PDB has been observed in some countries. No epidemiological data are available on PDB in Canada. AIMS We aimed at examining the evolution of the prevalence and incidence of PDB in Quebec (Canada) by analyzing health administrative databases. METHODS PDB case definition relied on one or more hospitalizations, or one or more physician-billing claims with a diagnosis code of PDB. To identify incident cases, a 'run-in' period of four years (1996-1999) was used to exclude prevalent cases. For each fiscal year from 2000 to 2001 to 2019-2020 (population size 2,914,480), crude age and sex-specific prevalence and incidence rates of PDB among individuals aged ≥55 years were determined, and sex-specific rates were also standardized to the 2011 age structure of the Quebec population. Generalized linear regressions were used to test for linear changes in standardized prevalence and incidence rates. RESULTS Over the study period, standardized prevalence of PDB has remained stable in Quebec, from 0.44 % in 2000/2001 to 0.43 % in 2019/2020 (mean change -0.002, p-value = 0.0935). For the 2019-2020 fiscal year, 13,165 men and women had been diagnosed with PDB and prevalence of PDB increased with age. Standardized incidence of PDB has decreased over time from 0.77/1000 in 2000/2001 to 0.28/1000 in 2019-2020 (mean change -0.228/year, p-value<0.0001), the incidence decreasing from 0.82/1000 to 0.37/1000 in men and from 0.76/1000 to 0.22/1000 in women, respectively. This decrease was observed in all age categories. CONCLUSION With the exception of a slight increase in PDB prevalence up to 0.55 % in years 2005 to 2007, the prevalence of PDB has remained stable in Quebec over the past 20 years, 13,160 men and women being currently diagnosed with PDB. The incidence has decreased over time. Our results support the epidemiological changes of PDB reported in other countries.
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Affiliation(s)
- Laetitia Michou
- CHU de Québec-Université Laval Research Centre, Quebec, Quebec, Canada; Department of Medicine, Université Laval, Quebec, Quebec, Canada.
| | - Philippe Gamache
- Institut national de santé publique du Québec, Quebec, Quebec, Canada
| | - Jason R Guertin
- CHU de Québec-Université Laval Research Centre, Quebec, Quebec, Canada; Department of preventive and social medicine, Université Laval, Quebec, Quebec, Canada
| | - Jean-Eric Tarride
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jacques P Brown
- CHU de Québec-Université Laval Research Centre, Quebec, Quebec, Canada; Department of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Sonia Jean
- Institut national de santé publique du Québec, Quebec, Quebec, Canada; Department of preventive and social medicine, Université Laval, Quebec, Quebec, Canada
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Di Conza G, Barbaro F, Zini N, Spaletta G, Remaggi G, Elviri L, Mosca S, Caravelli S, Mosca M, Toni R. Woven bone formation and mineralization by rat mesenchymal stromal cells imply increased expression of the intermediate filament desmin. Front Endocrinol (Lausanne) 2023; 14:1234569. [PMID: 37732119 PMCID: PMC10507407 DOI: 10.3389/fendo.2023.1234569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023] Open
Abstract
Background Disordered and hypomineralized woven bone formation by dysfunctional mesenchymal stromal cells (MSCs) characterize delayed fracture healing and endocrine -metabolic bone disorders like fibrous dysplasia and Paget disease of bone. To shed light on molecular players in osteoblast differentiation, woven bone formation, and mineralization by MSCs we looked at the intermediate filament desmin (DES) during the skeletogenic commitment of rat bone marrow MSCs (rBMSCs), where its bone-related action remains elusive. Results Monolayer cultures of immunophenotypically- and morphologically - characterized, adult male rBMSCs showed co-localization of desmin (DES) with vimentin, F-actin, and runx2 in all cell morphotypes, each contributing to sparse and dense colonies. Proteomic analysis of these cells revealed a topologically-relevant interactome, focused on cytoskeletal and related enzymes//chaperone/signalling molecules linking DES to runx2 and alkaline phosphatase (ALP). Osteogenic differentiation led to mineralized woven bone nodules confined to dense colonies, significantly smaller and more circular with respect to controls. It significantly increased also colony-forming efficiency and the number of DES-immunoreactive dense colonies, and immunostaining of co-localized DES/runx-2 and DES/ALP. These data confirmed pre-osteoblastic and osteoblastic differentiation, woven bone formation, and mineralization, supporting DES as a player in the molecular pathway leading to the osteogenic fate of rBMSCs. Conclusion Immunocytochemical and morphometric studies coupled with proteomic and bioinformatic analysis support the concept that DES may act as an upstream signal for the skeletogenic commitment of rBMSCs. Thus, we suggest that altered metabolism of osteoblasts, woven bone, and mineralization by dysfunctional BMSCs might early be revealed by changes in DES expression//levels. Non-union fractures and endocrine - metabolic bone disorders like fibrous dysplasia and Paget disease of bone might take advantage of this molecular evidence for their early diagnosis and follow-up.
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Affiliation(s)
- Giusy Di Conza
- Department of Medicine and Surgery - DIMEC, Unit of Biomedical, Biotechnological and Translational Sciences (S.BI.BI.T.), Laboratory of Regenerative Morphology and Bioartificial Structures (Re.Mo.Bio.S.), and Museum and Historical Library of Biomedicine - BIOMED, University of Parma, Parma, Italy
| | - Fulvio Barbaro
- Department of Medicine and Surgery - DIMEC, Unit of Biomedical, Biotechnological and Translational Sciences (S.BI.BI.T.), Laboratory of Regenerative Morphology and Bioartificial Structures (Re.Mo.Bio.S.), and Museum and Historical Library of Biomedicine - BIOMED, University of Parma, Parma, Italy
| | - Nicoletta Zini
- Unit of Bologna, National Research Council of Italy (CNR) Institute of Molecular Genetics “Luigi Luca Cavalli-Sforza”, Bologna, Italy
- IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giulia Spaletta
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
| | - Giulia Remaggi
- Food and Drug Department, University of Parma, Parma, Italy
| | - Lisa Elviri
- Food and Drug Department, University of Parma, Parma, Italy
| | - Salvatore Mosca
- Course on Disorders of the Locomotor System, Fellow Program in Orthopaedics and Traumatology, University Vita-Salute San Raffaele, Milan, Italy
| | - Silvio Caravelli
- II Clinic of Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Massimiliano Mosca
- II Clinic of Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Roberto Toni
- Department of Medicine and Surgery - DIMEC, Unit of Biomedical, Biotechnological and Translational Sciences (S.BI.BI.T.), Laboratory of Regenerative Morphology and Bioartificial Structures (Re.Mo.Bio.S.), and Museum and Historical Library of Biomedicine - BIOMED, University of Parma, Parma, Italy
- Endocrinology, Diabetes, and Nutrition Disorders Outpatient Clinic, Osteoporosis, Nutrition, Endocrinology, and Innovative Therapies (OSTEONET) Unit, Galliera Medical Center (GMC), San Venanzio di Galliera, BO, Italy
- Section IV - Medical Sciences, Academy of Sciences of the Institute of Bologna, Bologna, Italy
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Tufts Medical Center - Tufts University School of Medicine, Boston, MA, United States
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You Y, Simonyan D, Bureau A, Gagnon E, Albert C, Guertin JR, Tarride JE, Brown JP, Michou L. Molecular test of Paget's disease of bone in families not linked to SQSTM1 gene mutations. Bone Rep 2023; 18:101670. [PMID: 36915391 PMCID: PMC10006713 DOI: 10.1016/j.bonr.2023.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/26/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose Paget's disease of bone (PDB) is a focal metabolic bone disorder characterized by an increased bone remodeling. Fifteen to 40 % of PDB patients have a familial form with an autosomal dominant inheritance. Disease-causing mutations of the SQSTM1 gene have been linked to PDB in about 40 % of families whereas genes linked to the remaining families are unknown. Several single nucleotide polymorphisms (SNPs) have been associated with PDB in unrelated patient non-carriers of a SQSTM1 mutation. The current clinical practice guidelines still recommend the measure of serum total alkaline phosphatase (sALP) for PDB screening. In unrelated individual non-carriers of SQSTM1 mutations, we previously developed a genetic test combining male sex with five genetic markers (rs499345, rs5742915, rs2458413, rs3018362, rs2234968), giving rise to an area under the curve (AUC) for PDB phenotype of 0.73 (0.69; 0.77). A combination of male sex with total calcium corrected for albumin and Procollagen type I N-terminal propeptide (P1NP), had an AUC of 0.82 (0.73; 0.92). Combining both genetic and biochemical tests increased the AUC to 0.89 (0.83; 0.95). Objective This study aimed at estimating the performance of our previous test of PDB, in families not linked to SQSTM1 mutations with disease-causing genes yet unknown, and at developing a new algorithm if the performance is not satisfactory. Methods We genotyped the five SNPs cited above, and measured calcium corrected for albumin and P1NP in 181 relatives, with PDB or not, from 19 PDB families not linked to SQSTM1 mutations. Bivariate and multivariate logistic regression models including male sex were fitted to search for a molecular test that could best detect PDB in these families. A receiving operating characteristics analysis was done to establish a cut-off point for continuous variables. Results Logistic regression estimates of our previous molecular test gave rise to a high sensitivity of 78 %, 97 % and 88 % for the genetic, biochemical, and combined test but the specificity was very low, 35 %, 11 % and 21 %, respectively. This poor specificity persisted even when the cut-off point was changed. We then generated in these families, new logistic regression estimates but on the same parameters as mentioned above, giving rise to an AUC of 0.65 (0.55; 0.75) for the genetic test, of 0.84 (0.74; 0.94) for the biochemical test, and 0.89 (0.82; 0.96) for the combination test, the latter having a sensitivity of 96 % and specificity of 57 %. By comparison serum P1NP alone gave rise to an AUC of 0.84 (0.73; 0.94), with a sensitivity of 71 % and a specificity of 79 %. Conclusion In PDB families not linked to SQSTM1 mutations, the estimates of our previous molecular test gave rise to a poor specificity. Using new estimates, the biochemical and combined tests have similar predictive abilities than our former test. Serum P1NP is a bone marker of interest for the screening for PDB in families not linked to SQSTM1 mutations.
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Affiliation(s)
- Yang You
- CHU de Québec-Université Laval Research Centre, Québec, QC, Canada.,Division of Rheumatology, Department of Medicine, Université Laval, Québec, QC, Canada
| | - David Simonyan
- CHU de Québec-Université Laval Research Centre, Québec, QC, Canada
| | - Alexandre Bureau
- Département de médecine sociale et préventive, Université Laval, Québec, QC, Canada.,Centre de recherche du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Edith Gagnon
- CHU de Québec-Université Laval Research Centre, Québec, QC, Canada
| | | | - Jason R Guertin
- CHU de Québec-Université Laval Research Centre, Québec, QC, Canada.,Département de médecine sociale et préventive, Université Laval, Québec, QC, Canada
| | - Jean-Eric Tarride
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jacques P Brown
- CHU de Québec-Université Laval Research Centre, Québec, QC, Canada.,Division of Rheumatology, Department of Medicine, Université Laval, Québec, QC, Canada
| | - Laëtitia Michou
- CHU de Québec-Université Laval Research Centre, Québec, QC, Canada.,Division of Rheumatology, Department of Medicine, Université Laval, Québec, QC, Canada.,Department of Rheumatology, CHU de Québec-Université Laval, Québec, QC, Canada
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5
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Dessay M, Couture E, Maaroufi H, Fournier F, Gagnon E, Droit A, Brown JP, Michou L. Attenuated clinical and osteoclastic phenotypes of Paget's disease of bone linked to the p.Pro392Leu/SQSTM1 mutation by a rare variant in the DOCK6 gene. BMC Med Genomics 2022; 15:41. [PMID: 35241069 PMCID: PMC8895793 DOI: 10.1186/s12920-022-01198-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 02/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background We identified two families with Paget's disease of bone (PDB) linked to the p.Pro392Leu mutation within the SQSTM1 gene displaying a possible digenism. This study aimed at identifying this second genetic variant cosegregating with the p.Pro392Leu mutation and at characterizing its impact on the clinical and cellular phenotypes of PDB. Methods Whole exome sequencing was performed in one patient per family and two healthy controls. We compared clinical characteristics of PDB in 14 relatives from the two families. The osteoclastic phenotype was compared in in vitro differentiated osteoclasts from 31 participants carrying the DOCK6 and/or SQSTM1 variants. Tridimensional models of SQSTM1 and DOCK6 proteins were generated to evaluate the impact of these variants on their stability and flexibility. Statistical analyses were performed with Graphpad prism. Results Whole-exome sequencing allowed us to identify the p.Val45Ile missense variant in the DOCK6 gene in patients. In both families, the mean age at PDB diagnosis was delayed in pagetic patients carrier of the p.Val45Ile variant alone compared to those carrying the p.Pro392Leu mutation alone (67 vs. 44 years, P = 0.03). Although both p.Val45Ile and p.Pro392Leu variants gave rise to a pagetic phenotype of osteoclast versus healthy controls, the p.Val45Ile variant was found to attenuate the severity of the osteoclastic phenotype of PDB caused by the p.Pro392Leu mutation when both variants were present. The DOCK6 mRNA expression was higher in carriers of the p.Val45Ile variant than in pagetic patients without any mutations and healthy controls. Structural bioinformatics analyses suggested that the p.Pro392Leu mutation might rigidify the UBA domain and thus decrease its possible intramolecular interaction with a novel domain, the serum response factor–transcription factor (SRF-TF)-like domain, whereas the p.Val45Ile variant may decrease SRF-TF-like activity. Conclusion The p.Val45Ile variant may attenuate the severity of the clinical phenotype of PDB in patient carriers of both variants. In vitro, the rare variant of the DOCK6 may have a modifier effect on the p.Pro392Leu mutation, possibly via its effect on the SRF-TF-like. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-022-01198-9.
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Affiliation(s)
- Mariam Dessay
- CHU de Québec-Université Laval Research Centre, Quebec City, QC, Canada
| | - Emile Couture
- CHU de Québec-Université Laval Research Centre, Quebec City, QC, Canada
| | - Halim Maaroufi
- Institut de Biologie Intégrative Et Des Systèmes (IBIS), Université Laval, Quebec, QC, Canada
| | - Frédéric Fournier
- CHU de Québec-Université Laval Research Centre, Quebec City, QC, Canada
| | - Edith Gagnon
- CHU de Québec-Université Laval Research Centre, Quebec City, QC, Canada
| | - Arnaud Droit
- CHU de Québec-Université Laval Research Centre, Quebec City, QC, Canada
| | - Jacques P Brown
- CHU de Québec-Université Laval Research Centre, Quebec City, QC, Canada.,Department of Medicine, Université Laval, Quebec, QC, Canada
| | - Laëtitia Michou
- CHU de Québec-Université Laval Research Centre, Quebec City, QC, Canada. .,Department of Medicine, Université Laval, Quebec, QC, Canada. .,Department of Rheumatology-R4774, CHU de Québec-Université Laval, 2705 boulevard Laurier, Quebec, QC, G1V 4G2, Canada.
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De Ridder R, Vandeweyer G, Boudin E, Hendrickx G, Huybrechts Y, Cremers TC, Devogelaer JP, Mortier G, Fransen E, Van Hul W. A Panel-Based Sequencing Analysis of Patients with Paget's Disease of Bone Suggests Enrichment of Rare Genetic Variation in regulators of NF-κB Signaling and Supports the Importance of the 7q33 Locus. Calcif Tissue Int 2021; 109:656-665. [PMID: 34173013 DOI: 10.1007/s00223-021-00881-w] [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: 04/07/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
Paget's disease of bone (PDB) is a common bone disorder characterized by focal lesions caused by increased bone turnover. Monogenic forms of PDB and PDB-related phenotypes as well as genome-wide association studies strongly support the involvement of genetic variation in components of the NF-κB signaling pathway in the pathogenesis of PDB. In this study, we performed a panel-based mutation screening of 52 genes. Single variant association testing and a series of gene-based association tests were performed. The former revealed a novel association with NFKBIA and further supports an involvement of variation in NR4A1, VCP, TNFRSF11A, and NUP205. The latter indicated a trend for enrichment of rare genetic variation in GAB2 and PRKCI. Both single variant tests and gene-based tests highlighted two genes, NR4A1 and NUP205. In conclusion, our findings support the involvement of genetic variation in modulators of NF-κB signaling in PDB and confirm the association of previously associated genes with the pathogenesis of PDB.
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Affiliation(s)
- Raphaël De Ridder
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Geert Vandeweyer
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Eveline Boudin
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Gretl Hendrickx
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Yentl Huybrechts
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Tycho Canter Cremers
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Jean-Pierre Devogelaer
- Department of Rheumatology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Geert Mortier
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Erik Fransen
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Wim Van Hul
- Center of Medical Genetics, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium.
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Morley JE. Editorial: Old Bones. J Nutr Health Aging 2020; 24:544-546. [PMID: 32510103 DOI: 10.1007/s12603-020-1355-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J E Morley
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO 63104,
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Michou L, Orcel P. Has Paget's bone disease become rare? Joint Bone Spine 2019; 86:538-541. [DOI: 10.1016/j.jbspin.2019.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
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Kesterke MJ, Judd MA. A microscopic evaluation of Paget's disease of bone from a Byzantine monastic crypt in Jordan. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:293-298. [PMID: 30154045 DOI: 10.1016/j.ijpp.2018.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/10/2018] [Accepted: 08/12/2018] [Indexed: 06/08/2023]
Abstract
Paget's disease of bone (PDB) is a metabolic bone disease that has been present in human populations for over 2000 years, with the earliest cases reported in Western Europe. Now present globally, PDB is one of the most common metabolic bone diseases in modern populations. This study details possible PDB of an adult male (MNR-EN Skull 3) with abnormally thickened cranial bones (17 mm). The skull was recovered from commingled skeletal remains excavated from the Robebus crypt at the Byzantine monastery of Mount Nebo, Jordan (c. late 4-7th C). Micro-CT imaging and histological sections of the bone samples revealed an abnormal pattern of bone remodeling, with atypical osteon formation, convoluted and enlarged trabeculae, and an overall pattern of highly vascularized bone. Polarized microscopy produced a mix of woven bone and lamellar bone, the mosaic pattern of atypical bone remodeling indicative of PDB. Coupled with the dense, thickened nature of the vault bones, these data suggest that the individual had PDB. To our knowledge, this represents the earliest evidence of PDB in the Middle East supported by micro-analysis, and adds to the emerging paleopathological literature involving commingled skeletal remains and the potential for identifying unique disease processes.
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Affiliation(s)
- Matthew J Kesterke
- Texas A&M College of Dentistry, Department of Biomedical Sciences, 3302 Gaston Avenue, Dallas, TX, 75206, United States.
| | - Margaret A Judd
- University of Pittsburgh, Department of Anthropology, 3302 Posvar Hall, Pittsburgh, PA, 15260, United States.
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10
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Gene-environment interactions in Paget's disease of bone. Joint Bone Spine 2018; 86:373-380. [PMID: 30594595 DOI: 10.1016/j.jbspin.2018.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/28/2018] [Accepted: 12/19/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES This study explored the role of outdoor and indoor air pollutants in Paget's disease of bone (PDB). METHODS We performed a survey in 140 French-Canadian patients with PDB, including 39 carriers of p.Pro392Leu mutation (SQSTM1 gene) and 113 healthy not mutated controls. The survey covered outdoor air pollution near the residence and indoor air pollutants by focusing on heating fuels and exposure to tobacco smoke. In a subgroup of patients, urinary concentrations of 17 heavy metals and 11 polycyclic aromatic hydrocarbons were measured by mass spectrometry. In light of what we learned from the survey and urinary assays, we explored the in vitro effects of certain toxics on osteoclasts in PDB. We conducted in vitro monocytes differentiation from peripheral blood of more than 40 participants, whose osteoclasts were treated with or without the toxic. The morphology of osteoclasts, their bone resorption abilities, gene and protein expression levels, and cellular oxidative stress levels were assayed. RESULTS An inhibitory effect of cigarette smoke condensate and heavy metals was observed on morphology and bone resorption activity of patients' osteoclasts. SQSTM1 gene expression was upregulated in osteoclasts from patients with PDB versus healthy controls in presence of cadmium, and SQSTM1 protein expression was upregulated in presence of bismuth and tobacco smoke condensates, in particular in osteoclasts from carriers of the SQSTM1 mutation. Furthermore, high levels of oxidative stress in patients' osteoclasts were observed. CONCLUSIONS Our in vitro experiments suggest an interaction between SQSTM1 gene and exposure to cadmium and tobacco smoke condensates.
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de Melo VCP, Ferreira PRS, Ricardi LO, Batista MC, França CN, Ferreira CEDS. Definition of reference ranges for β-isomerized carboxy-terminal telopeptide collagen type I for children and adolescents. J Pediatr Endocrinol Metab 2018; 31:637-640. [PMID: 29750652 DOI: 10.1515/jpem-2018-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/03/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bone metabolism involves many complex pathways that are disturbed by several bone diseases. The literature shows some limitations concerning pediatric reference intervals to bone markers, mainly because of the low number of patients included in the studies, the heterogeneity of methods, beyond the fact that it is time-consuming and expensive. The aim of this study was to determine reference values for β-isomerized carboxy-terminal telopeptides collagen type I (β-CTX), a marker of bone resorption, for children and adolescents. METHODS Blood samples from 246 patients were collected and β-CTX was measured using an electrochemiluminescence immunoassay (ECLI). RESULTS AND CONCLUSIONS We propose reference ranges for β-CTX concentration from the 2.5 percentile and 97.5 percentile for each age group. The reference values obtained, concerning children and adolescents, might be useful in the evaluation of diseases such as osteosarcoma and anorexia in both childhood as adolescence.
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Affiliation(s)
| | | | | | | | - Carolina N França
- Universidade Santo Amaro, Pós Graduação em Ciências da Saúde, São Paulo, SP, Brazil
| | - Carlos E Dos S Ferreira
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Federal University of São Paulo, São Paulo, SP, Brazil
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Alaya R, Alaya Z, Nang M, Bouajina E. [Paget's disease of bone: Diagnostic and therapeutic updates]. Rev Med Interne 2017; 39:185-191. [PMID: 28690091 DOI: 10.1016/j.revmed.2017.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 03/09/2017] [Accepted: 05/30/2017] [Indexed: 11/15/2022]
Abstract
Paget's disease of bone is the second most common metabolic bone disease after osteoporosis. Its pathogenesis is not yet clearly understood. Geographic distribution and epidemiological variations suggest a role of genetic and environmental factors in its pathophysiology. The frequency of the Paget's disease of bone increases with age. Its discovery can be fortuitous. Prognosis mainly depends on the occurrence of complications involving bones and joints, neurological, cardiovascular or metabolic systems. Treatment of symptomatic forms currently relies on bisphosphonates that have transformed its prognosis.
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Affiliation(s)
- R Alaya
- Service de rhumatologie, centre hospitalier Sud Francilien, 91100 Corbeil-Essonnes, France
| | - Z Alaya
- Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
| | - M Nang
- Service de rhumatologie, centre hospitalier Sud Francilien, 91100 Corbeil-Essonnes, France
| | - E Bouajina
- Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
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Rai NP, Anekar J, Mustafa SM, Devang Divakar D. Paget's disease with craniofacial and skeletal bone involvement. BMJ Case Rep 2016; 2016:bcr-2016-216173. [PMID: 27587747 DOI: 10.1136/bcr-2016-216173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Paget's disease is a metabolic disorder of bone caused due to defect in the remodelling process and is very common in western countries but is very rare in Asians and Africans. It was first described by a British scientist Sir James Paget in 1877. It can be monostotic or polyostotic depending on the number of bones involved. It most commonly affects older people of more than 50 years. Disease involvement can be symptomatic or asymptomatic depending on the extent of the disease process. Diagnosis of Paget's disease can be made by raised serum alkaline phosphatase levels, radiological examination and by radioisotope bone scans.
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Affiliation(s)
- Narendra Prakash Rai
- Department of Oral Medicine and Radiology, Lincoln University College, Kuala Lumpur, Malaysia
| | - Jayaprasad Anekar
- Department of Oral Medicine and Radiology, KVG Dental College and Hospital, Karnataka, India
| | - Shabil Mohamed Mustafa
- Department of Oral Medicine and Radiology, Malabar Dental College and Research Centre, Kerala, India
| | - Darshan Devang Divakar
- Department of Oral Medicine and Radiology, College of Applied Medical Sciences, Dental Biomaterial Research Chair, King Saud University, Riyadh, Saudi Arabia
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