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Zhang R, Yin H, Yang M, Lei X, Zhen D, Zhang Z. Advanced Progress of the Relationship Between Antihypertensive Drugs and Bone Metabolism. Hypertension 2023; 80:2255-2264. [PMID: 37675564 DOI: 10.1161/hypertensionaha.123.21648] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Hypertension and osteoporosis are common comorbidities among elderly individuals. Drug therapy has been widely used in clinical practice as the preferred antihypertensive treatment. Therefore, antihypertensive drugs have become some of the most commonly prescribed drugs in healthcare settings. However, antihypertensive drugs have different effects on bone metabolism. The results of animal and clinical studies on the effects of antihypertensive drugs on osteoporosis or fracture risk are controversial and have aroused widespread concern among clinicians. Recent studies found that angiotensin receptor blockers, selective β-adrenergic receptor blockers, and thiazide diuretics might improve bone trabecular number and bone mineral density by stimulating osteoblast differentiation, reducing osteoclast generation, and other mechanism. Furthermore, nonselective β-adrenergic receptor blockers and dihydropyridine calcium channel blockers were found to have no significant relationship with bone mineral density or bone strength, and α-adrenergic receptor blockers and loop diuretics might increase fracture risk by decreasing bone mineral density. This article aimed to review previous animal experiments, clinical studies, and meta-analyses focusing on the effects of different antihypertensive drugs on bone metabolism, and to provide a new approach for the prevention and treatment of osteoporosis.
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Affiliation(s)
- Ruixing Zhang
- The First Clinical Medical College, Lanzhou University, China (R.Z., M.Y.)
- Department of Heart Center (R.Z., Z.Z.), The First Hospital of Lanzhou University, China
| | - Hongtao Yin
- Department of Endocrinology (H.Y., M.Y., D.Z.), The First Hospital of Lanzhou University, China
| | - Mengdi Yang
- The First Clinical Medical College, Lanzhou University, China (R.Z., M.Y.)
- Department of Endocrinology (H.Y., M.Y., D.Z.), The First Hospital of Lanzhou University, China
| | - Xianqiong Lei
- Department of Geriatrics, The First People's Hospital of Yibin, China (X.L.)
| | - Donghu Zhen
- Department of Endocrinology (H.Y., M.Y., D.Z.), The First Hospital of Lanzhou University, China
| | - Zheng Zhang
- Department of Heart Center (R.Z., Z.Z.), The First Hospital of Lanzhou University, China
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Treyball A, Bergeron AC, Brooks DJ, Langlais AL, Hashmi H, Nagano K, Barlow D, Neilson RJ, Roy TA, Nevola KT, Houseknecht KL, Baron R, Bouxsein ML, Guntur AR, Motyl KJ. Propranolol Promotes Bone Formation and Limits Resorption Through Novel Mechanisms During Anabolic Parathyroid Hormone Treatment in Female C57BL/6J Mice. J Bone Miner Res 2022; 37:954-971. [PMID: 35122666 PMCID: PMC9098680 DOI: 10.1002/jbmr.4523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/15/2022] [Accepted: 01/30/2022] [Indexed: 11/09/2022]
Abstract
Although the nonselective β-blocker, propranolol, improves bone density with parathyroid hormone (PTH) treatment in mice, the mechanism of this effect is unclear. To address this, we used a combination of in vitro and in vivo approaches to address how propranolol influences bone remodeling in the context of PTH treatment. In female C57BL/6J mice, intermittent PTH and propranolol administration had complementary effects in the trabecular bone of the distal femur and fifth lumbar vertebra (L5 ), with combination treatment achieving microarchitectural parameters beyond that of PTH alone. Combined treatment improved the serum bone formation marker, procollagen type 1 N propeptide (P1NP), but did not impact other histomorphometric parameters relating to osteoblast function at the L5 . In vitro, propranolol amplified the acute, PTH-induced, intracellular calcium signal in osteoblast-like cells. The most striking finding, however, was suppression of PTH-induced bone resorption. Despite this, PTH-induced receptor activator of nuclear factor κ-B ligand (RANKL) mRNA and protein levels were unaltered by propranolol, which led us to hypothesize that propranolol could act directly on osteoclasts. Using in situ methods, we found Adrb2 expression in osteoclasts in vivo, suggesting β-blockers may directly impact osteoclasts. Consistent with this, we found propranolol directly suppresses osteoclast differentiation in vitro. Taken together, this work suggests a strong anti-osteoclastic effect of nonselective β-blockers in vivo, indicating that combining propranolol with PTH could be beneficial to patients with extremely low bone density. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Annika Treyball
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
| | - Audrey C. Bergeron
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
| | - Daniel J. Brooks
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA
| | - Audrie L. Langlais
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME
| | - Hina Hashmi
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
| | - Kenichi Nagano
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA
| | - Deborah Barlow
- Department of Biomedical Sciences, University of New England, Biddeford, ME
| | - Ryan J. Neilson
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
| | - Tyler A. Roy
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
| | - Kathleen T. Nevola
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
- Tufts Graduate School of Biomedical Sciences, Tufts University, Boston, MA
| | | | - Roland Baron
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA
| | - Mary L. Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA
| | - Anyonya R. Guntur
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME
- Tufts University School of Medicine, Tufts University, Boston, MA
| | - Katherine J. Motyl
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME
- Tufts University School of Medicine, Tufts University, Boston, MA
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Zhong XP, Xia WF. Regulation of bone metabolism mediated by β-adrenergic receptor and its clinical application. World J Clin Cases 2021; 9:8967-8973. [PMID: 34786380 PMCID: PMC8567525 DOI: 10.12998/wjcc.v9.i30.8967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/18/2021] [Accepted: 09/01/2021] [Indexed: 02/06/2023] Open
Abstract
Recent studies have confirmed that β-adrenergic receptors (β-ARs) are expressed on the surface of osteoblasts and osteoclasts, and that the sympathetic nervous system can regulate bone metabolism by activating them. β-AR blockers (BBs) are commonly used in the treatment of cardiovascular diseases in the elderly. It is important to investigate whether BBs have a beneficial effect on bone metabolism in the treatment of cardiovascular diseases, so as to expand their clinical application. This article reviews the effects of BB on bone metabolism and the progress of clinical research.
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Affiliation(s)
- Xue-Ping Zhong
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Wen-Fang Xia
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
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Zhang YW, Li YJ, Lu PP, Dai GC, Chen XX, Rui YF. The modulatory effect and implication of gut microbiota on osteoporosis: from the perspective of "brain-gut-bone" axis. Food Funct 2021; 12:5703-5718. [PMID: 34048514 DOI: 10.1039/d0fo03468a] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Osteoporosis (OP) is a kind of systemic metabolic disease characterized by decreased bone mass and destruction of the bone microstructure. In recent years, it has become an expected research trend to explore the cross-linking relationship in the pathogenesis process of OP so as to develop reasonable and effective intervention strategies. With the further development of intestinal microbiology and the profound exploration of the gut microbiota (GM), it has been further revealed that the "brain-gut" axis may be a potential target for the bone, thereby affecting the occurrence and progression of OP. Hence, based on the concept of "brain-gut-bone" axis, we look forward to deeply discussing and summarizing the cross-linking relationship of OP in the next three parts, including the "brain-bone" connection, "gut-bone" connection, and "brain-gut" connection, so as to provide an emerging thought for the prevention strategies and mechanism researches of OP.
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Affiliation(s)
- Yuan-Wei Zhang
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China. and Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China and School of Medicine, Southeast University, Nanjing, Jiangsu, China and Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, China and Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Ying-Juan Li
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China and Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Pan-Pan Lu
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China. and Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China and School of Medicine, Southeast University, Nanjing, Jiangsu, China and Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, China and Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Guang-Chun Dai
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China. and Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China and School of Medicine, Southeast University, Nanjing, Jiangsu, China and Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, China and Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Xiang-Xu Chen
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China. and Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China and School of Medicine, Southeast University, Nanjing, Jiangsu, China and Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, China and Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Yun-Feng Rui
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China. and Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China and School of Medicine, Southeast University, Nanjing, Jiangsu, China and Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, China and Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
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YAVUZ KELEŞ B, VURAL M, ÖNDER B, ÖNEŞ K. Evaluation of the effects of β1-selective beta-blockers on bone mineral density and fracture risk in postmenopausal women. Turk J Med Sci 2020; 50:994-998. [PMID: 32283907 PMCID: PMC7379456 DOI: 10.3906/sag-1909-187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 04/11/2020] [Indexed: 12/14/2022] Open
Abstract
Background/aim β1-selective beta-blockers (BBs) are sympatholytic agents, and discerning their effects on bone health would be of great importance. This study aimed to investigate the influence of β1-selective BBs on bone mineral density (BMD) and fracture risk. Materials and methods This study included postmenopausal women who used β1-selective BBs (BB group) and control group. Sociodemographic characteristics, BMD and previous fragility fractures were recorded. Additionally, the 10-year probability of a major osteoporotic and hip fracture was calculated using the fracture risk assessment tool (FRAX). Results A total of 60 participants were included in the study. L1-4 and L2-4 BMD values were significantly higher in BB group than control group (P = 0.015 and P = 0.025, respectively). Moreover, T-scores of lumbar and femur total were significantly higher in the BB group. Two patients in BB and 6 patients in control group had previous fragility fracture. No statistically significant intergroup difference was noted regarding FRAX. Conclusion Based on our results, β1-selective BB usage was associated with higher BMD at the lumbar region in postmenopausal women.
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Affiliation(s)
- Betül YAVUZ KELEŞ
- İstanbul Physical Medicine and Rehabilitation Training and Research Hospital, İstanbulTurkey
| | - Meltem VURAL
- Bakırköy Dr. Sadi Konuk Training Hospital, İstanbulTurkey
| | - Burcu ÖNDER
- İstanbul Physical Medicine and Rehabilitation Training and Research Hospital, İstanbulTurkey
| | - Kadriye ÖNEŞ
- İstanbul Physical Medicine and Rehabilitation Training and Research Hospital, İstanbulTurkey
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The effects of intraperitoneal metoprolol administration on healing of bone defects in rat tibia: a pilot study. Clin Oral Investig 2019; 24:1239-1247. [PMID: 31317257 DOI: 10.1007/s00784-019-02987-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/20/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Metoprolol is a cardioselective competitive beta-1 adrenergic receptor antagonist with antihypertensive properties, devoid of intrinsic sympathomimetic activity. Various studies have suggested the effect of beta-blockers on bone remodeling. We aimed to investigate whether metoprolol affects bone remodeling by altering anti-inflammatory and pro-inflammatory cytokines. MATERIALS AND METHODS Surgical defects of 3 mm diameter were created in tibiae of 72 Sprague-Dawley rats. Rats were randomly assigned to a control group without metoprolol treatment (n = 36), and a test group treated with 0.1 mg/kg/day metoprolol (n = 36). Six rats from each group were sacrificed at days 0, 1, 3, 5, 7, and 14. The percentages of cells, which showed positive immunohistochemical staining for IL-1β, IL-6, IL-10, and RANKL, were assessed in the defect area. Differences in percentages of stained cells within each of the test and control groups over various time intervals were tested using one-way ANOVA test. A P value of < 0.05 was considered statistically significant. RESULTS No significant differences in IL-1β, IL-10, IL-6, and RANKL expressions were found between test and control groups at the same interval. Significant reduction was observed at different time intervals in the same group (P < 0.05). CONCLUSION Metoprolol did not reduce bone-active cytokine: IL-1β, IL-6, and RANKL. It also did not elevate IL-10 expression levels. Thus, it does not appear to decrease osteoclastogenesis. CLINICAL RELEVANCE Results from this animal model help us understand any effect of metoprolol on bone healing by potential contribution to different real-world clinical research.
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Ye Y, Liu CZ, Wang R, Zhang YW, Zhang B, Cui Y, Liu XW, Huang SM. A new animal model for menopausal transition: combination of ovariectomy and empty bottle stimulation. Gynecol Endocrinol 2018; 34:840-844. [PMID: 29546795 DOI: 10.1080/09513590.2018.1451835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Previous small animal models for menopausal transition are mainly performed to mimic the biochemical changes of patients with menopausal transition. The psychological symptoms in animal models are often overlooked. To mimic clinical situation, we developed a new mouse model of menopausal transition: the combination of bilateral ovariectomy (OVX) and empty bottle stimulation (EBS). After OVX and 21 days of EBS, behavioral test and pentobarbital-induced sleep test were carried out. Then all the animals were euthanized for further investigations. Compared with the control group, the combination of OVX and EBS group (OVX + EBS) showed higher bodyweight, lower organ index of uteri, and lower concentrations of serum estradiol. In addition, behavioral manifestations, sleep quality, and morphologic features in OVX + EBS group showed significant differences compared with the control group. OVX alone or EBS alone failed to include all the changes of OVX + EBS group. These findings indicate ovariectomy or EBS alone could not well mimic the symptoms of menopausal transition. The combination of bilateral ovariectomy and EBS offers an easy and repeatable method for building comprehensive menopausal transition model in mice.
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Affiliation(s)
- Yang Ye
- a Department of Neuroscience , Institute for Chinese Medicine, Heilongjiang University of Chinese Medicine , Harbin , China
- b Graduate School , Beijing University of Chinese Medicine , Beijing , China
| | - Cun-Zhi Liu
- c Department of Acupuncture and Moxibustion , Dongfang Hospital, Beijing University of Chinese Medicine , Beijing , China
| | - Rui Wang
- d Research Center of Medical Science , Qiqihar Medical University , Qiqihar , China
| | - Yu-Wei Zhang
- a Department of Neuroscience , Institute for Chinese Medicine, Heilongjiang University of Chinese Medicine , Harbin , China
| | - Bo Zhang
- a Department of Neuroscience , Institute for Chinese Medicine, Heilongjiang University of Chinese Medicine , Harbin , China
| | - Yu Cui
- e Department of Veterinary Medicine , College of Agriculture, Hainan University , Haikou , China
| | - Xue-Wei Liu
- d Research Center of Medical Science , Qiqihar Medical University , Qiqihar , China
| | - Shu-Ming Huang
- a Department of Neuroscience , Institute for Chinese Medicine, Heilongjiang University of Chinese Medicine , Harbin , China
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