Regional distinctions in cortical bone mineral density measured by pQCT can predict alterations in material property at the tibial diaphysis of the Cynomolgus monkey

Changes in diaphyseal cross-sectional properties with age in macaques

OBJECTIVES

The present study seeks to quantify changes in long bone cross-sectional properties in a colony of semi-free-ranging rhesus macaques and compare observed aging patterns to those of other primates, including humans.

METHODS

Peripheral quantitative computed tomography was used to obtain midshaft cross sections of the femora, tibiae, humeri, and radii of 115 macaque specimens ranging from 7 to 31 years of age. Linear regressions of cross-sectional properties on age were analyzed. An analysis of covariance was conducted to quantify differences in rates of change between males and females.

RESULTS

Results show that medullary area increases while cortical area decreases with age in both sexes. The polar section modulus and the polar strain-strength index, measuring torsional and bending strength, show no decline in most sections but decrease significantly with age in the hindlimb elements of female macaques. Volumetric bone mineral density (vBMD) also decreases with age in both male and female macaques; however, the cumulative change in vBMD over the adult lifespan is relatively small, equivalent to a less than 10% decrease in material strength. An analysis of covariance shows no differences between males and females in the rate of change of properties with age.

DISCUSSION

Overall, this study shows that there are some similarities in the skeletal aging patterns of macaques and those of other primates, including humans, but also some differences, with greater losses of bone found in human females as a result of an extended post-reproductive period that is generally not found among wild or semi-wild macaques.

Three-dimensional distribution of CT attenuation in the lumbar spine pedicle wall

This study investigated in vivo the three-dimensional distribution of CT attenuation in the lumbar spine pedicle wall measured in Hounsfield Unit (HU). Seventy-five volunteers underwent clinical lumbar spine CT scans. Data was analyzed with custom-written software to determine the regional variation in pedicle wall attenuation values. A cylindrical coordinate system oriented along the pedicle's long axis was used to calculate the pedicular wall attenuation distribution three-dimensionally and the highest attenuation value was identified. The pedicular cross-section was divided into four quadrants: lateral, medial, cranial, and caudal. The mean HU value for each quadrant was calculated for all lumbar spine levels (L1-5). The pedicle wall attenuation was analyzed by gender, age, spinal levels and anatomical quadrant. The mean HU values of the pedicle wall at L1 and L5 were significantly lower than the values between L2-4 in both genders and in both age groups. Furthermore, the medial quadrant showed higher HU values than the lateral quadrant at all levels and the caudal quadrant showed higher HU values at L1-3 and lower HU values at L4-5 than the cranial quadrant. These findings may explain why there is a higher incidence of pedicle screw breach in the pedicle lateral wall.

Reexamining the Surfaces of Bone in Boys and Girls During Adolescent Growth: A 12-Year Mixed Longitudinal pQCT Study

We revisit Stanley Garn's theory related to sex differences in endocortical and periosteal apposition during adolescence using a 12-year mixed longitudinal study design. We used peripheral quantitative computed tomography to examine bone parameters in 230 participants (110 boys, 120 girls; aged 11.0 years at baseline). We assessed total (Tt.Ar, mm(2)), cortical (Ct.Ar, mm(2)), and medullary canal area (Me.Ar, mm(2)), Ct.Ar/Tt.Ar, cortical bone mineral density (Ct.BMD, mg/cm(3)), and polar strength-strain index (SSIp , mm(3)) at the tibial midshaft (50% site). We used annual measures of height and chronological age to identify age at peak height velocity (APHV) for each participant. We compared annual accrual rates of bone parameters between boys and girls, aligned on APHV using a linear mixed effects model. At APHV, boys demonstrated greater Tt.Ar (ratio = 1.27; 95% confidence interval [CI] 1.21, 1.32), Ct.Ar (1.24 [1.18, 1.30]), Me.Ar (1.31 [1.22, 1.40]), and SSIp (1.36 [1.28, 1.45]) and less Ct.Ar/Tt.Ar (0.98 [0.96, 1.00]) and Ct.BMD (0.97 [0.96, 0.97]) compared with girls. Boys and girls demonstrated periosteal bone formation and net bone loss at the endocortical surface. Compared with girls, boys demonstrated greater annual accrual rates pre-APHV for Tt.Ar (1.18 [1.02, 1.34]) and Me.Ar (1.34 [1.11, 1.57]), lower annual accrual rates pre-APHV for Ct.Ar/Tt.Ar (0.56 [0.29, 0.83]) and Ct.BMD (-0.07 [-0.17, 0.04]), and similar annual accrual rates pre-APHV for Ct.Ar (1.10 [0.94, 1.26]) and SSIp (1.14 [0.98, 1.30]). Post-APHV, boys demonstrated similar annual accrual rates for Ct.Ar/Tt.Ar (1.01 [0.71, 1.31]) and greater annual accrual rates for all other bone parameters compared with girls (ratio = 1.23 to 2.63; 95% CI 1.11 to 3.45). Our findings support those of Garn and others of accelerated periosteal apposition during adolescence, more evident in boys than girls. However, our findings challenge the notion of greater endocortical apposition in girls, suggesting instead that girls experience diminished endocortical resorption compared with boys.

An In Vivo Ovine Model of Bone Tissue Alterations in Simulated Microgravity Conditions

Microgravity and its inherent reduction in body-weight associated mechanical loading encountered during spaceflight have been shown to produce deleterious effects on important human physiological processes. Rodent hindlimb unloading is the most widely-used ground-based microgravity model. Unfortunately, results from these studies are difficult to translate to the human condition due to major anatomic and physiologic differences between the two species such as bone microarchitecture and healing rates. The use of translatable ovine models to investigate orthopedic-related conditions has become increasingly popular due to similarities in size and skeletal architecture of the two species. Thus, a new translational model of simulated microgravity was developed using common external fixation techniques to shield the metatarsal bone of the ovine hindlimb during normal daily activity over an 8 week period. Bone mineral density, quantified via dual-energy X-ray absorptiometry, decreased 29.0% (p < 0.001) in the treated metatarsi. Post-sacrifice biomechanical evaluation revealed reduced bending modulus (–25.8%, p < 0.05) and failure load (–27.8%, p < 0.001) following the microgravity treatment. Microcomputed tomography and histology revealed reduced bone volume (–35.9%, p < 0.01), trabecular thickness (–30.9%, p < 0.01), trabecular number (–22.5%, p < 0.05), bone formation rate (–57.7%, p < 0.01), and osteoblast number (–52.5%, p < 0.001), as well as increased osteoclast number (269.1%, p < 0.001) in the treated metatarsi of the microgravity group. No significant alterations occurred for any outcome parameter in the Sham Surgery Group. These data indicate that the external fixation technique utilized in this model was able to effectively unload the metatarsus and induce significant radiographic, biomechanical, and histomorphometric alterations that are known to be induced by spaceflight. Further, these findings demonstrate that the physiologic mechanisms driving bone remodeling in sheep and humans during prolonged periods of unloading (specifically increased osteoclast activity) are more similar than previously utilized models, allowing more comprehensive investigations of microgravity-related bone remodeling as it relates to human spaceflight.

A structural modulator of tumor necrosis factor type 1 receptor promotes bone formation under lipopolysaccharide-induced inflammation in a murine tooth extraction model

Recently an increase in the serum levels of a bone formation marker after anti-tumor necrosis factor (TNF)-α therapy in rheumatoid arthritis patients has been reported. However, there remains no direct evidence that TNF-α antagonist could accelerate bone formation under inflammatory condition. Cavity-induced allosteric modification (CIAM) compound, F002, is a newly developed-TNF-α antagonist, which was designed by using the structure of TNF type 1 receptor, thus preventing TNF-α-induced signaling. In this study, we examined whether the CIAM compound can promote bone formation under inflammatory condition induced by lipopolysaccharide (LPS). Thirty-six 10-week-old male mice (C57BL/6J) were used. Half of the mice received 10 mg/kg LPS, while the other half received PBS. Thereafter, incisor extraction was performed at 4 days after either LPS or PBS injection. Intraperitoneal injections of 2 mg/kg/day, 4 mg/kg/day CIAM, or vehicle (10% DMSO) were performed once a day from day 0 to day 7 after incisor tooth extraction. The mice were sacrificed at 21 days after the extraction. The regenerated bone mineral density (BMD) in the tooth socket, and the mineral apposition rate and the bone formation rate, direct evidences of bone formation, were significantly decreased in the LPS-injected group compared to the PBS-injected group. CIAM compound dose-dependently prevented the decrease of BMD under the LPS-injected condition, and promoted both the mineral apposition rate and the bone formation rate significantly compared to the LPS-injected group. We did not observe any significant differences among the PBS-injected groups. Taken together, TNF-α antagonist CIAM compound, was found to accelerate bone formation under LPS-induced inflammatory condition.

Amount of bone lengthening affects blood flow recovery and bone mineralization after distraction osteogenesis in a canine cleft palate model

OBJECTIVES

Distraction osteogenesis has been applied to the craniofacial region. To reduce the cleft width of patients with cleft lip and palate, alveolar bones are distracted toward the cleft. However, no reports have described limitations to the amount of lengthening that can be achieved by distraction osteogenesis in this area. Therefore, we investigated the healing process following different extents of distraction osteogenesis using a canine cleft palate model.

METHODS

A 10-mm bone defect was made in the palates. A bony segment including the canine was prepared and translocated into the defect area at a rate of 1 mm/d for 6 or 10 days, resulting in two groups (6- and 10-mm groups). Canine pulpal blood flow was monitored for 100 days with Doppler flowmetry. Then, the animals were sacrificed and the regenerated bone area was evaluated radiologically and histologically. Statistical significance was confirmed with the Mann-Whitney rank test.

RESULTS

Pulpal blood flow in the 6-mm group recovered to original levels earlier than in the 10-mm group. Cortical bone density in the regenerated bone, measured by peripheral quantitative computed tomography, was significantly greater in the 6-mm group than in the 10-mm group. The amount of regenerated bone in histologic sections was also significantly greater in the 6-mm group.

CONCLUSION

We clearly showed that healing progress depends on the extent of distraction osteogenesis, highlighting the importance of limited distraction osteogenesis in the alveolar area.

Raloxifene ameliorates detrimental enzymatic and nonenzymatic collagen cross-links and bone strength in rabbits with hyperhomocysteinemia

We demonstrate a reduction in enzymatic divalent immature and trivalent pyridinium cross-links and an increase in the nonenzymatic cross-link, pentosidine (Pen), in rabbits with methionine (Met)-induced hyperhomocysteinemia. Such detrimental cross-link formation in bone was ameliorated by raloxifene (RLX) treatment.

INTRODUCTION

Collagen cross-links are determinants of bone quality. Homocysteine (Hcys) interferes with collagen cross-linking. Because RLX is thought to ameliorate bone quality, we investigated whether RLX ameliorated hyperhomocysteinemia-induced cross-link abnormalities using a Met-rich diet rabbit model.

METHODS

We divided New Zealand white rabbits into six groups (n = 6 per group): baseline control, sham operation, sham + 1% Met diet, ovariectomy (OVX), 1% Met diet + OVX, OVX + RLX (10 mg/kg/day), and 1% Met diet + OVX + RLX. RLX was administered for 16 weeks. We measured the amount of enzymatic immature and mature pyridinium cross-links and the nonenzymatic cross-link, Pen, and correlated the cross-link content to bone strength.

RESULTS

Hcys levels were significantly higher in the Met diet groups than in the normal diet groups. Met-fed rabbits with or without OVX showed a significant reduction of enzymatic cross-links, whereas an increase in Pen was observed in Met-fed rabbits with OVX. The cross-link content of the RLX-treated Met-fed rabbits with OVX was restored to similar levels as the sham group, accompanied by an improvement of bone strength.

CONCLUSION

These results demonstrate that hyperhomocysteinemia reduced bone strength via a reduction of enzymatic cross-links and an increase of nonenzymatic cross-links. RLX may ameliorate hyperhomocysteinemia-induced detrimental cross-linking in rabbits with OVX and may improve bone strength via the amelioration of collagen cross-links.

A three-dimensional microcomputed tomographic study of site-specific variation in trabecular microarchitecture in the human second metacarpal

Variation in trabecular microarchitecture is widely accepted as being regulated by both functional (mechanical loading) and genetic parameters, although the relative influence of each is unclear. Studies reporting inter-site differences in trabecular morphology (volume, number and structure) reveal a complex interaction at the gene-environment interface. We report inter- and intra-site variation in trabecular anatomy using a novel model of contralateral (left vs right) and ipsilateral (head vs base) comparisons for the human second metacarpal in a sample of n = 29 historically known 19th century EuroCanadians. Measures of bone volume fraction, structure model index, connectivity, trabecular number, spacing and thickness as well as degree of anisotropy were obtained from 5-mm volumes of interest using three-dimensional microcomputed tomography. We hypothesized that: (i) the more diverse loading environment of metacarpal heads should produce a more robust trabecular architecture than corresponding bases within sides and (ii) the ipsilateral differences between epiphyses will be larger on the right side than on the left side, as a function of handedness. Analysis of covariance (Side x Epiphysis) with Age as covariate revealed a clear dichotomy between labile and constrained architectures within and among anatomical sites. The predicted variation in loading was accommodated by changes in trabecular volume, whereas trabecular structure did not vary significantly by side or by epiphysis within sides. Age was a significant covariate only for females. We conclude that environmental and genetic regulation of bone adaptation may act through distinct pathways and local anatomies to ensure an integrated lattice of sufficient mass to meet normal functional demands.

Anterior-posterior bending strength at the tibial shaft increases with physical activity in boys: evidence for non-uniform geometric adaptation

We investigated bone structural adaptations to a 16-month school-based physical activity intervention in 202 young boys using a novel analytical method for peripheral quantitative computed tomography scans of the tibial mid-shaft. Our intervention effectively increased bone bending strength in the anterior-posterior plane as estimated with the maximum second moment of area (I(max)).

INTRODUCTION

We previously reported positive effects of a physical activity intervention on peripheral quantitative computed tomography (pQCT)-derived bone strength at the tibial mid-shaft in young boys. The present study further explored structural adaptations to the intervention using a novel method for pQCT analysis.

METHODS

Participants were 202 boys (aged 9-11 years) from 10 schools randomly assigned to control (CON, 63 boys) and intervention (INT, 139 boys) groups. INT boys participated in 60 min/week of classroom physical activity, including a bone-loading program. We used ImageJ to process pQCT images of the tibial mid-shaft and determine the second moments of area (I(max), I(min)) and cortical area (CoA) and thickness (CTh) by quadrant (anterior, medial, lateral, posterior). We defined quadrants according to pixel coordinates about the centroid. We used mixed linear models to compare change in bone outcomes between groups.

RESULTS

The INT boys had a 3% greater gain in I(max) than the CON boys (p = 0.04) and tended to have a greater gain in I(min) ( approximately 2%, NS). Associated with the greater gain in I(max) was a slightly greater (NS) gain (1-1.4%) in CoA and CTh in the anterior, medial, and posterior (but not lateral) quadrants.

CONCLUSION

Our results suggest regional variation in bone adaptation consistent with patterns of bone formation induced by anterior-posterior bending loads.

Receptor activator of nuclear factor kappaB ligand and osteoprotegerin regulation of bone remodeling in health and disease

Osteoclasts and osteoblasts dictate skeletal mass, structure, and strength via their respective roles in resorbing and forming bone. Bone remodeling is a spatially coordinated lifelong process whereby old bone is removed by osteoclasts and replaced by bone-forming osteoblasts. The refilling of resorption cavities is incomplete in many pathological states, which leads to a net loss of bone mass with each remodeling cycle. Postmenopausal osteoporosis and other conditions are associated with an increased rate of bone remodeling, which leads to accelerated bone loss and increased risk of fracture. Bone resorption is dependent on a cytokine known as RANKL (receptor activator of nuclear factor kappaB ligand), a TNF family member that is essential for osteoclast formation, activity, and survival in normal and pathological states of bone remodeling. The catabolic effects of RANKL are prevented by osteoprotegerin (OPG), a TNF receptor family member that binds RANKL and thereby prevents activation of its single cognate receptor called RANK. Osteoclast activity is likely to depend, at least in part, on the relative balance of RANKL and OPG. Studies in numerous animal models of bone disease show that RANKL inhibition leads to marked suppression of bone resorption and increases in cortical and cancellous bone volume, density, and strength. RANKL inhibitors also prevent focal bone loss that occurs in animal models of rheumatoid arthritis and bone metastasis. Clinical trials are exploring the effects of denosumab, a fully human anti-RANKL antibody, on bone loss in patients with osteoporosis, bone metastasis, myeloma, and rheumatoid arthritis.