Bone Therapeutics: Safety Considerations, Session Summary

This session was a series of presentations focused on safety considerations for late stage or currently marketed bone therapeutic agents. The first presentation was an overview of a major regulatory requirement in the nonclinical filing package for bone therapeutics, studies designed to assess the impact of an agent on bone quality. Two presentations focused on safety issues associated with drugs whose primary mechanism of action is inhibition of bone resorption. Typical findings associated with this class of agents in general and reproductive toxicology studies were reviewed, highlighting INHAND (International Harmonization of Nomenclature and Diagnostic Criteria) nomenclature. This was followed by an overview of safety issues that have been identified largely through clinical experience. Similar presentations followed emphasizing safety and regulatory issues associated with classes of drugs whose primary mechanism of action is stimulation of bone formation known broadly as bone anabolic agents. The major focus of these discussions was carcinogenicity risk assessment. The final presentation was an introduction to a rapidly evolving area in bone therapeutics, treatment of rare genetic bone diseases, and the developmental challenges associated with these indications and novel therapeutic modalities.

Treatment with a potent cathepsin K inhibitor preserves cortical and trabecular bone mass in ovariectomized monkeys

The cysteine protease cathepsin K is involved in osteoclast-mediated bone resorption. We evaluated the effect of daily oral dosing of an inhibitor of human cathepsin K (SB-462795 [relacatib]) for 9 months on bone turnover, mass, and architecture in estrogen-deficient cynomolgus monkeys. Ovariectomized animals were treated orally with relacatib at 1, 3, or 10 mg/kg/day, or oral vehicle plus alendronate at 0.05 mg/kg by IV injection once every 2 weeks. The control groups, ovariectomized and sham-ovariectomized animals, received vehicle (all groups n = 20 animals). Samples for biomarker analysis were collected at various times, bone mass changes were evaluated at 6 and 9 months of treatment, and histomorphometric analysis was performed at 9 months. Relacatib significantly reduced urinary N-telopeptide excretion within 1 week of treatment at all dose levels, an effect that was maintained at the highest dose level. At some time points bone formation markers were elevated at the lowest dose of relacatib. Animals treated with relacatib had dose-dependent preservation of areal bone mineral density reaching statistical significance in distal femur. In femur neck there was significant preservation of total volumetric BMD (vBMD) by relacatib. By histomorphometry, relacatib reduced indices of bone resorption and formation at cancellous sites as did alendronate. In cortical bone, osteonal bone formation rate was reduced by alendronate but preserved at low and medium doses of relacatib. Thus, relacatib preserved cortical and cancellous bone mass in ovariectomized monkeys.

Bone mass and soy isoflavones in socially housed, premenopausal macaques

BACKGROUND

Soy consumption is associated with a lower incidence of hip fracture in Asian than in Western women, an effect often attributed to estrogen-like compounds (isoflavones) in soy. It is not known whether premenopausal soy exposure initiated in adulthood can increase bone mass and thereby reduce fracture risk.

OBJECTIVE

We aimed to determine whether a high-isoflavone soy diet influences bone mass in soy-naïve, premenopausal cynomolgus monkeys (Macaca fascicularis).

DESIGN

Ninety-four skeletally mature females were randomly assigned to consume diets whose protein content came from either high-isoflavone soy or casein and lactalbumin. Animals were socially housed. Bone mass and circulating isoflavone concentrations were measured at baseline and 19 and 31 mo after the start of treatment; bone biomarkers were measured at baseline and 31 mo.

RESULTS

There were no significant differences at any timepoint in whole-body bone mineral content between casein-fed (112.5 +/- 2.1, 119.2 +/- 1.9, and 120.7 +/- 2.1 g) and soy-fed (117.2 +/- 2.1, 122.4 +/- 2.0, and 125.4 +/- 2.3 g; P=0.12) monkeys. Similar results were seen for spinal bone mineral density (casein-fed: 0.46 +/- 0.01, 0.50 +/- 0.01, and 0.52 +/- 0.01 g/cm(2); soy-fed: 0.47 +/- 0.01, 0.51 +/- 0.01, and 0.52 +/- 0.01 g/cm(2); P=0.30) and bone biomarker measurements-bone-specific alkaline phosphatase (soy-fed: 82.3 +/- 4.1 and 63.2 +/- 3.4 ng/mL; casein-fed: 94.1 +/- 4.5 and 61.7 +/- 4.3 ng/mL; P=0.22) and C-terminal crosslink of type 1 collagen (soy-fed: 0.944 +/- 0.06 and 0.89 +/- 0.08 nmol/L; casein-fed: 0.97 +/- 0.07 and 0.78 +/- 0.06 nmol/L; P=0.20).

CONCLUSION

A soy diet high in isoflavones does not significantly affect bone characteristics in initially soy-naïve premenopausal monkeys.

Interrelationships between bone microarchitecture and strength in ovariectomized monkeys treated with teriparatide

Bone microarchitecture measured at the iliac crest at 6 mo was confirmed to be a reasonable surrogate for, and a predictor of, architecture and strength of the femoral neck and lumbar vertebra after 18 mo of teriparatide treatment. However, the data taken together showed the importance of cortical bone volume for vertebra to assess pharmacological effects on bone quality.

INTRODUCTION

Improvements in bone architecture with teriparatide treatment are suggested to contribute to fracture risk reduction in osteoporotic patients. Teriparatide significantly improves microarchitecture in the iliac crest of humans by stimulating bone modeling and remodeling processes that differ dramatically from those induced by antiresorptives. The relationship between improvements of bone microarchitecture and improvements of bone strength with teriparatide treatment has not yet been fully studied.

MATERIALS AND METHODS

Ovariectomized monkeys were administered vehicle (n = 20); teriparatide 1.0 microg/kg/d (n = 19); or teriparatide 5.0 microg/kg/d (n = 21) for 18 mo. Iliac crest biopsies were obtained at 6 and 15 mo after initiation of treatment. Animals were killed after 18 mo of treatment, and adjacent vertebrae or contralateral proximal femora were processed for biomechanical or histomorphometric analyses. Pearson correlation analyses were performed to assess the relationship between biomechanical and static histomorphometric parameters of lumbar vertebra, femoral neck, and iliac crest biopsies.

RESULTS

Static histomorphometric parameters of the 6- and 15-mo biopsies were significantly correlated with the vertebral and femoral neck parameters obtained at 18 mo of teriparatide treatment. Iliac crest biopsy parameters at 6 and 15 mo also correlated with vertebral and femoral neck strength at 18 mo. Static histomorphometry of the lumbar vertebra and femoral neck at 18 mo also significantly correlated with strength at these sites. However, cortical bone volume of the lumbar vertebrae had the strongest correlation with vertebral and femoral neck strength (r = 0.74 and 0.71, respectively).

CONCLUSIONS

Teriparatide dose dependently improved cortical and trabecular microarchitecture of vertebra and femoral neck, as well as trabecular microarchitecture of the iliac crest. Bone microarchitecture at all sites was significantly correlated with lumbar vertebra and femoral neck strength. Cortical bone volume of vertebra had the strongest correlation with vertebral and femoral neck strength. Therefore, structural improvement seemed to be part of the mechanism for improved strength observed with teriparatide treatment. Trabecular bone architecture of the iliac crest at 6 mo also correlated with vertebral and femoral neck strength, as did femoral neck (cortical and trabecular) histomorphometry and trabecular histomorphometry of vertebra after 18 mo of treatment. Because clinical assessment of cortical bone volume is not readily possible for vertebra noninvasively, these findings confirm the importance of iliac crest biopsies to monitor skeletal health and show that biopsies are a reasonable surrogate to assess spine and femoral neck structure and function.

Endocrine disruption in adolescence: immunologic, hematologic, and bone effects in monkeys

Environmental contaminants with estrogenic properties have the potential to alter pubertal development. In addition to the reproductive system, other systems that mature under the influence of estrogen could be affected. This study examined the effect on immune, hematologic, and bone mass parameters of treatment with estrogenic agents (methoxychlor, MXC, 25 and 50 mg/kg/day; diethylstilbestrol, DES, 0.5 mg/kg/day) given in the peripubertal period to female rhesus monkeys. DES had striking effects on several parameters assessed measures CBC and clinical chemistry including hematocrit, hemoglobin, serum albumin, liver transaminases, and lipids. Circulating lymphocytes, particularly B cells, were depressed by DES, and a maturational shift in a memory T-cell population was altered. Bone mass and length, as measured after a 9-month recovery period, were significantly lower in the DES group and bone mass tended to be reduced in the femur of the MXC50 group relative to controls. In conclusion, the data indicate that DES had a clear effect on immunohematology and bone growth, while MXC influenced fewer parameters. Disruption in these systems during puberty could alter adolescent risk for anemia and infectious disease and subsequent adult risk for diseases such as osteoporosis, heart disease, and autoimmune disease.

Teriparatide [PTH(1-34)] strengthens the proximal femur of ovariectomized nonhuman primates despite increasing porosity

OVX monkeys treated for 18 months with 1 or 5 microg/kg/d teriparatide [PTH (1-34)] had significantly stronger proximal femora relative to ovariectomized controls. Teriparatide enhancement of cortical area, cortical width, and trabecular bone volume seemed to more than compensate for the dose-dependent increase in cortical porosity. Beneficial effects of teriparatide treatment on the proximal femur persisted beyond the treatment period and may extend to the marrow.

INTRODUCTION

We conducted a detailed quantitative analysis of the effects of teriparatide on the proximal femur of ovariectomized monkeys. Teriparatide increased bone mass, enhanced structural architecture, and strengthened the hip, despite increasing cortical porosity.

MATERIALS AND METHODS

Monkeys were treated with vehicle (sham or OVX controls), 1 microg/kg/day teriparatide [parathyroid hormone (1-34); PTH1], or 5 microg/kg/day teriparatide (PTH5) for 18 months or for 12 months followed by 6 months of treatment withdrawal (PTH1W and PTH5W, respectively). Excised proximal femora were analyzed by microCT, conventional histomorphometry, and biomechanics.

RESULTS AND CONCLUSIONS

The femoral neck showed significant reduction in trabecular bone volume (BV/TV) for OVX compared with sham, whereas PTH1 BV/TV was restored to sham levels and PTH5 BV/TV was greater than sham and OVX. The withdrawal groups had BV/TVs intermediate between sham and OVX. PTH1 had trabecular number (Tb.N) greater than OVX, and PTH5 Tb.N was greater than sham and OVX. The withdrawal groups had Tb.Ns intermediate between sham and OVX. No differences between groups were observed for trabecular orientation or trabecular thickness. Teriparatide dose-dependently increased bone formation rate and activation frequency in the femoral neck. Cellular composition analyses suggested a tendency of ovariectomy to increase adiposity of marrow by 100%, whereas PTH tended to reduce adipocyte number and increase osteoblast number compared with OVX. Analyses of the cortex showed dose-dependent elevation of cortical porosity, which was consistent with enhanced bone turnover with treatment. Cortical porosity was reduced after withdrawal of teriparatide, because PTH1W cortical porosity was lower than OVX, whereas PTH5W cortical porosity was intermediate between sham and OVX. Increased cortical porosity did not weaken the proximal femora. Biomechanics showed that ovariectomy weakened proximal femora compared with sham, but PTH1, PTH5, and PTH1W were stronger than OVX and not different from sham. PTH5W strength was intermediate between sham and OVX. Therefore, teriparatide had beneficial effects on the proximal femur, despite increasing cortical porosity. Cortical porosity did not adversely affect the mechanical integrity of the proximal femora, because enhanced cortical area and trabecular bone volume more than compensated for the porosity. Much of the beneficial effects of teriparatide were retained after 6 months withdrawal from treatment. PTH effects on the femoral neck were not limited to bone but may include inhibition of OVX-stimulated adiposity of the marrow.

Hormonal Therapies and Osteoporosis

Osteoporosis, now defined as a disease characterized by low bone mass and a microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. Classic hormonal therapies to prevent and treat osteoporosis associated with menopause have recently been questioned due to the risk/benefit ratio of prolonged treatment. There is a critical need for safe and effective alternative therapeutics for this disease. Nonhuman primates have been used as models to assess bone changes associated with estrogen deficiency because their trabecular and cortical bone remodeling processes, monthly menstrual cycles, and reproductive-hormone patterns are similar to those of humans. The ovariectomized nonhuman primate has become the preferred model in which to study effects on bone remodeling, particularly with regard to bone mass, architecture, and strength, in fulfillment of studies required by international guidelines for the development of antiosteoporotic drugs. The nonhuman primate is amenable to several methodologies that assess bone quantity and quality, including dual energy x-ray absorptiometry (DXA), quantitative computed tomography (QCT), histology, static and dynamic histomorphometry, and biomechanical testing, as well as assays developed for clinical use, which serve as biomarkers of bone metabolic processes. The use of the nonhuman primate model in the assessment of osteoporosis therapeutics, both hormonal (sex steroids and their analogues, parathyroid hormone) and nonhormonal (bisphosphonates), has provided valuable information on the safety and efficacy as well as the mechanisms of bone loss associated with estrogen deficiency that is directly applicable to the human situation.

Effects of raloxifene on bone density, biomarkers, and histomorphometric and biomechanical measures in ovariectomized cynomolgus monkeys

OBJECTIVE

The purpose of this study was to determine the effect of raloxifene on bone density, strength, metabolism, and histomorphometric characteristics in ovariectomized cynomolgus monkeys.

DESIGN

A prospective, longitudinal study was designed to examine the effects of conjugated equine estrogens (0.04 mg/kg, CEE) and raloxifene (1 or 5 mg/kg, R1 and R5, respectively) on bone density, biomarkers, histomorphometry, and strength. Control groups included ovariectomized and sham-operated monkeys. Treatment was initiated the day after ovariectomy and continued for 24 months. Bone biomarker data were collected at baseline and every 3 months after surgery. Bone mass was determined at baseline and every 6 months after ovariectomy. Iliac biopsies were collected at baseline and 16 months postovariectomy, and the second lumbar vertebra and left midshaft femur collected at necropsy were examined histomorphometrically. Bone biomechanical properties were determined for the right femur and vertebrae.

RESULTS

Compared with the placebo-treated ovariectomized monkeys, the high-dose raloxifene group had lower levels of alkaline phosphatase, tartrate-resistant acid phosphatase, urinary CrossLaps (collagen degradation products), and greater bone mass in the lumbar vertebrae. In the endocortical compartment, the high-dose raloxifene group had significantly lower mineralizing surface, mineral apposition rate, and bone formation rate in the iliac biopsy collected at 16 months and lower bone formation rate in the second lumbar vertebra. Within the midshaft femur, low-dose raloxifene significantly decreased the osteonal and total bone formation rates and also prevented the decrease in Young's modulus induced by ovariectomy in the midshaft femur.

CONCLUSIONS

High-dose raloxifene prevented the development of osteopenia in the ovariectomized monkey by reducing bone turnover, albeit to a lesser extent than CEE. Histomorphometric and biomarker data suggest that mechanisms underlying the effect of raloxifene differ somewhat from that of CEE.

Treatment with human parathyroid hormone (1-34) for 18 months increases cancellous bone volume and improves trabecular architecture in ovariectomized cynomolgus monkeys (Macaca fascicularis)

A key feature of postmenopausal osteoporosis is the loss of trabecular bone mass and connectivity. The current study focuses on these parameters in the assessment of long-term (12 and 18 months) parathyroid hormone (PTH) therapy and its withdrawal (6 months) in the ovariectomized cynomolgus monkey (Macaca fascicularis), a well-characterized model for bone changes associated with postmenopausal osteoporosis. We used static and dynamic histomorphometric parameters to assess the amount and architecture of cancellous bone in four clinically important sites for osteoporotic fractures, including the lumbar vertebra, femoral neck, distal radius, and iliac crest. Recombinant human PTH(1-34) was administered daily to two groups for 18 months at 1.0 microg/kg per day (n = 19) and 5.0 microg/kg per day (n = 21). To study the effects of PTH withdrawal, two groups were administered PTH(1-34) daily for 12 months at 1.0 microg/kg per day (n = 20) and 5.0 microg/kg per day (n = 20), followed by daily administration of vehicle for 6 months. Sham-ovariectomized and ovariectomized (ovx) groups each received daily injections of vehicle for 18 months. Treatment with PTH had minimal effects on bone formation rates at the timepoints studied, but markedly increased cancellous bone volume relative to ovx monkeys in iliac crest biopsies at 6 and 15 months, as well as in terminal specimens of lumbar vertebrae, femoral neck, and distal radius after 18 months. At all sites, PTH significantly improved trabecular architecture, as evidenced by increased trabecular number (Tb.N) and decreased trabecular separation (Tb.Sp), with no significant change in trabecular thickness (Tb.Th). The mechanism of these structural changes is suggested by qualitative observations of trabecular tunneling observed in the iliac crest and vertebra. Longitudinal tunneling of thickened individual trabeculae is hypothesized to convert them into multiple trabeculae, resulting in a normalization of Tb.Th, but an increase in Tb.N. A significant positive effect on cancellous bone volume was still apparent after a 3-6 month withdrawal period following 12 months of PTH treatment in the iliac crest, vertebra, and femoral neck. Corresponding increases in Tb.N and decreases in Tb.Sp also remained significant after PTH withdrawal at these three sites. The distal radius was relatively insensitive to PTH treatment or its withdrawal, compared with the other bones. In summary, PTH therapy dramatically improved cancellous bone mass and architecture in both axial and appendicular sites.

Unbiased determination of cytokine localization in bone: colocalization of interleukin-6 with osteoblasts in serial sections from monkey vertebrae

Few data are available describing the in vivo localization of cytokines in bone. The objective of this study was to describe the histological localization of interleukin-6 (IL-6) relative to osteoblasts (alkaline phosphate [ALP]-positive cells) and osteoclasts (tartrate-resistant acid phosphate [TRAP]-positive cells) in midsagittal, paraffin-embedded serial sections of thoracic 13 (T-13) vertebrae from 49 female cynomolgus monkeys. Serial sections 1 and 4 were immunostained for IL-6, section 2 was histochemically stained for TRAP, and section 3 was immunostained for ALP. Sixteen centrally located fields were measured in the cancellous compartment and grid alignment among sections was verified using image analysis. Using a Merz grid, IL-6 localized to 6% of the bone surface on sections 1 and 4, whereas TRAP localized to 8.5% and ALP to 12% of the bone surface. Colocalization was defined as positive staining within an 80 x 80 microm block in the first serial section that "overlapped" staining in either the corresponding block or its eight surrounding blocks within the second serial section. For each section, 1600 blocks were analyzed. Using Monte Carlo simulations, random colocalization was calculated to determine the statistical significance of experimental colocalizations. Colocalization of approximately 90% between the two IL-6 sections verified staining reproducibility and proper grid alignment among sections. Colocalization of TRAP and ALP was not statistically different from random (p 0.3). As identified using ALP- or TRAP-positive surfaces, there was significant IL-6 colocalization with osteoblasts (p < 0.003), but not with osteoclasts (p 0.3). These in vivo colocalization data support the hypothesis that osteoblasts produce and respond to IL-6.

Magnetic resonance imaging as a screening procedure to avoid arthroscopy for meniscal tears

The objective of this study was to evaluate the role of magnetic resonance imaging (MRI) as a screening procedure before arthroscopy of meniscal tears. Forty-one knees in 40 patients underwent MRI and arthroscopy. Compared with arthroscopy, the sensitivity, specificity, positive predictive value and negative predictive value for MRI for the nmedial meniscus were 100%, 77%, 71% and 100%, respectively, while the values for the lateral meniscus were 40%, 89%, 33% and 91%, respectively. The overall accuracy for MRI of the medial and lateral menisci combined was 84%. On the basis of the high predictive value of negative MRI, we conclude that MRI is useful to exclude patients from unnecessary arthroscopy.

Daily treatment with human recombinant parathyroid hormone-(1-34), LY333334, for 1 year increases bone mass in ovariectomized monkeys

PTH stimulates bone formation to increase bone mass and strength in rats and humans. The aim of this study was to determine the skeletal effects of recombinant human PTH-(1-34) [rhPTH-(1-34)] in monkeys, as monkey bone remodeling and structure are similar to those in human bone. Adult female cynomolgus monkeys were divided into sham-vehicle (n = 21), ovariectomized (OVX)-vehicle (n = 20), and OVX groups given daily s.c. injections of rhPTH-(1-34) at 1 (n = 39) or 5 (n = 41) microg/kg for 12 months. Whole body bone mineral content was measured, as was bone mineral density (BMD) in the spine, proximal tibia, midshaft radius, and distal radius. Serum and urine samples were also analyzed. rhPTH-(1-34) treatment did not influence serum ionized Ca levels or urinary Ca excretion, but depressed endogenous PTH while increasing serum calcitriol levels. Compared to that in the OVX group, the higher dose of rhPTH-(1-34) increased spine BMD by 14.3%, whole body bone mineral content by 8.6%, and proximal tibia BMD by 10.8%. Subregion analyses suggested that the anabolic effect of rhPTH-(1-34) on the proximal tibia was primarily in cancellous bone. Similar, but less dramatic, effects on BMD were observed with the lower dose of rhPTH-(1-34). Daily s.c. rhPTH-(1-34) treatment for 1 yr increases BMD in ovariectomized monkeys without inducing sustained hypercalcemia or hypercalciuria.

Effect of treatment for 6 months with human parathyroid hormone (1-34) peptide in ovariectomized cynomolgus monkeys (Macaca fascicularis)

A potential negative side effect of intermittent parathyroid hormone (PTH) therapy to treat osteoporosis is the loss of cortical bone concomitant with increased cancellous bone mass. We addressed this issue by studying the effects of PTH on whole-body, axial, and appendicular bone mass in an animal model with haversian cortical bone remodeling. Ovariectomized, young adult female cynomolgus monkeys were assigned to placebo (n = 9) or PTH groups (n = 10). The PTH group received 10 microg/kg synthetic human PTH(1-34) peptide by subcutaneous injection, 3 days/week for 6 months, and the placebo group received vehicle. Multiple endpoints of bone mass, strength, and turnover in the axial and appendicular skeleton were assessed, including dual-energy X-ray absorptiometry (DEXA), quantitative computed tomography (qCT), analysis of serum (calcium, phosphorus, alkaline phosphatase, osteocalcin, and tartrate-resistant acid phosphatase) and urinary (calcium and creatinine) biomarkers, histomorphometry, and biomechanical testing. Compared with placebo-treated animals, PTH-treated monkeys had no change in whole-body bone mass, but a 6.7% increase in spinal areal bone mineral density (aBMD) was observed. Cortical bone mass measured by qCT at appendicular sites was not affected by PTH treatment, but there were significant increases in cancellous bone mass in the proximal tibia, and a similar trend in the distal radius. Small, transient increases in serum and urinary calcium were observed, but there were no treatment-related effects on other biochemical endpoints. Increased bone formation rate (BFR/BV) in the midradius and midfemur was accompanied by a nonsignificant increase in midfemur porosity. Increased vertebral cancellous bone volume (BV/TV) was associated with greater trabecular and interstitial thickness with no effect on wall thickness. Increases in bone strength were observed in both axial (vertebral maximum stress and load at fracture) and appendicular (femoral neck fracture load) skeleton. Together, these results indicate that PTH therapy in the cynomolgus monkey results in a net gain of spinal and appendicular cancellous bone mass with no adverse effect on cortical bone.

Changes in bone mass and bone biomarkers of cynomolgus monkeys during pregnancy and lactation

A substantial amount of calcium is transferred from the mother to the fetus and infant during pregnancy and lactation. Involvement of the skeleton in meeting this demand should be reflected in changes in bone mass and turnover. The purpose of the study was to determine the effects of pregnancy, lactation, and recovery on the skeleton in 43 young (prepeak bone mass) female monkeys. Whole body (WBBMC) and lumbar vertebrae 2-4 bone mineral content were determined by dual x-ray absorptiometry at baseline and 1, 4, and 10 months postpartum. Alkaline phosphatase, bone Gla protein, and urinary crosslinks were measured at baseline, during the third trimester, and 1, 4, and 10 months postpartum. Compared to nonpregnant, nonlactating monkeys, pregnant monkeys had similar rates of bone mass gain (nonpregnant, nonlactating WBBMC, 25+/-9 mg/day; pregnant WBBMC, 20+/-14 mg/day). Compared to pregnant monkeys, lactating females had increased bone turnover, as indicated by elevated bone biomarker levels (lactating alkaline phosphatase, 259+/-20 IU/L) and decreased bone mass (lactating WBBMC, -99+/-21 mg/day). Densitometry showed that bone mass gain in the lactating monkeys did not compensate for lactational loss by 10 months postpartum (WBBMC, 6.95+/-9 mg/day). This lack of recovery may have been due to the fact that serum estrogen concentrations were just beginning to return to baseline at 10 months postpartum. In conclusion, the cynomolgus monkey skeleton responds similarly to that of women during pregnancy and lactation. Recovery from lactational bone loss is not complete by 10 months postpartum.

The anesthetic isoflurane decreases ionized calcium and increases parathyroid hormone and osteocalcin in cynomolgus monkeys

The effects of anesthetics on calcium metabolism in cynomolgus monkeys were studied. Eight adult female cynomolgus monkeys were used in a crossover design. Blood was collected from each of the monkeys at four timepoints: (1) while conscious; (2) following induction of anesthesia with ketamine, ketamine and atropine, isoflurane, or no anesthetic; (3) at 30 min; and (4) 120 min thereafter. Four experiments were performed with a 1 week washout period between sessions, such that each monkey received each treatment. Potassium was lower in anesthetized monkeys than in those that remained conscious. Cortisol, although high, did not differ among anesthetic treatments. Ketamine and ketamine/atropine did not consistently affect ionized calcium or parathyroid hormone (PTH) concentrations. Isoflurane decreased ionized calcium (0.05 mmol/L), and increased PTH and osteocalcin twofold. The serum inorganic fluoride concentration was higher in monkeys anesthetized with isoflurane than with ketamine/atropine, which may partially account for the decrease in ionized calcium with isoflurane. The increases in PTH and osteocalcin are presumably secondary to the decrease in ionized calcium.

Evaluation of a nonhuman primate model to study circadian rhythms of calcium metabolism

We evaluated primate models for the study of circadian rhythms in calcium and bone metabolism. Blood and urine were collected from two cynomolgus macaques every 4 h for 24 h. Studies were initiated at three different clock times to separate the effects of repeated experimental sampling from circadian effects. Also, samples were collected from seven monkeys at times of expected maxima and minima. Some parameters exhibited the expected circadian rhythm with increases at night (serum total calcium) or in the early morning (urinary collagen cross-links). Others displayed the effects of the experimental procedure, either increasing (urinary creatinine and phosphorus) or decreasing (osteocalcin, urinary calcium) with repeated sampling. Serum phosphorus, cortisol, and type I procollagen were influenced by both clock time and experimental procedures. Alkaline phosphatase and parathyroid hormone did not show any differences with time or sampling. This data is consistent with findings in humans that bone resorption increases at night and that endogenous corticosteroids decrease bone formation. The usefulness of the monkey model is limited by the physiological stress of sample collection in these subjects.

Effects of pregnancy and lactation on bone in cynomolgus macaques: histomorphometric analysis of iliac biopsies

The effects of pregnancy and lactation on bone histomorphometry have been studied extensively in rats and dogs. However, these models differ greatly in reproductive physiology compared with women. The purpose of this study was to evaluate histomorphometric changes in iliac crest bone biopsies taken from cynomolgus monkeys (Macaca fascicularis), animals similar to women both skeletally and reproductively. After fluorochrome labeling, paired iliac crest bone biopsies were collected and subjected to structural and dynamic histomorphometric analyses during the third trimester and 3 months postpartum in one group (n=16), at 3 and 9 months postpartum in the second group (n=14), and at 4 month intervals in a nonpregnant control group (n=6). Serum was collected at the time of surgery to measure total alkaline phosphatase (ALP), bone gla-protein (BGP), calcium, and estradiol. Trabecular thickness increased significantly between 3 and 9 months postpartum. Bone formation rates did not differ between control and pregnant monkeys, but were significantly increased during lactation (3 months postpartum) and remained elevated at 9 months postpartum. ALP and BGP levels were elevated at 3 months postpartum, compared with levels during pregnancy, and remained elevated at 9 months postpartum. Estradiol concentrations were greatly elevated during pregnancy, dropped below normal nonpregnant levels by 3 months postpartum, and remained suppressed at 9 months postpartum. These results suggest that, during the third trimester, the rate of bone turnover was not altered, but lactational demands for calcium were met in part by increased bone turnover.

Lack of effect of raloxifene on coronary artery atherosclerosis of postmenopausal monkeys

Raloxifene has been shown to have estrogen agonist effects on bone and cholesterol metabolism while having estrogen antagonist effects on mammary gland and uterus. Reported here are the results of a study to determine whether raloxifene had the estrogen agonist effect of inhibiting coronary artery atherogenesis and to compare its effects with those of traditional conjugated equine estrogens (CEE) treatment. Ovariectomized (surgically postmenopausal) cynomolgus monkeys were fed a moderately atherogenic diet and treated with a placebo, raloxifene (1 mg/kg x day), raloxifene (5 mg/kg x day), or CEE (Premarin) at a dose that mimicked that of 0.625 mg/day in women. The effects of raloxifene on plasma lipid concentrations were generally comparable to those reported in postmenopausal women treated with raloxifene: reductions in low density lipoprotein cholesterol concentrations and no significant effects on high density lipoprotein cholesterol. We found no evidence that raloxifene had an estrogen agonist effect on coronary arteries. Treatment with CEE resulted in about a 70% reduction in coronary artery plaque size relative to that in the placebo group, whereas neither the low nor the high dose of raloxifene had an effect on coronary artery plaque size. The low dose raloxifene group had about 2 times more atherosclerosis and the high dose group had about 3 times more atherosclerosis than the CEE group.

The androgenic anabolic steroid nandrolone decanoate prevents osteopenia and inhibits bone turnover in ovariectomized cynomolgus monkeys

We examined the effects of nandrolone decanoate (25 mg im every 3 weeks) on bone mass, serum biomarkers, and bone histomorphometric endpoints in 52 female cynomolgus macaques randomized into four treatment groups: (1) sham-ovariectomized (sham); (2) ovariectomized + placebo for 2 years (ovx); (3) ovx + nandrolone decanoate for 2 years (Nan); and (4) ovx + nandrolone decanoate beginning 1 year after ovx (dNan). Serum alkaline phosphatase (ALP), osteocalcin, and tartrate-resistant acid phosphatase (TRAP) were assayed every 3 months, and X-ray densitometry of the lumbar spine was done every 6 months. Fluorochrome-labeled iliac biopsies collected at baseline and 1 year, and lumbar vertebrae and midshaft femur collected at 2 years, were evaluated histomorphometrically. Body weight increased over 50% with administration of nandrolone. After 2 years, ovx animals had lower spinal BMC and BMD than all other groups. Ovx animals also had higher bone turnover rates than all other groups, as indicated by higher levels of the serum and urine biomarkers, and by at least twofold higher label-based bone formation rates in the femur diaphysis and in both cancellous and cortical bone of the ilium and vertebral bodies. Nandrolone-treated animals had similar serum estradiol levels as the sham animals, presumably due to conversion of endogenous or exogenous androgens. The effects of nandrolone on bone in this experiment are consistent with estradiol action and may be attributable to the increased serum estradiol. Despite >50% higher body weight, nandrolone-treated, ovariectomized animals did not have higher bone mass than sham animals.

Short-term effects of growth hormone and insulin-like growth factor I on cancellous bone in rhesus macaque monkeys

The purpose of our study was to determine the effects of GH and insulin-like growth factor I (IGF-I) administration singly and in combination on vertebral, tibial, and femoral bone in aged female monkeys as well as the various treatment effects on serum hormone levels and osteocalcin gene expression. Twenty-one ovulating female monkeys (rhesus macaque), aged 16-20 yr (5-6 kg), were divided into four groups to receive the following treatment for 7 weeks via Alzet pumps inserted sc: A, eluant (control group); B, recombinant human IGF-I (rhIGF-I; 120 micrograms/kg.day); C) rhGH (100 micrograms/kg.day); D, combination of rhIGF-I (120 micrograms/kg.day) and rhGH (100 micrograms/kg.day). Serum was assayed serially for glucose, IGF-I, GH, and IGF-binding protein-3 levels. All groups received double labeling with calcein. On the day of death, the primates' second lumbar vertebrae, tibiae, and femora were carefully dissected, fixed in 70% ethanol, and subjected to histomorphometric analysis. Ribonucleic acid was extracted from contralateral tibiae for the purpose of osteocalcin gene expression analysis. Serum glucose was unaffected by treatment. Serum GH was significantly elevated in groups C and D, whereas serum IGF-I and IGFBP-3 were only significantly increased in group D. Histomorphometric analysis showed no significant differences or trends for bone volume in any treatment group. Bone formation rate, surface and/or bone volume referent were significantly higher in both groups treated with GH (C and D) in tibia and femur, with a similar trend in vertebrae. The increase in bone formation rate was due mainly to a significant increase in mineral apposition rate, but there was also an increase in tibial mineralizing surface by GH by factorial analysis (P < 0.05). There were significant treatment effects on osteoid surface and osteoclastic surface in femur in the combination treatment group vs. the controls. Osteocalcin gene expression analysis supported an enhanced expression in both groups treated with GH. These findings are consistent with a short term effect of GH to increase bone remodeling and predominantly osteoblastic activity in the appendicular skeleton. In contrast, other than an isolated increase in osteoclastic surface in femoral bone, IGF-I, when administered alone, was unable to significantly influence bone formation or resorption activity in this short term study.

Decreased bone mass and strength in ovariectomized cynomolgus monkeys (Macaca fascicularis)

Agents for prevention or treatment of osteoporosis must now be tested in a large animal species that exhibits bone remodeling. Ovariectomized, nonhuman primates provide one such model, and they consistently develop osteopenia accompanied by high bone turnover rates. The goal of this study was to further characterize this model, and particularly to determine the effect of ovariectomy on bone strength in vertebrae and femoral necks. Longitudinal evaluations of spinal bone mass and serum markers of bone turnover were performed in 19 sham-ovariectomized (SHAM) and 18 ovariectomized (OVX), domestically reared cynomolgus monkeys, aged > 9 years. OVX monkeys lost bone relative to both baseline values and SHAM controls. Serum markers of bone turnover were increased by OVX. After 72 weeks, both vertebral bone compressive strength and femoral neck breaking strength were significantly decreased in OVX animals compared with SHAM. Ovariectomized cynomolgus monkeys, like postmenopausal women, develop accelerated bone loss, increased bone turnover, and reduced bone strength, and provide a suitable large animal model for efficacy studies with agents for prevention or treatment of osteoporosis.

Oral contraceptive treatment inhibits the normal acquisition of bone mineral in skeletally immature young adult female monkeys

The purpose of the present study was to determine the effects of oral contraceptive therapy on bone density and serum markers of bone metabolism in a prospective, longitudinal study of young adult female cynomolgus monkeys. Two hundred and seven intact cynomolgus monkeys were randomized to two groups, and fed an atherogenic diet containing either no drug (Control) or a triphasic oral contraceptive regimen (Contraceptive). Measurements of bone density were carried out by dual-energy X-ray absorptiometry at 10-month intervals (0, 10, and 20 months) and serum bone biomarkers were determined at 5-month intervals over the 20-month time course. No significant differences in these variables were observed prior to treatment. Both groups of animals gained bone mineral during the study, indicating that peak bone mass had not been reached at baseline. Contraceptive-treated animals gained less spinal (lumbar vertebrae 2-4) bone mineral content and density and less whole-body bone mineral content than Controls over the course of the study. Significant depressive effects of contraceptive treatment on gains in BMC and BMD were observed during each 10-month interval of the study. Bone metabolism was inhibited in the Contraceptive group, as reflected by marked reductions (approximately 40%) in serum osteocalcin and alkaline phosphatase levels along with moderate reductions in serum acid phosphatase and calcium. The results suggest that triphasic oral contraceptive treatment of young adult female monkeys that have not reached peak bone mass inhibits net bone accretion and/or growth by reducing bone metabolism. Thus, prolonged continuous oral contraceptive use in skeletally immature females may lead to a lower peak bone mass--an effect which could increase the risk of fractures in later life.

Osteoarthritis in cynomolgus macaques. III: Effects of age, gender, and subchondral bone thickness on the severity of disease

Knee joints from cynomolgus monkeys of both genders and a wide range of ages were examined to characterize further the natural history of osteoarthritis (OA) in these animals. The objectives of this study were to characterize better the subchondral bone changes previously noted in this disease, to determine whether the severity of OA in these animals is affected by age or weight, and to determine whether males and females are affected similarly. As had been seen in previous studies, the medial tibial plateau was the most severely affected site. The thickness of the subchondral plate in the medial tibial plateau increased with increasing severity of articular cartilage lesions in both males and females; however, in monkeys with subchondral plate thicknesses less than 400 microns, articular cartilage lesions were essentially absent. Subchondral plate thickness increased with increasing weight in both genders, but females had a higher subchondral plate thickness than males for a given body weight. There was no correlation between bone volume in the proximal tibial epiphysis and articular cartilage lesions of OA. The prevalence and severity of OA in the medial tibial plateau increased with increasing age, but were not affected by gender or weight. Although there was no correlation between articular cartilage lesions and body mass index or weight, the waist/hip circumference ratio and severity of articular cartilage lesions were correlated in the female monkeys. This work provides evidence that thickening of the subchondral bone plate may be more important than the volume of epiphyseal/metaphyseal cancellous bone in determining the biomechanical stresses in the joint and in influencing the development of articular cartilage lesions.

Development of osteopenia in ovariectomized cynomolgus monkeys (Macaca fascicularis)

Spinal osteopenia that is due in part to failure to gain bone has previously been reported in ovariectomized nonhuman primates. In these studies, development of osteopenia over one year was followed by dual-energy x-ray absorptiometry in both domestically-reared and feral ovariectomized (OVX) and sham-ovariectomized (SHAM) cynomolgus monkeys. To promote development of absolute osteopenia, the domestically-reared animals were all older than nine years and were fed a diet containing 0.14% calcium for most of the experimental period. Both SHAM and OVX feral animals fed 0.6% calcium gained bone mass, with significantly lower rates of gain in SHAM monkeys. OVX domestically-reared monkeys lost bone during one year, while SHAM domestically-reared animals showed no significant change from baseline. Thus, relative osteopenia developed in both experiments, but only the domestically-reared animals developed absolute osteopenia. Nonhuman primates are the only animal model shown to develop absolute osteopenia after ovariectomy. These data suggest that absolute osteopenia develops after ovariectomy in monkeys with stable pre-ovariectomy bone mass which are fed a level of calcium comparable to that consumed by American women.

Effect of treatment for 3 months with human parathyroid hormone 1-34 peptide in ovariectomized cynomolgus monkeys (Macaca fascicularis)

Clinical data suggest that PTH may increase cancellous bone mass at the expense of cortical bone in human beings. In this study, the effects of PTH on whole body, axial and appendicular bone mass were studied in an animal model with Haversian cortical bone remodelling. Ovariectomized, young adult, female cynomolgus monkeys were assigned to Placebo (n = 9) or PTH groups (n = 10). The PTH group received 10 micrograms/kg synthetic human PTH(1-34) peptide by SC injection, 3 days/week for 3 months and the Placebo group received vehicle. Spinal and whole body bone mass were measured by DXA, and proximal tibia, distal radius and mid-radius bone mass were measured by quantitative computed tomography (QCT) at baseline and 3 months. Small, transient increases in serum calcium were observed 4 hours after injection with PTH. Compared to placebo-treated animals, PTH-treated monkeys had no change in whole body bone mass, but a 5% increase in spinal bone mineral density. Cortical bone mass measured by QCT at appendicular sites was not affected by PTH treatment, but there were significant increases in cancellous bone mass in the proximal tibia, and a similar trend in distal radius. PTH stimulated dramatic bone gain in the lumbar spine and at appendicular trabecular bone sites during three months' treatment. There was no evidence of cortical bone loss during the same period.

Anabolic effect of high doses of human parathyroid hormone (1-38) in mature intact female rats

Adult female retired breeder Wistar rats were treated with placebo or with synthetic human parathyroid hormone (hPTH) fragment (1-38) by subcutaneous injection at doses ranging from 50 to 1000 micrograms/kg, 5 days per week, for 2-8 weeks. One group of rats received hPTH-(1-38), 400 micrograms/kg, 5 days per week for 4 weeks, followed by 4 weeks placebo. The effects on bone mass and structure were evaluated by histomorphometric analysis of cross sections of femoral metaphyses. The effects on bone formation were evaluated by measuring uptake of [3H]tetracycline into femora and by qualitative evaluation of histologic sections after labeling with calcein and tetracycline. All doses of hPTH-(1-38) were anabolic. Lamellar bone formation was stimulated on all surfaces, and cancellous bone mass was increased as a result of trabecular thickening. Small quantities of woven bone were also formed in marrow cavities after treatment with 400 or 1000 micrograms/kg. Treatment with 1000 micrograms/kg had an effect on measured parameters similar to that with 400 micrograms/kg, and there was no evidence for a diminution of the anabolic effect at high doses. Animals treated with hPTH-(1-38) for 4 weeks followed by 4 weeks placebo tended to have less bone than those that received hPTH-(1-38) for 8 weeks but had significantly more bone than placebo-treated rats. In conclusion, daily injection of hPTH-(1-38) for 2-8 weeks at doses ranging from 50 to 1000 micrograms/kg had an anabolic effect on both cortical and trabecular bone in the femur of mature female intact rats. After withdrawal of treatment, the bone formation rate fell below levels in untreated animals, but bone mass remained higher.

Osteoarthritis in cynomolgus macaques: a primate model of naturally occurring disease

The objective of the present study was to determine if naturally occurring osteoarthritis of the knee joints that is similar to the condition in humans develops in cynomolgus macaques. Knee joints from 58 young adult (mean age, 7.4 years) female cynomolgus macaques were studied with x-ray densitometry, high-detail radiography, and histology. The animals studied were subjects in a triad designed to examine the effects of the administration of sex steroids on atherosclerosis; except for a control group, the monkeys had been either ovariectomized or treated with sex steroids for 2 years. Therefore, the data were analyzed to determine if these treatments, both of which can influence bone density, affected the severity of osteoarthritis. There was a high prevalence of osteoarthritic lesions, morphologically similar to those seen in humans. Bone changes were more common and severe than cartilage changes and morphologically appeared to precede the cartilage changes. Treatment with testosterone resulted in increased body weight, body mass index, and bone mineral content in the femur and tibia but did not affect the severity of osteoarthritis. These data indicate that naturally occurring osteoarthritis developed in the knee joints of cynomolgus macaques; these animals may be a useful model for the study of osteoarthritis in humans.

Bone functional changes in intact, ovariectomized, and ovariectomized, hormone-supplemented adult cynomolgus monkeys (Macaca fascicularis) evaluated by serum markers and dynamic histomorphometry

Several parameters of bone mass and function were investigated in three experiments involving intact, ovariectomized, or hormone-supplemented ovariectomized female cynomolgus monkeys. Ovariectomized animals had increased serum levels of alkaline phosphatase and acid phosphatase compared with intact and hormone-supplemented animals. Vertebral bone mass measured ex vivo by dual-photon absorptiometry was reduced by 11-19% in ovariectomized animals compared with intact and hormone-supplemented animals. The most dramatic effects observed with ovariectomy were markedly increased (30-60%) bone formation rates in vertebral cancellous bone, primarily caused by higher activation frequency of basic multicellular units of bone. In addition, combined resorption and reversal periods were decreased and formation period increased in untreated ovariectomized animals. Changes in static histomorphometry parameters were less dramatic, cancellous bone volume being 1-14% lower in ovariectomized animals compared with intact or ovariectomized hormone-supplemented animals. The data indicate that changes in bone resorption are primarily responsible for the lower bone mass of estrogen deficiency and increased bone mass in hormone-supplemented animals. Bone changes in ovariectomized cynomolgus monkeys resemble those in women after menopause and similarly respond positively to hormone supplementation. As such, cynomolgus monkeys are an excellent model for studying the basic mechanisms of osteoporosis and for the development of suitable therapeutic regimens.

Bone mass in female cynomolgus macaques: a cross-sectional and longitudinal study by age

A cross-sectional study by age was designed to evaluate and describe the bone mineral content (BMC, g) and density (BMD, g/cm2) in a population of female cynomolgus macaques (Macaca fascicularis). Dual-energy X-ray absorptiometry was used to measure, in segments L2-L4 of the lumbar spine, the BMC (BMCs), BMD (BMDs), length, and total-body BMC(BMCTB) in 171 female monkeys ranging in age between 3.7 and 22.0 years. The animals were divided into three age groups: (1) young (< 6.5 years, n = 51); (2) adult (> 6.5 years and < 10.5 years, n = 63); and (3) mature (> 10.5 years, n = 57). Young animals had a significantly lower (P < 0.05) body weight and shorter trunk length than adult or mature animals. Young animals also had significantly less (P < 0.05) BMCS, BMDS, and BMCTB than adult or mature animals, and had significantly shorter (P < 0.01) lumbar spine vertebral segments than the other two groups. Longitudinally, 63 animals had repeated lumbar spine scans to examine changes over time. Young animals showed a positive and significant change (P < 0.05) in BMCs and BMDs through time, whereas these parameters did not change in adult animals, and mature animals had a trend towards bone loss through time. Densitometric results suggested that peak bone mass in the lumbar spine was achieved by 9 years of age. Radiographic and dental criteria were developed to identify animals that had reached peak bone mass, and the combined radiographic and dental scoring system reliably identified animals 9 years and older. Female cynomolgus macaques 9 years old or older are recommended for investigations of bone remodeling and associated conditions, such as osteoporosis.

The effect of rat parathyroid hormone (1-34) infusion on urinary 3-hydroxypyridinium cross-link excretion in the rat

The utility of measurement of the urinary excretion of the 3-hydroxypyridinium cross-links, pyridinoline (Pyr) and deoxypyridinoline (Dpyr) as indices of bone resorption in rats was investigated. Total Pyr and Dpyr excretion were measured in young rats treated by s.c. infusion with rat parathyroid hormone (1-34) (PTH) at 22-30 micrograms/kg/day or with diluent (controls) for 14 days. During infusion, average urinary excretion of both cross-links was significantly higher in PTH rats (Pyr: 11.77 +/- 0.44 nmol/day), Dpyr: 15.81 +/- 0.95 nmol/day) than in controls (Pyr: 10.17 +/- 0.35 nmol/day, Dpyr: 12.03 +/- 0.67 nmol/day). These results were consistent with the magnitude of the expected increase in bone resorption rate with this dose of PTH. The method appears to provide a sensitive measure of bone resorption for in vivo bone studies in rats.

Experimental determination of "the law of bone remodeling" and effect of rat parathyroid hormone (1-34) infusion on derived parameters

The dependence of bone remodeling probability on bone age was investigated by fitting a previously described mathematical model to data describing the decline of radioactivity in the femurs of growing rats prelabeled with [3H]tetracycline. The remodeling probability declined with increasing bone age, but because the data were obtained at the whole bone level, several explanations for this finding are possible, and the results cannot be extrapolated beyond the duration of the experiment. A simpler exponential model that assumes remodeling probability is constant can be used to calculate bone resorption rate within a limited time period. A significantly increased bone resorption rate in PTH-infused rats could readily be demonstrated using the exponential model. A more sophisticated statistical analysis was required to discriminate between control and PTH-infused rats using the more complex model in which resorption rate was not constant.

Estimation of the bone mineral density variation associated with changes in turnover rate

Bone matrix mineral density (BMDn, fraction of maximum) is the mean mineral density of a bone sample comprising moieties of bone of varying ages/mineral densities. A method for calculating BMDn as a function of bone turnover rate is presented. The method is based on a mineralization curve defined by values for mineralization lag time, total mineralization time, and levels of primary and final mineralization. The calculations illustrate that BMDn decreases linearly in direct proportion to increases in bone turnover rate, and that the slope of the line is dependent on the assumptions used to calculate the mineralization curve. BMDn variation is important because it is reflected in whole bone density variation, independent of changes in bone mass, when bone turnover rate is altered.

Maternal factors affecting reproduction in a breeding colony of cynomolgus macaques (Macaca fascicularis)

A breeding colony of cynomolgus macaques (Macaca fascicularis), composed of imported and colony-born animals and established for 9 years, was evaluated for maternal factors associated with reproductive failure. The factors evaluated included age, gravidity, parity, origin, previous stillbirths, clinical incidents and type of housing. The effects of each factor on pregnancy rate (PR), stillbirth rate (SR), infant mortality rate (IMR) and pregnancy success (PS) were evaluated. The overall colony rates were: PR = 53%, SR = 22%, IMR = 22%, and PS = 60%. Neonatal death rate for the group was 12%. Pregnancy rate was most affected by maternal factors. Clinical incidents occurring during pregnancy were associated with a significant increase in the stillbirth rate, but did not affect infant mortality rate. Maternal age did not affect any of the measures of reproductive output. Pregnancy rate peaked at 6-8 years of age and decreased thereafter, while pregnancy success peaked at 9-11 years of age. Gravidity and parity had a positive linear relationship with pregnancy rate.

Effects of shock waves on the structure and growth of the immature rat epiphysis

The left proximal tibia of eighteen five week old male Sprague-Dawley rats was exposed to 1500 shock waves at 20 kV in a Dornier XL-1 experimental lithotripter. Six of these rats, and six age-matched controls, were sacrificed two, four and ten weeks later. Eight of 18 (44%) of treated animals had lesions of focal growth plate dysplasia attributable to treatment. In the absence of extensive lesions, no significant difference was identified in the growth plate thickness of shocked versus unshocked limbs. In the group sacrificed at ten weeks, two of six (33%) treated animals had extensive dysplastic lesions which were associated with marked shortening of the shocked limb. In the absence of extensive lesions, there was no significant shortening of shocked limbs. Shock wave exposure of the rat epiphysis can affect subsequent bone growth.

Maxillo-orbital lymphoma (Burkitt's-type) in an infant Macaca fascicularis

A 5-month-old male cynomolgus monkey (Macaca fascicularis) with facial deformation and proptosis of the left eye was euthanized due to a rapidly-growing peribulbar and retro-orbital mass. The mass invaded the soft tissue behind the right eye and extended ventro-medially through the lacrimal, ethmoid, maxillary and frontal bones. Caudo-dorsal extention of the mass through the left frontal bone and into the meninges and parenchyma of the frontal cerebral lobe was observed. Histologically, the cell population making up the mass was variable, but most of the neoplastic cells were blast-like with a large central round to ovoid nucleus, active coarsely stippled euchromatic chromatin, 1-4 prominent nucleoli and sparse cytoplasm. Interspersed between these neoplastic lymphocytes were numerous aberrant mitoses and histiocytes with foamy cytoplasm producing a "starry-sky" pattern. Cells further away from the central neoplastic core and closer to fragmented bone surfaces had plasmacytoid features with an eccentric hyperchromatic nucleus and abundant eosinophilic cytoplasm. Electron microscopy confirmed the formentioned cell types. Morphometric analysis of tumor cell indicated similarities to cells of human Burkitt's lymphoma. The tumor cells indicated similarities to cells of human Burkitt's lymphoma. The tumor was diagnosed as a malignant lymphoma of unknown etiology, similar to those seen in African children with Burkitt's lymphoma.

Gluten-sensitive enteropathy in a cynomolgus monkey

A malabsorption syndrome was observed in a cynomolgus macaque. Clinical signs included weight loss despite increased appetite, and diarrhea, characterized by an increased volume of soft, tan, malodorous feces. Clinicopathologic findings included hypoalbuminemia, generalized dilation of bowel loops with a prolonged transit time, steatorrhea and markedly diminished absorption of D-xylose. Biopsies of the duodenum and jejunum had total villous atrophy, crypt hyperplasia and a plasmacytic-lymphocytic infiltrate of the lamina propria. The monkey's diet was changed to a semi-synthetic diet containing no grain products. Subsequently, stool characteristics, body weight and intestinal villous morphology returned to normal. This response to removal of grain products from the diet suggests a syndrome similar to gluten-sensitivity enteropathy in human beings.

Unusual lesion morphology and skin test reaction for Mycobacterium avium complex in macaques

Three rhesus (Macaca mulatta) and one cynomolgus (M. fascicularis) monkey were euthanized because of positive reactions to intradermal tests with mammalian Old Tuberculin (mOT). All the animals had gross or microscopic lesions consisting of unitized macro- or microgranulomas with central necrosis, involving the lung or mesenteric lymph nodes. Small numbers of acid fast organisms were demonstrated in the lesions. Mycobacterium avium complex, serotype 2 was isolated from three of the cases. The cases were unusual because the lesion morphology and mOT hypersensitivity were more typical of mammalian tuberculosis than avian tuberculosis in monkeys.

Ultrastructure of the rostral notochord of the 35-day rhesus monkey (Macaca mulatta) embryo

The notochords of three normal, 35-day Macaca mulatta embryos were examined ultrastructurally. Notochordal cells had numerous polysomes and ribosomes, and some rough endoplasmic reticulum, mitochondria, Golgi complexes, coated vesicles, and secretory granules. A discontinuous basal lamina surrounded the notochord. Intercellular channels and the perinotochordal sheath contained fibrils. It was found that the ultrastructure of the rhesus monkey notochord at stage 17 resembles that of the chick and mouse.

Congenital malformations and twinning in a breeding colony of Old World monkeys

Clinical and necropsy records of malformations in Old World monkeys were compiled. The numbers of malformations and birth incidence rate for each species were: Rhesus macaque (Macaca mulatta) 3 (1.02%); Cynomolgus macaque (Macaca fascicularis) 11 (1.62%); Stumptail macaque (Macaca arctoides) 3 (1.55%); African green monkey (Cercopithecus aethiops) 4 (1.5%). There was one pair of rhesus twins (twinning rate: 0.34%). Cardiovascular and central nervous system lesions accounted for 55% of all malformations. Only two of the malformations were in inbred infants. Nine of twenty-one colony-born malformed infants lived 24 hours or more.

Iliac biopsy for histomorphometric analysis of trabecular bone in cynomolgus monkeys and baboons

A humane, repeatable surgical technique was developed to harvest trabecular bone for histomorphometry from nonhuman primates. Using a direct surgical approach to the iliac crest, bone specimens with a mean cross sectional area of trabecular bone plus marrow (AT) of 12.02 and 18.07 mm2 were harvested from cynomolgus monkeys (Macaca fascicularis) and baboons (Papio anubis) respectively. The method provides bone samples with little artifact or bone dust contamination, and easy orientation and reproducibility of the plane of section. None of the cynomolgus monkeys were affected adversely by the surgery, but the baboons were quieter than normal for 12-24 hours afterward. The technique offers excellent biopsy specimens, repeatability and a minimum of stress to the subjects.

Craniorachischisis in a squirrel monkey

A stillborn squirrel monkey had craniorachischisis. The calvarium was absent and the skin and vertebral neural arches were cleft from the foramen magnum to the midlumbar region. Cranial nerves and degenerating neural tissue were attached to the cranial base and there were remnants of spinal cord in skin-covered areas of the spinal canal. The adrenal glands were normal. This is the only reported case of craniorachischisis in a monkey fetus.

Effects of ovariectomy on iliac trabecular bone in baboons (Papio anubis)

Biopsies were collected from the left iliac crest of six adult female baboons, after which three of the animals were ovariectomized. Biopsies were collected from the right iliac crest six months later. Histomorphometric evaluation of the biopsies revealed consistent increases in fractional forming surface, appositional rate, and volume-based bone formation rate after ovariectomy. The data indicate that bone turnover is increased following ovariectomy in the baboon.

Salmonella osteomyelitis in a rhesus monkey

An adult male rhesus monkey (Macaca mulatta) developed clinical signs of severe osteomyelitis of the left femur 42 days after onset of enteritis. Salmonella sp. were cultured from feces, blood, and femoral lesions. Response to antibiotic therapy was poor, and the animal was euthanized. The left femur, with pathologic fracture and involucrum, and the right femur, tibia and fibula were most severely affected. Additionally hepatic microgranulomas, mild tubulointerstitial nephritis, medullary histiocytosis and erythrophagocytosis in the lymph nodes, and a mild colitis were diagnosed microscopically. The severity of the disease and serum electrophoresis findings were suggestive of lowered resistance to the organism, possibly due to anemia or polychlorinated biphenyl toxicosis.

A tubal pregnancy in a rhesus monkey (Macaca mulatta)

Tubal pregnancy was diagnosed on histological section of a nodule within the uterine tube of a multiparous rhesus monkey. Clinical signs were anorexia and weight loss. The tube contained a placenta of approximately 35 days gestation, but no recognizable embryo or amnion. The ipsilateral ovary contained a degenerating corpus luteum.