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Liu Y, Zhou M, Wang R, Liang Y, Zhuang G, Chen X, Luo S, Cai Y, Song C, Liu L, Ma L, Yao W, Liu Y, Cui L. Alleviation of Glucocorticoid-Induced Osteoporosis in Rats by Ethanolic Reynoutria multiflora (Thunb.) Moldenke Extract. J Med Food 2024; 27:287-300. [PMID: 38442325 DOI: 10.1089/jmf.2023.k.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
Secondary osteoporosis is frequently due to the use of high-dose glucocorticoids (GCs). The existing strategy for managing glucocorticoid-induced osteoporosis (GIOP) is considered insufficient and remains in a state of ongoing evolution. Therefore, it is crucial to develop more precise and effective agents for the treatment of GIOP. The constituents of Reynoutria multiflora (Thunb.) Moldenke, specifically Polygonum multiflorum (PM) Thunb, have previously shown promise in mitigating osteopenia. This study aimed to investigate the therapeutic effects of an ethanolic PM extract (PMR30) against GIOP in male rats. Prednisone (6 mg/kg/day, GC) was continuously administered to rats to induce GIOP, and they were subjected to treatment with or without ethanolic PMR30 for a duration of 120 days. Serum was collected for biochemical marker analysis. Bone histomorphometric, histological, and TUNEL analyses were performed on tibia samples. The protein expressions of LC3, Agt5, and Beclin 1 in the femur underwent examination through western blotting. Prolonged and excessive GC treatment significantly impeded bone formation, concomitant with reduced bone mass and body weight. It also suppressed OCN and OPG/RANKL in serum, and decreased Beclin 1 and LC3 in bone. Simultaneously, there was an elevation in bone resorption markers and apoptosis. Treatments with both high dose and low dose of PMR30 alleviated GIOP, stimulated bone formation, and upregulated OCN and OPG/RANKL, while suppressing TRACP-5b, CTX-I, and apoptosis. The impact of PMR30 possibly involves the enhancement of autophagy proteins (LC3, Agt5, and Beclin 1) and the inhibition of apoptosis within the bone. PMR30 holds promise as a prospective therapeutic agent for preventing and treating GIOP.
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Affiliation(s)
- Yuyu Liu
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
| | - Manru Zhou
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
- Guangdong Vocational Institute of Public Administration, Guangzhou, China
| | - Rui Wang
- Chemistry and Pharmacy Experimental Teaching Center, Guangdong Medical University, Zhanjiang, China
| | - Yuyu Liang
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
| | - Guangjie Zhuang
- The First School of Clinical Medical, Guangdong Medical University, Zhanjiang, China
| | - Xuelin Chen
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
| | - Shiying Luo
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
| | - Yuliang Cai
- Department of Respiratory Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Chuge Song
- Department of Respiratory Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Lingna Liu
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
| | - Luoyang Ma
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
| | - Weimin Yao
- Department of Respiratory Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yanzhi Liu
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
- Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, China
| | - Liao Cui
- Guangdong Key Laboratory for Research and Development of Natural Drug, Department of Pharmacology, Guangdong Medical University, Zhanjiang, China
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Chanakul A, Khunrattanaphon S, Deekajorndech T. Low bone mineral density in Thai children with systemic lupus erythematosus: prevalence and risk factors. ASIAN BIOMED 2021; 15:245-250. [PMID: 37551322 PMCID: PMC10388791 DOI: 10.2478/abm-2021-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Improvement of disease recognition and management has increased the survival of children with systemic lupus erythematosus (SLE), but has shifted the morbidity focus toward long-term complications, such as low bone mass and osteoporosis. Studies in adults with SLE show older age, chronic inflammation, and corticosteroid therapy are risk factors for low bone mineral density (BMD) and osteoporosis. Objectives To determine the prevalence of and identify risk factors associated with low BMD in Thai children with SLE. Methods We conducted a retrospective review of demographic data and clinical variables for a cohort of 60 Thai children with SLE who underwent 2 dual-energy X-ray absorptiometry (DXA) at their initial examination and later follow-up. We considered a BMD z score ≤ -2.0 to indicate low BMD. Binary logistic regression was used to assess risk factors potentially associated with low BMD. Results The prevalence of low BMD at the first visit was 40% and increased to 55% over follow-up. We found a significantly decreased hip BMD z score (median difference -0.25, 95% confidence interval [CI] -0.40 to -0.05; P = 0.016) and lumbar BMD z score (median difference -0.49, 95% CI -0.69 to -0.28; P < 0.001) over time. The cumulative steroid dose tended to be higher for patients with low BMD (adjusted odds ratio [OR] = 1.08, 95% CI 1.00 to 1.17; P = 0.050). Conclusion Low BMD has a 40% prevalence in Thai children newly diagnosed with SLE and progresses significantly over time. Higher cumulative corticosteroid dose tended to be associated with a low BMD, but we did not find a significant risk in this small sample.
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Affiliation(s)
- Ankanee Chanakul
- Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok10330, Thailand
| | | | - Tawatchai Deekajorndech
- Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok10330, Thailand
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Jacobson DL, Lindsey JC, Gordon C, Hazra R, Spiegel H, Ferreira F, Amaral FR, Pagano-Therrien J, Gaur A, George K, Benson J, Siberry GK. Alendronate Improves Bone Mineral Density in Children and Adolescents Perinatally Infected With Human Immunodeficiency Virus With Low Bone Mineral Density for Age. Clin Infect Dis 2021; 71:1281-1288. [PMID: 31573608 DOI: 10.1093/cid/ciz957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 09/25/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Children and adolescents with perinatal human immunodeficiency virus (HIV) infection and with low bone mineral density (BMD) may be at higher risk of osteoporosis and fractures in later life than their uninfected peers. Bisphosphonate therapy has been shown to reduce fractures in adults with osteoporosis, but has not been formally studied in youths living with HIV. METHODS Fifty-two children and adolescents (aged 11-24 years) perinatally infected with HIV with low lumbar spine (LS) BMD (Z score < -1.5) were randomized to receive once-weekly alendronate or placebo in a double-blind cross-over study designed to assess the safety and efficacy of 48 and 96 weeks of alendronate in the United States and Brazil. All participants received daily calcium carbonate and vitamin D supplementation and were asked to engage in regular weight-bearing exercise. Safety and efficacy are summarized for the initial 48 weeks of the trial. RESULTS Grade 3 or higher abnormal laboratory values, signs, or symptoms developed in 5 of 32 (16%) participants on alendronate and 2 of 18 (11%) on placebo (P > .99). No cases of jaw osteonecrosis, atrial fibrillation, or nonhealing fractures were reported. Mean increases (95% confidence interval) in LS BMD over 48 weeks were significantly larger on alendronate (20% [14%-25%]) than placebo (7% [5%-9%]) (P < .001). Similar improvements were seen for whole body BMD. CONCLUSIONS In this small study in children and adolescents perinatally infected with HIV with low LS BMD, 48 weeks of alendronate was well-tolerated, showed no safety concerns, and significantly improved LS and whole body BMD compared to participants on vitamin D/calcium supplementation and exercise alone. CLINICAL TRIALS REGISTRATION NCT00921557.
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Affiliation(s)
- Denise L Jacobson
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jane C Lindsey
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Catherine Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Rohan Hazra
- Maternal and Pediatric Infectious Diseases Branch, Division of Extramural Research, Department of Health and Human Services, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Hans Spiegel
- Kelly Government Solutions, contractor to National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Flavia Ferreira
- Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fabiana R Amaral
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Aditya Gaur
- St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Kathy George
- Family Health International 360, Durham, North Carolina, USA
| | - Jane Benson
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - George K Siberry
- Office of HIV/AIDS, US Agency for International Development, Arlington, Virginia, USA; for the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1076 Study Team
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Hsu CN, Jen CY, Chen YH, Peng SY, Wu SC, Yao CL. Glucocorticoid transiently upregulates mitochondrial biogenesis in the osteoblast. CHINESE J PHYSIOL 2021; 63:286-293. [PMID: 33380613 DOI: 10.4103/cjp.cjp_51_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Glucocorticoid (GC)-induced bone loss is the most prevalent form of secondary osteoporosis. Previous studies demonstrated that long-term incubation of dexamethasone (DEX) induced oxidative stress and mitochondrial dysfunctions, consequently leading to apoptosis of differentiated osteoblasts. This DEX-induced cell death might be the main causes of bone loss. We previously described that DEX induced biphasic mitochondrial alternations. As GC affects mitochondrial physiology through several different possible routes, the short-term and long-term effects of GC treatment on mitochondria in the osteoblast have not been carefully characterized. Here, we examined the expression levels of genes that are associated with mitochondrial functions at several different time points after incubation with DEX. Mitochondrial biogenesis-mediated genes nuclear respiratory factor 1 (Nrf1) and Nrf2 were upregulated after 4-h incubation, and then declined after 24-h incubation, suggesting that mitochondrial biogenesis were transiently upregulated by DEX. In contrast, mitochondrial fusion gene optic atrophy 1 (Opa1) and mitofusin 2 (Mfn2) started to be elevated as the biogenesis started to decrease. Finally, the mitochondrial fission increased and apoptosis becomes prominent. Agree with the mitochondrial biphasic alterations hypothesis, the results suggested an early increase of mitochondrial activities and biogenesis upon DEX stimulation to the osteoblasts. The oxidative phosphorylation and inducible nitric oxide synthase levels increased results in oxidative stress accumulation, leading to mitochondrial fusion, and subsequently fission and triggering the apoptosis. Our results indicated that the primary effects of GC on mitochondria are promoting their functions and biogenesis. Mitochondrial breakdown and the activation of the apoptotic pathways appeared to be the secondary effect after long-term treatment.
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Affiliation(s)
- Chien-Ning Hsu
- Department of Orthopedics, Taoyuan General Hospital, Ministry of Health and Welfare; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Chih-Yuan Jen
- Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yu-Hsu Chen
- Department of Orthopedics, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan; Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - Shao-Yu Peng
- Department of Animal Science, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Shinn-Chih Wu
- Department of Animal Science and Technology; Institute of Biotechnology, National Taiwan University, Taipei, Taiwan
| | - Chao-Ling Yao
- Graduate School of Biotechnology and Bioengineering; Department of Chemical Engineering and Materials Science, Yuan Ze University, Taoyuan, Taiwan
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Jacobson D, Liu JZ, Lindsey JC, Shiau S, Coull B, Aldrovandi G. Immune Markers and Their Association with Bone Density in Children, Adolescents, and Young Adults with Perinatally Acquired HIV. AIDS Res Hum Retroviruses 2021; 37:122-129. [PMID: 33066711 DOI: 10.1089/aid.2020.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To describe distributions of immune markers in children and young adults by sex and HIV status, and within groups, investigate associations of immune markers with bone density across Tanner stage. Using data and samples from 353 participants in a cross-sectional study in youth with perinatally acquired HIV (PHIV) and matched HIV-negative controls, distributions of inflammation and activation immune markers were described by sex and HIV status. Correlations and structural equation models (SEM) were used to explore marginal and multivariable associations of the immune markers with bone density and to assess whether patterns of association varied by sex and HIV status. Immune marker distributions did not differ by sex, but there were some differences by HIV status. Correlation patterns among bone, body composition, and immune markers were similar across the sex and HIV status groups. Conclusions from SEMs were limited by small sample sizes, but there was some indication that patterns of association between bone density and certain immune markers differed in male PHIV with more advanced Tanner stage compared to the other three groups. In conclusion, distributions of bone density, body composition, and immune markers may vary by sex and HIV status, although associations among these outcomes within sex and HIV status groups appear similar. Bone density of male PHIV appears to be more negatively affected than females, regardless of female HIV status. Larger longitudinal studies across Tanner stages are needed to further explore potential biological relationships between immune markers and bone density in youth living with HIV.
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Affiliation(s)
- Denise Jacobson
- Center for Biostatistics in AIDS Research; Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Jeremiah Zhe Liu
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Jane C. Lindsey
- Center for Biostatistics in AIDS Research; Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Stephanie Shiau
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Brent Coull
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Grace Aldrovandi
- Division of Infectious Diseases, Children's Hospital of Los Angeles, Los Angeles, California, USA
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Prevalence and Predictors of Compromised Bone Mineral Density in Pediatric Eosinophilic Esophagitis. J Pediatr Gastroenterol Nutr 2020; 71:764-770. [PMID: 32740533 PMCID: PMC8009279 DOI: 10.1097/mpg.0000000000002866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The aim of the study was to determine whether patients with eosinophilic esophagitis (EoE) have lower bone mineral density (BMD) than expected and if bone deficits are more pronounced in subgroups of patients according to comorbidities (atopic disease and joint hypermobility) or treatments (dietary restriction, medication exposure). STUDY DESIGN Retrospective chart review was performed to obtain clinical data, including length of diagnosis, comorbidities, and methods of treatment for patients with EoE ages 3 to 21 years who had a lumbar spine dual-energy x-ray absorptiometry scan performed between 2014 and 2017. BMD was standardized by calculation of age, sex, and race-specific z scores. RESULTS A total of 269 patients met study criteria. The mean BMD z score (-0.55, 95% confidence interval: -0.68, -0.42) was lower than expected (P < 0.0001), and the prevalence of low BMD z score (≤-2.0) was higher than expected (8.5%, 95% confidence interval: 5.2%-11.9%, P < 0.0001). In multivariable regression models, BMD z scores were -0.27 lower among those following an elimination diet and -0.65 lower among those with any lifetime use of a proton pump inhibitor (93% of the sample). There was no association with swallowed steroid use. CONCLUSIONS In our sample, pediatric patients with EoE had a slightly lower BMD z score compared to peers, and the prevalence of low BMD was higher than expected. Taken cautiously given the limitations of our sample, risk factors for bone deficits included any lifetime use of proton pump inhibitor and a restrictive elimination diet, but not swallowed steroid use. Larger prospective studies are needed to better characterize risk factors for low BMD to help inform screening, selection of therapies, and provide appropriate anticipatory guidance for patients with EoE.
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de Mendonça RP, Mitre GP, Real FH, da Silva Kataoka MS, de Melo Alves Júnior S, Vianna P, Da Silva Júnior NG, de Jesus Viana Pinheiro J. Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study. Head Neck Pathol 2019; 14:497-502. [PMID: 31297738 PMCID: PMC7235135 DOI: 10.1007/s12105-019-01053-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/06/2019] [Indexed: 12/11/2022]
Abstract
Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the head and neck with potential for aggressive and locally destructive behaviour. Lesions of the maxilla tend to expand more than those of the mandible due to the thinner cortices and spongy tissue of this location. Surgical removal is the most common treatment; however, it may be disfiguring in aggressive cases, especially for lesions located in the maxilla. Alternative treatments, such as intralesional corticosteroid injections, have been performed with satisfactory results. We report a case of a 12-year-old female patient with a CGCG of the left maxilla that was treated with 40 doses of intralesional triamcinolone acetonide infiltrations combined with alendronate sodium and calcium carbonate. Clinical and imaging follow-up over 12 years demonstrates improvement in the patient's condition.
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Affiliation(s)
- Raíssa Pinheiro de Mendonça
- Department of Oral Pathology, School of Dentistry, Federal University of Ceara, Rua Monsenhor Furtado, Fortaleza, Ceara 60430-355 Brazil
| | - Geovanni Pereira Mitre
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - Flavio Henrique Real
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Para, Avenida Augusto Correa, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - Maria Sueli da Silva Kataoka
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - Sérgio de Melo Alves Júnior
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | | | - Newton Guerreiro Da Silva Júnior
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Para, Avenida Augusto Correa, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
| | - João de Jesus Viana Pinheiro
- Department of Oral Pathology, School of Dentistry, Federal University of Para, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
- Cell Culture Laboratory, Department of Oral Pathology, School of Dentistry, Federal University of Para - UFPA - Institute of Health Sciences, Avenida Augusto Correa, 01, Belem, Para 66075-110 Brazil
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Pathological fracture due to prolonged steroid use in a child with transverse myelitis. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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