Causes of High Bone Alkaline Phosphatase

Enhancement of selectivity, 25-hydroxyvitamin D3 level, alkaline phosphatase activity and reproductive performance in gilts and primiparous sows using 14-epimer of 25-hydroxyvitamin D3

Selecting breed-worthy gilts as sow replacements is essential for continuity of pig production cycle. Though vitamin D3 (VD3) is known to enhance reproductive performance of multiparous sows, there is still a knowledge gap on its impact in developing gilts and primiparous sows. This study was aimed to quantify plasma 25-hydroxyvitamin D3 (25(OH)D3), serum alkaline phosphatase (ALP), and examine the reproductive performance of primiparous sows fed diets supplemented with regular VD3, and its 25(OH)D3 epimers. The study sample comprised 10-week-old replacement gilts (50 % Landrace x 50 % Yorkshire, N = 180) assigned in a randomized complete block design to three treatments [2,000 IU/kg of VD3 (T1), 25 µg/kg of 14‑epi-25(OH)D3, half dose (T2), and 50 µg/kg of 25(OH)D3 (T3)] equilibrated to 2,000 IU/kg in base diets. Selections occurred at 22, 27 and 35 weeks of age, respectively. Plasma 25(OH)D3, serum alkaline phosphatase (ALP), bone structure and reproductive performance were analyzed. Dietary treatments influenced carpus (P = 0.023), fore view stance (P = 0.017), infantile vulva (P = 0.014), inverted (P = 0.048), and prominent teat (P < 0.001). Post-partum 25(OH)D3 concentration and ALP activity were elevated by day 25 (P < 0.001). Treatment diets also influenced total born (P < 0.001), born alive (P = 0.048), and still born (P = 0.049). Two factors affect circulating 25(OH)D3 and ALP activity: physiological changes in sows during lactation, and dietary 25(OH)D3 intake. 14‑epi-25(OH)D3 is a potent metabolite for improving maturation of reproductive organs in developing gilts. It also reduces still birth in primiparous sows.

Elevated alkaline phosphatase independently predicts early postoperative complications in noninfectious revision total shoulder arthroplasty

PURPOSE

This study investigates the association between preoperative serum alkaline phosphatase levels and 30 day postoperative complications following noninfectious revision total shoulder arthroplasty (TSA). We hypothesize that elevated alkaline phosphatase levels are significantly associated with an increased 30 day postoperative complication rate.

METHODS

The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent noninfectious revision TSA from 2015 to 2022. The study population was divided into two groups based on preoperative serum alkaline phosphatase: normal (44-147 IU/L) and elevated (> 147 IU/L). Logistic regression analysis was conducted to investigate the relationship between elevated alkaline phosphatase levels and postoperative complications.

RESULTS

Compared to normal levels, elevated alkaline phosphatase was independently associated with a significantly greater likelihood of experiencing any complications (odds ratio [OR] 2.54, 95% confidence interval [CI] 1.41-4.55; P = .002), sepsis (OR 9.96, 95% CI 1.67-59.29; P = .012), blood transfusions (OR 3.77, 95% CI 1.48-9.61; P = .005), readmission (OR 3.65, 95% CI 1.48-9.01; P = .005), and length of stay > 2 days (OR 2.37, 95% CI 1.31-4.30; P = .004).

CONCLUSIONS

Elevated preoperative alkaline phosphatase was associated with a greater rate of early postoperative complications following noninfectious revision TSA.

LEVEL OF EVIDENCE

Level III; Retrospective Cohort Comparison; Prognosis Study.

Evaluation of Vitamin D Level in Children With Febrile Seizure Referred to Amirkola Children's Hospital, Babol

Objective. This study aim to evaluate the level of vitamin D with the incidence of febrile seizure. Method. This case-control study was conducted on 90 febrile children referred to Amirkola Children's Hospital from 19 February to 21 August 2021. Febrile children with and without seizures were considered as case and control groups, respectively. Vitamin D, calcium, phosphorus, and alkaline phosphatase were evaluated. Results. The mean level of vitamin D was not significant between the 2 groups (P = .62), but the mean level of alkaline phosphatase was higher in the case group, statistically (P = .04). 46.75% and 15.6% of case group, 28.9% and 26.7% of control group had deficiency and insufficiency levels of vitamin D, respectively (P = .17). Conclusion. In this study the mean level and deficiency of Vitamin D were not significant between the 2 groups. No correlation was also found between Vitamin D levels and the incidence of Febrile Seizure.

Factors influencing serum calcium levels and the incidence of hypocalcemia after parathyroidectomy in primary hyperparathyroidism patients

Background

Parathyroidectomy (PTX) is an effective treatment for primary hyperparathyroidism (PHPT) patients. Postoperative hypocalcemia is a common complication after PTX. This study aimed to analyze the factors influencing serum calcium levels and the incidence of hypocalcemia after parathyroidectomy in primary hyperparathyroidism patients.

Methods

The retrospective study included 270 PHPT patients treated with PTX and collected their demographic and clinical information and their laboratory indices. Factors influencing serum calcium levels and hypocalcemia after PTX in PHPT patients were analyzed using univariate and multifactorial analyses.

Results

First, in patients with normal preoperative serum calcium levels (2.20-2.74 mmol/L), the higher the preoperative alkaline phosphatase and serum phosphorus levels, the lower the postoperative serum calcium levels. Furthermore, the higher the preoperative serum calcium levels and the accompanying clinical symptoms, the higher the postoperative serum calcium levels. Low preoperative serum calcium levels were shown to be a risk factor for postoperative hypocalcemia (OR=0.022), and the optimal preoperative serum calcium threshold was 2.625 mmol/L (sensitivity and specificity were 0.587 and 0.712, respectively). Second, in the mild preoperative hypercalcemia group (2.75-3.00 mmol/L), the older the patient, the higher the preoperative and postoperative serum calcium levels, the higher the postoperative serum calcium; the lower the alkaline phosphatase and calcitonin levels, the higher the postoperative serum calcium levels. On the other hand, the younger the patient was, the more likely hypocalcemia blood was (OR=0.947), with an optimal age threshold of 47.5 years (sensitivity and specificity were 0.543 and 0.754, respectively). Third, in the preoperative moderate to severe hypercalcemia group (>3.0mmol/L), patients undergoing a combined contralateral thyroidectomy and a total thyroidectomy had low postoperative serum calcium levels.

Conclusion

Patients with different preoperative serum calcium levels had various factors influencing their postoperative serum calcium levels and postoperative hypocalcemia, which facilitated the assessment of their prognosis.

Dose-responses of zinc as zinc-methionine supplements on antioxidant status, hematological parameters, immune response and the expression of IL-4 and IL-6 genes of ewes in the hot season

This study was implemented to evaluate the effects of different zinc doses as Zinc-Met supplement (Zinpro®) on the antioxidant status, blood immune cells, antibody titers, and the expression of IL-4 and IL-6 genes of ewes in the hot season. In a completely randomized design, 24 ewes were assigned to treatments as follow: 0, 15, 30 and 45 mg/kg zinc as Zinc-Met supplementation for 40 days in region with 40 °C and vaccinated against food-and-mouth disease as an immune challenge at day 30, and then blood samples were collected on day 40. Ewes were fed a basal diet containing 29.9 mg zinc/kg. The highest activity of the antioxidant enzyme and the lowest lipid peroxidation values were found in ewes receiving 30 and 45 mg/kg zinc following a linear trend. The highest lymphocytes count and antibody titers were found in ewes received 30 mg zinc/kg. There were no significant differences among treatments for the relative expression of genes. In overall, zinc supplementation non-significantly up-regulate interleukin-4 and down-regulate interleukin-6. It was concluded that zinc supplementation as Zinc-Met could enhance the antioxidant status and immune response of ewes under heat stress; supplementation of diet with 30 mg zinc/kg (300 mg/kg Zinpro®) appeared to be the most effective dose.

Using Machine Learning to Identify the Relationships between Demographic, Biochemical, and Lifestyle Parameters and Plasma Vitamin D Concentration in Healthy Premenopausal Chinese Women

INTRODUCTION

Vitamin D plays a vital role in maintaining homeostasis and enhancing the absorption of calcium, an essential component for strengthening bones and preventing osteoporosis. There are many factors known to relate to plasma vitamin D concentration (PVDC). However, most of these studies were performed with traditional statistical methods. Nowadays, machine learning methods (Mach-L) have become new tools in medical research. In the present study, we used four Mach-L methods to explore the relationships between PVDC and demographic, biochemical, and lifestyle factors in a group of healthy premenopausal Chinese women. Our goals were as follows: (1) to evaluate and compare the predictive accuracy of Mach-L and MLR, and (2) to establish a hierarchy of the significance of the aforementioned factors related to PVDC.

METHODS

Five hundred ninety-three healthy Chinese women were enrolled. In total, there were 35 variables recorded, including demographic, biochemical, and lifestyle information. The dependent variable was 25-OH vitamin D (PVDC), and all other variables were the independent variables. Multiple linear regression (MLR) was regarded as the benchmark for comparison. Four Mach-L methods were applied (random forest (RF), stochastic gradient boosting (SGB), extreme gradient boosting (XGBoost), and elastic net). Each method would produce several estimation errors. The smaller these errors were, the better the model was.

RESULTS

Pearson's correlation, age, glycated hemoglobin, HDL-cholesterol, LDL-cholesterol, and hemoglobin were positively correlated to PVDC, whereas eGFR was negatively correlated to PVDC. The Mach-L methods yielded smaller estimation errors for all five parameters, which indicated that they were better methods than the MLR model. After averaging the importance percentage from the four Mach-L methods, a rank of importance could be obtained. Age was the most important factor, followed by plasma insulin level, TSH, spouse status, LDH, and ALP.

CONCLUSIONS

In a healthy Chinese premenopausal cohort using four different Mach-L methods, age was found to be the most important factor related to PVDC, followed by plasma insulin level, TSH, spouse status, LDH, and ALP.

Anti-Menopausal Effect of Soybean Germ Extract and Lactobacillus gasseri in the Ovariectomized Rat Model

Menopause is a significant phase in a woman's life. Menopausal symptoms can affect overall well-being and quality of life. Conventionally, hormone replacement therapy (HRT) is used to alleviate menopausal symptoms; however, depending on the conditions, HRT may lead to side effects, necessitating the exploration of alternative therapies with fewer side effects. In this study, we investigated the effects of a combination of soybean germ extract (S30) containing 30% (w/w) isoflavone and a probiotic, Lactobacillus gasseri (LGA1), on menopausal conditions in an ovariectomized (OVX) rat model. We evaluated the impact of S30+LGA on body weight, estrogen markers, uterine and bone health, vascular markers, and neurotransmitter levels. The results revealed that treatment with S30+LGA1 significantly improved body weight and uterine and bone health. Moreover, S30+LGA1 demonstrated promising effects on lipid profile, liver function, and vascular markers and positively impacted serotonin and norepinephrine levels, indicating potential mood-enhancing effects. In conclusion, S30+LGA1, possessing anti-menopausal effects in vitro and in vivo, can be recommended as a soy-based diet, which offers various health benefits, especially for menopausal women.

Formulation and validation of a baseline prognostic score for osteosarcoma treated uniformly with a non-high dose methotrexate-based protocol from a low middle income healthcare setting: a single centre analysis of 594 patients

Introduction

The outcomes of osteosarcoma in low middle income countries (LMICs) are different due to patients presenting in advanced stages, resource constraints and the use of non-high-dose-methotrexate (HDMTX)-based regimens. This study derived and validated a prognostic score for osteosarcoma that integrates biologic and social factors and is tailored for patients from an LMIC setting using a non-HDMTX-based protocol.

Materials and methods

A retrospective study including osteosarcoma patients enrolled for treatment at a single tertiary care centre in India between 2003-19 was conducted. Baseline biologic and social characteristics were extracted from medical records and survival outcomes were noted. The cohort was randomised into a derivation and validation cohort. Multivariable Cox regression was used to identify baseline characteristics that were independently prognostic for survival outcomes in the derivation cohort. A score was derived from the prognostic factors identified in the derivation cohort and further validated in the validation cohort with estimation of its predictive ability.

Results

594 patients with osteosarcoma were eligible for inclusion in the study. Around one-third of the cohort had metastatic disease with 59% of the patients residing in rural areas. The presence of metastases at baseline (HR 3.39; p<0.001; score=3), elevated serum alkaline phosphatase (SAP) >450 IU/L (HR 1.57; p=0.001; score=1) and baseline tumour size > 10 cm (HR 1.68; p<0.001; score=1) were identified to be independent factors predicting inferior event free survival (EFS) and were included in development of the prognostic score. Patients were categorized as low risk (score 0), intermediate risk (score 1-3) and high risk (4-5). Harrell's c-indices for the score were 0.682, 0.608 and 0.657 respectively for EFS in the derivation, validation and whole cohort respectively. The timed AUC of ROC was 0.67 for predicting 18-month EFS in the derivation, validation and whole cohorts while that for 36-month EFS were 0.68, 0.66 and 0.68 respectively.

Conclusions

The study describes the outcomes among osteosarcoma patients from an LMIC treated uniformly with a non-HDMTX-based protocol. Tumor size, baseline metastases and SAP were prognostic factors used to derive a score with good predictive value for survival outcomes. Social factors did not emerge as determinants of survival.

Tough Photo-Cross-Linked PCL-Hydroxyapatite Composites for Bone Tissue Engineering

Acrylate-based photo-cross-linked poly(ε-caprolactone) (PCL) tends to show low elongation and strength. Incorporation of osteo-inductive hydroxyapatite (HAp) further enhances this effect, which limits its applicability in bone tissue engineering. To overcome this, the thiol-ene click reaction is introduced for the first time in order to photo-cross-link PCL composites with 0, 10, 20, and 30 wt % HAp nanoparticles. It is demonstrated that the elongation at break and ultimate strength increase 10- and 2-fold, respectively, when the photopolymerization mechanism is shifted from a radical chain-growth (i.e., acrylate cross-linking) toward a radical step-growth polymerization (i.e., thiol-ene cross-linking). Additionally, it is illustrated that osteoblasts can attach to and proliferate on the surface of the photo-cross-linked PCL-HAp composites. Finally, the incorporation of HAp nanoparticles is shown to reduce the ALP activity of osteoblasts. Overall, thiol-ene cross-linked PCL-HAp composites can be considered as promising potential materials for bone tissue engineering.

Dietary calcium requirements of broilers fed a conventional corn-soybean meal diet from 1 to 21 days of age

Background

The current calcium (Ca) recommendation for broilers is primarily based on studies conducted more than 30 years ago with birds of markedly different productive potentials from those which exist today. And the response indicators in these studies are mainly growth performance and bone ash percentage. Therefore, the present study was carried out to investigate the effect of dietary Ca level on growth performance, serum parameters, bone characteristics and Ca metabolism-related gene expressions, so as to estimate dietary Ca requirements of broilers fed a conventional corn-soybean meal diet from 1 to 21 days of age.

Methods

A total of 420 1-day-old Arbor Acres male broilers were randomly assigned to 1 of 7 treatments with 6 replicates (10 birds per cage) and fed the corn-soybean meal diets containing 0.60%, 0.70%, 0.80%, 0.90%, 1.00%, 1.10% or 1.20% Ca for 21 days. Each diet contained the constant non-phytate phosphorus content of about 0.39%.

Results

The average daily gain decreased linearly (P < 0.001) as dietary Ca level increased. The serum and tibia alkaline phosphatase (ALP) activities, tibia bone mineral density (BMD), middle toe BMD, tibia ash percentage, tibia breaking strength, and tibia ALP protein expression level were affected (P < 0.05) by dietary Ca level, and showed significant quadratic responses (P < 0.02) to dietary Ca levels. The estimates of dietary Ca requirements were 0.80 to 1.00% based on the best fitted broken-line or quadratic models (P < 0.03) of the above serum and bone parameters, respectively.

Conclusions

The results from the present study indicate that the Ca requirements would be about 0.60% to obtain the best growth rate, and 1.00% to meet all of the Ca metabolisms and bone development of broilers fed a conventional corn-soybean meal diet from 1 to 21 days of age.

Effect of Intramuscular Injection of Vitamin D on 25-Hydroxyvitamin D Levels, Glycaemic Control, and Liver Enzymes in Libyan Patients with Type 2 Diabetes Mellitus

Background Vitamin D is a fat-soluble hormone that plays an important role in glycaemic control. In addition, it has a positive effect on improving liver enzyme function.

Aim This study was performed to examine the effect of intramuscular injection of vitamin D on serum 25-hydroxyvitamin D [25(OH)D] levels, glycemic control, and liver enzymes in Libyan patients suffering from type 2 diabetes mellitus (T2DM) with vitamin D deficiency.

Methods and Materials This cross-sectional study enrolled 100 T2DM (50 males and 50 females). Their serum 25(OH)D, fasting blood glucose (FBG), and liver enzymes were measured at the baseline and 12 weeks after treatment with vitamin D (200,000 IU) injection monthly for 3 months. Data analysis involved the estimation of mean ± standard error (SE) and comparison of means between pre and post-treatment values using paired t-test. Independent t-test was used to compare the means between males and females. The level of significance was set at p < 0.05.

Results Females had a lower 25(OH)D blood levels than males at baseline (7.03 ± 0.25 ng/mL versus 7.86 ± 0.26 ng/mL, respectively p < 0.02). 25(OH)D levels in both sexes was increased significantly from 7.45 ± 0.18 ng/mL to 26.69 ± 0.24 ng/mL after 12 weeks of vitamin D injections (p < 0.001), with no significant differences between male and females. FBG levels in both sexes was significantly decreased from 144.68 ± 1.84 mg/dL to 85.96 ± 0.34 mg/dL post treatment (p < 0.001). Alanine aminotransferase (ALT) was increased from 10.24 ± 0.17 U/L at baseline to 20.34 ± 1.15 U/L post treatment (p < 0.001). Similarly, aspartate aminotransferase (AST) was increased from 11.23 ± 0.21 to 20.57 ± 0.22 U/L (p < 0.001), and alkaline phosphatase (ALP) was decreased from 124.95 ± 1.15 U/L to 111.17 ± 1.27 U/L (p < 0.001). There were no significant differences between male and female liver enzymes either pre- or post-vitamin D injections

Conclusion Treatment with vitamin D injection showed a significant increase in 25(OH)D accompanied by decreased FBG and ALP levels and increased ALT and AST levels. Vitamin D levels should be monitored and adjusted in diabetic patients.

Metabolomic characteristics of hand-foot-mouth disease facilitate discovery and diagnosis of pathogeny

BACKGROUND

Hand-foot-mouth disease (HFMD) is a significant public health concern, especially in Asia-Pacific countries. Its diagnosis mainly depends on clinical symptoms. It is easy to miss the source of infection and best treatment period. This research aims to provide a tool for its early clinical diagnosis and for predicting the possibility of complications.

METHODS

The serum samples of 39 HFMD children and 36 healthy children were collected for clinical testing and ¹ H-NMR spectroscopy. Metabolomic analyses were performed to obtain the metabolic differences between the HFMD and healthy children and to speculate on the pathogenesis of HFMD.

RESULTS

Thirty-nine children were divided into severe cases and mild cases. Severe cases demonstrated more obvious inflammatory responses, but no metabolic difference was observed between the severe and mild cases. The metabolic differences between HFMD and healthy children were noticeable. Ten differential metabolites were screened out as the potential biomarkers for HFMD, and seven disturbed metabolic pathways responsible for HFMD were affected by inflammation, impaired intestinal absorptive function, and immune response.

CONCLUSIONS

Our results will provide a complementary tool for the early diagnosis of HFMD and potential ideas for later treatment.

Influence of dietary phosphorus concentrations on the performance of rearing pigeons (Columba livia), and bone properties of squabs

The objective of this study was to investigate the effects of dietary P levels on the performance of rearing pigeons, and bone characteristics of squabs from 7 to 21 d of age. A total of 192 pairs of adult Silver King pigeons (40 wk of age) were used. The pigeons were randomly allocated to one of 4 treatment groups, each consisting of eight replicates of 6 pigeon pairs per replicate. Dietary treatments included the basal diet (containing 0.3% of P), the basal diet supplemented with 0.2, 0.4, or 0.8% inorganic P. And the dietary Ca content was kept at 1.40% across all treatments. The experimental diets were fed to parent pigeons as corn-soybean complete pellet feed, and squabs fed with crop milk secreted by parent pigeons. Pigeons in the group of 0.4% supplemental non-phytate phosphorus (NPP) had shorter (P = 0.045) oviposition interval than those in the control group and group of 0.8% NPP. When the diet was supplemented with 0.8% of NPP, the least average egg weight was observed (P = 0.006). Female breeding birds had much higher (P < 0.01) Ca, P, and ALP in serum than male ones. At 7-d of age, dietary P supplementation influenced P and Ca content in tibia ash of squabs (P < 0.05). The tibia ash Ca content in the group of 0.2% NPP was the highest among the treatments (P = 0.007). At d 21 of age, both the birds in the group of 0.4 and 0.8% NPP had higher tibia breaking strength (P < 0.01) and tibia ash contents (P < 0.001) compared to the ones in the control group. In conclusion, the P deficiency in the diet of parent pigeons could cause poor bone mineralization of squabs, especially impaired the bone-breaking strength and bone ash content. The 0.8% of NPP supplementation in the diet has a positive influence on mineralization of squabs although production depression was observed. Both P and Ca metabolism of female breeding birds were more active than male ones at earlier time points of rearing period. The desirable supplemental NPP level in diet for breeding pigeon was 0.4% according to the performance data in the present trial. The recommended Ca: P ratio for pigeons, which was different from the optimum value for broilers, needs to be studied in the future.

Nanomaterial-induced mesenchymal stem cell differentiation into osteoblast for counteracting bone resorption in the osteoporotic rats

The current approach was designed to unearth the therapeutic potential of osteoblasts infusion, yielded from cultivating rat mesenchymal stem cells of bone marrow source in osteogenic differentiation media supplied with either hydroxyapatite nanoparticles (HA-NPs), chitosan/hydroxyapatite nanomaterials (C/HA-NPs), or chitosan nanoparticles, in the osteoporotic rats. The successful migration of the osteoblasts to the diseased bones of rats in C/HA-NPs and HA-NPs groups was evidenced by PCR screening of the Y-linked sex-determining gene (SRY) in the femoral bone tissue. Serum bone biomarker levels and gene expression patterns of cathepsin K, receptor activator of nuclear factor kappa B ligand (RANKL), and osteoprotegerin (OPG) were assessed. Additionally, histological examination of the femoral bone tissues of rats was performed. The current outcomes revealed that osteoblast implantation, resulted from C/HA-NPs or HA-NPs group, significantly lessened bone sialoprotein level. In Addition, it yielded a significant decline in the gene expression patterns of cathepsin K, RANKL, and RANKL/OPG proportion as well as up-regulation in BMP-2 and Runx-2 gene expression levels as opposed to the untreated ovariectomized animals. Moreover, it could restrain bone resorption and refine bone histoarchitecture. Conclusively, this study sheds light on the therapeutic significance of osteoblasts transplantation in alleviating the intensity of the bone remodeling cycle, consequently representing a hopeful therapeutic approach for primary osteoporosis.

Tissue-Nonspecific Alkaline Phosphatase, a Possible Mediator of Cell Maturation: Towards a New Paradigm

Alkaline phosphatase (ALP) is a ubiquitous membrane-bound glycoprotein capable of providing inorganic phosphate by catalyzing the hydrolysis of organic phosphate esters, or removing inorganic pyrophosphate that inhibits calcification. In humans, four forms of ALP cDNA have been cloned, among which tissue-nonspecific ALP (TNSALP) (TNSALP) is widely distributed in the liver, bone, and kidney, making it an important marker in clinical and basic research. Interestingly, TNSALP is highly expressed in juvenile cells, such as pluripotent stem cells (i.e., embryonic stem cells and induced pluripotent stem cells (iPSCs)) and somatic stem cells (i.e., neuronal stem cells and bone marrow mesenchymal stem cells). Hypophosphatasia is a genetic disorder causing defects in bone and tooth development as well as neurogenesis. Mutations in the gene coding for TNSALP are thought to be responsible for the abnormalities, suggesting the essential role of TNSALP in these events. Moreover, a reverse-genetics-based study using mice revealed that TNSALP is important in bone and tooth development as well as neurogenesis. However, little is known about the role of TNSALP in the maintenance and differentiation of juvenile cells. Recently, it was reported that cells enriched with TNSALP are more easily reprogrammed into iPSCs than those with less TNSALP. Furthermore, in bone marrow stem cells, ALP could function as a "signal regulator" deciding the fate of these cells. In this review, we summarize the properties of ALP and the background of ALP gene analysis and its manipulation, with a special focus on the potential role of TNSALP in the generation (and possibly maintenance) of juvenile cells.

Parathyroid hormone in Sri Lankan pregnant women: Vitamin D and other determinants

INTRODUCTION

Determinants of parathyroid hormone level during pregnancy have been less frequently studied. We aimed to describe the serum parathyroid hormone (PTH) and its determinants in Sri Lankan pregnant women in a community setting.

MATERIALS AND METHODS

In this cross-sectional analysis, 390 pregnant mothers in their third trimester were enrolled from primary care centers of 15 health divisions in the Colombo District in Sri Lanka. Venous blood was analyzed for a total 25-hydroxyvitamin-D [25(OH)D], serum parathyroid hormone (PTH), serum calcium, and alkaline phosphatase. The bone quality was assessed in terms of speed of sound (SOS) using the quantitative ultrasound scan (QUS). Univariate and multivariate regression analysis was used to examine the determinants of PTH concentration in blood.

RESULTS

Median serum 25(OH)D was 17.5ng/mL. Most (61.6%) were vitamin D deficient (<20ng/mL). Median PTH was 23.7pg/mL. Only 0.8% had hyperparathyroidism (PTH >65pg/mL). The correlation between 25(OH)D and PTH was weak but significant (r = -0.197; p<0.001). SOS Z-score was below the cut-off (≤-2) in fifty-six women (14.7%), and SOS did not relate significantly to PTH. In regression analysis, serum 25(OH)D, serum calcium, body mass index, educational level, and weeks of pregnancy were significant independent variables when adjusted. The model explained 16% of the variation in the PTH level.

CONCLUSIONS

A high prevalence of vitamin D deficiency was observed among Sri Lankan pregnant women in the present study. Serum 25(OH)D, calcium, weeks of pregnancy, and educational level were determinants of serum PTH.

Risk factors of skeletal-related events in patients with bone metastatic castration-resistant prostate cancer undergoing treatment with zoledronate

BACKGROUND

Skeletal-related events (SREs) are related to morbidity and mortality in patients with bone metastatic prostate cancer, and preventive strategies based on patient risk assessment are recommended. However, potentiating factors for SREs in patients with bone metastatic prostate cancer are not well elucidated.

METHODS

We analyzed the clinical data from a controlled arm of a clinical trial comparing denosumab with zoledronate in patients with bone metastatic, castration resistant prostate cancer (ClinicalTrial.gov ID: NCT00321620) available at Project Data Sphere, a broad-access research platform. The primary endpoint was the first SRE after the inclusion to the trial, and the time to the first SRE was analyzed using Cox proportional hazards model based on patients' baseline characteristics including age, race, ECOG performance status (PS), Gleason score, TNM stage at diagnosis, metastasis pattern, and urine and serum laboratory data.

RESULTS

Seven hundred ten patients without documented history of osteopenia or osteoporosis whose data was available in the zoledronate arm of the trial were analyzed. The median age of the patients was 71 years old, the median follow-up was 225 days, and 295 patients (42%) had at least one SRE during this period. The univariate analysis showed that history of SREs, Gleason score ≥ 7, elevated serum alkaline phosphatase (ALP), and high urine N-telopeptide cross-links/creatinine ratio (NTx/Cre) are significant baseline risk factors for SREs. Patients with the characteristics of history of SREs, Gleason score ≥ 7 and elevated serum ALP also showed a significantly higher hazard ratio of SREs in multivariate analysis.

CONCLUSIONS

The incidence of SREs in patients with bone metastatic prostate cancer may be higher in those with history of SREs, Gleason ≥ 7, and elevated serum ALP.

Exploration of several plants from Baung Forest on bone formation cell models

OBJECTIVES

Osteoporosis is an ailment described by a skeletal degradation of bone skeletal dominating to increases the chance of fracture. In order to find out the bone formation agents from Baung Forest plants, this research analyzed the effects of 96% ethanol extract of several plants from Baung Forest on antioxidant activity and the effect of osteoblast differentiation-related to the bone formation on the most potent extract.

METHODS

The antioxidant effect and osteoblast differentiation of 96% ethanol extracts were evaluated by measuring DPPH scavenging and alkaline phosphatase in p-nitrophenyl phosphate effects by the enzyme-linked immunosorbent assay (ELISA) reader method, respectively.

RESULTS

The 96% ethanol extract of Elaeocarpus serratus L. from Baung Forest had the strongest DPPH radical scavenging as anti oxidant (82.17%) and stimulated osteoblast differentiation (116%). Then, this extract had been fractionated based on polarity to become hexane, ethyl acetate, butanol, and aqueous fractions. All the fractions stimulated their alkaline phosphatase (ALP) activity to 138.11 ± 9.72%, 108 ± 5.05%, 148.56 ± 8.47, and 144.58 ± 1.04, respectively.

CONCLUSIONS

The extract and fractions of E. serratus L. can successfully inhibit DPPH radical scavenging value and increase ALP activities as markers of osteoblast functions.

Peri-operative derangement in liver function tests in older patients with neck of femur fracture

Neck of femur fracture is a common consequence of falls in the elderly with a large burden of morbidity and mortality. Derangement in liver function tests (LFTs) is frequently seen in elderly people with neck of femur (NOF) fracture in the peri-operative period and can indicate serious and treatable underlying pathology as well as prognosis.On admission, raised alkaline phosphatase (ALP) levels with normal gamma-glutamyl transferase (GGT) suggest underlying bone pathology such as osteomalacia or Paget's disease but do not confirm or exclude osteoporosis. ALP can also be raised by non-bone pathology such as congestive cardiac failure and chronic kidney disease. LFT derangement in cardiac failure is associated with poorer prognosis. Post-operatively, ALP levels rise after the first week with a peak at 3-4 weeks and then fall thereafter. The rate at which they fall may help indicate bone healing in trochanteric fractures. Derangement in other LFTs is commonly due to hepatic injury; causes include trauma, alcohol, and viral hepatitis. There are also iatrogenic causes including surgery and commonly prescribed medication such as beta-lactam antibiotics, non-steroidal anti-inflammatories, and paracetamol.The differential diagnosis for deranged LFTs in the elderly peri-operatively is wide; however, most causes can be elicited through careful history and examination with occasional need for further investigations.

Effects and interaction of dietary calcium and non-phytate phosphorus for slow-growing yellow-feathered broilers during the starter phase

Calcium (Ca) and non-phytate phosphorus (NPP) are fundamental minerals for bone formation and growth, and optimizing their level is required in broiler production. This experiment was conducted to investigate the effect and interaction of dietary Ca and NPP on growth performance, tibial characteristics and biochemical variables for slow-growing yellow-feathered broilers during 1-28 d (the starter phase). Seven hundred and twenty hatchling female broilers were randomly divided into nine groups, which received three levels of Ca (0.80%, 0.90%, 1.00%) each with three levels of NPP (0.40%, 0.45%, 0.50%). The results showed: (1) Dietary Ca level influenced (P < 0.05) the feed to gain ratio (F:G) and average daily feed intake (ADFI). Compared with broilers provided 1.00% Ca, ADFI of birds provided with 0.80% or 0.90% Ca and F:G of those with 0.90% Ca were decreased (P < 0.05). Dietary NPP level did not affect (P > 0.05) growth performance of broilers. (2) Dietary Ca affected (P < 0.05) tibial length. Compared with birds provided with 0.80% Ca, the length of tibia was decreased (P < 0.05) in birds received 1.00% Ca. Interactions between dietary Ca and NPP were observed (P < 0.05) on ash content, breaking strength and bone density of tibia. These three characteristics were better when birds received 0.90% Ca and 0.40% NPP or 1.00% Ca and 0.45% NPP. (3) Dietary Ca significantly affected (P < 0.05) the activity of alkaline phosphatase (ALP) in serum with decreased activity in birds fed 0.80% or 0.90% Ca. The dietary NPP influenced (P < 0.05) the contents of Ca in serum. Serum Ca was increased when birds were provided 0.40% NPP compared with other levels (P < 0.05). Again, there was interaction between Ca and NPP in diet on the contents of phosphorus (P) in serum (P < 0.05). In conclusion, interactions occurred between dietary Ca and NPP level on tibial breaking strength, density, ash content, and the content of P in the serum of young yellow-feathered broilers. Furthermore, dietary Ca affected ADFI, F:G and serum ALP activity, and dietary NPP also affected the P content in serum. Considering all indicators, 0.90% Ca and 0.40% NPP are optimal for slow-growing yellow-feathered broilers during 1-28 d of age.

Risk factors for skeletal-related events in patients with bone metastasis from breast cancer undergoing treatment with zoledronate

BACKGROUND

Skeletal-related events (SREs) are significant contributors to the morbidity and mortality in patients with bone metastasis from breast cancer. Thus, bone-modifying agents (BMAs) are recommended in this population. However, the baseline risk factors of SREs in patients with bone metastasis from breast cancer receiving BMAs are not well understood.

METHODS

We analyzed the patient-level data from a controlled arm of a clinical trial comparing denosumab with zoledronate in patients with bone metastases from breast cancer (ClinicalTrial.gov ID: NCT00321464) available at Project Data Sphere, a broad-access research platform that collects and curates patient-level data from completed, phase III cancer trials. The primary endpoint was the first SRE after the inclusion to the trial. The time to the first on study SRE was analyzed using Cox proportional hazards model based on patients' baseline characteristics including age, race, ECOG performance status (PS), histology and immunohistochemistry of breast cancer, and urine and serum laboratory data.

RESULTS

Among 756 patients in the zoledronate arm of the trial, we excluded 64 patients with a documented history of osteopenia or osteoporosis. The median age of the patients was 56 years old, the median follow-up was 553 days, and 249 patients (36%) had SREs. The univariate analysis showed that black or African American heritage, ECOG PS > 0, human epidermal growth factor receptor 2 (HER2) positivity, high urine N-telopeptide cross-links / creatinine ratio (NTx/Cre), and elevated serum alkaline phosphatase (ALP) are significant baseline risk factors for SREs. Patients with the characteristics of ECOG PS > 0, HER2 positivity, and elevated ALP also showed a significantly higher hazard ratio of SREs in multivariate analysis.

CONCLUSIONS

We determined risk factors for SREs in patients with bone metastasis from breast cancer.

Antioxidant and hepatoprotective effects of Korean ginseng extract GS-KG9 in a D-galactosamine-induced liver damage animal model

BACKGROUND/OBJECTIVES

This study was designed to investigate the improvement effect of white ginseng extract (GS-KG9) on D-galactosamine (Ga1N)-induced oxidative stress and liver injury.

SUBJECTS/METHODS

Sixty Sprague-Dawley rats were divided into 6 groups. Rats were orally administrated with GS-KG9 (300, 500, or 700 mg/kg) or silymarin (25 mg/kg) for 2 weeks. The rats of the GS-KG9- and silymarin-treated groups and a control group were then intraperitoneally injected Ga1N at a concentration of 650 mg/kg for 4 days. To investigate the protective effect of GS-KG9 against GalN-induced liver injury, blood liver function indicators, anti-oxidative stress indicators, and histopathological features were analyzed.

RESULTS

Serum biochemical analysis indicated that GS-KG9 ameliorated the elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) in GalN-treated rats. The hepatoprotective effects of GS-KG9 involved enhancing components of the hepatic antioxidant defense system, including glutathione, glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT). In addition, GS-KG9 treatment inhibited reactive oxygen species (ROS) production induced by GalN treatment in hepatocytes and significantly increased the expression levels of nuclear factor erythroid-2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) proteins, which are antioxidant proteins. In particular, by histological analyses bases on hematoxylin and eosin, Masson's trichrome, α-smooth muscle actin, and transforming growth factor-β1 staining, we determined that the administration of 500 mg/kg GS-KG9 inhibited hepatic inflammation and fibrosis due to the excessive accumulation of collagen.

CONCLUSIONS

These findings demonstrate that GS-KG9 improves GalN-induced liver inflammation, necrosis, and fibrosis by attenuating oxidative stress. Therefore, GS-KG9 may be considered a useful candidate in the development of a natural preventive agent against liver injury.

Dietary calcium or phosphorus deficiency impairs the bone development by regulating related calcium or phosphorus metabolic utilization parameters of broilers

An experiment was conducted to investigate the effect of dietary calcium (Ca) or phosphorus (P) deficiency on bone development and related Ca or P metabolic utilization parameters of broilers. A total of 504 one-day-old Arbor Acres male broilers were randomly assigned to 1 of 4 treatments with 7 replicates of 18 birds per replicate in a completely randomized design. A 2 (Ca levels: 1.00 and 0.35%) × 2 (nonphytate P [NPP] levels: 0.45 and 0.23%) factorial arrangement of treatments was adopted in the 21-day trial. The 4 treatments were the Ca- and P-adequate diet (1.00% Ca + 0.45% NPP), the Ca-deficient diet (0.35% Ca + 0.45% NPP), the P-deficient diet (1.00% Ca + 0.23% NPP), and the Ca- and P-deficient diet (0.35% Ca + 0.23% NPP). The greatest impact on tibia bone mineral density, bone breaking strength, and ash content was in the P-deficient diets, especially in broilers fed with the Ca-adequate diet, whereas adequate P and reduced Ca reduced (P < 0.05) these parameters compared with adequate Ca and P, but not to the same level as P deficiency. Furthermore, dietary Ca or P deficiency, especially adequate Ca and P deficiency decreased (P < 0.05) serum P, 25-hydroxyvitamin D₃ (25-OHD₃) contents, and tibia ash Ca and P contents but increased (P < 0.05) the serum Ca content and tibia alkaline phosphatase (ALP) activity compared with adequate Ca and P. The results from this study indicated that the bone development and Ca or P metabolic utilization parameters of broilers were the most sensitive ones to dietary P deficiency, followed by dietary Ca deficiency or Ca and P deficiencies. Dietary P deficiency impaired the bone development by increasing serum Ca content and tibia ALP activity but decreasing serum P, 25-OHD₃ contents, and tibia ash Ca and P contents of broilers. Dietary Ca deficiency impaired bone development by increasing serum Ca content, tibia ALP activity, and tibia ash P content but decreasing serum P, 25-OHD₃ contents, and tibia ash Ca content of broilers.

Growth performance, nutrient digestibility, bone mineralization, and hormone profile in broilers fed with phosphorus-deficient diets supplemented with butyric acid and Saccharomyces boulardii

The present study evaluated the effects of butyric acid supplementation and Saccharomyces boulardii (alone or in combination) on growth performance, nutrient digestibility, bone mineralization, and blood hormones of male broiler chickens fed a diet including reduced levels of nonphytate phosphorus (NPP). The chickens were allocated to 6 dietary treatments: 1) positive control diet with adequate amounts of NPP (PC; 0.48, 0.43, and 0.39% in the starter, grower, and finisher period, respectively); 2) negative control diet with low amounts of NPP (NC; 0.38, 0.33, and 0.29% in the starter, grower, and finisher period, respectively); 3) NC plus 500 FTU/kg microbial phytase (PHY); 4) NC plus 0.2% butyric acid (BA); 5) NC plus 1 × 10⁸ cfu/kg S. boulardii (SB); 6) NC plus butyric acid and S. boulardii (BA+SB). Each treatment had 5 pen replicates of 25 birds. After 6 wk, the body weight and ADG in birds fed with any of the diets were higher (P < 0.001) than those in birds fed with the NC diet, where the birds fed with the PHY and BA+SB diets had the highest values. However, only the PHY diet improved (P = 0.041) overall F:G. All diets, except the SB diet, resulted in the increased apparent ileal digestibility coefficient (AIDC) of CP, AME_n, and tibia ash content and decreased serum alkaline phosphatase level compared with the NC diet (P < 0.05). Broiler chickens fed with the PHY, SB, and BA+SB diets also had increased AIDC of phosphorus (P = 0.017) than those fed with the NC and PC diets. Feeding PC, PHY, and BA+SB diets increased (P = 0.007) the tibia phosphorus content but decreased (P = 0.033) serum parathyroid hormone concentration. Overall, the present data indicate that the simultaneous inclusion of butyric acid plus S. boulardii in the low-NPP diets was beneficial for improving growth rate and bone mineralization, but not for feed efficiency.

Nanotechnological Applications Hold a Pivotal Position in Boosting Stem Cells Osteogenic Activity: In Vitro and In Vivo Studies

This approach was constructed to appraise the therapeutic effectiveness of a single i.v. dose of osteoblasts generated from co-culturing BM-MSCs with nano-HA, Pt-NPs, or Pt-HA-nanocomposite in osteoporotic rats. MSCs were grown, propagated in culture, and characterized. The effect of the suggested nanoplatforms on the survival, osteogenic differentiation, and mineralization of BM-MSCs was assessed by MTT assay, real-time PCR analysis, and Alizarin red S staining, respectively. Thereafter, the generated osteoblasts were employed for the treatment of ovariectomized rats. Our results revealed that the selected nanoplatforms upregulate the expression of osteogenic differentiation related genes (Runx-2 and BMP-2) significantly and enhance calcium deposition in BM-MSCs after 7 and 21 days, respectively, whereas the in vivo study validated that the infusion of the generated osteoblasts considerably downturn serum BALP, BSP, and SOST levels; upswing OSX level; and regain femur bone mineralization and histoarchitecture. Conclusively, the outcomes of this work provide scientific evidence that transplanting osteoblasts derived from differentiation of BM-MSCs in the presence of nanoplatforms in ovariectomized rats restores bone remodeling balance which constitutes a new hope for the treatment of osteoporosis.

Bone phosphorus retention and bone development of broilers at different ages

The present study was carried out to investigate the tibia phosphorus (P) retention and development as well as their correlations and possible mechanisms of broilers at different ages. A total of 320 1-day-old Arbor Acres male broilers were raised in 8 replicate cages of 40 birds per cage, and fed the same corn-soybean diets for 42 d. Plasma and tibia samples of broilers were collected on day 0, 7, 14, 21, 28, 35, or 42. The results showed that the tibia ash P content increased linearly (P = 0.017), and the total P accumulation in tibia ash increased linearly and quadratically (P < 0.001) with age. The traits of bone development including the tibia bone mineral content (BMC), the tibia bone mineral density (BMD), and the tibia ash content increased linearly and quadratically (P < 0.001), while the tibia breaking strength increased linearly (P < 0.001) with age. The tibia bone gal protein (BGP) content decreased linearly (P = 0.011), but neither a linear nor quadratic (P > 0.15) response was observed for the tibia alkaline phosphatase (ALP) with age. The tibia ash P content was positively correlated with the tibia BMD (r = 0.325, P = 0.014), ash (r = 0.325, P = 0.001), and ALP (r = 0.377, P = 0.004). The total P accumulation in tibia ash also was positively correlated with all of the above traits of bone development (r = 0.437 to 0.976, P < 0.001); however, it was negatively correlated with the tibia BGP (r = -0.426, P = 0.0014). Additionally, the tibia ALP was positively correlated with the tibia ash (r = 0.369, P < 0.001), and the tibia BGP was negatively correlated with the tibia BMC (r = -0.453, P < 0.001), breaking strength (r = -0.384, P < 0.001), and ash content (r = -0.361, P < 0.001). The above results indicated that the bone P retention was involved in the bone development of broilers from 1 to 42 d of age possibly via the regulation of the bone ALP and BGP.

Are certain factors involved in calcium metabolism associated with temporomandibular disorders?

Objective: The aim of the present study was to investigate whether there is an association between serum concentrations of calcium, phosphate, alkaline phosphatase, parathyroid hormone (PTH), and vitamin D and temporomandibular disorders (TMDs).Methods: In this case-control study, 51 patients with TMDs (28 patients with TMJ clicking, 5 patients with muscular disorders, and 18 osteoarthritis patients) and 29 healthy subjects within the age range of 20-50 years as the control group, were referred to the laboratory for calcium, phosphate, alkaline phosphatase, PTH, and vitamin D (25 OHD) analysis tests. The TMJ status of all participants was examined according to RDC-TMD criteria by a prosthodontist who is an expert in TMDs. The results were analyzed with Fisher's precise test.Results: No statistically significant difference was observed between TMD patients and healthy subjects.Conclusion: Serum concentrations of calcium, phosphate, alkaline phosphatase, PTH, and vitamin D are not associated with TMDs.

Evaluation of the osteoprotective potential of whey derived-antioxidative (YVEEL) and angiotensin-converting enzyme inhibitory (YLLF) bioactive peptides in ovariectomised rats

Milk contains various bioactive components with osteoanabolic properties. This study investigates the comparative effect of the whey-derived antioxidative (YVEEL) and angiotensin-converting enzyme inhibitory (YLLF) bioactive peptides on bone remodelling in ovariectomised (OVX) osteoporotic rat model. OVX animals were administered with antioxidative (AO) (500 μg kg-1 day-1) and angiotensin-converting enzyme inhibitory (ACE inhibitory) (50 μg kg-1 day-1) peptides for eight weeks. Trabecular microarchitectural parameters of femoral and tibiae bone were determined using micro-CT scan. Bone formation, resorption, turnover markers (ALP, RANKL, OCN) and inflammatory cytokines (TNF-α, TGF-β, IFN-γ) were determined by ELISA. Both AO and ACE inhibitory peptides inhibited the increase in bone turnover and inflammatory cytokines while increased the bone formation markers. The altered morphometric parameters of femoral and tibiae bones due to OVX were strikingly attenuated by the peptide administration. The results indicated that AO peptide exerts more osteoprotective potential than ACE inhibitory peptide by suppressing inflammatory status and enhancing bone formation markers.

Regulation of osteoblasts by alkaline phosphatase in ankylosing spondylitis

AIM

Ankylosing spondylitis (AS) is characterized by excessive spinal ankylosis and bone formation. Alkaline phosphatase (ALP) activity is reported to be high in AS, but little is known about the molecular relationship between ALP and AS. The aims of this study were to investigate the relevance of ALP to AS and the role of ALP in the regulation of osteoblast differentiation in AS.

METHODS

High-throughput data with accession numbers GSE73754 and GSE41038 were downloaded from the Gene Expression Omnibus. We retrospectively collected and compared the ALP levels of male patients with AS to those of sex- and age-matched healthy controls (HC) and rheumatoid arthritis (RA) patients. Total serum ALP and ALP activity were measured in the AS and RA groups. ALP gene expression and intracellular ALP activity were analyzed in microarray data from primary diseases control (Ct) and AS-bone-derived cells (BdCs) and in vitro experiments. Furthermore, the effect of ALP inhibitor was examined in both primary Ct- and AS-BdCs under osteoblast differentiation. Regulation of runt-related transcription factor 2 (RUNX2) by ALP was also analyzed.

RESULTS

Alkaline phosphatase level was higher in AS compared with RA and HC and was associated with radiograph progression. ALP expression was also enriched in the bone tissue of AS patients. Furthermore, AS-BdCs exhibited increasing ALP activity, leading to accelerated osteoblastic activity and differentiation. Intriguingly, inhibition of ALP reduced RUNX2 expression, a master transcriptional factor in osteoblasts, and differentiation status of both primary Ct- and AS-BdCs. Treatment of ALP activator or inhibitor modulated RUNX2 protein level and RUNX2 regulated ALP promoter activity, indicating a reciprocal ALP-RUNX2 positive feedback to regulate osteoblast differentiation.

CONCLUSION

Alkaline phosphatase was highly expressed in AS patients, may be involved in the ankylosis of AS, and represents a possible therapeutic target for ankylosis.

MiR-122 and other microRNAs as potential circulating biomarkers of drug-induced liver injury

INTRODUCTION

Drug-induced liver injury (DILI) is a severe adverse drug reaction which is of major concern to patients, clinicians and the pharmaceutical industry. Accurate and rapid detection of DILI is important for patient stratification and treatment in the clinic and benefits preclinical drug design and risk assessment. MicroRNAs (miRNAs) offer a potential new and improved class of circulating biomarkers of DILI over the current gold standard biomarkers. Areas covered: This review highlights the shortcomings of the currently used panel of biomarkers and how miRNAs, primarily miR-122, show an improved level of specificity and sensitivity in the prediction of DILI. Furthermore, the use of miRNAs as potential markers of progression of DILI and specific zonated damage within the liver is discussed. Expert commentary: MiRNAs offer more sensitive and specific markers over the current biomarkers for DILI. Combinations of different miRNAs may be able to relay the location of DILI and the progression of disease. More studies using different hepatotoxins apart from acetaminophen will ultimately strengthen the case for the clinical introduction of miRNAs as biomarkers of DILI.

Angiotensin (1-7) ameliorates the structural and biochemical alterations of ovariectomy-induced osteoporosis in rats via activation of ACE-2/Mas receptor axis

The local and systemic renin angiotensin system (RAS) influences the skeletal system micro-structure and metabolism. Studies suggested angiotensin 1-7 (Ang(1-7)) as the beneficial RAS molecule via Mas receptor activation. This study examines the function of Ang(1-7) in bone micro-architecture and metabolism in an ovariectomized (OVX) rodent model of osteoporosis. OVX rats showed structural and bone metabolic degeneration in parallel with suppressed expressions of the angiotensin converting enzyme-2 (ACE-2)/Ang(1-7)/Mas components. The infusion of Ang(1-7) markedly alleviated the altered bone metabolism and significantly enhanced both trabecular (metaphyseal) and cortical (metaphyseal-diaphyseal) morphometry. Urinary and bones minerals were also improved in OVX rats by Ang(1-7). The infusion of the heptapeptide enhanced ACE-2/Mas receptor expressions, while down-regulated AngII, ACE, and AngII type-1 receptor (AT1R) in OVX animals. Moreover, Ang(1-7) markedly improved osteoprotegerin (OPG) and lowered receptor activator NF-κB ligand (RANKL) expressions. The defensive properties of Ang(1-7) on bone metabolism, structure and minerals were considerably eradicated after blockage of Mas receptor with A-779. Ang(1-7)-induced up-regulated ACE-2/Ang(1-7)/Mas cascade and OPG expressions were abolished and the expressions of ACE/AngII/AT1R and RANKL were provoked by A-779. These findings shows for the first time the novel valuable therapeutic role of Ang(1-7) on bone health and metabolism through the ACE-2/Mas cascade.

Immunological, anti-angiogenic and clinical effects of intratumoral interleukin 12 electrogene therapy combined with metronomic cyclophosphamide in dogs with spontaneous cancer: A pilot study

The immunological, anti-angiogenic and clinical effects of metronomic cyclophosphamide and 3 consecutive intratumoral interleukin (IL)-12 gene therapy (electrogene therapy (EGT)) treatments were evaluated in 6 dogs with spontaneous cancer. In all dogs, a decrease in peripheral leukocytes 2 days after IL-12 EGT coincided with erythema and swelling of the tumor. In the tumor, a transient increase in IL-12 levels was measured, whereas a continuous increase in interferon γ (IFNγ) and thrombospondin 1 (TSP-1) were determined in contrast to a continuous decrease in vascular endothelial growth factor (VEGF). In the serum, a transient increase in IL-12 and IL-10 levels were noted in contrast to a transient decrease in VEGF and TSP-1. The treatment resulted in a significant anti-angiogenic effect. Although all primary tumors continued to progress in time, this progression was slower than before treatment according to the contrast-enhanced ultrasound data. Besides the encouraging immunostimulatory and anti-angiogenic effects observed in all dogs we also noticed in 4 out of 6 dogs clinically relevant improvements in quality of life and weight. These results hold great promise for combinatorial strategies of IL-12 EGT and metronomic chemotherapy with conventional antitumor (immuno)therapies.

The antidepressant bupropion exerts alleviating properties in an ovariectomized osteoporotic rat model

AIM

Depression is a risk factor for impaired bone mass and micro-architecture, but several antidepressants were found to increase the incidence of osteoporotic fractures. In the present study we used ovariectomized (OVX) rats as a model of osteoporosis to investigate the effects of the antidepressant bupropion on the femoral bones.

METHODS

OVX animals were treated with bupropion (30, 60 mg·kg(-1)·d(-1)) for six weeks. Bone turnover biomarkers (urinary DPD/Cr ratio, serum BALP, OC, TRAcP 5b, CTX and sRANKL levels) and inflammatory cytokines (TNF-α, IL-1β and IL-6) were determined using ELISA. Inductively coupled plasma mass spectroscopy (ICP-MS) was used to determine the femoral bone mineral concentrations. The cortical and trabecular morphometric parameters of femoral bones were determined using micro-CT scan and histopathology.

RESULTS

In OVX rats, the levels of bone turnover biomarkers and inflammatory cytokines were significantly elevated and femoral bone Ca(2+) and PO4(3-) concentrations were significantly reduced. Moreover, cortical and trabecular morphometric parameters and histopathology of femoral bones were severely altered by ovariectomy. Bupropion dose-dependently inhibited the increases in bone turnover biomarkers and inflammatory cytokines. OVX rats treated with the high dose of bupropion showed normal mineral concentrations in femoral bones. The altered morphometric parameters and histopathology of femoral bones were markedly attenuated by the treatment.

CONCLUSION

Bupropion exerts osteo-protective action in OVX rats through suppressing osteoclastogenesis-inducing factors and inflammation, which stabilize the osteoclasts and decrease bone matrix degradation or resorption.