1
|
Zheng Z, Fan Y, Zhang J, Wang J, Li Z. Cedrol alleviates postmenopausal osteoporosis in rats through inhibiting the activation of the NF-κB signaling pathway. In Vitro Cell Dev Biol Anim 2024:10.1007/s11626-024-00921-3. [PMID: 38814422 DOI: 10.1007/s11626-024-00921-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/22/2024] [Indexed: 05/31/2024]
Abstract
Pharmacological studies have shown that Cedrol (CE) exhibits extensive biological activities, including anti-inflammatory and analgesic. Moreover, it can inhibit the NF-κB pathway and the expression of various associated proteins. This study aimed to investigate the role of CE in postmenopausal osteoporosis. The results showed that intragastric administration of CE (10 and 20 mg/kg) significantly improved the bone microstructure damage and increased bone mineral density, trabecular bone volume, and bone trabecular thickness in ovariectomized (OVX) rats (p < 0.05). CE treatment additionally made a well-organized arrangement of bone trabeculae and improved its thickness and density. Compared with the OVX group, the levels of tartrate-resistant acid phosphatase from 5b and C-terminal telopeptide of type I collagen were significantly reduced by 42.75% and 49.27% in the OVX + CE rats (p < 0.05). TRAP staining visually showed that the number of osteoclasts in the femur tissue of CE-treated rats was less than that of the OVX group. The expressions of nuclear factor of activated T-cells, cytoplasmic 1, acid phosphatase 5, and cathepsin K in OVX + CE rats were significantly decreased by 51.61%, 46.07%, and 50.34% compared to the OVX group (p < 0.01). In addition, CE intervention effectively reduced the phosphorylation levels of P65 and IκBα and inhibited the NF-κB signaling pathway. Meanwhile, CE diminished the number of multinucleated osteoclasts induced by receptor activator for nuclear factor-κB ligand and hindered cell fusion as well as nuclear translocation of osteoclast precursor cells P65. In conclusion, CE inhibits osteoclastogenesis by suppressing the activation of the NF-κB signaling pathway, thereby alleviating postmenopausal osteoporosis.
Collapse
Affiliation(s)
- Zhen Zheng
- Department of Medical Technology, Liaoning Vocational College of Medicine, Shenyang, China.
| | - Ying Fan
- Department of Medical Technology, Liaoning Vocational College of Medicine, Shenyang, China
| | - Jingyun Zhang
- Department of Medical Technology, Liaoning Vocational College of Medicine, Shenyang, China
| | - Jian Wang
- Department of Medical Technology, Liaoning Vocational College of Medicine, Shenyang, China
| | - Zhenyu Li
- Department of Nursing, Liaoning Vocational College of Medicine, Shenyang, China
| |
Collapse
|
2
|
Rodriguez AB, Kripfgans OD, Kozloff KM, Samal A, Woo JM, Shehabeldin M, Chan HL. Ultrasound-based jawbone surface quality evaluation after alveolar ridge preservation. J Periodontol 2024. [PMID: 38742564 DOI: 10.1002/jper.23-0370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high-frequency ultrasound (US) can classify bone readiness in humans, using micro-CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans. METHODS A total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co-registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B-mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro-CT as the gold standard. RESULTS Hydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm3; >0.45 mm3/mm3), questionable (1500-2200 mg/cm3; 0.4-0.45 mm3/mm3), and unfavorable (<1500 mg/cm3; <0.4 mm3/mm3). The present US B-mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T-test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US-derived tiers and BVTV. CONCLUSION Preliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US-based socket healing evaluation after ARP.
Collapse
Affiliation(s)
- Amanda B Rodriguez
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Oliver D Kripfgans
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kenneth M Kozloff
- Department of Biomedical Engineering, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Orthopedic Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ankita Samal
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jae-Man Woo
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Mostafa Shehabeldin
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
3
|
Kirkham AM, Bailey AJM, Tieu A, Maganti HB, Montroy J, Shorr R, Campbell TM, Fergusson DA, Lalu MM, Elmoazzen H, Allan DS. MSC-Derived Extracellular Vesicles in Preclinical Animal Models of Bone Injury: A Systematic Review and Meta-Analysis. Stem Cell Rev Rep 2021; 18:1054-1066. [PMID: 34313927 DOI: 10.1007/s12015-021-10208-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Mesenchymal stromal cell-derived extracellular vesicles (MSC-EVs) are a promising treatment for bone injuries, although studies remain preclinical. A systematic review and meta-analysis can assess the efficacy of MSC-EVs and identify treatment aspects associated with enhanced bone repair. METHODS English language, preclinical, controlled, in vivo studies identified in our systematic search (up to May 8, 2020) examining the use of MSC-EVs in bone healing were included. Risk of bias (ROB) was assessed using the SYRCLE tool. Aggregate Data Meta-Analysis was performed to determine the effect of MSC-EVs on Bone Volume/Total Volume (BV/TV) and New Bone Formation (NBF). RESULTS Thirteen studies were included. Twelve reported either BV/TV or NBF and were included in meta-analysis. ROB was unclear in all studies. Overall, MSC-EVs displayed benefit in terms of bone healing for both BV/TV (22.2% mean difference (MD); 95% CI: 15.8-28.5%, p < 0.001) and NBF (26.1% MD; 10.3-41.8%, p = 0.001) versus controls. Substantial heterogeneity, however, was observed between studies. MSC-EVs were reported to activate multiple signaling pathways including mTOR/AKT, AMPK and BMP2. Subgroup analysis indicated no significant difference in the improvement of BV/TV when using modified EVs isolated after gene transfection, preconditioning (p = 0.61), or using EVs in combination with a tissue scaffold and/or hydrogel versus other delivery methods (p = 0.20). CONCLUSION Use of MSC-EVs to promote healing of bone injury appears promising, however, heterogeneity between studies and the potential for reporting bias limits confidence in the extent of benefit. Reducing bias between studies and addressing aspects of potential reporting bias should augment confidence in future meta-analyses and propel the field towards clinical studies. Forest Plot analysis assessing the percentage change in bone volume (BV) / total volume (TV) in the presence (experimental) or absence (control) of MSC-EVs.
Collapse
Affiliation(s)
- Aidan M Kirkham
- Stem Cells, Canadian Blood Services, Ottawa, ON, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada
| | - Adrian J M Bailey
- Stem Cells, Canadian Blood Services, Ottawa, ON, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada
| | - Alvin Tieu
- Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada.,Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Harinad B Maganti
- Stem Cells, Canadian Blood Services, Ottawa, ON, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada
| | - Joshua Montroy
- Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada
| | - Risa Shorr
- Medical Information and Education Services, The Ottawa Hospital, Ottawa, ON, Canada
| | - T Mark Campbell
- Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Physical Medicine and Rehabilitation, Elisabeth Bruyère Hospital, Ottawa, ON, Canada
| | - Dean A Fergusson
- Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada.,Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Manoj M Lalu
- Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada.,Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Departments of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,School of Public Health and Epidemiology, University of Ottawa, Ottawa, ON, Canada
| | | | - David S Allan
- Stem Cells, Canadian Blood Services, Ottawa, ON, Canada. .,Clinical Epidemiology, Ottawa Hospital Research Institute, 501 Smyth Rd, Box 704, Ottawa, ON, K1H 8L6, Canada. .,Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada. .,Medicine, The Ottawa Hospital, Ottawa, ON, Canada. .,Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| |
Collapse
|
4
|
Morais GP, Chemerka C, Masson A, Seerattan RA, da Rocha AL, Krawetz R, da Silva ASR, Herzog W. Excessive downhill training leads to early onset of knee osteoarthritis. Osteoarthritis Cartilage 2021; 29:870-881. [PMID: 33798706 DOI: 10.1016/j.joca.2021.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Increased levels of pro-inflammatory cytokines are associated with the release of degradative enzymes leading to osteoarthritis (OA) development. Although physical exercise (PE) is generally recognized as beneficial for OA symptoms, excessive training workload and eccentric muscular exercise have increased OA risk. Here, we investigated the effects of excessive exercise workload and exercise type on systemic inflammation and knee joint OA. METHODS Mice were divided into five groups: sedentary (SED), uphill training (TRU), downhill training (TRD), excessive uphill training (ETU), and excessive downhill training (ETD) for an 8-week training intervention protocol. RESULTS ETD group had increased pro-inflammatory cytokines in serum, vastus lateralis (VL), and vastus medialis (VM) muscles, while ETU group mice had increased cytokine levels in the VL and VM. Total knee joint OARSI score were more significant in ETD group compared to SED and TRU groups. They were also more meaningful for the medial tibial plateau of ETD group compared to SED group. MMP-3 and cleaved Caspase-3 were higher in the ETD group than the SED and TRU group, while Adamts-5 was higher in the ETD group than the SED group. TRU group had increased PRG-4 levels compared to ETU and ETD group. ETD group had decreased total bone volume, trabecular bone volume, and cortical thickness compared to SED group. CONCLUSION Excessive downhill training induced a chronic pro-inflammatory state in mice and was associated with early signs of cartilage and bone degeneration that are clinical indicators of knee OA.
Collapse
Affiliation(s)
- G P Morais
- Postgraduate Program in Physical Education and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | - C Chemerka
- Koblenz University of Applied Sciences, Rhineland-Palatinate, Germany.
| | - A Masson
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.
| | - R-A Seerattan
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
| | - A L da Rocha
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
| | - R Krawetz
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.
| | - A S R da Silva
- Postgraduate Program in Physical Education and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil; Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
| | - W Herzog
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Biomechanics Laboratory, School of Sports, Federal University of Santa Catarina, Florianopolis, SC, Brazil.
| |
Collapse
|
5
|
Kazama JJ, Wakasugi M. Parathyroid Hormone and Bone in Dialysis Patients. Ther Apher Dial 2018; 22:229-235. [DOI: 10.1111/1744-9987.12678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 01/18/2018] [Accepted: 02/02/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Junichiro James Kazama
- Department of Nephrology and Hypertension; Fukushima Medical University; Fukushima Japan
| | - Minako Wakasugi
- Division of Comprehensive Geriatrics in Community; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| |
Collapse
|
6
|
Sano H, Kondo N, Shimakura T, Fujisawa J, Kijima Y, Kanai T, Poole KES, Yamamoto N, Takahashi HE, Endo N. Evidence for Ongoing Modeling-Based Bone Formation in Human Femoral Head Trabeculae via Forming Minimodeling Structures: A Study in Patients with Fractures and Arthritis. Front Endocrinol (Lausanne) 2018; 9:88. [PMID: 29615973 PMCID: PMC5868326 DOI: 10.3389/fendo.2018.00088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 02/23/2018] [Indexed: 12/21/2022] Open
Abstract
Bone modeling is a biological process of bone formation that adapts bone size and shape to mechanical loads, especially during childhood and adolescence. Bone modeling in cortical bone can be easily detected using sequential radiographic images, while its assessment in trabecular bone is challenging. Here, we performed histomorphometric analysis in 21 bone specimens from biopsies collected during hip arthroplasty, and we proposed the criteria for histologically identifying an active modeling-based bone formation, which we call a "forming minimodeling structure" (FMiS). Evidence of FMiSs was found in 9 of 20 specimens (45%). In histomorphometric analysis, bone volume was significant higher in specimens displaying FMiSs compared with the specimens without these structures (BV/TV, 31.7 ± 10.2 vs. 23.1 ± 3.9%; p < 0.05). Osteoid parameters were raised in FMiS-containing bone specimens (OV/BV, 2.1 ± 1.6 vs. 0.6 ± 0.3%; p < 0.001, OS/BS, 23.6 ± 15.5 vs. 7.6 ± 4.2%; p < 0.001, and O.Th, 7.4 µm ± 2.0 vs. 5.2 ± 1.0; p < 0.05). Our results showed that the modeling-based bone formation on trabecular bone surfaces occurs even during adulthood. As FMiSs can represent histological evidence of modeling-based bone formation, understanding of this physiology in relation to bone homeostasis is crucial.
Collapse
Affiliation(s)
- Hiroshige Sano
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Niigata Bone Science Institute, Niigata, Japan
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Hiroshige Sano,
| | - Naoki Kondo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Junichi Fujisawa
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yasufumi Kijima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomotake Kanai
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Noriaki Yamamoto
- Niigata Bone Science Institute, Niigata, Japan
- Department of Orthopedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Hideaki E. Takahashi
- Niigata Bone Science Institute, Niigata, Japan
- Department of Orthopedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Naoto Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
7
|
Tatsumoto N, Arioka M, Yamada S, Takahashi-Yanaga F, Tokumoto M, Tsuruya K, Kitazono T, Sasaguri T. Inhibition of GSK-3β increases trabecular bone volume but not cortical bone volume in adenine-induced uremic mice with severe hyperparathyroidism. Physiol Rep 2017; 4:4/21/e13010. [PMID: 27803315 PMCID: PMC5112491 DOI: 10.14814/phy2.13010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/29/2016] [Indexed: 02/06/2023] Open
Abstract
Patients with chronic kidney disease (CKD) are at increased risk for bone fractures compared with the general population. Repression of the Wnt/β‐catenin signaling pathway is associated with bone abnormalities. Inhibition of glycogen synthase kinase (GSK)‐3β, a critical component of the Wnt/β‐catenin signaling pathway, increases bone volume through accumulation of β‐catenin. It remains unknown whether inhibition of GSK‐3β increases bone volume in CKD. The present in vivo study examined the effects of GSK‐3β inhibition on bone volume in CKD mice. Wild‐type mice were divided into three groups. One group was fed a control diet (CNT) and the other two groups were fed a diet containing 0.2% adenine and given water with or without lithium chloride (LiCl), a GSK‐3 inhibitor (CKD, CKD+LiCl, respectively). GSK‐3β heterozygous knockout mice were fed a diet containing 0.2% adenine (CKD‐GSK‐3β+/−). After 6 weeks, trabecular and cortical bone volumes of the femur were analyzed using microcomputed tomography. CKD mice developed azotemia, hyperphosphatemia, and hyperparathyroidism, followed by a decrease in cortical bone volume without any change in trabecular bone volume. Serum levels of urea nitrogen, phosphate, and parathyroid hormone were comparable among the three groups of CKD mice. Trabecular bone volume increased in CKD‐GSK‐3β+/− and CKD+LiCl mice compared with CNT and CKD mice. However, there were no significant differences in cortical bone volume among the three groups of CKD mice. The results suggest that inhibition of GSK‐3β increases trabecular bone volume but not cortical bone volume in adenine‐induced uremic mice with uncontrolled hyperparathyroidism.
Collapse
Affiliation(s)
- Narihito Tatsumoto
- Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaki Arioka
- Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Yamada
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumi Takahashi-Yanaga
- Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,Global Medical Science Education Unit, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanori Tokumoto
- Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan
| | - Kazuhiko Tsuruya
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiyuki Sasaguri
- Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
8
|
Yamamoto S, Fukagawa M. Uremic Toxicity and Bone in CKD. J Nephrol 2017; 30:623-627. [PMID: 28573386 DOI: 10.1007/s40620-017-0406-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/18/2017] [Indexed: 01/16/2023]
Abstract
Patients with chronic kidney disease (CKD), especially those on dialysis treatment, are at high risk of bone fracture. In CKD-mineral and bone disorder (CKD-MBD), secondary hyperparathyroidism in patients with advanced CKD induces bone abnormalities, and skeletal resistance to parathyroid hormone (PTH) starts in the early stages of kidney disease. Uremic toxins such as indoxyl sulfate and p-cresyl sulfate reduce the expression of PTH receptor as well as PTH-induced cyclic adenosine 3',5' monophosphate production in osteoblasts. CKD also impairs bone strength, especially quality. In a rat model, kidney damage reduces the bone-storage modulus and changes the cortical bone chemical composition with or without hyperparathyroidism. The oral charcoal adsorbent AST-120 improves CKD-induced bone abnormalities as blood levels of indoxyl sulfate decrease. Uremic osteoporosis, a new concept of CKD-related bone fragility, is a main cause of CKD-induced bone abnormalities, particularly impaired bone quality. There is limited information about the effect and safety of anti-osteoporotic drugs for patients with CKD, especially those on dialysis, but the use of AST-120 and renin-angiotensin system inhibitors may modulate bone quality and decrease the incidence of fracture. Thus, the management of CKD-MBD plus use of other therapeutic interventions for uremic osteoporosis is necessary to prevent bone fragility in patients with CKD.
Collapse
Affiliation(s)
- Suguru Yamamoto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Blood Purification Therapy, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| |
Collapse
|
9
|
Molecular Abnormalities Underlying Bone Fragility in Chronic Kidney Disease. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3485785. [PMID: 28421193 PMCID: PMC5380833 DOI: 10.1155/2017/3485785] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/28/2017] [Accepted: 03/13/2017] [Indexed: 02/08/2023]
Abstract
Prevention of bone fractures is one goal of therapy for patients with chronic kidney disease-mineral and bone disorder (CKD-MBD), as indicated by the Kidney Disease: Improving Global Outcomes guidelines. CKD patients, including those on hemodialysis, are at higher risk for fractures and fracture-related death compared to people with normal kidney function. However, few clinicians focus on this issue as it is very difficult to estimate bone fragility. Additionally, uremia-related bone fragility has a more complicated pathological process compared to osteoporosis. There are many uremia-associated factors that contribute to bone fragility, including severe secondary hyperparathyroidism, skeletal resistance to parathyroid hormone, and bone mineralization disorders. Uremia also aggravates bone volume loss, disarranges microarchitecture, and increases the deterioration of material properties of bone through abnormal bone cells or excess oxidative stress. In this review, we outline the prevalence of fractures, the interaction of CKD-MBD with osteoporosis in CKD patients, and discuss possible factors that exacerbate the mechanical properties of bone.
Collapse
|
10
|
Shimizu Y, Ono T. Three-dimensional structural analysis of the morphological condition of the alveolar bone before and after orthodontic treatment. Korean J Orthod 2017; 47:394-400. [PMID: 29090127 PMCID: PMC5653688 DOI: 10.4041/kjod.2017.47.6.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 04/04/2017] [Accepted: 05/16/2017] [Indexed: 11/14/2022] Open
Abstract
Assessing the condition of the alveolar bone before and after orthodontic treatment is important. Recently, cone-beam computed tomography has been widely accepted as a useful tool for orthodontic treatment. Moreover, using a three-dimensional (3D) structural analysis software enables gathering detailed information and quantifying data. The aim of this study was to introduce various quantitative analyses performed before and after orthodontic treatment by using a 3D structural analysis software for evaluating the morphological condition of the alveolar bone of a patient with gingival recession around the canines.
Collapse
Affiliation(s)
- Yasuhiro Shimizu
- Division of Oral Health Sciences, Department of Orofacial Development and Function, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ono
- Division of Oral Health Sciences, Department of Orofacial Development and Function, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
11
|
Kaur H, Uludağ H, Dederich DN, El-Bialy T. Effect of Increasing Low-Intensity Pulsed Ultrasound and a Functional Appliance on the Mandibular Condyle in Growing Rats. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:109-120. [PMID: 27925675 DOI: 10.7863/ultra.15.06063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 04/07/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Functional appliances are used for treatment of lower-jaw deficiencies in growing individuals; however, their effectiveness is debatable. Low-intensity pulsed ultrasound (US) is a noninvasive method, which has been shown to stimulate cartilage and bone formation with 20 minutes of application. This study was designed to test the hypothesis that increasing low-intensity pulsed US application from 20 to 40 min/d will enhance mandibular condylar growth in growing rats, especially when combined with a functional appliance. METHODS Fifty-four Sprague Dawley rats were divided into 6 groups (n = 9): control, low-intensity pulsed US for 20 minutes, low-intensity pulsed US for 40 minutes, the functional appliance, the functional appliance plus low-intensity pulsed US for 20 minutes, and the functional appliance plus low-intensity pulsed US for 40 minutes. Low-intensity pulsed US was applied for 28 days. All rats were then euthanized, and their mandibles were dissected for morphometric, histomorphometric, and micro-computed tomographic analyses. RESULTS Among all study groups, the 20-minute US group showed significant increases in most of the measured variables (P < .05) except for condylar process length (P = .18), whereas the functional appliance-plus-40-min US group showed the least favorable results. The 20-minute US group showed increases in proliferative and hypertrophic cell counts and widths and enhanced microarchitecture of trabecular bone compared with the 40-minute US group. The functional appliance-plus-20-minute US group showed better results compared with the functional appliance-alone and functional appliance-plus-40-minute US groups. CONCLUSIONS A daily application of low-intensity pulsed US for 20 minutes in growing rats affects mandibular growth, either alone or in combination with a functional appliance. Further study with a longer observation period is required to study the long-term effects and stability of newly formed bone.
Collapse
Affiliation(s)
- Harmanpreet Kaur
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Medical Science Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Hasan Uludağ
- Department of Chemical and Materials Engineering, Faculty of Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Douglas N Dederich
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tarek El-Bialy
- Departments of Dentistry and Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
12
|
Bone Histo-Morphology in Chronic Kidney Disease Mineral Bone Disorder. Indian J Hematol Blood Transfus 2016; 33:603-610. [PMID: 29075077 DOI: 10.1007/s12288-016-0754-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022] Open
Abstract
Chronic Kidney Disease-Mineral Bone Disorder(CKD-MBD) is a systemic disorder of the mineral and bone metabolism seen in patients with Chronic Kidney Disease(CKD). It is manifested by either one or a combination of the following: (a) Abnormalities of calcium, phosphorus, PTH, or vitamin D metabolism. (b) Abnormalities in bone turnover, mineralization, volume, linear growth, or strength. (c) Vascular or other soft- tissue calcification. Renal osteodystrophy measures the skeletal component of CKD-MBD. To study the histomorphology of bone marrow biopsy in patients with CKD-MBD and correlate the histological features of bone biopsy with the clinicobiochemical parameters. 32 cases of diagnosed CKD-MBD formed the study group. Detailed clinical history and biochemical analysis was done for them. Bone marrow trephine biopsies were conducted and the histology was studied. The clinicobiochemical and the histomorphological findings were correlated. Based on the bone biopsy findings, Hyperparathyroid bone disease consisted of-14 cases (44%), Mixed uremic osteodystrophy of-16 cases (50%) and one case (3%) each of Low turnover disease (Adynamic bone disease) and Normal histology. The mean blood urea, S. Creatinine, S Phosphate and the S. Vit D3 were found to be statistically significant between the two major subgroups. The area of the bone trabeculae and the osteoid percentage was found to be more in the MUO group and was found to be statistically significant. CONCLUSION A trephine biopsy helps us in understanding the skeletal symptoms of the CKD when the clinical and biochemical parameters are not conclusive. A biopsy in unexplained bone pain/fractures, unexplained hypercalcemia and elevated phosphate levels helps in guiding the proper management of the patient.
Collapse
|
13
|
Calcium regulation and bone mineral metabolism in elderly patients with chronic kidney disease. Nutrients 2013; 5:1913-36. [PMID: 23760058 PMCID: PMC3725483 DOI: 10.3390/nu5061913] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 04/25/2013] [Accepted: 05/08/2013] [Indexed: 12/20/2022] Open
Abstract
The elderly chronic kidney disease (CKD) population is growing. Both aging and CKD can disrupt calcium (Ca2+) homeostasis and cause alterations of multiple Ca2+-regulatory mechanisms, including parathyroid hormone, vitamin D, fibroblast growth factor-23/Klotho, calcium-sensing receptor and Ca2+-phosphate product. These alterations can be deleterious to bone mineral metabolism and soft tissue health, leading to metabolic bone disease and vascular calcification and aging, termed CKD-mineral and bone disorder (MBD). CKD-MBD is associated with morbid clinical outcomes, including fracture, cardiovascular events and all-cause mortality. In this paper, we comprehensively review Ca2+ regulation and bone mineral metabolism, with a special emphasis on elderly CKD patients. We also present the current treatment-guidelines and management options for CKD-MBD.
Collapse
|
14
|
Greater Skeletal Gains in Ovary Intact Rats at Maturity Are Achieved by Supplementing a Standardized Extract of Butea monosperma Stem Bark that Confers Better Bone Conserving Effect following Ovariectomy and Concurrent Treatment Withdrawal. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:519387. [PMID: 23710224 PMCID: PMC3655608 DOI: 10.1155/2013/519387] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 03/13/2013] [Indexed: 12/17/2022]
Abstract
With a longitudinally designed study, we tested whether an acetone soluble fraction (ASF) from the stem bark of Butea monosperma resulted in maximizing bone gain in rats during growth and maturation and thus protected against osteopenia following ovariectomy (OVx) with concomitant treatment withdrawal. Female rats at weaning were given ASF (100 mg/kg/d) or vehicle for 12 weeks, and baseline skeletal parameters (micro-CT) and total plasma antioxidant status (TAS) were measured. At this stage, one group was OVx and the other group was sham operated. Vehicle group (untreated) after OVx was given E2 or continued with vehicle (OVx control). ASF group after OVx was given vehicle (ASF withdrawn, ASFW). After another 12 weeks, all groups were killed and various skeletal parameters were determined. ASF resulted in substantially better skeletal parameters and higher plasma TAS over control at maturity. Rats treated with ASF before OVx had reduced rates of bone loss compared to OVx control. Twelve weeks after OVx, the ASFW group exhibited better trabecular microarchitectural preservation, bone turnover profiles, increased cortical deposition, and biomechanical strength over the OVx control, and the effects were comparable to OVx + E2 group. ASF supplementation during skeletal growth could maximize bone accrual and could confer increased resistance to post-OVx osteopenia despite treatment withdrawal.
Collapse
|
15
|
Kiattisunthorn K, Moe SM. Chronic Kidney Disease-Mineral Bone Disorder: Definitions and Rationale for a Systemic Disorder. Clin Rev Bone Miner Metab 2012. [DOI: 10.1007/s12018-011-9119-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Buccal to Lingual Transalveolar Implant Placement for All On Four Immediate Function in Posterior Mandible: Report of 10 Cases. J Oral Maxillofac Surg 2011; 69:1919-22. [DOI: 10.1016/j.joms.2011.02.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 01/05/2011] [Accepted: 02/06/2011] [Indexed: 11/23/2022]
|
17
|
Iwasaki Y, Kazama JJ, Yamato H, Fukagawa M. Changes in chemical composition of cortical bone associated with bone fragility in rat model with chronic kidney disease. Bone 2011; 48:1260-7. [PMID: 21397740 DOI: 10.1016/j.bone.2011.03.672] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Revised: 02/10/2011] [Accepted: 03/04/2011] [Indexed: 01/07/2023]
Abstract
Bone fragility is a complication of chronic kidney disease (CKD). Patients on dialysis have higher risk of fracture than the general population, but the reason remains obscure. Bone strength is determined by bone mass and bone quality. Although factors affecting bone quality include microarchitecture, remodeling activity, mineral content, and collagen composition, it remains unclear which factor is critically important for bone strength in CKD. We conducted an in vivo study to elucidate the factors that reduce bone mechanical property in CKD. Rats underwent thyroparathyroidectomy and progressive partial nephrectomy (TPTx-Nx). Bone mechanical property, bone mineral density (BMD), and cortical bone chemical composition (all in femur) as well as histomorphometry (in tibia) were determined. The storage modulus, which is a mechanical factor, was reduced in CKD model rats compared with controls that underwent thyroparathyroidectomy alone (TPTx). There were no differences in BMD and histomorphometric parameters between groups. However, cortical bone chemical composition differed: mineral to matrix ratio and carbonate substitution increased whereas crystallinity decreased in TPTx-Nx. In addition, enzymatic crosslinks ratio and pentosidine to matrix ratio also increased. These changes were significant in TPTx-Nx rats with most impaired renal function. Stepwise multiple regression analysis identified mature to immature crosslink ratio and crystallinity as independent contributors to storage modulus. Deteriorated bone mechanical properties in CKD may be caused by changes in chemical composition of the cortical bone, and is independent of BMD or cancellous bone microarchitecture.
Collapse
Affiliation(s)
- Yoshiko Iwasaki
- Department of Health Sciences, Oita University of Nursing and Health Sciences, Oita, 870-1201, Japan.
| | | | | | | |
Collapse
|
18
|
Kazama JJ. Bone Histology in Chronic Kidney Disease-related Mineral and Bone Disorder. Ther Apher Dial 2011; 15 Suppl 1:23-5. [DOI: 10.1111/j.1744-9987.2011.00923.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|