1
|
Ohata Y, Kitaoka T, Ishimi T, Yamada C, Nakano Y, Yamamoto K, Takeyari S, Nakayama H, Fujiwara M, Kubota T, Ozono K. Association of trabecular bone score and bone mineral apparent density with the severity of bone fragility in children and adolescents with osteogenesis imperfecta: A cross-sectional study. PLoS One 2023; 18:e0290812. [PMID: 37643181 PMCID: PMC10464990 DOI: 10.1371/journal.pone.0290812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a hereditary skeletal disease characterized by bone fragility. Areal bone mineral density (BMD), evaluated by dual-energy X-ray absorptiometry (DXA), is used to assess bone brittleness. The height-adjusted BMD Z-score (BMDHAZ) is calculated in children and adolescents with OI to reduce the confounding factor of short stature. However, even with the BMDHAZ, severity evaluation in children and adolescents with OI is challenging because certain abnormalities in bone quality cannot be accurately assessed by BMD analysis. The trabecular bone scores (TBS) and bone mineral apparent density (BMAD), which represent the structural integrity of bone and bone-size-associated BMD, respectively, are associated with fracture risk. Recently, age- and sex-specific reference ranges have been reported, enabling the calculation of Z-scores for children. To evaluate which density measurements show the highest correlation with fracture risk, we analyzed the associations between the Z-scores of TBS, BMAD, and BMDHAZ, fracture rate, and genetic variants. We retrospectively reviewed 42 participants with OI aged 5 to 20 years who underwent DXA. COL1A1/2 pathogenic variants were detected in 41 of the 42 participants. In participants with nonsense and frameshift variants (n = 17) resulting in haploinsufficiency and mild phenotype, the TBS Z-score was negatively correlated with fracture rate (FR) (r = -0.50, p = 0.042). In participants with glycine substitution (n = 9) causing the severe phenotype, the BMAD Z-scores were negatively correlated with FR (r = -0.74, p = 0.022). No correlation between the BMDHAZ and FR was observed in both groups. These findings suggest that the TBS and BMAD are useful in assessing children and adolescents with OI with specific genetic variants.
Collapse
Affiliation(s)
- Yasuhisa Ohata
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Taichi Kitaoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takeshi Ishimi
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Chieko Yamada
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yukako Nakano
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kenichi Yamamoto
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Shinji Takeyari
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hirofumi Nakayama
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- The 1st. Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Makoto Fujiwara
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| |
Collapse
|
2
|
Shrivas NV, Tiwari AK, Kumar R, Patil S, Tripathi D, Badhyal S. Physiological Loading-Induced Interstitial Fluid Dynamics in Osteon of Osteogenesis Imperfecta Bone. J Biomech Eng 2021; 143:1106937. [PMID: 33834233 DOI: 10.1115/1.4050818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Indexed: 11/08/2022]
Abstract
Osteogenesis imperfecta (OI), also known as "brittle bone disease," is a genetic bone disorder. OI bones experience frequent fractures. Surgical procedures are usually followed by clinicians in the management of OI. It has been observed physical activity is equally beneficial in reducing OI bone fractures in both children and adults as mechanical stimulation improves bone mass and strength. Loading-induced mechanical strain and interstitial fluid flow stimulate bone remodeling activities. Several studies have characterized strain environment in OI bones, whereas very few studies attempted to characterize the interstitial fluid flow. OI significantly affects bone micro-architecture. Thus, this study anticipates that canalicular fluid flow reduces in OI bone in comparison to the healthy bone in response to physiological loading due to altered poromechanical properties. This work attempts to understand the canalicular fluid distribution in single osteon models of OI and healthy bone. A poromechanical model of osteon is developed to compute pore-pressure and interstitial fluid flow as a function of gait loading pattern reported for OI and healthy subjects. Fluid distribution patterns are compared at different time-points of the stance phase of the gait cycle. It is observed that fluid flow significantly reduces in OI bone. Additionally, flow is more static than dynamic in OI osteon in comparison to healthy subjects. This work attempts to identify the plausible explanation behind the diminished mechanotransduction capability of OI bone. This work may further be extended for designing better biomechanical therapies to enhance the fluid flow in order to improve osteogenic activities in OI bone.
Collapse
Affiliation(s)
- Nikhil Vivek Shrivas
- Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India; Department of Mechatronics Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India
| | - Abhishek Kumar Tiwari
- Department of Applied Mechanics, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, Uttar Pradesh 211004, India
| | - Rakesh Kumar
- Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India
| | - Santosh Patil
- Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan 303007, India
| | - Dharmendra Tripathi
- Department of Mathematics, National Institute of Technology Uttarakhand, Srinagar, Uttarakhand 246174, India
| | - Subham Badhyal
- Sports Authority of India, Jawahar Lal Nehru Stadium, Lodhi Road, New Delhi 110003, India; MYAS-GNDU Department of Sports Sciences and Medicine, Guru Nanak Dev University, Amritsar, Punjab 143005, India
| |
Collapse
|
3
|
Pragnère S, Auregan JC, Bosser C, Linglart A, Bensidhoum M, Hoc T, Nouguier-Lehon C, Chaussain C. Human dentin characteristics of patients with osteogenesis imperfecta: insights into collagen-based biomaterials. Acta Biomater 2021; 119:259-267. [PMID: 33122145 DOI: 10.1016/j.actbio.2020.10.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/05/2020] [Accepted: 10/22/2020] [Indexed: 11/28/2022]
Abstract
Osteogenesis imperfecta (OI), also known as "brittle bone disease", is a rare genetic disorder of the skeleton, whose most benign form I corresponds to autosomal dominant mutations in the genes encoding type I collagen (COLA1, COLA2). Several associated skeletal manifestations are often observed but, surprisingly, while dentin defects often reflect genetic bone disorders, about half of OI patients have no obvious oral manifestations. Here, we investigated the collagen, mineral and mechanical properties of dentin from deciduous teeth collected from patients with mild form of OI and displaying no obvious clinical signs of dentinogenesis imperfecta. For the first time, an increase in the hardness of OI dentin associated with an increase in mineral content compared to healthy patients was reported. In addition, OI altered the tissue characteristics of the dentin-enamel junction but the interfacial gradient was preserved. The impact of changes in molecular structure due to mutations in OI was assessed by Raman microspectroscopy. Our results highlighted a change in the hydroxyproline-proline ratio in direct association with collagen mineralization. Our findings suggest that the evaluation of teeth could be an important aid for mild types of OI that are often difficult to diagnose clinically and provide experimental evidence that hydroxyproline content should be considered in future studies on collagen-based biomaterials.
Collapse
Affiliation(s)
- S Pragnère
- Equipex IVTV, Centrale Innovation, 64 Chemin des Mouilles, 69130 Ecully, France
| | - J-C Auregan
- Université de Paris, B3OA, UMR CNRS 7052, INSERM U1271, 10 Avenue de Verdun, 75010 Paris, France; AP-HP, Antoine Béclère Université Paris-Saclay hospital, Orthopeadics Department, 157, rue de la Porte de Trivaux, 92140 Clamart, France
| | - C Bosser
- Equipex IVTV, Centrale Innovation, 64 Chemin des Mouilles, 69130 Ecully, France
| | - A Linglart
- Université de Paris Saclay, Le Kremlin-Bicêtre, France; AP-HP, Department of Endocrinology and Diabetology for children, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR and Platform of expertise for rare diseases Paris-Sud, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - M Bensidhoum
- Université de Paris, B3OA, UMR CNRS 7052, INSERM U1271, 10 Avenue de Verdun, 75010 Paris, France
| | - T Hoc
- Université de Paris, B3OA, UMR CNRS 7052, INSERM U1271, 10 Avenue de Verdun, 75010 Paris, France; Mechanical Department, MSGMGC, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, 69134 Ecully Cedex, France.
| | - C Nouguier-Lehon
- Université de Lyon, LTDS UMR CNRS 5513, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, 69134 Ecully Cedex, France
| | - C Chaussain
- Université de Paris, Dental School, UR2496, Montrouge, F-92120, France; AP-HP Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism (OSCAR, ERN Bond), Dental Medicine Department, Bretonneau Hospital, GHN, 75018 Paris, France
| |
Collapse
|
4
|
Prenatal Diagnosis of Osteogenesis Imperfecta Type III. J Obstet Gynaecol India 2019; 69:374-376. [DOI: 10.1007/s13224-019-01230-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/09/2019] [Indexed: 10/27/2022] Open
|
5
|
Nijhuis WH, Eastwood DM, Allgrove J, Hvid I, Weinans HH, Bank RA, Sakkers RJ. Current concepts in osteogenesis imperfecta: bone structure, biomechanics and medical management. J Child Orthop 2019; 13:1-11. [PMID: 30838070 PMCID: PMC6376438 DOI: 10.1302/1863-2548.13.180190] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The majority of patients with osteogenesis imperfecta (OI) have mutations in the COL1A1 or COL1A2 gene, which has consequences for the composition of the bone matrix and bone architecture. The mutations result in overmodified collagen molecules, thinner collagen fibres and hypermineralization of bone tissue at a bone matrix level. Trabecular bone in OI is characterized by a lower trabecular number and connectivity as well as a lower trabecular thickness and volumetric bone mass. Cortical bone shows a decreased cortical thickness with less mechanical anisotropy and an increased pore percentage as a result of increased osteocyte lacunae and vascular porosity. Most OI patients have mutations at different locations in the COL1 gene. Disease severity in OI is probably partly determined by the nature of the primary collagen defect and its location with respect to the C-terminus of the collagen protein. The overall bone biomechanics result in a relatively weak and brittle structure. Since this is a result of all of the above-mentioned factors as well as their interactions, there is considerable variation between patients, and accurate prediction on bone strength in the individual patient with OI is difficult. Current treatment of OI focuses on adequate vitamin-D levels and interventions in the bone turnover cycle with bisphosphonates. Bisphosphonates increase bone mineral density, but the evidence on improvement of clinical status remains limited. Effects of newer drugs such as antibodies against RANKL and sclerostin are currently under investigation. This paper was written under the guidance of the Study Group Genetics and Metabolic Diseases of the European Paediatric Orthopaedic Society.
Collapse
Affiliation(s)
- W. H. Nijhuis
- Department of Orthopaedic Surgery, University Medical Centre Utrecht, Wilhelmina Children’s Hospital, The Netherlands
| | - D. M. Eastwood
- Department of Orthopaedic Surgery, Great Ormond Street Hospital, London, United Kingdom
| | - J. Allgrove
- Department of Endocrinology, Great Ormond Street Hospital, London, United Kingdom
| | - I. Hvid
- Department of Orthopaedic Surgery, Oslo University Hospital, Norway
| | - H. H. Weinans
- Department of Orthopaedic Surgery, University Medical Centre Utrecht, Wilhelmina Children’s Hospital, The Netherlands and Technical University, Delft, The Netherlands
| | - R. A. Bank
- Department of Pathology and Medical Biology, University Medical Centre Groningen, The Netherlands
| | - R. J. Sakkers
- Department of Orthopaedic Surgery, University Medical Centre Utrecht, Wilhelmina Children’s Hospital, The Netherlands, Correspondence should be sent to R. Sakkers, MD, PhD, Department of Orthopaedic Surgery University Medical Centre Utrecht, Wilhelmina Children’s Hospital, Lundlaan 6, 3548EA Utrecht, The Netherlands. E-mail:
| |
Collapse
|
6
|
Macroscopic anisotropic bone material properties in children with severe osteogenesis imperfecta. J Biomech 2017; 64:103-111. [DOI: 10.1016/j.jbiomech.2017.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 07/12/2017] [Accepted: 09/04/2017] [Indexed: 01/06/2023]
|
7
|
Anisotropic properties of human cortical bone with osteogenesis imperfecta. Biomech Model Mechanobiol 2015; 15:155-67. [DOI: 10.1007/s10237-015-0727-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 09/07/2015] [Indexed: 10/23/2022]
|
8
|
Abstract
Osteogenesis imperfecta (OI) is an uncommon genetic bone disease associated with brittle bones and fractures in children and adults. Although OI is most commonly associated with mutations of the genes for type I collagen, many other genes (some associated with type I collagen processing) have now been identified. The genetics of OI and advances in our understanding of the biomechanical properties of OI bone are reviewed in this article. Treatment includes physiotherapy, fall prevention, and sometimes orthopedic procedures. In this brief review, we will also discuss current understanding of pharmacologic therapies for treatment of OI.
Collapse
Affiliation(s)
- Joseph L Shaker
- Endocrinology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Carolyne Albert
- Orthopaedic and Rehabilitation Engineering Center, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA ; Shriners Hospitals for Children, Chicago, IL, USA
| | - Jessica Fritz
- Orthopaedic and Rehabilitation Engineering Center, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gerald Harris
- Orthopaedic and Rehabilitation Engineering Center, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA ; Shriners Hospitals for Children, Chicago, IL, USA
| |
Collapse
|
9
|
Sun W, Inayathullah M, Manoukian MAC, Malkovskiy AV, Manickam S, Marinkovich MP, Lane AT, Tayebi L, Seifalian AM, Rajadas J. Transdermal Delivery of Functional Collagen Via Polyvinylpyrrolidone Microneedles. Ann Biomed Eng 2015; 43:2978-90. [PMID: 26066056 DOI: 10.1007/s10439-015-1353-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 06/03/2015] [Indexed: 12/22/2022]
Abstract
Collagen makes up a large proportion of the human body, particularly the skin. As the body ages, collagen content decreases, resulting in wrinkled skin and decreased wound healing capabilities. This paper presents a method of delivering type I collagen into porcine and human skin utilizing a polyvinylpyrrolidone microneedle delivery system. The microneedle patches were made with concentrations of 1, 2, 4, and 8% type I collagen (w/w). Microneedle structures and the distribution of collagen were characterized using scanning electron microscopy and confocal microscopy. Patches were then applied on the porcine and human skin, and their effectiveness was examined using fluorescence microscopy. The results illustrate that this microneedle delivery system is effective in delivering collagen I into the epidermis and dermis of porcine and human skin. Since the technique presented in this paper is quick, safe, effective and easy, it can be considered as a new collagen delivery method for cosmetic and therapeutic applications.
Collapse
Affiliation(s)
- Wenchao Sun
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Building A, Room A148, Palo Alto, CA, 94304, USA.,Cardiovascular Pharmacology Division, Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Mohammed Inayathullah
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Building A, Room A148, Palo Alto, CA, 94304, USA.,Cardiovascular Pharmacology Division, Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Martin A C Manoukian
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Building A, Room A148, Palo Alto, CA, 94304, USA.,Department of Dermatology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Andrey V Malkovskiy
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Building A, Room A148, Palo Alto, CA, 94304, USA
| | - Sathish Manickam
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Building A, Room A148, Palo Alto, CA, 94304, USA
| | - M Peter Marinkovich
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,Division of Dermatology, Palo Alto VA Medical Center, Palo Alto, CA, 94304, USA
| | - Alfred T Lane
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Lobat Tayebi
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Building A, Room A148, Palo Alto, CA, 94304, USA.,Department of Developmental Sciences, Marquette University School of Dentistry, Milwaukee, WI, 53201, USA
| | - Alexander M Seifalian
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Jayakumar Rajadas
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Building A, Room A148, Palo Alto, CA, 94304, USA. .,Cardiovascular Pharmacology Division, Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, 94305, USA.
| |
Collapse
|
10
|
Microstructure and compressive mechanical properties of cortical bone in children with osteogenesis imperfecta treated with bisphosphonates compared with healthy children. J Mech Behav Biomed Mater 2015; 46:261-70. [PMID: 25828157 DOI: 10.1016/j.jmbbm.2014.12.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/12/2014] [Accepted: 12/18/2014] [Indexed: 01/17/2023]
Abstract
Osteogenesis imperfecta (OI) is a genetic disorder characterized by a change in bone tissue quality, but little data are available to describe the factors involved at the macroscopic scale. To better understand the effect of microstructure alterations on the mechanical properties at the sample scale, we studied the structural and mechanical properties of six cortical bone samples from children with OI treated with bisphosphonates and compared them to the properties of three controls. Scanning electron microscopy, high resolution computed tomography and compression testing were used to assess these properties. More resorption cavities and a higher osteocyte lacunar density were observed in OI bone compared with controls. Moreover, a higher porosity was measured for OI bones along with lower macroscopic Young's modulus, yield stress and ultimate stress. The microstructure was impaired in OI bones; the higher porosity and osteocyte lacunar density negatively impacted the mechanical properties and made the bone more prone to fracture.
Collapse
|
11
|
Strain amplification analysis of an osteocyte under static and cyclic loading: a finite element study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:376474. [PMID: 25664319 PMCID: PMC4312579 DOI: 10.1155/2015/376474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/21/2014] [Accepted: 09/25/2014] [Indexed: 12/22/2022]
Abstract
Osteocytes, the major type of bone cells which reside in their lacunar and canalicular system within the bone matrix, function as biomechanosensors and biomechanotransducers of the bone. Although biomechanical behaviour of the osteocyte-lacunar-canalicular system has been investigated in previous studies mostly using computational 2-dimensional (2D) geometric models, only a few studies have used the 3-dimensional (3D) finite element (FE) model. In the current study, a 3D FE model was used to predict the responses of strain distributions of osteocyte-lacunar-canalicular system analyzed under static and cyclic loads. The strain amplification factor was calculated for all simulations. Effects on the strain of the osteocyte system were investigated under 500, 1500, 2000, and 3000 microstrain loading magnitudes and 1, 5, 10, 40, and 100 Hz loading frequencies. The maximum strain was found to change with loading magnitude and frequency. It was observed that maximum strain under 3000-microstrain loading was higher than those under 500, 1500, and 2000 microstrains. When the loading strain reached the maximum magnitude, the strain amplification factor of 100 Hz was higher than those of the other frequencies. Data from this 3D FE model study suggests that the strain amplification factor of the osteocyte-lacunar-canalicular system increases with loading frequency and loading strain increasing.
Collapse
|
12
|
Albert C, Jameson J, Smith P, Harris G. Reduced diaphyseal strength associated with high intracortical vascular porosity within long bones of children with osteogenesis imperfecta. Bone 2014; 66:121-30. [PMID: 24928496 PMCID: PMC4467578 DOI: 10.1016/j.bone.2014.05.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/10/2014] [Accepted: 05/07/2014] [Indexed: 01/16/2023]
Abstract
Osteogenesis imperfecta is a genetic disorder resulting in bone fragility. The mechanisms behind this fragility are not well understood. In addition to characteristic bone mass deficiencies, research suggests that bone material properties are compromised in individuals with this disorder. However, little data exists regarding bone properties beyond the microstructural scale in individuals with this disorder. Specimens were obtained from long bone diaphyses of nine children with osteogenesis imperfecta during routine osteotomy procedures. Small rectangular beams, oriented longitudinally and transversely to the diaphyseal axis, were machined from these specimens and elastic modulus, yield strength, and maximum strength were measured in three-point bending. Intracortical vascular porosity, bone volume fraction, osteocyte lacuna density, and volumetric tissue mineral density were determined by synchrotron micro-computed tomography, and relationships among these mechanical properties and structural parameters were explored. Modulus and strength were on average 64-68% lower in the transverse vs. longitudinal beams (P<0.001, linear mixed model). Vascular porosity ranged between 3 and 42% of total bone volume. Longitudinal properties were associated negatively with porosity (P≤0.006, linear regressions). Mechanical properties, however, were not associated with osteocyte lacuna density or volumetric tissue mineral density (P≥0.167). Bone properties and structural parameters were not associated significantly with donor age (P≥0.225, linear mixed models). This study presents novel data regarding bone material strength in children with osteogenesis imperfecta. Results confirm that these properties are anisotropic. Elevated vascular porosity was observed in most specimens, and this parameter was associated with reduced bone material strength. These results offer insight toward understanding bone fragility and the role of intracortical porosity on the strength of bone tissue in children with osteogenesis imperfecta.
Collapse
Affiliation(s)
- Carolyne Albert
- Shriners Hospitals for Children-Chicago, Chicago, IL, USA; Department of Biomedical Engineering, Marquette University, Orthopaedic and Rehabilitation Engineering Center (OREC), Milwaukee, WI, USA.
| | - John Jameson
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, USA; Department of Biomedical Engineering, Marquette University, Orthopaedic and Rehabilitation Engineering Center (OREC), Milwaukee, WI, USA.
| | - Peter Smith
- Shriners Hospitals for Children-Chicago, Chicago, IL, USA; Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
| | - Gerald Harris
- Shriners Hospitals for Children-Chicago, Chicago, IL, USA; Department of Biomedical Engineering, Marquette University, Orthopaedic and Rehabilitation Engineering Center (OREC), Milwaukee, WI, USA.
| |
Collapse
|
13
|
Imbert L, Aurégan JC, Pernelle K, Hoc T. Mechanical and mineral properties of osteogenesis imperfecta human bones at the tissue level. Bone 2014; 65:18-24. [PMID: 24803077 DOI: 10.1016/j.bone.2014.04.030] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/18/2014] [Accepted: 04/25/2014] [Indexed: 12/12/2022]
Abstract
Osteogenesis imperfecta (OI) is a genetic disorder characterized by an increase in bone fragility on the macroscopic scale, but few data are available to describe the mechanisms involved on the tissue scale and the possible correlations between these scales. To better understand the effects of OI on the properties of human bone, we studied the mechanical and chemical properties of eight bone samples from children suffering from OI and compared them to the properties of three controls. High-resolution computed tomography, nanoindentation and Raman microspectroscopy were used to assess those properties. A higher tissue mineral density was found for OI bone (1.131 gHA/cm3 vs. 1.032 gHA/cm3, p=0.032), along with a lower Young's modulus (17.6 GPa vs. 20.5 GPa, p=0.024). Obviously, the mutation-induced collagen defects alter the collagen matrix, thereby affecting the mineralization. Raman spectroscopy showed that the mineral-to-matrix ratio was higher in the OI samples, while the crystallinity was lower, suggesting that the mineral crystals were smaller but more abundant in the case of OI. This change in crystal size, distribution and composition contributes to the observed decrease in mechanical strength.
Collapse
Affiliation(s)
- Laurianne Imbert
- LTDS UMR CNRS 5513, Ecole Centrale Lyon, 36 avenue Guy de Collongue, 69134 Ecully, France
| | - Jean-Charles Aurégan
- Department of Pediatric Orthopedics, Necker - Enfants Malades Hospital, AP-HP, Paris Descartes University, 145 rue de Sèvres, 75014 Paris, France; B2OA UMR CNRS 7052, University Paris-Diderot, 10 avenue de Verdun, 75010 Paris, France
| | - Kélig Pernelle
- LTDS UMR CNRS 5513, Ecole Centrale Lyon, 36 avenue Guy de Collongue, 69134 Ecully, France
| | - Thierry Hoc
- LTDS UMR CNRS 5513, Ecole Centrale Lyon, 36 avenue Guy de Collongue, 69134 Ecully, France.
| |
Collapse
|
14
|
Stagi S, Cavalli L, Seminara S, de Martino M, Brandi ML. The ever-expanding conundrum of primary osteoporosis: aetiopathogenesis, diagnosis, and treatment. Ital J Pediatr 2014; 40:55. [PMID: 24906390 PMCID: PMC4064514 DOI: 10.1186/1824-7288-40-55] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/27/2014] [Indexed: 01/07/2023] Open
Abstract
In recent years, as knowledge regarding the etiopathogenetic mechanisms of bone involvement characterizing many diseases has increased and diagnostic techniques evaluating bone health have progressively improved, the problem of low bone mass/quality in children and adolescents has attracted more and more attention, and the body evidence that there are groups of children who may be at risk of osteoporosis has grown. This interest is linked to an increased understanding that a higher peak bone mass (PBM) may be one of the most important determinants affecting the age of onset of osteoporosis in adulthood. This review provides an updated picture of bone pathophysiology and characteristics in children and adolescents with paediatric osteoporosis, taking into account the major causes of primary osteoporosis (PO) and evaluating the major aspects of bone densitometry in these patients. Finally, some options for the treatment of PO will be briefly discussed.
Collapse
Affiliation(s)
- Stefano Stagi
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
| | | | | | | | | |
Collapse
|