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Luo W, Yao C, Sun J, Zhang B, Chen H, Miao J, Zhang Y. Alamandine attenuates ovariectomy-induced osteoporosis by promoting osteogenic differentiation via AMPK/eNOS axis. BMC Musculoskelet Disord 2024; 25:45. [PMID: 38200474 PMCID: PMC10777585 DOI: 10.1186/s12891-023-07159-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Alamandine is a newly characterized peptide of renin angiotensin system. Our study aims to investigate the osteo-preservative effects of alamandine, explore underlying mechanism and bring a potential preventive strategy for postmenopausal osteoporosis in the future. METHODS An ovariectomy (OVX)-induced rat osteoporosis model was established for in vivo experiments. Micro-computed tomography and three-point bending test were used to evaluate bone strength. Histological femur slices were processed for immunohistochemistry (IHC). Bone turnover markers and nitric oxide (NO) concentrations in serum were determined with enzyme-linked immunosorbent assay (ELISA). The mouse embryo osteoblast precursor (MC3T3-E1) cells were used for in vitro experiments. The cell viability was analysed with a Cell Counting Kit‑8. We performed Alizarin Red S staining and alkaline phosphatase (ALP) activity assay to observe the differentiation status of osteoblasts. Western blotting was adopted to detect the expression of osteogenesis related proteins and AMP-activated protein kinase/endothelial nitric oxide synthase (AMPK/eNOS) in osteoblasts. DAF-FM diacetate was used for semi-quantitation of intracellular NO. RESULTS In OVX rats, alamandine alleviated osteoporosis and maintained bone strength. The IHC showed alamandine increased osteocalcin and collagen type I α1 (COL1A1) expression. The ELISA revealed alamandine decreased bone turnover markers and restored NO level in serum. In MC3T3-E1 cells, alamandine promoted osteogenic differentiation. Western blotting demonstrated that alamandine upregulated the expression of osteopontin, Runt-related transcription factor 2 and COL1A1. The intracellular NO was also raised by alamandine. Additionally, the activation of AMPK/eNOS axis mediated the effects of alamandine on MC3T3-E1 cells and bone tissue. PD123319 and dorsomorphin could repress the regulating effect of alamandine on bone metabolism. CONCLUSION Alamandine attenuates ovariectomy-induced osteoporosis by promoting osteogenic differentiation via AMPK/eNOS axis.
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Affiliation(s)
- Wanxin Luo
- Department of Orthopaedics, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong City, 226001, Jiangsu Province, PR China
| | - Chen Yao
- Department of Orthopaedics, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong City, 226001, Jiangsu Province, PR China
| | - Jie Sun
- Department of Orthopaedics, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong City, 226001, Jiangsu Province, PR China
| | - Bo Zhang
- Department of Orthopaedics, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong City, 226001, Jiangsu Province, PR China
| | - Hao Chen
- Department of Orthopaedics, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong City, 226001, Jiangsu Province, PR China
| | - Jin Miao
- Laboratory Animal Center of Nantong University, Medical School of Nantong University, Nantong City, 226001, Jiangsu Province, PR China
| | - Yafeng Zhang
- Department of Orthopaedics, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong City, 226001, Jiangsu Province, PR China.
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Mulinari-Santos G, dos Santos JS, Kitagawa IL, de Souza Batista FR, Botacin PR, Antoniali C, Lisboa-Filho PN, Okamoto R. Estrogen Deficiency Impairs Osseointegration in Hypertensive Rats Even Treated with Alendronate Coated on the Implant Surface. J Funct Biomater 2023; 14:471. [PMID: 37754885 PMCID: PMC10532300 DOI: 10.3390/jfb14090471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/03/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
Hypertension and estrogen deficiency can affect bone metabolism and therefore increase the risk of osseointegration. Antihypertensive drugs such as losartan not only control blood pressure but also enhance bone healing. In addition, alendronate sodium is widely used to treat postmenopausal osteoporosis. Hence, we evaluated the effect of systemic antihypertensive and local alendronate coted on implants on osseointegration under hypertensive and estrogen-deficiency conditions. A total of 64 spontaneously hypertensive rats (SHRs) treated with losartan were randomly divided according to the estrogen-deficiency induction by ovariectomy (OVX) or not (SHAM), and whether the implant surface was coated with sodium alendronate (ALE) or not, resulting in four groups: SHR SHAM, SHR SHAM ALE, SHR OVX, and SHR OVX ALE. The removal torque, microcomputed tomography, and epifluorescence microscopy were the adopted analyses. The hypertensive and estrogen-deficiency animals presented a lower removal torque even when treated with alendronate on implant surface. The microcomputed tomography revealed a higher bone volume and bone-to-implant contact in the SHRs than the SHR OVX rats. Epifluorescence showed a decreased mineral apposition ratio in the SHR OVX ALE group. The data presented indicate that estrogen deficiency impairs osseointegration in hypertensive rats; in addition, alendronate coated on the implant surface does not fully reverse this impaired condition caused by estrogen deficiency.
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Affiliation(s)
- Gabriel Mulinari-Santos
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Jaqueline Silva dos Santos
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Igor Lebedenco Kitagawa
- Federal Institute of Education, Science and Technology of São Paulo (IFSP), Birigui, SP, Brazil
| | | | - Paulo Roberto Botacin
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Cristina Antoniali
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | | | - Roberta Okamoto
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
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Ozturk S, Cuneyit I, Altuntas F, Karagur ER, Donmez AC, Ocak M, Unal M, Sarikanat M, Donmez BO. Resveratrol prevents ovariectomy-induced bone quality deterioration by improving the microarchitectural and biophysicochemical properties of bone. J Bone Miner Metab 2023:10.1007/s00774-023-01416-z. [PMID: 37031330 DOI: 10.1007/s00774-023-01416-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/01/2023] [Indexed: 04/10/2023]
Abstract
INTRODUCTION Osteoporosis is a major health problem that is very common worldwide and is characterized by both low bone density and deterioration in bone quality. New treatment options without side effects have become an active area of research in recent years. This study was designed to investigate the preventive effects of resveratrol on bone quality deterioration caused by ovariectomy. MATERIALS AND METHODS Sixty rats were randomly divided into five groups (12 animals per group): Control, Sham-operated (SHAM), ovariectomized (OVX), OVX + Resveratrol-40 mg/kg/day (OVX + Res40), OVX + Resveratrol-80 mg/kg/day (OVX + Res80). Resveratrol was administered by oral gavage (40 and 80 mg/kg/day) for ten weeks. Micro-CT measurements, biomechanical testing, Raman spectroscopy analysis, and RT-PCR analysis were performed. ALP, OCN, TAS, and TOS levels were also measured from blood serum. RESULTS Bone strength, bone volume/total volume, trabecular volume, and trabecular thickness were higher in the OVX + RES-80 group than in the OVX group. Resveratrol increased osteogenic differentiation, as the expression of osteogenic markers ALP, Col1A1, Runx2, OPG, OCN increased in both OVX + RES-80 and OVX + RES-40 groups compared to the OVX group. 80 mg/kg/day resveratrol administration decreased the levels of ALP, OCN and TOS in ovariectomized rats. Raman spectroscopy findings showed a preventive effect of resveratrol administration against ovariectomy-induced deterioration in biophysiochemical properties of bone tissue. CONCLUSION This study revealed that administration of different doses of 80 mg/kg/day and 40 mg/kg/day of resveratrol had protective effects on bone quality deterioration caused by ovariectomy.
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Affiliation(s)
- Sevval Ozturk
- School of Medicine, Department of Anatomy, Pamukkale University, 20070, Denizli, Turkey
| | - Ibrahim Cuneyit
- School of Medicine, Department of Anatomy, Pamukkale University, 20070, Denizli, Turkey
| | - Fatih Altuntas
- School of Medicine, Department of Physiology, Pamukkale University, 20070, Denizli, Turkey
| | - Ege Riza Karagur
- School of Medicine, Department of Medical Genetics, Pamukkale University, 20070, Denizli, Turkey
| | - Aysegul Cort Donmez
- School of Medicine, Department of Medical Biochemistry, Pamukkale University, 20070, Denizli, Turkey
| | - Mert Ocak
- School of Dentistry, Department of Anatomy, Ankara University, 06650, Ankara, Turkey
| | - Mustafa Unal
- School of Medicine, Department of Biophysics, Karamanoglu Mehmetbey University, 70200, Karaman, Turkey
- Faculty of Engineering, Department of Bioengineering, Karamanoglu Mehmetbey University, 70200, Karaman, Turkey
| | - Mehmet Sarikanat
- Faculty of Engineering, Department of Mechanical Engineering, Ege University, 35040, Izmir, Turkey
| | - Baris Ozgur Donmez
- School of Medicine, Department of Anatomy, Pamukkale University, 20070, Denizli, Turkey.
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Deng Z, Gao X, Utsunomiya H, Arner JW, Ruzbarsky JJ, Huard M, Ravuri S, Philippon MJ, Huard J. Effects of oral losartan administration on homeostasis of articular cartilage and bone in a rabbit model. Bone Rep 2022; 16:101526. [PMID: 35372645 PMCID: PMC8971351 DOI: 10.1016/j.bonr.2022.101526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/26/2022] Open
Abstract
Background and aims Previous work has shown that oral losartan can enhance microfracture-mediated cartilage repair in a rabbit osteochondral defect injury model. In this study, we aimed to determine whether oral losartan would have a detrimental effect on articular cartilage and bone homeostasis in the uninjured sides. Methods New Zealand rabbits were divided into 4 groups including normal uninjured (Normal), contralateral uninjured side of osteochondral defect (Defect), osteochondral defect plus microfracture (Microfracture) and osteochondral defect plus microfracture and losartan oral administration (10 mg/kg/day) (Losartan). Rabbits underwent different surgeries and treatment and were sacrificed at 12 weeks. Both side of the normal group and uninjured side of treatment groups tibias were harvested for Micro-CT and histological analysis for cartilage and bone including H&E staining, Herovici's staining (bone and cartilage) Alcian blue and Safranin O staining (cartilage) as well as immunohistochemistry of losartan related signaling pathways molecules for both cartilage and bone. Results Our results showed losartan oral treatment at 10 mg/kg/day slightly increase Alcian blue positive matrix as well as decrease collagen type 3 in articular cartilage while having no significant effect on articular cartilage structure, cellularity, and other matrix. Losartan treatment also did not affect angiotensin receptor type 1 (AGTR1), angiotensin receptor type 2 (AGTR2) and phosphorylated transforming factor β1 activated kinase 1 (pTAK1) expression level and pattern in the articular cartilage. Furthermore, losartan treatment did not affect microarchitecture of normal cancellous bone and cortical bone of tibias compared to normal and other groups. Losartan treatment slightly increased osteocalcin positive osteoblasts on the surface of cancellous bone and did not affect bone matrix collagen type 1 content and did not change AGTR1, AGTR2 and pTAK1 signal molecule expression. Conclusion Oral losartan used as a microfracture augmentation therapeutic does not have significant effect on uninjured articular cartilage and bone based on our preclinical rabbit model. These results provided further evidence that the current regimen of using losartan as a microfracture augmentation therapeutic is safe with respect to bone and cartilage homeostasis and support clinical trials for its application in human cartilage repair.
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Antihypertensive drugs demonstrate varying levels of hip fracture risk: A systematic review and meta-analysis. Injury 2022; 53:1098-1107. [PMID: 34627629 DOI: 10.1016/j.injury.2021.09.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/17/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE By aggregating the literature, we evaluated the association between use of specific antihypertensive drugs and the risk of hip fractures compared with nonuse. STUDY DESIGN AND SETTING We systematically searched the Pubmed, Embase, and Cochrane databases from inception of each database until July 30, 2020 to identify articles including patients 18 years of age or older reporting on the association between antihypertensive drugs and the risk of hip fracture. Antihypertensive drugs were restricted to thiazides; beta-blockers; calcium-channel blockers; angiotensin-converting enzyme (ACE) inhibitors; and angiotensin receptor blockers. Nonusers encompass all patients that are not using the specific antihypertensive drug that has been reported. Unadjusted odds ratios with 95% confidence intervals (CIs) of the association between antihypertensive drug use and hip fractures were reported. Meta-analysis was performed when a minimum of five studies were identified for each antihypertensive drug class. Quality assessment was done using ROBINS-I tool. The GRADE approach was used to evaluate the certainty of the evidence. RESULTS Of 962 citations, 22 observational studies were included; 9 studies had a cohort design and 13 studies were case-control studies. No randomized controlled trials were identified. We found very low certainty of evidence that both thiazides (pooled odds ratio: 0.85, 95% CI 0.73 to 0.99, p = 0.04) as well as beta-blockers (pooled odds ratio: 0.88, 95% CI 0.79 to 0.98, p = 0.02) were associated with a reduced hip fracture risk as compared to specific nonuse. One study, reporting on angiotensin receptor blockers, also suggested a protective effect for hip fractures, whereas we found conflicting findings in four studies for calcium-channel blockers and in two studies for ACE inhibitors. CONCLUSION Among 22 observational studies, we found very low certainty of evidence that, compared to specific nonuse of antihypertensive drugs, use of thiazides, beta-blockers, and angiotensin receptor blockers were associated with a reduced protective hip fracture risk, while conflicting findings for calcium-channel blockers and ACE inhibitors were found. Given the low quality of included studies, further research -randomized controlled trials- are needed to definitively assess the causal relationship between specific antihypertensive drug classes and (relatively infrequent) hip fractures.
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Guo X, Zhong K, Zou L, Xue H, Zheng S, Guo J, Lv H, Duan K, Huang D, Tan M. Effect of Lactobacillus casei fermented milk on fracture healing in osteoporotic mice. Front Endocrinol (Lausanne) 2022; 13:1041647. [PMID: 36387894 PMCID: PMC9649960 DOI: 10.3389/fendo.2022.1041647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022] Open
Abstract
The interaction between the gut microbiota and the host has been described experimentally by germ-free animals or by antibiotic-disturbed gut microbiota. Studies on germ-free mice have shown that gut microbiota is critical for bone growth and development in mice, emphasizing that microbiota dysbiosis may interfere with normal bone development processes. This study aimed to clarify the effect of antibiotic treatment on disturbed gut microbiota on bone development in mice and to investigate the effect of probiotic treatment on fracture healing in mice with dysbiosis. Our results showed that 4 weeks old female Kunming mice showed significantly lower abundance and diversity of the gut microbiota and significantly lower bone mineral density after 12 weeks of antibiotic treatment and significantly increased levels of RANKL and Ang II in serum (p<0.05). Mice with dysbiosis received 5 mL of Lactobacillus casei fermented milk by daily gavage after internal fixation of femoral fractures, and postoperative fracture healing was evaluated by X-ray, micro-CT scan, and HE staining, which showed faster growth of the broken ends of the femur and the presence of more callus. Serological tests showed decreased levels of RANKL and Ang II (p<0.05). Similarly, immunohistochemical results also showed increased expression of α smooth muscle actin in callus tissue. These results suggest that oral antibiotics can lead to dysbiosis of the gut microbiota in mice, which in turn leads to the development of osteoporosis. In contrast, probiotic treatment promoted fracture healing in osteoporotic mice after dysbiosis, and the probiotic effect on fracture healing may be produced by inhibiting the RAS/RANKL/RANK pathway.
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Affiliation(s)
- Xing Guo
- Department of Burn and Plastic Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Kai Zhong
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - LongFei Zou
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hao Xue
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - ShuLing Zheng
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jiang Guo
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hui Lv
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ke Duan
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - DengHua Huang
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - MeiYun Tan
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: MeiYun Tan,
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Balera Brito VG, Patrocinio MS, Alves Barreto AE, Tfaile Frasnelli SC, Lara VS, Santos CF, Penha Oliveira SH. Telmisartan impairs the in vitro osteogenic differentiation of mesenchymal stromal cells from spontaneously hypertensive male rats. Eur J Pharmacol 2021; 912:174609. [PMID: 34743978 DOI: 10.1016/j.ejphar.2021.174609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 11/19/2022]
Abstract
Telmisartan (TELM) is an angiotensin II (Ang II) type 1 receptor (Agtr1) antagonist, with partial agonism for Pparg, and has been shown to affect bone metabolism. Therefore, the aim of this study was to investigate the effects of TELM in the in vitro osteogenic differentiation of bone marrow-derived mesenchymal stromal cells (BMSC) from spontaneously hypertensive rats (SHRs). BMSC were obtained from male SHR, and the osteogenic medium (OM) was added to the cells concomitantly with TELM (0.005, 0.05, and 0.5 μM). Undifferentiated BMSC, in control medium (CM), showed an increased viability, while the addition of OM reduced this parameter, and TELM did not show cytotoxicity in the concentrations used. BMSC in OM had an alkaline phosphatase (ALP) activity peak at d10, which decreased at d14 and d21, and TELM reduced ALP at d10 in a dose-dependent manner. Mineralization was observed in the OM at d14, which intensified at d21, but was inhibited by TELM. Agtr1b was increased in the OM, and TELM inhibited its expression. TELM reduced Opn, Ocn, and Bsp and increased Pparg expression, and at the higher concentration TELM also increased the expression of adipogenic markers, Fabp4 and Adipoq. In addition, TELM 0.5 μM increased Irs1 and Glut4, insulin and glucose metabolism markers, known to be regulated by Pparg and to be related to adipogenic phenotype. Our data shows that TELM inhibited the osteogenic differentiation and mineralization of SHR BMSC, by favoring an adipogenic prone phenotype due to Pparg upregulation.
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Affiliation(s)
- Victor Gustavo Balera Brito
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil; Multicenter Postgraduate Program in Physiological Sciences, Brazilian Society of Physiology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Mariana Sousa Patrocinio
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Ayná Emanuelli Alves Barreto
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil; Multicenter Postgraduate Program in Physiological Sciences, Brazilian Society of Physiology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | - Vanessa Soares Lara
- Department of Stomatology, Bauru School of Dentistry, University of São Paulo (USP), SP, Brazil
| | - Carlos Ferreira Santos
- Department of Biological Science, Bauru School of Dentistry, University of São Paulo (USP), SP, Brazil
| | - Sandra Helena Penha Oliveira
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil; Multicenter Postgraduate Program in Physiological Sciences, Brazilian Society of Physiology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil.
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Holloway-Kew KL, Betson AG, Anderson KB, Gaston J, Kotowicz MA, Liao WH, Henneberg M, Pasco JA. Association between bone measures and use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Arch Osteoporos 2021; 16:137. [PMID: 34536130 DOI: 10.1007/s11657-021-01004-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 09/13/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Angiotensin-converting enzyme inhibitor use in women was associated with lower femoral neck and lumbar spine bone mineral density as well as trabecular bone score compared to non-users. No differences were identified for men or for those who used ARB medications. PURPOSE Many individuals at high fracture risk use medications such as angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) that could affect bone; thus, this study aimed to investigate whether there are any differences in bone mineral density (BMD) and trabecular bone score (TBS) between ACEI users, ARB users, and non-users. METHODS Participants (685 men, 573 women) were from the Geelong Osteoporosis Study. Current medication use was self-reported. BMD at the femoral neck (FNBMD) and lumbar spine (LSBMD) were measured using DXA. TBS was calculated using TBS iNsight software. Linear regression models were used to investigate associations between ACEI or ARB use and bone measures, adjusting for other potential confounders. Due to interaction terms, data were stratified by age. RESULTS There were 88 (12.8%) men and 41 (7.2%) women taking an ACEI medication, and 71 (10.4%) men and 76 (13.3%) women taking an ARB medication. Compared to non-users, ACEI use was associated with lower FNBMD (- 7.2%), LSBMD (- 12.2%), and TBS (- 9.0%) for women aged < 65 years. Lower TBS was also observed for women aged ≥ 65 years (- 17.3%). No differences were identified for ARB use. CONCLUSIONS Women who used an ACEI medication had lower values for FNBMD, LSBMD and TBS compared to non-users. No differences were identified for men or for those who used ARB medications.
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Affiliation(s)
- Kara L Holloway-Kew
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.
| | - Amelia G Betson
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Kara B Anderson
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - James Gaston
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Mark A Kotowicz
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.,Barwon Health, Geelong, Australia.,Department of Medicine, The University of Melbourne-Western Health, St Albans, Australia
| | - Wan-Hui Liao
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Maciej Henneberg
- Biological and Comparative Anatomy Research Unit, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.,Department of Archaeology, Flinders University, Adelaide, Australia
| | - Julie A Pasco
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.,Barwon Health, Geelong, Australia.,Department of Medicine, The University of Melbourne-Western Health, St Albans, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia
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Antihypertensive drug classes and the risk of hip fracture: results from the Swedish primary care cardiovascular database. J Hypertens 2020; 38:167-175. [PMID: 31568060 DOI: 10.1097/hjh.0000000000002245] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Hypertension and fractures related to osteoporosis are major public health problems that often coexist. This study examined the associations between exposure to different antihypertensive drug classes and the risk of hip fracture in hypertensive patients. METHOD We included 59 246 individuals, 50 years and older, diagnosed with hypertension during 2001-2008 in the Swedish Primary Care Cardiovascular Database. Patients were followed from 1 January 2006 (or the date of diagnosis of hypertension) until they had their first hip fracture, died, or reached the end of the study on 31 December 2012. Cox proportional hazards models were used to calculate the risk of hip fracture across types of antihypertensive medications, adjusted for age, sex, comorbidity, medications, and socioeconomic factors. RESULTS In total, 2593 hip fractures occurred. Compared to nonusers, current use of bendroflumethiazide or hydrochlorothiazide was associated with a reduced risk of hip fracture (hazard ratio 0.86; 95% CI 0.75-0.98 and hazard ratio 0.84; 95% CI 0.74-0.96, respectively), as was use of fixed drug combinations containing a thiazide (hazard ratio 0.69; 95% CI 0.57-0.83). Current use of loop diuretics was associated with an increased risk of hip fracture (hazard ratio 1.23; 95% CI 1.11-1.35). No significant associations were found between the risk of hip fracture and current exposure to beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone-receptor blockers or calcium channel blockers. CONCLUSION In this large observational study of hypertensive patients, the risk of hip fracture differed across users of different antihypertensive drugs, results that could have practical implications when choosing antihypertensive drug therapy.
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Rothe R, Schulze S, Neuber C, Hauser S, Rammelt S, Pietzsch J. Adjuvant drug-assisted bone healing: Part III - Further strategies for local and systemic modulation. Clin Hemorheol Microcirc 2020; 73:439-488. [PMID: 31177207 DOI: 10.3233/ch-199104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this third in a series of reviews on adjuvant drug-assisted bone healing, further approaches aiming at influencing the healing process are discussed. Local and systemic modulation of bone metabolism is pursued with use of a number of drugs with completely different indications, which are characterized by a pleiotropic spectrum of action. These include drugs used to treat lipid disorders (HMG-CoA reductase inhibitors), hypertension (ACE inhibitors), osteoporosis (bisphosphonates), cancer (proteasome inhibitors) and others. Potential applications to enhance bone healing are discussed.
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Affiliation(s)
- Rebecca Rothe
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sabine Schulze
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christin Neuber
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sandra Hauser
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Stefan Rammelt
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Center for Regenerative Therapies Dresden (CRTD), Tatzberg 4, Dresden
| | - Jens Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, Dresden, Germany
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11
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Wu Z, Pan Z, Wen Y, Xiao H, Shangguan Y, Wang H, Chen L. Egr1/p300/ACE signal mediates postnatal osteopenia in female rat offspring induced by prenatal ethanol exposure. Food Chem Toxicol 2019; 136:111083. [PMID: 31887396 DOI: 10.1016/j.fct.2019.111083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/22/2019] [Accepted: 12/23/2019] [Indexed: 01/01/2023]
Abstract
Prenatal ethanol exposure induces developmental toxicities of multiple organs in offspring. Here, we investigate the effects of prenatal ethanol exposure on bone mass in postnatal offspring and explore its intrauterine programming mechanism. We found that prenatal ethanol exposure could induce bone dysplasia in fetuses and postnatal osteopenia in female offspring, accompanied by the sustained activation of the local renin-angiotensin systems (RAS) and inhibition of bone formation. Additionally, we also found that histone 3 lysine 9 acetylation (H3K9ac) and H3K27ac levels in the promoter region of angiotensin-converting enzyme (ACE) were increased in female offspring exposed to ethanol during pregnancy. In vitro, ethanol suppressed the formation of mineralized nodules and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), which was blocked by enalapril. Furthermore, ethanol promoted the expression and nuclear translocation of early growth response factor 1 (Egr1), which participated in the promotion of histone acetylation of ACE and subsequent RAS activation, by recruiting p300 and binding to the ACE promoter region directly. These findings indicate that the sustained activation of the local RAS might participate in bone dysplasia in fetus and postnatal osteopenia in the female offspring, while the Egr1/p300/ACE signal might be a key promoter of the sustained activation of the local RAS of the long bone.
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Affiliation(s)
- Zhixin Wu
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Zhengqi Pan
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Yinxian Wen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Hao Xiao
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Yangfan Shangguan
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Hui Wang
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China; Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China.
| | - Liaobin Chen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
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12
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Mulinari-Santos G, Santos JSD, Palin LP, Silva ACED, Antoniali C, Faverani LP, Okamoto R. Losartan improves alveolar bone dynamics in normotensive rats but not in hypertensive rats. J Appl Oral Sci 2019; 27:e20180574. [PMID: 31596365 PMCID: PMC6768119 DOI: 10.1590/1678-7757-2018-0574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 04/09/2019] [Indexed: 12/14/2022] Open
Abstract
Hypertension is one of the main causes of premature death in the world; also, it is associated with several bone alterations. Preclinical studies have demonstrated delayed alveolar bone healing in hypertensive rats. However, losartan has been favorable for consolidation of bone grafts and reduction in active periodontitis. Therefore, losartan is suggested to be effective in bone formation stages, as well as in the synthesis of matrix proteins and mineralization.
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Affiliation(s)
- Gabriel Mulinari-Santos
- Universidade Estadual Paulista - UNESP, Departmento de Cirurgia e Clínica Integrada, Faculdade de Odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Jaqueline Silva Dos Santos
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Letícia Pitol Palin
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Ana Cláudia Ervolino da Silva
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Cristina Antoniali
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Leonardo Perez Faverani
- Universidade Estadual Paulista - UNESP, Departmento de Cirurgia e Clínica Integrada, Faculdade de Odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Roberta Okamoto
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil.,Affiliated with Research productivity scholarship (Process:306389/2017-7)
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13
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Rody WJ, Chamberlain CA, Emory-Carter AK, McHugh KP, Wallet SM, Spicer V, Krokhin O, Holliday LS. The proteome of extracellular vesicles released by clastic cells differs based on their substrate. PLoS One 2019; 14:e0219602. [PMID: 31291376 PMCID: PMC6619814 DOI: 10.1371/journal.pone.0219602] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/27/2019] [Indexed: 12/29/2022] Open
Abstract
Extracellular vesicles (EVs) from osteoclasts are important regulators in intercellular communication. Here, we investigated the proteome of EVs from clastic cells plated on plastic (clasts), bone (osteoclasts) and dentin (odontoclasts) by two-dimensional high performance liquid chromatography mass spectrometry seeking differences attributable to distinct mineralized matrices. A total of 1,952 proteins were identified. Of the 500 most abundant proteins in EVs, osteoclast and odontoclast EVs were 83.3% identical, while clasts shared 70.7% of the proteins with osteoclasts and 74.2% of proteins with odontoclasts. For each protein, the differences between the total ion count values were mapped to an expression ratio histogram (Z-score) in order to detect proteins differentially expressed. Stabilin-1 and macrophage mannose receptor-1 were significantly-enriched in EVs from odontoclasts compared with osteoclasts (Z = 2.45, Z = 3.34) and clasts (Z = 13.86, Z = 1.81) and were abundant in odontoclast EVs. Numerous less abundant proteins were differentially-enriched. Subunits of known protein complexes were abundant in clastic EVs, and were present at levels consistent with them being in assembled protein complexes. These included the proteasome, COP1, COP9, the T complex and a novel sub-complex of vacuolar H+-ATPase (V-ATPase), which included the (pro) renin receptor. The (pro) renin receptor was immunoprecipitated using an anti-E-subunit antibody from detergent-solubilized EVs, supporting the idea that the V-ATPase subunits present were in the same protein complex. We conclude that the protein composition of EVs released by clastic cells changes based on the substrate. Clastic EVs are enriched in various protein complexes including a previously undescribed V-ATPase sub-complex.
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Affiliation(s)
- Wellington J. Rody
- Department of Orthodontics and Pediatric Dentistry, Stony Brook University School of Dental Medicine, Stony Brook, NY, United States of America
- * E-mail: (WJR); (LSH)
| | - Casey A. Chamberlain
- Department of Orthodontics, University of Florida College of Dentistry, Gainesville, FL, United States of America
| | - Alyssa K. Emory-Carter
- Department of Orthodontics, University of Florida College of Dentistry, Gainesville, FL, United States of America
| | - Kevin P. McHugh
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, United States of America
| | - Shannon M. Wallet
- School of Dental Medicine, East Carolina University, Greenville, NC, United States of America
| | - Victor Spicer
- Manitoba Center for Proteomics and Systems Biology, Winnipeg, MB, Canada
| | - Oleg Krokhin
- Manitoba Center for Proteomics and Systems Biology, Winnipeg, MB, Canada
| | - L. Shannon Holliday
- Department of Orthodontics and Pediatric Dentistry, Stony Brook University School of Dental Medicine, Stony Brook, NY, United States of America
- Department of Anatomy & Cell Biology, University of Florida College of Medicine, Gainesville, FL, United States of America
- * E-mail: (WJR); (LSH)
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14
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Santhosh S, Mukherjee D, Anbu J, Murahari M, Teja BV. Improved treatment efficacy of risedronate functionalized chitosan nanoparticles in osteoporosis: formulation development, in vivo, and molecular modelling studies. J Microencapsul 2019; 36:338-355. [DOI: 10.1080/02652048.2019.1631401] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Shivalingappa Santhosh
- Department of Pharmacology, M. S. Ramaiah University of Applied Sciences, Bengaluru, India
| | - Dhrubojyoti Mukherjee
- Department of Pharmaceutics, M.S. Ramaiah University of Applied Sciences, Bengaluru, India
| | - Jayaraman Anbu
- Department of Pharmacology, M. S. Ramaiah University of Applied Sciences, Bengaluru, India
| | - Manikanta Murahari
- Pharmacological Modelling and Simulation Centre, M. S. Ramaiah University of Applied Sciences, Bengaluru, India
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15
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Zhao J, Yang H, Chen B, Zhang R. The skeletal renin-angiotensin system: A potential therapeutic target for the treatment of osteoarticular diseases. Int Immunopharmacol 2019; 72:258-263. [PMID: 31003003 DOI: 10.1016/j.intimp.2019.04.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 02/07/2023]
Abstract
The classical renin-angiotensin system (RAS) is known to be a key regulator of blood pressure as well as fluid and electrolyte homeostasis. Additionally, it is now evident that components of the RAS are produced and act locally in many tissues, including liver, kidney, heart, lung, eye, bone, reproductive organ, adipose, and adrenal tissue, and these components are collectively known as tissue RAS. Recently, several studies have shown that local bone RAS is directly involved in bone metabolism, and activation of skeletal RAS plays an important role in bone diseases, such as osteoporosis, arthritis, and deterioration as well as in fracture healing. Based on the identification of RAS components in bone, we examined a new therapeutic approach to attenuate bone diseases through RAS inhibitors: renin inhibitor, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. In this paper, we provide a systematic review of the skeletal RAS in the pathophysiology of bone diseases and the beneficial effect of RAS inhibitors on bone tissue.
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Affiliation(s)
- Jingjing Zhao
- Translational Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China.
| | - Hao Yang
- Translational Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China
| | - Bo Chen
- Translational Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China
| | - Rui Zhang
- Translational Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China
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16
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Wen Y, Shangguan Y, Pan Z, Hu H, Magdalou J, Chen L, Wang H. Activation of local bone RAS by maternal excessive glucocorticoid participated in the fetal programing of adult osteopenia induced by prenatal caffeine exposure. Toxicol Appl Pharmacol 2018; 363:1-10. [PMID: 30423288 DOI: 10.1016/j.taap.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 11/15/2022]
Abstract
This study was aimed to investigate whether and how prenatal caffeine exposure (PCE) could induce osteopenia in the adult offspring. Pregnant rats were treated with prenatal caffeine 12 mg/100 g body weight per day from pregnant day 9 to 20, while rat bone marrow mesenchymal stem cells (BMSCs) were treated with exogenous corticosterone during osteogenic induction. Shorter femur and primary ossification center was observed in the PCE offspring, as well as less bone trabecular and poor biomechanical intensity. Local gene expression of glucocorticoid receptor (GR) and angiotensin converting enzyme (ACE), as well as angiotensin 2 content, was found to be stimulated, while the expression of bone gamma-carboxyglutamate protein (BGLAP), alkaline phosphatase (ALP) and bone sialoprotein (BSP) was found to be suppressed, with hypomethylation of ACE promoter. Corticosterone (1250 nM) suppressed osteogenic differentiation of BMSCs and gene expression of BGLAP, ALP and BSP, which was attenuated by enalapril, while it stimulated ACE mRNA expression and induced hypomethylation of ACE promoter, which was attenuated by mifepristone. It indicated that PCE caused bone growth retardation and adult osteopenia in offspring, which might be triggered by the activation of local RAS induced by excessive maternal glucocorticoid, while the hypomethylation of ACE gene might be the key point of the sustained activation of the local RAS.
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Affiliation(s)
- Yinxian Wen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Yangfan Shangguan
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Zhengqi Pan
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Hang Hu
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | | | - Liaobin Chen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
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17
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Mukherjee D, Srinivasan B, Anbu J, Azamthulla M, Banala VT, Ramachandra SG. Improvement of bone microarchitecture in methylprednisolone induced rat model of osteoporosis by using thiolated chitosan-based risedronate mucoadhesive film. Drug Dev Ind Pharm 2018; 44:1845-1856. [PMID: 30028215 DOI: 10.1080/03639045.2018.1503297] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE In this study, we investigated the potential of thiolated chitosan-based mucoadhesive film, loaded with risedronate sodium in the treatment of osteoporosis. SIGNIFICANCE Risedronate sodium is a bisphosphonate derivative having very low bioavailability when administered through the oral route. Moreover, the adverse effects associated with the drug when administered through GIT necessitate an alternative and feasible route which can improve its bioavailability and therapeutic efficacy. METHODS Thiolation of chitosan was interpreted by different analytical techniques. The mucoadhesive films were prepared by the solvent evaporation method and evaluated for drug content analysis, swelling degree, mucoadhesive parameters, and permeation characterization. For the screening of preclinical efficacy and pharmacodynamic parameters, a methylprednisolone induced osteoporotic rat model was used. The trabecular microarchitecture and biochemical markers were evaluated for determination of bone resorption. RESULTS The different analytical characterization of synthesized thiolated chitosan revealed that chitosan was successfully incorporated with thiol groups. The formulation containing 2:1 ratio of thiolated chitosan and HPMC-4KM was found to have the maximum swelling degree, mucoadhesive strength with a good force of adhesion and better in vitro permeability compared to the marketed formulation. With respect to trabecular microarchitecture, the drug-loaded film formulation showed superior and promising results. Furthermore, the film formulation also improved the serum level of biomarkers better than the marketed formulation. CONCLUSIONS The results significantly suggest that risedronate loaded novel mucoadhesive film formulation could be a logical approach in the therapeutic intervention of osteoporosis.
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Affiliation(s)
- Dhrubojyoti Mukherjee
- a Department of Pharmaceutics , M. S. Ramaiah University of Applied Sciences , Bengaluru , India
| | - Bharath Srinivasan
- a Department of Pharmaceutics , M. S. Ramaiah University of Applied Sciences , Bengaluru , India
| | - J Anbu
- b Department of Pharmacology , M. S. Ramaiah University of Applied Sciences , Bengaluru , India
| | - Mohammad Azamthulla
- b Department of Pharmacology , M. S. Ramaiah University of Applied Sciences , Bengaluru , India
| | | | - S G Ramachandra
- d Central Animal Facility , Indian Institute of Science , Bengaluru , India
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18
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Fabris ALDS, Mulinari-Santos G, Hassumi JS, Freire AR, Faverani LP, Gruber R, Okamoto R. Morphometric and histologic characterization of alveolar bone from hypertensive patients. Clin Implant Dent Relat Res 2017; 19:1106-1113. [DOI: 10.1111/cid.12548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 09/08/2017] [Accepted: 09/22/2017] [Indexed: 11/29/2022]
Affiliation(s)
- André Luís da Silva Fabris
- Department of Surgery and Integrated Clinic; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Gabriel Mulinari-Santos
- Department of Surgery and Integrated Clinic; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Jaqueline Suemi Hassumi
- Division of Anatomy, Department of Basic Science; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Alexandre Rodrigues Freire
- Department of Morphology; Piracicaba Dental School, State University of Campinas; Piracicaba São Paulo Brazil
| | - Leonardo Perez Faverani
- Department of Surgery and Integrated Clinic; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry; Medical University of Vienna; Vienna Austria
- Department of Periodontology, School of Dental Medicine; University of Bern; Bern Switzerland
| | - Roberta Okamoto
- Division of Anatomy, Department of Basic Science; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
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19
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Kunutsor SK, Blom AW, Whitehouse MR, Kehoe PG, Laukkanen JA. Renin-angiotensin system inhibitors and risk of fractures: a prospective cohort study and meta-analysis of published observational cohort studies. Eur J Epidemiol 2017; 32:947-959. [PMID: 28752198 PMCID: PMC5684291 DOI: 10.1007/s10654-017-0285-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 07/12/2017] [Indexed: 12/28/2022]
Abstract
The renin-angiotensin system (RAS) represents an important target of antihypertensive medications. Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB), which are widely-used RAS inhibiting drugs, have been suggested to have beneficial effects on bone tissue. We aimed to assess the associations of use of ACEIs and/or ARBs with the risk of fractures using a population-based prospective cohort and a meta-analysis of published prospective cohort studies. Information on antihypertensive medication use (including both ACEIs and ARBs) were assessed in 1743 men and women of the Kuopio Ischemic Heart Disease prospective cohort study. Hazard ratios (HRs) [95% confidence intervals (CI)] of ACEIs or ARBs use with incident fractures were calculated. A total of 203 composite (hip, humeral, and wrist) fractures occurred during a median follow-up of 14.8 years. In multivariate adjusted analysis, the HR for composite fractures comparing users of ACEIs or ARBs with non-users was 1.00 (0.59-1.69). The corresponding adjusted HR for hip fractures comparing users versus non-users of ACEIs or ARBs was 0.89 (0.32-2.47). Including the current study, a total of 11 observational cohort studies involving 3526,319 participants and >323,355 fractures were included in a meta-analysis. Comparing ACEI users with non-users and ARB users with non-users, the HRs for composite fractures were 1.09 (0.89-1.33) and 0.87 (0.76-1.01) respectively. The corresponding HRs for hip fractures were 0.91 (0.86-0.95) and 0.80 (0.75-0.85) respectively. Use of RAS inhibitors was not associated with long-term risk of composite fractures in both primary and pooled analyses. Pooled evidence however suggests a beneficial effect of RAS blockers on hip fracture risk.
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Affiliation(s)
- Setor K Kunutsor
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Learning and Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
| | - Ashley W Blom
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Learning and Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Michael R Whitehouse
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Learning and Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Patrick G Kehoe
- Dementia Research Group, School of Clinical Sciences, Faculty of Health Sciences, University of Bristol, Learning and Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, UK
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Internal Medicine, Central Finland Central Hospital, Jyväskylä, Finland
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20
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Abuohashish HM, Ahmed MM, Sabry D, Khattab MM, Al-Rejaie SS. The ACE-2/Ang1-7/Mas cascade enhances bone structure and metabolism following angiotensin-II type 1 receptor blockade. Eur J Pharmacol 2017; 807:44-55. [DOI: 10.1016/j.ejphar.2017.04.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 12/22/2022]
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21
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Abuohashish HM, Ahmed MM, Sabry D, Khattab MM, Al-Rejaie SS. Angiotensin (1-7) ameliorates the structural and biochemical alterations of ovariectomy-induced osteoporosis in rats via activation of ACE-2/Mas receptor axis. Sci Rep 2017; 7:2293. [PMID: 28536469 PMCID: PMC5442122 DOI: 10.1038/s41598-017-02570-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 04/12/2017] [Indexed: 12/19/2022] Open
Abstract
The local and systemic renin angiotensin system (RAS) influences the skeletal system micro-structure and metabolism. Studies suggested angiotensin 1-7 (Ang(1-7)) as the beneficial RAS molecule via Mas receptor activation. This study examines the function of Ang(1-7) in bone micro-architecture and metabolism in an ovariectomized (OVX) rodent model of osteoporosis. OVX rats showed structural and bone metabolic degeneration in parallel with suppressed expressions of the angiotensin converting enzyme-2 (ACE-2)/Ang(1-7)/Mas components. The infusion of Ang(1-7) markedly alleviated the altered bone metabolism and significantly enhanced both trabecular (metaphyseal) and cortical (metaphyseal-diaphyseal) morphometry. Urinary and bones minerals were also improved in OVX rats by Ang(1-7). The infusion of the heptapeptide enhanced ACE-2/Mas receptor expressions, while down-regulated AngII, ACE, and AngII type-1 receptor (AT1R) in OVX animals. Moreover, Ang(1-7) markedly improved osteoprotegerin (OPG) and lowered receptor activator NF-κB ligand (RANKL) expressions. The defensive properties of Ang(1-7) on bone metabolism, structure and minerals were considerably eradicated after blockage of Mas receptor with A-779. Ang(1-7)-induced up-regulated ACE-2/Ang(1-7)/Mas cascade and OPG expressions were abolished and the expressions of ACE/AngII/AT1R and RANKL were provoked by A-779. These findings shows for the first time the novel valuable therapeutic role of Ang(1-7) on bone health and metabolism through the ACE-2/Mas cascade.
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Affiliation(s)
- Hatem M Abuohashish
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. .,Department of Biomedical Dental Sciences, College of Dentistry, University of Dammam, Dammam, Saudi Arabia.
| | - Mohammed M Ahmed
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Dina Sabry
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mahmoud M Khattab
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Salim S Al-Rejaie
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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22
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Shen L, Ma C, Shuai B, Yang Y. Effects of 1,25-dihydroxyvitamin D 3 on the local bone renin-angiotensin system in a murine model of glucocorticoid-induced osteoporosis. Exp Ther Med 2017; 13:3297-3304. [PMID: 28587403 PMCID: PMC5450694 DOI: 10.3892/etm.2017.4404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 02/10/2017] [Indexed: 12/12/2022] Open
Abstract
Active vitamin D is closely related to the circulating renin-angiotensin system (RAS) in experimental animal models and humans; however, corresponding local bone data remain limited. The present study examined whether 1,25-dihydroxyvitamin D3 supplementation altered local bone RAS elements in a murine model of glucocorticoid-induced osteoporosis (GIOP). A total of 36 8-week-old mice were randomized into three equal-sized groups: The sham, GIOP and 1,25-dihydroxyvitamin D3 treatment groups. After 12 weeks, the cancellous bone microstructure of the third lumbar vertebra and left femur from the mice from each group were examined using micro-computed tomography. To access the impact of glucocorticoid use, the effect of 1,25-dihydroxyvitamin D3 on cancellous bone microstructure, the expression of bone turnover markers, circulation and expression of the main RAS components was assessed. Results demonstrated that bone volume fraction, trabecular number and trabecular thickness of the treatment and sham groups were significantly higher than the GIOP group (P<0.05). Furthermore, the structure model index, trabecular separation and bone surface to bone volume ratio of the sham and treatment groups were significantly reduced compared with the GIOP group (P<0.05). All assessed parameters exhibited no significant differences between the treatment and sham groups. mRNA expression levels of local bone angiotensin type 1 and 2 receptors and receptor activator of nuclear factor-κB ligand were significantly lower in the treatment group than in the GIOP group (P<0.05); however, there were no significant differences in circulating protein levels between the groups (P>0.05). In conclusion, 1,25-dihydroxyvitamin D3 may modulate bone metabolism by downregulating the local bone RAS in mice with GIOP.
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Affiliation(s)
- Lin Shen
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Chen Ma
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Bo Shuai
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Yanping Yang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
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Donmez BO, Unal M, Ozdemir S, Ozturk N, Oguz N, Akkus O. Effects of losartan treatment on the physicochemical properties of diabetic rat bone. J Bone Miner Metab 2017; 35:161-170. [PMID: 27038987 DOI: 10.1007/s00774-016-0748-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 02/22/2016] [Indexed: 01/22/2023]
Abstract
Inhibitors of the renin-angiotensin system used to treat several diseases have also been shown to be effective on bone tissue, suggesting that angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may reduce fracture risk. The present study investigated the effects of losartan on the physicochemical and biomechanical properties of diabetic rat bone. Losartan (5 mg/kg/day) was administered via oral gavage for 12 weeks. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Whole femurs were tested under tension to evaluate the biomechanical properties of bone. The physicochemical properties of bone were analyzed by Fourier transform infrared spectroscopy. Although losartan did not recover decreases in the BMD of diabetic bone, it recovered the physicochemical (mineral and collagen matrix) properties of diabetic rat bone. Furthermore, losartan also recovered ultimate tensile strength of diabetic rat femurs. Losartan, an angiotensin II type 1 receptor blocker, has a therapeutic effect on the physicochemical properties of diabetic bone resulting in improvement of bone strength at the material level. Therefore, specific inhibition of this pathway at the receptor level shows potential as a therapeutic target for diabetic patients suffering from bone diseases such as osteopenia.
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Affiliation(s)
- Baris Ozgur Donmez
- Department of Nutrition and Dietetics, School of Health, Akdeniz University, 07070, Antalya, Turkey.
| | - Mustafa Unal
- Department of Mechanical and Aerospace Engineering, Orthopaedic Bioengineering Laboratories, Case Western Reserve University, Cleveland, OH, USA
| | - Semir Ozdemir
- Department of Biophysics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Nihal Ozturk
- Department of Biophysics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Nurettin Oguz
- Department of Anatomy, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ozan Akkus
- Department of Mechanical and Aerospace Engineering, Orthopaedic Bioengineering Laboratories, Case Western Reserve University, Cleveland, OH, USA
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Ethnomedicine based evaluation of osteoprotective properties of Tinospora cordifolia on in vitro and in vivo model systems. Biomed Pharmacother 2017; 87:342-354. [DOI: 10.1016/j.biopha.2016.12.094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/07/2016] [Accepted: 12/22/2016] [Indexed: 11/19/2022] Open
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Kwok T, Leung J, Barrett-Connor E. ARB users exhibit a lower fracture incidence than ACE inhibitor users among older hypertensive men. Age Ageing 2017; 46:57-64. [PMID: 28181652 DOI: 10.1093/ageing/afw150] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 06/27/2016] [Indexed: 11/14/2022] Open
Abstract
Introduction Angiotensin II, a major effector protein of the renin angiotensin system (RAS), induces bone loss under certain conditions. Drugs that block the RAS may therefore reduce bone loss and fracture incidence. The fracture incidence in older hypertensive men with long-term use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) were compared with the incidence in users of calcium channel blockers (CCBs) and non-users. Methods A total of 5,994 US men aged 65 years or older who had bone mineral density measured at baseline in the Osteoporotic Fractures in Men Study (MrOS) were followed for fracture incidence for an average of 6.8 years. Men with follow-up dual-energy X-ray absorptiometry bone mineral density data and who reported hypertension at any visit, or use of antihypertensive medications at any visit among those with non-missing mediation data were included in the study (N = 2,573). Results Six hundred and nineteen men had taken ACE inhibitors, while 182 took ARBs for at least 4 years. Using Cox regression for the incidence of non-vertebral fractures, we found that long-term users of ACE inhibitors and ARBs each had a significantly lower fracture incidence than non-users. The hazard ratio of non-vertebral fractures was three times lower in ARB users than ACE inhibitor users (Hazard ratio (95% confidence interval): 0.194 (0.079–0.474) versus 0.620 (0.453–0.850), P = 0.0168). There was a trend of greater fracture risk reduction with longer duration of ARB use, but not for ACE inhibitor use. Conclusions In older hypertensive men, ARBs use was associated with lower incidence of non-vertebral fracture than ACE inhibitors or CCBs.
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Affiliation(s)
- Timothy Kwok
- Department of Medicine & Therapeutics, the Chinese University of Hong Kong
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, the Chinese University of Hong Kong
| | - Elizabeth Barrett-Connor
- Division of Epidemiology, Department of Family Medicine and Public Health, School of Medicine, University of California
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Zhang Y, Wang L, Liu JX, Wang XL, Shi Q, Wang YJ. Involvement of skeletal renin-angiotensin system and kallikrein-kinin system in bone deteriorations of type 1 diabetic mice with estrogen deficiency. J Diabetes Complications 2016; 30:1419-1425. [PMID: 27614725 DOI: 10.1016/j.jdiacomp.2016.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 07/21/2016] [Accepted: 08/19/2016] [Indexed: 01/06/2023]
Abstract
AIMS This study was aimed to investigate the involvement of skeletal renin-angiotensin system (RAS) and kallikrein-kinin system (KKS) in bone deteriorations of mice in response to the combination treatment of estrogen deficiency and hyperglycemia. METHODS The female C57BL/6J mice were sham-operated or ovariectomized with vehicle or streptozotocin (STZ) treatment. Two weeks later, the biochemistries in serum and urine were determined by standard colorimetric methods or ELISA. The H&E and TRAP staining were performed at the tibial proximal metaphysis. The polymerase chain reaction and immunoblotting were applied for molecular analysis on mRNA and protein expression. RESULTS The mice after treating with ovariectomy and STZ showed the decreased level of serum Ca and the increased level of serum PTH and urine Ca. The H&E staining showed trabecular bone abnormalities as demonstrated by the loss, disconnection and separation of trabecular bone network as well as the loss of chondrocytes and appearance of chondrocyte cluster at growth plate of tibia. The significant increase of matured osteoclast number was shown in group with double treatments. The combination treatment significantly up-regulated mRNA expression of AGT, ACE, renin receptor, MMP-9 and CAII, and protein expression of renin, and decreased the ratio of OPG/RANKL and the expression of bradykinin receptors in bone tissue. CONCLUSION Ovariectomy combined with STZ induction produced more detrimental actions on bone through the activation of local bone RAS and the down-regulation of bradykinin receptors, as compared to the respective single treatment.
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Affiliation(s)
- Yan Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
| | - Liang Wang
- Department of Orthopaedics, The 309th hospital of Chinese People's Liberation Army, Beijing 100091, China
| | - Jin-Xin Liu
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Xin-Luan Wang
- Translational Medicine R&D Center, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Qi Shi
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Yong-Jun Wang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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Kuipers AL, Kammerer CM, Pratt JH, Bunker CH, Wheeler VW, Patrick AL, Zmuda JM. Association of Circulating Renin and Aldosterone With Osteocalcin and Bone Mineral Density in African Ancestry Families. Hypertension 2016; 67:977-82. [PMID: 26975710 DOI: 10.1161/hypertensionaha.115.06837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/22/2016] [Indexed: 11/16/2022]
Abstract
Hypertension is associated with accelerated bone loss, and the renin-angiotensin-aldosterone system is a key regulator of blood pressure. Although components of this system are expressed in human bone cells, studies in humans are sparse. Thus, we studied the association of circulating renin and aldosterone with osteocalcin and bone mineral density. We recruited 373 African ancestry family members without regard to health status from 6 probands (mean family size: 62 and relative pairs: 1687). Participants underwent a clinical examination, dual-energy x-ray absorptiometry, and quantitative computed tomographic scans. Renin activity, aldosterone concentration, and osteocalcin were measured in fasting blood samples. Aldosterone/renin ratio was calculated as aldosterone concentration/renin activity. All models were analyzed using pedigree-based variance components methods. Full models included adjustment for age, sex, body composition, comorbidities, lifestyle factors, blood pressure, and antihypertensive medication. Higher renin activity was significantly associated with lower total osteocalcin and with higher trabecular bone mineral density (both P<0.01). There were also significant genetic correlations between renin activity and whole-body bone mineral density. There were no associations with aldosterone concentration in any model and results for aldosterone/renin ratio were similar to those for renin activity. This is the first study to report a significant association between renin activity and a marker of bone turnover and bone mineral density in generally healthy individuals. Also, there is evidence for significant genetic pleiotropy and, thus, there may be a shared biological mechanism underlying both the renin-angiotensin-aldosterone system and bone metabolism that is independent of hypertension.
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Affiliation(s)
- Allison L Kuipers
- From the Departments of Epidemiology (A.L.K., C.H.B., J.M.Z.) and Human Genetics (C.M.K., J.M.Z.), University of Pittsburgh, PA; Department of Medicine, Indiana University School of Medicine, Indianapolis (J.H.P.); and Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago (V.W.W., A.L.P.).
| | - Candace M Kammerer
- From the Departments of Epidemiology (A.L.K., C.H.B., J.M.Z.) and Human Genetics (C.M.K., J.M.Z.), University of Pittsburgh, PA; Department of Medicine, Indiana University School of Medicine, Indianapolis (J.H.P.); and Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago (V.W.W., A.L.P.)
| | - J Howard Pratt
- From the Departments of Epidemiology (A.L.K., C.H.B., J.M.Z.) and Human Genetics (C.M.K., J.M.Z.), University of Pittsburgh, PA; Department of Medicine, Indiana University School of Medicine, Indianapolis (J.H.P.); and Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago (V.W.W., A.L.P.)
| | - Clareann H Bunker
- From the Departments of Epidemiology (A.L.K., C.H.B., J.M.Z.) and Human Genetics (C.M.K., J.M.Z.), University of Pittsburgh, PA; Department of Medicine, Indiana University School of Medicine, Indianapolis (J.H.P.); and Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago (V.W.W., A.L.P.)
| | - Victor W Wheeler
- From the Departments of Epidemiology (A.L.K., C.H.B., J.M.Z.) and Human Genetics (C.M.K., J.M.Z.), University of Pittsburgh, PA; Department of Medicine, Indiana University School of Medicine, Indianapolis (J.H.P.); and Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago (V.W.W., A.L.P.)
| | - Alan L Patrick
- From the Departments of Epidemiology (A.L.K., C.H.B., J.M.Z.) and Human Genetics (C.M.K., J.M.Z.), University of Pittsburgh, PA; Department of Medicine, Indiana University School of Medicine, Indianapolis (J.H.P.); and Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago (V.W.W., A.L.P.)
| | - Joseph M Zmuda
- From the Departments of Epidemiology (A.L.K., C.H.B., J.M.Z.) and Human Genetics (C.M.K., J.M.Z.), University of Pittsburgh, PA; Department of Medicine, Indiana University School of Medicine, Indianapolis (J.H.P.); and Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago (V.W.W., A.L.P.)
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Zhang Y, Wang L, Song Y, Zhao X, Wong MS, Zhang W. Renin inhibitor aliskiren exerts beneficial effect on trabecular bone by regulating skeletal renin-angiotensin system and kallikrein-kinin system in ovariectomized mice. Osteoporos Int 2016; 27:1083-1092. [PMID: 26439241 DOI: 10.1007/s00198-015-3348-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/28/2015] [Indexed: 02/06/2023]
Abstract
SUMMARY The skeletal renin-angiotensin system contributes to the development of osteoporosis. The renin inhibitor aliskiren exhibited beneficial effects on trabecular bone of osteoporotic mice, and this action might be mediated through angiotensin and bradykinin receptor pathways. This study implies the potential application of renin inhibitor in the management for postmenopausal osteoporosis. INTRODUCTION The skeletal renin-angiotensin system plays key role in the pathological process of osteoporosis. The present study is designed to elucidate the effect of renin inhibitor aliskiren on trabecular bone and its potential action mechanism in ovariectomized (OVX) mice. METHODS The OVX mice were treated with low dose (5 mg/kg) or high dose (25 mg/kg) of aliskiren or its vehicle for 8 weeks. The bone turnover markers were measured by ELISA. The structural parameters of trabecular bone at lumbar vertebra (LV) and distal femoral metaphysis were measured by micro-CT. The expression of messenger RNA (mRNA) and protein was studied by RT-PCR and immunoblotting, respectively. RESULTS Aliskiren treatment reduced urinary excretion of calcium and serum level of tartrate-resistant acid phosphatase in OVX mice. The treatment with aliskiren significantly increased bone volume (BV/TV) and connectivity density (Conn.D) of trabecular bone at LV-2 and LV-5 as well as dramatically enhanced BV/TV, Conn.D, bone mineral density (BMD/BV) and decreased bone surface (BS/BV) at the distal femoral end. Aliskiren significantly down-regulated the expression of angiotensinogen, angiotensin II (Ang II), Ang II type 1 receptor, bradykinin receptor (BR)-1, and osteocytic-specific gene sclerostin as well as the osteoclast-specific genes, including carbonic anhydrase II, matrix metalloproteinase-9, and cathepsin K. CONCLUSIONS This study revealed that renin inhibitor aliskiren exhibited the beneficial effects on trabecular bone of ovariectomy-induced osteoporotic mice, and the underlying mechanism for this action might be mediated through Ang II and BR signaling pathways in bone.
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Affiliation(s)
- Y Zhang
- School of Pharmacy, Nantong University, Qixiu Road 19, Nantong, 226001, Jiangsu Province, China.
| | - L Wang
- Department of Orthopaedics, The 309th Hospital of Chinese People's Liberation Army, Beijing, 100091, China
| | - Y Song
- School of Pharmacy, Nantong University, Qixiu Road 19, Nantong, 226001, Jiangsu Province, China
| | - X Zhao
- School of Pharmacy, Nantong University, Qixiu Road 19, Nantong, 226001, Jiangsu Province, China
| | - M S Wong
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - W Zhang
- School of Pharmacy, Nantong University, Qixiu Road 19, Nantong, 226001, Jiangsu Province, China
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Noorafshan A, Dabbaghmanesh MH, Tanideh N, Koohpeyma F, Rasooli R, Hajihoseini M, Bakhshayeshkaram M, Hosseinabadi OK. Stereological study of the effect of black olive hydroalcoholic extract on osteoporosis in vertebra and tibia in ovariectomized rats. Osteoporos Int 2015; 26:2299-307. [PMID: 26174878 DOI: 10.1007/s00198-015-3126-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 04/01/2015] [Indexed: 01/18/2023]
Abstract
UNLABELLED A cocktail of many different antioxidants might be more effective than supplementation with a single molecule, and it closely resembles the natural environment in which active compounds were found. This is the first study well-grounded in stereological examination that showed that black olive extract effectively can ameliorate the quantitative changes of the bone structure and prevented bone loss in this osteoporosis animal model. INTRODUCTION The aim of this study was to quantitatively evaluate the effects of black olive extract consumption on treatment of ovariectomized (OVX) induced osteoporosis in rats. This is the first study well-grounded in stereological examination. METHODS Ninety adult rats were allocated to control, sham-operated, OVX, and olive-supplemented OVX groups (received 250-, 500-, and 750-mg/kg body weight black olive hydroalcoholic extract orally) for 16 weeks. At the end of the experiment, blood samples were collected, and plasma levels of calcium, phosphorus, and alkaline phosphatase were assayed. Then, the specimens from both the tibia and fifth lumbar vertebra (L5) bones were processed, and stereological analysis was performed. RESULTS Administration of extract resulted in decrease of alkaline phosphatase level during the treatment. After treatment of OVX rats with three doses of extract, the total number of the osteocytes revealed an increment in 500- and 750-mg/kg treated groups in comparison to the OVX group. This increment was significant only in L5. Compared to the OVX group, a significant increase was observed in the number of osteoblastsin L5 vertebra in three doses of extract-treated groups. However, this increment in tibia was statistically significant only in 750-mg/kg black olive hydroalcoholic extract-treated group. Moreover, the number of osteoclast cells were significantly decreased in vertebra and tibia in the treated groups compared to the OVX group (P < 0.05). CONCLUSION Black olive hydroalcoholic extract effectively can ameliorate the quantitative changes of the bone structure and prevented bone loss in this osteoporosis animal model. Thus, it can be a promising candidate for treatment of accelerated bone loss especially in postmenopausal osteoporosis.
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Affiliation(s)
- A Noorafshan
- Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
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Zhang FY, Yang FJ, Yang JL, Wang L, Zhang Y. Renin inhibition improves ovariectomy-induced osteoporosis of lumbar vertebra in mice. Biol Pharm Bull 2015; 37:1994-7. [PMID: 25590090 DOI: 10.1248/bpb.b14-00576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The skeletal renin–angiotensin system (RAS) is involved in the progression of osteoporosis and the active peptide within the RAS, angiotensin II (ANG II), has deleterious effects on bones. This study was performed to investigate whether suppression of the rate-limiting step of the RAS cascade by the renin inhibitor aliskiren has a benefit on trabecular bone in osteoporotic mice. A postmenopausal osteoporosis model was induced by bilateral ovariectomy. The ovariectomized (OVX) mice were treated with a low (5 mg/kg) or high (25 mg/kg) dose of aliskiren for 6 weeks. Micro-computed tomography was performed to detect trabecular bone parameters of lumbar vertebra and to obtain 3-dimensional (3D) images. Treatment with aliskiren markedly increased bone volume over total volume (p<0.05), trabecular bone number (p<0.05), connectivity density (p<0.05), and bone mineral density (p<0.05) and reduced trabecular bone separation (p<0.05) compared to vehicle-treated OVX mice. Similarly, the 3D images were consistent with the quantitative data that showed aliskiren could markedly reverse the ovariectomy-induced pathological changes of trabecular bone. Thus, this study indicated that the treatment of estrogen-deficient mice with aliskiren could markedly increase bone mass and improve trabecular bone structure, suggesting its potential application in treating postmenopausal osteoporosis.
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Affiliation(s)
- Fang-Yi Zhang
- Center for Systems Biomedical Sciences, University of Shanghai for Science and Technology; Shanghai 200093, China
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Relationship Between Aldosterone and Parathyroid Hormone, and the Effect of Angiotensin and Aldosterone Inhibition on Bone Health. Clin Rev Bone Miner Metab 2015. [DOI: 10.1007/s12018-015-9182-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chen S, Grover M, Sibai T, Black J, Rianon N, Rajagopal A, Munivez E, Bertin T, Dawson B, Chen Y, Jiang MM, Lee B, Yang T, Bae Y. Losartan increases bone mass and accelerates chondrocyte hypertrophy in developing skeleton. Mol Genet Metab 2015; 115:53-60. [PMID: 25779879 PMCID: PMC4426054 DOI: 10.1016/j.ymgme.2015.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 10/23/2022]
Abstract
Angiotensin receptor blockers (ARBs) are a group of anti-hypertensive drugs that are widely used to treat pediatric hypertension. Recent application of ARBs to treat diseases such as Marfan syndrome or Alport syndrome has shown positive outcomes in animal and human studies, suggesting a broader therapeutic potential for this class of drugs. Multiple studies have reported a benefit of ARBs on adult bone homeostasis; however, its effect on the growing skeleton in children is unknown. We investigated the effect of Losartan, an ARB, in regulating bone mass and cartilage during development in mice. Wild type mice were treated with Losartan from birth until 6 weeks of age, after which bones were collected for microCT and histomorphometric analyses. Losartan increased trabecular bone volume vs. tissue volume (a 98% increase) and cortical thickness (a 9% increase) in 6-weeks old wild type mice. The bone changes were attributed to decreased osteoclastogenesis as demonstrated by reduced osteoclast number per bone surface in vivo and suppressed osteoclast differentiation in vitro. At the molecular level, Angiotensin II-induced ERK1/2 phosphorylation in RAW cells was attenuated by Losartan. Similarly, RANKL-induced ERK1/2 phosphorylation was suppressed by Losartan, suggesting a convergence of RANKL and angiotensin signaling at the level of ERK1/2 regulation. To assess the effect of Losartan on cartilage development, we examined the cartilage phenotype of wild type mice treated with Losartan in utero from conception to 1 day of age. Growth plates of these mice showed an elongated hypertrophic chondrocyte zone and increased Col10a1 expression level, with minimal changes in chondrocyte proliferation. Altogether, inhibition of the angiotensin pathway by Losartan increases bone mass and accelerates chondrocyte hypertrophy in growth plate during skeletal development.
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Affiliation(s)
- Shan Chen
- Department of Biostatistics, University of Texas Health Science Center at Houston School of Public Health
| | - Monica Grover
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Tarek Sibai
- Boston University School of Medicine Orthopedic Surgery, Boston University, Boston, MA, USA
| | - Jennifer Black
- Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN, USA
| | - Nahid Rianon
- Department of Internal Medicine, University of Texas Medical School at Houston, TX, USA
| | - Abbhirami Rajagopal
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Elda Munivez
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Terry Bertin
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Brian Dawson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Yuqing Chen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Ming-Ming Jiang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Tao Yang
- Laboratory of Skeletal Biology, Center for Skeletal Disease and Tumor Metastasis, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Yangjin Bae
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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Shuai B, Yang YP, Shen L, Zhu R, Xu XJ, Ma C, Lv L, Zhao J, Rong JH. Local renin-angiotensin system is associated with bone mineral density of glucocorticoid-induced osteoporosis patients. Osteoporos Int 2015; 26:1063-71. [PMID: 25516362 DOI: 10.1007/s00198-014-2992-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 12/05/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED The local renin-angiotensin system (RAS) is closely related to bone metabolism. However, it is unknown whether the local RAS is related to bone mineral density (BMD) in glucocorticoid-induced osteoporosis (GIOP). Here, we revealed that the two main characteristics of GIOP might inhibit bone formation and enhance bone resorption. INTRODUCTION The aim of this study is to assess the expression of the main RAS components in the trabecular bone of lumbar vertebrae in GIOP and analyze the relationship between the major RAS components and BMD. METHODS We collected 96 inpatient cases of lumbar disc herniation from patients who underwent dual-energy X-ray absorptiometry examinations followed by surgical treatment in our hospital. Patients were divided into the GIOP group (n = 48) and control group (n = 48). The circulating and local expression levels of the main RAS components were examined. The correlation between the main RAS components and BMD was then analyzed. RESULTS The mRNA expression of local bone angiotensin type 1 and 2 receptors (AT1R and AT2R, respectively) and RANKL was higher in the GIOP group compared with the control group (p < 0.001), but there was no difference in the circulating protein levels between groups (p > 0.05). Multiple logistic regression analysis revealed that AT1R and AT2R expression and the RANKL/OPG ratio in local bone were negatively associated with BMD (p < 0.001, odds ratio (OR) 1.236, 95 % confidence interval (CI) 1.207-1.333; p < 0.001, OR 1.971, 95% CI 1.809-2.233; and p < 0.001, OR 1.676, 95% CI 1.546-1.845, respectively). CONCLUSION This study provides evidence that the role of local RAS is related to BMD in GIOP patients, and suggests that local RAS might influence RANKL/OPG signaling to modulate bone metabolism.
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Affiliation(s)
- B Shuai
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
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Choi HJ, Park C, Lee YK, Ha YC, Jang S, Shin CS. Risk of fractures in subjects with antihypertensive medications: A nationwide claim study. Int J Cardiol 2015; 184:62-67. [PMID: 25697872 DOI: 10.1016/j.ijcard.2015.01.072] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/16/2014] [Accepted: 01/26/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND The effect of antihypertensives on fracture has important clinical implications, since antihypertensives are frequently prescribed with lifelong exposure. This study aimed to compare risk of fracture between antihypertensive medication classes and non-users among adults. METHODS Nationwide claim data from January 1, 2007 to December 31, 2011 were analyzed. Among 8,315,709 subjects with antihypertensive prescriptions in nationwide medical claim database in South Korea, 528,522 subjects, who initiated single-drug antihypertensives or non-users, were analyzed. Subjects were classified as non-user, alpha-blocker (AB), angiotensin-converting-enzyme-inhibitor (ACEI), angiotensin-receptor-blocker (ARB), beta-blocker (BB), calcium-channel-blocker (CCB), and diuretic users. Subjects with combination antihypertensive medications were excluded. RESULTS A total of 16,805 fracture outcomes were observed during mean follow-up duration of 1.9 years. Fracture rate per 10,000 person-years varied significantly across type of antihypertensives, with ARB having the lowest rate (152.7, 95% confidence interval (CI) 145.4-160.4), and AB having the highest rate (323.7, 95% CI 237.4-441.4). Non-users had fracture rates (152.2, 95% CI 148.7-155.7) similar to ARB users. In models adjusting for age, gender, comorbidity score, diagnosis of diabetes, diagnosis of osteoporosis, osteoporosis treatment, and osteoporosis related diseases, AB users (adjusted hazard ratio (aHR)=2.26), ACEI users (aHR=1.68), diuretic users (aHR=1.45), CCB users (aHR=1.23), and BB users (aHR=1.15) showed significantly increased risk of fractures compared with non-users (P<0.05). Only the fracture risk of ARB users (aHR=1.00, 95% CI 0.95-1.05) was not significantly different from the non-users. CONCLUSIONS The use of antihypertensives except for ARB is associated with increased risk of fracture, with ACEI and AB having higher risk among hypertensive adults.
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Affiliation(s)
- Hyung Jin Choi
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Chanmi Park
- Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Sunmee Jang
- College of Pharmacy Gachon University, Incheon, Republic of Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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The Effect of Phospholipids (Surfactant) on Adhesion and Biomechanical Properties of Tendon: A Rat Achilles Tendon Repair Model. BIOMED RESEARCH INTERNATIONAL 2015; 2015:689314. [PMID: 26101776 PMCID: PMC4458519 DOI: 10.1155/2015/689314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/22/2015] [Accepted: 03/30/2015] [Indexed: 12/05/2022]
Abstract
Adhesion of the tendon is a major challenge for the orthopedic surgeon during tendon repair. Manipulation of biological environment is one of the concepts to prevent adhesion. Lots of biochemicals have been studied for this purpose. We aimed to determine the effect of phospholipids on adhesion and biomechanical properties of tendon in an animal tendon repair model.
Seventy-two Wistar rats were divided into 4 groups. Achilles tendons of rats were cut and repaired. Phospholipids were applied at two different dosages. Tendon adhesion was determined histopathologically and biomechanical test was performed. At macroscopic evaluation of adhesion, there are statistically significant differences between multiple-dose phospholipid injection group and Control group and also hyaluronic acid group and Control group (p < 0.008). At microscopic evaluation of adhesion, there was no statistically significant difference (p > 0.008). Ultimate strength was highest at hyaluronic acid injection group and lowest at multiple-dose phospholipid injection group. Single-dose phospholipids (surfactant) application may have a beneficial effect on the tendon adhesion. Although multiple applications of phospholipids seem the most effective regime to reduce the tendon adhesion among groups, it deteriorated the biomechanical properties of tendon.
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Yongtao Z, Kunzheng W, Jingjing Z, Hu S, Jianqiang K, Ruiyu L, Chunsheng W. Glucocorticoids activate the local renin-angiotensin system in bone: possible mechanism for glucocorticoid-induced osteoporosis. Endocrine 2014; 47:598-608. [PMID: 24519760 DOI: 10.1007/s12020-014-0196-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 01/28/2014] [Indexed: 11/26/2022]
Abstract
Bone metabolism disorder has been identified to play a vital role in the pathogenesis of glucocorticoid-induced osteoporosis (GIOP). The local renin-angiotensin system (RAS) in bone is newly defined to be closely related to the bone metabolism. However, it is unknown whether the local RAS is involved in GIOP. Adult male New Zealand white rabbits were treated with saline, dexamethasone (DXM) alone, or DXM combined with perindopril. The expression of main RAS components in trabecular bone was examined at mRNA and/or protein levels. Bone metabolism was analyzed using dual-energy X-ray absorptiometry, histomorphometry, biomechanics, biochemical techniques, and quantitative RT-PCR. The expressions of local bone angiotensin II, angiotensin types 1 and 2 receptors, and angiotensin-converting enzyme at mRNA and/or protein levels increased when DXM-induced osteoporosis was present. Whereas, perindopril significantly blocked the activation of the local RAS and partially reversed GIOP. Mineralizing surface, mineral apposition rate, and bone formation rate were decreased by DXM, along with serum osteocalcin being downregulated. These changes were then reversed by the use of perindopril. Osteoclast number, osteoclast surface, and eroded surface increased after the administration of DXM, and urinary deoxypyridinoline was upregulated. These were also inhibited when perindopril was given. Quantitative RT-PCR using RNA isolated from the lumbar vertebrae revealed an increase in the SOST expression and a decrease in the Runx2 expression, whereas the receptor activator of nuclear factor-κB ligand/osteoprotegerin ratio and the expression of tartrate resistant acid phosphatase were increased, which were all inhibited by perindopril. The results of this study provide evidence for the role of local RAS is involved in GIOP, and GIOP may be ameliorated by blocking the activation of local RAS in the bone.
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Affiliation(s)
- Zhang Yongtao
- Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
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Butt DA, Mamdani M, Gomes T, Lix L, Lu H, Tu K. Risk of Osteoporotic Fractures With Angiotensin II Receptor Blockers Versus Angiotensin-Converting Enzyme Inhibitors in Hypertensive Community-Dwelling Elderly. J Bone Miner Res 2014; 29:2483-8. [PMID: 24806397 DOI: 10.1002/jbmr.2271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 04/18/2014] [Accepted: 04/30/2014] [Indexed: 01/11/2023]
Abstract
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are used to treat hypertension; however, in vivo and clinical studies suggest that ARBs and ACE inhibitors may exert different effects on bone. The association between long-term use of ARBs and ACE inhibitors and fracture requiring medical attention is limited. We conducted a population-based, retrospective cohort study with propensity score matching using administrative databases in Ontario, Canada, to examine the risk of osteoporosis-related fractures in hypertensive elderly treated with ARBs versus ACE inhibitors. We identified a cohort of newly treated hypertensive patients aged 66 years and older who initiated an ACE inhibitor from May 1, 2004, to March 31, 2012, and matched them to ARB users on propensity score, sex, and age at drug initiation. The primary outcome was hip fracture, and secondary outcomes were non-hip major osteoporotic fractures (other femoral, clinical vertebral, forearm, wrist, humerus) and other osteoporotic fractures (pelvis, clavicle, patella, shoulder, upper arm, tibia, fibula, ankle, scapula, ribs, sternum, trunk). We calculated hazard ratios (HRs) using Cox proportional hazards model with robust standard errors. Of the 87,635 patients who initiated treatment, 28,819 (32.9%) started ARBs and 58,816 (67.1%) started ACE inhibitors. Among new ARB users, 27,815 (96.5%) were successfully matched to ACE inhibitor users. Without dose adjustment, no significant association was observed for ARBs relative to ACE inhibitor users for hip fractures (HR = 0.88; 95% confidence interval [CI] 0.70-1.11), with a decreased risk of other major osteoporotic fractures (HR = 0.81; CI 0.70-0.93) and no significant association for other osteoporotic fractures (HR = 0.88; CI 0.74-1.05). When adjusted for dosage, there was no significant difference between the effects of ARBs and ACE inhibitors on hip (HR = 0.99; CI 0.78-1.25), other major osteoporotic (HR = 0.87; CI 0.75-1.01), and other osteoporotic fractures (HR = 0.90; CI 0.74-1.08).
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Affiliation(s)
- Debra A Butt
- Department of Family and Community Medicine, University of Toronto, Research Department, Toronto, Canada; Family and Community Medicine, The Scarborough Hospital, Scarborough, Canada
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Skov J, Persson F, Frøkiær J, Christiansen JS. Tissue Renin-Angiotensin systems: a unifying hypothesis of metabolic disease. Front Endocrinol (Lausanne) 2014; 5:23. [PMID: 24592256 PMCID: PMC3938116 DOI: 10.3389/fendo.2014.00023] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 02/13/2014] [Indexed: 01/11/2023] Open
Abstract
The actions of angiotensin peptides are diverse and locally acting tissue renin-angiotensin systems (RAS) are present in almost all tissues of the body. An activated RAS strongly correlates to metabolic disease (e.g., diabetes) and its complications and blockers of RAS have been demonstrated to prevent diabetes in humans. Hyperglycemia, obesity, hypertension, and cortisol are well-known risk factors of metabolic disease and all stimulate tissue RAS whereas glucagon-like peptide-1, vitamin D, and aerobic exercise are inhibitors of tissue RAS and to some extent can prevent metabolic disease. Furthermore, an activated tissue RAS deteriorates the same risk factors creating a system with several positive feedback pathways. The primary effector hormone of the RAS, angiotensin II, stimulates reactive oxygen species, induces tissue damage, and can be associated to most diabetic complications. Based on these observations, we hypothesize that an activated tissue RAS is the principle cause of metabolic syndrome and type 2 diabetes, and additionally is mediating the majority of the metabolic complications. The involvement of positive feedback pathways may create a self-reinforcing state and explain why metabolic disease initiate and progress. The hypothesis plausibly unifies the major predictors of metabolic disease and places tissue RAS regulation in the center of metabolic control.
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Affiliation(s)
- Jeppe Skov
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Novo Nordisk A/S, Bagsvaerd, Denmark
- *Correspondence: Jeppe Skov, Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Norrebrogade 44, Aarhus DK-8000, Denmark e-mail:
| | | | - Jørgen Frøkiær
- Department of Clinical Physiology and Molecular Imaging, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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