Pancreatic neuroendocrine tumors: signal pathways and targeted therapies

Pancreatic neuroendocrine tumors (PNETs) are rare but are well understood to cover a broad spectrum of clinical presentation, tumor biology and prognosis. More than 60% of PNETs are diagnosed at advanced disease stage and are ineligible for surgical resection. Prior to 2011, streptozocin was the only approved agent for unresectable advanced PNETs. In recent years, breakthroughs in signal pathway research have led to the identification of new therapeutic targets and agents directed at the molecular level. In 2011, two new targeted therapeutic agents, sunitinib and everolimus, were approved by the Food and Drug Administration (FDA). Sunitinib is an inhibitor of multiple tyrosine kinases, and everolimus is an inhibitor of the mammalian target of rapamycin (mTOR) pathway. This review discusses the major signaling pathways that are frequently mutated or deregulated in PNETs, and the implications of molecular alterations for PNET therapy. Biologic therapy through targeting relevant pathways represents a promising approach in the therapy of advanced and unresectable PNETs.

Disruption of cellulose synthesis by 2,6-dichlorobenzonitrile affects the structure of the cytoskeleton and cell wall construction in Arabidopsis

Cellulose is the major component of plant cell walls and is an important source of industrial raw material. Although cellulose biosynthesis is one of the most important biochemical processes in plant biology, the regulatory mechanisms of cellulose synthesis are still unclear. Here, we report that 2,6-dichlorobenzonitrile (DCB), an inhibitor of cellulose synthesis, inhibits Arabidopsis root development in a dose- and time-dependent manner. When treated with DCB, the plant cell wall showed altered cellulose distribution and intensity, as shown by calcofluor white and S4B staining. Moreover, pectin deposition was reduced in the presence of DCB when immunostained with the monoclonal antibody JIM5, which was raised against pectin epitopes. This result was confirmed using Fourier transform infrared (FTIR) analysis. Confocal microscopy revealed that the organisation of the microtubule cytoskeleton was significantly disrupted in the presence of low concentrations of DCB, whereas the actin cytoskeleton only showed changes with the application of high DCB concentrations. In addition, the subcellular dynamics of Golgi bodies labelled with N-ST-YFP and TGN labelled with VHA-a1-GFP were both partially blocked by DCB. Transmission electron microscopy indicated that the cell wall structure was affected by DCB, as were the Golgi bodies. Scanning electron microscopy showed changes in the organisation of cellulose microfibrils. These results suggest that the inhibition of cellulose synthesis by DCB not only induced changes in the chemical composition of the root cell wall and cytoskeleton structure, but also changed the distribution of cellulose microfibrils, implying that cellulose plays an important role in root development in Arabidopsis.

[A study on the relationship between HPV infection and the oncogenesis of primary squamous carcinoma of the lung.]

BACKGROUND

To research the relationship between human papillomavirus (HPV) infection and the oncogenesis of primary squamous carcinoma of the lung.

METHODS

50 formalin-fixed paraffin-embedded tissues of squamous cell carcinoma of the lung , 30 samples of areas of squamous epithelium metaplasia near tumors , and 30 samples of normal bronchial mucosa were detected for the presence of HPV DNA by polymerase chain reaction (PCR) .

RESULTS

In these samples , the positive detection rate of HPV DNA was 26%, 36.7% and 10% respectively. Of the detected HPV DNA , HPV16 was of the highest ratio. The positive rate of HPV6/11 and HPV16 in squamous cell carcinoma and squamous epithelium metaplasia had no significant difference by Chi-Square test ( P > 0. 05) .

CONCLUSIONS

These results suggest that HPV infection might play an important role in the oncogenesis of squamous cell carcinomas of the lung , and squamous epithelium metaplasia of the bronchus could be regarded as a precancer lesion. Compared with biotinylated DNA probes and hybridization technique , PCR has a higher sensitivity.

Comparison of Preincisional and Postincisional Parecoxib Administration on Postoperative Pain Control and Cytokine Response After Total Hip Replacement

Objective:

To investigate whether preincisional parecoxib administration can reduce postoperative pain and modulate the inflammatory cytokine response to a greater extent than preincisional parecoxib administration in total hip replacement patients.

Methods:

Patients were randomized to receive 40 mg parecoxib intravenously either before or after skin incision (preincisional and postincisional groups, respectively). Morphine was administered for postoperative analgesia. Visual analogue pain scale (VAS) scores and morphine consumption were recorded at 1, 6, 18 and 24 h postoperation. Plasma levels of interleukin (IL)-6, IL-8 and tumour necrosis factor-a were measured 30 min before skin incision and 6 h postoperation.

Results:

Compared with the post - incisional group, VAS pain scores at 1 and 6 h postoperation were significantly lower in the preincisional group. Morphine consumption was significantly lower in the preincisional group at 6, 18 and 24 h postoperation. In both groups, IL-6 and IL- 8 levels increased significantly at 6 h postoperation compared with pre - operation, and the preincisional group had significantly lower levels of IL-6 and IL-8 at 6 h postoperation compared with the postincisional group.

Conclusions:

Preincisional parecoxib administration reduced postoperative pain and morphine consumption compared with post - incisional administration, and attenuated IL-6 and IL-8 production 24 h after hip replacement surgery.

Impaired learning and memory performance in a subclinical hypothyroidism rat model induced by hemi-thyroid electrocauterisation

It is well known that clinical hypothyroidism (CH) can induce cognitive deficits, and the decision to start treatment for CH with thyroxine is usually straightforward. However, the relationship of cognition dysfunction with subclinical hypothyroidism (SCH) is inconsistent, and the decision concerning the need to treat SCH is controversial. In the present study, we induced a SCH rat model by hemi-thyroid electrocauterisation; then employed a serial of behavioural tests, including a beam balance, open field task and Morris water maze (MWM), to investigate the behaviour performance of SCH rats; and finally explored the protein expression of phosphorylated extracellular signal-regulated kinase (ERK)1/2 in the hippocampus by western blotting. The results demonstrated that hemi-thyroid electrocauterised rats had an elevated plasma thyrotrophin-stimulating hormone (TSH) level, with normal free thyroxine (fT4) and triiodothyronine (T3) concentrations, which defines SCH in humans. If rat SCH is diagnosed according to measurements of both plasma TSH higher than 97.5 percentile for the sham group and fT4 in the range 2.5-97.5 percentile for the sham group, the success rate of SCH modelling was 66.6%. SCH decreased exploratory behaviour but did not affect motor function in rats, showing a negative correlation of exploratory behaviour with plasma TSH concentration. Moreover, SCH rats displayed an impairment of learning and memory ability in the MWM task, with a longer escape latency in the acquisition phase and a shorter duration in the target quadrant in the test phase compared to that of sham rats. The mechanism for this might be related to the increased plasma TSH concentration, the decreased hippocampal T3 level and the enhanced expression of phosphorylated ERK1/2 in the hippocampus. The results of the present study, together with the results obtained in other studies, suggest that treatment is necessary for SCH.

Identification and expression profiles of grass carp Ctenopharyngodon idella tlr7 in responses to double-stranded RNA and virus infection

The toll-like receptor 7 (tlr7) gene was identified and characterized from grass carp Ctenopharyngodon idella (designated as citlr7), and the messenger (m)RNA expression profiles were examined in vivo and in vitro. The citlr7 genomic sequence consists of 4276 nucleotides (nts), including two exons and one intron. The full length of citlr7 complementary (c)DNA sequence is 3354 nts with the longest open reading frame (ORF) of 3156 nts encoding a peptide of 1051 amino acids. citlr7 mRNA expression was high in spleen, skin and heart, and low in hepatopancreas, muscle, head kidney and trunk kidney in healthy fish. The expression of citlr7 was rapidly and significantly up-regulated at 6 h after grass carp reovirus (GCRV) injection (72·91 fold, P < 0·05), and recovered to the original level at 24 h post-injection in the spleen. The citlr7 transcript was rapidly and significantly down-regulated at the 6 h time point (0·32 fold, P < 0·05) and retrieved the normal level at 72 h post-injection in the hepatopancreas. The citlr7 transcripts were rapidly and significantly inhibited at 2 h post-GCRV infection in the C. idella kidney (CIK) cell line (0·62 fold, P < 0·05), and were rapidly and significantly elevated by the stimulation of the synthetic double-stranded RNA polyriboinosinic-polyribocytidylic acid sodium salt [poly(I:C)] in CIK in a dose and time-dependent manner (P < 0·05). The results imply that citlr7 is involved in the responses to double-stranded RNA and virus infection.

Identification of a novel HLA-A*24:02:55 allele by sequence-based typing

HLA-A*24:02:55 differs from A*24:02:01:01 by a single nucleotide substitution at position 295, in exon 2.

Active-targeted nanotherapy strategies for prostate cancer

Castration-resistant prostate cancer remains incurable and a major cause of mortality worldwide. The absence of effective therapeutic approaches for advanced prostate cancer has led to an intensive search for novel treatments. Emerging nanomedical approaches have shown promising results, in vitro and in vivo, in improving drug distribution and bioavailability, tumor penetration and in limiting toxicity. Nanoscaled carriers bearing finely controlled size and surface properties such as liposomes, dendrimers and nanoparticles have been developed for successful passive and active tumortargeting. Enhanced pharmacokinetics of nanotherapeutics, through improved target delivery and prolonged tissue halflife provides optimal drug delivery that is tumor-specific. Tumor-targeting may be improved through ligand directed delivery systems binding to tumor-specific surface receptors improving cellular uptake through receptor-mediated endocytosis. Recently published data have provided pre-clinical evidence showing the potential of active-targeted nanotherapeutics in prostate cancer therapy; unfortunately, only a few of these therapies have translated into early phase clinical trials development. Hence, progress of active-targeted nanotherapy improving efficiency of site-specific drug delivery is a critical challenge in future clinical treatment of prostate cancer. Exploring specific prostate cell-surface antigens or receptor overexpression may elaborate promising strategies for future therapeutic design. This review presents an overview of some new strategies for prostate cancer active-targeting nanotherapeutics.

The value of multislice spiral CT features of cavitary walls in differentiating between peripheral lung cancer cavities and single pulmonary tuberculous thick-walled cavities

OBJECTIVES

Form discordance of cavity walls (FDCW) and form concordance of cavity walls (FCCW) in multislice spiral CT (MSCT) were investigated to determine their value in differentiating between peripheral lung cancer cavities and single pulmonary tuberculous thick-walled cavities. An assessment of the role of multiplanar reconstruction (MPR) in detecting FDCW and FCCW was also performed.

METHODS

MSCT cross-sectional images of 116 consecutive cases (including 60 cases with available MPR images) with peripheral lung cancer cavities and 118 consecutive cases (including 62 cases with available MPR images) with single pulmonary tuberculous thick-walled cavities (wall thickness >3 mm) were retrospectively analysed. According to the characteristics of cavitary internal and external walls on MSCT, these cavities were divided into two types (FDCW and FCCW). FDCW was further divided into three subtypes (FDCW-I, FDCW-II and FDCW-III); FCCW was further divided into two subtypes (FCCW-I and FCCW-II).

RESULTS

On the cross-sectional and MPR images, the total detection rate of FDCW-I and FDCW-III in peripheral lung cancer cavities was 76.7% (89/116) and 93.3% (56/60), respectively, whereas the total detection rate of FCCW-I and FCCW-II in single pulmonary tuberculous thick-walled cavities was 75.4% (89/118) and 91.9% (57/62), respectively.

CONCLUSIONS

FDCW-I, FDCW-III, FCCW-I and FCCW-II were valuable in differentiating between peripheral lung cancer cavities and single pulmonary tuberculous thick-walled cavities. MPR could improve the detection of FDCW-I and FDCW-III in peripheral lung cancer cavities and FCCW-I and FCCW-II in single pulmonary tuberculous thick-walled cavities.

Development and use of EST-SSR markers for assessing genetic diversity in the brown planthopper (Nilaparvata lugens Stål)

To assess genetic diversity in populations of the brown planthopper (Nilaparvata lugens Stål) (Homoptera: Delphacidae), we have developed and applied microsatellite, or simple sequence repeat (SSR), markers from expressed sequence tags (ESTs). We found that the brown planthopper clusters of ESTs were rich in SSRs with unique frequencies and distributions of SSR motifs. Three hundred and fifty-one EST-SSR markers were developed and yielded clear bands from samples of four brown planthopper populations. High cross-species transferability of these markers was detected in the closely related planthopper N. muiri. The newly developed EST-SSR markers provided sufficient resolution to distinguish within and among biotypes. Analyses based on SSR data revealed host resistance-based genetic differentiation among different brown planthopper populations; the genetic diversity of populations feeding on susceptible rice varieties was lower than that of populations feeding on resistant rice varieties. This is the first large-scale development of brown planthopper SSR markers, which will be useful for future molecular genetics and genomics studies of this serious agricultural pest.

The Valence Electronic Structure of Co3O4: Is It a Charge-Transfer Insulator?

Despite the relevance to a variety of materials applications, the electronic and bonding properties of spinel transition metal oxides are not well established. We report here the slow oxidation of CoO(100) to Co3O4, studied by photoemission (UPS and XPS), low energy electron diffraction (LEED) and high resolution electron energy loss spectroscopy (HREELS) with the aim of elucidating the valence band electronic structure of the Co3O4 spinel. The original Mott insulator picture of the parent CoO substrate has been revised in recent times, after careful analyses and extensive debate, to the more detailed charge-transfer insulator model which includes some admixture of oxygen 2p levels in the 3d-derived valence band. No equivalent band structure analysis has been performed on the spinel oxides, perhaps in part because of the greater complexity of the 56-atom unit cell with two different cation lattice sites and oxidation states. In this study, we determine the valence band structure of the spinel oxide and address the question of whether Co3O4 can be modeled as a charge-transfer insulator in analogy with its closely related rocksalt substrate.

Wnt5a promotes differentiation of human dental papilla cells

AIM

To investigate the role of Wnt5a in the process of differentiation of human dental papilla cells (HDPCs).

METHODOLOGY

Recombinant adenovirus encoding full-length Wnt5a cDNA was constructed to investigate the biological role of Wnt5a on the differentiation of HDPCs. The effect of Wnt5a on HDPCs differentiation was determined by ALP activity assay, ALP staining and mineral induction assay. Mineralization-related gene expressions were assessed by RT-PCR.

RESULTS

Immunostaining revealed Wnt5a expression in the odontoblast layer and dental papilla tissue. Over-expression of Wnt5a by transfecting HDPCs with an Wnt5a-carrying construct increased ALPase activity and the formation of mineralized nodules of HDPCs. RT-PCR analysis showed that the expressions of mineralization-related genes, such as bone sialoprotein, collagen type I, osteonectin, osteopontin (OCN), dentine matrix protein-1 were up-regulated by Wnt5a.

CONCLUSIONS

Wnt5a promoted differentiation of HDPCs.

Effects of adenoviral-mediated coexpression of bone morphogenetic protein-7 and insulin-like growth factor-1 on human periodontal ligament cells

BACKGROUND AND OBJECTIVE

Bone morphogenetic protein-7 (BMP-7) and insulin-like growth factor-1 (IGF-1) are important in periodontal reconstruction. However, their synergistic effect in periodontal regeneration by gene delivery has not been reported. In this study, gene delivery of these two growth factors to human periodontal ligament cells (hPDLCs) was examined for its effects on cell proliferation and differentiation.

MATERIAL AND METHODS

Recombinant adenoviruses containing both human BMP-7 and IGF-1 cDNA created by introducing the internal ribosome entry site (IRES) sequence were used to transfer the genes into hPDLCs. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and cell cycle analysis were used to observe their effects on cell proliferation, while alkaline phosphatase activity measurement, RT-PCR and in vivo tests were conducted to investigate their effects on cell differentiation.

RESULTS

The proliferation of hPDLCs transduced by adenoviruses coexpressing BMP-7 and IGF-1 was suppressed while their differentiation ability was enhanced. There was a synergism of BMP-7 and IGF-1 in up-regulating alkaline phosphatase activity and mRNA levels of collagen type I and Runx2. Implantation in vivo with scaffolds illustrated that the transduced cells exhibited osteogenic differentiation and formed bone-like structures.

CONCLUSION

The combined delivery of BMP-7 and IGF-1 genes using an IRES-based strategy synergistically enhanced differentiation of hPDLCs. It is suggested that this could be a new potential method in gene therapy for periodontal reconstruction.

PHF10 is required for cell proliferation in normal and SV40-immortalized human fibroblast cells

Normal human diploid fibroblasts have limited life span in culture and undergo replicative senescence after 50-60 population doublings. On the contrary, cancer cells typically divide indefinitely and are immortal. Expression of SV40 large T and small t antigens in human fibroblasts transiently extends their life span by 20-30 population doublings and facilitates immortalization. We have identified a rearrangement in chromosome 6 shared by SV40-transformed human fibroblasts. Rearrangements involving chromosome 6 are among the most frequent in human carcinogenesis. In this paper, we extend analysis of the 6q26-q27 region, a putative site for a growth suppressor gene designated SEN6 involved in immortalization of SV40-transformed cells. Detailed molecular characterization of the rearranged chromosomes (6q*, normal appearing; and 6q(t), translocated) in the SV40-immortalized cell line HALneo by isolating each of these 2 chromosomes in mouse/HAL somatic cell hybrids is presented. Analysis of these mouse/HAL somatic cell hybrids with polymorphic and nonpolymorphic markers revealed that the 6q* has undergone a chromosomal break in the MLLT4 gene (alias AF6). This result in conjunction with previous published observations leads us to conclude that SEN6 lies between MLLT4 and TBP at chromosomal region 6q27. Examination of different genes (MLLT4, DLL1, FAM120B, PHF10) located within this interval that are expressed in HS74 normal fibroblast cells reveals that overexpression of epitope-tagged truncated PHF10 cDNAs resulted in reduced cell proliferation in multiple cell lines. Paradoxically, down-regulation of PHF10 by RNAi also resulted in loss of cell proliferation in normal fibroblast cells, indicating PHF10 function is required for cell growth. Taken together, these observations suggest that decreased cell proliferation with epitope-tagged truncated PHF10 proteins may be due to dominant negative effects or due to unregulated expression of these mutant proteins. Hence we conclude that PHF10 is not SEN6 but is required for cell growth.

A global sensitivity test for evaluating statistical hypotheses with nonidentifiable models

We consider the problem of evaluating a statistical hypothesis when some model characteristics are nonidentifiable from observed data. Such a scenario is common in meta-analysis for assessing publication bias and in longitudinal studies for evaluating a covariate effect when dropouts are likely to be nonignorable. One possible approach to this problem is to fix a minimal set of sensitivity parameters conditional upon which hypothesized parameters are identifiable. Here, we extend this idea and show how to evaluate the hypothesis of interest using an infimum statistic over the whole support of the sensitivity parameter. We characterize the limiting distribution of the statistic as a process in the sensitivity parameter, which involves a careful theoretical analysis of its behavior under model misspecification. In practice, we suggest a nonparametric bootstrap procedure to implement this infimum test as well as to construct confidence bands for simultaneous pointwise tests across all values of the sensitivity parameter, adjusting for multiple testing. The methodology's practical utility is illustrated in an analysis of a longitudinal psychiatric study.

Osteopontin induces angiogenesis through activation of PI3K/AKT and ERK1/2 in endothelial cells

Angiogenesis is a key step in tumor growth and metastasis. The mechanism by which osteopontin (OPN) induces the angiogenesis of endothelial cells remains unclear. Here, we show that OPN confers cytoprotection through the activation of the PI3K/Akt pathway with subsequent upregulation of Bcl-xL and activation of nuclear factor-kappaB. OPN enhances the expression of vascular endothelial growth factor (VEGF) through the phosphorylation of AKT and extracellular signal-regulated kinase (ERK). In turn, OPN-induced VEGF activates PI3K/AKT and the ERK1/2 pathway as a positive feedback signal. Blocking the feedback signal by anti-VEGF antibody, PI3-kinase inhibitor or ERK inhibitor can partially inhibit the OPN-induced human umbilical vein endothelial cell (HUVEC) motility, proliferation and tube formation, while blocking the signal by anti-OPN or anti-alphavbeta3 antibody completely abrogates the biological effects of OPN on HUVECs. In addition, blood vessel formation is also investigated in vivo. The antiangiogenesis efficacy of anti-OPN antibody in vivo is more effective than that of anti-VEGF antibody, which only blocks the feedback signals. These data show that OPN enhances angiogenesis directly through PI3K/AKT- and ERK-mediated pathways with VEGF acting as a positive feedback signal. The results suggest that OPN might be a valuable target for developing novel antiangiogenesis therapy for treatment of cancer.

Neoadjuvant chemoradiotherapy for locally advanced low-lying rectal cancer

e15095

Objective: The aim of this trial was to explore the possibility of further improvement of efficacy in neoadjuvant chemoradiation for the treatment of locally advanced low-lying rectal cancer and the management of patients with clinical complete regression. Methods: 192 cases with locally advanced low-lying rectal cancer (T3/T4 or N+) received preoperative radiotherapy comprising 40–46 Gy/20–23 fractions and concomitant oral capecitabine 625 mg/m2 bid for 10 weeks prior to surgery. Curative resection with TME was carried out 6 weeks after the end of radiation. Results: Patients (pts) were recruited from May 2001 through August 2007. Overall, 117 pts (60.9%) experienced adverse events but only 2 suffered from grade 3 hand-foot syndrome. 17 pts (8.9%) had clinical complete tumor regression without surgery, 175 pts underwent curative resection including of 134 pts with low anterior resection (LAR), 32 pts with ultra-low anterior resection with Parks’ coloanal anastomosis and among them 6 pts with diverting temporary colostomy and 9 pts with APR. Sphincter preservation was achieved in 95.3%. Pathologically, 24 pts (12.5%) showed CR together with 17 pts with clinical CR; the overall CR rate was 21.4%. According to the pathological staging: T0N0 41 cases, T2N0 43 cases, T3N0 77 cases, T4N0 5 cases, T2N1 11 cases, T3N1 13 cases, T4N0 5 cases, and T4N1 2 cases; in semiquantitative Dworak's tumor regression grade, TRG0 8 pts,TRG1 32, TRG2 28,TRG3 83 and TRG4 41 with an overall tumor downstaging of 79.2%. There were no operative deaths, 5 pts suffered from rectovaginal fistulas and 4 anastomotic leakages with an overall anastomotic leakage rate of 5.1% (9/175) and all recovered without further events. All patients have been followed up for a median of 46 months (range 12–87). During the time, 11 pts had lung metastases, 6 liver metastases and 7 had local recurrences. The 3-year disease-free survival was 86.6% and overall survival was 92.6%. Conclusions: Neoadjuvant chemoradiotherapy has high efficacy resulting in tumor down-staging, increased resectability and sphincter preservation, and a reduction in local recurrences. Meanwhile those patients with clinical complete response can be followed up closely and safely without surgery.

No significant financial relationships to disclose.

Characterization of the germination of Bacillus megaterium spores lacking enzymes that degrade the spore cortex

AIMS

To determine roles of cortex lytic enzymes (CLEs) in Bacillus megaterium spore germination.

METHODS AND RESULTS

Genes for B. megaterium CLEs CwlJ and SleB were inactivated and effects of loss of one or both on germination were assessed. Loss of CwlJ or SleB did not prevent completion of germination with agents that activate the spore's germinant receptors, but loss of CwlJ slowed the release of dipicolinic acid (DPA). Loss of both CLEs also did not prevent release of DPA and glutamate during germination with KBr. However, cwlJ sleB spores had decreased viability, and could not complete germination. Loss of CwlJ eliminated spore germination with Ca2+ chelated to DPA (Ca-DPA), but loss of CwlJ and SleB did not affect DPA release in dodecylamine germination.

CONCLUSIONS

CwlJ and SleB play redundant roles in cortex degradation during B. megaterium spore germination, and CwlJ accelerates DPA release and is essential for Ca-DPA germination. The roles of these CLEs are similar in germination of B. megaterium and Bacillus subtilis spores.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results indicate that redundant roles of CwlJ and SleB in cortex degradation during germination are similar in spores of Bacillus species; consequently, inhibition of these enzymes will prevent germination of Bacillus spores.

Alendronate is effective to treat bone loss in renal transplantation recipients

Bone loss is a common complication among renal transplant patients. Some studies have shown that alendronate may be effective to treat bone loss in these patients. In this study, we have reported our experience with administration of alendronate to treat bone loss in renal transplanted patients.

METHODS

The 46 kidney transplant recipients with bone loss were randomly divided into 2 groups: group I was treated with calcium and calcitriol, and group II with calcium, calcitriol, and alendronate. We examined bone mineral density (BMD) and biochemical indicators of both groups. All patients received cyclosporine and prednisone treatment.

RESULTS

There was no significant difference in age, body mass index, gender, immunosuppression, time since transplantation, 25(OH)D(3), or intact parathyroid hormone levels at study commencement. The BMD of the femoral neck was significantly increased (P < .05), and the serum type I collagen-cross-linked N telopeptide (NTx) dramatically (P < .05) decreased in posttransplantation group II recipients treated with calcium, calcitriol, and alendronate. There were also significant differences in BMD and serum NTx between recipients treated with versus without alendronate (P < .05).

CONCLUSION

At least in the short term, alendronate is a effective inhibitor for the treatment of bone loss in renal transplantation patients.