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Pecorelli A, Cordone V, Schiavone ML, Caffarelli C, Cervellati C, Cerbone G, Gonnelli S, Hayek J, Valacchi G. Altered Bone Status in Rett Syndrome. Life (Basel) 2021; 11:life11060521. [PMID: 34205017 PMCID: PMC8230033 DOI: 10.3390/life11060521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/24/2022] Open
Abstract
Rett syndrome (RTT) is a monogenic neurodevelopmental disorder primarily caused by mutations in X-linked MECP2 gene, encoding for methyl-CpG binding protein 2 (MeCP2), a multifaceted modulator of gene expression and chromatin organization. Based on the type of mutation, RTT patients exhibit a broad spectrum of clinical phenotypes with various degrees of severity. In addition, as a complex multisystem disease, RTT shows several clinical manifestations ranging from neurological to non-neurological symptoms. The most common non-neurological comorbidities include, among others, orthopedic complications, mainly scoliosis but also early osteopenia/osteoporosis and a high frequency of fractures. A characteristic low bone mineral density dependent on a slow rate of bone formation due to dysfunctional osteoblast activity rather than an increase in bone resorption is at the root of these complications. Evidence from human and animal studies supports the idea that MECP2 mutation could be associated with altered epigenetic regulation of bone-related factors and signaling pathways, including SFRP4/WNT/β-catenin axis and RANKL/RANK/OPG system. More research is needed to better understand the role of MeCP2 in bone homeostasis. Indeed, uncovering the molecular mechanisms underlying RTT bone problems could reveal new potential pharmacological targets for the treatment of these complications that adversely affect the quality of life of RTT patients for whom the only therapeutic approaches currently available include bisphosphonates, dietary supplements, and physical activity.
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Affiliation(s)
- Alessandra Pecorelli
- Animal Science Department, Plants for Human Health Institute, North Carolina State University, Kannapolis, NC 28081, USA;
- Correspondence: (A.P.); (G.V.)
| | - Valeria Cordone
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy;
| | - Maria Lucia Schiavone
- Animal Science Department, Plants for Human Health Institute, North Carolina State University, Kannapolis, NC 28081, USA;
| | - Carla Caffarelli
- Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, 53100 Siena, Italy; (C.C.); (S.G.)
| | - Carlo Cervellati
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy;
| | - Gaetana Cerbone
- Division of Medical Genetics, “S.G. Moscati” Hospital, 74100 Avellino, Italy;
| | - Stefano Gonnelli
- Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, 53100 Siena, Italy; (C.C.); (S.G.)
| | - Joussef Hayek
- Toscana Life Sciences Foundation, 53100 Siena, Italy;
| | - Giuseppe Valacchi
- Animal Science Department, Plants for Human Health Institute, North Carolina State University, Kannapolis, NC 28081, USA;
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy;
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (A.P.); (G.V.)
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Hamza S, Fathy S, El-Azab S. Effect of diode laser biostimulation compared to Teriparatide on induced osteoporosis in rats: an animal study from Egypt. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2020; 13:1970-1985. [PMID: 32922592 PMCID: PMC7476941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
Our aim in this study was to evaluate the effect of low-level laser therapy (LLLT) by means of diode laser bio-stimulation compared to Teriparatide in induced osteoporosis in rats. A total of 45 adult female Egyptian albino rats were used. Rats were divided into five groups: normal control, osteoporotic control, Teriparatide (TPTD) group (T), laser group (L), and laser and teriparatide (T+L) combination group. Osteoporosis was induced by performing double ovariectomy in rats. Lower jaws and left femurs were dissected. The specimens were tested using a Computed tomography unit, scanning EM (SEM) equipped with Energy Dispersive X-Ray Analyzer, and Rat PINP ELISA Kit. The histopathologic examination of experimental rat jaws and femurs revealed changes in bone architecture among the various groups throughout the experiment. CT examination showed a noticeable difference in radiodensity between jaw and femur bones. By SEM, bones of the Normal Control (NC) group showed normal bone porosity. However, bones of the Osteoporotic Control (OC) group showed a great difference as bone pores were large and numerous with irregular outlines. The ELISA test for PINP concentration showed a steady rise in the PINP concentrations in OC, T, L and T+L groups. We concluded that TPTD has osteogenic potential and is capable to enhance bone architecture by inducing the formation of new well-organized bone with narrower bone pore diameter. LLLT can be used as a good alternative local treatment strategy with minimal side effects and superior outcomes.
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Affiliation(s)
- Shymaa Hamza
- Department of Oral Pathology, Faculty of Dentistry, Cairo University Cairo, Egypt
| | - Safa Fathy
- Department of Oral Pathology, Faculty of Dentistry, Cairo University Cairo, Egypt
| | - Samia El-Azab
- Department of Oral Pathology, Faculty of Dentistry, Cairo University Cairo, Egypt
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Ciurlia E, Leali PT, Doria C. Use of teriparatide off-label: our experience and review of literature. ACTA ACUST UNITED AC 2017; 14:28-34. [PMID: 28740522 DOI: 10.11138/ccmbm/2017.14.1.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this paper is to report our experience and to present a review of literature about the use of teriparatide off-label in the therapy of non-unions. Teriparatide is used exclusively in treatment of osteoporosis and to prevent bone fracture because it has a positive effect on bone strength and architecture. The use of teriparatide in non-unions is described as effective in numerous case report.
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Affiliation(s)
| | | | - Carlo Doria
- Orthopaedic Department, University of Sassari, Sassari, Italy
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Zanchetta MB, Scioscia MF, Zanchetta JR. Bone microarchitecture in Rett syndrome and treatment with teriparatide: a case report. Osteoporos Int 2016; 27:2873-2877. [PMID: 27068223 DOI: 10.1007/s00198-016-3586-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/30/2016] [Indexed: 01/07/2023]
Abstract
We present the case of a 28-year-old female Rett syndrome patient with low bone mass and a recent fracture who was successfully treated with teriparatide. Bone mineral density and microarchitecture substantially improved after treatment. Rett syndrome (RTT), an X-linked progressive neuro-developmental disorder caused by mutations in the methyl-CpG-binding 2 (MECP2) gene, has been consistently associated with low bone mass. Consequently, patients with RTT are at increased risk of skeletal fractures. Teriparatide is a bone-forming agent for the treatment of osteoporosis that has demonstrated its effectiveness in increasing bone strength and reducing the risk of fractures in postmenopausal women, but, recently, its positive action has also been reported in premenopausal women. We present the case of a 28-year-old female RTT patient with low bone mass and a recent fracture who was successfully treated with teriparatide. Both bone mass measured by DXA and microarchitecture assessed by high resolution peripheral computed tomography (HR pQCT) were substantially improved after treatment.
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Affiliation(s)
- M B Zanchetta
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Cátedra de Osteología y Metabolismo Mineral, Facultad de Medicina, Universidad del Salvador, Libertad 836, 1st Floor, 1012, Buenos Aires, Argentina.
| | - M F Scioscia
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Cátedra de Osteología y Metabolismo Mineral, Facultad de Medicina, Universidad del Salvador, Libertad 836, 1st Floor, 1012, Buenos Aires, Argentina
| | - J R Zanchetta
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Cátedra de Osteología y Metabolismo Mineral, Facultad de Medicina, Universidad del Salvador, Libertad 836, 1st Floor, 1012, Buenos Aires, Argentina
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