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Vampertzis T, Barmpagianni C, Bekiari C, Brellou GD, Zervos IA, Tsiridis E, Galanis N. The Role of Botulinum Neurotoxin A in the Conservative Treatment of Fractures: An Experimental Study on Rats. ScientificWorldJournal 2024; 2024:7446251. [PMID: 38854678 PMCID: PMC11161265 DOI: 10.1155/2024/7446251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 06/11/2024] Open
Abstract
This paper explores the role of botulinum neurotoxin in aiding fracture recovery through temporary muscle paralysis. Specifically, it investigates the effects of botulinum neurotoxin-induced paralysis of the sternocleidomastoid muscle on clavicle fractures in rats. The research aims to assess safety, effectiveness, and the impact on fracture healing. Healthy male Albino Wistar rats were divided into four groups: clavicle fracture, botulinum neurotoxin injection, both, and control. Surgeries were conducted under anaesthesia, and postoperatively, animals were monitored for 28 days. Euthanasia and radiological assessment followed, examining fracture healing and muscle changes, while tissues were histopathologically evaluated. The modified Lane-Sandhu scoring system was used for the radiographic evaluation of clavicle fractures, and the results varied from complete healing to nonunion. Histopathological examination at 28 days postfracture showed fibrous tissue, mesenchymal cells, and primary callus formation in all groups. Despite varied callus compositions, botulinum neurotoxin administration did not affect clavicle healing, as evidenced by similar scores to the control group. Several studies have explored botulinum neurotoxin applications in fracture recovery. Research suggests its potential to enhance functional recovery in certain types of fractures. Theoretical benefits include managing muscle spasticity, aiding reduction techniques, and preventing nonunion. However, botulinum neurotoxin's transient effect and nonuniversal applications should be considered. The present study found that botulinum toxin had no clear superiority in healing compared to controls, while histological evaluation showed potential adverse effects on muscle tissue. Further research is essential to understand its risk-benefit balance and long-term effects.
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Affiliation(s)
- Themistoklis Vampertzis
- Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Chryssa Bekiari
- Laboratory of Anatomy and Histology, Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia D. Brellou
- Department of Pathology, Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis A. Zervos
- Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftherios Tsiridis
- Academic Orthopaedic Department, Papageorgiou General Hospital and CORE Laboratory at CIRI-AUTH, AUTH Medical School, Thessaloniki, Greece
| | - Nikiforos Galanis
- Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ausk BJ, Tucker AN, Huber P, Firoozabadi R, Gross JM, Gross TS, Bain SD. A microCT-based platform to quantify drug targeting. Eur Radiol Exp 2023; 7:38. [PMID: 37532922 PMCID: PMC10397158 DOI: 10.1186/s41747-023-00355-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/12/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Heterotopic ossification (HO) is a frequent and debilitating complication of traumatic musculoskeletal injuries and orthopedic procedures. Prophylactic dosing of botulinum toxin type A (BTxA) holds potential as a novel treatment option if accurately distributed throughout soft-tissue volumes where protection is clinically desired. We developed a high-resolution, microcomputed tomography (microCT)-based imaging strategy to assess drug distribution and validated this platform by quantifying distribution achieved via a prototype delivery system versus a single-bolus injection. METHODS We injected an iodine-containing contrast agent (iodixanol 320 mg I/mL) into dissected rabbit musculature followed by microCT imaging and analysis. To contrast the performance of distributed versus bolus injections, a three-dimensional (3D) 64-cm3-printed soft-tissue holder was developed. A centered 2-cm3 volume of interest (VOI) was targeted with a single-bolus injection or an equal volume distributed injection delivered via a 3D-printed prototype. VOI drug coverage was quantified as a percentage of the VOI volume that was < 1.0 mm from the injected fluid. RESULTS The microCT-based approach enabled high-resolution quantification of injection distribution within soft tissue. The distributed dosing prototype provided significantly greater tissue coverage of the targeted VOI (72 ± 3%, mean ± standard deviation) when compared to an equal volume bolus dose (43 ± 5%, p = 0.031) while also enhancing the precision of injection targeting. CONCLUSIONS A microCT-based imaging technique precisely quantifies drug distribution within a soft-tissue VOI, providing a path to overcome a barrier for clinical translation of prophylactic inhibition of HO by BTxA. RELEVANCE STATEMENT This platform will facilitate rapid optimization of injection parameters for clinical devices used to effectively and safely inhibit the formation of heterotopic ossification. KEY POINTS • MicroCT provides high-resolution quantification of soft-tissue drug distribution. • Distributed dosing is required to maximize soft-tissue drug coverage. • Imaging platform will enable rapid screening of 3D-printed drug distribution prototypes.
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Affiliation(s)
| | - Adam N Tucker
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, USA
| | - Philippe Huber
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, USA
| | - Reza Firoozabadi
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, USA
| | | | - Ted S Gross
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, USA
| | - Steven D Bain
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, USA
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Liu N, Li B, Zhang L, Yang D, Yang F. Basolateral Amygdala Mediates Central Mechanosensory Feedback of Musculoskeletal System. Front Mol Neurosci 2022; 15:834980. [PMID: 35250478 PMCID: PMC8889035 DOI: 10.3389/fnmol.2022.834980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/24/2022] [Indexed: 12/01/2022] Open
Abstract
Musculoskeletal diseases, such as osteoporosis and sarcopenia, are tremendous and growing public health concerns. Considering the intimate functional relationship between muscle and bone throughout development, growth, and aging, muscle provides the primary source of skeletal loading through contraction force. However, significant gaps exist in our knowledge regarding the role of muscle in bone homeostasis and little is known regarding the mechanism through which the central nervous system responds and regulates unloading-induced bone loss. Here, we showed that the basolateral amygdala (BLA) and medial part of the central nucleus (CeM) are anatomically connected with the musculoskeletal system. Unloading-induced bone loss is accompanied by a decrease in serum semaphorin 3A (Sema3A) levels as well as sensory denervation. In vivo fiber photometry recordings indicated that the mechanical signal is integrated by the BLA and CeM within 24 h and subsequently regulates bone remodeling. Moreover, chemogenetic activation of BLACaMKII neurons mitigates severe bone loss caused by mechanical unloading via increased serum levels of Sema3A and sensory innervation. These results indicate that the BLA integrates the mechanosensory signals rapidly and mediates the systemic hormonal secretion of Sema3A to maintain bone homeostasis.
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Affiliation(s)
- Nian Liu
- Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Botai Li
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Lu Zhang
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Dazhi Yang
- Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- *Correspondence: Dazhi Yang,
| | - Fan Yang
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- Fan Yang,
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The Action of Botulinum Toxin A on the Sternocleidomastoid Muscle: An Experimental Study on Rats. ScientificWorldJournal 2022; 2022:2188783. [PMID: 35177957 PMCID: PMC8846976 DOI: 10.1155/2022/2188783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/13/2022] [Indexed: 11/18/2022] Open
Abstract
In this study, we aim to investigate the effective dose of botulinum neurotoxin A that results in paralysis of the sternocleidomastoid muscle for a minimum duration of 28 days in Wistar rats. This research is the first in a series of studies to investigate the value of botulinum toxin A in the healing of clavicle fractures through the temporary paralysis of the sternocleidomastoid. A surgical incision was made under general anaesthesia, and botulinum neurotoxin A in respective doses of 4 and 6 international units (IU) or normal saline in equivalent volumes were injected directly into the exposed muscle. Electromyography was conducted on days 0, 7, and 28 following substance administration to determine the extent of muscle paralysis. Electromyography on day 0 showed no paralysis in either group. Animals injected with neurotoxin all exhibited paralysis on days 7 and 28 that was weaker in the group injected with the smaller dose of 4 IU. One death occurred in the group injected with the higher dose (6 IU), whereas in the control group, no paralysis was seen. Botulinum neurotoxin A in a dose of 6 IU resulted in complete paralysis of the sternocleidomastoid in rats for a minimum of 28 days. A dose of 4 IU resulted in less potent paralysis but was safer in our research. Botulinum neurotoxin is a substance utilised in cosmetics and therapeutics for many years, yet research shows that its use can be expanded to target a wider range of pathologies. In this series of studies, we aim to explore the neurotoxin's applications on the treatment of clavicle fractures. To investigate this, we need to first establish the duration of its action on the sternocleidomastoid muscle.
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Mazzaferro S, Bagordo D, De Martini N, Pasquali M, Rotondi S, Tartaglione L, Stenvinkel P. Inflammation, Oxidative Stress, and Bone in Chronic Kidney Disease in the Osteoimmunology Era. Calcif Tissue Int 2021; 108:452-460. [PMID: 33388898 PMCID: PMC7778498 DOI: 10.1007/s00223-020-00794-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022]
Abstract
Bone is not only a mineralized and apparently non-vital structure that provides support for locomotion and protection to inner organs. An increasing number of studies are unveiling new biologic functions and connections to other systems, giving the rise to new fields of research, such as osteoimmunology. The bone marrow niche, a new entity in bone physiology, seems to represent the site where a complex crosstalk between bone and immune/inflammatory responses takes place. An impressive interplay with the immune system is realized in bone marrow, with reciprocal influences between bone cells and haematopoietic cells. In this way, systemic chronic inflammatory diseases realize a crosstalk with bone, resulting in bone disease. Thus, pathogenetic links between chronic kidney disease-mineral bone disorders and osteoporosis, cardiovascular disease, and ageing are common. The aim of this narrative review is to provide a general view of the progresses in the field of bone research and their potential clinical implications, with emphasis on the links with inflammation and the connections to osteoimmunology and chemokines.
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Affiliation(s)
- Sandro Mazzaferro
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
- Nephrology Unit, Policlinico Umberto I, Rome, Italy.
| | - Domenico Bagordo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Natalia De Martini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy
| | | | - Silverio Rotondi
- Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, Rome, Italy
| | - Lida Tartaglione
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Tang MJ, Graham HK, Davidson KE. Botulinum Toxin A and Osteosarcopenia in Experimental Animals: A Scoping Review. Toxins (Basel) 2021; 13:toxins13030213. [PMID: 33799488 PMCID: PMC8001269 DOI: 10.3390/toxins13030213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 01/24/2023] Open
Abstract
We conducted a scoping review to investigate the effects of intramuscular injection of Botulinum Toxin A (BoNT-A) on bone morphology. We investigated if the muscle atrophy associated with Injection of BoNT-A had effects on the neighboring bone. We used the search terms: osteopenia, bone atrophy, Botulinum Toxin A, Micro-CT, mice or rat. The following databases were searched: Medline, Embase, PubMed and the Cochrane Library, between 1990 and 2020. After removal of duplicates, 228 abstracts were identified of which 49 studies satisfied our inclusion and exclusion criteria. The majority of studies (41/49) reported a quantitative reduction in at least one measure of bone architecture based on Micro-CT. The reduction in the ratio of bone volume to tissue volume varied from 11% to 81% (mean 43%) according to the experimental set up and study time points. While longer term studies showed muscle recovery, no study showed complete recovery of all bone properties at the termination of the study. In experimental animals, intramuscular injection of BoNT-A resulted in acute muscle atrophy and acute degradation of the neighboring bone segment. These findings may have implications for clinical protocols in the use of Botulinum Toxin in children with cerebral palsy, with restraint recommended in injection protocols and consideration for monitoring bone density. Clinical studies in children with cerebral palsy receiving injections of Botulinum are indicated.
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Affiliation(s)
- Min Jia Tang
- Department of Orthopaedics, The Royal Children’s Hospital, Parkville, VIC 3052, Australia;
| | - H. Kerr Graham
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3010, Australia;
| | - Kelsey E. Davidson
- Department of Orthopedics, Shriners Hospitals for Children, Chicago, IL 60707, USA
- Correspondence:
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Zarzeczny R, Polak A, Nawrat-Szołtysik A, Manasar A. Associations between the serum levels of selected bone turnover markers and biological traits in nursing home women aged 80+ without inflammation. A pilot study. Exp Gerontol 2020; 137:110970. [PMID: 32428562 DOI: 10.1016/j.exger.2020.110970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/27/2020] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bone turnover markers (BTM) reflect the status of bone remodeling processes responsible for bone mineral density. The existing body of evidence that osseous tissue can interact with many other body tissues and organs suggests that the cross-talks can lead to different relationships. The biological traits associated with BTMs have not been thoroughly studied in the elderly despite bone turnover being known to increase with age. OBJECTIVE To determine whether the C-terminal crosslinking telopeptides of type I collagen (CTXI) and the serum levels of total (TAP) and bone-specific (BAP) alkaline phosphatase are associated with the biological traits in nursing home women aged 80-92 years without inflammation and, if so, to indicate the best predictors of these BTM's blood concentrations. METHODS A group of 64 female volunteers aged 80 years and older, the residents of nursing homes, were screened for the study. Fifty two women were ineligible as they met the exclusion criteria. As a result, the study group consisted of 12 participants (85.1 ± 3.9 years; 58.1 ± 8.7 kg; 1.52 ± 0.06 m), all having blood C-reactive protein (CRP) levels below 3 mg/l. Also assessed were the participants' morphology, glucose and insulin levels, lipid profiles, CTXI, TAP, and BAP. Other measured parameters included body composition, resting heart rate and arterial blood pressure, isometric knee extension peak torque (IKEPT), and walking capacity (6-min walk test). The statistical analysis was performed using Pearson's correlation coefficients, the Benjamini-Hochberg procedure, and a stepwise multiple regression analysis with backward elimination. RESULTS Inverse correlations were found between CTX-I and hemoglobin concentration (HGB) (r = -0.680; p = .015), red blood cells count (RBC) (r = -0.664; p = .019), fat-free mass (r = -0.633; p = .027), body weight (r = -0.589; p = .044), and total cholesterol (r = -0.581; p = .048). The multiple regression analysis of CTX-I showed that body weight was the only independent variable that was statistically significant (r2 = 0.346; p < .05; SEE = 0.347 ng/ml). BAP was positively correlated with double product (DP) (r = 0.742; p = .006), RBC (r = 0.650; p = .022), HGB (r = 0.637; p = .026), mean arterial pressure (MAP) (r = 0.622; p = .031), diastolic blood pressure (DBP) (r = 0.612; p = .034), body height (r = 0.603; p = .038), IKEPT (r = 0.565; p = .056), and systolic blood pressure (SBP) (r = 0.538; p = .071). BAP, a dependent variable, was the most closely correlated with DP (r2 = 0.550; p < .01; SEE = 9.161 U/l). TAP was also significantly associated with DP (r = 0.775; p = .003), with the association being stronger than between BAP and DP (r2 = 0.600; p < .01; SEE = 1000.5 beats/min*mm Hg). CONCLUSIONS In relatively healthy the oldest-old nursing home women without inflammation, total body weight was the best predictor of bone resorption shown by the CTX-I concentration, whereas the rate pressure product (DP) turned out to best predict osteoblastic activity determinable from serum alkaline phosphatase activity. The results of the study suggest that the activity of serum TAP and BAP can be enhanced by different mechanisms.
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Affiliation(s)
- Ryszard Zarzeczny
- Chair of Biomedical Sciences, Józef Piłsudski University of Physical Education, 34 Marymoncka str., 00-968 Warsaw 45, Poland.
| | - Anna Polak
- Chair of Physiotherapy Basics, The Jerzy Kukuczka Academy of Physical Education in Katowice, 72A Mikołowska str., 40-065 Katowice, Poland.
| | - Agnieszka Nawrat-Szołtysik
- Chair of Physiotherapy Basics, The Jerzy Kukuczka Academy of Physical Education in Katowice, 72A Mikołowska str., 40-065 Katowice, Poland.
| | - Ahmed Manasar
- Silesians Analytical Laboratories in Katowice, 1 Żelazna str., 40-851 Katowice, Poland.
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Sørensen TG, Brent MB, Thomsen JS, Brüel A. Disuse-induced loss of bone mineral density and bone strength is attenuated by post-lactational bone gain in NMRI mice. Bone 2020; 131:115183. [PMID: 31794846 DOI: 10.1016/j.bone.2019.115183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 12/20/2022]
Abstract
Lactation in mice is associated with a substantial bone loss, which almost completely recovers within four weeks after weaning. The post-lactational recovery mechanism is considered one of the most potent physiological bone anabolic responses in adult life. The aim of the study was to investigate whether the post-lactational bone anabolic response could attenuate or prevent a disuse bone loss induced by botulinum toxin (BTX) in mice. Eighty-one 10-week-old female NMRI mice were divided into the following groups: Pregnant, Lactation, Recovery + Vehicle, Recovery + BTX, No Lactation, No Lactation + Vehicle, No Lactation + BTX, and Virgin Control. The mice lactated for 12 days before weaning followed by 21 days of recovery. On the last day of lactation, disuse was induced by injecting 2 IU of BTX per 100 g body weight into the right hind limb. Mechanical testing, μCT, and dynamic bone histomorphometry were performed on the right femur. Lactation induced a loss of aBMD and of vBMD, Tb.Th, and MS/BS at the distal femoral metaphysis, Ct.Th and bone strength at the femoral mid-diaphysis, and femoral neck bone strength compared to pregnant mice. This bone loss was partly or fully reversed after 21 days of recovery from lactation. In non-lactating mice, BTX resulted in a loss of aBMD and of vBMD, BV/TV, Tb.Th, MS/BS, and BFR/BS at the distal femoral metaphysis, Ct.Th at the femoral mid-diaphysis, and femoral neck bone strength compared to ambulating non-lactating mice. The post-lactational response attenuated the BTX-induced loss of aBMD, Tb.Th, Ct.Th, trabecular MS/BS and BFR/BS, and femoral neck bone strength indicating that the recovery after lactation had reduced the negative effects of BTX on these parameters. In contrast, it was unable to counteract the loss of BV/TV and vBMD at the distal femoral metaphysis. In conclusion, the post-lactational response attenuated disuse-induced decrease of femoral aBMD, femoral neck bone strength, trabecular and cortical thickness, and trabecular MS/BS, BFR/BS, while it could not counteract the disuse-induced loss of BV/TV and vBMD.
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Affiliation(s)
| | - Mikkel Bo Brent
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
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9
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Dutra EH, Yadav S. The effects on the mandibular condyle of Botox injection into the masseter are not transient. Am J Orthod Dentofacial Orthop 2019; 156:193-202. [PMID: 31375229 DOI: 10.1016/j.ajodo.2018.08.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate whether the effects on the mandibular condylar cartilage (MCC) and subchondral bone are transient of botulinum neurotoxin (Botox) injection into the masseter muscle. METHODS Botox (0.3 U) was injected into the right masseter of 6-week-old female mice (C57BL/6; n = 16). In addition, 16 mice were used as control and received no injections. Experimental and matching control mice were killed 4 or 8 weeks after the single Botox injection. Mandibles and mandibular condyles were analyzed by means of microscopic computed tomography (microCT) and histology. Sagittal sections of condyles were stained for tartrate-resistant acid phosphatase (TRAP), toluidine blue, 5-ethynyl-2'-deoxyuridine (EdU), and terminal deoxynucleotide transferase-mediated dUTP nick-end labeling. RESULTS Bone volume fraction was significantly decreased on the subchondral bone of the Botox-injected side, compared with the control side and control mice, 4 and 8 weeks after injection. Furthermore, histologic analysis revealed decrease in mineralization, cartilage thickness, TRAP activity, and EdU-positive cells in the MCC of the Botox-injected side 4 and 8 weeks after injection. CONCLUSIONS The effects on the MCC and subchondral bone of Botox injection into the masseter muscle persisted for 8 weeks after injection and were not considered to be transient.
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Affiliation(s)
- Eliane H Dutra
- Division of Orthodontics, University of Connecticut Health Center, Farmington, Conn
| | - Sumit Yadav
- Division of Orthodontics, University of Connecticut Health Center, Farmington, Conn.
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10
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Gatti V, Ghobryal B, Gelbs MJ, Gerber MB, Doty SB, Cardoso L, Fritton SP. Botox-induced muscle paralysis alters intracortical porosity and osteocyte lacunar density in skeletally mature rats. J Orthop Res 2019; 37:1153-1163. [PMID: 30839119 DOI: 10.1002/jor.24276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 02/12/2019] [Indexed: 02/04/2023]
Abstract
Reduced mechanical loading can lead to disuse osteoporosis, resulting in bone fragility. Disuse models report macroscopic bone loss due to muscle inactivity and immobilization, yet only recently has there been quantification of the effects of disuse on the vascular pores and osteocyte network, which are believed to play an important role in mechanotransduction via interstitial fluid flow. The goal of this study was to perform a high-resolution analysis of the effects of muscle inactivity on intracortical porosity and osteocyte lacunar density in skeletally mature rats. Muscle paralysis was induced in 20-week-old female Sprague Dawley rats by injection of botulinum neurotoxin. Rats were injected in the right hindlimb muscles with either Botox (BTX, n = 8) or saline solution (CTRL, n = 8), with a third group used as baseline controls (n = 8). Four weeks after injection, Botox caused a ∼60% reduction in hindlimb muscle mass. High-resolution micro-CT analysis showed that Botox-induced muscle paralysis increased vascular canal porosity and reduced osteocyte lacunar density within the tibial metaphysis cortex. Cortical thickness and other areal properties were diminished in the proximal tibial metaphysis, whereas no differences were found in the mid-diaphysis. Within the BTX group, the injected limbs showed a lower cancellous bone volume fraction relative to the contralateral limb. These results indicate that diminished muscle activity alters the vascular canal porosity and osteocyte lacunar density in cortical bone, which could alter interstitial fluid flow, affecting molecular transport and the transmission of mechanical signals to osteocytes. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- Vittorio Gatti
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, New York, New York, 10031
| | - Bishoy Ghobryal
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, New York, New York, 10031
| | - Michelle J Gelbs
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, New York, New York, 10031
| | - Michael B Gerber
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, New York, New York, 10031
| | - Stephen B Doty
- Hospital for Special Surgery Research Institute, 515 East 71st Street, New York, New York
| | - Luis Cardoso
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, New York, New York, 10031
| | - Susannah P Fritton
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, New York, New York, 10031
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11
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Bain SD, Huber P, Ausk BJ, Kwon RY, Gardiner EM, Srinivasan S, Gross TS. Neuromuscular dysfunction, independent of gait dysfunction, modulates trabecular bone homeostasis in mice. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2019; 19:79-93. [PMID: 30839306 PMCID: PMC6454260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To clarify the effects of neuromuscular dysfunction on hindlimb loading, muscle atrophy, and bone homeostasis. METHODS We quantified changes to hindlimb loading, muscle atrophy, and bone morphology following either Botulinum toxin A (BTxA) induced muscle paralysis or peripheral nerve injury (PNI) in mice; two in vivo models that we anticipated would differently alter gait and mechanical loading patterns due to their distinct effects on neuromuscular signaling. To confirm the expected behavioral effects of PNI, we assessed mechanical allodynia of the ipsilateral hindlimb using von Frey testing and activity (distance traveled and speed) was monitored in both groups using open field testing. Peak vertical ground reaction forces (GRF) and ankle and knee kinematics during normal locomotion were quantified and used to estimate peak mid-diaphyseal normal strains. Muscle atrophy and trabecular and cortical bone morphology were assessed via high-resolution microCT imaging. RESULTS BTxA-induced calf paralysis caused severe muscle atrophy and altered gait kinetics and kinematics and reduced gait-induced normal strains. PNI increased mechanical allodynia but did not alter gait, nor did it cause muscle atrophy. We observed that muscle paralysis and PNI both led to severe trabecular bone loss but only BTxA-induced paralysis increased cortical bone resorption. CONCLUSIONS While mechanical stimuli clearly have essential functions in bone development and adaptation, these data emphasize that neuromuscular signaling, independent of load-induced mechanical strains, may modulate trabecular bone homeostasis in normal and disease states.
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Affiliation(s)
- Steven D. Bain
- Department of Orthopaedics and Sports Medicine, University of Washington,Corresponding author: Steven D. Bain, Ph.D., Department of Orthopaedics and Sports Medicine, University of Washington, Box 359798, 325 9th Ave, Seattle, WA 98104 E-mail:
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12
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Balanta-Melo J, Torres-Quintana MA, Bemmann M, Vega C, González C, Kupczik K, Toro-Ibacache V, Buvinic S. Masseter muscle atrophy impairs bone quality of the mandibular condyle but not the alveolar process early after induction. J Oral Rehabil 2018; 46:233-241. [PMID: 30468522 DOI: 10.1111/joor.12747] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/15/2018] [Accepted: 11/17/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Masseter muscle function influences mandibular bone homeostasis. As previously reported, bone resorption markers increased in the mouse mandibular condyle two days after masseter paralysis induced with botulinum toxin type A (BoNTA), followed by local bone loss. OBJECTIVE This study aimed to evaluate the bone quality of both the mandibular condyle and alveolar process in the mandible of adult mice during the early stage of a BoNTA-induced masseter muscle atrophy, using a combined 3D histomorphometrics and shape analysis approach. METHODS Adult BALB/c mice were divided into an untreated control group and an experimental group; the latter received one single BoNTA injection in the right masseter (BoNTA-right) and saline in the left masseter (Saline-left). 3D bone microstructural changes in the mandibular condyle and alveolar process were determined with high-resolution microtomography. Additionally, landmark-based geometric morphometrics was implemented to assess external shape changes. RESULTS After 2 weeks, masseter mass was significantly reduced (P-value <0.001). When compared to Saline-left and untreated condyles, BoNTA-right condyles showed significant bone loss (P-value <0.001) and shape changes. No significant bone loss was observed in the alveolar processes of any of the groups (P-value >0.05). CONCLUSION Condyle bone quality deteriorates at an early stage of BoNTA-induced masseter muscle atrophy, and before the alveolar process is affected. Since the observed bone microstructural changes resemble those in human temporomandibular joint degenerative disorders, the clinical safety of BoNTA intervention in the masticatory apparatus remains to be clarified.
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Affiliation(s)
- Julián Balanta-Melo
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,School of Dentistry, Universidad del Valle, Cali, Colombia.,Max Planck Weizmann Center for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | | | - Maximilian Bemmann
- Max Planck Weizmann Center for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Carolina Vega
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | | | - Kornelius Kupczik
- Max Planck Weizmann Center for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.,Center for Quantitative Analysis in Dental Anthropology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Viviana Toro-Ibacache
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Center for Quantitative Analysis in Dental Anthropology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Sonja Buvinic
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Center for Exercise, Metabolism and Cancer Studies CEMC2016, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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13
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Bettis T, Kim BJ, Hamrick MW. Impact of muscle atrophy on bone metabolism and bone strength: implications for muscle-bone crosstalk with aging and disuse. Osteoporos Int 2018; 29:1713-1720. [PMID: 29777277 PMCID: PMC7861141 DOI: 10.1007/s00198-018-4570-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
Abstract
Bone fractures in older adults are often preceded by a loss of muscle mass and strength. Likewise, bone loss with prolonged bed rest, spinal cord injury, or with exposure to microgravity is also preceded by a rapid loss of muscle mass. Recent studies using animal models in the setting of hindlimb unloading or botulinum toxin (Botox) injection also reveal that muscle loss can induce bone loss. Moreover, muscle-derived factors such as irisin and leptin can inhibit bone loss with unloading, and knockout of catabolic factors in muscle such as the ubiquitin ligase Murf1 or the myokine myostatin can reduce osteoclastogenesis. These findings suggest that therapies targeting muscle in the setting of disuse atrophy may potentially attenuate bone loss, primarily by reducing bone resorption. These potential therapies not only include pharmacological approaches but also interventions such as whole-body vibration coupled with resistance exercise and functional electric stimulation of muscle.
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Affiliation(s)
- T Bettis
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Laney Walker Blvd. CB2915, Augusta, GA, 30912, USA
| | - B-J Kim
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Laney Walker Blvd. CB2915, Augusta, GA, 30912, USA
- ASAN Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - M W Hamrick
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Laney Walker Blvd. CB2915, Augusta, GA, 30912, USA.
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14
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Abstract
PURPOSE OF REVIEW The identity and functional roles of stem cell population(s) that contribute to fracture repair remains unclear. This review provides a brief history of mesenchymal stem cell (MSCs) and provides an updated view of the many stem/progenitor cell populations contributing to fracture repair. RECENT FINDINGS Functional studies show MSCs are not the multipotential stem cell population that form cartilage and bone during fracture repair. Rather, multiple studies have confirmed the periosteum is the primary source of stem/progenitor cells for fracture repair. Newer work is also identifying other stem/progenitor cells that may also contribute to healing. Although the heterogenous periosteal cells migrate to the fracture site and contribute directly to callus formation, other cell populations are involved. Pericytes and bone marrow stromal cells are now thought of as key secretory centers that mostly coordinate the repair process. Other populations of stem/progenitor cells from the muscle and transdifferentiated chondroctyes may also contribute to repair, and their functional role is an area of active research.
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Affiliation(s)
- Beth C Bragdon
- Department of Orthopaedic Surgery, Boston University School of Medicine, 72 East Concord St, Evans 243, Boston, MA, 02118, USA.
| | - Chelsea S Bahney
- Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of California, San Francisco (UCSF), San Francisco, CA, USA
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15
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Balanta-Melo J, Toro-Ibacache V, Torres-Quintana MA, Kupczik K, Vega C, Morales C, Hernández-Moya N, Arias-Calderón M, Beato C, Buvinic S. Early molecular response and microanatomical changes in the masseter muscle and mandibular head after botulinum toxin intervention in adult mice. Ann Anat 2017; 216:112-119. [PMID: 29289710 DOI: 10.1016/j.aanat.2017.11.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/22/2017] [Accepted: 11/27/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Masseter muscle paralysis induced by botulinum toxin type A (BoNTA) evokes subchondral bone loss in mandibular heads of adult rats and growing mice after 4 weeks. However, the primary cellular and molecular events leading to altered bone remodeling remain unexplored. Thus, the aim of the current work has been to assess the molecular response that precedes the early microanatomical changes in the masseter muscle and subchondral bone of the mandibular head in adult mice after BoNTA intervention. METHODS A pre-clinical in vivo study was performed by a single intramuscular injection of 0.2 U BoNTA in the right masseter (experimental) of adult BALB/c mice. The contralateral masseter was injected with vehicle (control). Changes in mRNA levels of molecular markers of bone loss or muscle atrophy/regeneration were addressed by qPCR at day 2 or 7, respectively. mRNA levels of receptor activator of nuclear factor-κB ligand (RANKL) was assessed in mandibular heads, whilst mRNA levels of Atrogin-1/MAFbx, MuRF-1 and Myogenin were addressed in masseter muscles. In order to identify the early microanatomical changes at day 14, fiber diameters in transversal sections of masseter muscles were quantified, and histomorphometric analysis was used to determine the bone per tissue area and the trabecular thickness of subchondral bone of the mandibular heads. RESULTS An increase of up to 4-fold in RANKL mRNA levels were detected in mandibular heads of the BoNTA-injected sides as early as 2 days after intervention. Moreover, a 4-6 fold increase in Atrogin-1/MAFbx and MuRF-1 and an up to 25 fold increase in Myogenin mRNA level were detected in masseter muscles 7 days after BoNTA injections. Masseter muscle mass, as well as individual muscle fiber diameter, were significantly reduced in BoNTA-injected side after 14 days post-intervention. At the same time, in the mandibular heads from the treated side, the subchondral bone loss was evinced by a significant reduction in bone per tissue area (-40%) and trabecular thickness (-55%). CONCLUSIONS Our results show that masseter muscle paralysis induced by BoNTA leads to significant microanatomical changes by day 14, preceded by molecular changes as early as 2 days in bone, and 7 days in muscle. Therefore, masseter muscle atrophy and subchondral bone loss detected at 14 days are preceded by molecular responses that occur during the first week after BoNTA intervention.
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Affiliation(s)
- Julián Balanta-Melo
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile; School of Dentistry, Universidad del Valle, Colombia
| | - Viviana Toro-Ibacache
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile; Quantitative Analysis Center in Dental Anthropology, Faculty of Dentistry, Universidad de Chile, Chile; Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Germany
| | | | - Kornelius Kupczik
- Max Planck Weizmann Center for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, Germany
| | - Carolina Vega
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile
| | - Camilo Morales
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile; Department of Basic Sciences, Health Faculty, Pontificia Universidad Javeriana, Colombia; Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
| | - Nadia Hernández-Moya
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile
| | - Manuel Arias-Calderón
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile; Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
| | - Carolina Beato
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile; Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
| | - Sonja Buvinic
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Chile.
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16
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Vegger J, Brüel A, Thomsen J. Pantoprazole, a proton pump inhibitor, does not prevent botulinum toxin induced disuse osteopenia in mice. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2017; 17:162-175. [PMID: 28860418 PMCID: PMC5601261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Pantoprazole is a proton pump inhibitor that has been shown to inhibit bone resorption. The aim of the study was to investigate whether pantoprazole can prevent development of botulinum toxin (BTX)-induced disuse osteopenia in mice. METHODS Forty-eight 16-week-old female C57BL/6J mice were randomized into 4 groups (n=12): Base, Ctrl, BTX, and BTX+Pan. The Base group was euthanized at study start. The BTX and BTX+Pan groups were immobilized by injections with BTX in one hind limb. The BTX+Pan group was injected i.p. daily with 100 mg pantoprazole per kg bodyweight. The mice were euthanized after 3 weeks of treatment. The skeletal status was investigated by DEXA, µCT, mechanical testing, dynamic bone histomorphometry, and RT-qPCR. The bone sites investigated were tibia, femur, L5 vertebra, and humerus. RESULTS Injections of BTX induced a pronounced and significant loss of bone density, microstructure, and strength in the immobilized hind limb. Furthermore, the localized intramuscular injections of BTX lead to a slight loss of bone and bone strength at the L5 vertebra and humerus. Treatment with pantoprazole did not have any bone protective or deleterious effects. CONCLUSION Pantoprazole was unable to prevent the development of BTX induced disuse osteopenia in skeletally mature female C57BL/6J mice.
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Affiliation(s)
- J.B. Vegger
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 3, DK-8000 Aarhus C, Denmark,Corresponding author: Jens Bay Vegger, Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 3, DK-8000 Aarhus C, Denmark E-mail:
| | - A. Brüel
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 3, DK-8000 Aarhus C, Denmark
| | - J.S. Thomsen
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 3, DK-8000 Aarhus C, Denmark
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17
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Ausk BJ, Worton LE, Smigiel KS, Kwon RY, Bain SD, Srinivasan S, Gardiner EM, Gross TS. Muscle paralysis induces bone marrow inflammation and predisposition to formation of giant osteoclasts. Am J Physiol Cell Physiol 2017; 313:C533-C540. [PMID: 28855162 DOI: 10.1152/ajpcell.00363.2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 12/11/2022]
Abstract
Transient muscle paralysis engendered by a single injection of botulinum toxin A (BTxA) rapidly induces profound focal bone resorption within the medullary cavity of adjacent bones. While initially conceived as a model of mechanical disuse, osteoclastic resorption in this model is disproportionately severe compared with the modest gait defect that is created. Preliminary studies of bone marrow following muscle paralysis suggested acute upregulation of inflammatory cytokines, including TNF-α and IL-1. We therefore hypothesized that BTxA-induced muscle paralysis would rapidly alter the inflammatory microenvironment and the osteoclastic potential of bone marrow. We tested this hypothesis by defining the time course of inflammatory cell infiltration, osteoinflammatory cytokine expression, and alteration in osteoclastogenic potential in the tibia bone marrow following transient muscle paralysis of the calf muscles. Our findings identified inflammatory cell infiltration within 24 h of muscle paralysis. By 72 h, osteoclast fusion and pro-osteoclastic inflammatory gene expression were upregulated in tibia bone marrow. These alterations coincided with bone marrow becoming permissive to the formation of osteoclasts of greater size and greater nuclei numbers. Taken together, our data are consistent with the thesis that transient calf muscle paralysis induces acute inflammation within the marrow of the adjacent tibia and that these alterations are temporally consistent with a role in mediating muscle paralysis-induced bone resorption.
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Affiliation(s)
- Brandon J Ausk
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington; and
| | - Leah E Worton
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington; and
| | - Kate S Smigiel
- Department of Immunology, University of Washington, Seattle, Washington
| | - Ronald Y Kwon
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington; and
| | - Steven D Bain
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington; and
| | - Sundar Srinivasan
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington; and
| | - Edith M Gardiner
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington; and
| | - Ted S Gross
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington; and
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18
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Laurent MR, Jardí F, Dubois V, Schollaert D, Khalil R, Gielen E, Carmeliet G, Claessens F, Vanderschueren D. Androgens have antiresorptive effects on trabecular disuse osteopenia independent from muscle atrophy. Bone 2016; 93:33-42. [PMID: 27622887 DOI: 10.1016/j.bone.2016.09.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/07/2016] [Accepted: 09/09/2016] [Indexed: 12/18/2022]
Abstract
Aging hypogonadal men are at increased risk of osteoporosis and sarcopenia. Testosterone is a potentially appealing strategy to prevent simultaneous bone and muscle loss. The androgen receptor (AR) mediates antiresorptive effects on trabecular bone via osteoblast-lineage cells, as well as muscle-anabolic actions. Sex steroids also modify the skeletal response to mechanical loading. However, it is unclear whether the effects of androgens on bone remain effective independent of mechanical stimulation or rather require indirect androgen effects via muscle. This study aims to characterize the effects and underlying mechanisms of androgens on disuse osteosarcopenia. Adult male mice received a unilateral botulinum toxin (BTx) injection, and underwent sham surgery or orchidectomy (ORX) without or with testosterone (ORX+T) or dihydrotestosterone (ORX+DHT) replacement. Compared to the contralateral internal control hindlimb, acute trabecular number and bone volume loss was increased by ORX and partially prevented DHT. T was more efficient and increased BV/TV in both hindlimbs over sham values, although it did not reduce the detrimental effect of BTx. Both androgens and BTx regulated trabecular osteoclast surface as well as tartrate-resistant acid phosphatase expression. Androgens also prevented BTx-induced body weight loss but did not significantly influence paralysis or muscle atrophy. BTx and ORX both reduced cortical thickness via endosteal expansion, which was prevented by T but not DHT. In long-term follow-up, the residual trabecular bone volume deficit in sham-BTx hindlimbs was prevented by DHT but T restored it more efficiently to pre-treatment levels. Conditional AR deletion in late osteoblasts and osteocytes or in the satellite cell lineage increased age-related trabecular bone loss in both hindlimbs without influencing the effect of BTx on trabecular osteopenia. We conclude that androgens have antiresorptive effects on trabecular disuse osteopenia which do not require AR actions on bone via muscle or via osteocytes.
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MESH Headings
- Acute Disease
- Androgens/pharmacology
- Androgens/therapeutic use
- Animals
- Body Weight
- Bone Diseases, Metabolic/complications
- Bone Diseases, Metabolic/drug therapy
- Bone Diseases, Metabolic/pathology
- Bone Diseases, Metabolic/physiopathology
- Bone Remodeling/drug effects
- Bone Resorption/complications
- Bone Resorption/drug therapy
- Bone Resorption/pathology
- Bone Resorption/physiopathology
- Calcification, Physiologic
- Cancellous Bone/diagnostic imaging
- Cancellous Bone/drug effects
- Cancellous Bone/pathology
- Cancellous Bone/physiopathology
- Cortical Bone/diagnostic imaging
- Cortical Bone/drug effects
- Cortical Bone/pathology
- Cortical Bone/physiopathology
- Extracellular Matrix Proteins/metabolism
- Female
- Gene Deletion
- Integrases/metabolism
- Male
- Mice, Inbred C57BL
- Muscular Atrophy/complications
- Muscular Atrophy/drug therapy
- Muscular Atrophy/pathology
- Muscular Atrophy/physiopathology
- Muscular Disorders, Atrophic/complications
- Muscular Disorders, Atrophic/drug therapy
- Muscular Disorders, Atrophic/pathology
- Muscular Disorders, Atrophic/physiopathology
- MyoD Protein/metabolism
- Organ Size
- Receptors, Androgen/metabolism
- X-Ray Microtomography
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Affiliation(s)
- Michaël R Laurent
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 901, 3000 Leuven, Belgium; Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Herestraat 49, PO box 7003, 3000 Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Ferran Jardí
- Clinical and Experimental Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 902, 3000 Leuven, Belgium.
| | - Vanessa Dubois
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 901, 3000 Leuven, Belgium.
| | - Dieter Schollaert
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 901, 3000 Leuven, Belgium.
| | - Rougin Khalil
- Clinical and Experimental Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 902, 3000 Leuven, Belgium.
| | - Evelien Gielen
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Herestraat 49, PO box 7003, 3000 Leuven, Belgium; Center for Metabolic Bone Diseases, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Geert Carmeliet
- Clinical and Experimental Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 902, 3000 Leuven, Belgium.
| | - Frank Claessens
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 901, 3000 Leuven, Belgium.
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, PO box 902, 3000 Leuven, Belgium.
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19
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Laurent MR, Dubois V, Claessens F, Verschueren SMP, Vanderschueren D, Gielen E, Jardí F. Muscle-bone interactions: From experimental models to the clinic? A critical update. Mol Cell Endocrinol 2016; 432:14-36. [PMID: 26506009 DOI: 10.1016/j.mce.2015.10.017] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/13/2015] [Accepted: 10/20/2015] [Indexed: 02/06/2023]
Abstract
Bone is a biomechanical tissue shaped by forces from muscles and gravitation. Simultaneous bone and muscle decay and dysfunction (osteosarcopenia or sarco-osteoporosis) is seen in ageing, numerous clinical situations including after stroke or paralysis, in neuromuscular dystrophies, glucocorticoid excess, or in association with vitamin D, growth hormone/insulin like growth factor or sex steroid deficiency, as well as in spaceflight. Physical exercise may be beneficial in these situations, but further work is still needed to translate acceptable and effective biomechanical interventions like vibration therapy from animal models to humans. Novel antiresorptive and anabolic therapies are emerging for osteoporosis as well as drugs for sarcopenia, cancer cachexia or muscle wasting disorders, including antibodies against myostatin or activin receptor type IIA and IIB (e.g. bimagrumab). Ideally, increasing muscle mass would increase muscle strength and restore bone loss from disuse. However, the classical view that muscle is unidirectionally dominant over bone via mechanical loading is overly simplistic. Indeed, recent studies indicate a role for neuronal regulation of not only muscle but also bone metabolism, bone signaling pathways like receptor activator of nuclear factor kappa-B ligand (RANKL) implicated in muscle biology, myokines affecting bone and possible bone-to-muscle communication. Moreover, pharmacological strategies inducing isolated myocyte hypertrophy may not translate into increased muscle power because tendons, connective tissue, neurons and energy metabolism need to adapt as well. We aim here to critically review key musculoskeletal molecular pathways involved in mechanoregulation and their effect on the bone-muscle unit as a whole, as well as preclinical and emerging clinical evidence regarding the effects of sarcopenia therapies on osteoporosis and vice versa.
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Affiliation(s)
- Michaël R Laurent
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium; Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Vanessa Dubois
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Frank Claessens
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Sabine M P Verschueren
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Science, KU Leuven, 3000 Leuven, Belgium
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Evelien Gielen
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ferran Jardí
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
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20
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Bone and cartilage changes in rabbit mandibular condyles after 1 injection of botulinum toxin. Am J Orthod Dentofacial Orthop 2016; 148:999-1009. [PMID: 26672706 DOI: 10.1016/j.ajodo.2015.05.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 05/01/2015] [Accepted: 05/01/2015] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Temporary paralysis of the masseter muscle caused by botulinum toxin is a common treatment for temporomandibular disorders, bruxism, and muscle hypertrophy. Loss of masseter force is associated with decreased mandibular mineral density. Our objectives were (1) to establish whether bone loss at the mandibular condyle is regionally specific and (2) to ascertain whether the treatment affects the condylar cartilage. METHODS Young adult female rabbits received a unilateral masseter injection of botulinum neurotoxin serotype A (BoNT/A, n = 31), saline solution (n = 19), or no injection (n = 3) and were also injected with bromodeoxyuridine (BrdU), a replication marker. The rabbits were killed at 4 or 12 weeks after treatment. The condyles were processed for paraffin histology. Cortical thickness, cartilage thickness, and trabecular bone areal density were measured, and replicating cells were counted after BrdU reaction. RESULTS The BoNT/A rabbits exhibited a high frequency of defects in the condylar bone surface, occurring equally on the injected and uninjected sides. Bone loss was seen only on the side of the BoNT/A injection. Cortical as well as trabecular bone was severely affected. The midcondylar region lost the most bone. Recovery at 12 weeks was insignificant. Condylar cartilage thickness showed no treatment effect but did increase with time. The numbers of proliferating cells were similar in the treatment groups, but the BoNT/A animals showed more side asymmetry associated with the condylar defects. CONCLUSIONS Bone loss may be a risk factor for the use of botulinum toxin in jaw muscles.
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Bloomfield SA, Martinez DA, Boudreaux RD, Mantri AV. Microgravity Stress: Bone and Connective Tissue. Compr Physiol 2016; 6:645-86. [PMID: 27065165 DOI: 10.1002/cphy.c130027] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The major alterations in bone and the dense connective tissues in humans and animals exposed to microgravity illustrate the dependency of these tissues' function on normal gravitational loading. Whether these alterations depend solely on the reduced mechanical loading of zero g or are compounded by fluid shifts, altered tissue blood flow, radiation exposure, and altered nutritional status is not yet well defined. Changes in the dense connective tissues and intervertebral disks are generally smaller in magnitude but occur more rapidly than those in mineralized bone with transitions to 0 g and during recovery once back to the loading provided by 1 g conditions. However, joint injuries are projected to occur much more often than the more catastrophic bone fracture during exploration class missions, so protecting the integrity of both tissues is important. This review focuses on the research performed over the last 20 years in humans and animals exposed to actual spaceflight, as well as on knowledge gained from pertinent ground-based models such as bed rest in humans and hindlimb unloading in rodents. Significant progress has been made in our understanding of the mechanisms for alterations in bone and connective tissues with exposure to microgravity, but intriguing questions remain to be solved, particularly with reference to biomedical risks associated with prolonged exploration missions.
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Affiliation(s)
- Susan A Bloomfield
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Daniel A Martinez
- Department of Mechanical Engineering, University of Houston, Houston, Texas, USA
| | - Ramon D Boudreaux
- Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Anita V Mantri
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA.,Health Science Center School of Medicine, Texas A&M University, College Station, Texas, USA
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22
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Lodberg A, Vegger JB, Jensen MV, Larsen CM, Thomsen JS, Brüel A. Immobilization induced osteopenia is strain specific in mice. Bone Rep 2015; 2:59-67. [PMID: 28377955 PMCID: PMC5365160 DOI: 10.1016/j.bonr.2015.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 03/18/2015] [Accepted: 04/13/2015] [Indexed: 11/30/2022] Open
Abstract
Immobilization causes rapid and massive bone loss. By comparing Botulinum Toxin A (BTX)-induced bone loss in mouse strains with different genetic backgrounds we investigated whether the genetic background had an influence on the severity of the osteopenia. Secondly, we investigated whether BTX had systemic effects on bone. Female mice from four inbred mouse strains (BALB/cJ, C57BL/6 J, DBA/2 J, and C3H/HeN) were injected unilaterally with BTX (n = 10/group) or unilaterally with saline (n = 10/group). Mice were euthanized after 21 days, and the bone properties evaluated using μCT, DXA, bone histomorphometry, and mechanical testing. BTX resulted in substantially lower trabecular bone volume fraction (BV/TV) and trabecular thickness in all mouse strains. The deterioration of BV/TV was significantly greater in C57BL/6 J (− 57%) and DBA/2 J (− 60%) than in BALB/cJ (− 45%) and C3H/HeN (− 34%) mice. The loss of femoral neck fracture strength was significantly greater in C57BL/6 J (− 47%) and DBA/2 J (− 45%) than in C3H (− 25%) mice and likewise the loss of mid-femoral fracture strength was greater in C57BL/6 J (− 17%), DBA/2 J (− 12%), and BALB/cJ (− 9%) than in C3H/HeN (− 1%) mice, which were unaffected. Using high resolution μCT we found no evidence of a systemic effect on any of the microstructural parameters of the contralateral limb. Likewise, there was no evidence of a systemic effect on the bone strength in any mouse strain. We did, however, find a small systemic effect on aBMD in DBA/2 J and C3H/HeN mice. The present study shows that BTX-induced immobilization causes the greatest loss of cortical and trabecular bone in C57BL/6 J and DBA/2 J mice. A smaller loss of bone microstructure and fracture strength was seen in BALB/cJ mice, while the bone microstructure and fracture strength of C3H/HeN mice were markedly less affected. This indicates that BTX-induced loss of bone is mouse strain dependent. We found only minimal systemic effects of BTX. Botulinum Toxin A (Botox) causes only minimal systemic effects in mice. The degree of immobilization induced osteopenia is highly strain specific in mice. The greatest degree of bone loss was observed with C57BL/6 J and DBA/2 J mice followed by BALB/cJ mice after Botox-injection. C3H/HeN mice had the smallest bone loss following Botox-injection.
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Affiliation(s)
- Andreas Lodberg
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Jens Bay Vegger
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | | | | | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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23
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Davis K, Griffin K, Chu TM, Wenke J, Corona B, McKinley T, Kacena M. Muscle-bone interactions during fracture healing. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2015; 15:1-9. [PMID: 25730647 PMCID: PMC4433554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 11/06/2022]
Abstract
Although it is generally accepted that the rate and strength of fracture healing is intimately linked to the integrity of surrounding soft tissues, the contribution of muscle has largely been viewed as a vascular supply for oxygen and nutrient exchange. However, more is becoming known about the cellular and paracrine contributions of muscle to the fracture healing process. Research has shown that muscle is capable of supplying osteoprogenitor cells in cases where the periosteum is insufficient, and the muscular osteoprogenitors possess similar osteogenic potential to those derived from the periosteum. Muscle's secrotome includes proteins capable of inhibiting or enhancing osteogenesis and myogenesis following musculoskeletal injury and can be garnered for therapeutic use in patients with traumatic musculoskeletal injuries. In this review, we will highlight the current knowledge on muscle-bone interaction in the context of fracture healing as well as concisely present the current models to study such interactions.
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Affiliation(s)
- K.M. Davis
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - K.S. Griffin
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - T-M.G. Chu
- Department of Restorative Dentistry, Indiana University School of Dentistry, Indianapolis, IN
| | - J.C. Wenke
- Extremity Trauma & Regenerative Medicine Task Area, United States Army Institute of Surgical Research, San Antonio, TX
| | - B.T. Corona
- Extremity Trauma & Regenerative Medicine Task Area, United States Army Institute of Surgical Research, San Antonio, TX
| | - T.O. McKinley
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - M.A. Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN
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24
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Abstract
There is growing interest in the interaction between skeletal muscle and bone, particularly at the genetic and molecular levels. However, the genetic and molecular linkages between muscle and bone are achieved only within the context of the essential mechanical coupling of the tissues. This biomechanical and physiological linkage is readily evident as muscles attach to bone and induce exposure to varied mechanical stimuli via functional activity. The responsiveness of bone cells to mechanical stimuli, or their absence, is well established. However, questions remain regarding how muscle forces applied to bone serve to modulate bone homeostasis and adaptation. Similarly, the contributions of varied, but unique, stimuli generated by muscle to bone (such as low-magnitude, high-frequency stimuli) remains to be established. The current article focuses upon the mechanical relationship between muscle and bone. In doing so, we explore the stimuli that muscle imparts upon bone, models that enable investigation of this relationship, and recent data generated by these models.
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Affiliation(s)
- Keith G. Avin
- Center for Translational Musculoskeletal Research and Department of Physical Therapy, School of the Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St., CF-120, Indianapolis, IN, USA,
| | - Susan A. Bloomfield
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA,
| | - Ted S. Gross
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA,
| | - Stuart J. Warden
- Center for Translational Musculoskeletal Research and Department of Physical Therapy, School of the Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St., CF-120, Indianapolis, IN, USA
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25
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Poliachik SL, Khokhlova TD, Wang YN, Simon JC, Bailey MR. Pulsed focused ultrasound treatment of muscle mitigates paralysis-induced bone loss in the adjacent bone: a study in a mouse model. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:2113-2124. [PMID: 24857416 PMCID: PMC4410740 DOI: 10.1016/j.ultrasmedbio.2014.02.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 02/19/2014] [Accepted: 02/20/2014] [Indexed: 06/03/2023]
Abstract
Bone loss can result from bed rest, space flight, spinal cord injury or age-related hormonal changes. Current bone loss mitigation techniques include pharmaceutical interventions, exercise, pulsed ultrasound targeted to bone and whole body vibration. In this study, we attempted to mitigate paralysis-induced bone loss by applying focused ultrasound to the midbelly of a paralyzed muscle. We employed a mouse model of disuse that uses onabotulinumtoxinA-induced paralysis, which causes rapid bone loss in 5 d. A focused 2 MHz transducer applied pulsed exposures with pulse repetition frequency mimicking that of motor neuron firing during walking (80 Hz), standing (20 Hz), or the standard pulsed ultrasound frequency used in fracture healing (1 kHz). Exposures were applied daily to calf muscle for 4 consecutive d. Trabecular bone changes were characterized using micro-computed tomography. Our results indicated that application of certain focused pulsed ultrasound parameters was able to mitigate some of the paralysis-induced bone loss.
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Affiliation(s)
- Sandra L Poliachik
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA.
| | - Tatiana D Khokhlova
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA; Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
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26
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Niehoff A, Lechner P, Ratiu O, Reuter S, Hamann N, Brüggemann GP, Schönau E, Bloch W, Beccard R. Effect of whole-body vibration and insulin-like growth factor-I on muscle paralysis-induced bone degeneration after botulinum toxin injection in mice. Calcif Tissue Int 2014; 94:373-83. [PMID: 24292598 DOI: 10.1007/s00223-013-9818-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 11/13/2013] [Indexed: 10/26/2022]
Abstract
Botulinum toxin A (BTX)-induced muscle paralysis results in pronounced bone degradation with substantial bone loss. We hypothesized that whole-body vibration (WBV) and insulin-like growth factor-I (IGF-I) treatment can counteract paralysis-induced bone degradation following BTX injections by activation of the protein kinase B (Akt) signaling pathway. Female C57BL/6 mice (n = 60, 16 weeks) were assigned into six groups (n = 10 each): SHAM, BTX, BTX+WBV, BTX+IGF-I, BTX+WBV+IGF-I, and a baseline group, which was killed at the beginning of the study. Mice received a BTX (1.0 U/0.1 mL) or saline (SHAM) injection in the right hind limb. The BTX+IGF-I and BTX+WBV+IGF-I groups obtained daily subcutaneous injections of human IGF-I (1 μg/day). The BTX+WBV and BTX+WBV+IGF-I groups underwent WBV (25 Hz, 2.1 g, 0.83 mm) for 30 min/day, 5 days/week for 4 weeks. Femora were scanned by pQCT, and mechanical properties were determined. On tibial sections TRAP staining, static histomorphometry, and immunohistochemical staining against Akt, phospho-Akt, IGF-IR (IGF-I receptor), and phospho-IGF-IR were conducted. BTX injection decreased trabecular and cortical bone mineral density. The WBV and WBV+IGF-I groups showed no difference in trabecular bone mineral density compared to the SHAM group. The phospho-IGF-IR and phospho-Akt stainings were not differentially altered in the injected hind limbs between groups. We found that high-frequency, low-magnitude WBV can counteract paralysis-induced bone loss following BTX injections, while we could not detect any effect of treatment with IGF-I.
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Affiliation(s)
- Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany,
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27
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Ausk BJ, Huber P, Srinivasan S, Bain SD, Kwon RY, McNamara EA, Poliachik SL, Sybrowsky CL, Gross TS. Metaphyseal and diaphyseal bone loss in the tibia following transient muscle paralysis are spatiotemporally distinct resorption events. Bone 2013; 57:413-22. [PMID: 24063948 PMCID: PMC3865853 DOI: 10.1016/j.bone.2013.09.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 08/23/2013] [Accepted: 09/11/2013] [Indexed: 11/25/2022]
Abstract
When the skeleton is catabolically challenged, there is great variability in the timing and extent of bone resorption observed at cancellous and cortical bone sites. It remains unclear whether this resorptive heterogeneity, which is often evident within a single bone, arises from increased permissiveness of specific sites to bone resorption or localized resorptive events of varied robustness. To explore this question, we used the mouse model of calf paralysis induced bone loss, which results in metaphyseal and diaphyseal bone resorption of different timing and magnitude. Given this phenotypic pattern of resorption, we hypothesized that bone loss in the proximal tibia metaphysis and diaphysis occurs through resorption events that are spatially and temporally distinct. To test this hypothesis, we undertook three complimentary in vivo/μCT imaging studies. Specifically, we defined spatiotemporal variations in endocortical bone resorption during the 3weeks following calf paralysis, applied a novel image registration approach to determine the location where bone resorption initiates within the proximal tibia metaphysis, and explored the role of varied basal osteoclast activity on the magnitude of bone loss initiation in the metaphysis using μCT based bone resorption parameters. A differential response of metaphyseal and diaphyseal bone resorption was observed throughout each study. Acute endocortical bone loss following muscle paralysis occurred almost exclusively within the metaphyseal compartment (96.5% of total endocortical bone loss within 6days). Using our trabecular image registration approach, we further resolved the initiation of metaphyseal bone loss to a focused region of significant basal osteoclast function (0.03mm(3)) adjacent to the growth plate. This correlative observation of paralysis induced bone loss mediated by basal growth plate cell dynamics was supported by the acute metaphyseal osteoclastic response of 5-week vs. 13-month-old mice. Specifically, μCT based bone resorption rates normalized to initial trabecular surface (BRRBS) were 3.7-fold greater in young vs. aged mice (2.27±0.27μm(3)/μm(2)/day vs. 0.60±0.44μm(3)/μm(2)/day). In contrast to the focused bone loss initiation in the metaphysis, diaphyseal bone loss initiated homogeneously throughout the long axis of the tibia predominantly in the second week following paralysis (81.3% of diaphyseal endocortical expansion between days 6 and 13). The timing and homogenous nature are consistent with de novo osteoclastogenesis mediating the diaphyseal resorption. Taken together, our data suggests that tibial metaphyseal and diaphyseal bone loss induced by transient calf paralysis are spatially and temporally discrete events. In a broader context, these findings are an essential first step toward clarifying the timing and origins of multiple resorptive events that would require targeting to fully inhibit bone loss following neuromuscular trauma.
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Affiliation(s)
- Brandon J Ausk
- Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.
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28
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Schwartz AG, Lipner JH, Pasteris JD, Genin GM, Thomopoulos S. Muscle loading is necessary for the formation of a functional tendon enthesis. Bone 2013; 55:44-51. [PMID: 23542869 PMCID: PMC3650099 DOI: 10.1016/j.bone.2013.03.010] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/06/2013] [Accepted: 03/18/2013] [Indexed: 11/28/2022]
Abstract
Muscle forces are essential for skeletal patterning during development. Eliminating muscle forces, e.g., through paralysis, leads to bone and joint deformities. Botulinum toxin (BtxA)-induced paralysis of mouse rotator cuffs throughout postnatal development closely mimics neonatal brachial plexus palsy, a significant clinical condition in infants. In these mice, the tendon-to-bone attachment (i.e., the tendon enthesis) presents defects in mineral accumulation and fibrocartilage formation, presumably impairing the function of the tissue. The objective of the current study was to investigate the functional consequences of muscle unloading using BtxA on the developing supraspinatus tendon enthesis. We found that the maximum endurable load and stiffness of the supraspinatus tendon attachment decreased after four and eight weeks of post-natal BtxA-muscle unloading relative to controls. Tendon cross-sectional area was not significantly reduced by BtxA-unloading, while, strength, modulus, and toughness were decreased in the BtxA-unloaded group compared to controls, indicating a decrease in tissue quality. Polarized-light microscopy and Raman microprobe analysis were used to determine collagen fiber alignment and mineral characteristics, respectively, in the tendon enthesis that might contribute to the reduced biomechanical performance in BtxA-unloaded shoulders. Collagen fiber alignment was significantly reduced in BtxA-unloaded shoulders. The mineral-to-matrix ratio in mineralized fibrocartilage was not affected by loading. However, the crystallographic atomic order of the hydroxylapatite phase (a measure of crystallinity) was reduced and the amount of carbonate (substituting for phosphate) in the hydroxylapatite crystals was increased. Taken together, these micrometer-scale structural and compositional changes partly explain the observed decreases in the mechanical functionality of the tendon enthesis in the absence of muscle loading.
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Affiliation(s)
- AG Schwartz
- Department of Orthopaedic Surgery, Washington University, St Louis, MO
| | - JH Lipner
- Department of Orthopaedic Surgery, Washington University, St Louis, MO
| | - JD Pasteris
- Department of Earth and Planetary Sciences, Washington University, St Louis, MO
| | - GM Genin
- Department of Mechanical Engineering & Materials Science, Washington University, St Louis, MO
| | - S Thomopoulos
- Department of Orthopaedic Surgery, Washington University, St Louis, MO
- Corresponding Author: Stavros Thomopoulos Washington University Department of Orthopaedic Surgery 660 South Euclid, Campus Box 8233 St Louis, MO 63110 Phone: 314-362-8605, Fax: 314-362-0334
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29
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Warden SJ, Galley MR, Richard JS, George LA, Dirks RC, Guildenbecher EA, Judd AM, Robling AG, Fuchs RK. Reduced gravitational loading does not account for the skeletal effect of botulinum toxin-induced muscle inhibition suggesting a direct effect of muscle on bone. Bone 2013; 54:98-105. [PMID: 23388417 PMCID: PMC3757093 DOI: 10.1016/j.bone.2013.01.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 01/24/2013] [Accepted: 01/29/2013] [Indexed: 10/27/2022]
Abstract
Intramuscular injection of botulinum toxin (botox) into rodent hindlimbs has developed as a useful model for exploring muscle-bone interactions. Botox-induced muscle inhibition rapidly induces muscle atrophy and subsequent bone loss, with the latter hypothesized to result from reduced muscular loading of the skeleton. However, botox-induced muscle inhibition also reduces gravitational loading (as evident by reduced ground reaction forces during gait) which may account for its negative skeletal effects. The aim of this study was to investigate the skeletal effect of botox-induced muscle inhibition in cage control and tail suspended mice, with tail suspension being used to control for the reduced gravitational loading associated with botox. Female C57BL/6J mice were injected unilaterally with botox and contralaterally with vehicle, and subsequently exposed to tail suspension or normal cage activities for 6 weeks. Botox-induced muscle inhibition combined with tail suspension had the largest detrimental effect on the skeleton, causing the least gains in midshaft tibial bone mass, cortical area and cortical thickness, greatest gains in midshaft tibial medullary area, and lowest proximal tibial trabecular bone volume fraction. These data indicate botox-induced muscle inhibition has skeletal effects over and above any effect it has in altering gravitational loading, suggesting that muscle has a direct effect on bone. This effect may be relevant in the development of strategies targeting musculoskeletal health.
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Affiliation(s)
- Stuart J Warden
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN 46202, USA.
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30
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Willett NJ, Li MTA, Uhrig BA, Boerckel JD, Huebsch N, Lundgren TL, Warren GL, Guldberg RE. Attenuated human bone morphogenetic protein-2-mediated bone regeneration in a rat model of composite bone and muscle injury. Tissue Eng Part C Methods 2013; 19:316-25. [PMID: 22992043 PMCID: PMC3583252 DOI: 10.1089/ten.tec.2012.0290] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 09/10/2012] [Indexed: 01/06/2023] Open
Abstract
Extremity injuries involving large bone defects with concomitant severe muscle damage are a significant clinical challenge often requiring multiple treatment procedures and possible amputation. Even if limb salvage is achieved, patients are typically left with severe short- and long-term disabilities. Current preclinical animal models do not adequately mimic the severity, complexity, and loss of limb function characteristic of these composite injuries. The objectives of this study were to establish a composite injury model that combines a critically sized segmental bone defect with an adjacent volumetric muscle loss injury, and then use this model to quantitatively assess human bone morphogenetic protein-2 (rhBMP-2)-mediated tissue regeneration and restoration of limb function. Surgeries were performed on rats in three experimental groups: muscle injury (8-mm-diameter full-thickness defect in the quadriceps), bone injury (8-mm nonhealing defect in the femur), or composite injury combining the bone and muscle defects. Bone defects were treated with 2 μg of rhBMP-2 delivered in the pregelled alginate injected into a cylindrical perforated nanofiber mesh. Bone regeneration was quantitatively assessed using microcomputed tomography, and limb function was assessed using gait analysis and muscle strength measurements. At 12 weeks postsurgery, treated bone defects without volumetric muscle loss were consistently bridged. In contrast, the volume and mechanical strength of regenerated bone were attenuated by 45% and 58%, respectively, in the identically treated composite injury group. At the same time point, normalized muscle strength was reduced by 51% in the composite injury group compared to either single injury group. At 2 weeks, the gait function was impaired in all injury groups compared to baseline with the composite injury group displaying the greatest functional deficit. We conclude that sustained delivery of rhBMP-2 at a dose sufficient to induce bridging of large segmental bone defects failed to promote regeneration when challenged with concomitant muscle injury. This model provides a platform with which to assess bone and muscle interactions during repair and to rigorously test the efficacy of tissue engineering approaches to promote healing in multiple tissues. Such interventions may minimize complications and the number of surgical procedures in limb salvage operations, ultimately improving the clinical outcome.
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Affiliation(s)
- Nick J Willett
- George W. Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia 30307, USA.
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31
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Charles JF, Coury F, Sulyanto R, Sitara D, Wu J, Brady N, Tsang K, Sigrist K, Tollefsen DM, He L, Storm D, Aliprantis AO. The collection of NFATc1-dependent transcripts in the osteoclast includes numerous genes non-essential to physiologic bone resorption. Bone 2012; 51:902-12. [PMID: 22985540 PMCID: PMC3457000 DOI: 10.1016/j.bone.2012.08.113] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 07/30/2012] [Accepted: 08/06/2012] [Indexed: 01/15/2023]
Abstract
Osteoclasts are specialized secretory cells of the myeloid lineage important for normal skeletal homeostasis as well as pathologic conditions of bone including osteoporosis, inflammatory arthritis and cancer metastasis. Differentiation of these multinucleated giant cells from precursors is controlled by the cytokine RANKL, which through its receptor RANK initiates a signaling cascade culminating in the activation of transcriptional regulators which induce the expression of the bone degradation machinery. The transcription factor nuclear factor of activated T-cells c1 (NFATc1) is the master regulator of this process and in its absence osteoclast differentiation is aborted both in vitro and in vivo. Differential mRNA expression analysis by microarray is used to identify genes of potential physiologic relevance across nearly all biologic systems. We compared the gene expression profile of murine wild-type and NFATc1-deficient osteoclast precursors stimulated with RANKL and identified that the majority of the known genes important for osteoclastic bone resorption require NFATc1 for induction. Here, five novel RANKL-induced, NFATc1-dependent transcripts in the osteoclast are described: Nhedc2, Rhoc, Serpind1, Adcy3 and Rab38. Despite reasonable hypotheses for the importance of these molecules in the bone resorption pathway and their dramatic induction during differentiation, the analysis of mice with mutations in these genes failed to reveal a function in osteoclast biology. Compared to littermate controls, none of these mutants demonstrated a skeletal phenotype in vivo or alterations in osteoclast differentiation or function in vitro. These data highlight the need for rigorous validation studies to complement expression profiling results before functional importance can be assigned to highly regulated genes in any biologic process.
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Affiliation(s)
- Julia F. Charles
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Fabienne Coury
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Oral Medicine Infection and Immunity, Harvard Dental School, Boston, Massachusetts, USA
- Institut de Génomique Fonctionnelle de Lyon, Ecole Normale Supérieure de Lyon, Lyon, France
| | - Rosalyn Sulyanto
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
- OCC Dentistry, Columbus, OH, USA
| | - Despina Sitara
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
- New York University College of Dentistry, New York, NY, USA
| | - Jing Wu
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
- China Novartis Institutes for BioMedical Research Co., Shanghai 201203, China
| | - Nicholas Brady
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Laboratory Medicine and Pathology and Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Kelly Tsang
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Kirsten Sigrist
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI, USA
| | - Douglas M. Tollefsen
- Division of Hematology, Washington University School of Medicine, St. Louis, MO, USA
| | - Li He
- Division of Hematology, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel Storm
- Department of Pharmacology, University of Washington Medical School, Seattle, WA, USA
| | - Antonios O. Aliprantis
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
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32
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Abstract
Mice lacking the large zinc finger protein Schnurri-3 (Shn3) display increased bone mass, in part, attributable to augmented osteoblastic bone formation. Here, we show that in addition to regulating bone formation, Shn3 indirectly controls bone resorption by osteoclasts in vivo. Although Shn3 plays no cell-intrinsic role in osteoclasts, Shn3-deficient animals show decreased serum markers of bone turnover. Mesenchymal cells lacking Shn3 are defective in promoting osteoclastogenesis in response to selective stimuli, likely attributable to reduced expression of the key osteoclastogenic factor receptor activator of nuclear factor-κB ligand. The bone phenotype of Shn3-deficient mice becomes more pronounced with age, and mice lacking Shn3 are completely resistant to disuse osteopenia, a process that requires functional osteoclasts. Finally, selective deletion of Shn3 in the mesenchymal lineage recapitulates the high bone mass phenotype of global Shn3 KO mice, including reduced osteoclastic bone catabolism in vivo, indicating that Shn3 expression in mesenchymal cells directly controls osteoblastic bone formation and indirectly regulates osteoclastic bone resorption.
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Voor MJ, Brown EH, Xu Q, Waddell SW, Burden RL, Burke DA, Magnuson DSK. Bone loss following spinal cord injury in a rat model. J Neurotrauma 2012; 29:1676-82. [PMID: 22181016 DOI: 10.1089/neu.2011.2037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The current study was undertaken to follow the time course of bone loss in the proximal tibia of rats over several weeks following thoracic contusion spinal cord injury (SCI) of varying severity. It was hypothesized that bone loss would be more pronounced in the more severely injured animals, and that hindlimb weight bearing would help prevent bone loss. Twenty-six female Sprague-Dawley rats (200-225 g, 6-7 weeks old) received standard thoracic (T9) injuries at energies of 6.25, 12.5, 25, or 50 g-cm. The rats were scored weekly for hindlimb function during locomotion. At 0, 2 or 3, and 8 weeks, high-resolution micro-CT images of each right tibia were obtained. Mechanical indentation testing was done to measure the compressive strength of the cancellous bone structure. The 6.25 g-cm group showed near normal locomotion, the 12.5 and 25 g-cm groups showed the ability to frequently or occasionally generate weight-supported plantar steps, respectively, and the 50 g-cm group showed only movement without weight-supported plantar stepping. The 6.25, 12.5 and 25 g-cm groups remained at the same level of bone volume fraction (cancBV/TV=0.24±0.07), while the 50 g-cm group experienced severe bone loss (67%), resulting in significantly lower (p<0.05) bone volume fraction (cancBV/TV=0.11±0.05) at 8 weeks. Proximal tibia cancellous bone strength was reduced by approximately 50% in these severely injured rats. Instead of a linear proportionality between injury severity and bone loss, there appears to be a distinct functional threshold, marked by occasional weight-supported stepping, above which bone loss does not occur.
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Affiliation(s)
- Michael J Voor
- Department of Orthopaedic Surgery, Orthopaedic Bioengineering Laboratory, University of Louisville, Louisville, KY, USA.
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