1
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Yoo YS, Kim MG, Park HJ, Chae MY, Choi YJ, Oh CK, Son CG, Lee EJ. Additional effects of herbal medicine combined with bisphosphonates for primary osteoporosis: a systematic review and meta-analysis. Front Pharmacol 2024; 15:1413515. [PMID: 39346562 PMCID: PMC11427380 DOI: 10.3389/fphar.2024.1413515] [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: 04/07/2024] [Accepted: 08/26/2024] [Indexed: 10/01/2024] Open
Abstract
Background Osteoporosis (OP) is a significant medical issue associated with population aging. Recent research on herbal medicines (HMs) for OP has been increasing, with these therapies sometimes used in conjunction with bisphosphonates (BPs), the standard treatment for OP. We conducted a systematic review and meta-analysis to evaluate the effects of combining HMs with BPs on improving bone mineral density (BMD) in patients with primary OP. Methods We searched nine databases-PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Wanfang, KISS, Kmbase, Science On, and Oasis-up to 31 August 2023. We selected randomized controlled trials (RCTs) comparing BMD between HMs plus BPs and BPs alone in primary OP. A meta-analysis with BMD as the primary outcome was performed using RevMan version 5.4. Study quality and evidence certainty were assessed through Cochrane's risk of bias2 and GRADE. Results Out of 43 RCTs involving 4,470 participants (mean age 65.8 ± 6.6 years), 35 RCTs with 3,693 participants were included in the meta-analysis. The combination of HMs and BPs was found to be more effective in improving BMD compared to BPs alone, with improvements of 0.10 g/cm2 at the lumbar spine (33 RCTs, 95% CI: 0.07-0.12, p < 0.001, I2 = 93%) and 0.08 g/cm2 at the femoral neck (20 RCTs, 95% CI: 0.05-0.12, p < 0.001, I2 = 94%), though this result was associated with high heterogeneity, high risk of bias, and very low certainty of evidence. Conclusion Our data suggest the possibility that combining HMs with BPs may improve BMD in primary OP more effectively than using BPs alone. However, the results should be interpreted with caution due to the high heterogeneity and low quality of the studies included in the review. Therefore, further well-designed RCTs are needed to confirm these findings. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023392139.
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Affiliation(s)
- Young-Seo Yoo
- College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Min-Gyeong Kim
- College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Hee-Joo Park
- College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Min-Young Chae
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Yu-Jin Choi
- Institute of Bioscience and Integrative Medicine, Department of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chae-Kun Oh
- Department of Herbal Formula, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Institute of Bioscience and Integrative Medicine, Department of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
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2
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Pan W, Gu J, Xu S, Zhang C, Wang J, Wang S, Xu J. Dietary nitrate improves jaw bone remodelling in zoledronate-treated mice. Cell Prolif 2023:e13395. [PMID: 36810909 DOI: 10.1111/cpr.13395] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 02/24/2023] Open
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication that occurs in patients with osteoporosis or metastatic bone cancer treated with bisphosphonate. There is still no effective treatment and prevention strategy for BRONJ. Inorganic nitrate, which is abundant in green vegetables, has been reported to be protective in multiple diseases. To investigate the effects of dietary nitrate on BRONJ-like lesions in mice, we utilized a well-established mouse BRONJ model, in which tooth extraction was performed. Specifically, 4 mM sodium nitrate was administered in advance through drinking water to assess the short- and long-term effects on BRONJ. Zoledronate injection could induce severe healing inhibition of the tooth extraction socket, while addition of pretreating dietary nitrate could alleviate the inhibition by reducing monocyte necrosis and inflammatory cytokines production. Mechanistically, nitrate intake increased plasma nitric oxide levels, which attenuated necroptosis of monocytes by downregulating lipid and lipid-like molecule metabolism via a RIPK3 dependent pathway. Our findings revealed that dietary nitrate could inhibit monocyte necroptosis in BRONJ, regulate the bone immune microenvironment and promote bone remodelling after injury. This study contributes to the understanding of the immunopathogenesis of zoledronate and supports the feasibility of dietary nitrate for the clinical prevention of BRONJ.
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Affiliation(s)
- Wen Pan
- Salivary Gland Disease Centre and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Jianyu Gu
- Salivary Gland Disease Centre and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Shihan Xu
- Salivary Gland Disease Centre and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Chunmei Zhang
- Salivary Gland Disease Centre and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,Immunology Research Centre for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Laboratory for Oral and General Health Integration and Translation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinsong Wang
- Salivary Gland Disease Centre and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Songlin Wang
- Salivary Gland Disease Centre and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,Immunology Research Centre for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Laboratory for Oral and General Health Integration and Translation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Research Units of Tooth Development and Regeneration, Chinese Academy of Medical Sciences, Beijing, China
| | - Junji Xu
- Salivary Gland Disease Centre and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China.,Immunology Research Centre for Oral and Systemic Health, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Laboratory for Oral and General Health Integration and Translation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Research Units of Tooth Development and Regeneration, Chinese Academy of Medical Sciences, Beijing, China.,Department of Periodontics, Beijing Stomatological Hospital, Capital Medical University School of Stomatology, Beijing, China.,Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
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3
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Xiong Y, Li L, Liu P, Zhou B, Kang Y, Wang G. Effect of Teriparatide Versus Zoledronate on Posterior Lumbar Interbody Fusion in Postmenopausal Women with Osteoporosis. World Neurosurg 2022; 167:e1310-e1316. [PMID: 36096387 DOI: 10.1016/j.wneu.2022.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We evaluated the efficacy of teriparatide versus zoledronate on spinal fusion in osteoporotic patients after posterior lumbar interbody fusion (PLIF). METHODS Postmenopausal women with osteoporosis undergoing PLIF for degenerative spondylolisthesis were randomly assigned to receive either zoledronate or teriparatide. During the 2-year follow-up period, serial radiographs were used to determine fusion status and instrumentation-related sequelae (a composite of adjacent vertebral compressive fracture, instrumentation failure, and fusion failure). The bone mineral density (BMD) and Oswestry disability index (ODI) were also serially measured. RESULTS Of the 77 patients, 36 were in the teriparatide group and 41 in the zoledronate group and had completed the 2-year follow-up assessments. Bony union had been achieved more frequently in the teriparatide group than in the zoledronate group at 6 months postoperatively (P < 0.05), although the overall rate of bone union was comparable between the 2 groups. The incidence of instrumentation-related sequelae was also comparable between the 2 groups (teriparatide vs. zoledronate group, 13.9% vs. 22.0%). Regarding antiosteoporosis, the BMD values had significantly improved in both groups at the last follow-up. The teriparatide group had attained more BMD increments at 12 months postoperatively than had the zoledronate group. Furthermore, the ODI had consistently decreased in both groups with a lower ODI in the teriparatide group than in the zoledronate group at 12 months postoperatively. CONCLUSIONS Among postmenopausal women with osteoporosis, teriparatide showed superior bone union at 6 months and greater BMD improvement at 12 months after PLIF compared with zoledronate administration, although both resulted in similar overall effects on spinal fusion.
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Affiliation(s)
- Yu Xiong
- Department of Spine Surgery, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Liang Li
- Department of Spine Surgery, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Ping Liu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha City, China
| | - Bin Zhou
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha City, China
| | - Yijun Kang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha City, China
| | - Guoqiang Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha City, China.
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4
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Lu J, Hu D, Ma C, Shuai B. Advances in Our Understanding of the Mechanism of Action of Drugs (including Traditional Chinese Medicines) for the Intervention and Treatment of Osteoporosis. Front Pharmacol 2022; 13:938447. [PMID: 35774616 PMCID: PMC9237325 DOI: 10.3389/fphar.2022.938447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/23/2022] [Indexed: 12/12/2022] Open
Abstract
Osteoporosis (OP) is known as a silent disease in which the loss of bone mass and bone density does not cause obvious symptoms, resulting in insufficient treatment and preventive measures. The losses of bone mass and bone density become more severe over time and an only small percentage of patients are diagnosed when OP-related fractures occur. The high disability and mortality rates of OP-related fractures cause great psychological and physical damage and impose a heavy economic burden on individuals and society. Therefore, early intervention and treatment must be emphasized to achieve the overall goal of reducing the fracture risk. Anti-OP drugs are currently divided into three classes: antiresorptive agents, anabolic agents, and drugs with other mechanisms. In this review, research progress related to common anti-OP drugs in these three classes as well as targeted therapies is summarized to help researchers and clinicians understand their mechanisms of action and to promote pharmacological research and novel drug development.
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5
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Chin KY, Ekeuku SO, Trias A. The Role of Geranylgeraniol in Managing Bisphosphonate-Related Osteonecrosis of the Jaw. Front Pharmacol 2022; 13:878556. [PMID: 35600875 PMCID: PMC9114760 DOI: 10.3389/fphar.2022.878556] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/20/2022] [Indexed: 12/03/2022] Open
Abstract
Medication-related osteonecrosis of the jaw (ONJ) is a rare but significant adverse side effect of antiresorptive drugs. Bisphosphonate-related ONJ (BRONJ) is the most prevalent condition due to the extensive use of the drug in cancer and osteoporosis treatment. Nitrogen-containing bisphosphonates suppress osteoclastic resorption by inhibiting farnesyl pyrophosphate synthase in the mevalonate pathway, leading to deficiency of the substrate for GTPase prenylation. The bone remodelling process is uncoupled, subsequently impairing bone healing and causing ONJ. Targeted administration of geranylgeraniol (GGOH) represents a promising approach to mitigate BRONJ because GGOH is a substrate for GTPase prenylation. In the current review, the in vitro effects of GGOH on osteoclasts, osteoblasts and other related cells of the jaw are summarised. We also present and appraise the current in vivo evidence of GGOH in managing BRONJ in animal models. Lastly, several considerations of using GGOH in the clinical management of BRONJ are highlighted. As a conclusion, GGOH is a promising topical agent to manage BRONJ, pending more research on an effective delivery system and validation from a clinical trial.
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Affiliation(s)
- Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- *Correspondence: Kok-Yong Chin,
| | - Sophia Ogechi Ekeuku
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Anne Trias
- American River Nutrition, Hadley, MA, United States
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6
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The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review. Heliyon 2021; 7:e05914. [PMID: 33490677 PMCID: PMC7810783 DOI: 10.1016/j.heliyon.2021.e05914] [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: 09/12/2020] [Revised: 12/21/2020] [Accepted: 01/05/2021] [Indexed: 01/05/2023] Open
Abstract
Objectives Medication-related osteonecrosis of the jaw (MRONJ) is rare. It is a serious adverse effect of certain drugs, of which bisphosphonates (BPs) are the most widely known. The aim of this systematic review was to analyze all published evidence for the reported adverse outcomes as a result of orthodontic treatment in patients undergoing antiresorptive therapy. Data All types of studies involving patients undergoing orthodontic treatment and treated with antiresorptive drugs were considered. A meta-analysis was not conducted due to the high amount of variability and heterogeneity in the reporting and presentation of data among the studies meeting the inclusion criteria. Sources A systematic search was performed using 4 databases (PubMed, MEDLINE, EMBASE and CINAHL). Study selection Seven studies matched the inclusion criteria for this review, reporting a total of 29 patients. MRONJ was only reported in 1 patient. The adverse outcomes following orthodontic treatment included difficulty achieving root parallelism (n = 4), difficulty achieving complete space closure (n = 3), exaggerated tooth mobility post-debond (n = 2), increased duration of orthodontic treatment beyond expected completion (n = 1), sclerotic alveolar bone changes seen on post-op radiographic images (n = 2), and an increased amount of root resorption (n = 1). Conclusions The high amount of heterogeneity and limited evidence precluded a valid interpretation and analysis of the results through pooling of data. Additional data with sufficient quality, a reduction of bias, and a greater prospective cohort of patients is crucial to assess adverse effects, mechanisms of action, and associated risk factors in at-risk patients. Clinical significance Based on the limited evidence available in the literature, it is unclear whether orthodontic treatment alone can precipitate MRONJ. However, antiresorptive drug therapy may be associated with a sub-optimal treatment outcome.
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7
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Cometa S, Bonifacio MA, Tranquillo E, Gloria A, Domingos M, De Giglio E. A 3D Printed Composite Scaffold Loaded with Clodronate to Regenerate Osteoporotic Bone: In Vitro Characterization. Polymers (Basel) 2021; 13:polym13010150. [PMID: 33401469 PMCID: PMC7795460 DOI: 10.3390/polym13010150] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/16/2022] Open
Abstract
Additive manufacturing (AM) is changing our current approach to the clinical treatment of bone diseases, providing new opportunities to fabricate customized, complex 3D structures with bioactive materials. Among several AM techniques, the BioCell Printing is an advanced, integrated system for material manufacture, sterilization, direct cell seeding and growth, which allows for the production of high-resolution micro-architectures. This work proposes the use of the BioCell Printing to fabricate polymer-based scaffolds reinforced with ceramics and loaded with bisphosphonates for the treatment of osteoporotic bone fractures. In particular, biodegradable poly(ε-caprolactone) was blended with hydroxyapatite particles and clodronate, a bisphosphonate with known efficacy against several bone diseases. The scaffolds' morphology was investigated by means of Scanning Electron Microscopy (SEM) and micro-Computed Tomography (micro-CT) while Energy Dispersive X-ray Spectroscopy (EDX) and X-ray Photoelectron Spectroscopy (XPS) revealed the scaffolds' elemental composition. A thermal characterization of the composites was accomplished by Thermogravimetric analyses (TGA). The mechanical performance of printed scaffolds was investigated under static compression and compared against that of native human bone. The designed 3D scaffolds promoted the attachment and proliferation of human MSCs. In addition, the presence of clodronate supported cell differentiation, as demonstrated by the normalized alkaline phosphatase activity. The obtained results show that the BioCell Printing can easily be employed to generate 3D constructs with pre-defined internal/external shapes capable of acting as a temporary physical template for regeneration of cancellous bone tissues.
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Affiliation(s)
| | - Maria Addolorata Bonifacio
- Department of Chemistry, University of Bari Aldo Moro, Via E. Orabona 4, 70126 Bari, Italy;
- INSTM, National Consortium of Materials Science and Technology, Via G. Giusti 9, 50121 Florence, Italy
| | - Elisabetta Tranquillo
- Department of Mechanical, Aerospace and Civil Engineering & Henry Royce Institute, School of Engineering, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK;
| | - Antonio Gloria
- Institute of Polymers, Composites and Biomaterials, National Research Council of Italy, V.le J.F. Kennedy 54-Mostra d’Oltremare Pad. 20, 80125 Naples, Italy;
| | - Marco Domingos
- Department of Mechanical, Aerospace and Civil Engineering & Henry Royce Institute, School of Engineering, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK;
- Correspondence: (M.D.); (E.D.G.)
| | - Elvira De Giglio
- Department of Chemistry, University of Bari Aldo Moro, Via E. Orabona 4, 70126 Bari, Italy;
- INSTM, National Consortium of Materials Science and Technology, Via G. Giusti 9, 50121 Florence, Italy
- Correspondence: (M.D.); (E.D.G.)
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8
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Rothe R, Schulze S, Neuber C, Hauser S, Rammelt S, Pietzsch J. Adjuvant drug-assisted bone healing: Part III - Further strategies for local and systemic modulation. Clin Hemorheol Microcirc 2020; 73:439-488. [PMID: 31177207 DOI: 10.3233/ch-199104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this third in a series of reviews on adjuvant drug-assisted bone healing, further approaches aiming at influencing the healing process are discussed. Local and systemic modulation of bone metabolism is pursued with use of a number of drugs with completely different indications, which are characterized by a pleiotropic spectrum of action. These include drugs used to treat lipid disorders (HMG-CoA reductase inhibitors), hypertension (ACE inhibitors), osteoporosis (bisphosphonates), cancer (proteasome inhibitors) and others. Potential applications to enhance bone healing are discussed.
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Affiliation(s)
- Rebecca Rothe
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sabine Schulze
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christin Neuber
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sandra Hauser
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Stefan Rammelt
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Center for Regenerative Therapies Dresden (CRTD), Tatzberg 4, Dresden
| | - Jens Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, Dresden, Germany
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9
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Kitasato S, Tanaka T, Chazono M, Komaki H, Kakuta A, Inagaki N, Akiyama S, Marumo K. Local application of alendronate controls bone formation and β-tricalcium phosphate resorption induced by recombinant human bone morphogenetic protein-2. J Biomed Mater Res A 2019; 108:528-536. [PMID: 31702866 DOI: 10.1002/jbm.a.36833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/28/2019] [Accepted: 11/01/2019] [Indexed: 12/22/2022]
Abstract
This study examined the ability of local alendronate (ALN) administration to control β-tricalcium phosphate (β-TCP) resorption as well as the induction of bone formation by recombinant human bone morphogenetic protein-2 (rhBMP-2). A 15-mm critical-sized bone defect was created in the diaphysis of rabbit ulnae. Nine female rabbits (4 to 5 months-old) were divided into 3 groups. Group 1 (n = 6 ulnae) animals received implants consisting of β-TCP granules and 25 μg of rhBMP-2 in 6.5% collagen gel. Group 2 (6 ulnae) and Group 3 (6 ulnae) animals received the same implants, but with 10-6 M and 10-3 M ALN-treated TCP granules, respectively. Two weeks postsurgery, tartrate-resistant acid phosphatase-positive cell counts, new bone formation, and residual β-TCP were evaluated. This study showed that a high dose of ALN strongly reduced osteoclastic resorption of β-TCP induced by rhBMP-2, resulting in decreased bone formation. In contrast, a low dose of ALN slightly reduced the bone resorptive effect but increased bone formation. These results suggest that osteoclast-mediated resorption plays an important role in bone formation and a coupling-like phenomenon could occur in the β-TCP-implanted area, and that administration of a low dose of ALN may solve clinical bone resorptive problems induced by rhBMP-2.
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Affiliation(s)
- Seiichiro Kitasato
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Takaaki Tanaka
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan.,Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Tochigi, Japan
| | - Masaaki Chazono
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan.,Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Tochigi, Japan
| | - Hirokazu Komaki
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Atsuhito Kakuta
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Naoya Inagaki
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Shoshi Akiyama
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Keishi Marumo
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
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10
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Özalp Ö, Toru HS, Altay MA, Sindel A. Evaluation of the Efficacy of EDTA Chelation on Alveolar Bone Healing After Ultrasonic and Conventional Surgery Under Bisphosphonate Medication: A Rat Model. J Oral Maxillofac Surg 2019; 77:1982-1989. [PMID: 31095928 DOI: 10.1016/j.joms.2019.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE The aims of the present study were 1) to investigate the effects of local ethylenediaminetetraacetic acid (EDTA) chelation on alveolar bone healing after systemic administration of bisphosphonates; and 2) to compare the healing in alveolar defects created with ultrasonic and conventional surgery. MATERIALS AND METHODS A total of 40 male Wistar rats were divided into 4 equal groups of 10 rats each (zoledronate and piezosurgery, zoledronate and bur, placebo and piezosurgery, and placebo and bur). The first 2 groups received weekly intraperitoneal injections of zoledronic acid (0.06 mg/kg), and the second 2 groups received saline solution for 4 weeks. After the last injections, horizontal defects 4 × 2 × 1 mm in size were created on the mandibular alveolar bone using piezosurgery or conventional bur surgery. The zoledronate groups received 10 minutes of local application of EDTA on 1 side and saline solution on the other side. In the placebo groups, only 1 side was treated (one half of the group with the bur and one half of the group with piezosurgery). All the rats were euthanized at 4 postoperative weeks for comparative histomorphometric evaluation of bone healing in the created defects. RESULTS Bone formation was found to be the greatest in the placebo groups (P < .05). Although a greater amount of bone formation was observed with piezosurgery and EDTA among the bisphosphonate-treated groups, the difference between the zoledronate groups was not statistically significant (P > .05). Similarly, no statistically significant difference was found between the use of piezosurgery and conventional bur surgery within the placebo groups (P > .05). CONCLUSIONS The findings of the present study revealed improved bone healing with the use of piezosurgery and EDTA chelation, although the difference did not reach statistical significance. Further research should be performed to clearly identify the role of EDTA as a chelating agent and in prevention of medication-related osteonecrosis of the jaws development.
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Affiliation(s)
- Öznur Özalp
- Specialist, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Havva Serap Toru
- Associate Professor, Department of Pathology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Mehmet Ali Altay
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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11
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Madhurakkat Perikamana SK, Lee SM, Lee J, Ahmad T, Lee MS, Yang HS, Shin H. Oxidative Epigallocatechin Gallate Coating on Polymeric Substrates for Bone Tissue Regeneration. Macromol Biosci 2019; 19:e1800392. [DOI: 10.1002/mabi.201800392] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/21/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Sajeesh Kumar Madhurakkat Perikamana
- Department of BioengineeringHanyang University 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
- BK21 Plus Future Biopharmaceutical Human Resources Training and Research Team 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
| | - Sang Min Lee
- Department of BioengineeringHanyang University 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
- BK21 Plus Future Biopharmaceutical Human Resources Training and Research Team 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
| | - Jinkyu Lee
- Department of BioengineeringHanyang University 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
- BK21 Plus Future Biopharmaceutical Human Resources Training and Research Team 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
| | - Taufiq Ahmad
- Department of BioengineeringHanyang University 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
- BK21 Plus Future Biopharmaceutical Human Resources Training and Research Team 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
| | - Min Suk Lee
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative MedicineDankook University Cheonan 31116 Republic of Korea
| | - Hee Seok Yang
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative MedicineDankook University Cheonan 31116 Republic of Korea
| | - Heungsoo Shin
- Department of BioengineeringHanyang University 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
- BK21 Plus Future Biopharmaceutical Human Resources Training and Research Team 222 Wangsimni‐ro Seongdong‐gu Seoul 04763 Republic of Korea
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12
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Makino T, Tsukazaki H, Ukon Y, Tateiwa D, Yoshikawa H, Kaito T. The Biological Enhancement of Spinal Fusion for Spinal Degenerative Disease. Int J Mol Sci 2018; 19:ijms19082430. [PMID: 30126106 PMCID: PMC6121547 DOI: 10.3390/ijms19082430] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/04/2018] [Accepted: 08/14/2018] [Indexed: 12/16/2022] Open
Abstract
In this era of aging societies, the number of elderly individuals who undergo spinal arthrodesis for various degenerative diseases is increasing. Poor bone quality and osteogenic ability in older patients, due to osteoporosis, often interfere with achieving bone fusion after spinal arthrodesis. Enhancement of bone fusion requires shifting bone homeostasis toward increased bone formation and reduced resorption. Several biological enhancement strategies of bone formation have been conducted in animal models of spinal arthrodesis and human clinical trials. Pharmacological agents for osteoporosis have also been shown to be effective in enhancing bone fusion. Cytokines, which activate bone formation, such as bone morphogenetic proteins, have already been clinically used to enhance bone fusion for spinal arthrodesis. Recently, stem cells have attracted considerable attention as a cell source of osteoblasts, promising effects in enhancing bone fusion. Drug delivery systems will also need to be further developed to assure the safe delivery of bone-enhancing agents to the site of spinal arthrodesis. Our aim in this review is to appraise the current state of knowledge and evidence regarding bone enhancement strategies for spinal fusion for degenerative spinal disorders, and to identify future directions for biological bone enhancement strategies, including pharmacological, cell and gene therapy approaches.
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Affiliation(s)
- Takahiro Makino
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Hiroyuki Tsukazaki
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yuichiro Ukon
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Daisuke Tateiwa
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Hideki Yoshikawa
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Takashi Kaito
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
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13
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Lacbay CM, Waller DD, Park J, Gómez Palou M, Vincent F, Huang XF, Ta V, Berghuis AM, Sebag M, Tsantrizos YS. Unraveling the Prenylation-Cancer Paradox in Multiple Myeloma with Novel Geranylgeranyl Pyrophosphate Synthase (GGPPS) Inhibitors. J Med Chem 2018; 61:6904-6917. [PMID: 30016091 DOI: 10.1021/acs.jmedchem.8b00886] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Post-translational prenylation of the small GTP-binding proteins (GTPases) is vital to a plethora of biological processes, including cellular proliferation. We have identified a new class of thienopyrimidine-based bisphosphonate (ThP-BP) inhibitors of the human geranylgeranyl pyrophosphate synthase (hGGPPS) that block protein prenylation in multiple myeloma (MM) cells leading to cellular apoptosis. These inhibitors are also effective in blocking the proliferation of other types of cancer cells. We confirmed intracellular target engagement, demonstrated the mechanism of action leading to apoptosis, and determined a direct correlation between apoptosis and intracellular inhibition of hGGPPS. Administration of a ThP-BP inhibitor to a MM mouse model confirmed in vivo downregulation of Rap1A geranylgeranylation and reduction of monoclonal immunoglobulins (M-protein, a biomarker of disease burden) in the serum. These results provide the first proof-of-principle that hGGPPS is a valuable therapeutic target in oncology and more specifically for the treatment of multiple myeloma.
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Affiliation(s)
- Cyrus M Lacbay
- Department of Chemistry , McGill University , Montreal , QC H3A 0B8 , Canada
| | - Daniel D Waller
- Department of Medicine , McGill University , Montreal , QC H3A 1A1 , Canada
| | - Jaeok Park
- Department of Biochemistry , McGill University , Montreal , QC H3G 1Y6 , Canada
| | - Mònica Gómez Palou
- Department of Medicine , McGill University , Montreal , QC H3A 1A1 , Canada
| | - Félix Vincent
- Department of Chemistry , McGill University , Montreal , QC H3A 0B8 , Canada
| | - Xian Fang Huang
- Department of Medicine , McGill University , Montreal , QC H3A 1A1 , Canada
| | - Viviane Ta
- Department of Chemistry , McGill University , Montreal , QC H3A 0B8 , Canada
| | - Albert M Berghuis
- Department of Biochemistry , McGill University , Montreal , QC H3G 1Y6 , Canada
| | - Michael Sebag
- Department of Medicine , McGill University , Montreal , QC H3A 1A1 , Canada.,Division of Hematology , McGill University Health Center , Montreal , QC H4A 3J1 , Canada
| | - Youla S Tsantrizos
- Department of Chemistry , McGill University , Montreal , QC H3A 0B8 , Canada.,Department of Biochemistry , McGill University , Montreal , QC H3G 1Y6 , Canada
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14
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Arbelaez ML, Viafara Garcia SM, Lopez JP, Avila D, Munevar JC, Pauwels A. Effect of bisphosphonates on orthodontic tooth movement in osteoporotic patients: A review. J World Fed Orthod 2018. [DOI: 10.1016/j.ejwf.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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15
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Shen M, Wu R, Jin R, Pan J, Guo F, Li Z, Lin X, Xu S. Injection of synthetic mesenchymal stem cell mitigates osteoporosis in rats after ovariectomy. J Cell Mol Med 2018; 22:3751-3757. [PMID: 29770568 PMCID: PMC6050498 DOI: 10.1111/jcmm.13618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 02/16/2018] [Indexed: 12/18/2022] Open
Abstract
Osteoporosis is a severe skeletal disorder. Patients have a low bone mineral density and bone structural deterioration. Mounting lines of evidence suggest that inappropriate apoptosis of osteoblasts/osteocytes leads to maladaptive bone remodelling in osteoporosis. It has been suggested that transplantation of stem cells, including mesenchymal stem cells, may alter the trajectory of bone remoulding and mitigate osteoporosis in animal models. However, stem cells needed to be carefully stored and characterized before usage. In addition, there is great batch‐to‐batch variation in stem cell production. Here, we fabricated therapeutic polymer microparticles from the secretome and membranes of mesenchymal stem cells (MSCs). These synthetic MSCs contain growth factors secreted by MSCs. In addition, these particles display MSC surface molecules. In vitro, co‐culture with synthetic MSCs increases the viability of osteoblast cells. In a rat model of ovariectomy‐induced osteoporosis, injection of synthetic MSCs mitigated osteoporosis by reducing cell apoptosis and systemic inflammation, but increasing osteoblast numbers. Synthetic MSC offers a promising therapy to manage osteoporosis.
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Affiliation(s)
- Miaoda Shen
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ronghuan Wu
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Rilong Jin
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Pan
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Fang Guo
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhuoyang Li
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiangjin Lin
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Sanzhong Xu
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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16
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Ho HJ, Shirakawa H, Giriwono PE, Ito A, Komai M. A novel function of geranylgeraniol in regulating testosterone production. Biosci Biotechnol Biochem 2018; 82:956-962. [PMID: 29303051 DOI: 10.1080/09168451.2017.1415129] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Isoprenoids play widely differing roles in various physiological processes in animals and plants. Geranylgeraniol (GGOH) is an isoprenoid found in plants, and is an important metabolic derivative in the isoprenoid/cholesterol synthesis pathway. Earlier studies focused on GGOH's ability to improve the side effects of bisphosphonate therapy by regulating the mevalonate pathway. More recently, the mevalonate pathway-independent effects of GGOH have been described, including anti-inflammatory, anti-tumorigenic, and neuroprotective activities. It is noteworthy that GGOH regulates the steroidogenesis pathway in testis-derived I-10 tumor cells. Testosterone is a hormone produced via steroidogenesis in testicles and plays a role in fetal development and the male reproductive system. GGOH enhanced testosterone and progesterone (its precursor) levels in I-10 cells by activating adenylate cyclase via cAMP/PKA signaling, without altering phosphodiesterase activity. These findings highlight the potential benefits of GGOH as a therapeutic agent for low testosterone levels, such as late-onset hypogonadism in men.
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Affiliation(s)
- Hsin-Jung Ho
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
| | - Hitoshi Shirakawa
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan.,b International Education and Research Center for Food Agricultural Immunology, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
| | - Puspo E Giriwono
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan.,c Southeast Asian Food & Agriculture Science & Technology (SEAFAST) Center , Bogor Agricultural University , Bogor , Indonesia
| | - Asagi Ito
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
| | - Michio Komai
- a Laboratory of Nutrition, Graduate School of Agricultural Science , Tohoku University , Sendai , Japan
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17
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Yoon BH, Kim JG, Lee YK, Ha YC, Koo KH, Kim JH. Femoral head trabecular micro-architecture in patients with osteoporotic hip fractures: Impact of bisphosphonate treatment. Bone 2017; 105:148-153. [PMID: 28842364 DOI: 10.1016/j.bone.2017.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/04/2017] [Accepted: 08/21/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Bisphosphonates are effective in preventing osteoporotic fractures. However, their limited efficacy of bisphosphonates has been suggested as a result of these drugs, which prevent the resorption of bone without improving bone connectivity. The trabecular microarchitecture in patients with osteoporotic hip fractures was evaluated according to their history of bisphosphonate treatment (BT). METHODS One hundred thirty-three patients with hip fractures admitted and treated between November 2014 and September 2016. The patients were divided into two groups based on whether they had received treatment with bisphosphonates for >3years or not [non-bisphosphonate-treated patients (NT)]. One-to-one propensity score matching generated 15 matched pairs of patients. Microstructural parameters of femoral head were measured by using micro-computed tomography (μCT). Mechanical compression test (Young's modulus, yield strength, and maximum compressive force) was performed following μCT. RESULTS Trabecular bone pattern factor (1.15±0.7mm-1 versus 1.61±0.5mm-1, p=0.037) and specific bone surface (14.1±0.8mm-1 versus 15.4±1.9mm-1, p=0.050) were significantly lower in the BT group than in the NT group. Furthermore, Young's modulus was significantly higher in the BT group than in the NT group (72.14±30.75MPa versus 47.89±29.89MPa, p=0.037). In both groups, trabecular bone pattern was the most closely correlated microstructural parameter to bone strength. Microstructural analysis demonstrated that bone connectivity was better preserved in the BT group than in the NT group. CONCLUSIONS Bisphosphonate treatment preserves bone mass and bone quality. The factors influencing osteoporotic hip fractures in patients treated with bisphosphonates warrant further research.
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Affiliation(s)
- Byung-Ho Yoon
- Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea
| | - Jung Gon Kim
- Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Jae Hwa Kim
- Department of Orthopedics & Joint Center, CHA Bundang Medical Center, Seongnam, South Korea.
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Nikfar Z, Shariatinia Z. Phosphate functionalized (4,4)-armchair CNTs as novel drug delivery systems for alendronate and etidronate anti-osteoporosis drugs. J Mol Graph Model 2017; 76:86-105. [DOI: 10.1016/j.jmgm.2017.06.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 06/17/2017] [Accepted: 06/19/2017] [Indexed: 11/26/2022]
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19
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Wu VM, Mickens J, Uskoković V. Bisphosphonate-Functionalized Hydroxyapatite Nanoparticles for the Delivery of the Bromodomain Inhibitor JQ1 in the Treatment of Osteosarcoma. ACS APPLIED MATERIALS & INTERFACES 2017; 9:25887-25904. [PMID: 28731328 PMCID: PMC5794714 DOI: 10.1021/acsami.7b08108] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Osteosarcoma (OS) is one of the most common neoplasia among children, and its survival statistics have been stagnating since the combinatorial anticancer therapy triad was first introduced. Here, we report on the assessment of the effect of hydroxyapatite (HAp) nanoparticles loaded with medronate, the simplest bisphosphonate, as a bone-targeting agent and JQ1, a small-molecule bromodomain inhibitor, as a chemotherapeutic in different 2D and 3D K7M2 OS in vitro models. Both additives decreased the crystallinity of HAp, but the effect was more intense for medronate because of its higher affinity for HAp. As the result of PO43--NH+ binding, JQ1 shielded the surface phosphates of HAp and pushed its surface charge to more positive values, exhibiting the opposite effect from calcium-blocking medronate. In contrast to the faster and more exponential release of JQ1 from monetite, its release from HAp nanoparticles followed a zero-order kinetics, but 98% of the payload was released after 48 h. The apoptotic effect of HAp nanoparticles loaded with JQ1, with medronate and with both JQ1 and medronate, was selective in 2D culture: pronounced against the OS cells and nonexistent against the healthy fibroblasts. While OS cell invasion was significantly inhibited by all of the JQ1-containing HAp formulations, that is, with and without medronate, all of the combinations of the targeting compound, medronate, and the chemotherapeutic, JQ1, delivered using HAp, but not HAp alone, inhibited OS cell migration from the tumor spheroids. JQ1 delivered using HAp had an effect on tumor migration, invasion, and apoptosis even at extremely low, subnanomolar concentrations, at which no effect of JQ1 per se was observed, meaning that this form of delivery could help achieve a multifold increase of this drug's efficacy. More than 80% of OS cells internalized JQ1-loaded HAp nanoparticles after 24 h of coincubation, suggesting that this augmentation of the activity of JQ1 may be due to the intracellular delivery and sustained release of the drug enabled by HAp. In addition to the reduction of the OS cell viability, the reduction of the migration and invasion radii was observed in OS tumor spheroids challenged with even JQ1-free medronate-functionalized HAp nanoparticles, demonstrating a definite anticancer activity of medronate alone when combined with HAp. The effect of medronate-functionalized JQ1-loaded HAp nanoparticles was most noticeable against OS cells differentiated into an osteoblastic lineage, in which case they surpassed in effect pure JQ1 and medronate-free compositions. The activity of JQ1 was mediated through increased Ezrin expression and decreased RUNX2 expression and was MYC and FOSL1 independent, but these patterns of gene expression changed in cells challenged with the nanoparticulate form of delivery, having been accompanied by the upregulation of RUNX2 and downregulation of Ezrin in OS cells treated with medronate-functionalized JQ1-loaded HAp nanoparticles.
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Affiliation(s)
- Victoria M. Wu
- Advanced Materials and Nanobiotechnology Laboratory, Department of Biomedical and Pharmaceutical Sciences, Center for Targeted Drug Delivery, Chapman University School of Pharmacy, 9401 Jeronimo Road, Irvine, California 92618-1908, United States
- Advanced Materials and Nanobiotechnology Laboratory, Department of Bioengineering, University of Illinois, Chicago, Illinois 60607-7052, United States
| | - Jarrett Mickens
- Advanced Materials and Nanobiotechnology Laboratory, Department of Bioengineering, University of Illinois, Chicago, Illinois 60607-7052, United States
| | - Vuk Uskoković
- Advanced Materials and Nanobiotechnology Laboratory, Department of Biomedical and Pharmaceutical Sciences, Center for Targeted Drug Delivery, Chapman University School of Pharmacy, 9401 Jeronimo Road, Irvine, California 92618-1908, United States
- Advanced Materials and Nanobiotechnology Laboratory, Department of Bioengineering, University of Illinois, Chicago, Illinois 60607-7052, United States
- Corresponding Author:
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20
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Kastritis E, Melea P, Bagratuni T, Melakopoulos I, Gavriatopoulou M, Roussou M, Migkou M, Eleutherakis-Papaiakovou E, Terpos E, Dimopoulos MA. Genetic factors related with early onset of osteonecrosis of the jaw in patients with multiple myeloma under zoledronic acid therapy. Leuk Lymphoma 2017; 58:2304-2309. [PMID: 28604257 DOI: 10.1080/10428194.2017.1300889] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Specific genetic polymorphisms (SNPs) have been correlated with the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in small series. We screened 140 myeloma patients (36 patients with and 104 without BRONJ) for the presence of previously identified SNPs in PPARG and CYP2C8 genes. All the patients received exclusively zolendronic acid (ZA) therapy and were followed prospectively for BRONJ. SNPs in both genes were associated with a higher risk of development of early BRONJ, occurring within less than 2 years of ZA therapy (59% vs. 16%, p = .022 for PPARG and 29% vs. 7%, p = .07 for CYP2C8) and a shorter time to develop BRONJ (59% versus 12%, p = .011 for PPARG and 29% versus 0% at 2 years, p = .037 for CYP2C8), independently of indices of poor oral hygiene. Thus, although preliminary, our data indicate that the presence of SNPs in PPARG and CYP2C8 genes may be associated with increased risk of early BRONJ.
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Affiliation(s)
- Efstathios Kastritis
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Pelagia Melea
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Tina Bagratuni
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Ioannis Melakopoulos
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Maria Gavriatopoulou
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Maria Roussou
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Magdalini Migkou
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | | | - Evangelos Terpos
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Meletios A Dimopoulos
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
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Phetfong J, Sanvoranart T, Nartprayut K, Nimsanor N, Seenprachawong K, Prachayasittikul V, Supokawej A. Osteoporosis: the current status of mesenchymal stem cell-based therapy. Cell Mol Biol Lett 2016; 21:12. [PMID: 28536615 PMCID: PMC5414670 DOI: 10.1186/s11658-016-0013-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/25/2016] [Indexed: 12/21/2022] Open
Abstract
Osteoporosis, or bone loss, is a progressive, systemic skeletal disease that affects millions of people worldwide. Osteoporosis is generally age related, and it is underdiagnosed because it remains asymptomatic for several years until the development of fractures that confine daily life activities, particularly in elderly people. Most patients with osteoporotic fractures become bedridden and are in a life-threatening state. The consequences of fracture can be devastating, leading to substantial morbidity and mortality of the patients. The normal physiologic process of bone remodeling involves a balance between bone resorption and bone formation during early adulthood. In osteoporosis, this process becomes imbalanced, resulting in gradual losses of bone mass and density due to enhanced bone resorption and/or inadequate bone formation. Several growth factors underlying age-related osteoporosis and their signaling pathways have been identified, such as osteoprotegerin (OPG)/receptor activator of nuclear factor B (RANK)/RANK ligand (RANKL), bone morphogenetic protein (BMP), wingless-type MMTV integration site family (Wnt) proteins and signaling through parathyroid hormone receptors. In addition, the pathogenesis of osteoporosis has been connected to genetics. The current treatment of osteoporosis predominantly consists of antiresorptive and anabolic agents; however, the serious adverse effects of using these drugs are of concern. Cell-based replacement therapy via the use of mesenchymal stem cells (MSCs) may become one of the strategies for osteoporosis treatment in the future.
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Affiliation(s)
- Jitrada Phetfong
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Phuttamonthon, Salaya, Nakhon Pathom 73170 Thailand
| | - Tanwarat Sanvoranart
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Phuttamonthon, Salaya, Nakhon Pathom 73170 Thailand
| | - Kuneerat Nartprayut
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Phuttamonthon, Salaya, Nakhon Pathom 73170 Thailand
| | - Natakarn Nimsanor
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Phuttamonthon, Salaya, Nakhon Pathom 73170 Thailand
| | - Kanokwan Seenprachawong
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Phuttamonthon, Salaya, Nakhon Pathom 73170 Thailand
| | - Virapong Prachayasittikul
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Phuttamonthon, Salaya, Nakhon Pathom 73170 Thailand
| | - Aungkura Supokawej
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Phuttamonthon, Salaya, Nakhon Pathom 73170 Thailand
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22
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Soares AP, do Espírito Santo RF, Line SRP, Pinto MDGF, Santos PDM, Toralles MBP, do Espírito Santo AR. Effects of Pamidronate on Dental Enamel Formation Assessed by Light Microscopy, Energy-Dispersive X-Ray Analysis, Scanning Electron Microscopy, and Microhardness Testing. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2016; 22:640-648. [PMID: 27212049 DOI: 10.1017/s1431927616000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of the present work was to investigate birefringence and morphology of the secretory-stage enamel organic extracellular matrix (EOECM), and structural and mechanical properties of mature enamel of upper incisors from adult rats that had been treated with pamidronate disodium (0.5 mg/kg/week for 56 days), using transmitted polarizing and bright-field light microscopies (TPLM and BFLM), energy-dispersive X-ray (EDX) analysis, scanning electron microscopy (SEM) and microhardness testing. BFLM showed no morphological changes of the EOECM in pamidronate and control groups, but TPLM revealed a statistically significant reduction in optical retardation values of birefringence brightness of pamidronate-treated rats when compared with control animals (p0.05). The present study indicates that pamidronate can affect birefringence of the secretory-stage EOECM, which does not seem to be associated with significant changes in morphological and/or mechanical properties of mature enamel.
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Affiliation(s)
- Ana P Soares
- 1Multidisciplinary Institute of Health,Federal University of Bahia-UFBA,Rua Rio de Contas,58,Quadra 17,Lote 58,Candeias,Vitória da Conquista,BACEP 45.029-094,Brasil
| | - Renan F do Espírito Santo
- 2Faculty of Pharmacy,Federal University of Bahia-UFBA,Rua Barão de Jeremoabo,S/N,Campus Universitário de Ondina,Ondina,Salvador,BA CEP 40.170-115,Brasil
| | - Sérgio R P Line
- 3Piracicaba Dental School,University of Campinas-UNICAMP,Av. Limeira,901,Areião,Piracicaba,SP CEP 13.414-903,Brasil
| | - Maria das G F Pinto
- 4School of Veterinary Medicine and Zootechny,Federal University of Bahia-UFBA,Av. Ademar de Barros,500,Ondina,Salvador,BA CEP 40.170-110,Brasil
| | - Pablo de M Santos
- 5Professor Edgard Santos University Hospital,Federal University of Bahia-UFBA,Rua Augusto Viana,S/N,Canela,Salvador,BA CEP 40.110-060,Brasil
| | - Maria Betania P Toralles
- 6Institute of Health Sciences,Federal University of Bahia-UFBA,Av. Reitor Miguel Calmon,S/N,Vale do Canela,Salvador,BA CEP 40.110-902,Brasil
| | - Alexandre R do Espírito Santo
- 6Institute of Health Sciences,Federal University of Bahia-UFBA,Av. Reitor Miguel Calmon,S/N,Vale do Canela,Salvador,BA CEP 40.110-902,Brasil
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Muthukrishnan A, Bijai Kumar L, Ramalingam G. Medication-related osteonecrosis of the jaw: a dentist's nightmare. BMJ Case Rep 2016; 2016:bcr-2016-214626. [PMID: 27053542 DOI: 10.1136/bcr-2016-214626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a complication in patients who are on anti-bone resorptive drugs. These drugs are prescribed for patients with multiple myeloma, osteoporosis, metastatic carcinoma and Paget's disease. Common anti-bone resorptive drugs such as bisphosphonate and monoclonal antibodies such as denosumab are prescribed for these patients to prevent bone resorption. Although very effective in preventing bone resorption, a complication arising from these groups of drugs is the development of osteomyelitis of the jaw. This medication-related osteonecrosis occurs only in the jaw bones. It could mimic a metastatic jaw tumour when a patient reports to the dental surgeon with pain and swelling in the jaw. This case report describes MRONJ in a 50-year-old Indian woman. This possible painful drug-induced complication of jaw bones can be prevented if proper medical history is taken and management protocol is followed in these patients.
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Affiliation(s)
- Arvind Muthukrishnan
- Department of Oral Medicine and Radiology, Saveetha University, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - Laliytha Bijai Kumar
- Department of Oral Medicine and Radiology, Saveetha University, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - Gomathi Ramalingam
- Department of Oral Medicine and Radiology, Saveetha University, Saveetha Dental College, Chennai, Tamil Nadu, India
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Soares AP, do Espírito Santo RF, Line SRP, Pinto MDGF, Santos PDM, Toralles MBP, do Espírito Santo AR. Bisphosphonates: Pharmacokinetics, bioavailability, mechanisms of action, clinical applications in children, and effects on tooth development. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2016; 42:212-217. [PMID: 26895384 DOI: 10.1016/j.etap.2016.01.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
Bisphosphonates (BPs) avidly bind to calcium crystals and inhibit osteoclastic bone resorption, making them useful for treatment of skeletal disorders such as osteoporosis, Paget's disease, osteogenesis imperfecta and metastatic bone diseases. BPs therapeutically act by causing toxic effects on osteoclasts or interfering with specific intracellular pathways in those cells. BPs that possess nitrogen in their composition are called nitrogen-containing BPs (NBPs) and include alendronate, pamidronate, risedronate, ibandronate, and zoledronate. Simple BPs or non-NBPs do not have nitrogen in their composition, include etiodronate and clodronate, and were the first to be tested in animals and clinically used. Because BPs may be administered to pregnant women or children during deciduous and permanent teeth development, it is expected that they might disturb tooth eruption and development. A review of current literature on pharmacokinetics, bioavailability, mechanisms of action, and clinical applications of BPs in children, and their effects on tooth eruption and development is presented.
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Affiliation(s)
- Ana Prates Soares
- Multidisciplinary Institute of Health, Federal University of Bahia - UFBA, Rua Rio de Contas, 58, Quadra 17, Lote 58, Candeias, Vitória da Conquista, BA CEP 45.029-094, Brazil.
| | - Renan Fernandes do Espírito Santo
- Faculty of Pharmacy, Federal University of Bahia - UFBA, Rua Barão de Jeremoabo, S/N, Campus Universitário de Ondina, Ondina, Salvador, BA CEP 40.170-115, Brazil.
| | - Sérgio Roberto Peres Line
- Piracicaba Dental School, University of Campinas - UNICAMP, Av. Limeira, 901, Areião, Piracicaba, SP CEP 13.414-903, Brazil.
| | - Maria das Graças Farias Pinto
- School of Veterinary Medicine and Zootechny, Federal University of Bahia - UFBA, Av. Ademar de Barros, 500, Ondina, Salvador, BA CEP 40.170-110, Brazil.
| | - Pablo de Moura Santos
- Professor Edgard Santos University Hospital, Federal University of Bahia - UFBA, Rua Augusto Viana, S/N, Canela, Salvador, BA CEP 40.110-060, Brazil.
| | - Maria Betânia Pereira Toralles
- Institute of Health Sciences, Federal University of Bahia - UFBA, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA CEP 40.110-902, Brazil.
| | - Alexandre Ribeiro do Espírito Santo
- Institute of Health Sciences, Federal University of Bahia - UFBA, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA CEP 40.110-902, Brazil.
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Zafar S, Coates DE, Cullinan MP, Drummond BK, Milne T, Seymour GJ. Effects of zoledronic acid and geranylgeraniol on the cellular behaviour and gene expression of primary human alveolar osteoblasts. Clin Oral Investig 2016; 20:2023-2035. [PMID: 26795621 DOI: 10.1007/s00784-015-1706-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 12/30/2015] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication of bisphosphonate therapy. The mechanism underlying BRONJ pathogenesis is poorly understood. OBJECTIVES To determine the effects of zoledronic acid (ZA) and geranylgeraniol (GGOH) on the mevalonate pathway (MVP) in osteoblasts generated from the human mandibular alveolar bone in terms of cell viability/proliferation, migration, apoptosis and gene expression. MATERIALS AND METHODS Primary human osteoblasts (HOBs) isolated from the mandibular alveolar bone were phenotyped. HOBs were cultured with or without ZA and GGOH for up to 72 h. Cellular behaviour was examined using a CellTiter-Blue® viability assay, an Ibidi culture-insert migration assay, an Apo-ONE® Homogeneous Caspase-3/7 apoptosis assay and transmission electron microscopy (TEM). Quantitative real-time reverse transcriptase polymerase chain reaction (qRT2-PCR) was used to determine the simultaneous expression of 168 osteogenic and angiogenic genes modulated in the presence of ZA and GGOH. RESULTS ZA decreased cell viability and migration and induced apoptosis in HOBs. TEM revealed signs of apoptosis in ZA-treated HOBs. However, the co-addition of GGOH ameliorated the effect of ZA and partially restored the cells to the control state. Twenty-eight genes in the osteogenic array and 27 genes in the angiogenic array were significantly regulated in the presence of ZA compared with those in the controls at one or more time points. CONCLUSION The cytotoxic effect of ZA on HOBs and its reversal by the addition of GGOH suggests that the effect of ZA on HOBs is mediated via the MVP. CLINICAL RELEVANCE The results suggest that GGOH could be used as a possible therapeutic/preventive strategy for BRONJ.
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Affiliation(s)
- S Zafar
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 310 Great King Street, PO Box 647, Dunedin, 9054, New Zealand.
| | - D E Coates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 310 Great King Street, PO Box 647, Dunedin, 9054, New Zealand
| | - M P Cullinan
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 310 Great King Street, PO Box 647, Dunedin, 9054, New Zealand
| | - B K Drummond
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 310 Great King Street, PO Box 647, Dunedin, 9054, New Zealand
| | - T Milne
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 310 Great King Street, PO Box 647, Dunedin, 9054, New Zealand
| | - G J Seymour
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 310 Great King Street, PO Box 647, Dunedin, 9054, New Zealand
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Effect of alendronate on the mandible and long bones: an experimental study in vivo. Pediatr Res 2015; 78:618-25. [PMID: 26331769 DOI: 10.1038/pr.2015.163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/21/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Bisphosphonates are anticatabolic agents that inhibit bone resorption and are widely used to treat osteoporosis and bone metastases in adults. They are also used in young patients with diseases like osteogenesis imperfecta or juvenile osteoporosis. Bone modeling/remodeling is elevated in growing subjects, and inhibition of osteoclastic activity has been shown to interfere with growth. Thus, our objective was to evaluate the effect of alendronate (ALN) on growing animals. METHODS Healthy male Wistar rats, aged 1 mo, received ALN or vehicle for 8 wk. Serum levels (calcemia, phosphatemia, and total alkaline phosphatase) were determined. Morphometric (rat: femur and tibia weight and length and hemimandible growth) and histomorphometric parameters (thickness of tibial epiphyseal cartilage and each cartilage zone, interradicular bone volume in the first lower molar, trabeculae volume, percentage of bone and cartilage, and osteoclast number in mandibular condyles) were assessed. RESULTS ALN caused a significant decrease in femur and tibia length, tibial cartilage thickness, and longitudinal growth of hemimandibles. It increased interradicular bone volume and mandibular condyle trabeculae volume, increasing the percentage of cartilage and osteoclast number. CONCLUSION These findings indicate that administration of ALN to growing animals alters the endochondral ossification process, and thus alters growth.
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Jang HW, Kim JW, Cha IH. Development of animal model for Bisphosphonates-related osteonecrosis of the jaw (BRONJ). Maxillofac Plast Reconstr Surg 2015. [PMID: 26217648 PMCID: PMC4513231 DOI: 10.1186/s40902-015-0020-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of this study is to develop a rat model of bisphosphonates-related osteonecrosis of the jaw (BRONJ) that would be verified with clinical, radiological and histological examination, and to confirm the influence of concurrent bisphosphonates and steroids use upon the occurrence and aggravation of BRONJ. METHODS Twenty seven rats were divided into 3 groups; Saline group (I), Zoledronate group (II), Zoledronate and Dexamethasone group (III). Rats got weekly intraperitoneal injection for 4 times and extraction of left maxillary and mandibular 1st, 2nd molars were followed. Consecutive injections were performed, and blood sampling for measurements of C-terminal crosslinked telopeptide of type I collagen and tartrate-resistant acid phosphate 5b rats were performed at the time of 2, 4 and 8 weeks. And then, rats were sacrificed and evaluated clinically, radiologically and histologically. RESULTS 12/18 (66.6 %) of experimental group were diagnosed as BRONJ. There was no significant difference in incidence between zoledronate alone group (ll) and concurrent use of zoledronate and dexamethasone group (lll). CONCLUSIONS Concurrent use of bisphosphonates and steroids increase incidence of BRONJ compared to saline group (l). Zoledronate alone group (ll) and concurrent use of zoledronate and dexamethasone group (lll) shows same incidence of BRONJ. Based on this study, the rat treated with bisphosphonates and steroids can be considered a novel, reliable and reproducible model to understand pathology of BRONJ.
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Affiliation(s)
- Hyo-Won Jang
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Mok-dong Hospital, Ewha Womans University, Seoul, South Korea
| | - In-Ho Cha
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, South Korea.,Department of Oral and Maxillofacial Surgery and Oral Cancer Research Institute, College of Dentistry, Yonsei University, 250 Seongsanno, Seodaemun-gu, Seoul 120-752 Republic of Korea
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Krishnan S, Pandian S, Kumar S A. Effect of bisphosphonates on orthodontic tooth movement-an update. J Clin Diagn Res 2015; 9:ZE01-5. [PMID: 26023659 DOI: 10.7860/jcdr/2015/11162.5769] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 01/23/2015] [Indexed: 11/24/2022]
Abstract
Bisphosphonates are a synthetic class of pyrophosphate analogues that are powerful inhibitors of bone resorption which are commonly used as a medication for the prevention and therapy of osteoporosis and osteopenia, also used to treat tumor diseases. As it affects bone metabolism, it is said to have an influence on orthodontic treatment and tooth movement. Also, this review gives an insight into the reported effects of Bisphosphonate medication in literature highlighting the status quo of scientific research regarding effects of Bisphosphonates on orthodontic tooth movement. A systematic literature search was done in Medline database (Pubmed) for the appropriate keywords. Manual handsearch was also done. From the available evidence it can be concluded that the duration of orthodontic treatment is increased for patients under Bisphosphonate therapy as they interfere with the osteoclastic resorption. However, they may be beneficial for anchorage procedures. Further long term prospective randomized controlled trials are required to assess possible benefits and adverse effects of bisphosphonate treatment, before Bisphosphonates can be therapeutically used in orthodontics.
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Affiliation(s)
- Sindhuja Krishnan
- Post Graduation, Department of Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College, Saveetha, University , Chennai, Tamilnadu, India
| | - Saravana Pandian
- Post Graduation, Department of Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College, Saveetha, University , Chennai, Tamilnadu, India
| | - Aravind Kumar S
- Professor, Department of Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College, Saveetha, University , Chennai, Tamilnadu, India
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Martins CA, Leyhausen G, Volk J, Geurtsen W. Effects of alendronate on osteoclast formation and activity in vitro. J Endod 2014; 41:45-9. [PMID: 25442070 DOI: 10.1016/j.joen.2014.07.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/13/2014] [Accepted: 07/07/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Root resorption is a common complication after replantation following traumatic dental avulsion. Endodontic therapy combined with local and intracanal medications aims to avoid osteoclastic activity. In such cases, the application of alendronate (ALN), a bisphosphonate widely used for the treatment of bone disorders, could be of clinical relevance. This study evaluated alendronate biocompatibility on periodontal ligament cells as well as its effects on an in vitro osteoclastogenesis model. METHODS Alendronate cytotoxicity (10(-3) to 10(-9) mol/L) in human periodontal ligament fibroblasts, human osteogenic sarcoma cells, and murine osteoclastic precursors (RAW 264.7) was analyzed using cell number determination, cell viability, and proliferation assays. ALN (10(-6) to 10(-12) mol/L) effects on RANKL-induced osteoclastogenesis of RAW cells were assessed by tartrate-resistant acid phosphatase (TRAP) staining and activity and real-time polymerase chain reaction. RESULTS ALN at higher concentrations was cytotoxic for all cell types, inhibiting significantly the proliferation of human osteogenic sarcoma cells and human periodontal ligament fibroblasts (≥10(-5) mol/L). TRAP activity and expression of the osteoclast markers TRAP and cathepsin K by RAW-derived osteoclasts decreased significantly with ALN at low concentrations, reaching the maximum effect at 10(-10) mol/L. CONCLUSIONS We showed that ALN at very low concentrations is an effective inhibitor of RANKL-generated osteoclasts, without causing cytotoxic effects on their precursors or periapical cells. ALN at such concentrations might be useful to prevent replacement resorption in avulsed teeth.
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Affiliation(s)
- Caroline A Martins
- Department of Conservative/Preventive Dentistry and Periodontology, Hannover Medical School, Hannover, Germany
| | - Gabriele Leyhausen
- Department of Conservative/Preventive Dentistry and Periodontology, Hannover Medical School, Hannover, Germany
| | - Joachim Volk
- Department of Conservative/Preventive Dentistry and Periodontology, Hannover Medical School, Hannover, Germany
| | - Werner Geurtsen
- Department of Conservative/Preventive Dentistry and Periodontology, Hannover Medical School, Hannover, Germany.
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Hagelauer N, Ziebart T, Pabst AM, Walter C. Bisphosphonates inhibit cell functions of HUVECs, fibroblasts and osteogenic cells via inhibition of protein geranylgeranylation. Clin Oral Investig 2014; 19:1079-91. [PMID: 25261400 DOI: 10.1007/s00784-014-1320-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 09/15/2014] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Bisphosphonate-associated osteonecrosis of the jaw is a severe side effect in patients receiving nitrogen-containing bisphosphonates (N-BPs). One characteristic is its high recurrence rate; therefore, basic research for new therapeutic options is necessary. N-BPs inhibit the farnesylpyrophosphate synthase in the mevalonate pathway causing a depletion of the cellular geranylgeranyl pool, resulting in a constriction of essential functions of different cell lines. Geranylgeraniol (GGOH) has been proven to antagonise the negative biological in vitro effects of bisphosphonates. MATERIAL AND METHODS This study analyses the influence of the isoprenoids eugenol, farnesol, R-limonene, menthol and squalene on different functions of zoledronate-treated human umbilicord vein endothelial cells (HUVEC), fibroblasts and osteogenic cells. In addition to the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl 2H-tetrazolium bromide (MTT) vitality test, the migration capacity was analysed by scratch wound assay and the morphological architecture of the treated cells by phallacidin staining. RESULTS In contrast to GGOH, none of the other tested isoprenoids were able to prevent cells from having negative zoledronate effects. CONCLUSIONS Despite structural analogy to GGOH, the investigated isoprenoids are not able to prevent the N-BP effect. The negative impact of zoledronate on fibroblasts, HUVEC and osteogenic cells is due to inhibition of protein geranylgeranylation since the substitution of squalene and farnesyl did not have any effect on viability and wound healing capacity whereas GGOH did reduce the negative impact. CLINICAL RELEVANCE These data suggest the importance and exclusiveness of the mevalonate pathway intermediate GGOH as a potential therapeutic approach to bisphosphonate-associated osteonecrosis of the jaws.
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Affiliation(s)
- Nadine Hagelauer
- Oral- and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
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Hsiao CH, Lin X, Barney R, Shippy R, Li J, Vinogradova O, Wiemer D, Wiemer A. Synthesis of a Phosphoantigen Prodrug that Potently Activates Vγ9Vδ2 T-Lymphocytes. ACTA ACUST UNITED AC 2014; 21:945-54. [DOI: 10.1016/j.chembiol.2014.06.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/12/2014] [Accepted: 06/18/2014] [Indexed: 12/31/2022]
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Wiemer DF, Wiemer AJ. Opportunities and challenges in development of phosphoantigens as Vγ9Vδ2 T cell agonists. Biochem Pharmacol 2014; 89:301-12. [DOI: 10.1016/j.bcp.2014.03.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/17/2014] [Accepted: 03/17/2014] [Indexed: 01/29/2023]
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Anghel R, Bachmann A, Bekşac M, Brodowicz T, Finek J, Komadina R, Krzemieniecki K, Lang I, Marencak J, von Moos R, Pecherstorfer M, Rordorf T, Vrbanec D, Zielinski C. Expert opinion 2011 on the use of new anti-resorptive agents in the prevention of skeletal-related events in metastatic bone disease. Wien Klin Wochenschr 2013; 125:439-47. [PMID: 23832237 DOI: 10.1007/s00508-013-0385-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 05/23/2013] [Indexed: 02/02/2023]
Abstract
Bisphosphonates have been a mainstay in the treatment of cancer-related bone disease and have greatly reduced the risk of skeletal complications. More recently, clinical studies suggested additional benefits of denosumab over zoledronic acid in the prevention of skeletal related events. Similar adverse event profiles have been reported for bisphosphonates and denosumab, with infrequent occurrences of osteonecrosis of the jaw with both agents, higher incidence of renal deterioration with zoledronic acid, and higher incidence of hypocalcaemia with denosumab. Based on current evidence, the American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines do not recommend one drug class over the other in patients with metastatic bone disease. Denosumab, however, may present advantages over bisphosphonates in patients suffering from chronic renal insufficiency. Further research and growing clinical experience will refine the evidence based on which decisions in daily clinical practice can be taken.
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Dedes PG, Kanakis I, Gialeli C, Theocharis AD, Tsegenidis T, Kletsas D, Tzanakakis GN, Karamanos NK. Preclinical evaluation of zoledronate using an in vitro mimetic cellular model for breast cancer metastatic bone disease. Biochim Biophys Acta Gen Subj 2013; 1830:3625-34. [PMID: 23395844 DOI: 10.1016/j.bbagen.2013.01.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/23/2013] [Accepted: 01/28/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND The interactions between metastatic breast cancer cells and host cells of osteoclastic lineage in bone microenvironment are essential for osteolysis. In vitro studies to evaluate pharmacological agents are mainly limited to their direct effects on cell lines. To mimic the communication between breast cancer cells and human osteoclasts, a simple and reproducible cellular model was established to evaluate the effects of zoledronate (zoledronic acid, ZOL), a bisphosphonate which exerts antiresorptive properties. METHODS Human precursor osteoclasts were cultured on bone-like surfaces in the presence of stimuli (sRANKL, M-CSF) to ensure their activation. Furthermore, immature as well as activated osteoclasts were co-cultured with MDA-MB-231 breast cancer cells. TRAP5b and type I collagen N-terminal telopeptide (NTx) were used as markers. Osteoclasts' adhesion to bone surface and subsequent bone breakdown were evaluated by studying the expression of cell surface receptors and certain functional matrix macromolecules in the presence of ZOL. RESULTS ZOL significantly suppresses the precursor osteoclast maturation, even when the activation stimuli (sRANKL and M-SCF) are present. Moreover, it significantly decreases bone osteolysis and activity of MMPs as well as precursor osteoclast maturation by breast cancer cells. Additionally, ZOL inhibits the osteolytic activity of mature osteoclasts and the expression of integrin β3, matrix metalloproteinases and cathepsin K, all implicated in adhesion and bone resorption. CONCLUSIONS ZOL exhibits a beneficial inhibitory effect by restricting activation of osteoclasts, bone particle decomposition and the MMP-related breast cancer osteolysis. GENERAL SIGNIFICANCE The proposed cellular model can be reliably used for enhancing preclinical evaluation of pharmacological agents in metastatic bone disease.
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Affiliation(s)
- P G Dedes
- Laboratory of Biochemistry, Department of Chemistry, University of Patras, Patras, Greece
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Kuchuk I, Mazzarello S, Butterfield K, Appleton A, Addison CL, Clemons M. Oral care and the use of bone-targeted agents in patients with metastatic cancers: A practical guide for dental surgeons and oncologists. J Bone Oncol 2013; 2:38-46. [PMID: 26909271 PMCID: PMC4723342 DOI: 10.1016/j.jbo.2012.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/26/2012] [Accepted: 12/11/2012] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Bone-targeted agents such as bisphosphonates and the RANKL antibody have revolutionised the care of patients with bone metastases. There has, however been increasing concern about the oral health of these patients and in particular osteonecrosis of the jaw (ONJ), especially with the increasing use of these agents at higher potencies for greater periods of time. METHODS A review of the published data in PubMed and meeting abstracts was performed to examine incidence, risk factors, pathogenesis, clinical course and management of osteonecrosis of the jaw with focus on cancer patients treated with bone-targeted agents (BTA) for bone metastases. This manuscript takes the most frequent and pertinent questions raised by oncologists, dentists and oral and maxillofacial surgeons and tries to give a pragmatic overview of the literature. RESULTS The incidence of ONJ varies depending on types of bone-targeted agents, duration of treatment and additional risk factors. The causes and pathogenesis of ONJ is not fully elucidated, however bone-targeted therapy induced impaired bone remodelling, microtrauma secondary to jaw activity, and oral bacterial infection seem to be important factors. Since the treatment options for ONJ are limited and not well established, preventive strategies have to be included in patients management. CONCLUSIONS Many unanswered questions remain about the optimal oral care of patients receiving bone-targeted agents. Prospective data collection will remedy this and help to provide practical guidelines for the management and treatment of those patients that require dental intervention.
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Affiliation(s)
- Iryna Kuchuk
- Division of Medical Oncology, Ottawa Regional Cancer Centre and University of Ottawa, Canada
| | - Sasha Mazzarello
- Division of Medical Oncology, Ottawa Regional Cancer Centre and University of Ottawa, Canada
| | - Kevin Butterfield
- Ottawa Hospital Division of Dentistry/Oral & Maxillofacial Surgery and University of Ottawa, Canada
| | | | | | - Mark Clemons
- Division of Medical Oncology, Ottawa Regional Cancer Centre and University of Ottawa, Canada
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Netsu T, Kondo N, Arai K, Ogose A, Endo N. Osteoconductive action of alendronate after implantation of beta tricalcium phosphate in rat adjuvant-induced arthritis. J Bone Miner Metab 2012; 30:609-18. [PMID: 22806136 DOI: 10.1007/s00774-012-0369-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 05/28/2012] [Indexed: 10/28/2022]
Abstract
The aim of the study was to determine the effect of alendronate on resorption of β-tricalcium phosphate (β-TCP) and bone formation in rats with adjuvant-induced arthritis (AIA). After preparation of a model of AIA in rats (day 0), alendronate or vehicle was injected intraperitoneally once daily five times in a week. Cylindrical β-TCP was implanted into the rat femoral condyle on day 7. Rats were killed on days 12, 15, and 21, and specimens and serum samples were collected. Specimens were analyzed by tartrate-resistant acid phosphate (TRAP) staining, immunohistochemistry of the ED1 protein, and in situ hybridization with digoxigenin-labeled α1 chain of type I procollagen (COL1A1). Mineralized bone sections were analyzed by Villanueva bone stain. The serum osteocalcin level was measured using an enzyme-linked immunosorbent assay kit. Alendronate decreased the number of TRAP-positive cells attached to β-TCP, the numbers of ED1-positive multinucleated giant cells, and resorption of β-TCP. In AIA rats treated with alendronate, COL1A1 mRNA-positive cells adhered to β-TCP were round or cuboid whereas the cells in untreated AIA rats were fibroblast-like cells. Alendronate increased calcification of newly formed bone whereas it did not restore the bone formation suppressed with inflammation. These results suggest that alendronate has the potential to conduct mature bone after implantation of β-TCP in AIA. Alendronate may help to reduce insufficiency of newly formed bone after implantation of β-TCP in diseases characterized by increased bone resorption such as rheumatoid arthritis.
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Affiliation(s)
- Takahiro Netsu
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Influence of bisphosphonate treatment on medullary macrophages and osteoclasts: an experimental study. BONE MARROW RESEARCH 2012; 2012:526236. [PMID: 23008775 PMCID: PMC3449103 DOI: 10.1155/2012/526236] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 08/03/2012] [Accepted: 08/04/2012] [Indexed: 12/31/2022]
Abstract
Nitrogen-containing bisphosphonates are widely used for treating diverse bone pathologies. They are anticatabolic drugs that act on osteoclasts inhibiting bone resorption. It remains unknown whether the mechanism of action is by decreasing osteoclast number, impairing osteoclast function, or whether they continue to effectively inhibit bone resorption despite the increase in osteoclast number. There is increasing evidence that bisphosphonates also act on bone marrow cells like macrophages and monocytes. The present work sought to evaluate the dynamics of preosteoclast fusion and possible changes in medullary macrophage number in bisphosphonate-treated animals. Healthy female Wistar rats received olpadronate, alendronate, or vehicle during 5 weeks, and 5-bromo-2-deoxyuridine (BrdU) on day 7, 28, or 34 of the experiment. Histomorphometric studies were performed to study femurs and evaluate: number of nuclei per osteoclast (N.Nu/Oc); number of BrdU-positive nuclei (N.Nu BrdU+/Oc); percentage of BrdU-positive nuclei per osteoclast (%Nu.BrdU+/Oc); medullary macrophage number (mac/mm2) and correlation between N.Nu/Oc and mac/mm2. Results showed bisphosphonate-treated animals exhibited increased N.Nu/Oc, caused by an increase in preosteoclast fusion rate and evidenced by higher N.Nu BrdU+/Oc, and significantly decreased mac/mm2. Considering the common origin of osteoclasts and macrophages, the increased demand for precursors of the osteoclast lineage may occur at the expense of macrophage lineage precursors.
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Arriero MDM, Ramis JM, Perelló J, Monjo M. Inositol hexakisphosphate inhibits osteoclastogenesis on RAW 264.7 cells and human primary osteoclasts. PLoS One 2012; 7:e43187. [PMID: 22905230 PMCID: PMC3419183 DOI: 10.1371/journal.pone.0043187] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 07/18/2012] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Inoxitol hexakisphosphate (IP6) has been found to have an important role in biomineralization and a direct effect inhibiting mineralization of osteoblasts in vitro without impairing extracellular matrix production and expression of alkaline phosphatase. IP6 has been proposed to exhibit similar effects to those of bisphosphonates on bone resorption, however, its direct effect on osteoclasts (OCL) is presently unknown. METHODOLOGY/PRINCIPAL FINDINGS The aim of the present study was to investigate the effect of IP6 on the RAW 264.7 monocyte/macrophage mouse cell line and on human primary osteoclasts. On one hand, we show that IP6 decreases the osteoclastogenesis in RAW 264.7 cells induced by RANKL, without affecting cell proliferation or cell viability. The number of TRAP positive cells and mRNA levels of osteoclast markers such as TRAP, calcitonin receptor, cathepsin K and MMP-9 was decreased by IP6 on RANKL-treated cells. On the contrary, when giving IP6 to mature osteoclasts after RANKL treatment, a significant increase of bone resorption activity and TRAP mRNA levels was found. On the other hand, we show that 1 µM of IP6 inhibits osteoclastogenesis of human peripheral blood mononuclear cells (PBMNC) and their resorption activity both, when given to undifferentiated and to mature osteoclasts. CONCLUSIONS/SIGNIFICANCE Our results demonstrate that IP6 inhibits osteoclastogenesis on human PBMNC and on the RAW264.7 cell line. Thus, IP6 may represent a novel type of selective inhibitor of osteoclasts and prove useful for the treatment of osteoporosis.
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Affiliation(s)
- María del Mar Arriero
- Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain
| | - Joana M. Ramis
- Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain
| | - Joan Perelló
- Laboratoris Sanifit, ParcBIT, Palma de Mallorca, Spain
| | - Marta Monjo
- Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain
- * E-mail:
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Roelofs AJ, Stewart CA, Sun S, Błażewska KM, Kashemirov BA, McKenna CE, Russell RGG, Rogers MJ, Lundy MW, Ebetino FH, Coxon FP. Influence of bone affinity on the skeletal distribution of fluorescently labeled bisphosphonates in vivo. J Bone Miner Res 2012; 27:835-47. [PMID: 22228189 DOI: 10.1002/jbmr.1543] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Bisphosphonates are widely used antiresorptive drugs that bind to calcium. It has become evident that these drugs have differing affinities for bone mineral; however, it is unclear whether such differences affect their distribution on mineral surfaces. In this study, fluorescent conjugates of risedronate, and its lower-affinity analogues deoxy-risedronate and 3-PEHPC, were used to compare the localization of compounds with differing mineral affinities in vivo. Binding to dentine in vitro confirmed differences in mineral binding between compounds, which was influenced predominantly by the characteristics of the parent compound but also by the choice of fluorescent tag. In growing rats, all compounds preferentially bound to forming endocortical as opposed to resorbing periosteal surfaces in cortical bone, 1 day after administration. At resorbing surfaces, lower-affinity compounds showed preferential binding to resorption lacunae, whereas the highest-affinity compound showed more uniform labeling. At forming surfaces, penetration into the mineralizing osteoid was found to inversely correlate with mineral affinity. These differences in distribution at resorbing and forming surfaces were not observed at quiescent surfaces. Lower-affinity compounds also showed a relatively higher degree of labeling of osteocyte lacunar walls and labeled lacunae deeper within cortical bone, indicating increased penetration of the osteocyte canalicular network. Similar differences in mineralizing surface and osteocyte network penetration between high- and low-affinity compounds were evident 7 days after administration, with fluorescent conjugates at forming surfaces buried under a new layer of bone. Fluorescent compounds were incorporated into these areas of newly formed bone, indicating that "recycling" had occurred, albeit at very low levels. Taken together, these findings indicate that the bone mineral affinity of bisphosphonates is likely to influence their distribution within the skeleton.
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Affiliation(s)
- Anke J Roelofs
- Musculoskeletal Research Programme, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
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Pompa G, Bignozzi I, Cristalli M, Quaranta A, Di Carlo S, Annibali S. Bisphosphonate and Osteonecrosis of the Jaw: The Oral Surgeon's Perspective. EUR J INFLAMM 2012. [DOI: 10.1177/1721727x1201000102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bisphosphonates (BPs) are an important class of drugs, useful in the treatment of some metabolic and oncologic skeletal diseases. BPs have shown a sure effectiveness in the treatment and in the palliative care of such pathologies; on the other hand, an avascular osteonecrosis of the jaws (B-ONJ = Bisphosphonate OsteoNecrosis of the Jaw) has recently been reported as an adverse effect not only of BP intravenous infusions, but also of their prolonged oral administration. B-ONJ normally follows a dental extraction or other surgical procedure in the oral cavity, but it also can develop spontaneously. In the latter case, some systemic risk factors, such as comorbidities and co-therapies or jaw anatomical conditions, can play a leading role in the onset of this pathologic condition. B-ONJ is an uncommon but potentially serious complication of BP therapy that can gravely affect the patient's quality of life, producing significant morbidity. To date, no therapies are completely effective and predictable in the treatment of B-ONJ, therefore prevention should be strongly promoted by sharing knowledge in the involved medical community.
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Affiliation(s)
- G. Pompa
- Department of Oral and Maxillofacial Sciences, Prosthodontics Unit, “Sapienza” University of Rome, Rome
| | - I. Bignozzi
- Department of Oral and Maxillofacial Sciences, Oral Surgery Unit, “Sapienza” University of Rome, Rome
| | - M.P. Cristalli
- Department of Oral and Maxillofacial Sciences, Oral Surgery Unit, “Sapienza” University of Rome, Rome
| | - A. Quaranta
- Department of Clinical and Odontostomatological Sciences, Periodontics Unit, Polytechnic University of the Marche, Ancona, Italy
| | - S. Di Carlo
- Department of Oral and Maxillofacial Sciences, Prosthodontics Unit, “Sapienza” University of Rome, Rome
| | - S. Annibali
- Department of Oral and Maxillofacial Sciences, Oral Surgery Unit, “Sapienza” University of Rome, Rome
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Liepe K, Kotzerke J. Internal radiotherapy of painful bone metastases. Methods 2011; 55:258-70. [DOI: 10.1016/j.ymeth.2011.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 06/16/2011] [Accepted: 07/07/2011] [Indexed: 02/03/2023] Open
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Boanini E, Torricelli P, Gazzano M, Fini M, Bigi A. The effect of zoledronate-hydroxyapatite nanocomposites on osteoclasts and osteoblast-like cells in vitro. Biomaterials 2011; 33:722-30. [PMID: 22014461 DOI: 10.1016/j.biomaterials.2011.09.092] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 09/29/2011] [Indexed: 01/06/2023]
Abstract
This study demonstrates that zoledronate containing hydroxyapatite nanocrystals (HA-ZOL) can be synthesized as a single crystalline phase up to a zoledronate content of about 7 wt% by direct synthesis in aqueous solution, at variance with what previously found for alendronate-hydroxyapatite nanocrystals (HA-AL). On increasing zoledronate incorporation, the length of the coherent crystalline domains and the crystal dimensions of hydroxyapatite decrease, whereas the specific surface area increases. Full profile fitting of the powder X-ray diffraction patterns does not indicate major structural modifications, but an increase of the hydroxyapatite unit cell, on increasing zoledronate content. These data, together with a structural similarity between hydroxyapatite and calcium zoledronate, suggest a preferential interaction between zoledronate and the hydroxyapatite faces parallel to the c-axis direction. Osteoblast-like MG-63 cells and human osteoclasts were cultured on HA-ZOL nanocrystals and as a comparison on HA-AL nanocrystals containing almost the same (about 7 wt%) bisphosphonate amount. The beneficial influence of bisphosphonates on osteoblast proliferation and differentiation is enhanced when the tests are performed in co-cultures. Similarly, the reduction of osteoclast proliferation and the increase of Caspase 3 production are dramatically enhanced in co-cultures, which highlight an even greater influence of HA-ZOL than HA-AL on osteoclast apoptosis.
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Affiliation(s)
- Elisa Boanini
- Department of Chemistry G. Ciamician, University of Bologna, Italy
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Abstract
Bisphosphonates have unique pharmacological characteristics unlike those of any other drug group. Millions of adults take oral bisphosphonates for long-term treatment of osteoporosis and osteopenia; some of these people will most likely also seek orthodontic treatment. Adverse dental effects from bisphosphonates have been reported, including decreased tooth movement, impaired bone healing, and osteonecrosis in the mandible and the maxilla. Osteonecrosis has been rarely observed after bisphosphonate use for osteoporosis. However, adverse drug effects might occur more frequently in orthodontic patients, and they would probably be noted before the end-stage pathology of osteonecrosis. Adverse effects during orthodontic treatment, including decreased tooth movement, could last for years after the drug therapy is stopped. Successful orthodontic treatment requires optimal bone healing to prevent excessive tooth mobility. Bisphosphonates appear to have two bone elimination rates - a fast elimination of weeks from the bone surface and a slow elimination of years after incorporation into the bone structure. This article presents methods to clinically and radiographically monitor orthodontic patients who are taking oral bisphosphonates. Efforts to minimize adverse effects and optimize orthodontic procedures with physician-approved drug holidays are discussed. The orthodontic treatment results of three patients who received bisphosphonate therapy are reported.
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Ngamphaiboon N, Frustino JL, Kossoff EB, Sullivan MA, O'Connor TL. Osteonecrosis of The Jaw: Dental Outcomes in Metastatic Breast Cancer Patients Treated With Bisphosphonates With/Without Bevacizumab. Clin Breast Cancer 2011; 11:252-7. [DOI: 10.1016/j.clbc.2011.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Revised: 01/22/2011] [Accepted: 02/16/2011] [Indexed: 11/29/2022]
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Cozin M, Pinker BM, Solemani K, Zuniga JM, Dadaian SC, Cremers S, Landesberg R, Raghavan S. Novel therapy to reverse the cellular effects of bisphosphonates on primary human oral fibroblasts. J Oral Maxillofac Surg 2011; 69:2564-78. [PMID: 21807448 DOI: 10.1016/j.joms.2011.03.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 02/21/2011] [Accepted: 03/01/2011] [Indexed: 01/03/2023]
Abstract
PURPOSE Osteonecrosis of the jaws (ONJ) is a clinical condition that is characterized by a nonhealing breach in the oral mucosa resulting in exposure of bone and has been increasingly reported in patients receiving bisphosphonate (BP) therapy. Although the pathogenesis and natural history of ONJ remain ill-defined, it appears that the oral soft tissues play a critical role in the development of this condition. We examined the effects of the nitrogen-containing BPs pamidronate and zoledronate on primary human gingival fibroblasts. MATERIALS AND METHODS Primary gingival fibroblasts were exposed to clinically relevant doses of pamidronate and zoledronate. Cellular proliferation was measured with an MTS/PMS reagent-based kit (Promega, Madison, WI), scratch wound assays were performed to measure cellular migration, and apoptosis was measured by use of terminal deoxynucleotidyl transferase-mediated dUTP-FITC end labeling and caspase assays. The BP-exposed cells were treated with 10-ng/mL recombinant human platelet-derived growth factor BB (rhPDGF-BB) and 50-μmol/L geranylgeraniol (GGOH). RESULTS Gingival fibroblasts are significantly more sensitive to inhibition of proliferation by zoledronate compared with pamidronate. Exposure of these cells to pamidronate but not zoledronate resulted in an increase in cellular apoptosis. Furthermore, exposure of gingival fibroblasts to pamidronate or zoledronate resulted in a decrease in cellular migration. We show that these defects are due to a loss of cell-substratum adhesion and a reduction of F-actin bundles. Finally, we show that the addition of rhPDGF-BB and GGOH in vitro is able to partially rescue the cell proliferation, migration, and adhesion defects. CONCLUSION The cytotoxic effects of BPs on oral fibroblasts and their significant reversal by the addition of GGOH and rhPDGF-BB provide both the potential mechanism and treatment options for ONJ.
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Affiliation(s)
- Matthew Cozin
- College of Dental Medicine, Columbia University, New York, NY 10032, USA
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Li B, Ling Chau JF, Wang X, Leong WF. Bisphosphonates, specific inhibitors of osteoclast function and a class of drugs for osteoporosis therapy. J Cell Biochem 2011; 112:1229-42. [DOI: 10.1002/jcb.23049] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Eslami B, Zhou S, Van Eekeren I, LeBoff MS, Glowacki J. Reduced osteoclastogenesis and RANKL expression in marrow from women taking alendronate. Calcif Tissue Int 2011; 88:272-80. [PMID: 21327765 PMCID: PMC3060993 DOI: 10.1007/s00223-011-9473-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 09/14/2010] [Indexed: 12/20/2022]
Abstract
Alendronate (AL) is commonly used for the prevention and treatment of osteoporotic fractures. Little is known about the effects of AL administration on osteoclast differentiation from human marrow progenitor cells. We used marrow discarded during orthopedic surgery to test the hypothesis that cultures of bone marrow-derived stem cells (BMCs) from subjects receiving AL (+AL) may differ from control subjects with respect to in vitro osteoclast differentiation and regulatory factors. The number of osteoclasts generated in BMC cultures from control subjects was 4.7-fold greater than that from +AL subjects (P = 0.015). RANKL expression in +AL BMCs was 57% of that in controls (P = 0.001), and OPG expression in +AL BMCs was greater than in controls (153%, P = 0.01). The mean RANKL/OPG ratio in BMCs was 0.65 ± 0.35 for +AL specimens and 1.28 ± 0.53 for controls (P = 0.031). In addition, we assessed the direct effect of AL on expression of RANKL and OPG in marrow stromal cells isolated from nine control women. Treatment with AL downregulated RANKL expression and upregulated OPG expression, with an average 50% decrease in RANKL/OPG ratio at 10(-7) M (P = 0.004). These results show that osteoclast differentiation is dysregulated in marrow isolated from +AL subjects. Furthermore, AL may inhibit human osteoclastogenesis by affecting the key regulatory genes in marrow cells.
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Affiliation(s)
- Behnam Eslami
- Department of Orthopedic Surgery, Brigham and Women Hospital and Harvard Medical School, Boston, MA
| | - Shuanhu Zhou
- Department of Orthopedic Surgery, Brigham and Women Hospital and Harvard Medical School, Boston, MA
| | - Inge Van Eekeren
- Department of Orthopedic Surgery, Brigham and Women Hospital and Harvard Medical School, Boston, MA
| | - Meryl S. LeBoff
- Division of Endocrinology, Brigham and Women Hospital and Harvard Medical School, Boston, MA
| | - Julie Glowacki
- Department of Orthopedic Surgery, Brigham and Women Hospital and Harvard Medical School, Boston, MA
- Department of Oral & Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA
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Optimized electro- and wet-spinning techniques for the production of polymeric fibrous scaffolds loaded with bisphosphonate and hydroxyapatite. J Tissue Eng Regen Med 2011; 5:253-63. [DOI: 10.1002/term.310] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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50
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Genetic polymorphisms and other risk factors associated with bisphosphonate induced osteonecrosis of the jaw. Int J Oral Maxillofac Surg 2011; 40:605-11. [PMID: 21396799 DOI: 10.1016/j.ijom.2011.02.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 11/29/2010] [Accepted: 02/03/2011] [Indexed: 11/22/2022]
Abstract
Bisphosphonate induced osteonecrosis of the jaw (BONJ) is a complication in patients taking bisphosphonate (BP) that affects their quality of life and compliance. In this cohort study, patients with multiple myeloma (MM) on intravenous BP therapy were enrolled over 1 year. Demographic and clinical data and genotyping of 10 single nucleotide polymorphisms (SNPs) from seven candidate genes associated with drug or bone metabolism were determined. Of the 78 patients enrolled, 12 had BONJ. The median time to developing BONJ was 28 months. Univariate and multivariate analysis revealed a significant association between BONJ and smoking (p=0.048) and type of BP treatment (p=0.03). A trend for higher odds for BONJ was found for SNPs in five genes: COL1A1 (rs1800012), RANK (rs12458117), MMP2 (rs243865), OPG (rs2073618) and OPN (rs11730582). Considering all five SNPs together, patients with genotype scores ≥ 5 had a BONJ event rate of 57%; those with scores < 5 had a rate of 10%. The adjusted odds ratio was 11.2 (95% confidence interval of 1.8-69.9; p value 0.0097). Smoking, type of BP and combined genotype score of COL1A1, RANK, MMP2, OPG and OPN were significantly associated with BONJ in MM patients undergoing BP therapy.
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