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Mohamed RH, Abdelrahim DS, Hay NHA, Fawzy NM, M DKM, Yehia DAY, AbdelMaksoud OM, Tamim YM. The role of protein prenylation inhibition through targeting FPPS by zoledronic acid in the prevention of renal fibrosis in rats. Sci Rep 2024; 14:18283. [PMID: 39112499 PMCID: PMC11306734 DOI: 10.1038/s41598-024-68303-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
Renal fibrosis (RF) represents the most widespread pathological condition in chronic kidney disease (CKD). Recently, protein prenylation has been implicated in the fibrosis's progression. The research examined the renoprotective effect of zoledronic acid (ZA) (50 µg/kg/week) in a rat model of carbon tetrachloride (CCl4)-induced RF through targeting protein prenylation. Forty Wistar male rats were split up into the control group, vehicle-treated group, model-RF group, and RF-ZA group. Mean arterial blood pressure (MBP), BUN, serum creatinine, and urine albumin-creatinine ratio (uACR), protein levels of farnesyl pyrophosphate (FPP), tumour necrosis factor-alpha (TNF-α), transforming growth factor-β (TGF-β), and malondialdehyde (MDA), and catalase and gene expression of farnesyl pyrophosphate synthase (FPPS) and nuclear factor-kB (NF-κB) were measured. Immunohistochemical staining for renal interleukin-6 (IL-6), α-smooth muscle actin (α-SMA), and caspase-3, as well as histopathological alterations, were assessed. ZA considerably ceased the reduction in MBP, markedly reduced uACR, serum creatinine, BUN, and expression of FPPS, FPP, NF-κB, TGF-β, TNF-α, and MDA, and significantly increased catalase levels compared to the model-RF rats. ZA ameliorated the CCl4-induced histopathological alterations and suppressed the expression of caspase-3, α-SMA, and IL-6. In conclusion, ZA preserved renal function and prevented renal fibrosis in a rat model. These were achieved through targeting protein prenylation mainly by inhibiting FPPS.
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Affiliation(s)
- Reham Hussein Mohamed
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, Egypt.
| | - Dina S Abdelrahim
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, Egypt
- Department of Pharmacology, Faculty of Medicine, Modern Technology & Information University, Cairo, Egypt
| | - Nesma Hussein Abdel Hay
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nesma Mohamed Fawzy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Doaa Karem M M
- Department of Histology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Omnia M AbdelMaksoud
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yomna M Tamim
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, Egypt
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Hadad H, Matheus HR, Pai SI, Souza FA, Guastaldi FPS. Rodents as an animal model for studying tooth extraction-related medication-related osteonecrosis of the jaw: assessment of outcomes. Arch Oral Biol 2024; 159:105875. [PMID: 38160519 DOI: 10.1016/j.archoralbio.2023.105875] [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] [Received: 01/27/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To assess the outcomes of several rodent animal models for studying tooth extraction-related medication-related osteonecrosis of the jaw (MRONJ). DESIGN After a search of the databases, 2004 articles were located, and 118 corroborated the inclusion factors (in vivo studies in rodents evaluating tooth extraction as a risk factor for the development of MRONJ). RESULTS Numerous studies attempting to establish an optimal protocol to induce MRONJ were found. Zoledronic acid (ZA) was the most used drug, followed by alendronate (ALN). Even when ZA did not lead to the development of MRONJ, its effect compromised the homeostasis of the bone and soft tissue. The association of other risk factors (dexamethasone, diabetes, and tooth-related inflammatory dental disease) besides tooth extraction also played a role in the development of MRONJ. In addition, studies demonstrated a relationship between cumulative dose and MRONJ. CONCLUSIONS Both ZA and ALN can lead to MRONJ in rodents when equivalent human doses (in osteoporosis or cancer treatment) are used. Local oral risk factors and tooth-related inflammatory dental disease increase the incidence of MRONJ in a tooth extraction-related rodent model.
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Affiliation(s)
- Henrique Hadad
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA; Department of Diagnosis and Surgery, Oral & Maxillofacial Surgery Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Henrique R Matheus
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA; Department of Diagnosis and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Sara I Pai
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Francisley A Souza
- Department of Diagnosis and Surgery, Oral & Maxillofacial Surgery Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Fernando P S Guastaldi
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.
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Senín LD, Pancorbo DM, Garcés MYR, Santos-Rubio MD, Calero JB. Relationship between Medication-Related Osteonecrosis of the Jaw and CDK4/6 Inhibitors in Breast Cancer. Curr Oncol 2024; 31:250-259. [PMID: 38248101 PMCID: PMC10814865 DOI: 10.3390/curroncol31010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/07/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE We aimed to evaluate the use of CDK4/6 inhibitors as a risk factor for medication-related osteonecrosis of the jaw (MRONJ) in a cohort of patients with metastatic breast cancer treated with denosumab. METHODS This was a multicentre, retrospective, observational study. All patients with breast cancer treated with denosumab (January 2011-December 2022) were included. The relationship between CDK4/6 inhibitors and MRONJ was analysed. RESULTS A total of 243 patients were included, ninety-five (44.2%) of whom used a CDK4/6 inhibitor. There were 21 patients with MRONJ. In patients treated with denosumab without CDK4/6 inhibitors, the incidence of MRONJ and mean time to the occurrence of MRONJ were 6.6% (8/120) and 16.8 months (SD 7.8), respectively; in patients treated with denosumab and CDK4/6 inhibitor, these values were 13.7% (13/95) and 15.4 months (SD 8.7), respectively. The difference in the incidence was not significant (p = 0.085). Among the 19 patients who used abemaciclib, the probability of MRONJ occurrence was significantly higher compared to patients not using CDK4/6 inhibitors (p = 0.0178). CONCLUSIONS These results suggest that the incidence of MRONJ in patients with metastatic breast cancer treated with denosumab is higher, and the onset of MRONJ occurs earlier in the presence of CDK4/6 inhibitors. The differences were statistically significant in the patients who used abemaciclib. Given that the use of this combination is very common in routine clinical practice, it would be advisable to carry out larger prospective studies to clarify the risk of this association.
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Affiliation(s)
| | - David Morales Pancorbo
- Department of Medical Oncology, Juan Ramón Jiménez University Hospital, 21005 Huelva, Spain; (D.M.P.)
| | | | | | - Juan Bayo Calero
- Department of Medical Oncology, Juan Ramón Jiménez University Hospital, 21005 Huelva, Spain; (D.M.P.)
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Hadad H, Matheus HR, Chen JE, Jounaidi Y, Souza FÁ, Guastaldi FPS. Dose-dependent effects of zoledronic acid on the osteogenic differentiation of human bone marrow stem cells (hBMSCs). JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101479. [PMID: 37080358 DOI: 10.1016/j.jormas.2023.101479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023]
Abstract
Recent studies have shown that bisphosphonates can also impact osteoblasts besides osteoclasts. This study aimed to evaluate the effects of different concentrations of Zoledronic acid (ZA) during the osteogenic differentiation of human Bone Marrow Stem Cells (hBMSCs) in vitro. Thus, osteogenic differentiation of hBMSCs was conducted with different concentrations of Zoledronic Acid (ZA) (0, 0.1, 1.0, and 5.0 μM) for the first 3 days. Cell metabolism was quantified at 1-, 3-, 7-, and 14 days. At 7- and 14-days, the following analyses were performed: 1) mineralization nodule assay, 2) LIVE/DEAD™, 3) cell adhesion and spreading, 4) alkaline phosphatase (ALP) activity, and 5) qPCR analysis for RUNX-2), ALPL, and COL1 A1. Data were analyzed by ANOVA 2-way, followed by Tukey's post hoc test (p < 0.05). Cell metabolism (3-, 7-, and 14-days) (p < 0.001), mineralization (7-, 14-days) (p < 0.001), and ALP activity (14-days) (p < 0.001) were reduced in ZA 5.0 µM when compared to control (no ZA). Also, ZA 5.0 µM downregulated the expression of RUNX2 at 7- and 14-days (p < 0.001). It is possible to conclude that ZA (5.0 µM) can impair hBMSC differentiation into osteoblasts and interferes with its mineralization phase.
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Affiliation(s)
- Henrique Hadad
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA; Department of Diagnosis and Surgery, Oral & Maxillofacial Surgery Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, 16.015-050, Brazil
| | - Henrique Rinaldi Matheus
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA; Department of Diagnosis and Surgery, Division of Periodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, 16.015-050, Brazil
| | - Jason Evan Chen
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA
| | - Youssef Jounaidi
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Francisley Ávila Souza
- Department of Diagnosis and Surgery, Oral & Maxillofacial Surgery Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, 16.015-050, Brazil
| | - Fernando Pozzi Semeghini Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA.
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Kozutsumi R, Kuroshima S, Al-Omari FA, Hayano H, Nakajima K, Kakehashi H, Sawase T. Depletion of macrophages deteriorates bisphosphonate-related osteonecrosis of the jaw-like lesions in mice. Bone 2023; 177:116899. [PMID: 37708951 DOI: 10.1016/j.bone.2023.116899] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a potentially intractable disease with no definitive pathophysiology and no treatment and prevention strategies. This study aimed to investigate whether time-selective depletion of macrophages worsens BRONJ-like lesions in mice. A murine model of high-prevalence BRONJ-like lesions in combination with zoledronate/chemotherapeutic drug administration and tooth extraction was created according to the methods of our previous studies. Daily intra-oral submucosal administration of clodronate-loaded liposomes, which temporarily depletes systemic macrophages, was performed immediately after tooth extraction. Spleens, femora, tibiae, and maxillae were dissected 2 weeks after extraction to evaluate BRONJ-like lesions and systemic conditions by micro-computed tomography analysis, histomorphometric and immunofluorescent analyses, and serum chemistry with ELISA. Depletion of macrophages significantly decreased the numbers of local and systemic macrophages and osteoclasts on the bone surface, which markedly worsened osseous healing, with increased necrotic bone and empty lacunae in the existing alveolar bone and newly formed bone in the extraction sockets, and soft tissue healing, with decreased collagen production and increased infiltration of polymorphonuclear cells. Interestingly, the depletion of macrophages significantly shifted macrophage polarization to M1 macrophages through an increase in F4/80+CD38+ M1 macrophages and a decrease in F4/80+CD163+ M2 macrophages, with decreases in the total number of F4/80+ macrophages. These data demonstrated that severe inhibition of osteoclasts in bone tissue and polarization shifting of macrophages in soft tissue are essential factors associated with BRONJ.
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Affiliation(s)
- Ryohei Kozutsumi
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Shinichiro Kuroshima
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan.
| | - Farah A Al-Omari
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Hiroki Hayano
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Kazunori Nakajima
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Hiroe Kakehashi
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnosis and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Takashi Sawase
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
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Lima-Verde MEQ, de Queiroz Rodrigues MI, Vieira BR, Lima-Verde Neto FTG, Agressott EVH, de Sousa FB, Paschoal AR, de Barros Silva PG, Sousa FB, Mota MRL, Alves APNN. Zoledronate treatment exerts sex-independent effects on bone and dental physicochemical properties in mice jaw necrosis. J Bone Miner Metab 2023; 41:760-771. [PMID: 37673837 DOI: 10.1007/s00774-023-01465-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Bisphosphonate (BF) therapy is strongly related to the occurrence of medication-related osteonecrosis of the jaw (ONJ). However, no previous study has evaluated if there are sex-related differences on the ONJ establishment together with bone biomechanical alterations, and if they could have a synergy with the ZA treatment. MATERIALS AND METHODS This study aimed to analyze the physicochemical properties of mineralized tissues in a zoledronate (ZA)-related osteonecrosis mouse model, by a 2 × 2-factorial design, considering sex (female/male) and treatment (ZA/Saline) factors (n = 8/group). After three ZA (1.0 mg/kg) or saline administrations (days 0, 7, 14), the lower left second molar was extracted (day 42). Further ZA administration (day 49) and euthanasia (day 70) were conducted. After confirmation of ZA-induced jaw necrosis (histologic and microtomographic analysis), spectroscopic and mechanical parameters were assessed. RESULTS ZA-treated groups presented lower bone density due to impaired healing of tooth extraction socket. Sex-related alterations were also observed, with lower bone density in females. Regarding biomechanical parameters, sex and treatment exerted independent influences. ZA, although decreasing flexural modulus and yield stress, increases stiffness mainly due to a higher bone volume. Females show less resistance to higher loads compared to males (considering dimension-independent parameters). Additionally, ZA increases crystallinity in bone and dental structure (p < 0.05). In summary, although strongly related to osteonecrosis occurrence, ZA modifies bone and dental mineral matrix, improving bone mechanical properties. CONCLUSION Despite sex-dependent differences in bone biomechanics and density, osteonecrosis was established with no sex influence. No synergistic association between sex and treatment factors was observed in this study.
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Affiliation(s)
- Maria Elisa Quezado Lima-Verde
- Faculty of Pharmacy, Dentistry and Nursing, Postgraduate Program in Dentistry, Federal University of Ceará (UFC), Rua Monsenhor Furtado, S/N, Rodolfo Teofilo, Fortaleza, CE, Brazil.
| | - Maria Imaculada de Queiroz Rodrigues
- Faculty of Pharmacy, Dentistry and Nursing, Postgraduate Program in Dentistry, Federal University of Ceará (UFC), Rua Monsenhor Furtado, S/N, Rodolfo Teofilo, Fortaleza, CE, Brazil
| | - Basílio Rodrigues Vieira
- Health Sciences Center, Graduate Program in Dentistry, Federal University of Paraíba, Joao Pessoa, PB, Brazil
| | | | | | - Frederico Barbosa de Sousa
- Department of Morphology, Health Sciences Center, Federal University of Paraíba, Joao Pessoa, PB, Brazil
| | | | - Paulo Goberlânio de Barros Silva
- Faculty of Pharmacy, Dentistry and Nursing, Postgraduate Program in Dentistry, Federal University of Ceará (UFC), Rua Monsenhor Furtado, S/N, Rodolfo Teofilo, Fortaleza, CE, Brazil
| | - Fabrício Bitu Sousa
- Faculty of Pharmacy, Dentistry and Nursing, Postgraduate Program in Dentistry, Federal University of Ceará (UFC), Rua Monsenhor Furtado, S/N, Rodolfo Teofilo, Fortaleza, CE, Brazil
| | - Mário Rogério Lima Mota
- Faculty of Pharmacy, Dentistry and Nursing, Postgraduate Program in Dentistry, Federal University of Ceará (UFC), Rua Monsenhor Furtado, S/N, Rodolfo Teofilo, Fortaleza, CE, Brazil
| | - Ana Paula Negreiros Nunes Alves
- Faculty of Pharmacy, Dentistry and Nursing, Postgraduate Program in Dentistry, Federal University of Ceará (UFC), Rua Monsenhor Furtado, S/N, Rodolfo Teofilo, Fortaleza, CE, Brazil
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Borges R, Zambanini T, Pelosine AM, Justo GZ, Souza ACS, Machado J, Schneider JF, de Araujo DR, Marchi J. A colloidal hydrogel-based drug delivery system overcomes the limitation of combining bisphosphonates with bioactive glasses: in vitro evidence of a potential selective bone cancer treatment allied with bone regeneration. BIOMATERIALS ADVANCES 2023; 151:213441. [PMID: 37167747 DOI: 10.1016/j.bioadv.2023.213441] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/23/2023] [Accepted: 04/21/2023] [Indexed: 05/13/2023]
Abstract
Bisphosphonates are a class of drugs that induce bone cancer cell death and favor bone regeneration, making them suitable for bone cancer treatment. However, when combined with bioactive glasses to enhance bone regeneration, a chemical bond between biphosphonates and the glass surface inactivates their mechanism of action. A new colloidal hydrogel-based drug delivery system could overcome that limitation once bisphosphonates, such as zoledronic acid (ZA), are incorporated into hydrogel micelles, avoiding their interaction with the glass surface. In this work, we proposed formulations based on a poloxamer 407 thermo-responsive hydrogel matrix containing holmium-doped bioactive glass nanoparticles and different concentrations (0.05 and 5 mg/mL) of ZA. We characterized the influence of the glass and the ZA on the hydrogel properties. In addition, a drug concentration screening was performed, and biological characterizations evaluated the best result. The biological characterization consisted of evaluating cytotoxicity and in vitro bone regeneration ability through cell migration and quantification of genes related to osteogeneses through RT-PCR. The results suggest that the addition of glasses and ZA to the poloxamer did not significantly influence the sol-gel transition of the hydrogels (around 13 °C) regardless of the ZA content. However, the ZA at high concentration (PL-ZA100) decreased the enthalpy of gel formation from 68 to 43 kJ.mol-1 when compared with the pure hydrogel formulation (PL), suggesting a water structurer role of ZA, which is withdrawn when glass particles are added to the system (PL-BG5Ho-ZA100). Solid-state 31P nuclear resonance spectroscopy results showed that part of the ZA is chemically bonded to the glass surface, which explains the withdrawal in the water structurer role of ZA when the glasses were incorporated into the hydrogel. Besides, based on the drug release results, we proposed a model where part of the ZA is "free," encapsulated in the hydrogel matrix, while another part of the ZA is bonded to the glass surface. Finally, considering the in vitro results and our proposed model, the ratio between "free" and "bonded" ZA in our drug delivery systems showed in vitro evidence of a cancer treatment that selectively kills osteosarcoma cells while still favoring an osteogenic microenvironment. By overcoming the limitation of combining bisphosphonates with bioactive glasses, hydrogel-based drug delivery systems can be a solution for the development of new formulations proposed for bone cancer treatment in conjunction with bone regeneration.
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Affiliation(s)
- Roger Borges
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil; School of Biomedical Engineering, Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Telma Zambanini
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Agatha Maria Pelosine
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Giselle Zenker Justo
- Departamento de Biologia Molecular, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
| | - Ana Carolina S Souza
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Joel Machado
- Departamento de Biologia, Universidade Federal do São Paulo, UNIFESP, Diadema, Brazil
| | - Jose Fabian Schneider
- Instituto de Física de São Carlos, Universidade de São Paulo, USP, São Carlos, Brazil
| | - Daniele R de Araujo
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Juliana Marchi
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil.
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Safari B, Aghazadeh M, Aghanejad A. Osteogenic differentiation of human adipose-derived mesenchymal stem cells in a bisphosphonate-functionalized polycaprolactone/gelatin scaffold. Int J Biol Macromol 2023; 241:124573. [PMID: 37100325 DOI: 10.1016/j.ijbiomac.2023.124573] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023]
Abstract
Recent trends in bone tissue engineering have focused on the development of biomimetic constructs with appropriate mechanical and physiochemical properties. Here, we report the fabrication of an innovative biomaterial scaffold based on a new bisphosphonate-containing synthetic polymer combined with gelatin. To this end, zoledronate (ZA)-functionalized polycaprolactone (PCL-ZA) was synthesized by a chemical grafting reaction. After adding gelatin to the PCL-ZA polymer solution, the porous PCL-ZA/gelatin scaffold was fabricated by the freeze-casting method. A scaffold with aligned pores and a porosity of 82.04 % was obtained. During in vitro biodegradability test, 49 % of its initial weight lost after 5 weeks. The elastic modulus of the PCL-ZA/gelatin scaffold was 31.4 MPa, and its tensile strength was 4.2 MPa. Based on the results of MTT assay, the scaffold had good cytocompatibility with human Adipose-Derived Mesenchymal Stem Cells (hADMSCs). Furthermore, cells grown in PCL-ZA/gelatin scaffold showed the highest mineralization and ALP activity compared to other test groups. Results of the RT-PCR test revealed that RUNX2, COL 1A1, and OCN genes were expressed in PCL-ZA/gelatin scaffold at the highest level, suggesting its good osteoinductive capacity. These results revealed that PCL-ZA/gelatin scaffold could be considered a proper biomimetic platform for bone tissue engineering.
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Affiliation(s)
- Banafsheh Safari
- Research Center for Pharmaceutical Nanotechnology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Marziyeh Aghazadeh
- Oral Medicine Department of Dental Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ayuob Aghanejad
- Research Center for Pharmaceutical Nanotechnology, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Nuclear Medicine, Faculty of Medicine, Imam Reza General Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
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Sildenafil reduces bisphosphonate-induced jaw osteonecrosis in rats. Clin Oral Investig 2023; 27:2437-2448. [PMID: 36764974 DOI: 10.1007/s00784-023-04890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023]
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Bone Morphogenetic Protein 2 Promotes Bone Formation in Bone Defects in Which Bone Remodeling Is Suppressed by Long-Term and High-Dose Zoledronic Acid. BIOENGINEERING (BASEL, SWITZERLAND) 2023; 10:bioengineering10010086. [PMID: 36671658 PMCID: PMC9854702 DOI: 10.3390/bioengineering10010086] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
The use of long-term and high-dose bisphosphate is associated with severely suppressed bone turnover and the delayed union of fractures. However, therapeutic methods to overcome the negative effects of bisphosphonate use are lacking. Bone morphogenetic proteins (BMPs) are powerful osteoinductive proteins. The development of the delivery system using BMP has been verified to have an excellent effect on fracture healing and the enhancement of osteointegration. We hypothesized that BMPs had similar effects as autografts in patients with decreased bone healing potential due to long-term bisphosphonate treatment. Forty rats were divided into the following four groups depending upon the materials implanted into the femoral defect after ten weeks of bisphosphonate (zoledronic acid) injections: Group I: absorbable collagen sponge (control); group II: demineralized freeze-dried bone graft; group III: autogenous bone graft; and group IV: rhBMP-2 with an absorbable collagen sponge. Radiographic union, micro-computed tomography (CT) analysis, manual palpation, and histologic analysis were evaluated. The radiographic union rate, manual union rate, and micro-CT bone volume in groups III and IV were significantly higher than those in groups I and II. Groups III and IV showed similar results to each other. Although the amount of immature bone in the BMP-treated group was large, the effect was similar to that of autografts in the bone defect model in which bone turnover was severely reduced by bisphosphonate treatment. BMP might be a good substitute for autografts in patients with decreased bone healing potential due to long-term bisphosphonate treatment.
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Blocking the cytohesin-2/ARF1 axis by SecinH3 ameliorates osteoclast-induced bone loss via attenuating JNK-mediated IRE1 endoribonuclease activity. Pharmacol Res 2022; 185:106513. [DOI: 10.1016/j.phrs.2022.106513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/19/2022]
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Soares MQS, Van Dessel J, Jacobs R, Ferreira GZ, da Silva Santos PS, Nicolielo LF, Duarte MAH, Rubira‐Bullen IRF. High doses of zoledronic acid induce differential effects on femur and jawbone microstructure. Clin Exp Dent Res 2022; 8:1487-1495. [PMID: 35933703 PMCID: PMC9760133 DOI: 10.1002/cre2.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The aim of this study is to investigate the long-term effects on jaw and femur bone induced by oncologic doses of zoledronic acid in a young rat model. MATERIAL AND METHODS Six 12-week-old male Wistar rats received zoledronic acid (0.6 mg/kg) and six control rats received saline solution in the same volume. Compounds were administered intraperitoneally in five doses every 28 days. Euthanasia was performed 150 days after therapy onset. After animal sacrifice, their mandibles and femurs were scanned ex vivo using a high-resolution (14 μm) micro-computed tomography. Morphometric bone parameters were calculated using CT-Analyzer (Bruker, Belgium) between the first and second mandibular molars and in the distal femur metaphysis and epiphysis. RESULTS The treatment group as compared to the controls showed a significantly (p < .05) increased bone quantity (↑BV/TV, ↓Po[Tot], ↑Tb.Th), bone density (↑TMD, ↑BMD), and osteosclerosis of the trabecular bone (↓Tb.Sp, ↓Conn.Dn, ↓Tb.Pf, ↓SMI) in all anatomical sites. Bone remodeling suppression due to zoledronic acid treatment was more pronounced (p < .05) in the femoral metaphysis relative to the mandible and epiphysis. The exploratory linear discriminant analysis showed that for the mandible, it was mainly the bone quantity-related morphometric indices (BV/TV and Tb.Th), while for the femoral epiphysis and metaphysis, it was bone structure-related (Tb.Pf and Tb.N), which are of primary importance to study the treatment effect. CONCLUSION High doses of bisphosphonates can differently affect the bone quantity, density, and structure in long bones and jawbones. In the metaphysis, bone changes were primarily concentrated in the region of the growth plate. Future studies may consider the use of bone morphometric indices to evaluate the effect of bisphosphonates.
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Affiliation(s)
- Mariana Q. S. Soares
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of DentistryUniversity of São PauloBauruBrazil,OMFS‐IMPATH Research Group, Department of Imaging and PathologyFaculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals LeuvenLeuvenBelgium,Division of Oral RadiologyFaculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo MandicCampinasBrazil
| | - Jeroen Van Dessel
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of DentistryUniversity of São PauloBauruBrazil,OMFS‐IMPATH Research Group, Department of Imaging and PathologyFaculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals LeuvenLeuvenBelgium
| | - Reinhilde Jacobs
- OMFS‐IMPATH Research Group, Department of Imaging and PathologyFaculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals LeuvenLeuvenBelgium,Department of Dental MedicineKarolinska InstitutetStockholmSweden
| | - Gustavo Z. Ferreira
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of DentistryUniversity of São PauloBauruBrazil,Department of Surgery and Stomatology, School of DentistryUniversity Center of MaringáMaringáBrazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of DentistryUniversity of São PauloBauruBrazil
| | - Laura F. P. Nicolielo
- OMFS‐IMPATH Research Group, Department of Imaging and PathologyFaculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals LeuvenLeuvenBelgium
| | - Marco A. H. Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of DentistryUniversity of São PauloBauruBrazil
| | - Izabel R. F. Rubira‐Bullen
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of DentistryUniversity of São PauloBauruBrazil
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Delfrate G, Mroczek T, Mecca LEA, Andreis JD, Fernandes D, Lipinski LC, Claudino M, Franco GCN. Effect of pentoxifylline and α-tocopherol on medication-related osteonecrosis of the jaw in rats: Before and after dental extraction. Arch Oral Biol 2022; 137:105397. [DOI: 10.1016/j.archoralbio.2022.105397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 02/25/2022] [Accepted: 03/06/2022] [Indexed: 11/16/2022]
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14
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Kozutsumi R, Kuroshima S, Kaneko H, Sasaki M, Ishisaki A, Sawase T. Zoledronic Acid Deteriorates Soft and Hard Tissue Healing of Murine Tooth Extraction Sockets in a Dose-Dependent Manner. Calcif Tissue Int 2022; 110:104-116. [PMID: 34363509 DOI: 10.1007/s00223-021-00890-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/05/2021] [Indexed: 12/24/2022]
Abstract
The pathophysiology, histopathology, and immunopathology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) Stage 0 remain unclear. The aim of this study was to investigate the effects of high-dose bisphosphonates on tooth extraction socket healing by creating a murine model of BRONJ Stage 0-like lesions using 8-week-old female C57BL/6J mice. Zoledronic acid (Zol) was administered subcutaneously twice a week for 7 weeks at doses of 0.1 mg/kg/week (moderate dose; Zol-M), 0.5 mg/kg/week (high dose; Zol-H1), and 1.0 mg/kg/week (higher dose; Zol-H2). Saline was used as a control (VC). Both maxillary first molars were extracted 3 weeks after drug treatment. Maxillae, long bones, and sera were collected 4 weeks post-extraction (n = 7 mice/group). Microcomputed tomography, histological, immunohistochemical, and ELISA analyses were performed. A ceiling effect for Zol was noted at the Zol-H1 dose. Osseous healing of extraction sites was significantly impaired with increased necrotic bone and the number of empty lacunae in a Zol dose-dependent manner. Zol significantly decreased epithelial thickness, due to a decrease in thickness of the stratum spinosum, in both Zol-H1 and Zol-H2. Both Zol-H1 and Zol-H2 significantly suppressed the distribution of F4/80+ macrophages in the connective tissue of tooth extraction sockets, although gross healing appeared to be normal. Intriguingly, both Zol-H1 and Zol-H2 significantly increased the numbers of TRAP+ mononuclear cells and detached osteoclasts in the connective tissue and bone marrow of extraction sites compared to VC and Zol-M, correlated with serum TRAcP5b levels. The created murine model of BRONJ Stage 0-like lesions becoming more severe in a dose-dependent manner may help to understand the pathophysiology and histopathology of BRONJ Stage 0 in humans.
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Affiliation(s)
- Ryohei Kozutsumi
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8588, Japan
| | - Shinichiro Kuroshima
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8588, Japan.
| | - Haruka Kaneko
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8588, Japan
| | - Muneteru Sasaki
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8588, Japan
| | - Akira Ishisaki
- Division of Cellular Biosignal Sciences, Department of Biochemistry, Iwate Medical University, Shiwa-gun, Iwate, 028-3694, Japan
| | - Takashi Sawase
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8588, Japan
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15
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Duan Y, Li H, Dong X, Geng Z, Xu X, Liu Y. VEGF mitigates bisphosphonate-induced apoptosis and differentiation inhibition of MC3T3-E1 cells. Exp Ther Med 2022; 23:130. [PMID: 34970353 PMCID: PMC8713161 DOI: 10.3892/etm.2021.11053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022] Open
Abstract
The present study aimed to investigate whether VEGF was involved in bisphosphonate (BP)-induced apoptosis and differentiation of osteoblasts. Murine MC3T3-E1 osteoblasts were stimulated with zoledronic acid (ZA) for 7 days. VEGF mRNA and protein expression levels were determined via reverse transcription-quantitative PCR and western blot analysis, respectively. Cell viability was evaluated using Cell Counting Kit-8 assay. In addition, the cell apoptotic rate and the expression levels of apoptosis-related proteins were measured using a TUNEL staining kit and western blot analysis, respectively. To evaluate mineralization, cells were stained with alizarin red, while the secretion levels of alkaline phosphatase (ALP) were measured using the corresponding assay kit. Finally, the expression levels of differentiation-related proteins and proteins of the Nod-like receptor family pyrin domain-containing 3 (NLRP3)/caspase 1/gasdermin D (GSDMD) pyroptosis pathway were measured by western blot analysis. VEGF expression level was notably decreased in ZA-stimulated MC3T3-E1 cells. However, the viability of these cells was enhanced following VEGF addition. Furthermore, VEGF attenuated apoptosis, promoted mineralization and increased ALP activity in ZA-stimulated MC3T3-E1 cells. The ZA-mediated decrease in the protein expression of the osteogenic genes osteopontin, osteocalcin and runt-related transcription factor 2 was restored after MC3T3-E1 cell treatment with 10 ng/ml VEGF. The present study demonstrated that VEGF could attenuate BP-induced apoptosis and differentiation of MC3T3 cells by regulating the NLRP3/caspase 1/GSDMD pathway.
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Affiliation(s)
- Yao Duan
- Department of Second Dental Center, Peking University School and Hospital of Stomatology, Beijing 100101, P.R. China
| | - Heija Li
- Department of Third Dental Center, Peking University School and Hospital of Stomatology, Beijing 100083, P.R. China
| | - Xiaohong Dong
- Stomatology Department, Changle People's Hospital, Weifang, Shandong 262400, P.R. China
| | - Zhaoli Geng
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong 250012, P.R. China
| | - Xinyi Xu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong 250012, P.R. China
| | - Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong 250012, P.R. China.,Shenzhen Research Institute of Shandong University, Shenzhen, Guangdong 518057, P.R. China
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16
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Oomura Y, Matsunaga S, Okamura M, Suzuki T, Kasahara N, Abe S, Nomura T. Effect of Zoledronic Acid on Bone Structure of the Mandible in Ovariectomized Mice. J HARD TISSUE BIOL 2022. [DOI: 10.2485/jhtb.31.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Yusuke Oomura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College
| | | | - Masahiro Okamura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Taiki Suzuki
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Norio Kasahara
- Department of Histology and Developmental Biology, Tokyo Dental College
| | | | - Takeshi Nomura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College
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17
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Aguirre JI, Castillo EJ, Kimmel DB. Preclinical models of medication-related osteonecrosis of the jaw (MRONJ). Bone 2021; 153:116184. [PMID: 34520898 PMCID: PMC8743993 DOI: 10.1016/j.bone.2021.116184] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/15/2021] [Accepted: 09/07/2021] [Indexed: 01/20/2023]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a potentially severe adverse event affecting patients with cancer and patients with osteoporosis who have been treated with powerful antiresorptives (pARs) or angiogenesis inhibitors (AgIs). pARs, including nitrogen-containing bisphosphonates (N-BPs; e.g., zoledronic acid, alendronate) and anti-RANKL antibodies (e.g., denosumab), are used to manage bone metastases in patients with cancer or to prevent fragility fractures in patients with osteoporosis. Though significant advances have been made in understanding MRONJ, its pathophysiology is still not fully elucidated. Multiple species have been used in preclinical MRONJ research, including the rat, mouse, rice rat, rabbit, dog, sheep, and pig. Animal research has contributed immensely to advancing the MRONJ field, particularly, but not limited to, in developing models and investigating risk factors that were first observed in humans. MRONJ models have been developed using clinically relevant doses of systemic risk factors, like N-BPs, anti-RANKL antibodies, or AgIs. Specific local oral risk factors first noted in humans, including tooth extraction and inflammatory dental disease (e.g., periodontitis, periapical infection, etc.), were then added. Research in rodents, particularly the rat, and, to some extent, the mouse, across multiple laboratories, has contributed to establishing multiple relevant and complementary preclinical models. Models in larger species produced accurate clinical and histopathologic outcomes suggesting a potential role for confirming specific crucial findings from rodent research. We view the current state of animal models for MRONJ as good. The rodent models are now reliable enough to produce large numbers of MRONJ cases that could be applied in experiments testing treatment modalities. The course of MRONJ, including stage 0 MRONJ, is characterized well enough that basic studies of the molecular or enzyme-level findings in different MRONJ stages are possible. This review provides a current overview of the existing models of MRONJ, their more significant features and findings, and important instances of their application in preclinical research.
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Affiliation(s)
- J I Aguirre
- Department of Physiological Sciences, University of Florida (UF), Gainesville, FL, United States of America.
| | - E J Castillo
- Department of Physiological Sciences, University of Florida (UF), Gainesville, FL, United States of America.
| | - D B Kimmel
- Department of Physiological Sciences, University of Florida (UF), Gainesville, FL, United States of America
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18
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Ma HY, Ma N, Liu YF, Wan YQ, Liu GQ, Liu GB, Meng HY, Li H, Wang X, Li CB, Peng J. Core Decompression with Local Administration of Zoledronate and Enriched Bone Marrow Mononuclear Cells for Treatment of Non-Traumatic Osteonecrosis of Femoral Head. Orthop Surg 2021; 13:1843-1852. [PMID: 34664417 PMCID: PMC8523758 DOI: 10.1111/os.13100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/09/2021] [Accepted: 05/17/2021] [Indexed: 01/04/2023] Open
Abstract
Objective To investigate the efficacy and safety of core decompression (CD) with local administration of zoledronate and enriched bone marrow mononuclear cells (BMMCS) for the treatment of non‐traumatic osteonecrosis of femoral head (ONFH). Methods A total of 17 patients (30 hips) diagnosed with stage II and III ONFH according to the 2019 revised Association for Research on Osseous Circulation (ARCO) staging criteria from 2012 to 2014 were retrospectively reviewed. The patients received the following therapy: the BMMCs and zoledronate were injected into the necrotic zone, respectively, along with CD. The mean age of the patients was 36.8 years; 14 were men and three were women. All patients included had non‐traumatic ONFH and a minimum follow‐up of 5 years, which ended when total hip arthroplasty (THA) was performed. Imaging modalities, including plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI) were taken pre‐ and postoperatively. Harris hip score (HHS) was used to evaluate the functional outcomes of femoral head necrosis. Kaplan–Meier analysis was adopted to determine the probability of survivorship with THA as the end point in this series of patients. The correlation between radiological progression or THA and related risk factors were further analyzed. All complications were recorded. Results With THA as the follow‐up endpoint, All patients were followed up for an average of 69.1 ± 20.5 months (range, 18–95 months). Preoperative imaging found six hips (20%) at ARCO stage II, 14 hips (46.7%) at stage IIIA, 10 hips (33.3%) at stage IIIB. Fourteen hips (46.7%) shown progression radiologically, while six hips (20%) underwent TKA among these patients with hip preservation. The cumulative survival was 80% (95% CI, 0.608–905) at 5 years with THA as the end point. HHS improved from 63.3 ± 8.7 preoperatively to 74.6 ± 20.6 postoperatively (P = 0.000). Radiological progression was found to be associated with ARCO stage, Japanese Investigation Committee (JIC) type, and corticosteroid exposure (P = 0.047; P = 0.012; P = 0.031). However, no correlation was found between conversion to THA and the known risk factors. No major complication was reported, with only four patients complaining about general weakness and muscle soreness, and all disappeared within 2–3 days. Conclusions The novel treatment modality could relieve pain, delay the progression of collapse, which might be an effective and safe method for hip preservation of early and mid‐term ONFH. However, the effect of this method may be related to ARCO stage, JIC type, and corticosteroid exposure.
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Affiliation(s)
- Hai-Yang Ma
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Ning Ma
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Yu-Feng Liu
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Yi-Qun Wan
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Gui-Qi Liu
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Guang-Bo Liu
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Hao-Ye Meng
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Huo Li
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Xin Wang
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Chun-Bao Li
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
| | - Jiang Peng
- Institute of Orthopaedics/Beijing Key Laboratory of Regenerative Medicine in Orthopedics/Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Chinese PLA General Hospital, Beijing, China
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Mohd Zaffarin AS, Ng SF, Ng MH, Hassan H, Alias E. Nano-Hydroxyapatite as a Delivery System for Promoting Bone Regeneration In Vivo: A Systematic Review. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:2569. [PMID: 34685010 PMCID: PMC8538947 DOI: 10.3390/nano11102569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/23/2022]
Abstract
Nano-hydroxyapatite (nHA) has been widely used as an orthopedic biomaterial and vehicle for drug delivery owing to its chemical and structural similarity to bone minerals. Several studies have demonstrated that nHA based biomaterials have a potential effect for bone regeneration with very minimal to no toxicity or inflammatory response. This systematic review aims to provide an appraisal of the effectiveness of nHA as a delivery system for bone regeneration and whether the conjugation of proteins, antibiotics, or other bioactive molecules to the nHA further enhances osteogenesis in vivo. Out of 282 articles obtained from the literature search, only 14 articles met the inclusion criteria for this review. These studies showed that nHA was able to induce bone regeneration in various animal models with large or critical-sized bone defects, open fracture, or methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis. The conjugations of drugs or bioactive molecules such as bone-morphogenetic protein-2 (BMP-2), vancomycin, calcitriol, dexamethasone, and cisplatin were able to enhance the osteogenic property of nHA. Thus, nHA is a promising delivery system for a variety of compounds in promoting bone regeneration in vivo.
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Affiliation(s)
- Anis Syauqina Mohd Zaffarin
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak 56000, W.P. Kuala Lumpur, Malaysia;
| | - Shiow-Fern Ng
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, W.P. Kuala Lumpur, Malaysia;
| | - Min Hwei Ng
- Centre for Tissue Engineering and Regenerative Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak 56000, W.P. Kuala Lumpur, Malaysia;
| | - Haniza Hassan
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Ekram Alias
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak 56000, W.P. Kuala Lumpur, Malaysia;
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Singhatanadgit W, Hankamolsiri W, Janvikul W. Geranylgeraniol prevents zoledronic acid-mediated reduction of viable mesenchymal stem cells via induction of Rho-dependent YAP activation. ROYAL SOCIETY OPEN SCIENCE 2021; 8:202066. [PMID: 34113452 PMCID: PMC8187992 DOI: 10.1098/rsos.202066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/23/2021] [Indexed: 05/03/2023]
Abstract
Long-term use of zoledronic acid (ZA) increases the risk of medication-related osteonecrosis of the jaw (MRONJ). This may be attributed to ZA-mediated reduction of viable mesenchymal stem cells (MSCs). ZA inhibits protein geranylgeranylation, thus suppressing cell viability and proliferation. Geranylgeraniol (GGOH), which is a naturally found intermediate compound in the mevalonate pathway, has positive effects against ZA. However, precise mechanisms by which GGOH may help preserve stem cell viability against ZA are not fully understood. The objective of this study was to investigate the cytoprotective mechanisms of GGOH against ZA. The results showed that while ZA dramatically decreased the number of viable MSCs, GGOH prevented this negative effect. GGOH-rescued ZA-exposed MSCs formed mineralization comparable to that produced by normal MSCs. Mechanistically, GGOH preserved the number of viable MSCs by its reversal of ZA-mediated Ki67+ MSC number reduction, cell cycle arrest and apoptosis. Moreover, GGOH prevented ZA-suppressed RhoA activity and YAP activation. The results also established the involvement of Rho-dependent YAP and YAP-mediated CDK6 in the cytoprotective ability of GGOH against ZA. In conclusion, GGOH preserves a pool of viable MSCs with osteogenic potency against ZA by rescuing the activity of Rho-dependent YAP activation, suggesting GGOH as a promising agent and YAP as a potential therapeutic target for MRONJ.
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Affiliation(s)
- Weerachai Singhatanadgit
- Faculty of Dentistry, Thammasat University, Pathumthani, 12121, Thailand
- Research Unit in Mineralized Tissue Reconstruction, Thammasat University, Pathumthani, 12121, Thailand
| | - Weerawan Hankamolsiri
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, Pathumthani 12120, Thailand
| | - Wanida Janvikul
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, Pathumthani 12120, Thailand
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21
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Lechner J, von Baehr V, Zimmermann B. Osteonecrosis of the Jaw Beyond Bisphosphonates: Are There Any Unknown Local Risk Factors? Clin Cosmet Investig Dent 2021; 13:21-37. [PMID: 33505172 PMCID: PMC7829671 DOI: 10.2147/ccide.s288603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/24/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) is a complication of intravenous (IV) BP therapy. BP therapy locally affects the dentoalveolar area, while systemic effects are associated with parenteral/IV BP use. Despite numerous publications, the pathogenesis of BRONJ is not fully understood, as only some patients receiving IV BPs develop BRONJ. PURPOSE Can impaired bone remodeling (found in aseptic-ischemic osteonecrosis of the jaw [AIOJ], bone marrow defects [BMD], or fatty-degenerative osteonecrosis of the jaw [FDOJ]) represent a risk factor for BRONJ formation? PATIENTS AND METHODS A literature search clarified the relationship between AIOJ, BMD, FDOJ, and BRONJ, in which common characteristics related to signal cascades, pathohistology, and diagnostics are explored and compared. A case description examining non-exposed BRONJ is presented. DISCUSSION Non-exposed BRONJ variants may represent one stage in undetected BMD development, and progression to BRONJ results from BPs. CONCLUSION Unresolved wound healing at extraction sites, where wisdom teeth have been removed for example, may contribute to the pathogenesis of BRONJ. With IV BP administration, persisting AIOJ/BMD/FDOJ areas may be behind BRONJ development. Therapeutic recommendations include IV BP administration following AIOJ/BMD/FDOJ diagnosis and surgical removal of ischemic areas. BPs should not be regarded as the only cause of osteonecrosis.
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Affiliation(s)
| | - Volker von Baehr
- Department of Immunology and Allergology, Institute for Medical Diagnostics, Berlin, Germany
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Mounier L, Morel A, Ferrandez Y, Morko J, Vääräniemi J, Gilardone M, Roche D, Cherfils J, Blangy A. Novel 2,7-Diazaspiro[4,4]nonane Derivatives to Inhibit Mouse and Human Osteoclast Activities and Prevent Bone Loss in Ovariectomized Mice without Affecting Bone Formation. J Med Chem 2020; 63:13680-13694. [PMID: 33175535 DOI: 10.1021/acs.jmedchem.0c01201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Osteoporosis is currently treated with drugs targeting the differentiation or viability osteoclasts, the cells responsible for physiological and pathological bone resorption. Nevertheless, osteoporosis drugs that target only osteoclast activity are expected to preserve bone formation by osteoblasts in contrast to current treatments. We report here the design, synthesis, and biological characterization of a series of novel N-arylsufonamides featuring a diazaspiro[4,4]nonane nucleus to target the guanine nucleotide exchange activity of DOCK5, which is essential for bone resorption by osteoclasts. These compounds can inhibit both mouse and human osteoclast activity. In particular, 4-chlorobenzyl-4-hydroxy-2-phenyl-1-thia-2,7-diazaspiro[4,4]nonane 1,1-dioxide (compound E197) prevented pathological bone loss in mice. Most interestingly, treatment with E197 did not affect osteoclast and osteoblast numbers and hence did not impair bone formation. E197 could represent a lead molecule to develop new antiosteoporotic drugs targeting the mechanism of osteoclast adhesion onto the bone.
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Affiliation(s)
- Lucile Mounier
- Centre de Recherche en Biologie Cellulaire de Montpellier, Univ Montpellier, CNRS, Montpellier, France, Université de Montpellier, CNRS, 34000 Montpellier, France
| | - Anne Morel
- Centre de Recherche en Biologie Cellulaire de Montpellier, Univ Montpellier, CNRS, Montpellier, France, Université de Montpellier, CNRS, 34000 Montpellier, France
| | - Yann Ferrandez
- Laboratoire de Biologie et Pharmacologie Appliquée, CNRS, Ecole Normale Supérieure Paris-Saclay and Université Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Jukka Morko
- Pharmatest Services Ltd., Itäinen Pitkäkatu 4, 20520 Turku, Finland
| | - Jukka Vääräniemi
- Pharmatest Services Ltd., Itäinen Pitkäkatu 4, 20520 Turku, Finland
| | | | - Didier Roche
- Edelris, 60 Avenue Rockefeller, 69008 Lyon, France
| | - Jacqueline Cherfils
- Laboratoire de Biologie et Pharmacologie Appliquée, CNRS, Ecole Normale Supérieure Paris-Saclay and Université Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Anne Blangy
- Centre de Recherche en Biologie Cellulaire de Montpellier, Univ Montpellier, CNRS, Montpellier, France, Université de Montpellier, CNRS, 34000 Montpellier, France
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Compressive force strengthened the pro-inflammatory effect of zoledronic acid on il-1ß stimulated human periodontal fibroblasts. Clin Oral Investig 2020; 25:3453-3461. [PMID: 33169272 DOI: 10.1007/s00784-020-03667-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The number of patients in dentistry taking bisphosphonates (BP) increases every year. There are only little data about the influence of biomechanical stress due to orthodontic treatment and periodontal inflammation in BP patients. This study focused on the effects of the induced inflammation by IL-1ß in compressed human periodontal ligament fibroblasts (HPdLF) exposed to the nitrogen-containing BP zoledronate in vitro. MATERIALS AND METHODS HPdLF were incubated with 5 μmol/l zoledronate and 10 ng/ml IL-1ß for 48 h. In the last 3 h, cells were exposed to a compressive, centrifugal force of 34.9 g/cm2. Cell viability was analyzed directly after the compressive force by MTT assay. Gene expression of COX-2 and IL-6 was investigated using quantitative qRT-PCR. PGE-2 and IL-6 protein secretion were measured via ELISA. RESULTS The cell viability of HPdLF was not affected. Without inflammatory pre-stimulation, COX-2 expression was increased by compression and zoledronate. IL-6 expression was increased under compression. On secretion level, the combination of compression and zoledronate induced a slightly increase of IL-6 secretion. In contrast, inflammatory pre-stimulation strengthened the compressive upregulation of COX-2, as well as induced a higher PGE-2 secretion. Further addition of zoledronate to pre-stimulated cells additionally strengthened the compression-induced upregulation of COX-2 and IL-6 expression as well as protein secretion compared to all other groups. CONCLUSIONS Biomechanical stress might trigger a pro-inflammatory potential of BP further enhanced in the presence of an inflammatory pre-stimulation. CLINICAL RELEVANCE To prevent excessive host inflammatory responses, occlusal overloading and mechanical stress due to orthodontic treatment should be avoided in BP patients with untreated periodontitis.
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Heymann MF, Lezot F, Heymann D. Bisphosphonates in common pediatric and adult bone sarcomas. Bone 2020; 139:115523. [PMID: 32622877 DOI: 10.1016/j.bone.2020.115523] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 01/23/2023]
Abstract
The therapeutic strategies proposed currently for bone sarcomas are based on neo-adjuvant chemotherapy, delayed en-bloc wide resection, and adjuvant chemotherapy. Unfortunately, bone sarcomas are characterized by high rates of poor drug response, with a high risk of drug resistance, local recurrence and/or a high propensity for induced metastases. The pathogenesis of bone sarcomas is strongly associated with dysregulation of local bone remodeling and increased osteolysis that plays a part in tumor development. In this context, bisphosphonates (BPs) have been proposed as a single agent or in combination with conventional drugs to block bone resorption and the vicious cycle established between bone and sarcoma cells. Pre-clinical in vitro studies revealed the potential "anti-tumor" activities of nitrogen-bisphosphonates (N-BPs). In pre-clinical models, N-BPs reduced significantly primary tumor growth in osteosarcoma and Ewing sarcoma, and the installation of lung metastases. In chondrosarcoma, N-BPs reduced the recurrence of local tumors after intralesional curettage, and increased overall survival. In pediatric and adult osteosarcoma patients, N-BPs have been assessed in combination with conventional chemotherapy and surgery in randomized phase 3 studies with no improvement in clinical outcome. The lack of benefit may potentially be explained by the biological impact of N-BPs on macrophage differentiation/recruitment which may alter CD8+-T lymphocyte infiltration. Thanks to their considerable affinity for the mineralized extracellular matrix, BPs are an excellent platform for drug delivery in malignant bone sites with reduced systemic toxicity, which opens up new opportunities for their future use.
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Affiliation(s)
- Marie-Francoise Heymann
- Institut de Cancérologie de l'Ouest, Saint-Herblain, France; Université de Nantes, Nantes, France
| | - Frederic Lezot
- Université de Nantes, Inserm, U1238, Faculty of Medicine, Nantes, France
| | - Dominique Heymann
- Institut de Cancérologie de l'Ouest, Saint-Herblain, France; Université de Nantes, Nantes, France; University of Sheffield, Dept of Oncology and Metabolism, School of Medicine, Sheffield, UK.
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25
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Boran G, Tavakoli S, Dierking I, Kamali AR, Ege D. Synergistic effect of graphene oxide and zoledronic acid for osteoporosis and cancer treatment. Sci Rep 2020; 10:7827. [PMID: 32385391 PMCID: PMC7211009 DOI: 10.1038/s41598-020-64760-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022] Open
Abstract
Zoledronic acid (ZOL) is a third generation bisphosphonate which can be used as a drug for the treatment of osteoporosis and metastasis. In this study, graphene oxide (GO) is conjugated with ZOL, and the nanostructured material is evaluated in terms viability, proliferation and differentiation. Furthermore, the associated morphological changes of bone marrow-derived mesenchymal stem cells (BM-MSC), and Michigan Cancer Foundation-7 (MCF-7) breast cancer cells, as well as the effect of the drugs on mineralization of BM-MSCs are investigated using a variety of characterization techniques including Fourier Transform Infrared Spectroscopy (FTIR), scanning electron microscopy (SEM) as well as alamar blue, acridine orange, and alizarin red assays. Nanostructured ZOL-GO with an optimum performance is synthesized using ZOL and GO suspensions with the concentration of 50 µM and 2.91 ng/ml, respectively. ZOL-GO nanostructures can facilitate the mineralization of BM-MSC cells, demonstrated by the formation of clusters around the cells. The results obtained confirm the performance of ZOL-GO nanostructures as promising drug complexes for the treatment of osteoporosis and metastasis.
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Affiliation(s)
- Gökçen Boran
- Boğaziçi University, Institute of Biomedical Engineering, İstanbul, Turkey, 34368
| | - Sepideh Tavakoli
- Boğaziçi University, Institute of Biomedical Engineering, İstanbul, Turkey, 34368
- Northeastern University, College of Engineering, Boston, Massachusetts USA 02115, Boğaziçi University, Institute of Biomedical Engineering, İstanbul, Turkey, 34368
| | - Ingo Dierking
- University of Manchester, Department of Physics and Astronomy, Manchester, M13 9PL, United Kingdom
| | - Ali Reza Kamali
- Energy and Environmental Materials Research Centre (E2MC), School of Metallurgy, Northeastern University, Shenyang, China, 110819
| | - Duygu Ege
- Boğaziçi University, Institute of Biomedical Engineering, İstanbul, Turkey, 34368.
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26
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Fliefel R, El Ashwah A, Entekhabi S, Kumbrink J, Ehrenfeld M, Otto S. Bifunctional effect of Zoledronic Acid (ZA) on human mesenchymal stem cells (hMSCs) based on the concentration level. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:634-641. [PMID: 32171967 DOI: 10.1016/j.jormas.2020.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Treatment of massive bone defects is a great challenge. Mesenchymal stem cells (MSCs) enhance bone regeneration by differentiating into osteoblasts. Bisphosphonates (BPs) are antiresorptives reducing bone resorption. Despite Medication-related osteonecrosis of the jaw (MRONJ) is a known side effect of antiresorptives, evidences suggest that BPs have positive effect on bone formation. The aims of this study were to investigate the effect of zoledronic acid (ZA) and geranylgeraniol (GGOH) on human mesenchymal stem cells (hMSCs) being a part of the bone microenvironment and evaluate whether low dose of bisphosphonate has enhanced osteogenic differentiation of hMSCs. MATERIALS AND METHODS The effect of ZA and GGOH on MSCs was investigated in addition to the effect of low doses of ZA on osteogenic differentiation of MSCs and analysed by WST-1, Live/Dead staining and coefficient of drug index (CDI). The osteogenic differentiation of the cells was confirmed by ALP activity, xylenol orange and alizarin red staining, microarray and PCR with levels of statistical significance indicated at *P<0.05, **P<0.01 and ***P<0.0001. MAIN FINDINGS Although, high concentration of ZA had significantly decreased the cell viability in MSCs, GGOH reversed the action of ZA on the cells while at very high concentration; it caused severe reduction in the cell viability. CDI showed antagonism or synergism depending on the concentrations of ZA and GGOH. CONCLUSION The treatment of cells with ZA has increased the mineralization and osteogenic differentiation of MSCs. Our study supported the hypothesis that zoledronic acid plays a bifunctional role depending on the concentration.
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Affiliation(s)
- R Fliefel
- Experimental Surgery and Regenerative Medicine (ExperiMed), Ludwig-Maximilians-University, Nussbaumstrasse 20, 80336 Munich, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Lindwurmstrasse 2a, 80337 Munich, Germany; Department of Oral and Maxillofacial Surgery, Alexandria-University, Champollion Street, 21500 Alexandria, Egypt.
| | - A El Ashwah
- Department of Oral and Maxillofacial Surgery, Alexandria-University, Champollion Street, 21500 Alexandria, Egypt
| | - S Entekhabi
- Experimental Surgery and Regenerative Medicine (ExperiMed), Ludwig-Maximilians-University, Nussbaumstrasse 20, 80336 Munich, Germany
| | - J Kumbrink
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-University, 36,Thalkirchner street, 80337 Munich Germany
| | - M Ehrenfeld
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Lindwurmstrasse 2a, 80337 Munich, Germany
| | - S Otto
- Experimental Surgery and Regenerative Medicine (ExperiMed), Ludwig-Maximilians-University, Nussbaumstrasse 20, 80336 Munich, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Lindwurmstrasse 2a, 80337 Munich, Germany
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27
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Vanderburgh J, Hill JL, Gupta MK, Kwakwa KA, Wang SK, Moyer K, Bedingfield SK, Merkel AR, d'Arcy R, Guelcher SA, Rhoades JA, Duvall CL. Tuning Ligand Density To Optimize Pharmacokinetics of Targeted Nanoparticles for Dual Protection against Tumor-Induced Bone Destruction. ACS NANO 2020; 14:311-327. [PMID: 31894963 PMCID: PMC7216559 DOI: 10.1021/acsnano.9b04571] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Breast cancer patients are at high risk for bone metastasis. Metastatic bone disease is a major clinical problem that leads to a reduction in mobility, increased risk of pathologic fracture, severe bone pain, and other skeletal-related events. The transcription factor Gli2 drives expression of parathyroid hormone-related protein (PTHrP), which activates osteoclast-mediated bone destruction, and previous studies showed that Gli2 genetic repression in bone-metastatic tumor cells significantly reduces tumor-induced bone destruction. Small molecule inhibitors of Gli2 have been identified; however, the lipophilicity and poor pharmacokinetic profile of these compounds have precluded their success in vivo. In this study, we designed a bone-targeted nanoparticle (BTNP) comprising an amphiphilic diblock copolymer of poly[(propylene sulfide)-block-(alendronate acrylamide-co-N,N-dimethylacrylamide)] [PPS-b-P(Aln-co-DMA)] to encapsulate and preferentially deliver a small molecule Gli2 inhibitor, GANT58, to bone-associated tumors. The mol % of the bisphosphonate Aln in the hydrophilic polymer block was varied in order to optimize BTNP targeting to tumor-associated bone by a combination of nonspecific tumor accumulation (presumably through the enhanced permeation and retention effect) and active bone binding. Although 100% functionalization with Aln created BTNPs with strong bone binding, these BTNPs had highly negative zeta-potential, resulting in shorter circulation time, greater liver uptake, and less distribution to metastatic tumors in bone. However, 10 mol % of Aln in the hydrophilic block generated a formulation with a favorable balance of systemic pharmacokinetics and bone binding, providing the highest bone/liver biodistribution ratio among formulations tested. In an intracardiac tumor cell injection model of breast cancer bone metastasis, treatment with the lead candidate GANT58-BTNP formulation decreased tumor-associated bone lesion area 3-fold and increased bone volume fraction in the tibiae of the mice 2.5-fold. Aln conferred bone targeting to the GANT58-BTNPs, which increased GANT58 concentration in the tumor-associated bone relative to untargeted NPs, and also provided benefit through the direct antiresorptive therapeutic function of Aln. The dual benefit of the Aln in the BTNPs was supported by the observations that drug-free Aln-containing BTNPs improved bone volume fraction in bone-tumor-bearing mice, while GANT58-BTNPs created better therapeutic outcomes than both unloaded BTNPs and GANT58-loaded untargeted NPs. These findings suggest GANT58-BTNPs have potential to potently inhibit tumor-driven osteoclast activation and resultant bone destruction in patients with bone-associated tumor metastases.
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Affiliation(s)
- Joseph Vanderburgh
- Department of Chemical and Biomolecular Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
- Center for Bone Biology , Vanderbilt University Medical Center , Nashville , Tennessee 37232 , United States
- Department of Veterans Affairs , Tennessee Valley Healthcare System , Nashville , Tennessee 37212 , United States
| | - Jordan L Hill
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
| | - Mukesh K Gupta
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
| | - Kristin A Kwakwa
- Center for Bone Biology , Vanderbilt University Medical Center , Nashville , Tennessee 37232 , United States
- Department of Veterans Affairs , Tennessee Valley Healthcare System , Nashville , Tennessee 37212 , United States
- Program in Cancer Biology , Vanderbilt University , Nashville , Tennessee 37232 , United States
| | - Sean K Wang
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
| | - Kathleen Moyer
- Interdisciplinary Graduate Program in Materials Science , Vanderbilt University , Nashville , Tennessee 37232 , United States
| | - Sean K Bedingfield
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
| | - Alyssa R Merkel
- Center for Bone Biology , Vanderbilt University Medical Center , Nashville , Tennessee 37232 , United States
- Department of Veterans Affairs , Tennessee Valley Healthcare System , Nashville , Tennessee 37212 , United States
| | - Richard d'Arcy
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
| | - Scott A Guelcher
- Department of Chemical and Biomolecular Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
- Center for Bone Biology , Vanderbilt University Medical Center , Nashville , Tennessee 37232 , United States
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
| | - Julie A Rhoades
- Center for Bone Biology , Vanderbilt University Medical Center , Nashville , Tennessee 37232 , United States
- Department of Veterans Affairs , Tennessee Valley Healthcare System , Nashville , Tennessee 37212 , United States
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
- Department of Medicine, Division of Clinical Pharmacology , Vanderbilt University Medical Center , Nashville , Tennessee 37232 , United States
| | - Craig L Duvall
- Department of Biomedical Engineering , Vanderbilt University , Nashville , Tennessee 37235 , United States
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28
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Vanderburgh JP, Kwakwa KA, Werfel TA, Merkel AR, Gupta MK, Johnson RW, Guelcher SA, Duvall CL, Rhoades JA. Systemic delivery of a Gli inhibitor via polymeric nanocarriers inhibits tumor-induced bone disease. J Control Release 2019; 311-312:257-272. [PMID: 31494183 DOI: 10.1016/j.jconrel.2019.08.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/22/2019] [Accepted: 08/31/2019] [Indexed: 12/22/2022]
Abstract
Solid tumors frequently metastasize to bone and induce bone destruction leading to severe pain, fractures, and other skeletal-related events (SREs). Osteoclast inhibitors such as bisphosphonates delay SREs but do not prevent skeletal complications or improve overall survival. Because bisphosphonates can cause adverse side effects and are contraindicated for some patients, we sought an alternative therapy to reduce tumor-associated bone destruction. Our previous studies identified the transcription factor Gli2 as a key regulator of parathyroid hormone-related protein (PTHrP), which is produced by bone metastatic tumor cells to promote osteoclast-mediated bone destruction. In this study, we tested the treatment effect of a Gli antagonist GANT58, which inhibits Gli2 nuclear translocation and PTHrP expression in tumor cells. In initial testing, GANT58 did not have efficacy in vivo due to its low water solubility and poor bioavailability. We therefore developed a micellar nanoparticle (NP) to encapsulate and colloidally stabilize GANT58, providing a fully aqueous, intravenously injectable formulation based on the polymer poly(propylene sulfide)135-b-poly[(oligoethylene glycol)9 methyl ether acrylate]17 (PPS135-b-POEGA17). POEGA forms the hydrophilic NP surface while PPS forms the hydrophobic NP core that sequesters GANT58. In response to reactive oxygen species (ROS), PPS becomes hydrophilic and degrades to enable drug release. In an intratibial model of breast cancer bone metastasis, treatment with GANT58-NPs decreased bone lesion area by 49% (p<.01) and lesion number by 38% (p<.05) and resulted in a 2.5-fold increase in trabecular bone volume (p<.001). Similar results were observed in intracardiac and intratibial models of breast and lung cancer bone metastasis, respectively. Importantly, GANT58-NPs reduced tumor cell proliferation but did not alter mesenchymal stem cell proliferation or osteoblast mineralization in vitro, nor was there evidence of cytotoxicity after repeated in vivo treatment. Thus, inhibition of Gli2 using GANT58-NPs is a potential therapy to reduce bone destruction that should be considered for further testing and development toward clinical translation.
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Affiliation(s)
- Joseph P Vanderburgh
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN 37235, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, USA
| | - Kristin A Kwakwa
- Program in Cancer Biology, Vanderbilt University, Nashville, TN 37232, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, USA
| | - Thomas A Werfel
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Alyssa R Merkel
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, USA; Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Mukesh K Gupta
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Rachelle W Johnson
- Program in Cancer Biology, Vanderbilt University, Nashville, TN 37232, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Scott A Guelcher
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN 37235, USA; Program in Cancer Biology, Vanderbilt University, Nashville, TN 37232, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Craig L Duvall
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Julie A Rhoades
- Program in Cancer Biology, Vanderbilt University, Nashville, TN 37232, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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29
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Geranylgeraniol (GGOH) as a Mevalonate Pathway Activator in the Rescue of Bone Cells Treated with Zoledronic Acid: An In Vitro Study. Stem Cells Int 2019; 2019:4351327. [PMID: 30728841 PMCID: PMC6343170 DOI: 10.1155/2019/4351327] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/12/2018] [Accepted: 11/28/2018] [Indexed: 01/30/2023] Open
Abstract
Bisphosphonates (BPs) are the keystone to treat bone disorders. Despite the great benefits of BPs, medication-related osteonecrosis of the jaw (MRONJ) arouse as a potential side effect. Nitrogen-containing BPs (N-BPs) as zoledronate (ZA) act by the inhibition of specific enzymes of the mevalonate pathway resulting in altering protein prenylation which is required for the posttranslational maturation of the small GTP-binding proteins. Geranylgeraniol (GGOH) is an intermediate product in the mevalonate pathway having positive effects on different cell types treated with BPs by salvaging protein prenylation improving cell viability and proliferation in tissue regeneration, thus overcoming N-BP-induced apoptosis. Here, the effect of different concentrations of zoledronate (ZA) on the bone cells has been investigated by cell viability assay, live/dead staining, and western blot to understand if GGOH was able to rescue bone cells and levels of statistical significance were indicated at ∗P < 0.05, ∗∗P < 0.01, ∗∗∗P < 0.001, and ∗∗∗∗P < 0.0001. Although the high concentration of ZA had significantly decreased the cell viability in the bone cells, GGOH reversed the action of ZA on the cells while at very high concentration; it caused severe reduction in the cell viability. Rap1A, a member of the GTPases family, was expressed in the negative controls but was absent in cells treated with high concentrations of ZA. The addition of GGOH had increased the expression of Rap1A up to a certain limit. The experiments proved that ZA acts directly on the mevalonate pathway and protein prenylation and that GGOH could be applied as a future local therapy to MRONJ.
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30
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Huang KC, Huang TW, Chuang PY, Yang TY, Chang SF. Zoledronate induces cell cycle arrest and differentiation by upregulating p21 in mouse MC3T3-E1 preosteoblasts. Int J Med Sci 2019; 16:751-756. [PMID: 31217743 PMCID: PMC6566742 DOI: 10.7150/ijms.32612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 03/23/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Increasing research has recently been focused on the supplementary use of drugs such as bisphosphonates that are known to influence bone turnover to prevent and treat periprosthetic bone loss and subsequent implant loosening following total joint replacements. However, there are still concerns about the conflicting effects of bisphosphonate treatment on osteoblastic bone formation in the literature. Methods: In this study, we investigate the role of zoledronate (ZOL) in regulating cell cycle distribution and differentiation in mouse MC3T3-E1 preosteoblasts and also explore the mechanism underlying this effect of ZOL. We examined the expression levels of osteocalcin (OCN) by quantitative polymerase chain reaction (qPCR), the total amount of CDK6, p21 and p27 proteins by Western blot analysis, and the cell cycle distribution by flow cytometric analysis in mouse MC3T3-E1 preosteoblasts to evaluate the effect of ZOL. Small interfering RNAs (siRNAs) were used to assess the individual contributions of genes to specific osteoblast phenotypes. Results: In addition to increased OCN expression, we found that ZOL treatment induces the G0/G1 arrest and results in the increase of p21 and p27 expressions and decrease of CDK6 expression in mouse MC3T3-E1 preosteoblasts. Both p21 and p27 mediates ZOL-induced cell cycle exit; however, p21, but not p27, is responsible for the increase of ZOL-induced OCN expression in these cells. Conclusions: These results endorse that ZOL might have an anabolic effect on osteoblasts. The CDK inhibitor p21 plays a key role in regulating osteoblast differentiation by controlling proliferation-related events in mouse MC3T3-E1 preosteoblasts.
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Affiliation(s)
- Kuo-Chin Huang
- Department of Orthopaedic Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan.,Chang Gung University College of Medicine, Taoyuan City 33302, Taiwan
| | - Tsan-Wen Huang
- Department of Orthopaedic Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
| | - Po-Yao Chuang
- Department of Orthopaedic Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
| | - Tien-Yu Yang
- Department of Orthopaedic Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
| | - Shun-Fu Chang
- Department of Medical Research and Development, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
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31
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Holtmann H, Lommen J, Kübler NR, Sproll C, Rana M, Karschuck P, Depprich R. Pathogenesis of medication-related osteonecrosis of the jaw: a comparative study of in vivo and in vitro trials. J Int Med Res 2018; 46:4277-4296. [PMID: 30091399 PMCID: PMC6166332 DOI: 10.1177/0300060518788987] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/25/2018] [Indexed: 12/20/2022] Open
Abstract
Objective This study was performed to determine whether the results of prevailing in vivo and in vitro studies offer a reliable model for investigation of medication-related osteonecrosis of the jaw (MRONJ). Methods Embase, Medline, and the Cochrane Library were searched for articles published from September 2003 to June 2017 involving experimental approaches to the pathogenesis of MRONJ. In vivo and in vitro trials were analyzed with respect to the scientific question, study design, methodology, and results. Results Of 139 studies, 87, 46, and 6 conducted in vivo, in vitro, and both in vivo and in vitro experiments, respectively. Rats, mice, dogs, minipigs, sheep, and rabbits were the preferred animal models used. Osteoblasts, osteoclasts, fibroblasts, keratinocytes, macrophages, and human umbilical vein endothelial cells were the preferred cell types. Zoledronate, alendronate, ibandronate, and risedronate were the most frequent bisphosphonates used. MRONJ was most reliably induced in minipigs because of the close relationship with human bone physiology. In vitro studies showed that reduced viability, growth, and migration of cells in the bone and soft tissues were causative for MRONJ. Other than exposed jawbone after tooth extraction, no reliable cofactors were found. Conclusion The minipig is the most suitable animal model for MRONJ.
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Affiliation(s)
- Henrik Holtmann
- Department of Oral and Maxillofacial Surgery,
Plastic Surgery of the Head and Neck, Heinrich-Heine-University, Düsseldorf,
Germany
| | - Julian Lommen
- Department of Oral and Maxillofacial Surgery,
Plastic Surgery of the Head and Neck, Heinrich-Heine-University, Düsseldorf,
Germany
| | - Norbert R. Kübler
- Department of Oral and Maxillofacial Surgery,
Plastic Surgery of the Head and Neck, Heinrich-Heine-University, Düsseldorf,
Germany
| | - Christoph Sproll
- Department of Oral and Maxillofacial Surgery,
Plastic Surgery of the Head and Neck, Heinrich-Heine-University, Düsseldorf,
Germany
| | - Majeed Rana
- Department of Oral and Maxillofacial Surgery,
Plastic Surgery of the Head and Neck, Heinrich-Heine-University, Düsseldorf,
Germany
| | - Patrick Karschuck
- Department of Oral and Maxillofacial Surgery,
Plastic Surgery of the Head and Neck, Heinrich-Heine-University, Düsseldorf,
Germany
| | - Rita Depprich
- Department of Oral and Maxillofacial Surgery,
Plastic Surgery of the Head and Neck, Heinrich-Heine-University, Düsseldorf,
Germany
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Cross-Sectional Study of four Serological Bone Turnover Markers for the Risk Assessment of Medication-Related Osteonecrosis of the Jaw. J Craniofac Surg 2018; 29:e137-e140. [PMID: 29215447 DOI: 10.1097/scs.0000000000004224] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Despite the benefits related to the use of bisphosphonates and denosumab, medication-related osteonecrosis of the jaw (MRONJ) is a serious complication. The purpose of this study was to investigate the utility of 4 biochemical markers including serum c-terminal telopeptide cross-link of type I collagen (s-CTX), serum osteocalcin (s-OC), serum parathormon (s-PTH), and serum bone-specific alkaline phosphatase (s-BAP) as useful clinical tools to help assess the risk for MRONJ prior to invasive oral surgery. MATERIALS AND METHODS Twenty patients diagnosed with MRONJ and 20 controls who have been on antiresorptive therapies with no occurrence of MRONJ were included in this 2-arm cross-sectional study. The s-CTX, s-OC, s-PTH, and s-BAP values were measured. Mann-Whitney U test compared the s-CTX, s-OC, s-PTH, and s-BAP values of the MRONJ group and the controls (P < 0.05). RESULTS Lower values were observed in the MRONJ group compared with the control group for s-CTX (130.00 pg/mL versus 230.0 pg/mL; P = 0.12) and for s-OC (10.6 ng/mL versus 14.80 ng/mL; P = 0.051) both without significance and for s-BAP (0.23 μkat/L versus 0.31 μkat/L; P = 0.002) with significance. By contrast, the median s-PTH value of the MRONJ group was higher (30.65 ng/L versus 25.50 ng/L; P = 0.89), but without significance. CONCLUSIONS The evaluation of the 4 biochemical markers showed that only the value of s-BAP was significantly decreased in the MRONJ patients compared with the controls. Presently, because of the lack of evidence, a routine check prior to oral surgery for the risk assessment of MRONJ cannot be recommended.
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Statkievicz C, Toro LF, de Mello-Neto JM, de Sá DP, Casatti CA, Issa JPM, Cintra LTA, de Almeida JM, Nagata MJH, Garcia VG, Theodoro LH, Ervolino E. Photomodulation multiple sessions as a promising preventive therapy for medication-related osteonecrosis of the jaws after tooth extraction in rats. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2018; 184:7-17. [DOI: 10.1016/j.jphotobiol.2018.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/12/2018] [Accepted: 05/03/2018] [Indexed: 12/16/2022]
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Cha M, Lee KM, Lee JH. Positive Effects of Bisphosphonates on Osteogenic Differentiation in Patient-Derived Mesenchymal Stem Cells for the Treatment of Osteoporosis. Tissue Eng Regen Med 2018; 15:467-475. [PMID: 30603570 DOI: 10.1007/s13770-018-0127-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Recent evidence from in vitro and in vivo studies indicates that bisphosphonates may promote osteoblastic bone formation and potently inhibit osteoclast activity. However, little is known about the potential effect of bisphosphonates on the recruitment of osteoblastic precursors from patient-derived bone marrow stromal cells due to difficulties in accessing human bone marrow from healthy and disease subjects. METHODS In this study, we evaluated the potential of using FDA-approved and clinically utilized bisphosphonates such as alendronate, ibandronate, and zoledronate to enhance the development of bone forming osteoblasts from osteoporosis patient- and healthy-person derived hBMSCs (op-MSCs and hp-MSCs, respectively). hBMSCs were obtained from postmenopausal women without endocrine diseases or receiving hormone replacement therapy. Cells were treated with or without a bisphosphonate (alendronate, ibandronate, and zoledronate) and analyzed over 21 days of culture. RESULTS hBMSC from osteoporosis-patient with bisphosphonates treatment demonstrated a significant increase in Alizarin red staining after 7 days compared to that from healthy-person. Calcium contents and alkaline phosphatase (ALP) enzyme activity also demonstrated an increased propensity in hMSCs from osteoporosis-patient compared to those from healthy-person, although there were inter-individual variations. Gene expression levels varied among different donors. There were no significant differences in the effect on the osteoblastic differentiation of hBMSCs among alendronate, ibandronate, and zoledronate. Statistical significance in the osteoblastic differentiation of hBMSCs between the positive control group cultured in osteogenic medium alone and groups cultured in osteogenic medium supplemented with bisphosphonate was not shown either. These results might be due to various cell types of hBMSCs from individual clinical patients and concentrations of bisphosphonate used. CONCLUSION Our study using a clinically relevant in vitro model suggests that bisphosphonate treatment is more effective for patients with osteoporosis than its preventive effect for healthy person. In addition, patient-specific responses to bisphosphonates should be considered rather than bisphosphonate type prior to prescription. Further investigations are needed to determine how bisphosphonates influence hBMSCs function to mediate bone quality and turnover in osteoporotic patients. Such studies can generate novel approaches to treat age-related osteoporotic bone loss.
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Affiliation(s)
- Misun Cha
- 1SMG-SNU Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061 South Korea.,Research Institute of Biotechnology, Medifab Co, Ltd., 70, Dusan-ro, Doksan-dong, Geumcheon-gu, Seoul, 08584 South Korea
| | - Kyung Mee Lee
- 3Department of Orthopedic Surgery, College of Medicine, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, 03080 South Korea
| | - Jae Hyup Lee
- 1SMG-SNU Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061 South Korea.,3Department of Orthopedic Surgery, College of Medicine, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, 03080 South Korea
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Shao Y, Hernandez-Buquer S, Childress P, Stayrook KR, Alvarez MB, Davis H, Plotkin LI, He Y, Condon KW, Burr DB, Warden SJ, Robling AG, Yang FC, Wek RC, Allen MR, Bidwell JP. Improving Combination Osteoporosis Therapy in a Preclinical Model of Heightened Osteoanabolism. Endocrinology 2017; 158:2722-2740. [PMID: 28637206 PMCID: PMC5659666 DOI: 10.1210/en.2017-00355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/15/2017] [Indexed: 11/19/2022]
Abstract
Combining anticatabolic agents with parathyroid hormone (PTH) to enhance bone mass has yielded mixed results in osteoporosis patients. Toward the goal of enhancing the efficacy of these regimens, we tested their utility in combination with loss of the transcription factor Nmp4 because disabling this gene amplifies PTH-induced increases in trabecular bone in mice by boosting osteoblast secretory activity. We addressed whether combining a sustained anabolic response with an anticatabolic results in superior bone acquisition compared with PTH monotherapy. Additionally, we inquired whether Nmp4 interferes with anticatabolic efficacy. Wild-type and Nmp4-/- mice were ovariectomized at 12 weeks of age, followed by therapy regimens, administered from 16 to 24 weeks, and included individually or combined PTH, alendronate (ALN), zoledronate (ZOL), and raloxifene (RAL). Anabolic therapeutic efficacy generally corresponded with PTH + RAL = PTH + ZOL > PTH + ALN = PTH > vehicle control. Loss of Nmp4 enhanced femoral trabecular bone increases under PTH + RAL and PTH + ZOL. RAL and ZOL promoted bone restoration, but unexpectedly, loss of Nmp4 boosted RAL-induced increases in femoral trabecular bone. The combination of PTH, RAL, and loss of Nmp4 significantly increased bone marrow osteoprogenitor number, but did not affect adipogenesis or osteoclastogenesis. RAL, but not ZOL, increased osteoprogenitors in both genotypes. Nmp4 status did not influence bone serum marker responses to treatments, but Nmp4-/- mice as a group showed elevated levels of the bone formation marker osteocalcin. We conclude that the heightened osteoanabolism of the Nmp4-/- skeleton enhances the effectiveness of diverse osteoporosis treatments, in part by increasing hyperanabolic osteoprogenitors. Nmp4 provides a promising target pathway for identifying barriers to pharmacologically induced bone formation.
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Affiliation(s)
- Yu Shao
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Selene Hernandez-Buquer
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Paul Childress
- Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Keith R. Stayrook
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Marta B. Alvarez
- Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Hannah Davis
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Lilian I. Plotkin
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Yongzheng He
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana 46202
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Keith W. Condon
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - David B. Burr
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Stuart J. Warden
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana 46202
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana 46202
| | - Alexander G. Robling
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Feng-Chun Yang
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, Florida 33136
| | - Ronald C. Wek
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Matthew R. Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
- Richard A. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana 46202
| | - Joseph P. Bidwell
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana 46202
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
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Jacobs C, Schramm S, Dirks I, Walter C, Pabst A, Meila D, Jacobs C, Wehrbein H. Mechanical loading increases pro-inflammatory effects of nitrogen-containing bisphosphonate in human periodontal fibroblasts. Clin Oral Investig 2017; 22:901-907. [PMID: 28688092 DOI: 10.1007/s00784-017-2168-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES There is increasing evidence that inflammation and biomechanical loading can influence the effects of bisphosphonates (BP). The aim of this study was to investigate the influence of tensile strain application combined with IL-1ß and clodronate or zoledronate on human periodontal ligament fibroblasts (HPdLF) in vitro. MATERIALS AND METHODS HPdLF were cultured with 10 nM IL-1ß and 5 μM clodronate or zoledronate for 48 h. Cells were applied to cyclic tensile strain (CTS; 3% elongation) for 12 h in vitro. Cell number was analyzed directly after CTS by MTT assay. Gene expression of receptor activator of cyclooxygenase-2 (COX-2) was investigated using real-time PCR. MMP-8, TIMP-1, and PGE2 were measured by ELISA. Statistics were performed with SPSS (ANOVA, p < 0.05). RESULTS Zoledronate reduced the cell number of HPdLF (60.3 vs. 100%), which was significant when combined with IL-1ß. Combined with 3% CTS, this effect was voided and cell number increased over the level of the control cells. IL-1ß led to a 10-fold increase of COX-2 gene expression. Combined with CTS and zoledronate, this increase was enhanced to a gene expression 70-fold that of control cells with related PGE2 synthesis. Clodronate neither reduce the cell number nor enhanced the COX-2 gene expression. CTS increased MMP-8 protein synthesis. Combined with BP, this increase was voided. TIMP-1 protein synthesis was increased at all conditions under CTS. CONCLUSIONS Mechanical loading might activate cell metabolism and abolish BP- and inflammation-induced reduction of viability. Combination of mechanical loading, inflammation, and nitrogen-containing bisphosphonates can cause pro-inflammatory effects. CLINICAL RELEVANCE Periodontal inflammation should be treated initially before BP intake to prevent decreased cell viability of the periodontium and increased inflammation, which might be enhanced by the addition of mastication forces.
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Affiliation(s)
- Collin Jacobs
- Department of Orthodontics, Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Sabrina Schramm
- Department of Orthodontics, Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Isabelle Dirks
- Department of Orthodontics, Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Christian Walter
- Department of Oral and Maxillofacial Surgery, Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Dan Meila
- Department of Radiology, MH-Hannover, Carl-Neuberg-Str. 1, Hannover, Germany
| | - Cornelius Jacobs
- Department of Traumatology, Medical Center, University of Bonn, Sigmund-Freud-Str. 25, Bonn, Germany
| | - Heinrich Wehrbein
- Department of Orthodontics, Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany
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Exposto CR, Oz U, Callard JS, Allen MJ, Khurana H, Atri AD, Mo X, Fernandez SA, Tatakis DN, Edmonds K, Westgate PM, Huja SS. Oncologic doses of zoledronic acid induce site specific suppression of bone modelling in rice rats. Orthod Craniofac Res 2017. [PMID: 28643933 DOI: 10.1111/ocr.12164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the effect of zoledronic acid (ZOL) on cortical bone modelling and healing of extraction sockets in the jaw bones of a rodent model. We hypothesized ZOL suppresses both the bone formation in the modelling mode in the jaw bones and alters the extraction site healing. MATERIAL & METHODS Rice rats were administered saline solution and two dose regimens of ZOL: 0.1 mg/kg, twice a week, for 4 weeks (n=17, saline=8 & ZOL=9) and a higher dose of 0.4 mg/kg, weekly, for 9 weeks (n=30, saline=15 & ZOL=15). Two pairs of fluorochrome bone labels were administered. Extraction of maxillary teeth was performed in maxilla. Mineral apposition rate, mineralizing surface and bone formation rate (BFR) were quantified on periodontal (PDL), alveolar and basal bone surfaces, and in the trabecular bone of proximal tibia. Bone volume (BV) was evaluated at extraction sockets. Multivariate Gaussian models were used to account for repeated measurements, and analyzes were conducted in SAS V9.3. RESULTS ZOL suppressed bone modelling (BFR/BS) at the PDL surfaces in the mandible (P<.05), but its effect was not significant at the periosteal surfaces of both jaws. BV for the healing sockets of ZOL treated animals was not significantly different (P=.07) compared to the saline group. ZOL suppressive effect was higher in the tibia compared to the jaws. CONCLUSION ZOL severely suppresses coupled remodelling in the tibia, and the suppression of bone formation in the modelling mode in the jaws demonstrates the site specific effects of ZOL in rice rats.
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Affiliation(s)
- C R Exposto
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - U Oz
- Department of Orthodontics, Near East University, North Nicosia, Northern Cyprus
| | - J S Callard
- Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - M J Allen
- Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - H Khurana
- Division of Orthodontics, The Ohio State University, Columbus, OH, USA
| | - A D' Atri
- Division of Orthodontics, The Ohio State University, Columbus, OH, USA
| | - X Mo
- Biostatistics, The Ohio State University, Columbus, OH, USA
| | - S A Fernandez
- Biostatistics, The Ohio State University, Columbus, OH, USA
| | - D N Tatakis
- Periodontics, The Ohio State University, Columbus, OH, USA
| | - K Edmonds
- School of Natural Sciences, Indiana University Southeast, New Albany, IN, USA
| | - P M Westgate
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - S S Huja
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Ma JH, Guo WS, Li ZR, Wang BL. Local Administration of Bisphosphonate-soaked Hydroxyapatite for the Treatment of Osteonecrosis of the Femoral Head in Rabbit. Chin Med J (Engl) 2017; 129:2559-2566. [PMID: 27779162 PMCID: PMC5125334 DOI: 10.4103/0366-6999.192768] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Systemic administration of bisphosphonates has shown promising results in the treatment of osteonecrosis of the femoral head (ONFH). However, few studies have evaluated the efficacy of local zoledronate (ZOL) administration in the treatment of ONFH. The purpose of this study was to investigate whether local administration of bisphosphonate-soaked hydroxyapatite (HA) could improve bone healing in an experimental rabbit model of ONFH. Methods: This experimental study was conducted between October 2014 and June 2015. Forty-five rabbits underwent simulated ONFH surgery. Immediately following surgery, they were divided into three groups: model (untreated, n = 15), HA (treated with HA alone, n = 15), and HA + ZOL (treated with HA soaked in a low-dose ZOL solution, n = 15). Histological, immunohistochemical, and quantitative analyses were performed to evaluate bone formation and resorption 2, 4, and 8 weeks after surgery. Results: Gross bone matrix and hematopoietic tissue formation were observed in the HA + ZOL group 4 weeks after surgery. The immunohistochemical staining intensities for 5-bromodeoxyuridine, runt-related transcription factor 2, osteocalcin, osteopontin, and osteoprotegerin were significantly higher in the HA + ZOL group than that in the model (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.018, respectively) and HA groups (P = 0.003, P = 0.049, P < 0.001, P = 0.020, and P = 0.019, respectively), whereas receptor activator of the nuclear factor-κB ligand staining intensity was significantly lower in the HA + ZOL group than that in the model and HA groups (P = 0.029 and P = 0.015, respectively) 4 weeks after surgery. No significant differences in bone formation or bone resorption marker expression were found between the three groups 2 or 8 weeks after surgery (P > 0.05). Conclusions: Local administration of HA soaked in a low-dose ZOL solution increased new bone formation while inhibiting bone resorption in an animal model of ONFH, which might provide new evidence for joint-preserving surgery in the treatment of ONFH.
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Affiliation(s)
- Jin-Hui Ma
- Department of Bone and Joint Surgery, Peking University China Japan Friendship School of Clinical Medicine, Beijing 100029, China
| | - Wan-Shou Guo
- Department of Bone and Joint Surgery, Peking University China Japan Friendship School of Clinical Medicine, Beijing 100029; Department of Bone and Joint Surgery, Center for Osteonecrosis and Joint Preserving and Reconstruction, China Japan Friendship Hospital, Beijing 100029, China
| | - Zi-Rong Li
- Department of Bone and Joint Surgery, Peking University China Japan Friendship School of Clinical Medicine, Beijing 100029; Department of Bone and Joint Surgery, Center for Osteonecrosis and Joint Preserving and Reconstruction, China Japan Friendship Hospital, Beijing 100029, China
| | - Bai-Liang Wang
- Department of Bone and Joint Surgery, Peking University China Japan Friendship School of Clinical Medicine, Beijing 100029; Department of Bone and Joint Surgery, Center for Osteonecrosis and Joint Preserving and Reconstruction, China Japan Friendship Hospital, Beijing 100029, China
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Vermeer J, Renders G, van Duin MA, Jansen I, Bakker LF, Kroon SA, de Vries TJ, Everts V. Bone-site-specific responses to zoledronic acid. Oral Dis 2016; 23:126-133. [PMID: 27706930 DOI: 10.1111/odi.12587] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 08/14/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Bisphosphonates are widely used to treat bone diseases such as osteoporosis. However, they may cause osteonecrosis of the jaw. Here, we investigated whether in vivo exposure to bisphosphonates has a different effect on long bone and jaw osteoclasts, and on the turnover of these different bones. MATERIALS AND METHODS Zoledronic acid (0.5 mg kg-1 weekly) was administered intraperitoneally to 3-month-old female mice for up to 6 months. The effects on the number of osteoclasts, bone mineralization and bone formation were measured in the long bones and in the jaw. RESULTS Long-term treatment with zoledronic acid reduced the number of jaw bone marrow cells, without affecting the number of long bone marrow cells. Zoledronic acid treatment did not affect the number of osteoclasts in vivo. Yet, the bisphosphonate increased bone volume and mineral density of both long bone and jaw. Interestingly, 6 months of treatment suppressed bone formation in the long bones without affecting the jaw. Unexpectedly, we showed that bisphosphonates can cause molar root resorption, mediated by active osteoclasts. CONCLUSIONS Our findings provide more insight into bone-site-specific effects of bisphosphonates and into the aetiology of osteonecrosis of the jaw. We demonstrated that bisphosphonates can stimulate osteoclast activity at the molar roots.
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Affiliation(s)
- Jaf Vermeer
- Department of Oral Cell Biology & Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Gap Renders
- Department of Oral Cell Biology & Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - M A van Duin
- Department of Oral Cell Biology & Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Idc Jansen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - L F Bakker
- Department of Oral Cell Biology & Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - S A Kroon
- Department of Oral Cell Biology & Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - T J de Vries
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - V Everts
- Department of Oral Cell Biology & Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
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Chkourko Gusky H, Diedrich J, MacDougald OA, Podgorski I. Omentum and bone marrow: how adipocyte-rich organs create tumour microenvironments conducive for metastatic progression. Obes Rev 2016; 17:1015-1029. [PMID: 27432523 PMCID: PMC5056818 DOI: 10.1111/obr.12450] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 12/30/2022]
Abstract
A number of clinical studies have linked adiposity with increased cancer incidence, progression and metastasis, and adipose tissue is now being credited with both systemic and local effects on tumour development and survival. Adipocytes, a major component of benign adipose tissue, represent a significant source of lipids, cytokines and adipokines, and their presence in the tumour microenvironment substantially affects cellular trafficking, signalling and metabolism. Cancers that have a high predisposition to metastasize to the adipocyte-rich host organs are likely to be particularly affected by the presence of adipocytes. Although our understanding of how adipocytes influence tumour progression has grown significantly over the last several years, the mechanisms by which adipocytes regulate the metastatic niche are not well-understood. In this review, we focus on the omentum, a visceral white adipose tissue depot, and the bone, a depot for marrow adipose tissue, as two distinct adipocyte-rich organs that share common characteristic: they are both sites of significant metastatic growth. We highlight major differences in origin and function of each of these adipose depots and reveal potential common characteristics that make them environments that are attractive and conducive to secondary tumour growth. Special attention is given to how omental and marrow adipocytes modulate the tumour microenvironment by promoting angiogenesis, affecting immune cells and altering metabolism to support growth and survival of metastatic cancer cells.
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Affiliation(s)
- H Chkourko Gusky
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, USA
| | - J Diedrich
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - O A MacDougald
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - I Podgorski
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, USA. .,Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA.
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Abstract
A known complication that can occur in patients using bisphosphonates (BPs) is osteonecrosis of the jaw (ONJ). ONJ features bone exposure that may be associated with severe pain, swelling, local infection, and pathological fracture of the jaw. Current literature indicates that a complex combination of factors is necessary to induce ONJ. Several hypotheses about the pathophysiology of ONJ were previously reported. Here, we review these hypotheses and introduce new ideas and suggestions on this topic, focusing on bone site-specific cells, and the effect that BPs and other anti-resorptive drugs have on those cells. Gaining more insight into bone site-specific effects may help to better understand the pathogenesis ONJ, and contribute to the development of new bone site-specific anti-resorptive drugs.
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Affiliation(s)
- Jenny A F Vermeer
- Department of Oral Cell Biology and Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Greetje A P Renders
- Department of Oral Cell Biology and Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Vincent Everts
- Department of Oral Cell Biology and Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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Córdova LA, Guilbaud F, Amiaud J, Battaglia S, Charrier C, Lezot F, Piot B, Redini F, Heymann D. Severe compromise of preosteoblasts in a surgical mouse model of bisphosphonate-associated osteonecrosis of the jaw. J Craniomaxillofac Surg 2016; 44:1387-94. [PMID: 27519659 DOI: 10.1016/j.jcms.2016.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 06/06/2016] [Accepted: 07/15/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The effect of amino-bisphosphonates on osteoblastic lineage and its potential contribution to the pathogenesis of bisphosphonate-associated osteonecrosis of the jaw (BONJ) remain controversial. We assessed the effects of zoledronic acid (ZOL) on bone and vascular cells of the alveolar socket using a mouse model of BONJ. MATERIAL AND METHODS Thirty-two mice were treated twice a week with either 100 μg/kg of ZOL or saline for 12 weeks. The first left maxillary molar was extracted at the third week. Alveolar sockets were assessed at both 3 weeks (intermediate) and 9 weeks (long-term) after molar extraction by semi-quantitative histomorphometry for empty lacunae, preosteoblasts (Osterix), osteoclasts (TRAP), and pericyte-like cells (CD146). Also, the bone microarchitecture was assessed by micro-CT. RESULTS Osteonecrotic-like lesions were observed in 21% of mice. Moreover, a decreased number of preosteoblasts contrasted with the increased number of osteoclasts at both time points. In addition, osteoclasts display multinucleation and detachment from the endosteal surface. Furthermore, the number of pericyte-like cells increased at the intermediate time point. The alveolar bone mass increased exclusively with long-term ZOL treatment. CONCLUSION The severe imbalance between bone-forming cells and bone-resorbing cells shown in this study could contribute to the pathogenesis of BONJ.
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Affiliation(s)
- Luis A Córdova
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; Department of Oral and Maxillofacial Surgery, San Borja Arriarán University Hospital - Faculty of Dentistry, University of Chile, Sergio Livingstone Polhammer 943, Independencia, Santiago, Chile.
| | - Florian Guilbaud
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France.
| | - Jérôme Amiaud
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France.
| | - Séverine Battaglia
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France.
| | - Céline Charrier
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France.
| | - Frédéric Lezot
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France.
| | - Benoît Piot
- Department of Stomatology and Maxillofacial Surgery, Nantes University Hospital, 1 Place Alexis-Ricordeau, 44093, Nantes Cedex 1, France; Nantes University Hospital, 1 Place Alexis-Ricordeau, 44093, Nantes Cedex 1, France.
| | - Françoise Redini
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France.
| | - Dominique Heymann
- INSERM, UMR 957, Equipe Ligue Contre le Cancer 2012, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; University of Nantes, Nantes Atlantique Universities, Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours Laboratory, 1 rue Gaston Veil, Nantes Cedex 1, 44035, Nantes, France; Nantes University Hospital, 1 Place Alexis-Ricordeau, 44093, Nantes Cedex 1, France; Department of Oncology and Metabolism, Medical School, Beech Hill Road, S10 2RX, Sheffield, UK.
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43
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Bagan J, Peydró A, Calvo J, Leopoldo M, Jiménez Y, Bagan L. Medication-related osteonecrosis of the jaw associated with bisphosphonates and denosumab in osteoporosis. Oral Dis 2016; 22:324-9. [PMID: 26818808 DOI: 10.1111/odi.12447] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/05/2016] [Accepted: 01/16/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To describe the clinical characteristics and evolution of our series of medication-related osteonecrosis of the jaws (MRONJ) associated with denosumab in osteoporotic patients. MATERIAL AND METHODS We present 10 new cases of MRONJ in patients receiving denosumab for osteoporosis. We describe the mean doses of denosumab, previous bisphosphonate intake, and the clinical characteristics associated with the osteonecrosis, such as local contributing factors, symptoms, and evolution after treatment. RESULTS The mean number of denosumab doses was 3.4 ± 2.2. In 90% of patients, there was a prior history of oral bisphosphonate intake, with a mean duration of 46.78 ± 25.11 months. The most common local factor was dental extraction (6 cases; 60%), and most cases had necrotic bone exposure (9/10, 90%). Sclerosis of the bone was the most common radiographic finding. Stage 1 was the most common ONM stage, found in 80%. 'Cure' after conservative treatments was obtained in 71.4%. CONCLUSIONS Most of our cases were in the early stages of MRONJ, and the success rate after conservative treatment was high.
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Affiliation(s)
- J Bagan
- Oral Medicine, University of Valencia, Valencia, Spain.,Service of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain
| | - A Peydró
- Oral Medicine, Valencia University, Valencia, Spain
| | - J Calvo
- Rheumatology, University General Hospital, Valencia, Spain
| | - M Leopoldo
- Service of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain
| | - Y Jiménez
- Oral Medicine, Valencia University, Valencia, Spain
| | - L Bagan
- Oral Medicine, Universidad Europea Valencia, Valencia, Spain
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44
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Huang X, Huang S, Guo F, Xu F, Cheng P, Ye Y, Dong Y, Xiang W, Chen A. Dose-dependent inhibitory effects of zoledronic acid on osteoblast viability and function in vitro. Mol Med Rep 2015; 13:613-22. [PMID: 26648136 PMCID: PMC4686069 DOI: 10.3892/mmr.2015.4627] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 06/23/2015] [Indexed: 12/30/2022] Open
Abstract
Zoledronic acid (ZA), which is one of the most potent and efficacious bisphosphonates, has been commonly used in clinical practice for the treatment of various bone disorders. The extensive use of ZA has been associated with increasing occurrence of jaw complications, now known as bisphosphonate-associated osteonecrosis of the jaw (BRONJ). However, the mechanism underlying BRONJ remains to be fully elucidated. The aim of the present study was to investigate the effects of different concentrations of ZA on the MC3T3-E1 murine preosteoblast cell line cells and examine the possible pathogenesis of BRONJ. In the present study, the effect of ZA on the viability, apoptosis, differentiation and maturation of MC3T3-E1 cells, as well as its relevant molecular mechanism, were examined The results of a Cell Counting Kit 8 assay, a flow cytometric Annexin-V/propidium iodide assay and western blot analysis demonstrated that ZA exhibited a significant inhibition of cell viability and induction of apoptosis at concentrations >10 µM. Subsequently, the effect of ZA on cell differentiation at concentrations <1 µM were investigated. In this condition, ZA inhibited bone nodule formation and decreased the activity of alkaline phosphatase. The results of reverse transcription-quantitative polymerase chain reaction and western blot analyses indicated that ZA downregulated the expression levels of the marker genes and proteins associated with osteogenic differentiation. Further investigation revealed that the suppression of differentiation by ZA was associated with decreased expression of bone morphogenetic protein-2 (BMP-2) and downregulation of the phosphorylation levels in the downstream extracellular signal-regulated kinase 1/2 and p38 pathways. These adverse effects of ZA were observed to be concentration-dependent. The results from the present study suggested that ZA at higher concentrations induces cytotoxicity towards osteoblasts, and ZA at lower concentrations suppresses osteoblast differentiation by downregulation of BMP-2. These results assist in further understanding the mechanisms of BRONJ.
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Affiliation(s)
- Xin Huang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Shilong Huang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Fengjin Guo
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Fei Xu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Peng Cheng
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Yaping Ye
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Yonghui Dong
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Wei Xiang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Anmin Chen
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
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45
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Lim HK, Lee HR, Do SH. Stimulation of cannabinoid receptors by using Rubus coreanus extracts to control osteoporosis in aged male rats. Aging Male 2015; 18:124-32. [PMID: 25136745 DOI: 10.3109/13685538.2014.949661] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A substantial proportion of men with prostatic disease have an increased risk of bone loss. In the present study, we investigated the effects of Rubus coreanus Miquel (RCM) extracts on osteoporosis that occurs with N-methyl-N-nitrosourea (MNU)-induced prostatic hyperplasia. The rats used in this study were categorized into groups of healthy controls, rats treated with MNU, and rats treated with MNU and RCM. The rats were sacrificed after 10 weeks of RCM treatment, after which ultrasonography, serum biochemical tests, histopathological examinations, immunohistochemical analysis, and semi-quantitative reverse-transcription polymerase chain reaction analysis were performed. There were no marked differences in body weight gain and the size and weight of the prostate gland between the MNU group and the MNU and RCM group. However, treatment with RCM inhibited osteoclastic osteolysis and reduced dysplastic progress in the prostate gland, as observed by histopathological evaluation and by analyzing changes in the levels of bone regulatory factors. In addition, the group treated with MNU and RCM had higher expression levels of cannabinoid receptors-1, -2, and osteoprotegerin. These results indicate that the anti-osteoporotic effect of RCM in prostatic hyperplasia is attributable to the cannabinoid receptor-related upregulation of osteoblastogenesis and inhibition of prostatic hyperplasia. The results of the present study suggest that treatment with RCM may benefit osteoporotic patients with prostatic disease by simultaneously altering the activation of osteoblasts and osteoclasts.
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Affiliation(s)
- Hae-Kyoung Lim
- Department of Clinical Pathology, College of Veterinary Medicine, Konkuk University , Seoul , Republic of Korea
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46
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47
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Li GW, Xu Z, Chang SX, Zhou L, Wang XY, Nian H, Shi X. Influence of early zoledronic acid administration on bone marrow fat in ovariectomized rats. Endocrinology 2014; 155:4731-8. [PMID: 25243855 DOI: 10.1210/en.2014-1359] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Although the primary target cell of bisphosphonates is the osteoclast, increasing attention is being given to other effector cells influenced by bisphosphonates, such as osteoblasts and marrow adipocytes. Early zoledronic acid (ZA) treatment to ovariectomized (OVX) rats has been found to fully preserve bone microarchitecture over time. However, little is known regarding the influence of ZA on marrow adipogenesis. The purpose of this study was to monitor the ability of early administration of ZA in restoring marrow adiposity in an estrogen-deficient rat model. Thirty female Sprague-Dawley rats were randomly divided into sham-operated (SHAM), OVX + vehicle, and OVX + ZA groups (n=10/group). Dual-energy x-ray absorptiometry and water/fat magnetic resonance imaging were performed at baseline, 6 weeks, and 12 weeks after treatment to assess bone mineral density and marrow fat fraction. Serum biochemical markers, bone remodeling, and marrow adipocyte parameters were analyzed using biochemistry, histomorphometry, and histopathology, respectively. The expression levels of osteoblast, adipocyte, and osteoclast-related genes in bone marrow were assessed using RT-PCR. The OVX rats showed marked bone loss, first detected at 12 weeks, but estrogen deficiency resulted in a remarked increase in marrow fat fraction, first detected at 6 weeks compared with the SHAM rats (all P < .001). Similarly, the OVX rats had a substantially larger percent adipocyte area (+163.0%), mean diameter (+29.5%), and higher density (+57.3%) relative to the SHAM rats. Bone histomorphometry, levels of osteoclast-related gene expression, and a serum resorption marker confirmed that ZA significantly suppressed bone resorption activities. Furthermore, ZA treatment returned adipocyte-related gene expression and marrow adipocyte parameters toward SHAM levels. These data suggest that a single dose of early ZA treatment acts to reverse marrow adipogenesis occurring during estrogen deficiency, which may contribute to its capacity to reduce bone loss.
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Affiliation(s)
- Guan-Wu Li
- Departments of Radiology (G.-W.L., S.-X.C., L.Z., X.-Y.W.), Pharmacy (H.N.), and Gerontology (X.S.), Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; and Medico-Technical Department (Z.X.), Xin-Zhuang Community Health Service Center, Shanghai 201199, China
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48
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Renders GAP, Vermeer JAF, Leung PM, Reynaert F, Prins C, Langenbach GEJ, Everts V. Implications of high-dosage bisphosphonate treatment on bone tissue in the jaw and knee joint. Calcif Tissue Int 2014; 95:436-45. [PMID: 25183284 DOI: 10.1007/s00223-014-9912-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 08/22/2014] [Indexed: 01/06/2023]
Abstract
Bisphosphonates are bone antiresorptive agents traditionally used on a relatively large scale for treatment of bone metabolic diseases and on a smaller scale for bone metastasis treatment. A study on the effects of bisphosphonate treatment on healthy instead of diseased animals will give more insight into the basic mechanisms of bisphosphonates and their effects on different bone sites. We aimed to assess the effect of BP on the mouse knee and jaw joint. Three-month old female C57BL/6 mice were used (twenty-four and eighteen control and experimental group, respectively). At baseline and after treatment with zoledronic acid (ZA) for one, three or six months, we combined bone assessment via µCT and additional histology. Our results showed that, in the knee joint, ZA treatment increased TMD, bone volume, trabecular thickness but did not influence cortical thickness. In both control and ZA group, a higher trabecular TMD compared to cortical TMD was seen. Unseen in the knee joint, ZA treatment in the jaw joint resulted in bone-site specific changes in mineralization; a significant time-dependent higher TMD was evident in the subchondral bone compared to the most distal region of the condyle. MicroCT images revealed the presence of mineral in this region and histology showed that this region did not contain mature bone tissue but cartilage-like tissue. Our data indicate the possibility of site-specific negative side effects, i.e., disturbing normal mandibular development under the influence of bisphosphonate therapy.
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Affiliation(s)
- Greetje A P Renders
- Department of Oral Cell Biology & Functional Anatomy, Academic Center for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands,
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49
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Verzola MHA, Frizzera F, de Oliveira GJPL, Pereira RMR, Rodrigues-Filho UP, Nonaka KO, Orrico SRP. Effects of the long-term administration of alendronate on the mechanical properties of the basal bone and on osseointegration. Clin Oral Implants Res 2014; 26:1466-75. [PMID: 25318821 DOI: 10.1111/clr.12492] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the effect of the long-term administration of alendronate on the mechanical properties of the basal bone and on osseointegration. MATERIAL AND METHODS One hundred and sixty female rats were randomly allocated into two equally sized groups: the control (CTL) group, which received the subcutaneous administration of saline solution, and the alendronate (ALD) group, which received the subcutaneous administration of alendronate (1 mg/kg/week). After 120 days of these therapies, one implant was placed in each rat tibia. Ten animals in each group were euthanized at 5, 10, 15, 20, 25, 30, 45, or 60 days after surgery. The tibias with implants evaluated regarding the removal torque, bone-implant contact (BIC), the bone area fraction occupancy (BAFO), and Ca/P ratio. The femurs were evaluated regarding bone mineral density (BMD) and using mechanical tests to evaluate the maximal force of fracture, stiffness, and tenacity. RESULTS The ALD group presented statistically significant higher BMD (all periods except 15 days), maximal force of fracture (at 20, 30, and 45 days), tenacity (at 10, 20, 30, and 45 days), stiffness (45 days), removal torque (at 20, 25 and 30 days), BIC (at 20 and 60 days), and BAFO (at 20, 30, and 45 days) than the CTL group. No differences were found between the groups regarding the Ca/P ratio. CONCLUSION Previous long-term therapy with alendronate caused an increase in the BMD, maximal force of fracture of the bone without changing the inorganic composition and elastic deformability of this tissue. Furthermore, the ALD therapy enhanced osseointegration.
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Affiliation(s)
| | - Fausto Frizzera
- FOAr-UNESP, Araraquara Dental School, University Estadual Paulista, Araraquara, Brazil.,Integrated College Espírito Santentes, FAESA Dental School, Vitória, Brazil
| | | | - Rosa M R Pereira
- Department of Rheumatology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Keico Okino Nonaka
- Laboratory of Exercise Physiology, Federal University of São Carlos, São Carlos, Brazil
| | - Silvana R P Orrico
- FOAr-UNESP, Araraquara Dental School, University Estadual Paulista, Araraquara, Brazil
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50
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Haider MT, Holen I, Dear TN, Hunter K, Brown HK. Modifying the osteoblastic niche with zoledronic acid in vivo-potential implications for breast cancer bone metastasis. Bone 2014; 66:240-50. [PMID: 24971713 PMCID: PMC4127787 DOI: 10.1016/j.bone.2014.06.023] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/12/2014] [Accepted: 06/18/2014] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Bone metastasis is the most common complication of advanced breast cancer. The associated cancer-induced bone disease is treated with bone-sparing agents like zoledronic acid. Clinical trials have shown that zoledronic acid also reduces breast cancer recurrence in bone; potentially by modifying the bone microenvironment surrounding disseminated tumour cells. We have characterised the early effects of zoledronic acid on key cell types of the metastatic niche in vivo, and investigated how these modify the location of breast tumour cells homing to bone. METHODS Female mice were treated with a single, clinically achievable dose of zoledronic acid (100μg/kg) or PBS. Bone integrity, osteoclast and osteoblast activity and number/mm trabecular bone on 1, 3, 5 and 10days after treatment were assessed using μCT, ELISA (TRAP, PINP) and bone histomorphometry, respectively. The effect of zoledronic acid on osteoblasts was validated in genetically engineered mice with GFP-positive osteoblastic cells. The effects on growth plate cartilage were visualised by toluidine blue staining. For tumour studies, mice were injected i.c. with DID-labelled MDA-MB-231-NW1-luc2 breast cancer cells 5days after zoledronic acid treatment, followed by assessment of tumour cell homing to bone and soft tissues by multiphoton microscopy, flow cytometry and ex vivo cultures. RESULTS As early as 3days after treatment, animals receiving zoledronic acid had significantly increased trabecular bone volume vs. control. This rapid bone effect was reflected in a significant reduction in osteoclast and osteoblast number/mm trabecular bone and reduced bone marker serum levels (day 3-5). These results were confirmed in mice expressing GFP in osteoblastic linage cells. Pre-treatment with zoledronic acid caused accumulation of an extra-cellular matrix in the growth plate associated with a trend towards preferential [1] homing of tumour cells to osteoblast-rich areas of bone, but without affecting the total number of tumour cells. The number of circulating tumour cells was reduced in ZOL treated animals. CONCLUSION A single dose of zoledronic acid caused significant changes in the bone area suggested to contain the metastatic niche. Tumour cells arriving in this modified bone microenvironment appeared to preferentially locate to osteoblast-rich areas, supporting that osteoblasts may be key components of the bone metastasis niche and therefore a potential therapeutic target in breast cancer.
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Affiliation(s)
| | - Ingunn Holen
- CR-UK/YCR Cancer Research Centre, University of Sheffield, Sheffield, UK.
| | - T Neil Dear
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
| | - Keith Hunter
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - Hannah K Brown
- The Mellanby Centre for Bone Research, Department of Human Metabolism, The University of Sheffield, Sheffield, S10 2RX, UK.
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