L-arginine, the natural precursor of NO, is not effective for preventing bone loss in postmenopausal women

Alterations in bone metabolites with age in C57BL/6 mice model

Understanding the pathophysiology behind age-related diseases is an urgent need as the elderly population continues to grow. With age, there is a high risk of musculoskeletal deterioration and associated morbidity and mortality. Although the exact mechanism behind age-related degeneration is unknown, it is well established that alteration in cellular metabolism is one of the important contributing factors. Alteration in signaling pathways with age leads to the accumulation or depletion of several metabolites that play a vital role in musculoskeletal pathophysiology. This study aimed to identify age-related changes in bone tissue metabolites in C57BL/6 mice. We then correlated the differentially expressed metabolites with their functions in bone biology. In both aged males and females, hydroxyproline, glutamine, and alpha-linolenic acid levels were decreased. In aged females, Ornithine (p value = 0.001), L-Proline (p value = 0.008), Uridine (p value = 0.001), Aspartic Acid (p value = 0.004) levels were significantly decreased, and glutamate (p value = 0.002) was elevated. In aged males, N-acetyl-D-glucosamine (pvalue = 0.010), Adrenic acid (pvalue = 0.0099), Arachidonic acid (p value = 0.029) and Allantoin (p value = 0.004) levels were decreased. Metabolic pathway analysis revealed that purine and D-glutamine and D-glutamate metabolism were significantly altered in both sexes, while arginine biosynthesis in females and lipid metabolism in males were highly affected. These differences in metabolic signaling might be one of the reasons for the discrepancy in musculoskeletal disease manifestation between the two sexes. Understanding the role of these metabolites play in the aging bone will allow for new sex-specific targeted therapies against the progression of musculoskeletal diseases.

The potential role of beef and nutrients found in beef on outcomes of wellbeing in healthy adults 50 years of age and older: A systematic review of randomized controlled trials

Shifts in wellbeing and health occur as we age. As life expectancy increases, maintenance of wellbeing and health becomes increasingly important. Nutrients found in beef are associated with outcomes of wellbeing such as physical and cognitive function, lean body mass, and mood in older adults and individuals with chronic disease. However, it is unclear how beef and nutrients found in beef impact wellbeing in healthy adults ≥50 years of age. This study systematically reviewed evidence linking the intake of beef and nutrients found in beef to markers of wellbeing in healthy adults. PubMed, CINAHL, and Web of Science were searched up to August 31, 2021 for eligible randomized controlled trials (RCTs). Nutrients included in the analysis were beef, red meat, dietary protein, essential amino acids, branched chain amino acids, tryptophan, arginine, cysteine, glycine, glutamate, vitamin B6, vitamin B12, choline, zinc, and iron. We identified nine RCTs with results from 55 measurements of markers of wellbeing. An overall positive effect was found of beef and beef's nutrients on wellbeing. There was an overall positive effect of amino acids and protein on wellbeing, with no effect of arginine, vitamin B-12, leucine, and zinc. Physical function was also influenced by beef and nutrients found in beef. Eight of the studies found focused on specific nutrients found in beef, and not beef itself in older adults with one or more chronic diseases. This study identified a need for further research regarding the effect of beef and nutrients found in beef on defined functional outcomes of wellbeing in healthy adults ≥50 years of age.

Adjuvant drug-assisted bone healing: Part II - Modulation of angiogenesis

 The treatment of critical-size bone defects following complicated fractures, infections or tumor resections is a major challenge. The same applies to fractures in patients with impaired bone healing due to systemic inflammatory and metabolic diseases. Despite considerable progress in development and establishment of new surgical techniques, design of bone graft substitutes and imaging techniques, these scenarios still represent unresolved clinical problems. However, the development of new active substances offers novel potential solutions for these issues. This work discusses therapeutic approaches that influence angiogenesis or hypoxic situations in healing bone and surrounding tissue. In particular, literature on sphingosine-1-phosphate receptor modulators and nitric oxide (NO•) donors, including bi-functional (hybrid) compounds like NO•-releasing cyclooxygenase-2 inhibitors, was critically reviewed with regard to their local and systemic mode of action.

A radical form of nitric oxide inhibits porcine circovirus type 2 replication in vitro

Background

Porcine circovirus type 2 (PCV2) is the causal agent of postweaning multisystemic wasting syndrome (PMWS), causing large economical losses of the global swine industry. Nitric oxide (NO), as an important signaling molecule, has antiviral activity on some viruses. To date, there is little information on the role of NO during PCV2 infection.

Results

We used indirect fluorescence assay (IFA), TCID₅₀, real-time RT-qPCR and western blot assay to reveal the role of NO in restricting PCV2 replication. PCV2 replication was inhibited by a form of NO, NO^•, whereas PCV2 was not susceptible to another form of NO, NO⁺.

Conclusion

Our findings indicate that the form of NO^• has a potential role in the fight against PCV2 infection.

Nitric oxide-generating compound GSNO suppresses porcine circovirus type 2 infection in vitro and in vivo

Background

Nitric oxide (NO), an important signaling molecule with biological functions, has antimicrobial activity against a variety of pathogens including viruses. To our knowledge, little information is available about the regulatory effect of NO on porcine circovirus type 2 (PCV2) infection. This study was conducted to investigate the antiviral activity of NO generated from S-nitrosoglutathione (GSNO), during PCV2 infection of PK-15 cells and BALB/c mice.

Results

GSNO released considerable NO in the culture medium of PK-15 cells, and NO was scavenged by its scavenger hemoglobin (Hb) in a dose-dependent manner. NO strongly inhibited PCV2 replication in PK-15 cells, and the antiviral effect was reversed by Hb. An in vivo assay indicated that GSNO treatment reduced the progression of PCV2 infection in mice, evident as reductions in the percentages of PCV2-positive sera and tissue samples and in the viral DNA copies in serum samples. GSNO also improved the growth performance and immune organs (spleens and thymuses) of the PCV2-infected mice to some degree.

Conclusions

Our data demonstrate that the NO-generating compound GSNO suppresses PCV2 infection in PK-15 cells and BALB/c mice, indicating that NO and its donor, GSNO, have potential value as antiviral drugs against PCV2 infection.

A Trimodality Comparison of Volumetric Bone Imaging Technologies. Part II: 1-Yr Change, Long-Term Precision, and Least Significant Change

The previous article in this 3-part series demonstrated short-term precision and validity for volumetric bone outcome quantification using in vivo peripheral (p) quantitative computed tomography (pQCT) and magnetic resonance imaging (MRI) modalities at resolutions 200 μm or higher. However, 1-yr precision error and clinically significant references are yet to be reported for these modalities. This study examined 59 women with mean age of 75 ± 9 yr and body mass index of 26.84 ± 4.77 kg/m², demonstrating the lowest 1-yr precision error, standard errors of the estimate, and least significant change values for high-resolution (hr) pQCT followed by pQCT, and 1.0-T pMRI for all volumetric bone outcomes except trabecular number. Like short-term precision, 1-yr statistics for trabecular separation were similar across modalities. Excluding individuals with a previous history of fragility fractures, or who were current users of antiresorptives reduced 1-yr change for bone outcomes derived from pQCT and pMR images, but not hr-pQCT images. In Part II of this 3-part series focused on trimodality comparisons of 1-yr changes, hr-pQCT was recommended to be the prime candidate for quantifying change where smaller effect sizes are expected, but pQCT was identified as a feasible alternative for studies expecting larger changes.

Update on nutrients involved in maintaining healthy bone

Osteoporosis is a leading cause of morbidity and mortality in the elderly and influences quality of life, as well as life expectancy. Currently, there is a growing interest among the medical scientists in search of specific nutrients and/or bioactive compounds of natural origin for the prevention of disease and maintenance of bone health. Although calcium and vitamin D have been the primary focus of nutritional prevention of osteoporosis, a recent research has clarified the importance of several additional nutrients and food constituents. Based on this review of the literature, supplementation with vitamins B, C, K, and silicon could be recommended for proper maintenance of bone health, although further clinical studies are needed. The results of studies on long-chain polyunsaturated fatty acids, potassium, magnesium, copper, selenium, and strontium are not conclusive, although studies in vitro and in animal models are interesting and promising.

Effects of ovariectomy and ascorbic acid supplement on oxidative stress parameters and bone mineral density in rats

OBJECTIVES

The aim of this study is to investigate the effects of ovariectomy on bone mineral density (BMD) and oxidative state in rats, and the alterations in these effects that vitamin C supplementation may produce.

MATERIALS AND METHODS

TWENTY FEMALE WISTAR ALBINO RATS WERE RANDOMLY DIVIDED INTO THREE GROUPS: control (C, n=6); ovariectomy (O, n=7); and ovariectomy+vitamin C supplement (OV, n=7). Oxidative stress (OS) was assessed 100 days postovariectomy by measuring the activity of several enzymes, including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase, as well as the concentrations of malondialdehyde (MDA), nitric oxide (NO), and total sulfhydryl groups in plasma and bone homogenates.

RESULTS

A significant decrease in BMD was observed in O group compared with C group (p=0.015), and a significant increase was observed in OV compared with O group (p=0.003). When groups were compared with respect to parameters of OS, MDA and NO levels in bone tissue were significantly higher in O than in C (p=0.032, p=0.022) and were significantly lower in OV than in O (p=0.025, p=0.018). SOD activity was significantly higher in O than in C (p=0.032). In plasma, MDA activity was significantly higher in O than in C (p=0.022) and NO level was significantly higher in O than in C and OV (p=0.017, p=0.018).

CONCLUSIONS

Our results suggest that ovariectomy may produce osteoporosis and OS in females, and vitamin C supplementation may provide alterations regarding improvement in OS and BMD values. We assume that studies including more subjects are needed to make a decisive conclusion about OS-BMD relation.

L-arginine supplementation normalizes bone turnover and preserves bone mass in streptozotocin-induced diabetic rats

Osteopenia, an important complication of diabetes mellitus, is responsible of an increase in bone fracture and of a delay in fracture healing. The pathogenesis of this complication is unclear, however decreased availability and synthesis of nitric oxide (NO) may be regarded as a possible cause of disregulation of bone turnover. The aim of our study was to evaluate the effect of streptozotocin (STZ)-induced diabetes in the rat on bone mineral density (BMD) and bone turnover. We also examined whether supplementation of L-arginine (which acts as a NO substrate) could be beneficial for bone. After 6 weeks of STZ treatment, diabetic rats showed a significant decrease of BMD in the whole body, at the spine, at the pelvis, and at the femur. Bone turnover evaluation revealed a significant decrease in the serum levels of osteocalcin (a marker of bone formation), and an increase of the serum levels of the C-terminal telopeptide of type I collagen (RatLaps; a marker of bone resorption). L-arginine supplementation prevented the diabetes-induced reduction of BMD and osteocalcin, and the increase of RatLaps. These pharmacological actions of L-arginine produce a new suggestion that increase of NO synthesis and availability is potentially useful for effective prevention and treatment of osteopenia associated with diabetes.

Osteoporosis: pathogenesis, new therapies and surgical implications

Many developments occurred in the realm of bone healing in recent years. Genetic discoveries, new proteins affecting bone health, and new treatments have steered our treatment of traumatic and iatrogenic fractures in new directions. Osteoporosis strikes many subsets of the world population, including: women, the elderly, and those suffering from arthritis, autoimmune diseases, HIV, and the immunocompromised. This disease predisposes people to an increased risk of low trauma and fragility fractures. The baby boomer generation and an increasing lifespan may burden the economy by creating such a large group susceptible to such a potentially devastating disease. The novel treatments and coping with the potentially challenging surgical implications will aide the podiatric physician in both medical and surgical management of osteoporosis.

Effects of calcitonin, risedronate, and raloxifene on erythrocyte antioxidant enzyme activity, lipid peroxidation, and nitric oxide in postmenopausal osteoporosis

BACKGROUND

The aims of this study were to compare erythrocyte antioxidant enzyme activities, lipid peroxidation, and nitric oxide levels (NO) in women with postmenopausal osteoporosis (PMO) and non-porotic postmenopausal healthy controls and to assess the relationship between bone mineral density and these oxidant/antioxidant parameters. Additionally, in vivo effects of three different anti-osteoporotic drugs, calcitonin, risedronate and raloxifene, on the erythrocyte oxidant-antioxidant status in women with PMO were also assessed.

METHODS

Postmenopausal women aged 40-65 years and without previous diagnosis or treatment for osteoporosis and independent in activities of daily living were included. Bone mineral density was measured at the lumbar spine and proximal femur using DXA. Erythrocyte enzyme activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and lipid peroxidation end-product malondialdehyde (MDA) and nitrite/nitrate levels, by product of NO, were assessed. Fifty-nine women with PMO were included (mean age 56.7 years), 44 completed course of therapy and were analyzed. Twenty-two non-porotic healthy women (mean age 55.8 years) were included as controls.

RESULTS

Patients had significantly lower CAT and GSH-Px enzyme activity and higher levels of MDA and NO than non-porotic healthy controls. Proximal femur BMD measurements significantly correlated with NO levels. QUALEFFO scores improved in different levels with these short-term treatments. In all treatment groups, erythrocyte MDA levels significantly decreased; moreover, risedronate reduced NO levels and raloxifene enhanced CAT enzyme activity.

CONCLUSIONS

Oxidative stress plays an important role in the pathogenesis of PMO. Studied drugs had ultimate effects on reducing lipid peroxidation. Raloxifene also had potent effects in the enhancement of antioxidant defense system.

Role of antioxidant systems, lipid peroxidation, and nitric oxide in postmenopausal osteoporosis

In this study we assessed activities of antioxidant enzymes, lipid peroxidation end-products, and nitric oxide (NO) levels in women with postmenopausal osteoporosis (PMO). Relationship between oxidative stress parameters and NO levels with bone mineral density (BMD) and clinical variables influencing bone mass and health related quality of life measures was also investigated in women with PMO. Postmenopausal women (n=87), aged 40-65, without previous diagnosis or treatment for osteoporosis and independent in daily living activities were included. BMD was measured at the lumbar spine and proximal femur using dual-X-ray absorptiometry (DXA). Erythrocyte catalase (CATe) enzyme activity, erythrocyte and plasma enzyme activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and lipid peroxidation end-product malondialdehyde (MDA) and nitrite/nitrate levels, by product of NO were studied. A total of 23 healthy non-porotic women were included as controls. Women with PMO had significantly lower erythrocyte CATe enzyme activity and higher erythrocyte malondialdehyde (MDAe) and erythrocyte nitric oxide (NOe) levels in comparison to controls whereas erythrocyte SODe and GSH-Px enzyme activity was similar. In plasma, osteoporotic women had significantly higher SOD enzyme activity and higher MDA levels whereas similar GSH-Px enzyme activity and NO levels compared to non-porotic controls. Significant correlation was found between erythrocyte SODe, CATe enzyme activity and NOe levels with proximal femur BMD. Some of the quality of life scores as pain, mental, and social functions correlated with antioxidant enzyme activities and NO levels.Consequently, oxidative stress markers may be an important indicator for bone loss in postmenopausal women. Further researches assessing the oxidative stress markers and NO in bone tissue and changes with anti-osteoporotic drugs would be valuable to better understand the role of free radicals, antioxidants, and NO in the regulation of bone mass.