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Guo M, Tao S, Xiong Y, Dong M, Yan Z, Ye Z, Wu D. Comparative analysis of psychiatric medications and their association with falls and fractures: A systematic review and network meta-analysis. Psychiatry Res 2024; 338:115974. [PMID: 38833938 DOI: 10.1016/j.psychres.2024.115974] [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: 02/01/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
An association between psychiatric medications and falls and fractures in people taking them has been demonstrated, but which class or medication leads to the greatest risk of falls or fractures should be further investigated. The aim of this study was to compare and rank the magnitude of risk of falls and fractures due to different psychiatric medications. Eight databases were searched for this meta-analysis and evaluated using a frequency-based network meta-analysis. The results included a total of 28 papers with 14 medications from 5 major classes, involving 3,467,314 patients. The results showed that atypical antipsychotics were the class of medications with the highest risk of falls, and typical antipsychotics were the class of medications with the highest risk of resulting in fractures. Quetiapine ranked first in the category of 13 medications associated with risk of falls, and class Z drugs ranked first in the category of 6 medications associated with risk of fractures. The available evidence suggests that atypical antipsychotics and typical antipsychotics may be the drugs with the highest risk of falls and fractures, respectively. Quetiapine may be the medication with the highest risk of falls, and class Z drugs may be the medication with the highest risk of fractures.
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Affiliation(s)
- Mengjia Guo
- School of Nursing, Chengdu University of Traditional Chinese Medicine, China
| | - Silu Tao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, China
| | - Yi Xiong
- School of Nursing, Chengdu University of Traditional Chinese Medicine, China
| | - Meijun Dong
- School of Nursing, Chengdu University of Traditional Chinese Medicine, China
| | - Zhangrong Yan
- School of Nursing, Chengdu University of Traditional Chinese Medicine, China
| | - Zixiang Ye
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
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2
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Fricke HP, Hernandez LL. The Serotonergic System and Bone Metabolism During Pregnancy and Lactation and the Implications of SSRI Use on the Maternal-Offspring Dyad. J Mammary Gland Biol Neoplasia 2023; 28:7. [PMID: 37086330 PMCID: PMC10122632 DOI: 10.1007/s10911-023-09535-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
Lactation is a physiological adaptation of the class Mammalia and is a product of over 200 million years of evolution. During lactation, the mammary gland orchestrates bone metabolism via serotonin signaling in order to provide sufficient calcium for the offspring in milk. The role of serotonin in bone remodeling was first discovered over two decades ago, and the interplay between serotonin, lactation, and bone metabolism has been explored in the years following. It is estimated that postpartum depression affects 10-15% of the population, and selective serotonin reuptake inhibitors (SSRI) are often used as the first-line treatment. Studies conducted in humans, nonhuman primates, sheep, and rodents have provided evidence that there are consequences on both parent and offspring when serotonin signaling is disrupted during the peripartal period; however, the long-term consequences of disruption of serotonin signaling via SSRIs during the peripartal period on the maternal and offspring skeleton are not fully known. This review will focus on the relationship between the mammary gland, serotonin, and bone remodeling during the peripartal period and the skeletal consequences of the dysregulation of the serotonergic system in both human and animal studies.
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Affiliation(s)
- Hannah P Fricke
- Animal and Dairy Sciences Department, University of Wisconsin-Madison, Madison, WI, USA
| | - Laura L Hernandez
- Animal and Dairy Sciences Department, University of Wisconsin-Madison, Madison, WI, USA.
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3
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Erdem AS, Şimşek Kaya G, Kaya M, Altunay B, Alkan TY, Toru HS. Comparison of the effects of fluoxetine and venlafaxine on bone healing in a rat calvarial defect model. Injury 2023:S0020-1383(23)00290-5. [PMID: 37003871 DOI: 10.1016/j.injury.2023.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/02/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the effects of the selective serotonin reuptake inhibitor (SSRI) fluoxetine and the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine on bone defect healing. MATERIALS AND METHODS Wistar rats were randomly divided into three groups of eight animals each. The first received 0.1 ml/kg sterile saline solution, the second 5 mg/kg fluoxetine, and the third 5 mg/kg venlafaxine, daily by gastric gavage over 7 weeks. At week 3 of drug therapy, 5-mm diameter calvarial defects were created in the parietal bone of all of the animals. All rats were euthanized four weeks after surgery, micro-CT analysis and histomorphometric analysis were carried out to evaluate the following parameters: Bone volume fraction (BV/TV), bone surface (BS), bone surface density (BS/BV; bone surface/bone volume, 1/mm), trabecular number (Tb. N), trabecular thickness (Tb. Th), areas of new bone structure (positive areas), areas of mature bone structure (negative areas). RESULTS Micro-CT analysis showed the presence of similar levels of bone formation within the defect site in all three groups (p>0.05). Histomorphometric analysis revealed the presence of bone-forming cells at the defect periphery, with less activity indicating bone formation at the center. No statistically significant difference was observed between the groups (p>0.05). CONCLUSION Based on the findings of this study, it can be said that the use of both antidepressants hasn't any effect on bone defect healing.
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Affiliation(s)
- Arif Sermed Erdem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Göksel Şimşek Kaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Mahir Kaya
- Department of Medical Imaging Techniques, Vocational School of Health Services, Akdeniz University, Antalya, Turkey
| | - Büşra Altunay
- Department of Pathology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Taha Yiğit Alkan
- Department of Computer Engineering, Institute of Natural and Applied Sciences, Akdeniz University, Antalya, Turkey
| | - Havva Serap Toru
- Department of Pathology, School of Medicine, Akdeniz University, Antalya, Turkey
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4
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Design, Synthesis, and Pharmacology of New Triazole-Containing Quinolinones as CNS Active Agents. Molecules 2023; 28:molecules28041987. [PMID: 36838975 PMCID: PMC9965477 DOI: 10.3390/molecules28041987] [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: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
Epilepsy and major depressive disorder are the two of the most common central nervous system (CNS) diseases. Clinicians and patients call for new antidepressants, antiseizure medicines, and in particular drugs for depression and epilepsy comorbidities. In this work, a dozen new triazole-quinolinones were designed, synthesized, and investigated as CNS active agents. All compounds reduced the immobility time significantly during the forced swim test (FST) in mice at the dosage of 50 mg/kg. Compounds 3f-3j gave superior performance over fluoxetine in the FST with more reductions of the immobility time. Compound 3g also reduced immobility time significantly in a tail suspension test (TST) at the dosage of 50 mg/kg, though its anti-immobility activity was inferior to that of fluoxetine. An open field test was carried out and it eliminated the false-positive possibility of 3g in the FST and TST, which complementarily supported the antidepressant activity of 3g. We also found that almost all compounds except 3k exhibited antiseizure activity in the maximal electroshock seizure (MES) model at 100 or 300 mg/kg. Compounds 3c, 3f, and 3g displayed the ED50 of 63.4, 78.9, and 84.9 mg/kg, and TD50 of 264.1, 253.5, and 439.9 mg/kg, respectively. ELISA assays proved that the mechanism for the antiseizure and antidepressant activities of compound 3g was via affecting the concentration of GABA in mice brain. The molecular docking study showed a good interaction between 3g and the amino acid residue of the GABAA receptor. Excellent drug-like properties and pharmacokinetic properties of compound 3a-l were also predicted by Discovery Studio. These findings provided a new skeleton to develop agents for the treatment of epilepsy and depression comorbidities.
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5
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Fluoxetine improves bone microarchitecture and mechanical properties in rodents undergoing chronic mild stress - an animal model of depression. Transl Psychiatry 2022; 12:339. [PMID: 35987907 PMCID: PMC9392792 DOI: 10.1038/s41398-022-02083-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/20/2022] Open
Abstract
Depression is one of the most prevalent mental disorders associated with reductions in bone mineral density and increased fracture risk. Fluoxetine is a highly prescribed selective serotonin reuptake inhibitor (SSRI) in the treatment of depression and is reported to be a risk factor for fractures. The present study examined the effect of fluoxetine on bone microarchitecture and the mechanical properties under chronic mild stress (CMS), a rodent model of depression. Thirty-one 6-9 week-old rats were allocated to 4 groups: 1) CMS + fluoxetine group (n = 10), 2) fluoxetine-only group (n = 5), 3) CMS + placebo group (n = 10) and 4) control group (no CMS and treatment) (n = 6). After 16 weeks, bone microarchitecture of the distal femur was analyzed by µCT. Mechanical properties were assessed by the three-point bending test, and antidepressant efficacy was determined by sucrose preference and forced swimming tests. Significant correlations were found between volume of sucrose intake and bone volume/tissue volume (BV/TV) (p = 0.019) and elastic absorption energy (p = 0.001) in the fluoxetine only group. The fluoxetine-only group showed significantly higher in the second moment of area in y-direction (p = 0.0298), horizontal outer diameter (mm) (p = 0.0488) and average midshaft thickness (mm) (p = 0.00047) than control group. Comparing with the control group, there was a significant reduction in trabecular number (Tb.N) in the CMS + fluoxetine group (p = 0.026) but not the fluoxetine-only group (p > 0.05). Significant increases in trabecular separation were observed in the metaphysis of CMS + placebo (p = 0.003) and CMS + fluoxetine (p = 0.004) groups when compared to the control group but not in the fluoxetine-only group (p > 0.05). During the three-point bending test, the fluoxetine-only group demonstrated significantly higher structural strength than controls (p = 0.04). Micro computed tomography (µCT) slices showed loss of trabecular bone in the metaphysis region of the CMS + fluoxetine and CMS + placebo groups but not the fluoxetine-only and control groups. In an animal model of depression, the adverse effect on the bone microarchitecture was caused by CMS but not by fluoxetine. Without exposure to CMS, fluoxetine significantly increased the cross-sectional area, trabecular bone area, structural strength and osteoblasts / bone area as compared to control condition.
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6
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Resendes C, Horan DJ, Robling AG, Gao B, Milne GL, Warman ML. Transiently increased serotonin has modest or no effects on bone mass accrual in growing female C57BL6/J or growing male and female Lrp5 A214V mice. Bone 2022; 158:116307. [PMID: 34973493 DOI: 10.1016/j.bone.2021.116307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022]
Abstract
Serotonin (5HT) is a chemical messenger with biologic activities affecting multiple organs. Within the skeletal system, studies in mice and humans suggest blood 5HT levels affect bone, with elevations impairing and reductions enhancing bone accrual. Other studies, however, have not supported this hypothesis. Recently, administering 5HT to a Piezo1 mutant mouse strain with hyposerotonemia, intestinal dysmotility, and a doubling of femoral trabecular bone mass at 2 months of age, was reported to return the animals' intestinal motility and bone mass to normal. However, whether the 5HT directly affected bone metabolism or indirectly affected metabolism by improving intestinal function was not determined. Therefore, we administered 5HT to mice with normal intestinal function. We randomized female C57BL6/J mice and male and female mice that have increased bone mass due to a missense mutation in the WNT co-receptor LRP5 (Lrp5A214V) to receive 5HT or vehicle via daily IP injection from 4 weeks to 8 weeks of age. We did not observe consistent significant changes for distal femur trabecular, midshaft femur cortical, or vertebral body trabecular bone mass between 5HT treated and vehicle treated mice of either genotype. These data are compatible with other studies that have not observed a correlation between blood 5HT level and bone mass.
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Affiliation(s)
- Caitlin Resendes
- Orthopedic Research Laboratories, Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, United States; Department of Genetics, Harvard Medical School, Boston, MA, United States
| | - Daniel J Horan
- Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Benlian Gao
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
| | - Ginger L Milne
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
| | - Matthew L Warman
- Orthopedic Research Laboratories, Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, United States; Department of Genetics, Harvard Medical School, Boston, MA, United States.
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7
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Jia X, Yang R, Li J, Zhao L, Zhou X, Xu X. Gut-Bone Axis: A Non-Negligible Contributor to Periodontitis. Front Cell Infect Microbiol 2021; 11:752708. [PMID: 34869062 PMCID: PMC8637199 DOI: 10.3389/fcimb.2021.752708] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/26/2021] [Indexed: 02/05/2023] Open
Abstract
Periodontitis is a polymicrobial infectious disease characterized by alveolar bone loss. Systemic diseases or local infections, such as diabetes, postmenopausal osteoporosis, obesity, and inflammatory bowel disease, promote the development and progression of periodontitis. Accumulating evidences have revealed the pivotal effects of gut microbiota on bone health via gut-alveolar-bone axis. Gut pathogens or metabolites may translocate to distant alveolar bone via circulation and regulate bone homeostasis. In addition, gut pathogens can induce aberrant gut immune responses and subsequent homing of immunocytes to distant organs, contributing to pathological bone loss. Gut microbial translocation also enhances systemic inflammation and induces trained myelopoiesis in the bone marrow, which potentially aggravates periodontitis. Furthermore, gut microbiota possibly affects bone health via regulating the production of hormone or hormone-like substances. In this review, we discussed the links between gut microbiota and periodontitis, with a particular focus on the underlying mechanisms of gut-bone axis by which systemic diseases or local infections contribute to the pathogenesis of periodontitis.
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Affiliation(s)
- Xiaoyue Jia
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ran Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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8
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Gut microbiome depletion and repetitive mild traumatic brain injury differentially modify bone development in male and female adolescent rats. Bone Rep 2021; 15:101123. [PMID: 34553007 PMCID: PMC8441164 DOI: 10.1016/j.bonr.2021.101123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/14/2021] [Accepted: 08/27/2021] [Indexed: 11/21/2022] Open
Abstract
Dysregulation of the gut microbiome has been shown to disrupt both bone formation and bone resorption in several preclinical and clinical models. However, the role of microbiome in adolescent bone development remains poorly understood. This effect of disrupted bone development may be more pronounced during adolescence, when bone development is vulnerable to environmental stimuli and external insults (e.g., antibiotic treatment and traumatic brain injury), as this is a critical window of development. Therefore, in this study, we sought to investigate the effect of repetitive mild traumatic brain injury (RmTBI) and gut microbiome depletion by antibiotic treatment on femur length and bone density in male and female adolescent Sprague Dawley rats. Rats were randomly assigned to receive standard or antibiotic autoclaved drinking water and to receive sham or RmTBIs injuries. Using micro-computed tomography (μCT), we found sexually dimorphic changes in adolescent bone development in response to microbiome depletion and RmTBI. Specifically, gut microbiome depletion stunted femur growth in males and altered cross sectional bone area (CSA), bone area fraction, and the bone volume of low and mid density bone in the distal metaphyseal region of the femur. Conversely, RmTBI and antibiotic treatment individually disrupted bone growth, bone area fraction, and bone volume of high-density bone within the distal metaphyseal region of the femur in females, but not when combined. Therefore, findings from this study indicate that gut microbiome and RmTBI may alter bone development in a sex-dependent manner during adolescence.
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9
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Kang S, Han M, Park CI, Jung I, Kim EH, Boo YJ, Kang JI, Kim SJ. Use of serotonin reuptake inhibitors and risk of subsequent bone loss in a nationwide population-based cohort study. Sci Rep 2021; 11:13461. [PMID: 34188108 PMCID: PMC8241982 DOI: 10.1038/s41598-021-92821-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
This study examined whether the use of SRIs is associated with an increased risk of bone loss using a nested case-control design with a nationwide population-based cohort in Korea. Using the Korean National Health Screening Cohort, subjects newly diagnosed with osteoporosis or osteopenia (n = 55,799) were matched with controls (n = 278,995) at a ratio of 1:5. We stratified the participants by their time-dependent use of SRIs and sex and controlled for various confounders, including lifestyle habits, laboratory data, and comorbidities. Conditional logistic regression showed that both recent and former users of SRIs had an increased risk of subsequent bone loss compared with non-users: men [recent users: odds ratio (OR) 1.35, 95% confidential interval (CI) 1.20, 1.53; former-users: OR 1.10, 95% CI 1.01, 1.20]; women (recent users: OR 1.38, 95% CI 1.28-1.48; former-users: OR 1.07, 95% CI 1.02, 1.21). The use of SRIs was associated with an increased risk of bone loss in both men and women. In particular, the association was stronger in recent users. These findings provide population-level evidence for the risk of bone loss associated with SRI exposure and highlight the importance of monitoring the bone health of SRI users.
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Affiliation(s)
- Sunyoung Kang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Jun Boo
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee In Kang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Se Joo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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10
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Shah PA, Park CJ, Shaughnessy MP, Cowles RA. Serotonin as a Mitogen in the Gastrointestinal Tract: Revisiting a Familiar Molecule in a New Role. Cell Mol Gastroenterol Hepatol 2021; 12:1093-1104. [PMID: 34022423 PMCID: PMC8350061 DOI: 10.1016/j.jcmgh.2021.05.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 02/02/2023]
Abstract
Serotonin signaling is ubiquitous in the gastrointestinal (GI) system, where it acts as a neurotransmitter in the enteric nervous system (ENS) and influences intestinal motility and inflammation. Since its discovery, serotonin has been linked to cellular proliferation in several types of tissues, including vascular smooth muscle, neurons, and hepatocytes. Activation of serotonin receptors on distinct cell types has been shown to induce well-known intracellular proliferation pathways. In the GI tract, potentiation of serotonin signaling results in enhanced intestinal epithelial proliferation, and decreased injury from intestinal inflammation. Furthermore, activation of the type 4 serotonin receptor on enteric neurons leads to neurogenesis and neuroprotection in the setting of intestinal injury. It is not surprising that the mitogenic properties of serotonin are pronounced within the GI tract, where enterochromaffin cells in the intestinal epithelium produce 90% of the body's serotonin; however, these proliferative effects are attributed to increased serotonin signaling within the ENS compartment as opposed to the intestinal mucosa, which are functionally and chemically separate by virtue of the distinct tryptophan hydroxylase enzyme isoforms involved in serotonin synthesis. The exact mechanism by which serotonergic neurons in the ENS lead to intestinal proliferation are not known, but the activation of muscarinic receptors on intestinal crypt cells indicate that cholinergic signaling is essential to this signaling pathway. Further understanding of serotonin's role in mucosal and enteric nervous system mitogenesis may aid in harnessing serotonin signaling for therapeutic benefit in many GI diseases, including inflammatory bowel disease, malabsorptive conditions, and cancer.
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Affiliation(s)
- Pooja A Shah
- Division of Pediatric Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Christine J Park
- Division of Pediatric Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Matthew P Shaughnessy
- Division of Pediatric Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Robert A Cowles
- Division of Pediatric Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
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11
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Power C, Duffy R, Mahon J, McCarroll K, Lawlor BA. Bones of Contention: A Comprehensive Literature Review of Non-SSRI Antidepressant Use and Bone Health. J Geriatr Psychiatry Neurol 2020; 33:340-352. [PMID: 31665962 DOI: 10.1177/0891988719882091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Osteoporotic fractures are associated with major morbidity and mortality, particularly among older age groups. In recent decades, selective serotonin reuptake inhibitors (SSRI) antidepressants have been linked to reduced bone mineral density and increased risk of fragility fracture. However, up to one-third of antidepressant prescriptions are for classes other than SSRIs. Older patients, who are particularly vulnerable to osteoporosis and its clinical and psychosocial consequences, may be prescribed non-SSRI antidepressants preferentially because of increasing awareness of the risks SSRIs pose to bone health. However, to date, the skeletal effects of non-SSRI antidepressants have not been comprehensively reviewed. In this article, we collate and review the available data and discuss the findings. Based on the current literature, we tentatively suggest that tricyclic antidepressants may increase the risk of fracture via mechanisms other than a direct effect on bone mineral density. The risk is apparently confined to current users only and is greatest in the earliest stage of treatment, diminishing thereafter. There is, as yet, insufficient data to conclusively determine the effects of other antidepressant classes on bone. Judicious prescribing of antidepressants among higher risk groups necessitates a thorough review of the individual's risk factors for osteoporosis as well as attention to their falls risk. Further longitudinal, rigorously controlled studies are needed to answer some of the remaining questions on the effects of non-SSRI antidepressants on bone and the mechanisms by which they are exerted.
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Affiliation(s)
- Clodagh Power
- Mercer's Institute for Successful Ageing, 58024St James's Hospital, Dublin, Ireland
| | - Richard Duffy
- Jonathan Swift Clinic, 58024St James's Hospital, Dublin, Ireland
| | - James Mahon
- Mercer's Institute for Successful Ageing, 58024St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Mercer's Institute for Successful Ageing, 58024St James's Hospital, Dublin, Ireland
| | - Brian A Lawlor
- Mercer's Institute for Successful Ageing, 58024St James's Hospital, Dublin, Ireland
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12
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Davidson RK, Himes ER, Takigawa S, Chen A, Horn MR, Meijome T, Wallace JM, Kacena MA, Yokota H, Nguyen AV, Li J. The loss of STAT3 in mature osteoclasts has detrimental effects on bone structure. PLoS One 2020; 15:e0236891. [PMID: 32730332 PMCID: PMC7392311 DOI: 10.1371/journal.pone.0236891] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/15/2020] [Indexed: 01/05/2023] Open
Abstract
Signal Transducer and Activator of Transcription 3 (STAT3) has recently been shown to be involved in bone development and has been implicated in bone diseases, such as Job’s Syndrome. Bone growth and changes have been known for many years to differ between sexes with male bones tending to have higher bone mass than female bones and older females tending to lose bone mass at faster rates than older males. Previous studies using conditional knock mice with Stat3 specifically deleted from the osteoblasts showed both sexes exhibited decreased bone mineral density (BMD) and strength. Using the Cre-Lox system with Cathepsin K promotor driving Cre to target the deletion of the Stat3 gene in mature osteoclasts (STAT3-cKO mice), we observed that 8-week old STAT3-cKO female femurs exhibited significantly lower BMD and bone mineral content (BMC) compared to littermate control (CN) females. There were no differences in BMD and BMC observed between male knock-out and male CN femurs. However, micro-computed tomography (μCT) analysis showed that both male and female STAT3-cKO mice had significant decreases in bone volume/tissue volume (BV/TV). Bone histomorphometry analysis of the distal femur, further revealed a decrease in bone formation rate and mineralizing surface/bone surface (MS/BS) with a significant decrease in osteoclast surface in female, but not male, STAT3-cKO mice. Profiling gene expression in an osteoclastic cell line with a knockdown of STAT3 showed an upregulation of a number of genes that are directly regulated by estrogen receptors. These data collectively suggest that regulation of STAT3 differs in male and female osteoclasts and that inactivation of STAT3 in osteoclasts affects bone turnover more in females than males, demonstrating the complicated nature of STAT3 signaling pathways in osteoclastogenesis. Drugs targeting the STAT3 pathway may be used for treatment of diseases such as Job’s Syndrome and osteoporosis.
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Affiliation(s)
- Rebecca K. Davidson
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Evan R. Himes
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Shinya Takigawa
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Andy Chen
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - M. Ryne Horn
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Tomas Meijome
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Joseph M. Wallace
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Melissa A. Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Hiroki Yokota
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Andrew V. Nguyen
- Department of Biological Sciences and Geology, the City University of New York-Queensborough Community College, Bayside, New York, United States of America
- * E-mail: (JL); (AVN)
| | - Jiliang Li
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
- * E-mail: (JL); (AVN)
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13
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Lee S, Remark LH, Buchalter DB, Josephson AM, Wong MZ, Litwa HP, Ihejirika R, Leclerc K, Markus D, Yim NL, Tejwani R, Bradaschia-Correa V, Leucht P. Propranolol Reverses Impaired Fracture Healing Response Observed With Selective Serotonin Reuptake Inhibitor Treatment. J Bone Miner Res 2020; 35:932-941. [PMID: 31881108 PMCID: PMC8080057 DOI: 10.1002/jbmr.3950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 11/07/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are one of the most commonly prescribed antidepressants worldwide and recent data show significant impairment of fracture healing after treatment with the SSRI fluoxetine in mice. Here, we provide evidence that the negative effects of SSRIs can be overcome by administration of the beta-blocker propranolol at the time of fracture. First, in vitro experiments established that propranolol does not affect osteogenic differentiation. We then used a murine model of intramembranous ossification to study the potential rescue effect of propranolol on SSRI-induced impaired fracture healing. Micro-CT analysis revealed that fluoxetine treatment resulted in a smaller bony regenerate and that this decrease in bone formation can be overcome by co-treatment with propranolol. We then tested this in a clinically relevant model of endochondral ossification. Fluoxetine-treated mice with a femur fracture were treated with propranolol initiated at the time of fracture, and a battery of analyses demonstrated a reversal of the detrimental effect of fluoxetine on fracture healing in response to propranolol treatment. These experiments show for the first time to our knowledge that the negative effects of SSRIs on fracture healing can be overcome by co-treatment with a beta-blocker. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Sooyeon Lee
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Lindsey H Remark
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Daniel B Buchalter
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Anne M Josephson
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Madeleine Z Wong
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Hannah P Litwa
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Rivka Ihejirika
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Kevin Leclerc
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Danielle Markus
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Nury L Yim
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Ruchi Tejwani
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | | | - Philipp Leucht
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA.,Department of Cell Biology, Robert I. Grossman School of Medicine, New York University, New York, NY, USA
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14
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Cabrera RM, Linda Lin Y, Law E, Kim J, Wlodarczyk BJ. The teratogenic effects of sertraline in mice. Birth Defects Res 2020; 112:1014-1024. [PMID: 32077266 DOI: 10.1002/bdr2.1660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/04/2020] [Accepted: 02/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Selective serotonin reuptake inhibitors (SSRIs), which include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), and escitalopram (Lexapro), are the most common antidepressants prescribed to pregnant women. There is considerable debate in the literature regarding the developmental toxicities of SSRIs individually, and as a class. METHODS It is considered unethical to perform developmental toxicity studies on pregnant women, but rodent and nonrodent species provide laboratory-controlled experimental models to examine the toxicity of SSRI exposure during pregnancy. The Embryo-Fetal Developmental Toxicity Study was conducted with sertraline in mice, Crl:CD1 (lCR), during the period of organogenesis. RESULTS Increased resorption rates, lower fetal weight, and increased percentage of fetuses with visceral and skeletal abnormalities were found in the intermediate and high sertraline dose groups. In addition to incomplete ossification of treated animals, eleven sertraline exposed fetuses, two in group 2 (5 mg/kg), five in group 3 (25 mg/kg), and four in group 4 (60 mg/kg), had cleft palate (CP). This malformation was not observed in any controls. Only the highest dose of sertraline was found to be maternally toxic, as evidenced by significantly lower weight gain during pregnancy. CONCLUSION These data indicate that in utero exposure to sertraline at 25 and 60 mg/kg was embryotoxic, teratogenic, and fetotoxic in mice. The incidence of CP observed in groups 3 and 4 (2.99% and 2.5%, respectively) were higher than the maximum range value noted in historical controls and indicate sertraline is a teratogen in ICR mice.
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Affiliation(s)
- Robert M Cabrera
- Department of Pediatrics, Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas.,Center for Precision Environmental Health, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX
| | - Ying Linda Lin
- Department of Pediatrics, Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas.,Center for Precision Environmental Health, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX
| | - Elizabeth Law
- Department of Pediatrics, Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Jimi Kim
- Department of Pediatrics, Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Bogdan J Wlodarczyk
- Department of Pediatrics, Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas.,Center for Precision Environmental Health, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX
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15
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Coşgunarslan A, Aşantoğrol F, Soydan Çabuk D, Canger EM. The effect of selective serotonin reuptake inhibitors on the human mandible. Oral Radiol 2020; 37:20-28. [PMID: 31897966 DOI: 10.1007/s11282-019-00419-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Selective serotonin reuptake inhibitors (SSRI) are a group of drugs that selectively and strongly block the serotonin transporter. Aim of this study was to evaluate the mandibular bone structure of patients who are using SSRIs with fractal analysis and panoramic morphometric indices [mandibular cortical width (MCW), panoramic mandibular index (PMI) and Klemetti index (KI)] and to compare with control group. METHODS Patients who declared using SSRIs for more than six months had been included in the study group. In total, 212 dental panoramic radiographs (DPR) were assessed. For fractal analysis; three regions of interest (ROIs) were determined: ROI1 and ROI2 were chosen within trabecular bone, ROI3 was selected from cortical bone. MCW, PMI, and KI were obtained from DPRs. The study group was categorized into five subgroups of various SSRIs. The fractal dimension (FD) values and panoramic morphometric indices of these subgroups were also compared. RESULTS There was no significant difference between the groups for age and gender (p = 0.57, p = 0.5). There were significant differences in the mean FD values between the study and control groups both for the ROI1 and ROI2 (p < 0.01, p < 0.01). There was no significant difference between the groups for the mean FD value of ROI3, MCW, PMI and KI (p = 0.93, p = 0.98, p = 0.74, p = 0.06). There were no significant differences for all the values between the SSRI subgroups (p = 0.52, p = 0.7, p = 0.76, p = 0.24, p = 0.31, p = 0.08) CONCLUSIONS: Trabecular rich sites of the mandible were found to be affected by SSRI usage.
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Affiliation(s)
- Aykağan Coşgunarslan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey.
| | - Firdevs Aşantoğrol
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Damla Soydan Çabuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Emin Murat Canger
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
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16
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Agacayak KS, Guler R, Ilyasov B. Evaluation of the effect of long-term use of antidepressants in the SSRI group on bone density with dental volumetric tomography. DRUG DESIGN DEVELOPMENT AND THERAPY 2019; 13:3477-3484. [PMID: 31631972 PMCID: PMC6781739 DOI: 10.2147/dddt.s216822] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/26/2019] [Indexed: 11/23/2022]
Abstract
Aim The present study aims to employ dental volumetric tomography to examine bone mineral density among men that used antidepressants in the SSRI group for a long time. Method The present study was conducted through the utilisation of data related to patients that presented to the Faculty of Dentistry of Dicle University and had a dental volumetric tomography (DVT) scan for any reason. The patients were divided into 2 groups based on the use of antidepressants: Group 1 included 68 patients as the control group, and Group 2 consisted of 68 patients that used antidepressants. Radiomorphometric measurements were performed on DVT data: DVT-Mandibular Index (DVT-MI), DVT-Cortical Index (DVT-CI), Hounsfıeld Unit (HU) CORTICAL, and HU SPONGIOSIS values were calculated. Results The group of patients that used antidepressants exhibited a significant increase in DVT CI and a significant decrease in HU CORTICAL, HU SPONGIOSIS and DVT MI values. These findings were suggestive of osteoporosis. Conclusion Long-term use of antidepressants should be taken into consideration as a risk factor for osteoporosis in men.
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Affiliation(s)
- Kamil Serkan Agacayak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Rıdvan Guler
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
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17
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Drug-induced osteoporosis/osteomalacia: analysis in the French and Spanish pharmacovigilance databases. Eur J Clin Pharmacol 2019; 75:1705-1711. [DOI: 10.1007/s00228-019-02743-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/09/2019] [Indexed: 12/26/2022]
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18
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Serotonin in stem cell based-dental repair and bone formation: A review. Biochimie 2019; 161:65-72. [DOI: 10.1016/j.biochi.2018.07.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 07/31/2018] [Indexed: 01/08/2023]
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19
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Abstract
Peripheral serotonin continuously reveals its unexpected involvements in many organ functions. In bone tissue, there is an increasing evidence for a local serotonergic system affecting the cellular and molecular actors involved in bone turnover. During orthodontic treatment, tooth movement relies on bone remodeling, itself a result of the inflammatory process triggered by application of orthodontic forces to the teeth. Nowadays, many adults proceed to an orthodontic treatment, it therefore seems important to consider physiological growth-related factors and external factors as medications that may influence adverse effects and efficacy of orthodontic treatment techniques. In this review, we focus on peripheral serotonin mechanism of regulation of bone remodeling during orthodontic movement. We discuss the differential effect of serotonin on alveolar bone inflammation that may open new strategies in orthodontics.
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20
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Weaver SR, Xie C, Charles JF, Hernandez LL. In utero and lactational exposure to the Selective Serotonin Reuptake Inhibitor fluoxetine compromises pup bones at weaning. Sci Rep 2019; 9:238. [PMID: 30659249 PMCID: PMC6338725 DOI: 10.1038/s41598-018-36497-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/22/2018] [Indexed: 12/14/2022] Open
Abstract
Selective Serotonin Reuptake Inhibitors (SSRIs) such as fluoxetine are widely prescribed to pregnant and breastfeeding women, yet the effects of peripartum SSRI exposure on neonatal bone are not known. In adult populations, SSRI use is associated with compromised bone health, and infants exposed to in utero SSRIs have a smaller head circumference and are shorter, suggesting possible effects on longitudinal growth. Yet no study to date has examined the effects of peripartum SSRIs on long bone growth or mass. We used microCT to determine the outcomes of in utero and lactational SSRI exposure on C57BL6 pup bone microarchitecture. We found that peripartum exposure to 20 mg/kg fluoxetine reduced femoral bone mineral density and bone volume fraction, negatively impacted trabecular and cortical parameters, and resulted in shorter femurs on postnatal day 21. Although SSRIs are considered the first-choice antidepressant for pregnant and lactating women due to a low side effect profile, SSRI exposure may compromise fetal and neonatal bone development.
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Affiliation(s)
- Samantha R Weaver
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, USA
| | - Cynthia Xie
- Departments of Orthopedics and Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Julia F Charles
- Departments of Orthopedics and Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Laura L Hernandez
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, USA.
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21
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Huang S, Li Z, Liu Y, Gao D, Zhang X, Hao J, Yang F. Neural regulation of bone remodeling: Identifying novel neural molecules and pathways between brain and bone. J Cell Physiol 2018; 234:5466-5477. [PMID: 29377116 DOI: 10.1002/jcp.26502] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 01/20/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Shishu Huang
- Department of Orthopaedic Surgery West China Hospital, Sichuan University Chengdu China
| | - Zhenxia Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics West China Hospital of Stomatology, Sichuan University Chengdu China
| | - Yunhui Liu
- The Brain Cognition & Brain Disease Institute, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences Shenzhen China
| | - Dashuang Gao
- The Brain Cognition & Brain Disease Institute, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences Shenzhen China
| | - Xinzhou Zhang
- Department of Nephrology Shenzhen People's Hospital, Second Clinical Medical College, Jinan University Shenzhen China
| | - Jin Hao
- Program in Biological Sciences in Dental Medicine, Harvard School of Dental Medicine Boston Massachusetts
| | - Fan Yang
- The Brain Cognition & Brain Disease Institute, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences Shenzhen China
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22
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Fazeli PK, Klibanski A. Effects of Anorexia Nervosa on Bone Metabolism. Endocr Rev 2018; 39:895-910. [PMID: 30165608 PMCID: PMC6226604 DOI: 10.1210/er.2018-00063] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/21/2018] [Indexed: 01/14/2023]
Abstract
Anorexia nervosa is a psychiatric disease characterized by a low-weight state due to self-induced starvation. This disorder, which predominantly affects women, is associated with hormonal adaptations that minimize energy expenditure in the setting of low nutrient intake. These adaptations include GH resistance, functional hypothalamic amenorrhea, and nonthyroidal illness syndrome. Although these adaptations may be beneficial to short-term survival, they contribute to the significant and often persistent morbidity associated with this disorder, including bone loss, which affects >85% of women. We review the hormonal adaptions to undernutrition, review hormonal treatments that have been studied for both the underlying disorder as well as for the associated decreased bone mass, and discuss the important challenges that remain, including the lack of long-term treatments for bone loss in this chronic disorder and the fact that despite recovery, many individuals who experience bone loss as adolescents have chronic deficits and an increased risk of fracture in adulthood.
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Affiliation(s)
- Pouneh K Fazeli
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Anne Klibanski
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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23
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Weaver SR, Fricke HP, Xie C, Aiello RJ, Charles JF, Hernandez LL. Peripartum dietary supplementation of a small-molecule inhibitor of tryptophan hydroxylase 1 compromises infant, but not maternal, bone. Am J Physiol Endocrinol Metab 2018; 315:E1133-E1142. [PMID: 30351987 PMCID: PMC6336963 DOI: 10.1152/ajpendo.00198.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/28/2018] [Accepted: 10/19/2018] [Indexed: 12/20/2022]
Abstract
Long-term effects of breastfeeding on maternal bone are not fully understood. Excessive maternal bone loss stimulated by serotonin signaling during lactation may increase bone fragility later in life. We hypothesized that inhibiting nonneuronal serotonin activity by feeding a small-molecule inhibitor of the rate-limiting enzyme in serotonin synthesis [tryptophan hydroxylase 1 (TPH1)] would preserve maternal bone postweaning without affecting neonatal bone. Chow supplemented with the small-molecule TPH1 inhibitor LP778902 (~100 mg/kg) or control chow was fed to C57BL/6 dams throughout pregnancy and lactation, and blood was collected on days 1 and 21 of lactation. Dams returned to a common diet postweaning and were aged to 3 or 9 mo postweaning. Pups were euthanized at weaning. The effect of TPH1 inhibition on dam and pup femoral bone was determined by micro-computed tomography. Peripartum dietary supplementation with LP778902 decreased maternal serum serotonin concentrations ( P = 0.0007) and reduced bone turnover, indicated by serum NH2-terminal propeptide of type I collagen ( P = 0.01) and COOH-terminal collagen cross-links ( P = 0.02) concentrations, on day 21 of lactation. Repressed bone turnover from TPH1 inhibition was not associated with structural changes in maternal femur at 3 or 9 mo postweaning. By contrast, neonates exposed to peripartum LP778902 demonstrated differences in trabecular and cortical femoral bone compared with pups from control dams, with fewer ( P = 0.02) and thinner ( P = 0.001) trabeculae as well as increased trabecular spacing ( P = 0.04). Additionally, cortical porosity was increased ( P = 0.007) and cortical tissue mineral density was decreased ( P = 0.005) in pups of LP778902-treated dams. Small-molecule TPH1 inhibitors should be carefully considered in pregnant and lactating women, given potential risks to neonatal bone development.
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Affiliation(s)
- Samantha R Weaver
- Endocrinology and Reproductive Physiology Program, University of Wisconsin-Madison , Madison, Wisconsin
| | - Hannah P Fricke
- Department of Dairy Science, University of Wisconsin-Madison , Madison, Wisconsin
| | - Cynthia Xie
- Departments of Orthopedics and Medicine, Brigham and Women's Hospital , Boston, Massachusetts
| | | | - Julia F Charles
- Departments of Orthopedics and Medicine, Brigham and Women's Hospital , Boston, Massachusetts
| | - Laura L Hernandez
- Endocrinology and Reproductive Physiology Program, University of Wisconsin-Madison , Madison, Wisconsin
- Department of Dairy Science, University of Wisconsin-Madison , Madison, Wisconsin
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24
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Abu Nada L, Al Subaie A, Mansour A, Wu X, Abdallah M, Al‐Waeli H, Ersheidat A, Stone LS, Murshed M, Tamimi F. The antidepressant drug, sertraline, hinders bone healing and osseointegration in rats’ tibiae. J Clin Periodontol 2018; 45:1485-1497. [DOI: 10.1111/jcpe.13015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 08/16/2018] [Accepted: 09/30/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Lina Abu Nada
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Ahmed Al Subaie
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Alaa Mansour
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Xixi Wu
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Mohamed‐Nur Abdallah
- Faculty of DentistryMcGill University Montreal Quebec Canada
- Faculty of DentistryUniversity of Toronto Toronto Ontario Canada
| | - Haider Al‐Waeli
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Ala’ Ersheidat
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Laura S. Stone
- Faculty of DentistryMcGill University Montreal Quebec Canada
- Alan Edwards Center for Research on PainMcGill University Montreal Quebec Canada
| | - Monzur Murshed
- Faculty of DentistryMcGill University Montreal Quebec Canada
- Faculty of MedicineMcGill University Montreal Quebec Canada
- Genetics UnitShriners Hospital for Children Montreal Quebec Canada
| | - Faleh Tamimi
- Faculty of DentistryMcGill University Montreal Quebec Canada
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25
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Kristjansdottir HL, Lewerin C, Lerner UH, Waern E, Johansson H, Sundh D, Karlsson M, Cummings SR, Zetterberg H, Lorentzon M, Ohlsson C, Mellström D. High Serum Serotonin Predicts Increased Risk for Hip Fracture and Nonvertebral Osteoporotic Fractures: The MrOS Sweden Study. J Bone Miner Res 2018; 33:1560-1567. [PMID: 29750841 DOI: 10.1002/jbmr.3443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/16/2018] [Accepted: 04/04/2018] [Indexed: 11/08/2022]
Abstract
Because several studies have implicated serotonin as a regulator of bone mass, we here explore its potential association on fracture risk and falls, as on bone mineral density (BMD) and muscle strength, in humans. Serum levels of serotonin were analyzed in 950 men (aged 69 to 81 years), participating in the Gothenburg part of the population-based study MrOS Sweden. Men taking selective serotonin reuptake inhibitors (SSRIs) had a mean value of 31.2 μg/L compared with 159.4 μg/L in those not taking SSRIs. SSRI users were excluded from further analysis. During 10-year follow-up, 224 men exhibited fractures, including 97 nonvertebral osteoporotic fractures (57 hip fractures), and 86 vertebral fractures. Serotonin was associated with hip fracture in linear analysis (hazard ratio [HR] = 1.27, 95% confidence interval [CI] 1.03-1.58) and to all fractures in a nonlinear manner, when quintiles of serotonin was included in quadratic terms (HR = 1.12, 95% CI 1.04-1.21). Men in serotonin quintile 5 had, in multivariable analysis, a HR of 2.30 (95% CI 1.31-4.02) for hip fracture and 1.82 (95% CI 1.17-2.85) for nonvertebral fractures compared with men in quintiles 1 to 4. Men in quintile 1 had, in multivariable analysis, a HR of 1.76 (95% CI 1.03-2.99) for nonvertebral fractures compared with men in quintiles 2 to 4. No association was found with vertebral fractures. Individuals in serotonin quintile 1 had higher prevalence of falls compared with quintiles 2 to 5 (odds ratio = 1.90, 95% CI 1.26-2.87). Serotonin was positively associated with hand-grip strength (r = 0.08, p = 0.02) and inversely with hip BMD (r = -0.10, p = 0.003). To assess the association between SSRIs and falls and fractures, the total MrOS Sweden cohort was examined (n = 3014). SSRI users (n = 90) had increased prevalence of falls (16% versus 33%, p = 0.0001) and increased rate of incident fractures (28.0 versus 44.7 per 1000 person-years, p = 0.018). We present novel data showing that high levels of serotonin predict an increased risk for hip fracture and nonvertebral osteoporotic fractures. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Hallgerdur Lind Kristjansdottir
- Section of Hematology and Coagulation, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Catharina Lewerin
- Section of Hematology and Coagulation, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulf H Lerner
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute for Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ewa Waern
- Geriatric Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Johansson
- Institute for Health and Aging, Catholic University of Australia, Melbourne, Australia
| | - Daniel Sundh
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute for Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Karlsson
- Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Mattias Lorentzon
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute for Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Geriatric Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute for Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dan Mellström
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute for Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Geriatric Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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26
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Weaver SR, Fricke HP, Xie C, Lipinski RJ, Vezina CM, Charles JF, Hernandez LL. Peripartum Fluoxetine Reduces Maternal Trabecular Bone After Weaning and Elevates Mammary Gland Serotonin and PTHrP. Endocrinology 2018; 159:2850-2862. [PMID: 29893816 PMCID: PMC6456925 DOI: 10.1210/en.2018-00279] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/04/2018] [Indexed: 12/28/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) have been linked to osteopenia and fracture risk; however, their long-term impact on bone health is not well understood. SSRIs are widely prescribed to pregnant and breastfeeding women who might be at particular risk of bone pathology because lactation is associated with considerable maternal bone loss. We used microCT and molecular approaches to test whether the SSRI fluoxetine, administered to C57BL/6 mice from conception through the end of lactation, causes persistent maternal bone loss. We found that peripartum fluoxetine increases serum calcium and reduces circulating markers of bone formation during lactation but does not affect osteoclastic resorption. Peripartum fluoxetine exposure also enhances mammary gland endocrine function during lactation by increasing synthesis of serotonin and PTHrP, a hormone that liberates calcium for milk synthesis and reduces bone mineral volume. Peripartum fluoxetine exposure reduces the trabecular bone volume fraction at 3 months after weaning. These findings raise new questions about the long-term consequences of peripartum SSRI use on maternal health.
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Affiliation(s)
- Samantha R Weaver
- Department of Dairy Science, University of Wisconsin-Madison, Madison, Wisconsin
| | - Hannah P Fricke
- Department of Dairy Science, University of Wisconsin-Madison, Madison, Wisconsin
| | - Cynthia Xie
- Department of Orthopedics, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Robert J Lipinski
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Chad M Vezina
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Julia F Charles
- Department of Orthopedics, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Laura L Hernandez
- Department of Dairy Science, University of Wisconsin-Madison, Madison, Wisconsin
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27
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Lavoie B, Roberts JA, Haag MM, Spohn SN, Margolis KG, Sharkey KA, Lian JB, Mawe GM. Gut-derived serotonin contributes to bone deficits in colitis. Pharmacol Res 2018; 140:75-84. [PMID: 30030171 PMCID: PMC6336528 DOI: 10.1016/j.phrs.2018.07.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 06/14/2018] [Accepted: 07/16/2018] [Indexed: 02/07/2023]
Abstract
Osteoporosis and bone fractures occur at higher frequency in patients with inflammatory bowel disease (IBD), and decreased bone mass is observed in animal models of colitis. Another consistent feature of colitis is increased serotonin (5-HT) availability in the intestinal mucosa. Since gut-derived 5-HT can decrease bone mass, via activation of 5-HT1B receptors on pre-osteoblasts, we tested the hypothesis that 5-HT contributes to bone loss in colitis. Colitis was chronically induced in mice by adding dextran sodium sulfate (DSS) to their drinking water for 21 days. At day 21, circulating 5-HT levels were elevated in DSS-inflamed mice. Micro-computed tomography of femurs showed a decrease in trabecular bone volume fraction, formation, and surface area, due largely to decreased trabecular numbers in DSS-treated mice. The colitis-induced loss of trabecular bone was significantly suppressed in mice treated with the 5-HT synthesis inhibitor, p-chloro-DL-phenylalanine (PCPA; 300 mg/kg/day IP daily), and in mice treated with the 5-HT1B receptor antagonist GR55562 (1 mg/Kg/day SC daily). The 5-HT reuptake transporter (SERT) is critical for moving 5-HT from the interstitial space into enterocytes and from serum into platelets. Mice lacking SERT exhibited significant deficits in trabecular bone mass that are similar to those observed in DSS-inflamed mice, and these deficits were not extensively worsened by DSS-induced colitis in the SERT-/- mice. Taken together, findings from both the DSS and SERT-/- mouse models support a contributing role for 5-HT as a significant factor in bone loss induced by colitis.
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Affiliation(s)
- B Lavoie
- Department of Neurological Sciences, The University of Vermont, Burlington, VT, USA.
| | - J A Roberts
- Department of Neurological Sciences, The University of Vermont, Burlington, VT, USA
| | - M M Haag
- Department of Neurological Sciences, The University of Vermont, Burlington, VT, USA
| | - S N Spohn
- Department of Neurological Sciences, The University of Vermont, Burlington, VT, USA
| | - K G Margolis
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - K A Sharkey
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - J B Lian
- Department of Biochemistry, The University of Vermont, Burlington, VT, USA
| | - G M Mawe
- Department of Neurological Sciences, The University of Vermont, Burlington, VT, USA
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28
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Acute ketamine administration corrects abnormal inflammatory bone markers in major depressive disorder. Mol Psychiatry 2018; 23:1626-1631. [PMID: 28555075 PMCID: PMC5709243 DOI: 10.1038/mp.2017.109] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/16/2017] [Accepted: 04/04/2017] [Indexed: 12/21/2022]
Abstract
Patients with major depressive disorder (MDD) have clinically relevant, significant decreases in bone mineral density (BMD). We sought to determine if predictive markers of bone inflammation-the osteoprotegerin (OPG)-RANK-RANKL system or osteopontin (OPN)-play a role in the bone abnormalities associated with MDD and, if so, whether ketamine treatment corrected the abnormalities. The OPG-RANK-RANKL system plays the principal role in determining the balance between bone resorption and bone formation. RANKL is the osteoclast differentiating factor and diminishes BMD. OPG is a decoy receptor for RANKL, thereby increasing BMD. OPN is the bone glue that acts as a scaffold between bone tissues matrix composition to bind them together and is an important component of bone strength and fracture resistance. Twenty-eight medication-free inpatients with treatment-resistant MDD and 16 healthy controls (HCs) participated in the study. Peripheral bone marker levels and their responses to IV ketamine infusion in MDD patients and HCs were measured at four time points: at baseline, and post-infusion at 230 min, Day 1, and Day 3. Patients with MDD had significant decreases in baseline OPG/RANKL ratio and in plasma OPN levels. Ketamine significantly increased both the OPG/RANKL ratio and plasma OPN levels, and significantly decreased RANKL levels. Bone marker levels in HCs remained unaltered. We conclude that the OPG-RANK-RANKL system and the OPN system play important roles in the serious bone abnormalities associated with MDD. These data suggest that, in addition to its antidepressant effects, ketamine also has a salutary effect on a major medical complication of depressive illness.
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29
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Zhou C, Fang L, Chen Y, Zhong J, Wang H, Xie P. Effect of selective serotonin reuptake inhibitors on bone mineral density: a systematic review and meta-analysis. Osteoporos Int 2018; 29:1243-1251. [PMID: 29435621 DOI: 10.1007/s00198-018-4413-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/24/2018] [Indexed: 01/19/2023]
Abstract
Our work is the first systematic meta-analysis to investigate the effect of selective serotonin reuptake inhibitor (SSRI) medication on bone mineral density. Through meta-analyzed 11 studies, our findings suggested that compared with nonusers, use of SSRIs was significantly associated with lumbar spine BMD reduction, particularly for old people. The use of selective serotonin reuptake inhibitors (SSRIs) has already been associated with bone mass loss. Their effects on bone mineral density (BMD) for the different bone sections have, however, thus been inconsistent. Here, we aim to assess the effects of SSRIs on BMD using a meta-analysis. We searched PubMed, Scopus, ISI Web of Knowledge, the Cochrane Library, and PsycINFO for all English-written studies investigating the effects of SSRIs on BMD and published before November 2017. BMD was compared between non-SSRI users and SSRI users using a random-effect model with standardized mean differences (SMD) and 95% confidence intervals (CIs). Furthermore, subgroup analyses were performed based on study design, age, and sex in order to find the origins of high heterogeneity. Eleven studies met the inclusion criteria and were used for the meta-analysis. Our study demonstrated that the use of SSRIs was significantly associated with lower BMD values (SMD - 0.40; 95% CI - 0.79 to 0.00; p = 0.05) and BMD Z-scores (SMD - 0.28; 95% CI - 0.50 to - 0.05; p = 0.02) of the lumbar spine, but not of the total hip and femoral neck. In addition, SSRI use was associated with a greater bone loss in older people. SSRI use is a risk factor of lower BMD of the lumbar spine, especially for older people. Future studies into the relationship between SSRI use and bone metabolism and bone mass need to be conducted with larger sample sizes for both men and women at different bone sites.
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Affiliation(s)
- C Zhou
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
- Institute of Neuroscience, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Neurobiology, Chongqing Medical University, Chongqing, China
| | - L Fang
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Y Chen
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - J Zhong
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - H Wang
- Institute of Neuroscience, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Neurobiology, Chongqing Medical University, Chongqing, China
| | - P Xie
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
- Institute of Neuroscience, Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Neurobiology, Chongqing Medical University, Chongqing, China.
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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30
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Weaver SR, Hernandez LL. Could use of Selective Serotonin Reuptake Inhibitors During Lactation Cause Persistent Effects on Maternal Bone? J Mammary Gland Biol Neoplasia 2018; 23:5-25. [PMID: 29603039 DOI: 10.1007/s10911-018-9390-6] [Citation(s) in RCA: 4] [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] [Received: 12/14/2017] [Accepted: 03/13/2018] [Indexed: 02/07/2023] Open
Abstract
The lactating mammary gland elegantly coordinates maternal homeostasis to provide calcium for milk. During lactation, the monoamine serotonin regulates the synthesis and release of various mammary gland-derived factors, such as parathyroid hormone-related protein (PTHrP), to stimulate bone resorption. Recent evidence suggests that bone mineral lost during prolonged lactation is not fully recovered following weaning, possibly putting women at increased risk of fracture or osteoporosis. Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants have also been associated with reduced bone mineral density and increased fracture risk. Therefore, SSRI exposure while breastfeeding may exacerbate lactational bone loss, compromising long-term bone health. Through an examination of serotonin and calcium homeostasis during lactation, lactational bone turnover and post-weaning recovery of bone mineral, and the effect of peripartum depression and SSRI on the mammary gland and bone, this review will discuss the hypothesis that peripartum SSRI exposure causes persistent reductions in bone mineral density through mammary-derived PTHrP signaling with bone.
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Affiliation(s)
- Samantha R Weaver
- Endocrine and Reproductive Physiology Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Laura L Hernandez
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, USA.
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31
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Lavoie B, Lian JB, Mawe GM. Regulation of Bone Metabolism by Serotonin. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1033:35-46. [PMID: 29101650 DOI: 10.1007/978-3-319-66653-2_3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The processes of bone growth and turnover are tightly regulated by the actions of various signaling molecules, including hormones, growth factors, and cytokines. Imbalances in these processes can lead to skeletal disorders such as osteoporosis or high bone mass disease. It is becoming increasingly clear that serotonin can act through a number of mechanisms, and at different locations in the body, to influence the balance between bone formation and resorption. Its actions on bone metabolism can vary, based on its site of synthesis (central or peripheral) as well as the cells and subtypes of receptors that are activated. Within the central nervous system, serotonergic neurons act via the hypothalamus to suppress sympathetic input to the bone. Since sympathetic input inhibits bone formation, brain serotonin has a net positive effect on bone growth. Gut-derived serotonin is thought to inhibit bone growth by attenuating osteoblast proliferation via activation of receptors on pre-osteoblasts. There is also evidence that serotonin can be synthesized within the bone and act to modulate bone metabolism. Osteoblasts, osteoclasts, and osteocytes all have the machinery to synthesize serotonin, and they also express the serotonin-reuptake transporter (SERT). Understanding the roles of serotonin in the tightly balanced system of bone modeling and remodeling is a clinically relevant goal. This knowledge can clarify bone-related side effects of drugs that affect serotonin signaling, including serotonin-specific reuptake inhibitors (SSRIs) and receptor agonists and antagonists, and it can potentially lead to therapeutic approaches for alleviating bone pathologies.
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Affiliation(s)
- Brigitte Lavoie
- Department of Neurological Sciences, The University of Vermont, Burlington, VT, 05405, USA. .,The University of Vermont, D406 Given Building, Burlington, VT, 05405, USA.
| | - Jane B Lian
- Department of Biochemistry, The University of Vermont, Burlington, VT, 05405, USA
| | - Gary M Mawe
- Department of Neurological Sciences, The University of Vermont, Burlington, VT, 05405, USA
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32
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Differential effects of serotonin reuptake inhibitors fluoxetine and escitalopram on bone markers and microarchitecture in Wistar rats. Eur J Pharmacol 2018; 825:57-62. [PMID: 29470959 DOI: 10.1016/j.ejphar.2018.02.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/09/2018] [Accepted: 02/16/2018] [Indexed: 01/12/2023]
Abstract
Evidence from several studies indicates that the long-term treatment of selective serotonin reuptake inhibitors (SSRIs) is associated with a decrease in bone mass and increase the risk of fractures. The present work evaluated and compared the effect of treatment with two SSRIs viz. fluoxetine and escitalopram on bone biomarkers (P1NP and βCTX) in male Wistar rats. In addition, the effect of these drugs on bone microarchitecture of lumbar and tibia bones was carried out. Fluoxetine (8.2 mg/kg) treatment for 40 days significantly reduced (P < 0.01) the levels of the P1NP while escitalopram (2.0 mg/kg) was without such effects. Both drugs were devoid of any effects on bone resorption marker βCTX. The pCREB levels were reduced by both the antidepressants but the reduction was significantly (P < 0.001) marked in case of fluoxetine. The micro-CT data revealed that fluoxetine, but not escitalopram, treatment resulted in reduced bone volume fraction, trabecular thickness and number while increased trabecular separation, trabecular pattern factor and connectivity density in the proximal tibial metaphysis. No significant changes were, however, discernible in lumbar bones. The study shows that fluoxetine reduces bone formation possibly through reduced pCREB mediated by the action of gut serotonin in osteoblasts and that escitalopram can be a better treatment option as far as adverse effects on bone are concerned.
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33
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34
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Association of the serotonin transporter-linked polymorphic region genotype with lower bone mineral density. Transl Psychiatry 2017; 7:e1213. [PMID: 28892067 PMCID: PMC5611748 DOI: 10.1038/tp.2017.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/30/2017] [Accepted: 07/04/2017] [Indexed: 12/16/2022] Open
Abstract
The serotonin transporter-linked polymorphic region (5-HTTLPR) of the serotonin transporter gene (SLC6A4) S allele is linked to pathogenesis of depression and slower response to selective serotonin reuptake inhibitors (SSRIs); depression and SSRIs are independently associated with bone loss. We aimed to determine whether 5-HTTLPR was associated with bone loss. This cross-sectional study included psychiatric patients with both 5-HTTLPR analysis and bone mineral density (BMD) assessment (hip and spine Z-scores if age <50 years and T-scores if ⩾50 years). BMD association with 5-HTTLPR was evaluated under models with additive allele effects and dominant S allele effects using linear regression models. Patients were stratified by age (<50 and ⩾50 years) and sex. Of 3016 patients with 5-HTTLPR genotyping, 239 had BMD assessments. Among the younger patients, the S allele was associated with lower Z-scores at the hip (P=0.002, dominant S allele effects; P=0.004, additive allele effects) and spine (P=0.0006, dominant S allele effects; P=0.01, additive allele effects). In sex-stratified analyses, the association of the S allele with lower BMD in the younger patients was also significant in the subset of women (P⩽0.003 for both hip and spine BMD under the additive allele effect model). In the small group of men younger than 50 years, the S allele was marginally associated with higher spine BMD (P=0.05). BMD T-scores were not associated with 5-HTTLPR genotypes in patients 50 years or older. The 5-HTTLPR variants may modify serotonin effects on bone with sex-specific effects.
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35
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Abstract
Serotonin was first discovered in the gut, and its conventional actions as an intercellular signalling molecule in the intrinsic and extrinsic enteric reflexes are well recognized, as are a number of serotonin signalling pharmacotherapeutic targets for treatment of nausea, diarrhoea or constipation. The latest discoveries have greatly broadened our understanding of non-conventional actions of peripheral serotonin within the gastrointestinal tract and in a number of other tissues. For example, it is now clear that bacteria within the lumen of the bowel influence serotonin synthesis and release by enterochromaffin cells. Also, serotonin can act both as a pro-inflammatory and anti-inflammatory signalling molecule in the intestinal mucosa via activation of serotonin receptors (5-HT7 or 5-HT4 receptors, respectively). For decades, serotonin receptors have been known to exist in a variety of tissues other than the gut, but studies have now provided strong evidence for physiological roles of serotonin in several important processes, including haematopoiesis, metabolic homeostasis and bone metabolism. Furthermore, evidence for serotonin synthesis in peripheral tissues outside of the gut is emerging. In this Review, we expand the discussion beyond gastrointestinal functions to highlight the roles of peripheral serotonin in colitis, haematopoiesis, energy and bone metabolism, and how serotonin is influenced by the gut microbiota.
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36
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Bradaschia-Correa V, Josephson AM, Mehta D, Mizrahi M, Neibart SS, Liu C, Kennedy OD, Castillo AB, Egol KA, Leucht P. The Selective Serotonin Reuptake Inhibitor Fluoxetine Directly Inhibits Osteoblast Differentiation and Mineralization During Fracture Healing in Mice. J Bone Miner Res 2017; 32:821-833. [PMID: 27869327 PMCID: PMC5395314 DOI: 10.1002/jbmr.3045] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022]
Abstract
Chronic use of selective serotonin reuptake inhibitors (SSRIs) for the treatment of depression has been linked to osteoporosis. In this study, we investigated the effect of chronic SSRI use on fracture healing in two murine models of bone regeneration. First, we performed a comprehensive analysis of endochondral bone healing in a femur fracture model. C57/BL6 mice treated with fluoxetine, the most commonly prescribed SSRI, developed a normal cartilaginous soft-callus at 14 days after fracture and demonstrated a significantly smaller and biomechanically weaker bony hard-callus at 28 days. In order to further dissect the mechanism that resulted in a smaller bony regenerate, we used an intramembranous model of bone healing and revealed that fluoxetine treatment resulted in a significantly smaller bony callus at 7 and 14 days postinjury. In order to test whether the smaller bony regenerate following fluoxetine treatment was caused by an inhibition of osteogenic differentiation and/or mineralization, we employed in vitro experiments, which established that fluoxetine treatment decreases osteogenic differentiation and mineralization and that this effect is serotonin-independent. Finally, in a translational approach, we tested whether cessation of the medication would result in restoration of the regenerative potential. However, histologic and μCT analysis revealed non-union formation in these animals with fibrous tissue interposition within the callus. In conclusion, fluoxetine exerts a direct, inhibitory effect on osteoblast differentiation and mineralization, shown in two disparate murine models of bone repair. Discontinuation of the drug did not result in restoration of the healing potential, but rather led to complete arrest of the repair process. Besides the well-established effect of SSRIs on bone homeostasis, our study provides strong evidence that fluoxetine use negatively impacts fracture healing. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Vivian Bradaschia-Correa
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA
| | - Anne M Josephson
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA
| | - Devan Mehta
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA
| | - Matthew Mizrahi
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA
| | - Shane S Neibart
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA
| | - Chao Liu
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA.,Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, New York, NY, USA
| | - Oran D Kennedy
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA.,Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, New York, NY, USA
| | - Alesha B Castillo
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA.,Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, New York, NY, USA
| | - Kenneth A Egol
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA
| | - Philipp Leucht
- Department of Orthopaedic Surgery, Langone Medical Center-Hospital for Joint Diseases, New York University, New York, NY, USA.,Department of Cell Biology, School of Medicine, New York University, New York, NY, USA
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37
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Zhou Y, He Y, Xing W, Zhang P, Shi H, Chen S, Shi J, Bai J, Rhodes SD, Zhang F, Yuan J, Yang X, Zhu X, Li Y, Hanenberg H, Xu M, Robertson KA, Yuan W, Nalepa G, Cheng T, Clapp DW, Yang FC. An abnormal bone marrow microenvironment contributes to hematopoietic dysfunction in Fanconi anemia. Haematologica 2017; 102:1017-1027. [PMID: 28341737 PMCID: PMC5451333 DOI: 10.3324/haematol.2016.158717] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 03/20/2017] [Indexed: 01/04/2023] Open
Abstract
Fanconi anemia is a complex heterogeneous genetic disorder with a high incidence of bone marrow failure, clonal evolution to acute myeloid leukemia and mesenchymal-derived congenital anomalies. Increasing evidence in Fanconi anemia and other genetic disorders points towards an interdependence of skeletal and hematopoietic development, yet the impact of the marrow microenvironment in the pathogenesis of the bone marrow failure in Fanconi anemia remains unclear. Here we demonstrated that mice with double knockout of both Fancc and Fancg genes had decreased bone formation at least partially due to impaired osteoblast differentiation from mesenchymal stem/progenitor cells. Mesenchymal stem/progenitor cells from the double knockout mice showed impaired hematopoietic supportive activity. Mesenchymal stem/progenitor cells of patients with Fanconi anemia exhibited similar cellular deficits, including increased senescence, reduced proliferation, impaired osteoblast differentiation and defective hematopoietic stem/progenitor cell supportive activity. Collectively, these studies provide unique insights into the physiological significance of mesenchymal stem/progenitor cells in supporting the marrow microenvironment, which is potentially of broad relevance in hematopoietic stem cell transplantation.
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Affiliation(s)
- Yuan Zhou
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.,Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yongzheng He
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Wen Xing
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.,Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Peng Zhang
- Sylvester Comprehensive Cancer Center, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hui Shi
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.,Sylvester Comprehensive Cancer Center, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Shi Chen
- Sylvester Comprehensive Cancer Center, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jun Shi
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Jie Bai
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Steven D Rhodes
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fengqui Zhang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Jin Yuan
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Xianlin Yang
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Xiaofan Zhu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yan Li
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Helmut Hanenberg
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Otorhinolaryngology and Head/Neck Surgery, Heinrich Heine University, Düsseldorf, Germany
| | - Mingjiang Xu
- Sylvester Comprehensive Cancer Center, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kent A Robertson
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Weiping Yuan
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Grzegorz Nalepa
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA.,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tao Cheng
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - D Wade Clapp
- Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA .,Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Feng-Chun Yang
- Sylvester Comprehensive Cancer Center, Miami, FL, USA .,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
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38
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Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Is the intake of selective serotonin reuptake inhibitors associated with an increased risk of dental implant failure? Int J Oral Maxillofac Surg 2017; 46:782-788. [PMID: 28222946 DOI: 10.1016/j.ijom.2017.01.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/22/2016] [Accepted: 01/26/2017] [Indexed: 11/28/2022]
Abstract
The aim of this retrospective study was to investigate the association between the intake of selective serotonin reuptake inhibitors (SSRIs) and the risk of dental implant failure. Patients were included if they were taking SSRIs only and no other medication, did not present any other systemic condition or compromising habits (bruxism, smoking, snuff), and complied with the use of prophylactic antibiotics for implant surgery. The multivariate generalized estimating equation (GEE) method and multilevel mixed-effects parametric survival analysis were used to test the association between SSRI exposure (predictor variable) and the risk of implant failure (outcome variable), adjusting for several potential confounders (other variables). The total number of implants with information available and meeting the necessary eligibility criteria was 931 (35 failures). These were placed in 300 patients. The implant failure rate was 12.5% for SSRI users and 3.3% for non-users (P=0.007). Kaplan-Meier analysis showed a statistically significant difference in the cumulative survival rate (P<0.001). The multivariate GEE model did not show a statistically significant association between SSRI intake and implant failure (P=0.530), nor did the multilevel model (P=0.125). It is suggested that the intake of SSRIs may not be associated with an increased risk of dental implant failure.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - J Kisch
- Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Biomaterials, Gothenburg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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39
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Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Response to the Letter to the Editor: "Factors Influencing Early Dental Implant Failures". J Dent Res 2016; 96:118. [PMID: 27864468 DOI: 10.1177/0022034516680158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- B R Chrcanovic
- 1 Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - J Kisch
- 2 Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - T Albrektsson
- 1 Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,3 Department of Biomaterials, Gothenburg University, Göteborg, Sweden
| | - A Wennerberg
- 1 Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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40
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Drost S, Massicotte A. Are selective serotonin reuptake inhibitors associated with fractures? Can Pharm J (Ott) 2016; 149:332-336. [PMID: 27829856 DOI: 10.1177/1715163516671744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sarah Drost
- Ottawa Hospital (Civic Campus) Pharmacy Department, Ottawa, Ontario
| | - Anne Massicotte
- Ottawa Hospital (Civic Campus) Pharmacy Department, Ottawa, Ontario
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41
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Abstract
Recent meta-analyses report a 70 % increase in fracture risk in selective serotonin reuptake inhibitor (SSRI) users compared to non-users; however, included studies were observational and limited in their ability to establish causality. Here, we use the Bradford Hill criteria to explore causality between SSRIs and fractures. We found a strong, consistent, and temporal relationship between SSRIs and fractures, which appears to follow a biological gradient. However, specificity and biological plausibility remain concerns. In terms of specificity, the majority of available data have limitations due to either confounding by indication or channeling bias. Self-controlled case series address some of these limitations and provide relatively strong observational evidence for a causal relationship between SSRIs and fracture. In doing so, they suggest that falls contribute to fractures in SSRI users. Whether there are also underlying changes in skeletal properties remains unresolved. Initial studies provide some evidence for skeletal effects of SSRIs; however, the pathways involved need to be established before biological plausibility can be accepted. As the link between SSRIs and fractures is based on observational data and not evidence from prospective trials, there is insufficient evidence to definitively determine a causal relationship and it appears premature to label SSRIs as a secondary cause of osteoporosis. SSRIs appear to contribute to fracture-inducing falls, and addressing any fall risk associated with SSRIs may be an efficient approach to reducing SSRI-related fractures. As fractures stemming from SSRI-induced falls are more likely in individuals with compromised bone health, it is worth considering bone density testing and intervention for those presenting with risk factors for osteoporosis.
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Affiliation(s)
- Stuart J Warden
- Center for Translational Musculoskeletal Research and Department of Physical Therapy, School of the Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St., CF-120, Indianapolis, IN, USA.
| | - Robyn K Fuchs
- Center for Translational Musculoskeletal Research and Department of Physical Therapy, School of the Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St., CF-120, Indianapolis, IN, USA
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42
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Ortuño MJ, Robinson ST, Subramanyam P, Paone R, Huang YY, Guo XE, Colecraft HM, Mann JJ, Ducy P. Serotonin-reuptake inhibitors act centrally to cause bone loss in mice by counteracting a local anti-resorptive effect. Nat Med 2016; 22:1170-1179. [PMID: 27595322 PMCID: PMC5053870 DOI: 10.1038/nm.4166] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/19/2016] [Indexed: 02/06/2023]
Abstract
The use of selective serotonin-reuptake inhibitors (SSRIs) has been associated with an increased risk of bone fracture, raising concerns about their increasingly broader usage. This deleterious effect is poorly understood, and thus strategies to avoid this side effect remain elusive. We show here that fluoxetine (Flx), one of the most-prescribed SSRIs, acts on bone remodeling through two distinct mechanisms. Peripherally, Flx has anti-resorptive properties, directly impairing osteoclast differentiation and function through a serotonin-reuptake-independent mechanism that is dependent on intracellular Ca2+ levels and the transcription factor Nfatc1. With time, however, Flx also triggers a brain-serotonin-dependent rise in sympathetic output that increases bone resorption sufficiently to counteract its local anti-resorptive effect, thus leading to a net effect of impaired bone formation and bone loss. Accordingly, neutralizing this second mode of action through co-treatment with the β-blocker propranolol, while leaving the peripheral effect intact, prevents Flx-induced bone loss in mice. Hence, this study identifies a dual mode of action of SSRIs on bone remodeling and suggests a therapeutic strategy to block the deleterious effect on bone homeostasis from their chronic use.
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Affiliation(s)
- María José Ortuño
- Department of Genetics & Development, College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Samuel T. Robinson
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Prakash Subramanyam
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY, USA
| | - Riccardo Paone
- Department of Genetics & Development, College of Physicians & Surgeons, Columbia University, New York, NY, USA
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Yung-yu Huang
- Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - X. Edward Guo
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Henry M. Colecraft
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY, USA
| | - J. John Mann
- Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Patricia Ducy
- Department of Pathology & Cell Biology, College of Physicians & Surgeons, Columbia University, New York, NY, USA
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43
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Peripheral serotonin-mediated system suppresses bone development and regeneration via serotonin 6 G-protein-coupled receptor. Sci Rep 2016; 6:30985. [PMID: 27581523 PMCID: PMC5007490 DOI: 10.1038/srep30985] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/27/2016] [Indexed: 11/30/2022] Open
Abstract
Serotonin is important in brain functions and involved in neurological diseases. It is also drawn considerable attention in bone disease since it mainly produced by the gut. Serotonin 6 G-protein-coupled receptor (5-HT6R) is clinical targets for the treatment of neurological diseases. However, 5-HT6R as a therapeutic target in bone has not been reported. Herein, we found that 5-HT6R showed higher expression in bone, and its expression was increased during bone remodeling and osteoblast differentiation. The activation of 5-HT6R by ST1936 caused the inhibition of ALP activity and mineralization in primary osteoblast cultures, which was antagonized by SB258585, an antagonist and by the knockdown of 5-HT6R. Further investigation indicated that 5-HT6R inhibited osteoblast differentiation via Jab1 in BMP2 signaling but not PKA and ERK1/2. In vivo studies showed that the activation of 5-HT6R inhibited bone regeneration in the calvarial defect mice and also delayed bone development in newborn mice; this response was antagonized by SB258585. Therefore, our findings indicate a key role of 5-HT6R in bone formation through serotonin originating in the peripheral system, and suggest that it is a novel therapeutic target for drug development in the bone repair and bone diseases.
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44
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Kanner AM. Most antidepressant drugs are safe for patients with epilepsy at therapeutic doses: A review of the evidence. Epilepsy Behav 2016; 61:282-286. [PMID: 27236241 DOI: 10.1016/j.yebeh.2016.03.022] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 03/14/2016] [Indexed: 11/15/2022]
Abstract
For a long time, there has been a misconception that all antidepressant drugs have proconvulsant effects. Yet, antidepressants of the selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) families have been not only shown to be safe when used in patients with epilepsy (PWE) but have been found to display antiepileptic properties in animal models of epilepsy. In humans randomized to SSRIs vs. a placebo for the treatment of primary major depressive episodes, the incidence of epileptic seizures was significantly lower among those treated with the antidepressants. On the other hand, SSRIs and SNRIs can display proconvulsant properties at toxic doses. This article reviews the preclinical and clinical data of antiepileptic and proconvulsant properties of these drugs and addresses special considerations to take when prescribing them for PWE.
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Affiliation(s)
- Andres M Kanner
- Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW, 14th Street, Room #1324, Miami, FL 33136, United States.
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45
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Zhang P, Xing C, Rhodes SD, He Y, Deng K, Li Z, He F, Zhu C, Nguyen L, Zhou Y, Chen S, Mohammad KS, Guise TA, Abdel-Wahab O, Xu M, Wang QF, Yang FC. Loss of Asxl1 Alters Self-Renewal and Cell Fate of Bone Marrow Stromal Cell, Leading to Bohring-Opitz-like Syndrome in Mice. Stem Cell Reports 2016; 6:914-925. [PMID: 27237378 PMCID: PMC4911496 DOI: 10.1016/j.stemcr.2016.04.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/25/2016] [Accepted: 04/26/2016] [Indexed: 12/19/2022] Open
Abstract
De novo ASXL1 mutations are found in patients with Bohring-Opitz syndrome, a disease with severe developmental defects and early childhood mortality. The underlying pathologic mechanisms remain largely unknown. Using Asxl1-targeted murine models, we found that Asxl1 global loss as well as conditional deletion in osteoblasts and their progenitors led to significant bone loss and a markedly decreased number of bone marrow stromal cells (BMSCs) compared with wild-type littermates. Asxl1−/− BMSCs displayed impaired self-renewal and skewed differentiation, away from osteoblasts and favoring adipocytes. RNA-sequencing analysis revealed altered expression of genes involved in cell proliferation, skeletal development, and morphogenesis. Furthermore, gene set enrichment analysis showed decreased expression of stem cell self-renewal gene signature, suggesting a role of Asxl1 in regulating the stemness of BMSCs. Importantly, re-introduction of Asxl1 normalized NANOG and OCT4 expression and restored the self-renewal capacity of Asxl1−/− BMSCs. Our study unveils a pivotal role of ASXL1 in the maintenance of BMSC functions and skeletal development. Asxl1 loss impairs BMSC self-renewal and cell fate Asxl1 loss leads to dramatic bone loss Asxl1 loss alters the expression of genes critical for cell fates of BMSCs Re-introducing Asxl1 restores self-renewal and lineage commitment in Asxl1−/− BMSCs
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Affiliation(s)
- Peng Zhang
- Department of Biochemistry and Molecular Biology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Caihong Xing
- Key Laboratory of Genomic and Precision Medicine, Collaborative Innovation Center of Genetics and Development, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Steven D Rhodes
- Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Yongzheng He
- Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Kai Deng
- Department of Biochemistry and Molecular Biology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Zhaomin Li
- Department of Biochemistry and Molecular Biology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Fuhong He
- Key Laboratory of Genomic and Precision Medicine, Collaborative Innovation Center of Genetics and Development, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Caiying Zhu
- Key Laboratory of Genomic and Precision Medicine, Collaborative Innovation Center of Genetics and Development, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital and Center for Stem Cell Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China
| | - Lihn Nguyen
- Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Yuan Zhou
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital and Center for Stem Cell Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China
| | - Shi Chen
- Department of Biochemistry and Molecular Biology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Khalid S Mohammad
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Theresa A Guise
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Omar Abdel-Wahab
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Mingjiang Xu
- Department of Biochemistry and Molecular Biology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Qian-Fei Wang
- Key Laboratory of Genomic and Precision Medicine, Collaborative Innovation Center of Genetics and Development, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China.
| | - Feng-Chun Yang
- Department of Biochemistry and Molecular Biology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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46
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Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Factors Influencing Early Dental Implant Failures. J Dent Res 2016; 95:995-1002. [PMID: 27146701 DOI: 10.1177/0022034516646098] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present study was to assess the influence of local and systemic factors on the occurrence of dental implant failures up to the second-stage surgery (abutment connection). This retrospective study is based on 2,670 patients who received 10,096 implants and were consecutively treated with implant-supported prostheses between 1980 and 2014 at 1 specialist clinic. Several anatomic-, patient-, health-, and implant-related factors were collected. Descriptive statistics were used to describe the patients and implants. Univariate and multivariate logistic regression models were used at the patient level as well as the implant level to evaluate the effect of explanatory variables on the failure of implants up to abutment connection. A generalized estimating equation method was used for the implant-level analysis to account for the fact that repeated observations (several implants) were available for a single patient. Overall, 642 implants (6.36%) failed, of which 176 (1.74%) in 139 patients were lost up to second-stage surgery. The distribution of implants in sites of different bone quantities and qualities was quite similar between implants lost up to and after abutment connection. Smoking and the intake of antidepressants were the statistically significant predictors in the multivariate model (ClinicalTrials.gov NCT02369562).
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - J Kisch
- Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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47
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Hoffmann DB, Böker KO, Schneider S, Eckermann-Felkl E, Schuder A, Komrakova M, Sehmisch S, Gruber J. In Vivo siRNA Delivery Using JC Virus-like Particles Decreases the Expression of RANKL in Rats. MOLECULAR THERAPY. NUCLEIC ACIDS 2016; 5:e298. [PMID: 27003757 PMCID: PMC5014456 DOI: 10.1038/mtna.2016.15] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/04/2016] [Indexed: 01/29/2023]
Abstract
Bone remodeling requires a precise balance between formation and resorption. This complex process involves numerous factors that orchestrate a multitude of biochemical events. Among these factors are hormones, growth factors, vitamins, cytokines, and, most notably, osteoprotegerin (OPG) and the receptor activator for nuclear factor-kappaB ligand (RANKL). Inflammatory cytokines play a major role in shifting the RANKL/OPG balance toward excessive RANKL, resulting in osteoclastogenesis, which in turn initiates bone resorption, which is frequently associated with osteoporosis. Rebalancing RANKL/OPG levels may be achieved through either upregulation of OPG or through transient silencing of RANKL by means of RNA interference. Here, we describe the utilization of a viral capsid-based delivery system for in vivo and in vitro RNAi using synthetic small interfering RNA (siRNA) molecules in rat osteoblasts. Polyoma JC virus-derived virus-like particles are capable of delivering siRNAs to target RANKL in osteoblast cells both in vitro and in a rat in vivo system. Expression levels were monitored using quantitative real-time polymerase reaction and enzyme-linked immunosorbent assay after single and repeated injections over a 14-day period. Our data indicate that this is an efficient and safe route for in vivo delivery of gene modulatory tools to study important molecular factors in a rat osteoporosis model.
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Affiliation(s)
- Daniel B Hoffmann
- Department of Trauma Surgery and Reconstructive Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Kai O Böker
- Primate Genetics Laboratory, Junior Research Group "Medical RNA Biology," German Primate Center, Göttingen, Germany
| | - Stefan Schneider
- Primate Genetics Laboratory, Junior Research Group "Medical RNA Biology," German Primate Center, Göttingen, Germany
| | - Ellen Eckermann-Felkl
- Primate Genetics Laboratory, Junior Research Group "Medical RNA Biology," German Primate Center, Göttingen, Germany
| | - Angelina Schuder
- Primate Genetics Laboratory, Junior Research Group "Medical RNA Biology," German Primate Center, Göttingen, Germany
| | - Marina Komrakova
- Department of Trauma Surgery and Reconstructive Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Stephan Sehmisch
- Department of Trauma Surgery and Reconstructive Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Jens Gruber
- Primate Genetics Laboratory, Junior Research Group "Medical RNA Biology," German Primate Center, Göttingen, Germany
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48
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Erjavec I, Bordukalo-Niksic T, Brkljacic J, Grcevic D, Mokrovic G, Kesic M, Rogic D, Zavadoski W, Paralkar VM, Grgurevic L, Trkulja V, Cicin-Sain L, Vukicevic S. Constitutively Elevated Blood Serotonin Is Associated with Bone Loss and Type 2 Diabetes in Rats. PLoS One 2016; 11:e0150102. [PMID: 26907598 PMCID: PMC4764355 DOI: 10.1371/journal.pone.0150102] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 02/09/2016] [Indexed: 11/19/2022] Open
Abstract
Reduced peripheral serotonin (5HT) in mice lacking tryptophan hydroxylase (TPH1), the rate limiting enzyme for 5HT synthesis, was reported to be anabolic to the skeleton. However, in other studies TPH1 deletion either had no bone effect or an age dependent inhibition of osteoclastic bone resorption. The role of 5HT in bone therefore remains poorly understood. To address this issue, we used selective breeding to create rat sublines with constitutively high (high-5HT) and low (low-5HT) platelet 5HT level (PSL) and platelet 5HT uptake (PSU). High-5HT rats had decreased bone volume due to increased bone turnover characterized by increased bone formation and mineral apposition rate, increased osteoclast number and serum C-telopeptide level. Daily oral administration of the TPH1 inhibitor (LX1032) for 6 weeks reduced PSL and increased the trabecular bone volume and trabecular number of the spine and femur in high-5HT rats. High-5HT animals also developed a type 2 diabetes (T2D) phenotype with increased: plasma insulin, glucose, hemoglobin A1c, body weight, visceral fat, β-cell pancreatic islets size, serum cholesterol, and decreased muscle strength. Serum calcium accretion mediated by parathyroid hormone slightly increased, whereas treatment with 1,25(OH)2D3 decreased PSL. Insulin reduction was paralleled by a drop in PSL in high-5HT rats. In vitro, insulin and 5HT synergistically up-regulated osteoblast differentiation isolated from high-5HT rats, whereas TPH1 inhibition decreased the number of bone marrow-derived osteoclasts. These results suggest that constitutively elevated PSL is associated with bone loss and T2D via a homeostatic interplay between the peripheral 5HT, bone and insulin.
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Affiliation(s)
- Igor Erjavec
- Laboratory of Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tatjana Bordukalo-Niksic
- Laboratory of Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Jelena Brkljacic
- Laboratory of Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Danka Grcevic
- Department of Physiology and Immunology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Gordana Mokrovic
- Laboratory for Neurochemistry and Molecular Neurobiology, Molecular Biology Department, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Maja Kesic
- Laboratory for Neurochemistry and Molecular Neurobiology, Molecular Biology Department, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Dunja Rogic
- Clinical Hospital Center Zagreb, Zagreb, Croatia
| | | | | | - Lovorka Grgurevic
- Laboratory of Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vladimir Trkulja
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Lipa Cicin-Sain
- Laboratory for Neurochemistry and Molecular Neurobiology, Molecular Biology Department, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Slobodan Vukicevic
- Laboratory of Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, Croatia
- * E-mail:
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49
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Terry N, Margolis KG. Serotonergic Mechanisms Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance. Handb Exp Pharmacol 2016; 239:319-342. [PMID: 28035530 DOI: 10.1007/164_2016_103] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Serotonin (5-hydroxytryptamine; 5-HT) is best known as a neurotransmitter critical for central nervous system (CNS) development and function. 95% of the body's serotonin, however, is produced in the intestine where it has been increasingly recognized for its hormonal, autocrine, paracrine, and endocrine actions. This chapter provides the most current knowledge of the critical autocrine and paracrine roles of 5-HT in intestinal motility and inflammation as well as its function as a hormone in osteocyte homeostasis. Therapeutic applications in each of these areas are also discussed.
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Affiliation(s)
- Natalie Terry
- Division of Pediatric Gastroenterology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Kara Gross Margolis
- Division of Pediatric Gastroenterology, Department of Pediatrics, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA.
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50
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Golub MS, Bulleri AM, Hogrefe CE, Sherwood RJ. Bone growth in juvenile rhesus monkeys is influenced by 5HTTLPR polymorphisms and interactions between 5HTTLPR polymorphisms and fluoxetine. Bone 2015; 79:162-9. [PMID: 26067181 PMCID: PMC4511468 DOI: 10.1016/j.bone.2015.05.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/12/2015] [Accepted: 05/31/2015] [Indexed: 01/02/2023]
Abstract
Male rhesus monkeys received a therapeutic oral dose of the selective serotonin reuptake inhibitor (SSRI) fluoxetine daily from 1 to 3 years of age. Puberty is typically initiated between 2 and 3 years of age in male rhesus and reproductive maturity is reached at 4 years. The study group was genotyped for polymorphisms in the monoamine oxidase A (MAOA) and serotonin transporter (SERT) genes that affect serotonin neurotransmission. Growth was assessed with morphometrics at 4 month intervals and radiographs of long bones were taken at 12 month intervals to evaluate skeletal growth and maturation. No effects of fluoxetine, or MAOA or SERT genotype were found for growth during the first year of the study. Linear growth began to slow during the second year of the study and serotonin reuptake transporter (SERT) long polymorphic region (5HTTLPR) polymorphism effects with drug interactions emerged. Monkeys with two SERT 5HTTLPR L alleles (LL, putative greater transcription) had 25-39% less long bone growth, depending on the bone, than monkeys with one S and one L allele (SL). More advanced skeletal maturity was also seen in the LL group, suggesting earlier onset of puberty. An interaction between 5HTTLPR polymorphisms and fluoxetine was identified for femur and tibia growth; the 5HTTLPR effect was seen in controls (40% less growth for LL) but not in the fluoxetine treated group (10% less growth for LL). A role for serotonin in peripubertal skeletal growth and maturation has not previously been investigated but may be relevant to treatment of children with SSRIs.
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Affiliation(s)
- Mari S Golub
- Department of Environmental Toxicology, University of California, Davis, Davis, CA 95616, USA.
| | - Alicia M Bulleri
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Casey E Hogrefe
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Richard J Sherwood
- Division of Morphological Sciences and Biostatistics, Boonshoft School of Medicine, Wright State University, Dayton, OH 45434, USA
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