1
|
Demirtas A, Taylor EA, Gludovatz B, Ritchie RO, Donnelly E, Ural A. An integrated experimental-computational framework to assess the influence of microstructure and material properties on fracture toughness in clinical specimens of human femoral cortical bone. J Mech Behav Biomed Mater 2023; 145:106034. [PMID: 37494816 DOI: 10.1016/j.jmbbm.2023.106034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/08/2023] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
Microstructural and compositional changes that occur due to aging, pathological conditions, or pharmacological treatments alter cortical bone fracture resistance. However, the relative importance of these changes to the fracture resistance of cortical bone has not been quantified in detail. In this technical note, we developed an integrated experimental-computational framework utilizing human femoral cortical bone biopsies to advance the understanding of how fracture resistance of cortical bone is modulated due to modifications in its microstructure and material properties. Four human biopsy samples from individuals with varying fragility fracture history and osteoporosis treatment status were converted to finite element models incorporating specimen-specific material properties and were analyzed using fracture mechanics-based modeling. The results showed that cement line density and osteonal volume had a significant effect on crack volume. The removal of cement lines substantially increased the crack volume in the osteons and interstitial bone, representing straight crack growth, compared to models with cement lines due to the lack of crack deflection in the models without cement lines. Crack volume in the osteons and interstitial bone increased when mean elastic modulus and ultimate strength increased and mean fracture toughness decreased. Crack volume in the osteons and interstitial bone was reduced when material property heterogeneity was incorporated in the models. Although both the microstructure and the heterogeneity of the material properties of the cortical bone independently increased the fracture toughness, the relative contribution of the microstructure was more significant. The integrated experimental-computational framework developed here can identify the most critical microscale features of cortical bone modulated by pathological processes or pharmacological treatments that drive changes in fracture resistance and improve our understanding of the relative influence of microstructure and material properties on fracture resistance of cortical bone.
Collapse
Affiliation(s)
- Ahmet Demirtas
- Department of Mechanical Engineering, Villanova University, Villanova, PA, USA
| | - Erik A Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Bernd Gludovatz
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney, NSW, 2052, Australia
| | - Robert O Ritchie
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA; Musculoskeletal Integrity Program, Weill Cornell Medicine, Research Institute, Hospital for Special Surgery, New York City, NY, USA
| | - Ani Ural
- Department of Mechanical Engineering, Villanova University, Villanova, PA, USA.
| |
Collapse
|
2
|
Arora D, Taylor EA, King KB, Donnelly E. Increased tissue modulus and hardness in the TallyHO mouse model of early onset type 2 diabetes mellitus. PLoS One 2023; 18:e0287825. [PMID: 37418415 PMCID: PMC10328374 DOI: 10.1371/journal.pone.0287825] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 06/14/2023] [Indexed: 07/09/2023] Open
Abstract
Individuals with type 2 diabetes mellitus (T2DM) have a higher fracture risk compared to those without T2DM despite having higher bone mineral density (BMD). Thus, T2DM may alter other aspects of resistance to fracture beyond BMD such as bone geometry, microarchitecture, and tissue material properties. We characterized the skeletal phenotype and assessed the effects of hyperglycemia on bone tissue mechanical and compositional properties in the TallyHO mouse model of early-onset T2DM using nanoindentation and Raman spectroscopy. Femurs and tibias were harvested from male TallyHO and C57Bl/6J mice at 26 weeks of age. The minimum moment of inertia assessed by micro-computed tomography was smaller (-26%) and cortical porosity was greater (+490%) in TallyHO femora compared to controls. In three-point bending tests to failure, the femoral ultimate moment and stiffness did not differ but post-yield displacement was lower (-35%) in the TallyHO mice relative to that in C57Bl/6J age-matched controls after adjusting for body mass. The cortical bone in the tibia of TallyHO mice was stiffer and harder, as indicated by greater mean tissue nanoindentation modulus (+22%) and hardness (+22%) compared to controls. Raman spectroscopic mineral:matrix ratio and crystallinity were greater in TallyHO tibiae than in C57Bl/6J tibiae (mineral:matrix +10%, p < 0.05; crystallinity +0.41%, p < 0.10). Our regression model indicated that greater values of crystallinity and collagen maturity were associated with reduced ductility observed in the femora of the TallyHO mice. The maintenance of structural stiffness and strength of TallyHO mouse femora despite reduced geometric resistance to bending could potentially be explained by increased tissue modulus and hardness, as observed at the tibia. Finally, with worsening glycemic control, tissue hardness and crystallinity increased, and bone ductility decreased in TallyHO mice. Our study suggests that these material factors may be sentinels of bone embrittlement in adolescents with T2DM.
Collapse
Affiliation(s)
- Daksh Arora
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York, United States of America
| | - Erik A. Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, United States of America
| | - Karen B. King
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York, United States of America
- Research Institute, Hospital for Special Surgery, New York, New York, United States of America
| |
Collapse
|
3
|
Haffer H, Chiapparelli E, Muellner M, Moser M, Dodo Y, Reisener MJ, Adl Amini D, Salzmann SN, Zhu J, Han YX, Donnelly E, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP. Bone collagen quality in lumbar fusion patients: the association between volumetric bone mineral density and advanced glycation endproducts. Eur Spine J 2023; 32:1678-1687. [PMID: 36922425 PMCID: PMC10623215 DOI: 10.1007/s00586-023-07589-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/06/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE The sole determination of volumetric bone mineral density (vBMD) is insufficient to evaluate overall bone integrity. The accumulation of advanced glycation endproducts (AGEs) stiffens and embrittles collagen fibers. Despite the important role of AGEs in bone aging, the relationship between AGEs and vBMD is poorly understood. We hypothesized that an accumulation of AGEs, a marker of impaired bone quality, is related to decreased vBMD. METHODS Prospectively collected data of 127 patients undergoing lumbar fusion were analyzed. Quantitative computed tomography (QCT) measurements were performed at the lumbar spine. Intraoperative bone biopsies were obtained and analyzed with confocal fluorescence microscopy for fluorescent AGEs, both trabecular and cortical. Spearman's correlation coefficients were calculated to examine relationships between vBMD and fAGEs, stratified by sex. Multivariable linear regression analysis with adjustments for age, sex, body mass index (BMI), race, diabetes mellitus and HbA1c was used to investigate associations between vBMD and fAGEs. RESULTS One-hundred and twenty-seven patients (51.2% female, 61.2 years, BMI of 28.7 kg/m2) with 107 bone biopsies were included in the final analysis, excluding patients on anti-osteoporotic drug therapy. In the univariate analysis, cortical fAGEs increased with decreasing vBMD at (r = -0.301; p = 0.030), but only in men. In the multivariable analysis, trabecular fAGEs increased with decreasing vBMD after adjusting for age, sex, BMI, race, diabetes mellitus and HbA1c (β = 0.99;95%CI=(0.994,1.000); p = 0.04). CONCLUSION QCT-derived vBMD measurements were found to be inversely associated with trabecular fAGEs. Our results enhance the understanding of bone integrity by suggesting that spine surgery patients with decreased bone quantity may also have poorer bone quality.
Collapse
Affiliation(s)
- Henryk Haffer
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Erika Chiapparelli
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Maximilian Muellner
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Manuel Moser
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Department of Spine Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Yusuke Dodo
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Marie-Jacqueline Reisener
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dominik Adl Amini
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephan N Salzmann
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Jiaqi Zhu
- Department of Epidemiology and Biostatistics, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Yi Xin Han
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
- Musculoskeletal Integrity Program, Research Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Jennifer Shue
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Andrew A Sama
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Frank P Cammisa
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Federico P Girardi
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Alexander P Hughes
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA.
| |
Collapse
|
4
|
Haffer H, Muellner M, Chiapparelli E, Dodo Y, Zhu J, Han YX, Donnelly E, Tan ET, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP. Osteosarcopenia in the Spine Beyond Bone Mineral Density: Association between Paraspinal Muscle Impairment and Advanced Glycation Endproducts. Spine (Phila Pa 1976) 2023:00007632-990000000-00306. [PMID: 37036285 PMCID: PMC10330153 DOI: 10.1097/brs.0000000000004683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/31/2023] [Indexed: 04/11/2023]
Abstract
STUDY DESIGN Prospective cross-sectional study. OBJECTIVE To determine if an accumulation of advanced glycation endproducts (AGEs) is associated with impaired paraspinal muscle composition. SUMMARY OF BACKGROUND DATA Impaired bone integrity and muscle function are described as osteosarcopenia. Osteosarcopenia is associated with falls, fragility fractures and reduced quality of life. Bone integrity is influenced by bone quantity (bone mineral density) and quality (microarchitecture&collagen). The accumulation of AGEs stiffens collagen fibers and increases bone fragility. The relationship between paraspinal muscle composition and bone collagen properties has not been evaluated. METHODS Intraoperative bone biopsies from the posterior superior iliac spine were obtained and evaluated with multiphoton microscopy for fluorescent AGE crosslink density (fAGEs). Preoperative MRI measurements at level L4 included the musculus (m.) psoas and combined m. multifidus and m. erector spinae (posterior paraspinal musculature,PPM). Muscle segmentation on axial images (cross-sectional area,CSA) and calculation of an pixel intensity threshold method to differentiate muscle (functional cross-sectional area,fCSA) and intramuscular fat (FAT). Quantitative computed tomography was performed at the lumbar spine. Univariate and multivariable regression models were used to investigate associations between fAGEs and paraspinal musculature. RESULTS 107 prospectively enrolled patients (50.5% female,age 60.7 y,BMI 28.9 kg/m2) were analyzed. 41.1% and 15.0% of the patients demonstrated osteopenia and osteoporosis. Univariate linear regression analysis demonstrated a significant association between cortical fAGEs and CSA in the psoas (ρ=0.220,P=0.039), but not in the PPM. Trabecular fAGEs revealed no significant associations to PPM or psoas musculature. In the multivariable analysis, higher cortical fAGEs were associated with increased FAT (β=1.556;P=0.002) and CSA (β=1.305;P=0.005) in the PPM after adjusting for covariates. CONCLUSION This is the first investigation demonstrating that an accumulation of non-enzymatic collagen cross-linking product fAGEs in cortical bone is associated with increased intramuscular fat in the lumbar paraspinal musculature.
Collapse
Affiliation(s)
- Henryk Haffer
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maximilian Muellner
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Erika Chiapparelli
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Yusuke Dodo
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Jiaqi Zhu
- Department of Epidemiology and Biostatistics, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Yi Xin Han
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
- Musculoskeletal Integrity Program, Research Institute, Hospital for Special Surgery, Weill Cornell Medicine New York City, NY, USA
| | - Ek T Tan
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, NY, USA
| | - Jennifer Shue
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Andrew A Sama
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Frank P Cammisa
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Federico P Girardi
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Alexander P Hughes
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| |
Collapse
|
5
|
Heilbronner AK, Dash A, Straight BE, Snyder LJ, Ganesan S, Adu KB, Jae A, Clare S, Billings E, Kim HJ, Cunningham M, Lebl DR, Donnelly E, Stein EM. Peripheral cortical bone density predicts vertebral bone mineral properties in spine fusion surgery patients. Bone 2023; 169:116678. [PMID: 36646265 PMCID: PMC10081687 DOI: 10.1016/j.bone.2023.116678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/22/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
Spine fusion surgery is one of the most common orthopedic procedures, with over 400,000 performed annually to correct deformities and pain. However, complications occur in approximately one third of cases. While many of these complications may be related to poor bone quality, it is difficult to detect bone abnormalities prior to surgery. Areal BMD (aBMD) assessed by DXA may be artifactually high in patients with spine pathology, leading to missed diagnosis of deficits. In this study, we related preoperative imaging characteristics of both central and peripheral sites to direct measurements of bone quality in vertebral biopsies. We hypothesized that pre-operative imaging outcomes would relate to vertebral bone mineralization and collagen properties. Pre-operative assessments included DXA measurements of aBMD of the spine, hip, and forearm, central quantitative computed tomography (QCT) of volumetric BMD (vBMD) at the lumbar spine, and high resolution peripheral quantitative computed tomography (HRpQCT; Xtreme CT2) measurements of vBMD and microarchitecture at the distal radius and tibia. Bone samples were collected intraoperatively from the lumbar vertebrae and analyzed using Fourier-transform Infrared (FTIR) spectroscopy. Bone samples were obtained from 23 postmenopausal women (mean age 67 ± 7 years, BMI 28 ± 8 kg/m2). We found that patients with more mature bone by FTIR, measured as lower acid phosphate content and carbonate to phosphate ratio, and greater collagen maturity and mineral maturity/crystallinity (MMC), had greater cortical vBMD at the tibia and greater aBMD at the lumbar spine and one-third radius. Our data suggests that bone quality at peripheral sites may predict bone quality at the spine. As bone quality at the spine is challenging to assess prior to surgery, there is a great need for additional screening tools. Pre-operative peripheral bone imaging may provide important insight into vertebral bone quality and may foster identification of patients with bone quality deficits.
Collapse
Affiliation(s)
- Alison K Heilbronner
- Division of Endocrinology, Metabolic Bone Disease Service, Hospital for Special Surgery, New York, NY, United States of America
| | - Alexander Dash
- Division of Endocrinology, Metabolic Bone Disease Service, Hospital for Special Surgery, New York, NY, United States of America
| | - Beth E Straight
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States of America
| | - Leah J Snyder
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States of America
| | - Sandhya Ganesan
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States of America
| | - Kobby B Adu
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States of America
| | - Andy Jae
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States of America
| | - Shannon Clare
- Division of Endocrinology, Metabolic Bone Disease Service, Hospital for Special Surgery, New York, NY, United States of America
| | - Emma Billings
- Division of Endocrinology, Metabolic Bone Disease Service, Hospital for Special Surgery, New York, NY, United States of America
| | - Han Jo Kim
- Spine Service, Hospital for Special Surgery, New York, NY, United States of America
| | - Matthew Cunningham
- Spine Service, Hospital for Special Surgery, New York, NY, United States of America
| | - Darren R Lebl
- Spine Service, Hospital for Special Surgery, New York, NY, United States of America
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States of America; Research Institute, Hospital for Special Surgery, New York, NY, United States of America
| | - Emily M Stein
- Division of Endocrinology, Metabolic Bone Disease Service, Hospital for Special Surgery, New York, NY, United States of America.
| |
Collapse
|
6
|
Noordwijk KJ, Chen L, Ruspi BD, Schurer S, Papa B, Fasanello DC, McDonough SP, Palmer SE, Porter IR, Basran PS, Donnelly E, Reesink HL. Metacarpophalangeal Joint Pathology and Bone Mineral Density Increase with Exercise but Not with Incidence of Proximal Sesamoid Bone Fracture in Thoroughbred Racehorses. Animals (Basel) 2023; 13:ani13050827. [PMID: 36899684 PMCID: PMC10000193 DOI: 10.3390/ani13050827] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Proximal sesamoid bone (PSB) fracture is the leading cause of fatal musculoskeletal injury in Thoroughbred racehorses in Hong Kong and the US. Efforts are underway to investigate diagnostic modalities that could help identify racehorses at increased risk of fracture; however, features associated with PSB fracture risk are still poorly understood. The objectives of this study were to (1) investigate third metacarpal (MC3) and PSB density and mineral content using dual-energy X-ray absorptiometry (DXA), computed tomography (CT), Raman spectroscopy, and ash fraction measurements, and (2) investigate PSB quality and metacarpophalangeal joint (MCPJ) pathology using Raman spectroscopy and CT. Forelimbs were collected from 29 Thoroughbred racehorse cadavers (n = 14 PSB fracture, n = 15 control) for DXA and CT imaging, and PSBs were sectioned for Raman spectroscopy and ash fraction measurements. Bone mineral density (BMD) was greater in MC3 condyles and PSBs of horses with more high-speed furlongs. MCPJ pathology, including palmar osteochondral disease (POD), MC3 condylar sclerosis, and MC3 subchondral lysis were greater in horses with more high-speed furlongs. There were no differences in BMD or Raman parameters between fracture and control groups; however, Raman spectroscopy and ash fraction measurements revealed regional differences in PSB BMD and tissue composition. Many parameters, including MC3 and PSB bone mineral density, were strongly correlated with total high-speed furlongs.
Collapse
Affiliation(s)
- Kira J. Noordwijk
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Leyi Chen
- Department of Materials Science and Engineering, College of Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Bianca D. Ruspi
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Sydney Schurer
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Brittany Papa
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Diana C. Fasanello
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Sean P. McDonough
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Scott E. Palmer
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Ian R. Porter
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Parminder S. Basran
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, College of Engineering, Cornell University, Ithaca, NY 14853, USA
- Correspondence: (E.D.); (H.L.R.)
| | - Heidi L. Reesink
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
- Correspondence: (E.D.); (H.L.R.)
| |
Collapse
|
7
|
Lekkala S, Sacher SE, Taylor EA, Williams RM, Moseley KF, Donnelly E. Increased Advanced Glycation Endproducts, Stiffness, and Hardness in Iliac Crest Bone From Postmenopausal Women With Type 2 Diabetes Mellitus on Insulin. J Bone Miner Res 2023; 38:261-277. [PMID: 36478472 PMCID: PMC9898222 DOI: 10.1002/jbmr.4757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 11/25/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
Individuals with type 2 diabetes mellitus (T2DM) have a greater risk of bone fracture compared with those with normal glucose tolerance (NGT). In contrast, individuals with impaired glucose tolerance (IGT) have a lower or similar risk of fracture. Our objective was to understand how progressive glycemic derangement affects advanced glycation endproduct (AGE) content, composition, and mechanical properties of iliac bone from postmenopausal women with NGT (n = 35, age = 65 ± 7 years, HbA1c = 5.8% ± 0.3%), IGT (n = 26, age = 64 ± 5 years, HbA1c = 6.0% ± 0.4%), and T2DM on insulin (n = 25, age = 64 ± 6 years, HbA1c = 9.1% ± 2.2%). AGEs were assessed in all samples using high-performance liquid chromatography to measure pentosidine and in NGT/T2DM samples using multiphoton microscopy to spatially resolve the density of fluorescent AGEs (fAGEs). A subset of samples (n = 14 NGT, n = 14 T2DM) was analyzed with nanoindentation and Raman microscopy. Bone tissue from the T2DM group had greater concentrations of (i) pentosidine versus IGT (cortical +24%, p = 0.087; trabecular +35%, p = 0.007) and versus NGT (cortical +40%, p = 0.003; trabecular +35%, p = 0.004) and (ii) fAGE cross-link density versus NGT (cortical +71%, p < 0.001; trabecular +44%, p < 0.001). Bone pentosidine content in the IGT group was lower than in the T2DM group and did not differ from the NGT group, indicating that the greater AGE content observed in T2DM occurs with progressive diabetes. Individuals with T2DM on metformin had lower cortical bone pentosidine compared with individuals not on metformin (-35%, p = 0.017). Cortical bone from the T2DM group was stiffer (+9%, p = 0.021) and harder (+8%, p = 0.039) versus the NGT group. Bone tissue AGEs, which embrittle bone, increased with worsening glycemic control assessed by HbA1c (Pen: R2 = 0.28, p < 0.001; fAGE density: R2 = 0.30, p < 0.001). These relationships suggest a potential mechanism by which bone fragility may increase despite greater tissue stiffness and hardness in individuals with T2DM; our results suggest that it occurs in the transition from IGT to overt T2DM. © 2022 American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Sashank Lekkala
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY
| | - Sara E. Sacher
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY
| | - Erik A. Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY
| | | | - Kendall F. Moseley
- Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY
- Research Division, Hospital for Special Surgery, New York, NY
| |
Collapse
|
8
|
Haffer H, Chiapparelli E, Moser M, Muellner M, Dodo Y, Adl Amini D, Zhu J, Miller TT, Han YX, Donnelly E, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP. Dermal ultrasound measurements for bone quality assessment : An investigation of advanced glycation endproducts derived from confocal fluorescence microscopy. J Orthop Res 2023; 41:345-354. [PMID: 35470915 PMCID: PMC9596615 DOI: 10.1002/jor.25350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023]
Abstract
Bone quality is increasingly being recognized in the assessment of fracture risk. Nonenzymatic collagen cross-linking with the accumulation of advanced glycation end products stiffens and embrittles collagen fibers thus increasing bone fragility. Echogenicity is an ultrasound (US) parameter that provides information regarding the skin collagen structure. We hypothesized that both skin and bone collagen degrade in parallel fashion. Prospectively collected data of 110 patients undergoing posterior lumbar fusion was analyzed. Preoperative skin US measurements were performed in the lumbar region to assess dermal thickness and echogenicity. Intraoperative bone biopsies from the posterior superior iliac spine were obtained and analyzed with confocal fluorescence microscopy for fluorescent advanced glycation endproducts (fAGEs). Pearson's correlation was calculated to examine relationships between (1) US and fAGEs, and (2) age and fAGEs stratified by sex. Multivariable linear regression analysis with adjustments for age, sex, body mass index (BMI), diabetes mellitus, and hemoglobin A1c (HbA1c) was used to investigate associations between US and fAGEs. One hundred and ten patients (51.9% female, 61.6 years, BMI 29.8 kg/m2 ) were included in the analysis. In the univariate analysis cortical and trabecular fAGEs decreased with age, but only in women (cortical: r = -0.32, p = 0.031; trabecular: r = -0.32; p = 0.031). After adjusting for age, sex, BMI, diabetes mellitus, and HbA1c, lower dermal (β = 1.01; p = 0.012) and subcutaneous (β = 1.01; p = 0.021) echogenicity increased with increasing cortical fAGEs and lower dermal echogenicity increased with increasing trabecular fAGEs (β = 1.01; p = 0.021). This is the first study demonstrating significant associations between skin US measurements and in vivo bone quality parameters in lumbar fusion patients. As a noninvasive assessment tool, skin US measurements might be incorporated into future practice to investigate bone quality in spine surgery patients.
Collapse
Affiliation(s)
- Henryk Haffer
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Erika Chiapparelli
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Manuel Moser
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Department of Spine Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Maximilian Muellner
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Yusuke Dodo
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Dominik Adl Amini
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jiaqi Zhu
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Theodore T. Miller
- Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Yi Xin Han
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
- Musculoskeletal Integrity Program, Research Institute, Hospital for Special Surgery, New York City, NY, USA
| | - Jennifer Shue
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Andrew A. Sama
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Frank P. Cammisa
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Federico P. Girardi
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| | - Alexander P. Hughes
- Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA
| |
Collapse
|
9
|
Pannu J, Venious G, Gallagher R, Shaver A, Cloyes R, Josan E, Donnelly E, King M, Knopp M, Merritt R, Kneuertz P, D'souza D, Ghattas C, Revelo A, Pastis N, Sowers T, Eastep C, Ottersbach M, Malinky M, Reinbolt R, Wert M, Horowitz J, Carbone D. P1.03-01 Do We Follow Incidental Lung Nodules Appropriately? A Retrospective Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
10
|
Luedke LK, Ilevbare P, Noordwijk KJ, Palomino PM, McDonough SP, Palmer SE, Basran PS, Donnelly E, Reesink HL. Proximal sesamoid bone microdamage is localized to articular subchondral regions in Thoroughbred racehorses, with similar fracture toughness between fracture and controls. Vet Surg 2022; 51:952-962. [PMID: 35672916 DOI: 10.1111/vsu.13816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/04/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether proximal sesamoid bone (PSB) microdamage and fracture toughness differ between Thoroughbred racehorses sustaining PSB fracture and controls. STUDY DESIGN Cadaveric case-control. ANIMALS Twenty-four Thoroughbred racehorses (n = 12 PSB fracture, n = 12 control). METHODS Proximal sesamoid bones were dissected, and gross pathological changes and morphological measurements were documented. High-speed exercise history data were evaluated. Microdamage was assessed in fracture, fracture-contralateral limb (FXCL) and control PSBs using whole bone lead uranyl acetate (LUA) staining with micro-CT imaging or basic fuchsin histological analysis. Fracture toughness mechanical testing was carried out in 3-point-bending of microbeams created from PSB flexor cortices. Data were analyzed using ordinal logistic and linear regression models. RESULTS Microdamage was detected most commonly in the articular subchondral region of PSBs via LUA micro-CT and basic fuchsin histology. There were no differences in microdamage between FXCL and control PSBs. Fracture toughness values were similar for FXCL (1.31 MPa√m) and control (1.35 MPa√m) PSBs. Exercise histories were similar except that horses sustaining fracture spent a greater percentage of their careers in rest weeks. CONCLUSION Microdamage was detected in the articular region of PSBs but was not greater in horses sustaining catastrophic PSB fracture. Fracture toughness of PSB flexor cortices did not differ between FXCL and control PSBs. CLINICAL SIGNIFICANCE Although uncommon, microdamage is localized to the articular region of Thoroughbred racehorse PSBs. Catastrophic PSB failure is not associated with lower PSB flexor cortex fracture toughness.
Collapse
Affiliation(s)
- Lauren K Luedke
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, New York, USA
| | - Phoebe Ilevbare
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, New York, USA
| | - Kira J Noordwijk
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, New York, USA
| | - Pablo M Palomino
- Cornell University College of Engineering, Department of Biomedical Engineering, Ithaca, New York, USA
| | - Sean P McDonough
- Cornell University College of Veterinary Medicine, Department of Biomedical Sciences, Ithaca, New York, USA
| | - Scott E Palmer
- Cornell University College of Veterinary Medicine, Department of Population Medicine and Diagnostic Sciences, Ithaca, New York, USA
| | - Parminder S Basran
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, New York, USA
| | - Eve Donnelly
- Cornell University College of Engineering, Department of Materials Science and Engineering, Ithaca, New York, USA
| | - Heidi L Reesink
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, New York, USA
| |
Collapse
|
11
|
Sacher SE, Hunt HB, Lekkala S, Lopez KA, Potts J, Heilbronner AK, Stein EM, Hernandez CJ, Donnelly E. Distributions of Microdamage Are Altered Between Trabecular Rods and Plates in Cancellous Bone From Men With Type 2 Diabetes Mellitus. J Bone Miner Res 2022; 37:740-752. [PMID: 35064941 PMCID: PMC9833494 DOI: 10.1002/jbmr.4509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 01/13/2023]
Abstract
Individuals with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fracture despite exhibiting normal to high bone mineral density (BMD). Conditions arising from T2DM, such as reduced bone turnover and alterations in microarchitecture, may contribute to skeletal fragility by influencing bone morphology and microdamage accumulation. The objectives of this study were (i) to characterize the effect of T2DM on microdamage quantity and morphology in cancellous bone, and (ii) relate the accumulation of microdamage to the cancellous microarchitecture. Cancellous specimens from the femoral neck were collected during total hip arthroplasty (T2DM: n = 22, age = 65 ± 9 years, glycated hemoglobin [HbA1c] = 7.00% ± 0.98%; non-diabetic [non-DM]: n = 25, age = 61 ± 8 years, HbA1c = 5.50% ± 0.4%), compressed to 3% strain, stained with lead uranyl acetate to isolate microdamage, and scanned with micro-computed tomography (μCT). Individual trabeculae segmentation was used to isolate rod-like and plate-like trabeculae and their orientations with respect to the loading axis. The T2DM group trended toward a greater BV/TV (+27%, p = 0.07) and had a more plate-like trabecular architecture (+8% BVplates , p = 0.046) versus non-DM specimens. Rods were more damaged relative to their volume compared to plates in the non-DM group (DVrods /BVrods versus DVplates /BVplates : +49%, p < 0.0001), but this difference was absent in T2DM specimens. Longitudinal rods were more damaged in the non-DM group (DVlongitudinal rods /BVlongitudinal rods : +73% non-DM versus T2DM, p = 0.027). Total damage accumulation (DV/BV) and morphology (DS/DV) did not differ in T2DM versus non-DM specimens. These results provide evidence that cancellous microarchitecture does not explain fracture risk in T2DM, pointing to alterations in material matrix properties. In particular, cancellous bone from men with T2DM may have an attenuated ability to mitigate microdamage accumulation through sacrificial rods. © 2022 American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Sara E Sacher
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Heather B Hunt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Sashank Lekkala
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Kelsie A Lopez
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Jesse Potts
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Alison K Heilbronner
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, New York, NY, USA
| | - Emily M Stein
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, New York, NY, USA
| | - Christopher J Hernandez
- Research Division, Hospital for Special Surgery, New York, NY, USA.,Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.,Research Division, Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
12
|
Luna M, Guss JD, Vasquez-Bolanos LS, Castaneda M, Rojas MV, Strong JM, Alabi DA, Dornevil SD, Nixon JC, Taylor EA, Donnelly E, Fu X, Shea MK, Booth SL, Bicalho R, Hernandez CJ. Components of the Gut Microbiome That Influence Bone Tissue-Level Strength. J Bone Miner Res 2021; 36:1823-1834. [PMID: 33999456 PMCID: PMC8793322 DOI: 10.1002/jbmr.4341] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 12/19/2022]
Abstract
Modifications to the constituents of the gut microbiome influence bone density and tissue-level strength, but the specific microbial components that influence tissue-level strength in bone are not known. Here, we selectively modify constituents of the gut microbiota using narrow-spectrum antibiotics to identify components of the microbiome associated with changes in bone mechanical and material properties. Male C57BL/6J mice (4 weeks) were divided into seven groups (n = 7-10/group) and had taxa within the gut microbiome removed through dosing with: (i) ampicillin; (ii) neomycin; (iii) vancomycin; (iv) metronidazole; (v) a cocktail of all four antibiotics together (with zero-calorie sweetener to ensure intake); (vi) zero-calorie sweetener only; or (vii) no additive (untreated) for 12 weeks. Individual antibiotics remove only some taxa from the gut, while the cocktail of all four removes almost all microbes. After accounting for differences in geometry, whole bone strength was reduced in animals with gut microbiome modified by neomycin (-28%, p = 0.002) and was increased in the group in which the gut microbiome was altered by sweetener alone (+39%, p < 0.001). Analysis of the fecal microbiota detected seven lower-ranked taxa differentially abundant in animals with impaired tissue-level strength and 14 differentially abundant taxa associated with increased tissue-level strength. Histological and serum markers of bone turnover and trabecular bone volume per tissue volume (BV/TV) did not differ among groups. These findings demonstrate that modifications to the taxonomic components of the gut microbiome have the potential to decrease or increase tissue-level strength of bone independent of bone quantity and without noticeable changes in bone turnover. © 2021 American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Marysol Luna
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Jason D Guss
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | | | - Macy Castaneda
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Manuela Vargas Rojas
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Jasmin M Strong
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Denise A Alabi
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Sophie D Dornevil
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Jacob C Nixon
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Erik A Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Material Science and Engineering, Cornell University, Ithaca, NY, USA.,Hospital for Special Surgery, New York, NY, USA
| | - Xueyan Fu
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - M Kyla Shea
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sarah L Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Rodrigo Bicalho
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Christopher J Hernandez
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA.,Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
13
|
Seol S, Pflederer T, Weller L, Goodman C, Donnelly E, Hayes J, Strauss J. PH-0222 Irradiation With or Without Boost in Low Risk Early Breast Cancer: Data from a Large Health System. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
14
|
Moseley KF, Du Z, Sacher SE, Ferguson VL, Donnelly E. Advanced glycation endproducts and bone quality: practical implications for people with type 2 diabetes. Curr Opin Endocrinol Diabetes Obes 2021; 28:360-370. [PMID: 34183538 DOI: 10.1097/med.0000000000000641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Individuals with type 2 diabetes (T2D) are at increased risk of fracture, often despite normal bone density. This observation suggests deficits in bone quality in the setting of abnormal glucose homeostasis. The goal of this article is to review recent developments in our understanding of how advanced glycation end products (AGEs) are incorporated into the skeleton with resultant deleterious effects on bone health and structural integrity in patients with T2D. RECENT FINDINGS The adverse effects of skeletal AGE accumulation on bone remodeling and the ability of the bone to deform and absorb energy prior to fracture have been demonstrated both at the bench as well as in small human studies; however, questions remain as to how these findings might be better explored in large, population-based investigations. SUMMARY Hyperglycemia drives systemic, circulating AGE formation with subsequent accumulation in the bone tissue. In those with T2D, studies suggest that AGEs diminish fracture resistance, though larger clinical studies are needed to better define the direct role of longstanding AGE accumulation on bone strength in humans as well as to motivate potential interventions to reverse or disrupt skeletal AGE deposition with the goal of fracture prevention.
Collapse
Affiliation(s)
- Kendall F Moseley
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University, Baltimore, Maryland
| | - Zexu Du
- Department of Materials Science and Engineering, Cornell University, Ithaca
| | - Sara E Sacher
- Department of Materials Science and Engineering, Cornell University, Ithaca
| | - Virginia L Ferguson
- Department of Mechanical Engineering, UCB 427
- Biomedical Engineering Program, UCB 422, University of Colorado, Boulder, Colorado, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca
- Research Division, Hospital for Special Surgery, New York, New York
| |
Collapse
|
15
|
Zaworski C, Cheah J, Koff MF, Breighner R, Lin B, Harrison J, Donnelly E, Stein EM. MRI-based Texture Analysis of Trabecular Bone for Opportunistic Screening of Skeletal Fragility. J Clin Endocrinol Metab 2021; 106:2233-2241. [PMID: 33999148 DOI: 10.1210/clinem/dgab342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Many individuals at high risk for osteoporosis and fragility fracture are never screened by traditional methods. Opportunistic use of imaging obtained for other clinical purposes is required to foster identification of these patients. OBJECTIVE The aim of this pilot study was to evaluate texture features as a measure of bone fragility, by comparing clinically acquired magnetic resonance imaging (MRI) scans from individuals with and without a history of fragility fracture. METHODS This study retrospectively investigated 100 subjects who had lumbar spine MRI performed at our institution. Cases (n = 50) were postmenopausal women with osteoporosis and a confirmed history of fragility fracture. Controls (n = 50) were age- and race-matched postmenopausal women with no known fracture history. Trabecular bone from the lumbar vertebrae was segmented to create regions of interest within which a gray level co-occurrence matrix was used to quantify the distribution and spatial organization of voxel intensity. Heterogeneity in the trabecular bone texture was assessed by several features, including contrast (variability), entropy (disorder), and angular second moment (homogeneity). RESULTS Texture analysis revealed that trabecular bone was more heterogeneous in fracture patients. Specifically, fracture patients had greater texture variability (+76% contrast; P = 0.005), greater disorder (+10% entropy; P = 0.005), and less homogeneity (-50% angular second moment; P = 0.005) compared with controls. CONCLUSIONS MRI-based textural analysis of trabecular bone discriminated between patients with known osteoporotic fractures and controls. Further investigation is required to validate this promising methodology, which could greatly expand the number of patients screened for skeletal fragility.
Collapse
Affiliation(s)
- Caroline Zaworski
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, NY, NY 10021, USA
| | - Jonathan Cheah
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, NY, NY 10021, USA
| | - Matthew F Koff
- Department of Radiology and Imaging - MRI, Hospital for Special Surgery, NY, NY 10021, USA
| | - Ryan Breighner
- Department of Radiology and Imaging - MRI, Hospital for Special Surgery, NY, NY 10021, USA
| | - Bin Lin
- Department of Radiology and Imaging - MRI, Hospital for Special Surgery, NY, NY 10021, USA
| | - Jonathan Harrison
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, NY, NY 10021, USA
| | - Eve Donnelly
- Materials Science and Engineering, Cornell University, Ithaca NY 14853, USA
| | - Emily M Stein
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, NY, NY 10021, USA
| |
Collapse
|
16
|
Taylor EA, Mileti CJ, Ganesan S, Kim JH, Donnelly E. Measures of Bone Mineral Carbonate Content and Mineral Maturity/Crystallinity for FT-IR and Raman Spectroscopic Imaging Differentially Relate to Physical-Chemical Properties of Carbonate-Substituted Hydroxyapatite. Calcif Tissue Int 2021; 109:77-91. [PMID: 33710382 DOI: 10.1007/s00223-021-00825-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/12/2021] [Indexed: 12/31/2022]
Abstract
Bone mineral carbonate content assessed by vibrational spectroscopy relates to fracture incidence, and mineral maturity/ crystallinity (MMC) relates to tissue age. As FT-IR and Raman spectroscopy become more widely used to characterize the chemical composition of bone in pre-clinical and translational studies, their bone mineral outcomes require improved validation to inform interpretation of spectroscopic data. In this study, our objectives were (1) to relate Raman and FT-IR carbonate:phosphate ratios calculated through direct integration of peaks to gold-standard analytical measures of carbonate content and underlying subband ratios; (2) to relate Raman and FT-IR MMC measures to gold-standard analytical measures of crystal size in chemical standards and native bone powders. Raman and FT-IR direct integration carbonate:phosphate ratios increased with carbonate content (Raman: p < 0.01, R2 = 0.87; FT-IR: p < 0.01, R2 = 0.96) and Raman was more sensitive to carbonate content than the FT-IR (Raman slope + 95% vs FT-IR slope, p < 0.01). MMC increased with crystal size for both Raman and FT-IR (Raman: p < 0.01, R2 = 0.76; FT-IR p < 0.01, R2 = 0.73) and FT-IR was more sensitive to crystal size than Raman (c-axis length: slope FT-IR MMC + 111% vs Raman MMC, p < 0.01). Additionally, FT-IR but not Raman spectroscopy detected differences in the relationship between MMC and crystal size of carbonated hydroxyapatite (CHA) vs poorly crystalline hydroxyapatites (HA) (slope CHA + 87% vs HA, p < 0.01). Combined, these results contribute to the ability of future studies to elucidate the relationships between carbonate content and fracture and provide insight to the strengths and limitations of FT-IR and Raman spectroscopy of native bone mineral.
Collapse
Affiliation(s)
- Erik A Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, 14853, USA
| | - Cassidy J Mileti
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14853, USA
| | - Sandhya Ganesan
- Department of Materials Science Engineering, Cornell University, 227 Bard Hall, Ithaca, NY, 14853, USA
| | - Joo Ho Kim
- Department of Materials Science Engineering, Cornell University, 227 Bard Hall, Ithaca, NY, 14853, USA
| | - Eve Donnelly
- Department of Materials Science Engineering, Cornell University, 227 Bard Hall, Ithaca, NY, 14853, USA.
- Research Division, Hospital for Special Surgery, New York, NY, 10021, USA.
| |
Collapse
|
17
|
Sacher S, Hernandez CJ, Donnelly E. Characterization of Ultralow Density Cellular Solids: Lessons from 30 years of Bone Biomechanics Research. Adv Eng Mater 2021; 23:2100206. [PMID: 34456625 PMCID: PMC8389487 DOI: 10.1002/adem.202100206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Indexed: 06/13/2023]
Abstract
Advances in additive manufacturing techniques have enabled the development of micro-architectured materials displaying a combination of low-density and lightweight structures with high specific strength and toughness. The mechanical performance of micro-architectured materials can be assessed using standard techniques; however, when studying low- and ultralow density micro-architectured materials, standard characterization techniques can be subject to experimental artifacts. Additionally, quantitative assessment and comparisons of microarchitectures with distinct lattice patterns is not always straightforward. Cancellous bone is a natural, ultralow density (porosity often exceeding 90%), irregular, cellular solid that has been thoroughly characterized in terms of micro-architecture and mechanical performance over the past 30 years. However, most the literature on cancellous bone mechanical properties and micro-structure-function relationships is in the medical literature and is not immediately accessible to materials designers. Here we provide a brief review of state-of-the-art approaches for characterizing the micro-architecture and mechanical performance of ultralow density cancellous bone, including methods of addressing experimental artifacts during mechanical characterization of ultralow density cellular solids, methods of quantifying microarchitecture, and currently understood structure-function relationships.
Collapse
Affiliation(s)
- Sara Sacher
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY
| | - Christopher J Hernandez
- Research Division, Hospital for Special Surgery, New York, NY
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY
- Research Division, Hospital for Special Surgery, New York, NY
| |
Collapse
|
18
|
Affiliation(s)
- Christopher J Hernandez
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14853, USA
- Hospital for Special Surgery, New York, NY 10021, USA
- Correspondence: Christopher J. Hernandez, PhD, Sibley School of Mechanical and Aerospace Engineering, Cornell University, 124 Hoy Road, 355 Upson Hall, Ithaca, NY 14853, USA.
| | - Emily M Stein
- Hospital for Special Surgery, New York, NY 10021, USA
| | - Eve Donnelly
- Hospital for Special Surgery, New York, NY 10021, USA
- Materials Science and Engineering, Cornell University, Ithaca, New York, NY 14853, USA
| |
Collapse
|
19
|
Hunt HB, Miller NA, Hemmerling KJ, Koga M, Lopez KA, Taylor EA, Sellmeyer DE, Moseley KF, Donnelly E. Bone Tissue Composition in Postmenopausal Women Varies With Glycemic Control From Normal Glucose Tolerance to Type 2 Diabetes Mellitus. J Bone Miner Res 2021; 36:334-346. [PMID: 32970898 DOI: 10.1002/jbmr.4186] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
The risk of fragility fracture increases for people with type 2 diabetes mellitus (T2DM), even after controlling for bone mineral density, body mass index, visual impairment, and falls. We hypothesize that progressive glycemic derangement alters microscale bone tissue composition. We used Fourier-transform infrared (FTIR) imaging to analyze the composition of iliac crest biopsies from cohorts of postmenopausal women characterized by oral glucose tolerance testing: normal glucose tolerance (NGT; n = 35, age = 65 ± 7 years, HbA1c = 5.8 ± 0.3%), impaired glucose tolerance (IGT; n = 26, age = 64 ± 5 years, HbA1c = 6.0 ± 0.4%), and overt T2DM on insulin (n = 25, age = 64 ± 6 years, HbA1c = 9.13 ± 0.6). The distributions of cortical bone mineral content had greater mean values (+7%) and were narrower (-10%) in T2DM versus NGT groups (p < 0.05). The distributions of acid phosphate, an indicator of new mineral, were narrower in cortical T2DM versus NGT and IGT groups (-14% and -14%, respectively) and in trabecular NGT and IGT versus T2DM groups (-11% and -10%, respectively) (all p < 0.05). The distributions of crystallinity were wider in cortical NGT versus T2DM groups (+16%) and in trabecular NGT versus T2DM groups (+14%) (all p < 0.05). Additionally, bone turnover was lower in T2DM versus NGT groups (P1NP: -25%, CTx: -30%, ucOC: -24%). Serum pentosidine was similar across groups. The FTIR compositional and biochemical marker values of the IGT group typically fell between the NGT and T2DM group values, although the differences were not always statistically significant. In summary, worsening glycemic control was associated with greater mineral content and narrower distributions of acid phosphate, an indicator of new mineral, which together are consistent with observations of lower turnover; however, wider distributions of mineral crystallinity were also observed. A more mineralized, less heterogeneous tissue may affect tissue-level mechanical properties and in turn degrade macroscale skeletal integrity. In conclusion, these data are the first evidence of progressive alteration of bone tissue composition with worsening glycemic control in humans. © 2020 American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Heather B Hunt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Nicholas A Miller
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Kimberly J Hemmerling
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Maho Koga
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Kelsie A Lopez
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Erik A Taylor
- Sibley School of Mechanical Engineering, Cornell University, Ithaca, NY, USA
| | - Deborah E Sellmeyer
- Division of Endocrinology, Gerontology, and Metabolism, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kendall F Moseley
- Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.,Research Division, Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
20
|
Taylor EA, Donnelly E. Raman and Fourier transform infrared imaging for characterization of bone material properties. Bone 2020; 139:115490. [PMID: 32569874 DOI: 10.1016/j.bone.2020.115490] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 12/12/2022]
Abstract
As the application of Raman spectroscopy to study bone has grown over the past decade, making it a peer technology to FTIR spectroscopy, it has become critical to understand their complimentary roles. Recent technological advancements have allowed these techniques to collect grids of spectra in a spatially resolved fashion to generate compositional images. The advantage of imaging with these techniques is that it allows the heterogenous bone tissue composition to be resolved and quantified. In this review we compare, for non-experts in the field of vibrational spectroscopy, the instrumentation and underlying physical principles of FTIR imaging (FTIRI) and Raman imaging. Additionally, we discuss the strengths and limitations of FTIR and Raman spectroscopy, address sample preparation, and discuss outcomes to provide researchers insight into which techniques are best suited for a given research question. We then briefly discuss previous applications of FTIRI and Raman imaging to characterize bone tissue composition and relationships of compositional outcomes with mechanical performance. Finally, we discuss emerging technical developments in FTIRI and Raman imaging which provide new opportunities to identify changes in bone tissue composition with disease, age, and drug treatment.
Collapse
Affiliation(s)
- Erik A Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, United States of America
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States of America; Research division, Hospital for Special Surgery, New York, NY, United States of America.
| |
Collapse
|
21
|
Donnelly E. The Paradox of Fragile but Dense Bones in Type 2 Diabetes. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.00416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
22
|
Eng PA, Donnelly E. Hidden Dragons: The Revitalizing of Vancouver’s Chinatown From Humanistic Perspectives. Journal of Humanistic Psychology 2020. [DOI: 10.1177/0022167817696840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article presents a theoretical path for small communities to reverse rising tides of crime and addiction by means of a community reinforcement approach. Vancouver’s Chinatown offers an ideal opportunity for praxis due to the current enthusiasm of city planners in reviving this section of the city. At its highest level, we interpret a community’s revitalization to include progress toward individuation as a collective, accompanied with increased opportunities for self-fulfillment among its residents. Therefore, as a foundation for the suggested community reinforcement approach, we first apply the humanistic theories of Jung as a means to enhance the integration of Chinatown’s collective consciousness. Next, Maslow’s hierarchy of needs serves as a blueprint for the self-actualization of its inhabitants.
Collapse
Affiliation(s)
- Peter Anthony Eng
- California Institute of Integral Studies, San Francisco, CA, USA; Interchange Counseling Institute, Treasure Island, CA, USA
| | - Eve Donnelly
- California Institute of Integral Studies, San Francisco, CA, USA; Interchange Counseling Institute, Treasure Island, CA, USA
| |
Collapse
|
23
|
Taylor EA, Donnelly E, Yao X, Johnson ML, Amugongo SK, Kimmel DB, Lane NE. Sequential Treatment of Estrogen Deficient, Osteopenic Rats with Alendronate, Parathyroid Hormone (1-34), or Raloxifene Alters Cortical Bone Mineral and Matrix Composition. Calcif Tissue Int 2020; 106:303-314. [PMID: 31784772 DOI: 10.1007/s00223-019-00634-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/11/2019] [Indexed: 12/26/2022]
Abstract
Anti-resorptive and anabolic treatments can be used sequentially to treat osteoporosis, but their effects on bone composition are incompletely understood. Osteocytes may influence bone tissue composition with sequential therapies because bisphosphonates diffuse into the canalicular network and anabolic treatments increase osteocyte lacunar size. Cortical bone composition of osteopenic, ovariectomized (OVX) rats was compared to that of Sham-operated rats and OVX rats given monotherapy or sequential regimens of single approved anti-osteoporosis medications. Adult female Sprague-Dawley rats were OVX (N = 37) or Sham-OVXd (N = 6). After 2 months, seven groups of OVX rats were given three consecutive 3-month periods of treatment with vehicle (V), h-PTH (1-34) (P), alendronate (A), or raloxifene (R), using the following orders: VVV, PVV, RRR, RPR, AAA, AVA, and APA. Compositional properties around osteocyte lacunae of the left tibial cortex were assessed from Raman spectra in perilacunar and non-perilacunar bone matrix regions. Sequential treatments involving parathyroid hormone (PTH) caused lower mean collagen maturity relative to monotherapies. Mean mineral:matrix ratio was 2.2% greater, mean collagen maturity was 1.4% greater, and mean carbonate:phosphate ratio was 2.2% lower in the perilacunar than in the non-perilacunar bone matrix region (all P < 0.05). These data demonstrate cortical bone tissue composition differences around osteocytes caused by sequential treatment with anti-osteoporosis medications. We speculate that the region-specific differences demonstrate the ability of osteocytes to alter bone tissue composition adjacent to lacunae.
Collapse
Affiliation(s)
- Erik A Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
- Research Division, Hospital for Special Surgery, New York, NY, USA
| | - Xiaomei Yao
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Mark L Johnson
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sarah K Amugongo
- Center for Musculoskeletal Health, University of California Davis Medical Center, Sacramento, CA, USA
| | - Donald B Kimmel
- Department of Physiological Sciences, University of Florida, Gainesville, FL, USA
| | - Nancy E Lane
- Center for Musculoskeletal Health, University of California Davis Medical Center, Sacramento, CA, USA.
- Health Center, University of California At Davis, 4625 Second Avenue, Suite 2006, Sacramento, CA, 95817, USA.
| |
Collapse
|
24
|
Abstract
PURPOSE OF REVIEW Individuals with type 1 and type 2 diabetes mellitus (T1DM, T2DM) have an increased risk of bone fracture compared to non-diabetic controls that is not explained by differences in BMD, BMI, or falls. Thus, bone tissue fracture resistance may be reduced in individuals with DM. The purpose of this review is to summarize work that analyzes the effects of T1DM and T2DM on bone tissue compositional and mechanical properties. RECENT FINDINGS Studies of clinical T2DM specimens revealed increased mineralization and advanced glycation endproduct (AGE) concentrations and significant relationships between mechanical performance and composition of cancellous bone. Specifically, in femoral cancellous tissue, compressive stiffness and strength increased with mineral content; and post-yield properties decreased with AGE concentration. In addition, cortical resistance to in vivo indentation (bone material strength index) was lower in patients with T2DM vs. age-matched non-diabetic controls, and this resistance decreased with worsening glycemic control. Recent studies on patients with T1DM and history of a prior fragility fracture found greater mineral content and concentrations of AGEs in iliac trabecular bone and correspondingly stiffer, harder bone at the nanosacle. Recent observational data showed greater AGE and mineral content in surgically retrieved bone from patients with T2DM vs. non-DM controls, consistent with reduced bone remodeling. Limited data on human T1DM bone tissue also showed higher mineral and AGE content in patients with prior fragility fractures compared to non-DM and non-fracture controls.
Collapse
MESH Headings
- Animals
- Biomechanical Phenomena
- Blood Glucose/metabolism
- Bone Density
- Bone Remodeling
- Bone and Bones/diagnostic imaging
- Bone and Bones/metabolism
- Bone and Bones/physiopathology
- Cancellous Bone/diagnostic imaging
- Cancellous Bone/metabolism
- Cancellous Bone/physiopathology
- Cortical Bone/diagnostic imaging
- Cortical Bone/metabolism
- Cortical Bone/physiopathology
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/physiopathology
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 1/physiopathology
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/physiopathology
- Fractures, Bone/epidemiology
- Glycation End Products, Advanced/metabolism
- Humans
Collapse
Affiliation(s)
- Sashank Lekkala
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Erik A Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Heather B Hunt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.
- Research Division, Hospital for Special Surgery, New York, NY, USA.
| |
Collapse
|
25
|
Heveran CM, Schurman CA, Acevedo C, Livingston EW, Howe D, Schaible EG, Hunt HB, Rauff A, Donnelly E, Carpenter RD, Levi M, Lau AG, Bateman TA, Alliston T, King KB, Ferguson VL. Chronic kidney disease and aging differentially diminish bone material and microarchitecture in C57Bl/6 mice. Bone 2019; 127:91-103. [PMID: 31055118 PMCID: PMC6760860 DOI: 10.1016/j.bone.2019.04.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 03/15/2019] [Accepted: 04/26/2019] [Indexed: 12/31/2022]
Abstract
Chronic kidney disease (CKD) is a common disease of aging and increases fracture risk over advanced age alone. Aging and CKD differently impair bone turnover and mineralization. We thus hypothesize that the loss of bone quality would be greatest with the combination of advanced age and CKD. We evaluated bone from young adult (6 mo.), middle-age (18 mo.), and old (24 mo.) male C57Bl/6 mice three months following either 5/6th nephrectomy, to induce CKD, or Sham procedures. CKD exacerbated losses of cortical and trabecular microarchitecture associated with aging. Aging and CKD each resulted in thinner, more porous cortices and fewer and thinner trabeculae. Bone material quality was also reduced with CKD, and these changes to bone material were distinct from those due to age. Aging reduced whole-bone flexural strength and modulus, micrometer-scale nanoindentation modulus, and nanometer-scale tissue and collagen strain (small-angle x-ray scattering [SAXS]. By contrast, CKD reduced work to fracture and variation in bone tissue modulus and composition (Raman spectroscopy), and increased percent collagen strain. The increased collagen strain burden was associated with loss of toughness in CKD. In addition, osteocyte lacunae became smaller, sparser, and more disordered with age for Sham mice, yet these age-related changes were not clearly observed in CKD. However, for CKD, larger lacunae positively correlated with increased serum phosphate levels, suggesting that osteocytes play a role in systemic mineral homeostasis. This work demonstrates that CKD reduces bone quality, including microarchitecture and bone material properties, and that loss of bone quality with age is compounded by CKD. These findings may help reconcile why bone mass does not consistently predict fracture in the CKD population, as well as why older individuals with CKD are at high risk of fragility.
Collapse
Affiliation(s)
- Chelsea M Heveran
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States of America
| | - Charles A Schurman
- Department of Orthopaedic Surgery, University of California, San Francisco, CA, United States of America
| | - Claire Acevedo
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, United States of America
| | - Eric W Livingston
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, United States of America
| | - Danielle Howe
- Department of Biomedical Engineering, The College of New Jersey, Ewing, NJ, United States of America
| | - Eric G Schaible
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, United States of America
| | - Heather B Hunt
- Department of Materials Science & Engineering, Cornell University, Ithaca, NY, United States of America
| | - Adam Rauff
- Department of Bioengineering, University of Colorado, Denver, CO, United States of America
| | - Eve Donnelly
- Department of Materials Science & Engineering, Cornell University, Ithaca, NY, United States of America
| | - R Dana Carpenter
- Department of Mechanical Engineering, University of Colorado, Denver, CO, United States of America
| | - Moshe Levi
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University, Washington D.C., United States of America
| | - Anthony G Lau
- Department of Biomedical Engineering, The College of New Jersey, Ewing, NJ, United States of America
| | - Ted A Bateman
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, United States of America
| | - Tamara Alliston
- Department of Orthopaedic Surgery, University of California, San Francisco, CA, United States of America
| | - Karen B King
- Department of Orthopaedics, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Virginia L Ferguson
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States of America.
| |
Collapse
|
26
|
Guss JD, Taylor E, Rouse Z, Roubert S, Higgins CH, Thomas CJ, Baker SP, Vashishth D, Donnelly E, Shea MK, Booth SL, Bicalho RC, Hernandez CJ. The microbial metagenome and bone tissue composition in mice with microbiome-induced reductions in bone strength. Bone 2019; 127:146-154. [PMID: 31207357 PMCID: PMC6708759 DOI: 10.1016/j.bone.2019.06.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/29/2019] [Accepted: 06/13/2019] [Indexed: 01/10/2023]
Abstract
The genetic components of microbial species that inhabit the body are known collectively as the microbiome. Modifications to the microbiome have been implicated in disease processes throughout the body and have recently been shown to influence bone. Prior work has associated changes in the microbial taxonomy (phyla, class, species, etc.) in the gut with bone phenotypes but has provided limited information regarding mechanisms. With the goal of achieving a more mechanistic understanding of the effects of the microbiome on bone, we perform a metagenomic analysis of the gut microbiome that provides information on the functional capacity of the microbes (all microbial genes present) rather than only characterizing the microbial taxa. Male C57Bl/6 mice were subjected to disruption of the gut microbiota (ΔMicrobiome) using oral antibiotics (from 4 to 16 weeks of age) or remained untreated (n = 6-7/group). Disruption of the gut microbiome in this manner has been shown to lead to reductions in tissue mechanical properties and whole bone strength in adulthood with only minor changes in bone geometry and density. ΔMicrobiome led to modifications in the abundance of microbial genes responsible for the synthesis of the bacterial cell wall and capsule; bacterially synthesized carbohydrates; and bacterially synthesized vitamins (B and K) (p < 0.01). Follow up analysis focused on vitamin K, a factor that has previously been associated with bone health. The vitamin K content of the cecum, liver and kidneys was primarily microbe-derived forms of vitamin K (menaquinones) and was decreased by 32-66% in ∆Microbiome mice compared to untreated animals (p < 0.01). Bone mineral crystallinity determined using Raman spectroscopy was decreased in ∆Microbiome mice (p = 0.01). This study illustrates the use of metagenomic analysis to link the microbiome to bone phenotypes and provides preliminary findings implicating microbially synthesized vitamin-K as a regulator of bone matrix quality.
Collapse
Affiliation(s)
- Jason D Guss
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA; Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Erik Taylor
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Zach Rouse
- Material Science and Engineering, Cornell University, New York, NY, USA
| | - Sebastian Roubert
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | | | - Corinne J Thomas
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Shefford P Baker
- Material Science and Engineering, Cornell University, New York, NY, USA
| | - Deepak Vashishth
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Eve Donnelly
- Material Science and Engineering, Cornell University, New York, NY, USA; Hospital for Special Surgery, New York, NY, USA
| | - M Kyla Shea
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sarah L Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | | | - Christopher J Hernandez
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA; Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Hospital for Special Surgery, New York, NY, USA.
| |
Collapse
|
27
|
Hunt HB, Torres AM, Palomino PM, Marty E, Saiyed R, Cohn M, Jo J, Warner S, Sroga GE, King KB, Lane JM, Vashishth D, Hernandez CJ, Donnelly E. Altered Tissue Composition, Microarchitecture, and Mechanical Performance in Cancellous Bone From Men With Type 2 Diabetes Mellitus. J Bone Miner Res 2019; 34:1191-1206. [PMID: 30866111 PMCID: PMC6650336 DOI: 10.1002/jbmr.3711] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 01/24/2019] [Accepted: 02/19/2019] [Indexed: 01/07/2023]
Abstract
People with type 2 diabetes mellitus (T2DM) have normal-to-high BMDs, but, counterintuitively, have greater fracture risks than people without T2DM, even after accounting for potential confounders like BMI and falls. Therefore, T2DM may alter aspects of bone quality, including material properties or microarchitecture, that increase fragility independently of bone mass. Our objective was to elucidate the factors that influence fragility in T2DM by comparing the material properties, microarchitecture, and mechanical performance of cancellous bone in a clinical population of men with and without T2DM. Cancellous specimens from the femoral neck were collected during total hip arthroplasty (T2DM: n = 31, age = 65 ± 8 years, HbA1c = 7.1 ± 0.9%; non-DM: n = 34, age = 62 ± 9 years, HbA1c = 5.5 ± 0.4%). The T2DM specimens had greater concentrations of the advanced glycation endproduct pentosidine (+ 36%, P < 0.05) and sugars bound to the collagen matrix (+ 42%, P < 0.05) than the non-DM specimens. The T2DM specimens trended toward a greater bone volume fraction (BV/TV) (+ 24%, NS, P = 0.13) and had greater mineral content (+ 7%, P < 0.05) than the non-DM specimens. Regression modeling of the mechanical outcomes revealed competing effects of T2DM on bone mechanical behavior. The trend of higher BV/TV values and the greater mineral content observed in the T2DM specimens increased strength, whereas the greater values of pentosidine in the T2DM group decreased postyield strain and toughness. The long-term medical management and presence of osteoarthritis in these patients may influence these outcomes. Nevertheless, our data indicate a beneficial effect of T2DM on cancellous microarchitecture, but a deleterious effect of T2DM on the collagen matrix. These data suggest that high concentrations of advanced glycation endproducts can increase fragility by reducing the ability of bone to absorb energy before failure, especially for the subset of T2DM patients with low BV/TV. © 2019 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Heather B Hunt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Ashley M Torres
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Pablo M Palomino
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Eric Marty
- Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Rehan Saiyed
- Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Matthew Cohn
- Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan Jo
- Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Stephen Warner
- Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Grazyna E Sroga
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Karen B King
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Surgical Service/Orthopaedic Service, Rocky Mountain Veterans Affairs Regional Medical Center, Aurora, CO, USA
| | - Joseph M Lane
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Deepak Vashishth
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Christopher J Hernandez
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.,Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA.,Research Division, Hospital for Special Surgery, New York, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.,Research Division, Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
28
|
Mcgivern P, Donnelly E, Sheehy N, Rodríguez M, Lenehan E, Fitzgerald S. Analytical performance evaluation of an assay for the direct measurement of HbA1c in whole blood on RX series analysers of different throughput. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
Prescott A, Strauss J, Donnelly E, Gentile M, Patel R, Lipps D, Oza S. EP-1288 Dosimetric Comparison of Protons and Photons in Musculoskeletal Sparing During Breast Irradiation. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
30
|
Hunt HB, Pearl JC, Diaz DR, King KB, Donnelly E. Bone Tissue Collagen Maturity and Mineral Content Increase With Sustained Hyperglycemia in the KK-Ay Murine Model of Type 2 Diabetes. J Bone Miner Res 2018; 33:921-929. [PMID: 29281127 PMCID: PMC5935591 DOI: 10.1002/jbmr.3365] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/01/2017] [Accepted: 12/13/2017] [Indexed: 11/11/2022]
Abstract
Type 2 diabetes mellitus (T2DM) increases fracture risk for a given bone mineral density (BMD), which suggests that T2DM changes bone tissue properties independently of bone mass. In this study, we assessed the effects of hyperglycemia on bone tissue compositional properties, enzymatic collagen crosslinks, and advanced glycation end-products (AGEs) in the KK-Ay murine model of T2DM using Fourier transform infrared (FTIR) imaging and high-performance liquid chromatography (HPLC). Compared to KK-aa littermate controls (n = 8), proximal femoral bone tissue of KK-Ay mice (n = 14) exhibited increased collagen maturity, increased mineral content, and less heterogeneous mineral properties. AGE accumulation assessed by the concentration of pentosidine, as well as the concentrations of the nonenzymatic crosslinks hydroxylysylpyridinoline (HP) and lysyl pyridinoline (LP), did not differ in the proximal femurs of KK-Ay mice compared to controls. The observed differences in tissue-level compositional properties in the KK-Ay mice are consistent with bone that is older and echo observations of reduced remodeling in T2DM. © 2017 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Heather B Hunt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Jared C Pearl
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - David R Diaz
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Karen B King
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Surgical Service/Orthopaedic Service, Veterans Affairs Eastern Colorado Health Care System, Denver, CO, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.,Research Division, Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
31
|
Hao J, Yao W, Harris WBR, Vink JY, Myers KM, Donnelly E. Characterization of the collagen microstructural organization of human cervical tissue. Reproduction 2018; 156:71-79. [PMID: 29712877 DOI: 10.1530/rep-17-0763] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/30/2018] [Indexed: 11/08/2022]
Abstract
The cervix shortens and softens as its collagen microstructure remodels in preparation for birth. Altered cervical tissue collagen microstructure can contribute to a mechanically weak cervix and premature cervical dilation and delivery. To investigate the local microstructural changes associated with anatomic location and pregnancy, we used second-harmonic generation microscopy to quantify the orientation and spatial distribution of collagen throughout cervical tissue from 4 pregnant and 14 non-pregnant women. Across patients, the alignment and concentration of collagen within the cervix was more variable near the internal os and less variable near the external os. Across anatomic locations, the spatial distribution of collagen within a radial zone adjacent to the inner canal of the cervix was more homogeneous than that of a region comprising the middle and outer radial zones. Two regions with different collagen distribution characteristics were found. The anterior and posterior sections in the outer radial zone were characterized by greater spatial heterogeneity of collagen than that of the rest of the sections. Our findings suggest that the microstructural alignment and distribution of collagen varies with anatomic location within the human cervix. These observed differences in collagen microstructural alignment may reflect local anatomic differences in cervical mechanical loading and function. Our study deepens the understanding of specific microstructural cervical changes in pregnancy and informs investigations of potential mechanisms for normal and premature cervical remodeling.
Collapse
Affiliation(s)
- Jia Hao
- Department of Materials Science and EngineeringCornell University, Ithaca, New York, USA
| | - Wang Yao
- Department of Mechanical EngineeringColumbia University, New York, New York, USA
| | - W B Ryan Harris
- Department of Materials Science and EngineeringCornell University, Ithaca, New York, USA
| | - Joy Y Vink
- Department of Obstetrics and GynecologyColumbia University Medical Center, New York, New York, USA
| | - Kristin M Myers
- Department of Mechanical EngineeringColumbia University, New York, New York, USA
| | - Eve Donnelly
- Department of Materials Science and EngineeringCornell University, Ithaca, New York, USA .,Research DivisionHospital for Special Surgery, New York, New York, USA
| |
Collapse
|
32
|
Richards JM, Kunitake JA, Hunt HB, Wnorowski AN, Lin DW, Boskey AL, Donnelly E, Estroff LA, Butcher JT. Crystallinity of hydroxyapatite drives myofibroblastic activation and calcification in aortic valves. Acta Biomater 2018; 71:24-36. [PMID: 29505892 DOI: 10.1016/j.actbio.2018.02.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/15/2018] [Accepted: 02/22/2018] [Indexed: 12/30/2022]
Abstract
Calcific aortic valve disease (CAVD) is an inexorably degenerative pathology characterized by progressive calcific lesion formation on the valve leaflets. The interaction of valvular cells in advanced lesion environments is not well understood yet highly relevant as clinically detectable CAVD exhibits calcifications composed of non-stoichiometric hydroxyapatite (HA). In this study, Fourier transform infrared spectroscopic imaging was used to spatially analyze mineral properties as a function of disease progression. Crystallinity (size and perfection) increased with increased valve calcification. To study the relationship between crystallinity and cellular behavior in CAVD, valve cells were seeded into 3D mineral-rich collagen gels containing synthetic HA particles, which had varying crystallinities. Lower crystallinity HA drove myofibroblastic activation in both valve interstitial and endothelial cells, as well as osteoblastic differentiation in interstitial cells. Additionally, calcium accumulation within gels depended on crystallinity, and apoptosis was insufficient to explain differences in HA-driven cellular activity. The protective nature of endothelial cells against interstitial cell activation and calcium accumulation was completely inhibited in the presence of less crystalline HA particles. Elucidating valve cellular behavior post-calcification is of vital importance to better predict and treat clinical pathogenesis, and mineral-containing hydrogel models provide a unique 3D platform to evaluate valve cell responses to a later stage of valve disease. STATEMENT OF SIGNIFICANCE We implement a 3D in vitro platform with embedded hydroxyapatite (HA) nanoparticles to investigate the interaction between valve interstitial cells, valve endothelial cells, and a mineral-rich extracellular environment. HA nanoparticles were synthesized based on analysis of the mineral properties of calcific regions of diseased human aortic valves. Our findings indicate that crystallinity of HA drives activation and differentiation in interstitial and endothelial cells. We also show that a mineralized environment blocks endothelial protection against interstitial cell calcification. Our HA-containing hydrogel model provides a unique 3D platform to evaluate valve cell responses to a mineralized ECM. This study additionally lays the groundwork to capture the diversity of mineral properties in calcified valves, and link these properties to progression of the disease.
Collapse
|
33
|
Taylor EA, Lloyd AA, Salazar-Lara C, Donnelly E. Raman and Fourier Transform Infrared (FT-IR) Mineral to Matrix Ratios Correlate with Physical Chemical Properties of Model Compounds and Native Bone Tissue. Appl Spectrosc 2017; 71:2404-2410. [PMID: 28485618 DOI: 10.1177/0003702817709286] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Raman and Fourier transform infrared (FT-IR) spectroscopic imaging techniques can be used to characterize bone composition. In this study, our objective was to validate the Raman mineral:matrix ratios (ν1 PO4:amide III, ν1 PO4:amide I, ν1 PO4:Proline + hydroxyproline, ν1 PO4:Phenylalanine, ν1 PO4:δ CH2 peak area ratios) by correlating them to ash fraction and the IR mineral:matrix ratio (ν3 PO4:amide I peak area ratio) in chemical standards and native bone tissue. Chemical standards consisting of varying ratios of synthetic hydroxyapatite (HA) and collagen, as well as bone tissue from humans, sheep, and mice, were characterized with confocal Raman spectroscopy and FT-IR spectroscopy and gravimetric analysis. Raman and IR mineral:matrix ratio values from chemical standards increased reciprocally with ash fraction (Raman ν1 PO4/Amide III: P < 0.01, R2 = 0.966; Raman ν1 PO4/Amide I: P < 0.01, R2 = 0.919; Raman ν1 PO4/Proline + Hydroxyproline: P < 0.01, R2 = 0.976; Raman ν1 PO4/Phenylalanine: P < 0.01, R2 = 0.911; Raman ν1 PO4/δ CH2: P < 0.01, R2 = 0.894; IR P < 0.01, R2 = 0.91). Fourier transform infrared mineral:matrix ratio values from native bone tissue were also similar to theoretical mineral:matrix ratio values for a given ash fraction. Raman and IR mineral:matrix ratio values were strongly correlated ( P < 0.01, R2 = 0.82). These results were confirmed by calculating the mineral:matrix ratio for theoretical IR spectra, developed by applying the Beer-Lambert law to calculate the relative extinction coefficients of HA and collagen over the same range of wavenumbers (800-1800 cm-1). The results confirm that the Raman mineral:matrix bone composition parameter correlates strongly to ash fraction and to its IR counterpart. Finally, the mineral:matrix ratio values of the native bone tissue are similar to those of both chemical standards and theoretical values, confirming the biological relevance of the chemical standards and the characterization techniques.
Collapse
Affiliation(s)
- Erik A Taylor
- 1 Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Ashley A Lloyd
- 2 Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Carolina Salazar-Lara
- 2 Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- 2 Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
- 3 Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
34
|
Bacon S, Kyithar MP, Rizvi SR, Donnelly E, McCarthy A, Burke M, Colclough K, Ellard S, Byrne MM. Successful maintenance on sulphonylurea therapy and low diabetes complication rates in a HNF1A-MODY cohort. Diabet Med 2016; 33:976-84. [PMID: 26479152 DOI: 10.1111/dme.12992] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 02/06/2023]
Abstract
AIMS HNF1A gene mutations are the most common cause of maturity-onset diabetes of the young (MODY) in the UK. Persons with HNF1A-MODY display sensitivity to sulphonylurea therapy; however, the long-term efficacy is not established. There is limited literature as to the prevalence of micro- and macrovascular complications in this unique cohort. The aim of this study was to determine the natural progression and clinical management of HNF1A-MODY diabetes in a dedicated MODY clinic. METHODS Sixty patients with HNF1A-MODY and a cohort of 60 BMI-, age-, ethnicity- and diabetes duration-matched patients with Type 1 diabetes mellitus participated in the study. All patients were phenotyped in detail. Clinical follow-up of the HNF1A-MODY cohort occurred on a bi-annual basis. RESULTS Following a genetic diagnosis of MODY, the majority of the cohort treated with sulphonylurea therapy remained insulin independent at 84-month follow-up (80%). The HbA1c in the HNF1A-MODY group treated with sulphonylurea therapy alone improved significantly over the study period [from 49 (44-63) mmol/mol, 6.6 (6.2-7.9)% to 41 (31-50) mmol/mol, 5.9 (5-6.7)%; P = 0.003]. The rate of retinopathy was significantly lower than that noted in the Type 1 diabetes mellitus group (13.6 vs. 50%; P = 0.0001).There was also a lower rate of microalbuminuria and cardiovascular disease in the HNF1A-MODY group compared with the Type 1 diabetes mellitus group. CONCLUSIONS This study demonstrates that the majority of patients with HNF1A-MODY can be maintained successfully on sulphonylurea therapy with good glycaemic control. We note a significantly lower rate of micro- and macrovascular complications than reported previously. The use of appropriate therapy at early stages of the disorder may decrease the incidence of complications.
Collapse
Affiliation(s)
- S Bacon
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M P Kyithar
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - S R Rizvi
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - E Donnelly
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A McCarthy
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Burke
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Colclough
- Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
| | - S Ellard
- Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - M M Byrne
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| |
Collapse
|
35
|
Boskey AL, Donnelly E, Boskey E, Spevak L, Ma Y, Zhang W, Lappe J, Recker RR. Examining the Relationships Between Bone Tissue Composition, Compositional Heterogeneity, and Fragility Fracture: A Matched Case-Controlled FTIRI Study. J Bone Miner Res 2016; 31:1070-81. [PMID: 26636271 PMCID: PMC4862946 DOI: 10.1002/jbmr.2759] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 11/16/2015] [Accepted: 12/03/2015] [Indexed: 11/09/2022]
Abstract
Fourier transform infrared imaging (FTIRI) provides information on spatial distribution of the chemical composition of thin tissue specimens at ∼7 µm spatial resolution. This study of 120 age- and bone mineral density (BMD)-matched patients was designed to investigate the association of FTIRI variables, measured in iliac crest biopsies, with fragility fractures at any site. An earlier study of 54 women found hip BMD to be a significant explanatory variable of fracture risk for cortical bone but not for cancellous bone. In the current study, where age and BMD were controlled through matching, no such association was observed, validating the pairing scheme. Our first study of unmatched iliac crest biopsies found increases in collagen maturity (cancellous and cortical bone) and mineral crystal size (cortical bone only) to be a significant explanatory variable of fracture when combined with other covariates. The ratio for collagen maturity has been correlated to the amount of enzymatic collagen cross-links. To assess the impact of other FTIRI variables (acid phosphate substitution, carbonate-to-phosphate ratio, and the pixel distribution [heterogeneity] of all relevant FTIRI variables), we examined biopsies from a matched case-controlled study, in which 60 women with fractures were each paired with an age- and BMD-matched female control. With the matched data set of 120 women, conditional logistic regression analyses revealed that significant explanatory variables of fracture were decreased carbonate-to-phosphate ratio in both cancellous (odds ratio [OR] = 0.580, 95% confidence interval [CI] 0.37-0.909, p = 0.0176) and cortical bone (OR = 0.519, 95% CI 0.325-0.829, p = 0.0061), and increased heterogeneity (broadened pixel distribution) of collagen maturity for cancellous bone (OR = 1.549, 95% CI 1.002-2.396, p = 0.0491). The observation that collagen maturity was no longer linked to fracture in age- and BMD-matched samples suggests that age-dependent variation in collagen maturity may be a more important contributory factor to fragility fractures than previously thought. © 2015 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Adele L Boskey
- Musculoskeletal Integrity Program, Hospital for Special Surgery, New York, NY, USA
| | - Eve Donnelly
- Musculoskeletal Integrity Program, Hospital for Special Surgery, New York, NY, USA.,Materials Science and Engineering Department, Cornell University, Ithaca, NY, USA
| | | | - Lyudmila Spevak
- Musculoskeletal Integrity Program, Hospital for Special Surgery, New York, NY, USA
| | - Yan Ma
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Wei Zhang
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Joan Lappe
- Osteoporosis Research Center, Creighton University, Omaha, NE, USA
| | - Robert R Recker
- Osteoporosis Research Center, Creighton University, Omaha, NE, USA
| |
Collapse
|
36
|
Boyer R, Morgan V, Donnelly E, Brown D, Omary R. Comparison of structure and influence of the #IRad and #Radiology social media networks. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
37
|
Wang ZX, Lloyd AA, Burket JC, Gourion-Arsiquaud S, Donnelly E. Altered distributions of bone tissue mineral and collagen properties in women with fragility fractures. Bone 2016; 84:237-244. [PMID: 26780445 DOI: 10.1016/j.bone.2016.01.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/25/2015] [Accepted: 01/13/2016] [Indexed: 01/22/2023]
Abstract
Heterogeneity of bone tissue properties is emerging as a potential indicator of altered bone quality in pathologic tissue. The objective of this study was to compare the distributions of tissue properties in women with and without histories of fragility fractures using Fourier transform infrared (FTIR) imaging. We extended a prior study that examined the relationship of the mean FTIR properties to fracture risk by analyzing in detail the widths and the tails of the distributions of FTIR properties in biopsies from fracture and non-fracture cohorts. The mineral and matrix properties of cortical and trabecular iliac crest tissue were compared in biopsies from women with a history of fragility fracture (+Fx; n=21, age: mean 54±SD 15y) and with no history of fragility fracture (-Fx; n=12, age: 57±5y). A subset of the patients included in the -Fx group were taking estrogen-plus-progestin hormone replacement therapy (HRT) (-Fx+HRT n=8, age: 58±5y) and were analyzed separately from patients with no history of HRT (-Fx-HRT n=4, age: 56±7y). When the FTIR parameter mean values were examined by treatment group, the trabecular tissue of -Fx-HRT patients had a lower mineral:matrix ratio (M:M) and collagen maturity (XLR) than that of -Fx+HRT patients (-22% M:M, -18% XLR) and +Fx patients (-17% M:M, -18% XLR). Across multiple FTIR parameters, tissue from the -Fx-HRT group had smaller low-tail (5th percentile) values than that from the -Fx+HRT or +Fx groups. In trabecular collagen maturity and crystallinity (XST), the -Fx-HRT group had smaller low-tail values than those in the -Fx+HRT group (-16% XLR, -5% XST) and the +Fx group (-17% XLR, -7% XST). The relatively low values of trabecular mineral:matrix ratio and collagen maturity and smaller low-tail values of collagen maturity and crystallinity observed in the -Fx-HRT group are characteristic of younger tissue. Taken together, our data suggest that the presence of newly formed tissue that includes small/imperfect crystals and immature crosslinks, as well as moderately mature tissue, is an important characteristic of healthy, fracture-resistant bone. Finally, the larger mean and low-tail values of mineral:matrix ratio and collagen maturity noted in our -Fx+HRT vs. -Fx-HRT biopsies are consistent with greater tissue age and greater BMD arising from decreased osteoclastic resorption in HRT-treated patients.
Collapse
Affiliation(s)
- Zhen Xiang Wang
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States
| | - Ashley A Lloyd
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States
| | - Jayme C Burket
- Hospital for Special Surgery, New York, NY, United States
| | | | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, United States; Hospital for Special Surgery, New York, NY, United States.
| |
Collapse
|
38
|
Selaru P, Tang Y, Huang B, Polli A, Wilner KD, Donnelly E, Cohen DP. Sufficiency of Single-Arm Studies to Support Registration of Targeted Agents in Molecularly Selected Patients with Cancer: Lessons from the Clinical Development of Crizotinib. Clin Transl Sci 2016; 9:63-73. [PMID: 26841346 PMCID: PMC5351315 DOI: 10.1111/cts.12388] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/13/2016] [Accepted: 01/23/2016] [Indexed: 01/10/2023] Open
Affiliation(s)
- P Selaru
- Pfizer Oncology, La Jolla, California, USA
| | - Y Tang
- Pfizer Oncology, La Jolla, California, USA
| | - B Huang
- Pfizer Oncology, Groton, Connecticut, USA
| | - A Polli
- Pfizer Oncology, Milan, Italy
| | - K D Wilner
- Pfizer Oncology, La Jolla, California, USA
| | - E Donnelly
- Pfizer Oncology, Cambridge, Massachusetts, USA
| | - D P Cohen
- Pfizer Oncology, La Jolla, California, USA
| |
Collapse
|
39
|
Lloyd AA, Wang ZX, Donnelly E. Multiscale contribution of bone tissue material property heterogeneity to trabecular bone mechanical behavior. J Biomech Eng 2015; 137:1935360. [PMID: 25383615 PMCID: PMC4296240 DOI: 10.1115/1.4029046] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/05/2014] [Accepted: 11/12/2014] [Indexed: 11/08/2022]
Abstract
Heterogeneity of material properties is an important potential contributor to bone fracture resistance because of its putative contribution to toughness, but establishing the contribution of heterogeneity to fracture risk is still in an incipient stage. Experimental studies have demonstrated changes in distributions of compositional and nanomechanical properties with fragility fracture history, disease, and pharmacologic treatment. Computational studies have demonstrated that models with heterogeneous material properties predict apparent stiffness moderately better than homogeneous models and show greater energy dissipation. Collectively, these results suggest that microscale material heterogeneity affects not only microscale mechanics but also structural performance at larger length scales.
Collapse
Affiliation(s)
- Ashley A. Lloyd
- Department of Materials Scienceand Engineering,Cornell University,B60 Bard Hall,Ithaca, NY 14853e-mail:
| | - Zhen Xiang Wang
- Department of Materials Scienceand Engineering,Cornell University,B60 Bard Hall,Ithaca, NY 14853e-mail:
| | - Eve Donnelly
- Assistant ProfessorDepartment of Materials Scienceand Engineering,Cornell University,227 Bard Hall,Ithaca, NY 14853
- Hospital for Special Surgery,535 E. 70th Street,New York, NY 10021e-mail:
| |
Collapse
|
40
|
Donnelly E, Lane JM, Boskey AL. Research perspectives: The 2013 AAOS/ORS research symposium on Bone Quality and Fracture Prevention. J Orthop Res 2014; 32:855-64. [PMID: 24700449 PMCID: PMC4716655 DOI: 10.1002/jor.22626] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/05/2014] [Indexed: 02/04/2023]
Abstract
Bone fracture resistance is determined by the amount of bone present ("bone quantity") and by a number of other geometric and material factors grouped under the term "bone quality." In May 2013, a workshop was convened among a group of clinicians and basic science investigators to review the current state of the art in Bone Quality and Fracture Prevention and to make recommendations for future directions for research. The AAOS/ORS/OREF workshop was attended by 64 participants, including two representatives of the National Institutes of Arthritis and Musculoskeletal and Skin Diseases and 13 new investigators whose posters stimulated additional interest. A key outcome of the workshop was a set of recommendations regarding clinically relevant aspects of both bone quality and quantity that clinicians can use to inform decisions about patient care and management. The common theme of these recommendations was the need for more education of clinicians in areas of bone quality and for basic science studies to address specific topics of pathophysiology, diagnosis, prevention, and treatment of altered bone quality. In this report, the organizers with the assistance of the speakers and other attendees highlight the major findings of the meeting that justify the recommendations and needs for this field.
Collapse
Affiliation(s)
- Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York,Hospital for Special Surgery, New York, New York
| | | | | |
Collapse
|
41
|
Deeley MA, Chen A, Datteri RD, Noble J, Cmelak A, Donnelly E, Malcolm A, Moretti L, Jaboin J, Niermann K, Yang ES, Yu DS, Dawant BM. Segmentation editing improves efficiency while reducing inter-expert variation and maintaining accuracy for normal brain tissues in the presence of space-occupying lesions. Phys Med Biol 2013; 58:4071-97. [PMID: 23685866 DOI: 10.1088/0031-9155/58/12/4071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Image segmentation has become a vital and often rate-limiting step in modern radiotherapy treatment planning. In recent years, the pace and scope of algorithm development, and even introduction into the clinic, have far exceeded evaluative studies. In this work we build upon our previous evaluation of a registration driven segmentation algorithm in the context of 8 expert raters and 20 patients who underwent radiotherapy for large space-occupying tumours in the brain. In this work we tested four hypotheses concerning the impact of manual segmentation editing in a randomized single-blinded study. We tested these hypotheses on the normal structures of the brainstem, optic chiasm, eyes and optic nerves using the Dice similarity coefficient, volume, and signed Euclidean distance error to evaluate the impact of editing on inter-rater variance and accuracy. Accuracy analyses relied on two simulated ground truth estimation methods: simultaneous truth and performance level estimation and a novel implementation of probability maps. The experts were presented with automatic, their own, and their peers' segmentations from our previous study to edit. We found, independent of source, editing reduced inter-rater variance while maintaining or improving accuracy and improving efficiency with at least 60% reduction in contouring time. In areas where raters performed poorly contouring from scratch, editing of the automatic segmentations reduced the prevalence of total anatomical miss from approximately 16% to 8% of the total slices contained within the ground truth estimations. These findings suggest that contour editing could be useful for consensus building such as in developing delineation standards, and that both automated methods and even perhaps less sophisticated atlases could improve efficiency, inter-rater variance, and accuracy.
Collapse
Affiliation(s)
- M A Deeley
- Department of Radiology and Radiation Oncology, University of Vermont, Burlington, VT, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Hoit G, Hinkewich C, Tiao J, Porgo V, Moore L, Moore L, Tiao J, Wang C, Moffatt B, Wheeler S, Gillman L, Bartens K, Lysecki P, Pallister I, Patel S, Bradford P, Bradford P, Kidane B, Holmes A, Trajano A, March J, Lyons R, Kao R, Rezende-Neto J, Leblanc Y, Rezende-Neto J, Vogt K, Alzaid S, Jansz G, Andrusiek D, Andrusiek D, Bailey K, Livingston M, Calthorpe S, Hsu J, Lubbert P, Boitano M, Leeper W, Williamson O, Reid S, Alonazi N, Lee C, Rezende-Neto J, Aleassa E, Jennings P, Jennings P, Mador B, Hoffman K, Riley J, Vu E, Alburakan A, Alburakan A, Alburakan A, Mckee J, Bobrovitz N, Gabbe B, Gabbe B, Hodgkinson J, Hodgkinson J, Ali J, Ali J, Grant M, Roberts D, Holodinsky J, Cooper C, Santana M, Kruger K, Hodgkinson J, Waggott M, Da Luz L, Banfield J, Santana M, Dorigatti A, Birn K, Bobrovitz N, Zakirova R, Davies D, Das D, Gamme G, Pervaiz F, Almarhabi Y, Brainard A, Brown R, Bell N, Bell N, Jowett H, Jowett H, Bressan S, Hogan A, Watson I, Woodford S, Hogan A, Boulay R, Watson I, Howlett M, Atkinson P, Chesters A, Hamadani F, Atkinson P, Azzam M, Fraser J, Doucet J, Atkinson P, Muakkassa F, Sathivel N, Chadi S, Joseph B, Takeuchi L, Bradley N, Al Bader B, Kidane B, Harrington A, Nixon K, Veigas P, Joseph B, O’Keeffe T, Bracco D, Rezende-Neto J, Azzam M, Lin Y, Bailey K, Bracco D, Nash N, Alhabboubi M, Slobogean G, Spicer J, Heidary B, Joos E, Berg R, Berg R, Sankarankutty A, Zakrison T, Babul S, Lockhart S, Faux S, Jackson A, Lee T, Bailey K, Pemberton J, Green R, Tallon J, Moore L, Turgeon A, Boutin A, Moore L, Reinartz D, Lapointe G, Turgeon A, Stelfox H, Turgeon A, Nathens A, Neveu X, Stelfox H, Turgeon A, Nathens A, Neveu X, Moore L, Turgeon A, Bratu I, Gladwin C, Voaklander D, Lewis M, Vogt K, Eckert K, Williamson J, Stewart TC, Parry N, Gray D, L’Heureux R, Ziesmann M, Kortbeek J, Brindley P, Hicks C, Fata P, Engels P, Ball C, Paton-Gay D, Widder S, Vogt K, Hernandez-Alejandro R, Gray D, Vanderbeek L, Forrokhyar F, Anatharajah R, Howatt N, Lamb S, Sne N, Kahnamoui K, Lyons R, Walters A, Brooks C, Pinder L, Rahman S, Walters A, Kidane B, Parry N, Donnelly E, Lewell M, Mellow R, Hedges C, Morassutti P, Bulatovic R, Morassutti P, Galbraith E, McKenzie S, Bradford D, Lewell M, Peddle M, Dukelow A, Eby D, McLeod S, Bradford P, Stewart TC, Parry N, Williamson O, Fraga G, Pereira B, Sareen J, Doupe M, Gawaziuk J, Chateau D, Logsetty S, Pallister I, Lewis J, O’Doherty D, Hopkins S, Griffiths S, Palmer S, Gabbe B, Xu X, Martin C, Xenocostas A, Parry N, Mele T, Rui T, Abreu E, Andrade M, Cruz F, Pires R, Carreiro P, Andrade T, Lampron J, Balaa F, Fortuna R, Issa H, Dias P, Marques M, Fernandes T, Sousa T, Inaba K, Smith J, Okoye O, Joos E, Shulman I, Nelson J, Parry N, Rhee P, Demetriades D, Ostrofsky R, Butler-Laporte G, Chughtai T, Khwaja K, Fata P, Mulder D, Razek T, Deckelbaum D, Bailey K, Pemberton J, Evans D, Anton H, Wei J, Randall E, Sobolev B, Scott BB, van Heest R, Frankfurter C, Pemberton J, McKerracher S, Stewart TC, Merritt N, Barber L, Kimmel L, Hodgson C, Webb M, Holland A, Gruen R, Harrison K, Hwang M, Hsee L, Civil I, Muizelaar A, Baillie F, Leeper T, Stewart TC, Gray D, Parry N, Sutherland A, Hart M, Gabbe B, Tuma F, Coates A, Farrokhyar F, Faidi S, Gastaldo F, Paskar D, Reid S, Faidi S, Petrisor B, Bhandari M, Loh WL, Ho C, Chong C, Rodrigues G, Gissoni M, Martins M, Andrade M, Cunha-Melo J, Rizoli S, Abu-Zidan F, Cameron P, Bernard S, Walker T, Jolley D, Fitzgerald M, Masci K, Gabbe B, Simpson P, Smith K, Cox S, Cameron P, Evans D, West A, Barratt L, Rozmovits L, Livingstone B, Vu M, Griesdale D, Schlamp R, Wand R, Alhabboubi M, Alrowaili A, Alghamdi H, Fata P, Essbaiheen F, Alhabboubi M, Fata P, Essbaiheen F, Chankowsky J, Razek T, Stephens M, Vis C, Belton K, Kortbeek J, Bratu I, Dufresne B, Guilfoyle J, Ibbotson G, Martin K, Matheson D, Parks P, Thomas L, Kirkpatrick A, Santana M, Kline T, Kortbeek J, Stelfox H, Lyons R, Macey S, Fitzgerald M, Judson R, Cameron P, Sutherland A, Hart M, Morgan M, McLellan S, Wilson K, Cameron P, Sorvari A, Chaudhry Z, Khawaja K, Ali A, Akhtar J, Zubair M, Nickow J, Sorvari A, Holodinsky J, Jaeschke R, Ball C, Blaser AR, Starkopf J, Zygun D, Kirkpatrick A, Roberts D, Ball C, Blaser AR, Starkopf J, Zygun D, Jaeschke R, Kirkpatrick A, Santana M, Stelfox H, Stelfox H, Rizoli S, Tanenbaum B, Stelfox H, Redondano BR, Jimenez LS, Zago T, de Carvalho RB, Calderan TA, Fraga G, Campbell S, Widder S, Paton-Gay D, Engels P, Ferri M, Santana M, Kline T, Kortbeek J, Stelfox H, Nathens A, Lashoher A, McFarlan A, Ahmed N, Booy J, McDowell D, Nasr A, Wales P, Roberts D, Mercado M, Vis C, Kortbeek J, Kirkpatrick A, Lall R, Stelfox H, Ball C, Niven D, Dixon E, Stelfox H, Kirkpatrick A, Kaplan G, Hameed M, Ball C, Qadura M, Sne N, Reid S, Coates A, Faidi S, Veenstra J, Hennecke P, Gardner R, Appleton L, Sobolev B, Simons R, van Heest R, Hameed M, Sobolev B, Simons R, van Heest R, Hameed M, Palmer C, Bevan C, Crameri J, Palmer C, Hogan D, Grealy L, Bevan C, Palmer C, Jowett H, Boulay R, Chisholm A, Beairsto E, Goulette E, Martin M, Benjamin S, Boulay R, Watson I, Boulay R, Watson I, Watson I, Savoie J, Benjamin S, Martin M, Hogan A, Woodford S, Benjamin S, Chisholm A, Ondiveeran H, Martin M, Atkinson P, Doody K, Fraser J, Leblanc-Duchin D, Strack B, Naveed A, vanRensburg L, Madan R, Atkinson P, Boulva K, Deckelbaum D, Khwaja K, Fata P, Razek T, Fraser J, Verheul G, Parks A, Milne J, Nemeth J, Fata P, Correa J, Deckelbaum D, Bernardin B, Al Bader B, Khwaja K, Razek T, Atkinson P, Benjamin S, Sproul E, Mehta A, Galarneau M, Mahadevan P, Bansal V, Dye J, Hollingsworth-Fridlund P, Stout P, Potenza B, Coimbra R, Madan R, Marley R, Salvator A, Pisciotta D, Bridge J, Lin S, Ovens H, Nathens A, Abdo H, Dencev-Bihari R, Parry N, Lawendy A, Ibrahim-Zada I, Pandit V, Tang A, O’Keeffe T, Wynne J, Gries L, Friese R, Rhee P, Hameed M, Simons R, Taulu T, Wong H, Saleem A, Azzam M, Boulva K, Razek T, Khwaja K, Mulder D, Deckelbaum D, Fata P, Plourde M, Chadi S, Forbes T, Parry N, Martin G, Gaunt K, Bandiera G, Bawazeer M, MacKinnon D, Ahmed N, Spence J, Sankarankutty A, Nascimento B, Rizoli S, Ibrahim-Zada I, Aziz H, Tang A, Friese R, Wynne J, O’keeffe T, Vercruysse G, Kulvatunyou N, Rhee P, Sakles J, Mosier J, Wynne J, Kulvatunyou N, Tang A, Joseph B, Rhee P, Khwaja K, Fata P, Deckelbaum D, Razek T, Dias P, Issa H, Fortuna R, Sousa T, Abreu E, Bracco D, Khwaja K, Fata P, Deckelbaum D, Razek T, Bracco D, Khwaja K, Fata P, Deckelbaum D, Razek T, Norman D, Li J, Pemberton J, Al-Oweis J, Khwaja K, Fata P, Deckelbaum D, Razek T, Albuz O, Karamanos E, Vogt K, Okoye O, Talving P, Inaba K, Demetriades D, Elhusseini M, Sudarshan M, Deckelbaum D, Fata P, Razek T, Khwaja K, MacPherson C, Sun T, Pelletier M, Hameed M, Khalil MA, Azzam M, Valenti D, Fata P, Deckelbaum D, Razek T, Brown R, Simons R, Evans D, Hameed M, Inaba K, Vogt K, Okoye O, Gelbard R, Moe D, Grabo D, Demetriades D, Inaba K, Karamanos E, Okoye O, Talving P, Demetriades D, Inaba K, Karamanos E, Pasley J, Teixeira P, Talving P, Demetriades D, Fung S, Alababtain I, Brnjac E, Luz L, Nascimento B, Rizoli S, Parikh P, Proctor K, Murtha M, Schulman C, Namias N, Goldman R, Pike I, Korn P, Flett C, Jackson T, Keith J, Joseph T, Giddins E, Ouellet J, Cook M, Schreiber M, Kortbeek J. Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review. Can J Surg 2013. [DOI: 10.1503/cjs.005813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
43
|
Hammonds J, Price R, Donnelly E, Pickens D. SU-E-I-76: Optimizing Imaging Parameters for a Novel Radiographic Imaging System for the Detection of Corrosion in Aluminum Aircraft Structures. Med Phys 2012; 39:3642. [DOI: 10.1118/1.4734793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
44
|
Donnelly E, Meredith DS, Nguyen JT, Boskey AL. Bone tissue composition varies across anatomic sites in the proximal femur and the iliac crest. J Orthop Res 2012; 30:700-6. [PMID: 22034199 PMCID: PMC3277807 DOI: 10.1002/jor.21574] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 09/29/2011] [Indexed: 02/04/2023]
Abstract
The extent to which bone tissue composition varies across anatomic sites in normal or pathologic tissue is largely unknown, although pathologic changes in bone tissue composition are typically assumed to occur throughout the skeleton. Our objective was to compare the composition of normal cortical and trabecular bone tissue across multiple anatomic sites. The composition of cadaveric bone tissue from three anatomic sites was analyzed using Fourier transform infrared imaging: iliac crest (IC), greater trochanter (GT), and subtrochanteric femur (ST). The mean mineral:matrix ratio was 20% greater in the subtrochanteric cortex than in the cortices of the iliac crest (p = 0.004) and the greater trochanter (p = 0.02). There were also trends toward 30% narrower crystallinity distributions in the subtrochanteric cortex than in the greater trochanter (p = 0.10) and 30% wider crystallinity distributions in the subtrochanteric trabeculae than in the greater trochanter (p = 0.054) and the iliac crest (p = 0.11). Thus, the average cortical tissue mineral content and the widths of the distributions of cortical crystal size/perfection differ at the subtrochanteric femur relative to the greater trochanter and the iliac crest. In particular, the cortex of the iliac crest has lower mineral content relative to that of the subtrochanteric femur and may have limited utility as a surrogate for subtrochanteric bone.
Collapse
Affiliation(s)
- Eve Donnelly
- Mineralized Tissues Laboratory, Hospital for Special Surgery, New York, NY
| | | | - Joseph T. Nguyen
- Epidemiology and Biostatistics, Hospital for Special Surgery, New York, NY
| | - Adele L. Boskey
- Mineralized Tissues Laboratory, Hospital for Special Surgery, New York, NY,Graduate Program in Physiology, Biophysics, and Systems Biology, Weill Medical College of Cornell University, New York, NY
| |
Collapse
|
45
|
Donnelly E, Meredith DS, Nguyen JT, Gladnick BP, Rebolledo BJ, Shaffer AD, Lorich DG, Lane JM, Boskey AL. Reduced cortical bone compositional heterogeneity with bisphosphonate treatment in postmenopausal women with intertrochanteric and subtrochanteric fractures. J Bone Miner Res 2012; 27:672-8. [PMID: 22072397 PMCID: PMC4404705 DOI: 10.1002/jbmr.560] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Reduction of bone turnover with bisphosphonate treatment alters bone mineral and matrix properties. Our objective was to investigate the effect of bisphosphonate treatment on bone tissue properties near fragility fracture sites in the proximal femur in postmenopausal women with osteoporosis. The mineral and collagen properties of corticocancellous biopsies from the proximal femur were compared in bisphosphonate-naive (-BIS, n = 20) and bisphosphonate-treated (+BIS, n = 20, duration 7 ± 5 years) patients with intertrochanteric (IT) and subtrochanteric (ST) fractures using Fourier transform infrared imaging (FTIRI). The mean values of the FTIRI parameter distributions were similar across groups, but the widths of the parameter distributions tended to be reduced in the +BIS group relative to the -BIS group. Specifically, the widths of the cortical collagen maturity and crystallinity were reduced in the +BIS group relative to those of the -BIS group by 28% (+BIS 0.45 ± 0.18 versus -BIS 0.63 ± 0.28, p = 0.03) and 17% (+BIS 0.087 ± 0.012 versus -BIS 0.104 ± 0.036, p = 0.05), respectively. When the tissue properties were examined as a function of fracture morphology within the +BIS group, the FTIR parameters were generally similar regardless of fracture morphology. However, the cortical mineral:matrix ratio was 8% greater in tissue from patients with atypical ST fractures (n = 6) than that of patients with typical (IT or spiral ST) fractures (n = 14) (Atypical 5.6 ± 0.3 versus Typical 5.2 ± 0.5, p = 0.03). Thus, although the mean values of the FTIR properties were similar in both groups, the tissue in bisphosphonate-treated patients had a more uniform composition than that of bisphosphonate-naive patients. The observed reductions in mineral and matrix heterogeneity may diminish tissue-level toughening mechanisms.
Collapse
Affiliation(s)
- Eve Donnelly
- Mineralized Tissues Laboratory, Hospital for Special Surgery, New York, NY 10021, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Boyle J, Donnelly E, Lurain J, Schink J, Singh D, Gentile M, Weitner B, Strauss J, Rademaker A, Small W. Patterns of Recurrence After Definitive Radiation Therapy for Locoregionally-Confined Cervical Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
47
|
Affiliation(s)
- Adele L. Boskey
- Musculoskeletal Integrity Program, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
| | - Eve Donnelly
- Musculoskeletal Integrity Program, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
| | | |
Collapse
|
48
|
Abstract
BACKGROUND Bone mass, geometry, and tissue material properties contribute to bone structural integrity. Thus, bone strength arises from both bone quantity and quality. Bone quality encompasses the geometric and material factors that contribute to fracture resistance. QUESTIONS/PURPOSES This review presents an overview of the methods for assessing bone quality across multiple length scales, their outcomes, and their relative advantages and disadvantages. METHODS A PubMed search was conducted to identify methods related to bone mechanical testing, imaging, and compositional analysis. Using various exclusion criteria, articles were selected for inclusion. RESULTS Methods for assessing mechanical properties include whole-bone, bulk tissue, microbeam, and micro- and nanoindentation testing techniques. Outcomes include structural strength and material modulus. Advantages include direct assessment of bone strength; disadvantages include specimen destruction during testing. Methods for characterizing bone geometry and microarchitecture include quantitative CT, high-resolution peripheral quantitative CT, high-resolution MRI, and micro-CT. Outcomes include three-dimensional whole-bone geometry, trabecular morphology, and tissue mineral density. The primary advantage is the ability to image noninvasively; disadvantages include the lack of a direct measure of bone strength. Methods for measuring tissue composition include scanning electron microscopy, vibrational spectroscopy, nuclear magnetic resonance imaging, and chemical and physical analytical techniques. Outcomes include mineral density and crystallinity, elemental composition, and collagen crosslink composition. Advantages include the detailed material characterization; disadvantages include the need for a biopsy. CONCLUSIONS Although no single method can completely characterize bone quality, current noninvasive imaging techniques can be combined with ex vivo mechanical and compositional techniques to provide a comprehensive understanding of bone quality.
Collapse
Affiliation(s)
- Eve Donnelly
- Mineralized Tissues Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
| |
Collapse
|
49
|
Reumann MK, Strachna O, Lukashova L, Verdelis K, Donnelly E, Boskey AL, Mayer-Kuckuk P. Early growth response gene 1 regulates bone properties in mice. Calcif Tissue Int 2011; 89:1-9. [PMID: 21533960 DOI: 10.1007/s00223-011-9486-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 03/21/2011] [Indexed: 01/16/2023]
Abstract
Transcriptional regulation of the postnatal skeleton is incompletely understood. Here, we determined the consequence of loss of early growth response gene 1 (EGR-1) on bone properties. Analyses were performed on both the microscopic and molecular levels utilizing micro-computed tomography (micro-CT) and Fourier transform infrared imaging (FTIRI), respectively. Mice deficient in EGR-1 (Egr-1 (-/-)) were studied and compared to sex- and age-matched wild-type (wt) control animals. Femoral trabecular bone in male Egr-1 (-/-) mice demonstrated osteopenic characteristics marked by reductions in both bone volume fraction (BV/TV) and bone mineral density (BMD). Morphological analysis revealed fewer trabeculae in these animals. In contrast, female Egr-1 (-/-) animals had thinner trabeculae, but BV/TV and BMD were not significantly reduced. Analysis of femoral cortical bone at the mid-diaphysis did not show significant osteopenic characteristics but detected changes in cross-sectional geometry in both male and female Egr-1 (-/-) animals. Functionally, this resulted in decreased resistance to three-point bending as indicated by a reduction in maximum load, failure load, and stiffness. Assessment of compositional bone properties, including mineral-to-matrix ratio, carbonate-to-phosphate ratio, crystallinity, and cross-linking, in femurs by FTIRI did not show any significant differences or an appreciable trend between Egr-1 (-/-) and wt mice of either sex. Unexpectedly, rib bone from Egr-1 (-/-) animals displayed distinct osteopenic traits that were particularly pronounced in female mice. This study provides genetic evidence that both sex and skeletal site are critical determinants of EGR-1 activity in vivo and that its site-specific action may contribute to the mechanical properties of bone.
Collapse
Affiliation(s)
- Marie K Reumann
- Bone Cell Biology and Imaging Laboratory, Caspary Research Building, Rm. 623, Hospital for Special Surgery, New York, NY 10021, USA
| | | | | | | | | | | | | |
Collapse
|
50
|
Donnelly E, Chen DX, Boskey AL, Baker SP, van der Meulen MCH. Contribution of mineral to bone structural behavior and tissue mechanical properties. Calcif Tissue Int 2010; 87:450-60. [PMID: 20730582 PMCID: PMC2965269 DOI: 10.1007/s00223-010-9404-x] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 07/17/2010] [Indexed: 12/16/2022]
Abstract
Bone geometry and tissue material properties jointly govern whole-bone structural behavior. While the role of geometry in structural behavior is well characterized, the contribution of the tissue material properties is less clear, partially due to the multiple tissue constituents and hierarchical levels at which these properties can be characterized. Our objective was to elucidate the contribution of the mineral phase to bone mechanical properties across multiple length scales, from the tissue material level to the structural level. Vitamin D and calcium deficiency in 6-week-old male rats was employed as a model of reduced mineral content with minimal collagen changes. The structural properties of the humeri were measured in three-point bending and related to the mineral content and geometry from microcomputed tomography. Whole-cortex and local bone tissue properties were examined with infrared (IR) spectroscopy, Raman spectroscopy, and nanoindentation to understand the role of altered mineral content on the constituent material behavior. Structural stiffness (-47%) and strength (-50%) were reduced in vitamin D-deficient (-D) humeri relative to controls. Moment of inertia (-38%), tissue mineral density (TMD, -9%), periosteal mineralization (-28%), and IR mineral:matrix ratio (-19%) were reduced in -D cortices. Thus, both decreased tissue mineral content and changes in cortical geometry contributed to impaired skeletal load-bearing function. In fact, 97% of the variability in humeral strength was explained by moment of inertia, TMD, and IR mineral:matrix ratio. The strong relationships between structural properties and cortical material composition demonstrate a critical role of the microscale material behavior in skeletal load-bearing performance.
Collapse
Affiliation(s)
- Eve Donnelly
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, 219 Upson Hall, Ithaca, NY 14853, USA.
| | | | | | | | | |
Collapse
|