1
|
Cohen DJ, Lohmann CH, Scott KM, Olson LC, Boyan BD, Schwartz Z. Osseointegration and Remodeling of Mineralized Bone Graft Are Negatively Impacted by Prior Treatment with Bisphosphonates. J Bone Joint Surg Am 2022; 104:1750-1759. [PMID: 35983995 PMCID: PMC10007861 DOI: 10.2106/jbjs.21.01489] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Bisphosphonates limit resorption by inhibiting osteoclast formation and activation. They are removed during preparation of demineralized bone matrix (DBM) particles, but it is not known if osteogenesis and incorporation of mineralized bone allografts from patients treated with oral bisphosphonates are affected in vivo. METHODS Human block allografts from 3 bisphosphonate-treated donors and 3 age and sex-matched control donors who had not received bisphosphonates were obtained (Musculoskeletal Transplant Foundation); one-half from each donor was demineralized. In the first study, 3 × 2-mm mineralized and demineralized cylindrical grafts were implanted bilaterally in the femoral metaphysis of 56 rats. In the second study, samples from each group were pooled, prepared as particles, and implanted bilaterally in the femoral marrow canal of 24 rats. Osseointegration, defined as native bone in contact with allograft, was assessed at 10 weeks by micro-computed tomography (CT) and histomorphometry. RESULTS Micro-CT showed greater bone volume in sites treated with demineralized samples compared with the control mineralized and bisphosphonate-exposed mineralized samples. More new bone was generated along the cortical-endosteal interface compared with mineralized samples. Histology showed significantly less new bone in contact with the mineralized bisphosphonate-exposed allograft (10.4%) compared with mineralized samples that did not receive bisphosphonates (22.8%) and demineralized samples (31.7% and 42.8%). A gap was observed between native bone and allograft in the bisphosphonate-exposed mineralized samples (0.50 mm 2 ). The gap area was significantly greater compared with mineralized samples that did not receive bisphosphonates (0.16 mm 2 ) and demineralized samples (0.10 and 0.03 mm 2 ). CONCLUSIONS Mineralized allografts were osseointegrated, but not remodeled or replaced by living bone, preventing full regeneration of the bone defect. Prior treatment of the donor with bisphosphonates affected osteogenesis, preventing osteointegration and remodeling of the allograft into the regenerating bone. CLINICAL RELEVANCE Clinical use of mineralized allografts from patients who had received bisphosphonate therapy needs to be evaluated; in this animal model, such grafts were not integrated into the host bone or remodeled, and full regeneration of the bone defects was prevented.
Collapse
Affiliation(s)
- D Joshua Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Christoph H Lohmann
- Department of Orthopaedics, Otto-von-Guericke University, Magdeburg, Germany
| | - Kayla M Scott
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Lucas C Olson
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Barbara D Boyan
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia.,Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| |
Collapse
|
2
|
Heterotopic Ossification in Patients with Burns: a Systematic Literature Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00356-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
3
|
Hoemberg M, Schwenzfeur R, Berthold F, Simon T, Hero B. Hypercalcemia is a frequent side effect of 13-cis-retinoic acid treatment in patients with high-risk neuroblastoma. Pediatr Blood Cancer 2022; 69:e29374. [PMID: 34569150 DOI: 10.1002/pbc.29374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE 13-cis-Retinoic acid (13-cisRA) is used as a postconsolidation treatment in patients with high-risk neuroblastoma. Hypercalcemia is a known side effect of retinoids. Frequency, symptoms, treatment, and risk factors for hypercalcemia were analyzed. PATIENTS Data were retrospectively analyzed for 350 patients registered in the German Neuroblastoma trials NB97 and NB04 who were treated with high-risk protocols-including myeloablative chemotherapy with autologous stem cell transplantation (SCT) or maintenance therapy-and had received 13-cisRA between January 1, 2000 and December 31, 2010. RESULTS Hypercalcemia was reported in 78 patients (22.3%), and 37 patients (10.6%) developed Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4 hypercalcemia. The calcium levels were 2.5-4.6 mmol/L (median 3.1 mmol/L). Patients with a single kidney were at a higher risk of developing hypercalcemia (p = .001). Regarding postinduction treatment, 69 of 280 patients with SCT (24.6%) and nine of 70 patients without SCT (12.9%) developed hypercalcemia during 13-cisRA treatment (p = .037). Most patients developed hypercalcemia in the first cycle of 13-cisRA, and only in a single cycle. Hypercalcemia symptoms were frequent but moderate. In most patients, treatment with 13-cisRA was continued without dose reduction in subsequent cycles. CONCLUSION In this cohort, grades 3 and 4 hypercalcemia were observed more often than previously reported. A single kidney and pretreatment with myeloablative chemotherapy with stem cell transplantation were identified as potential risk factors for the development of hypercalcemia.
Collapse
Affiliation(s)
- Marc Hoemberg
- Department of Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Ruth Schwenzfeur
- Department of Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Frank Berthold
- Department of Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Thorsten Simon
- Department of Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Barbara Hero
- Department of Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| |
Collapse
|
4
|
Doyle KG, Blackstone MM, Barrett BC. Subacute Gummy Vitamin Overdose as a Rare Manifestation of Child Neglect. Pediatr Emerg Care 2021; 37:e479-e482. [PMID: 30624424 DOI: 10.1097/pec.0000000000001718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We present a case of a 20-month-old girl who presented to the emergency department with anorexia, progressive weakness, and lethargy who was found to have severe hypercalcemia (20.7 mg/dL) and vitamin D hypervitaminosis. Further questioning revealed that this was secondary to a subacute toxic ingestion of "L'il Critters" calcium and vitamin D3 gummy vitamins that were being administered by the patient's mother multiple times a day for several weeks or even months. This occurred in the setting of child neglect due to the mother's mental illness. The patient required intensive care unit admission and had a prolonged hospital course complicated by hypomagnesemia, hyperphosphatemia, weight loss, and persistent weakness. Her hypercalcemia was initially refractory to standard treatment of intravenous fluids, prednisone, multiple trials of calcitonin, and zoledronic acid. Our patient had the highest calcium level we are aware of in a toddler and is the only case we know of that occurred as a result of a prolonged, intentional exposure in the setting of child neglect and a complex social situation. This case reviews the causes and management of hypercalcemia and vitamin D intoxication. It also highlights the need for a comprehensive social history and exposes the vulnerabilities of children living in homes afflicted by parental depression and severe mental illness.
Collapse
Affiliation(s)
- Katherine G Doyle
- From the Department of Pediatrics, Children's Hospital of Philadelphia
| | | | - Brett C Barrett
- From the Department of Pediatrics, Children's Hospital of Philadelphia
| |
Collapse
|
5
|
Hedvičáková V, Žižková R, Buzgo M, Rampichová M, Filová E. The Effect of Alendronate on Osteoclastogenesis in Different Combinations of M-CSF and RANKL Growth Factors. Biomolecules 2021; 11:biom11030438. [PMID: 33809737 PMCID: PMC8035832 DOI: 10.3390/biom11030438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/16/2022] Open
Abstract
Bisphosphonates (BPs) are compounds resembling the pyrophosphate structure. BPs bind the mineral component of bones. During the bone resorption by osteoclasts, nitrogen-containing BPs are released and internalized, causing an inhibition of the mevalonate pathway. As a consequence, osteoclasts are unable to execute their function. Alendronate (ALN) is a bisphosphonate used to treat osteoporosis. Its administration could be associated with adverse effects. The purpose of this study is to evaluate four different ALN concentrations, ranging from 10−6 to 10−10 M, in the presence of different combinations of M-CSF and RANKL, to find out the effect of low ALN concentrations on osteoclastogenesis using rat and human peripheral blood mononuclear cells. The cytotoxic effect of ALN was evaluated based on metabolic activity and DNA concentration measurement. The alteration in osteoclastogenesis was assessed by the activity of carbonic anhydrase II (CA II), tartrate-resistant acid phosphatase staining, and actin ring formation. The ALN concentration of 10−6 M was cytotoxic. Low ALN concentrations of 10−8 and 10−10 M promoted proliferation, osteoclast-like cell formation, and CA II activity. The results indicated the induction of osteoclastogenesis with low ALN concentrations. However, when high doses of ALN were administered, their cytotoxic effect was demonstrated.
Collapse
Affiliation(s)
- Věra Hedvičáková
- Department of Tissue Engineering, Institute of Experimental Medicine, The Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic; (R.Ž.); (M.B.); (M.R.); (E.F.)
- Correspondence: ; Tel.: +420-241-062-387
| | - Radmila Žižková
- Department of Tissue Engineering, Institute of Experimental Medicine, The Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic; (R.Ž.); (M.B.); (M.R.); (E.F.)
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Studentska 1402/2, 461 17 Liberec, Czech Republic
| | - Matěj Buzgo
- Department of Tissue Engineering, Institute of Experimental Medicine, The Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic; (R.Ž.); (M.B.); (M.R.); (E.F.)
- InoCure, Politických Vězňů 935/13, 110 00 Praha, Czech Republic
| | - Michala Rampichová
- Department of Tissue Engineering, Institute of Experimental Medicine, The Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic; (R.Ž.); (M.B.); (M.R.); (E.F.)
| | - Eva Filová
- Department of Tissue Engineering, Institute of Experimental Medicine, The Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic; (R.Ž.); (M.B.); (M.R.); (E.F.)
| |
Collapse
|
6
|
Inhibition of RANKL-Induced Osteoclastogenesis by Novel Mutant RANKL. Int J Mol Sci 2021; 22:ijms22010434. [PMID: 33406741 PMCID: PMC7795528 DOI: 10.3390/ijms22010434] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Recently, it was reported that leucine-rich repeat-containing G-protein-coupled receptor 4 (LGR4, also called GPR48) is another receptor for RANKL and was shown to compete with RANK to bind RANKL and suppress canonical RANK signaling during osteoclast differentiation. The critical role of the protein triad RANK–RANKL in osteoclastogenesis has made their binding an important target for the development of drugs against osteoporosis. In this study, point-mutations were introduced in the RANKL protein based on the crystal structure of the RANKL complex and its counterpart receptor RANK, and we investigated whether LGR4 signaling in the absence of the RANK signal could lead to the inhibition of osteoclastogenesis.; Methods: The effects of point-mutated RANKL (mRANKL-MT) on osteoclastogenesis were assessed by tartrate-resistant acid phosphatase (TRAP), resorption pit formation, quantitative real-time polymerase chain reaction (qPCR), western blot, NFATc1 nuclear translocation, micro-CT and histomorphological assay in wild type RANKL (mRANKL-WT)-induced in vitro and in vivo experimental mice model. Results: As a proof of concept, treatment with the mutant RANKL led to the stimulation of GSK-3β phosphorylation, as well as the inhibition of NFATc1 translocation, mRNA expression of TRAP and OSCAR, TRAP activity, and bone resorption, in RANKL-induced mouse models; and Conclusions: The results of our study demonstrate that the mutant RANKL can be used as a therapeutic agent for osteoporosis by inhibiting RANKL-induced osteoclastogenesis via comparative inhibition of RANKL. Moreover, the mutant RANKL was found to lack the toxic side effects of most osteoporosis treatments.
Collapse
|
7
|
Kaur M, Nagpal M, Singh M. Osteoblast-n-Osteoclast: Making Headway to Osteoporosis Treatment. Curr Drug Targets 2020; 21:1640-1651. [DOI: 10.2174/1389450121666200731173522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/02/2020] [Accepted: 07/15/2020] [Indexed: 12/18/2022]
Abstract
Background:
Bone is a dynamic tissue that continuously undergoes the modeling and remodeling
process to maintain its strength and firmness. Bone remodeling is determined by the functioning
of osteoblast and osteoclast cells. The imbalance between the functioning of osteoclast and osteoblast
cells leads to osteoporosis. Osteoporosis is divided into primary and secondary osteoporosis.
Generally, osteoporosis is diagnosed by measuring bone mineral density (BMD) and various osteoblast
and osteoclast cell markers.
Methods:
Relevant literature reports have been studied and data has been collected using various
search engines like google scholar, scihub, sciencedirect, pubmed, etc. A thorough understanding of
the mechanism of bone targeting strategies has been discussed and related literature has been studied
and compiled.
Results:
Bone remodeling process has been described in detail including various approaches for targeting
bone. Several bone targeting moieties have been stated in detail along with their mechanisms.
Targeting of osteoclasts and osteoblasts using various nanocarriers has been discussed in separate sections.
The toxicity issues or Biosafety related to the use of nanomaterials have been covered.
Conclusion:
The treatment of osteoporosis targets the inhibition of bone resorption and the use of
agents that promote bone mineralization to slow disease progression. Current osteoporosis therapy involves
the use of targeting moieties such as bisphosphonates and tetracyclines for targeting various
drugs. Nanotechnology has been used for targeting various drug molecules such as RANKLinhibitors,
parathyroid hormone analogues, estrogen agonists and antagonists, Wnt signaling enhancer
and calcitonin specifically to bone tissue (osteoclast and osteoblasts). So, a multicomponent treatment
strategy targeting both the bone cells will be more effective rather than targeting only osteoclasts and
it will be a potential area of research in bone targeting used to treat osteoporosis.
The first section of the review article covers various aspects of bone targeting. Another section comprises
details of various targeting moieties such as bisphosphonates, tetracyclines; and various
nanocarriers developed to target osteoclast and osteoblast cells and summarized data on in vivo models
has been used for assessment of bone targeting, drawbacks of current strategies and future perspectives.
Collapse
Affiliation(s)
- Malkiet Kaur
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Manju Nagpal
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Manjinder Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| |
Collapse
|
8
|
Yuan W, Li Z, Xie X, Zhang ZY, Bian L. Bisphosphonate-based nanocomposite hydrogels for biomedical applications. Bioact Mater 2020; 5:819-831. [PMID: 32637746 PMCID: PMC7321771 DOI: 10.1016/j.bioactmat.2020.06.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
Nanocomposite hydrogels consist of polymeric network embedded with functional nanoparticles or nanostructures, which not only contribute to the enhanced mechanical properties but also exhibit the bioactivities for regulating cell behavior. Bisphosphonates (BPs) are capable of coordinating with various metal ions and modulating bone homeostasis. Thanks to the inherent dynamic properties of metal-ligand coordination bonds, BP-based nanocomposite hydrogels possess tunable mechanical properties, highly dynamic structures, and the capability to mediate controlled release of encapsulated therapeutic agents, thereby making them highly versatile for various biomedical applications. This review presents the comprehensive overview of recent developments in BP-based nanocomposite hydrogels with an emphasis on the properties of embedded nanoparticles (NPs) and interactions between hydrogel network and NPs. Furthermore, various challenges in the biomedical applications of these hydrogels are discussed to provide an outlook of potential clinical translation.
Collapse
Affiliation(s)
- Weihao Yuan
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong, 999077, PR China
| | - Zhuo Li
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong, 999077, PR China
| | - Xian Xie
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong, 999077, PR China
| | - Zhi-Yong Zhang
- Translational Research Centre of Regenerative Medicine and 3D Printing of Guangzhou Medical University, Guangdong Province Engineering Research Center for Biomedical Engineering, State Key Laboratory of Respiratory Disease, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Road, Liwan District, Guangzhou City, Guangdong Province, 510150, PR China
| | - Liming Bian
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong, 999077, PR China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, 518172, PR China
- Translational Research Centre of Regenerative Medicine and 3D Printing of Guangzhou Medical University, Guangdong Province Engineering Research Center for Biomedical Engineering, State Key Laboratory of Respiratory Disease, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Road, Liwan District, Guangzhou City, Guangdong Province, 510150, PR China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, Zhejiang, 310058, PR China
| |
Collapse
|
9
|
Albano CS, Moreira Gomes A, da Silva Feltran G, da Costa Fernandes CJ, Trino LD, Zambuzzi WF, Lisboa-Filho PN. Biofunctionalization of titanium surfaces with alendronate and albumin modulates osteoblast performance. Heliyon 2020; 6:e04455. [PMID: 32715131 PMCID: PMC7378701 DOI: 10.1016/j.heliyon.2020.e04455] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/08/2020] [Accepted: 07/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Biofunctionalization of titanium surfaces can improve host responses, especially considering the time for osteointegration and patient recovery. This prompted us to modify titanium surfaces with alendronate and albumin and to investigate the behavior of osteoblasts on these surfaces. METHODS The biofunctionalization of titanium surfaces was characterized using classical physicochemical approaches and later used to challenge pre-osteoblast cells up to 24 h. Then their viability and molecular behavior were investigated using mitochondrial dehydrogenase activity and RTq-PCR technologies, respectively. Potential stimulus of extracellular remodeling was also investigated by zymography. RESULTS Our data indicates a differential behavior of cells responding to the surfaces, considering the activity of mitochondrial dehydrogenases. Molecularly, the differential expression of genes related with cell adhesion highlighted the importance of Integrin-β1, Fak, and Src. These 3 genes were significantly decreased in response to titanium surfaces modified with alendronate, but this behavior was reverted when alendronate was associated with albumin. Alendronate-modified surfaces promoted a significant increase on ECM remodeling, as well as culminating with greater gene activity related to the osteogenic phenotype (Runx2, Alp, Bsp). CONCLUSION Altogether, our study found interesting osteogenic behavior of cells in response to alendronate and albumin surfaces, which indicates the need for in vivo analyses to better consider these surfaces before clinical trials within the biomedical field.
Collapse
Affiliation(s)
- Carolina Simão Albano
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
- Advanced Materials and Nanotechnology Laboratory – UNESP – São Paulo State University School of Sciences, Department of Physics, Bauru, Brazil
| | - Anderson Moreira Gomes
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Geórgia da Silva Feltran
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Célio Junior da Costa Fernandes
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Luciana Daniele Trino
- Advanced Materials and Nanotechnology Laboratory – UNESP – São Paulo State University School of Sciences, Department of Physics, Bauru, Brazil
| | - Willian Fernando Zambuzzi
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Paulo Noronha Lisboa-Filho
- Advanced Materials and Nanotechnology Laboratory – UNESP – São Paulo State University School of Sciences, Department of Physics, Bauru, Brazil
| |
Collapse
|
10
|
Larson-Casey JL, Vaid M, Gu L, He C, Cai GQ, Ding Q, Davis D, Berryhill TF, Wilson LS, Barnes S, Neighbors JD, Hohl RJ, Zimmerman KA, Yoder BK, Longhini ALF, Hanumanthu VS, Surolia R, Antony VB, Carter AB. Increased flux through the mevalonate pathway mediates fibrotic repair without injury. J Clin Invest 2020; 129:4962-4978. [PMID: 31609245 DOI: 10.1172/jci127959] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/13/2019] [Indexed: 12/22/2022] Open
Abstract
Macrophages are important in mounting an innate immune response to injury as well as in repair of injury. Gene expression of Rho proteins is known to be increased in fibrotic models; however, the role of these proteins in idiopathic pulmonary fibrosis (IPF) is not known. Here, we show that BAL cells from patients with IPF have a profibrotic phenotype secondary to increased activation of the small GTPase Rac1. Rac1 activation requires a posttranslational modification, geranylgeranylation, of the C-terminal cysteine residue. We found that by supplying more substrate for geranylgeranylation, Rac1 activation was substantially increased, resulting in profibrotic polarization by increasing flux through the mevalonate pathway. The increased flux was secondary to greater levels of acetyl-CoA from metabolic reprogramming to β oxidation. The polarization mediated fibrotic repair in the absence of injury by enhancing macrophage/fibroblast signaling. These observations suggest that targeting the mevalonate pathway may abrogate the role of macrophages in dysregulated fibrotic repair.
Collapse
Affiliation(s)
| | - Mudit Vaid
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - Linlin Gu
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - Chao He
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - Guo-Qiang Cai
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - Qiang Ding
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - Dana Davis
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - Taylor F Berryhill
- Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Landon S Wilson
- Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Stephen Barnes
- Targeted Metabolomics and Proteomics Laboratory, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeffrey D Neighbors
- Department of Medicine, and.,Department of Pharmacology, College of Medicine, Penn State University, Hershey, Pennsylvania, USA.,Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Raymond J Hohl
- Department of Medicine, and.,Department of Pharmacology, College of Medicine, Penn State University, Hershey, Pennsylvania, USA.,Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | | | - Bradley K Yoder
- Department of Cell, Developmental, and Integrative Biology, and
| | - Ana Leda F Longhini
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vidya Sagar Hanumanthu
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ranu Surolia
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - Veena B Antony
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and
| | - A Brent Carter
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, and.,Birmingham Veterans Administration Medical Center, Birmingham, Alabama, USA
| |
Collapse
|
11
|
Baba TT, Miyazaki T, Ohara‐Nemoto Y, Nemoto TK. Suppressive effects of N‐bisphosphonate in osteoblastic cells mitigated by non‐N‐bisphosphonate but not by sodium‐dependent phosphate cotransporter inhibitor. Cell Biochem Funct 2019; 37:400-407. [DOI: 10.1002/cbf.3418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 04/17/2019] [Accepted: 06/05/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Tomomi T. Baba
- Department of Oral Molecular BiologyNagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Toshihiro Miyazaki
- Department of Cell BiologyNagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Yuko Ohara‐Nemoto
- Department of Oral Molecular BiologyNagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Takayuki K. Nemoto
- Department of Oral Molecular BiologyNagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| |
Collapse
|
12
|
Ro DH, Jin H, Park JY, Lee MC, Won S, Han HS. The use of bisphosphonates after joint arthroplasty is associated with lower implant revision rate. Knee Surg Sports Traumatol Arthrosc 2019; 27:2082-2089. [PMID: 30547306 DOI: 10.1007/s00167-018-5333-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE This study hypothesized that the use of bisphosphonates (BPs) after total joint arthroplasty (TJA) is associated with a lower implant revision rate. This study aimed (1) to investigate the association between BP use and the revision rate of TJA and (2) to determine the relationship between the medication period and the revision rate of TJA. METHODS National Health Insurance Service data on surgeries, medications, diagnoses, and screenings of 50 million Koreans were reviewed. People who underwent TJA in the period from 2002 to 2012 were identified and followed until 2016. During that period, 331,660 patients underwent total knee arthroplasty (TKA), and 56,043 patients underwent total hip arthroplasty (THA). Among them, 8447 knee patients (2.5%) and 2851 hip patients (5.0%) required revision surgery due to aseptic loosening. Demographic data, the duration of BP medication, and comorbidities were identified. The rate of revision surgery according to BP medication was investigated. The extended Cox proportional hazard model was used to evaluate the effect of the medication period. RESULTS The rate of TKA revision was 1.4% for BP users and 2.9% for BP non-users (p < 0.001). The THA revision rate was 2.8% and 5.3% for BP users and non-users, respectively (p < 0.001). The hazard ratio (HR) of revision was significantly lower in patients who took BP medication for more than one year (TKA HR = 0.472, 95% CI [0.350-0.637]; THA HR = 0.490, 95% CI [0.247-0.972]) compared to that in short-term users (less than 1 year). CONCLUSIONS The use of BPs after TJA was associated with a lower revision rate. The use of BPs for more than one year further reduced the risk of revision. Bisphosphonate use can be highly recommended to reduce the revision rate of TJA. LEVEL OF EVIDENCE Retrospective cohort study, Level III.
Collapse
Affiliation(s)
- Du Hyun Ro
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Heejin Jin
- Department of Public Health Sciences, Seoul National University, Seoul, South Korea
| | - Jae-Young Park
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Sungho Won
- Department of Public Health Sciences, Seoul National University, Seoul, South Korea
| | - Hyuk-Soo Han
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
| |
Collapse
|
13
|
Effects of Strontium-Hydroxyapatite Mediated Active Compounds from Hippocampus Kuda Bleeler (HKB) on Osteogenesis. COATINGS 2019. [DOI: 10.3390/coatings9020141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Porous hydroxyapatite as a drug carrier is very popular and has many clinical applications. However, traditional hydroxyapatite materials have limited osteogenic capacity. Therefore, the development of a new hydroxyapatite drug delivery system is essential for bone tissue engineering. In this study, the metal element Sr was used to replace Ca, and the SrHA microspheres were successfully prepared by hydrothermal reaction. Scanning electron microscopy (SEM), X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS) were used to characterize SrHA (strontium-doped hydroxyapatite) microspheres obtained from hydrothermal reaction conditions. In addition, the drug utility was enhanced by loading the marine active compound 1-(5-bromo-2-hydroxy-4-methoxyphenyl)-ethanone (HKB). Furthermore, after co-culture with preosteoblasts, experiments indicated that HKB/SrHA composite microspheres had a more significant effect on the proliferation and differentiation of cells compared to pure SrHA. These HKB/SrHA composite microspheres may be applied to the drug delivery system of bone tissue repair.
Collapse
|
14
|
Kanellias N, Gavriatopoulou M, Terpos E, Dimopoulos MA. Management of multiple myeloma bone disease: impact of treatment on renal function. Expert Rev Hematol 2018; 11:881-888. [DOI: 10.1080/17474086.2018.1531702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Nikolaos Kanellias
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra General Hospital, Athens, Greece
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra General Hospital, Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra General Hospital, Athens, Greece
| | - Meletios Athanasios Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra General Hospital, Athens, Greece
| |
Collapse
|
15
|
Abstract
Atypical femoral fractures (AFF) are stress or ‘insufficiency’ fractures, often complicated by the use of bisphosphonates or other bone turnover inhibitors. While these drugs are beneficial for the intact osteoporotic bone, they probably prevent a stress fracture from healing which thus progresses to a complete fracture. Key features of atypical femoral fractures, essential for the diagnosis, are: location in the subtrochanteric region and diaphysis; lack of trauma history and comminution; and a transverse or short oblique configuration. The relative risk of patients developing an atypical femoral fracture when taking bisphosphonates is high; however, the absolute risk of these fractures in patients on bisphosphonates is low, ranging from 3.2 to 50 cases per 100,000 person-years. Treatment strategy in patients with AFF involves: radiograph of the contralateral side (computed tomography and magnetic resonance imaging should also be considered); dietary calcium and vitamin D supplementation should be prescribed following assessment; bisphosphonates or other potent antiresorptive agents should be discontinued; prophylactic surgical treatment of incomplete AFF with cephalomedullary nail, unless pain free; cephalomedullary nailing for surgical fixation of complete fractures; avoidance of gaps in the lateral and anterior cortex; avoidance of varus malreduction.
Cite this article: EFORT Open Rev 2018;3:494-500. DOI: 10.1302/2058-5241.3.170070.
Collapse
Affiliation(s)
| | - Hagen Schmal
- Department of Orthopaedics and Traumatology, Odense University Hospital, Denmark
| |
Collapse
|
16
|
Farrell KB, Karpeisky A, Thamm DH, Zinnen S. Bisphosphonate conjugation for bone specific drug targeting. Bone Rep 2018; 9:47-60. [PMID: 29992180 PMCID: PMC6037665 DOI: 10.1016/j.bonr.2018.06.007] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 12/26/2022] Open
Abstract
Bones provide essential functions and are sites of unique biochemistry and specialized cells, but can also be sites of disease. The treatment of bone disorders and neoplasia has presented difficulties in the past, and improved delivery of drugs to bone remains an important goal for achieving effective treatments. Drug targeting strategies have improved drug localization to bone by taking advantage of the high mineral concentration unique to the bone hydroxyapatite matrix, as well as tissue-specific cell types. The bisphosphonate molecule class binds specifically to hydroxyapatite and inhibits osteoclast resorption of bone, providing direct treatment for degenerative bone disorders, and as emerging evidence suggests, cancer. These bone-binding molecules also provide the opportunity to deliver other drugs specifically to bone by bisphosphonate conjugation. Bisphosphonate bone-targeted therapies have been successful in treatment of osteoporosis, primary and metastatic neoplasms of the bone, and other bone disorders, as well as refining bone imaging. In this review, we focus upon the use of bisphosphonate conjugates with antineoplastic agents, and overview bisphosphonate based imaging agents, nanoparticles, and other drugs. We also discuss linker design potential and the current state of bisphosphonate conjugate research progress. Ongoing investigations continue to expand the possibilities for bone-targeted therapeutics and for extending their reach into clinical practice.
Collapse
Affiliation(s)
- Kristen B Farrell
- MBC Pharma Inc., 12635 East Montview Blvd., Aurora, CO 80045-0100, United States of America
| | - Alexander Karpeisky
- MBC Pharma Inc., 12635 East Montview Blvd., Aurora, CO 80045-0100, United States of America
| | - Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523-1620, United States of America
| | - Shawn Zinnen
- MBC Pharma Inc., 12635 East Montview Blvd., Aurora, CO 80045-0100, United States of America
| |
Collapse
|
17
|
Bigi A, Boanini E. Calcium Phosphates as Delivery Systems for Bisphosphonates. J Funct Biomater 2018; 9:E6. [PMID: 29342839 PMCID: PMC5872092 DOI: 10.3390/jfb9010006] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 12/16/2022] Open
Abstract
Bisphosphonates (BPs) are the most utilized drugs for the treatment of osteoporosis, and are usefully employed also for other pathologies characterized by abnormally high bone resorption, including bone metastases. Due to the great affinity of these drugs for calcium ions, calcium phosphates are ideal delivery systems for local administration of BPs to bone, which is aimed to avoid/limit the undesirable side effects of their prolonged systemic use. Direct synthesis in aqueous medium and chemisorptions from solution are the two main routes proposed to synthesize BP functionalized calcium phosphates. The present review overviews the information acquired through the studies on the interaction between bisphosphonate molecules and calcium phosphates. Moreover, particular attention is addressed to some important recent achievements on the applications of BP functionalized calcium phosphates as biomaterials for bone substitution/repair.
Collapse
Affiliation(s)
- Adriana Bigi
- Department of Chemistry "G. Ciamician", University of Bologna, 40126 Bologna, Italy.
| | - Elisa Boanini
- Department of Chemistry "G. Ciamician", University of Bologna, 40126 Bologna, Italy.
| |
Collapse
|
18
|
Seifi M, Asefi S, Hatamifard G, Lotfi A. Effect of local injection of Zolena, zoledronic acid made in Iran, on orthodontic tooth movement and root and bone resorption in rats. J Dent Res Dent Clin Dent Prospects 2017; 11:257-264. [PMID: 29354254 PMCID: PMC5768960 DOI: 10.15171/joddd.2017.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 08/20/2017] [Indexed: 12/04/2022] Open
Abstract
Background. Anchorage control is an essential part of orthodontic treatment planning, especially in adult patients who demand a more convenient treatment. Zoledronic acid (ZA) is an effective choice to address this problem. It is the most potent member of the bisphosphonates family that has an inhibitory effect on bone resorption by suppressing osteoclast function. Therefore, ZA might be a good option for orthodontic anchorage control. The current study evaluated the effect of local administration of Zolena (ZA made in Iran) on orthodontic tooth movement (OTM) and root and bone resorption. Methods. The experimental group consisted of 30 rats in 3 subgroups (n=10). Anesthesia was induced, and one closed NiTi coil spring was installed between the first molar and central incisor unilaterally, except for the negative control group. The positive control group received vestibular injection of 0.01 mL of saline next to the maxillary first molar, and 0.01 mL of the solution was injected at the same site in the ZA group. After 21 days, the rats were sacrificed and the distance between the first and second molars was measured with a leaf gauge. Histological analysis was conducted by a blind pathologist for the number of Howship's lacunae, blood vessels, osteoclast-like cells and root resorption lacunae. Data were analyzed with ANOVA, Tukey test and t-test. Results. There were no significant differences in OTM between the force-applied groups. ZA significantly inhibited bone/root resorption and angiogenesis compared to the positive control group. Conclusion. Zolena did not decrease OTM but significantly inhibited bone and root resorption. Zolena might be less potent than its foreign counterparts.
Collapse
Affiliation(s)
- Massoud Seifi
- Department of Restorative Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sohrab Asefi
- Department of Orthodontics, International School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Hatamifard
- Faculty of Science and Technology, Life Sciences Department, Applied Biotechnology Research group, University of Westminster, London, United Kingdom
| | - Ali Lotfi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
19
|
Osorio JC, Jones MG, Schatz-Siemers N, Tang SJ. Twist on a classic: vitamin D and hypercalcaemia of malignancy. BMJ Case Rep 2017; 2017:bcr-2017-220819. [PMID: 29170170 DOI: 10.1136/bcr-2017-220819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Malignancy is the most common cause of hypercalcaemia in the inpatient setting. Most cases are caused by tumour production of parathyroid hormone-related protein and osseous metastases. In less than 1% of cases, hypercalcaemia is driven by increased production of 1,25-dihydroxyvitamin D (1,25(OH)2D), a mechanism most commonly seen in haematological malignancies. Here, we describe a woman with metastatic small cell cervical carcinoma who developed hypercalcaemia secondary to paraneoplastic overproduction of 1,25(OH)2D, a finding that, to our knowledge, has not been previously associated with this cancer. We also review the current cases of solid tumours reported to have this mechanism of hypercalcaemia and the evidence behind multiple therapeutic approaches.
Collapse
Affiliation(s)
- Juan C Osorio
- Department of Medicine, Cornell University Joan and Sanford I Weill Medical College, New York, USA
| | - Masha G Jones
- Department of Medicine, Cornell University Joan and Sanford I Weill Medical College, New York, USA
| | - Nina Schatz-Siemers
- Department of Pathology, Cornell University Joan and Sanford I Weill Medical College, New York, USA
| | - Stephanie J Tang
- Department of Medicine, Cornell University Joan and Sanford I Weill Medical College, New York, USA
| |
Collapse
|
20
|
Shi ZY, Zhang XG, Li CW, Liu K, Liang BC, Shi XL. Effect of Traditional Chinese Medicine Product, QiangGuYin, on Bone Mineral Density and Bone Turnover in Chinese Postmenopausal Osteoporosis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2017; 2017:6062707. [PMID: 28512501 PMCID: PMC5415859 DOI: 10.1155/2017/6062707] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/10/2017] [Accepted: 04/03/2017] [Indexed: 12/03/2022]
Abstract
Introduction. The aim of this study was to investigate the efficacy of herbal formula QiangGuYin (QGY) in postmenopausal women. Materials and Methods. A total of 240 participants from six clinical centers were randomly to receive alendronate 70 mg/week, QGY granules 20 g/day, and placebo. Primary end points were BMD changes over 6 and 12 months; secondary end points were bone turnover markers changes at 3, 6, 9, and 12 months. Safety was monitored by clinical adverse events reported during the follow-up. Results. Of 240 women recruited, 218 completed the study. Significant BMD increases from baseline were observed over 6 and 12 months at each observed part both in QGY and alendronate compared with placebo (p < 0.01). Alendronate-treated subjects had significant decreases in β-CTX compared to QGY-treated subjects at each time point assessed (p < 0.01). Reduction in t-P1NP was only observed in the QGY group at 3 and 6 months (-23.81% and -3.07%, resp.). No significant difference was observed in the overall incidence of clinical adverse events among the alendronate group and the QGY group (5.0% versus 7.5%, p = 0.513). Conclusion. 1-Year treatment with QGY demonstrated a safe statistical increase in BMD and new balance may be rebuilt after 9 months. This trail is registered with ChiCTR-POC-16008026.
Collapse
Affiliation(s)
- Zhen-Yu Shi
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
| | - Xin-Gen Zhang
- Department of Orthopedics and Traumatology, Rongjun Hospital of Zhejiang, Jiaxing, Zhejiang 314001, China
| | - Chun-Wen Li
- Department of Diagnostics of Traditional Chinese Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
| | - Kang Liu
- Department of Orthopedics and Traumatology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang 310005, China
| | - Bo-Cheng Liang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
| | - Xiao-Lin Shi
- Department of Orthopedics and Traumatology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang 310005, China
| |
Collapse
|
21
|
Minhas PS, Virdi JK. Hypercalcemia in Inpatient Setting: Diagnostic Approach and Management. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2017. [DOI: 10.1007/s40138-017-0126-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
Sabik OL, Farber CR. Using GWAS to identify novel therapeutic targets for osteoporosis. Transl Res 2017; 181:15-26. [PMID: 27837649 PMCID: PMC5357198 DOI: 10.1016/j.trsl.2016.10.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/17/2016] [Accepted: 10/20/2016] [Indexed: 12/14/2022]
Abstract
Osteoporosis is a common, increasingly prevalent, global health burden characterized by low bone mineral density (BMD) and increased risk of fracture. Despite its significant impact on human health, there is currently a lack of highly effective treatments free of side effects for osteoporosis. Therefore, a major goal in the field is to identify new drug targets. Genetic discovery has been shown to be effective in the unbiased identification of novel drug targets and genome-wide association studies (GWASs) have begun to provide insight into genetic basis of osteoporosis. Over the last decade, GWASs have led to the identification of ∼100 loci associated with BMD and other bone traits related to risk of fracture. However, there have been limited efforts to identify the causal genes underlying the GWAS loci or the mechanisms by which GWAS loci alter bone physiology. In this review, we summarize the current state of the field and discuss strategies for causal gene discovery and the evidence that the novel genes underlying GWAS loci are likely to be a new source of drug targets.
Collapse
Affiliation(s)
- Olivia L Sabik
- Center for Public Health Genomics, School of Medicine, University of Virginia, Charlottesville, Va; Department of Biochemistry and Molecular Genetics, School of Medicine, University of Virginia, Charlottesville, Va
| | - Charles R Farber
- Center for Public Health Genomics, School of Medicine, University of Virginia, Charlottesville, Va; Department of Biochemistry and Molecular Genetics, School of Medicine, University of Virginia, Charlottesville, Va; Department of Public Health Science, School of Medicine, University of Virginia, Charlottesville, Va.
| |
Collapse
|
23
|
Abstract
OBJECTIVES Bisphosphonates are widely used as first-line treatment for primary and secondary prevention of fragility fractures. Whilst they have proved effective in this role, there is growing concern over their long-term use, with much evidence linking bisphosphonate-related suppression of bone remodelling to an increased risk of atypical subtrochanteric fractures of the femur (AFFs). The objective of this article is to review this evidence, while presenting the current available strategies for the management of AFFs. METHODS We present an evaluation of current literature relating to the pathogenesis and treatment of AFFs in the context of bisphosphonate use. RESULTS Six broad themes relating to the pathogenesis and management of bisphosphonate-related AFFs are presented. The key themes in fracture pathogenesis are: bone microdamage accumulation; altered bone mineralisation and altered collagen formation. The key themes in fracture management are: medical therapy and surgical therapy. In addition, primary prevention strategies for AFFs are discussed. CONCLUSIONS This article presents current knowledge about the relationship between bisphosphonates and the development of AFFs, and highlights key areas for future research. In particular, studies aimed at identifying at-risk subpopulations and organising surveillance for those on long-term therapy will be crucial in both increasing our understanding of the condition, and improving population outcomes.Cite this article: N. Kharwadkar, B. Mayne, J. E. Lawrence, V. Khanduja. Bisphosphonates and atypical subtrochanteric fractures of the femur. Bone Joint Res 2017;6:144-153. DOI: 10.1302/2046-3758.63.BJR-2016-0125.R1.
Collapse
Affiliation(s)
- N Kharwadkar
- The Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK
| | - B Mayne
- F2, James Cook University Hospital, Marton Rd, Middlesbrough TS4 3BW, UK
| | - J E Lawrence
- Junior Clinical Fellow, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - V Khanduja
- Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Box 37, Hills Road, Cambridge CB2 0QQ, UK
| |
Collapse
|
24
|
Raman M, Aghdassi E, Baun M, Yeung M, Fairholm L, Saqui O, Allard JP. Metabolic Bone Disease in Patients Receiving Home Parenteral Nutrition: A Canadian Study and Review. JPEN J Parenter Enteral Nutr 2017; 30:492-6. [PMID: 17047173 DOI: 10.1177/0148607106030006492] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Metabolic bone disease (MBD) is a significant complication in patients receiving long-term home parenteral nutrition (HPN). Pamidronate has been poorly studied in this population. We examine the prevalence and risk factors for MBD and examine changes in bone mineral density (BMD) after pamidronate administration. METHODS First, a chart review of patients receiving HPN for >1 year was performed, and Pearson correlations were used to assess associations between MBD (defined as t score<-1) and risk factors. Second, the effect of IV pamidronate on BMD was studied prospectively in 11 HPN patients. Results were compared using a t-test. RESULTS Charts were reviewed in 25 patients (15 F, 10 M): age, 56.9+/-3.1 years; body mass index (BMI), 21.2+/-0.57 kg/m2; months receiving HPN, 113.2+/-0.09; and days per week receiving HPN, 5.08+/-0.39. MBD was present in 33% of patients for the spine and hip and in 50% for the femoral neck; 24% had previous fractures. There was a significant negative correlation between the duration of HPN and BMD (r=-0.40) for all measurements. From those patients, 11 received IV pamidronate for a mean of 22.2+/-5.4 months. At baseline, their mean HPN treatment duration was 10.6+/-6.3 years. Overall, BMD results showed a trend toward improvement in the mean t score of the spine and hip postpamidronate therapy (pre, -3.1+/-0.75; post, -2.9+/-0.69; p=.07). After excluding 2 patients receiving corticosteroids, the mean t score of the spine showed significant improvement (prepamidronate -3.4+/-0.57 vs post-pamidronate -3.1+/-0.65, p=.036). CONCLUSIONS In our HPN population, 76% had MBD and 24% had previous fractures. The results suggest that these patients may benefit from pamidronate. More studies are needed to assess the efficacy of pamidronate.
Collapse
Affiliation(s)
- M Raman
- University Health Network, Toronto, Canada
| | | | | | | | | | | | | |
Collapse
|
25
|
Ferrone M, Geraci M. A Review of the Relationship Between Parenteral Nutrition and Metabolic Bone Disease. Nutr Clin Pract 2016; 22:329-39. [PMID: 17507733 DOI: 10.1177/0115426507022003329] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Metabolic bone disease (MBD) refers to the conditions that produce a diffuse decrease in bone density and strength because of an imbalance between bone resorption and bone formation. MBD can be a potential complication in patients receiving chronic parenteral nutrition (PN) therapy and the management of this condition presents a challenge for many clinicians. The etiology of PN-associated MBD is poorly understood, but traditional risk factors can include malnutrition, vitamin and mineral deficiencies, toxic contaminants in the PN solution, concomitant medications, and presence of certain disease states. Although additional studies are warranted to further elucidate the development and management of this condition, the following review discusses some of the important factors that may play a role in the genesis of PN-associated MBD and evaluates some potential strategies for the diagnosis and treatment of this complication.
Collapse
Affiliation(s)
- Marcus Ferrone
- University of California, San Francisco, Drug Product Services Laboratory, San Francisco, CA 94118, USA.
| | | |
Collapse
|
26
|
Severe Hypercalcemia in a Child With Acute Lymphoblastic Leukemia Relapse: Successful Management With Combination of Calcitonin and Bisphosphonate. J Pediatr Hematol Oncol 2016; 38:232-4. [PMID: 26907650 DOI: 10.1097/mph.0000000000000525] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hypercalcemia is a rare complication of hematological malignancy in children. An 8-year-old girl with CALLA (+) Pre-B-cell ALL developed hypercalcemia during bone marrow relapse. She had nausea, vomiting, leg pain, polyuria, polydipsia, and muscle weakness. At the time of relapse, the ionized calcium level was 1.99 mmol/L. Rehydration with 0.9% saline and furosemide and methylprednisolone (MP) treatment were used for the treatment of hypercalcemia. The serum ionized calcium level increased to 2.2 mmol/L despite hydration, furosemide, and MP treatment. Then, a single-dose pamidronate (1 mg/kg/dose) was administered. Despite pamidronate treatment, the calcium level continued to rise. Next, calcitonin at a dose of 8 IU/kg/dose, 4 doses per day, was added to the treatment. After commencement of calcitonin treatment, her ionized calcium level decreased to normal reference ranges. In conclusion, because of the postponed effect of bisphosphonate treatment, pamidronate and calcitonin combination is an effective treatment option in the early resolution of malignancy-related hypercalcemia.
Collapse
|
27
|
Bala S, Shah B, Rajput P, Rao P. Unmasking of primary hyperparathyroidism by Vitamin D therapy. Indian J Nephrol 2015; 25:377-9. [PMID: 26664216 PMCID: PMC4663778 DOI: 10.4103/0971-4065.157427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 38-year-old female on Vitamin D therapy presented with hypercalcemia induced acute kidney injury. Evaluation revealed primary hyperparathyroidism (PHPT) and iatrogenic hypervitaminosis D. After medical stabilization, she underwent surgical removal of the parathyroid adenoma, and made a full recovery. This case highlights unmasking of subclinical hyperparathyroidism by vitamin D therapy leading to severe hypercalcemia.
Collapse
Affiliation(s)
- S Bala
- Department of Nephrology, Global Hospital, Mumbai, Maharashtra, India
| | - B Shah
- Department of Nephrology, Global Hospital, Mumbai, Maharashtra, India
| | - P Rajput
- Department of Nephrology, Global Hospital, Mumbai, Maharashtra, India
| | - P Rao
- Department of Surgery, Global Hospital, Mumbai, Maharashtra, India
| |
Collapse
|
28
|
Abstract
Hypercalcemia of malignancy affects up to one in five cancer patients during the course of their disease. It is associated with both liquid malignancies, commonly multiple myeloma, leukemia, and non-Hodgkins lymphoma and solid cancers, particularly breast and renal carcinomas as well as squamous cell carcinomas of any organ. The clinical manifestations of hypercalcemia are generally constitutional in nature and not specific to the inciting malignancy. Such physical manifestations can range from malaise to lethargy and confusion. Constipation and anorexia are common. Acute kidney injury is likely the most frequently encountered manifestation of end organ damage. Symptomatology is closely linked to both the absolute elevation of serum calcium levels and the rapidity of calcium rise. The majority of cases are humoral in etiology and related to parathyroid hormone-related protein (PTHrP). Approximately 20% of cases are the result of direct bone metastasis with extra-renal 1,25-dihydroxyvitamin D (calcitriol) and ectopic parathyroid hormone production likely accounting for less than 1% of cases. The diagnosis of hypercalcemia of malignancy is confirmed either by an elevated PTHrP or by an evidence of bone metastasis in the appropriate clinical setting. Treatment is predicated on the patient’s symptoms and absolute serum calcium level. Interventions are aimed at lowering the serum calcium concentration by inhibiting bone resorption and increasing urinary calcium excretion, the former accomplished via bisphosphonate therapy and the latter with aggressive hydration. Novel therapies for refractory disease include denosumab, a monoclonal antibody against the receptor activator of nuclear factor κB ligand, and the calcimimetic cinacalcet. Finally, anti-PTHrP antibodies have been successfully deployed in animal models of disease. Despite the efficacy of the above therapies, hypercalcemia of malignancy portends an ominous prognosis, indicating advanced and often refractory cancer with survival on the order of months.
Collapse
Affiliation(s)
- Hillel Sternlicht
- Division of Nephrology and Hypertension, Weill Cornell Medical College
| | - Ilya G Glezerman
- Division of Nephrology and Hypertension, Weill Cornell Medical College ; Renal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
29
|
Qiao H, Wang TY, Yan W, Qin A, Fan QM, Han XG, Wang YG, Tang TT. Synergistic suppression of human breast cancer cells by combination of plumbagin and zoledronic acid In vitro. Acta Pharmacol Sin 2015; 36:1085-98. [PMID: 26235741 DOI: 10.1038/aps.2015.42] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 04/15/2015] [Indexed: 11/09/2022] Open
Abstract
AIM Zoledronic acid (ZA), a bisphosphonate, is currently used in combination with chemotherapeutic agents to suppress breast cancer cell proliferation or breast cancer-induced osteolysis. The aim of this study was to investigate the effects of ZA combined with a natural anticancer compound plumbagin (PL) against human breast cancer cells in vitro. METHODS Human breast cancer MDA-MB-231SArfp cells were treated with ZA, PL or a combination of ZA and PL. The cell growth, apoptosis and migration were evaluated using CCK-8 assay, flow cytometry and transwell assay, respectively. The expression of apoptosis-related proteins was measured using real-time PCR and Western blotting. Synergism was evaluated using Compusyn software, and the combination index (CI) and drug reduction index (DRI) values were determined. RESULTS PL or ZA alone caused mild cytotoxicity (the IC50 value at 24 h was 12.18 and above 100 μmol/L, respectively). However, the combination of ZA and PL caused a synergistic cytotoxicity (CI=0.26). The DRI values also showed a synergistic effect between PL and ZA, with actual values of 5.52 and 3.59, respectively. Furthermore, PL and ZA synergistically induced apoptosis and inhibited migration of the breast cancer cells. Moreover, the combination of ZA and PL decreased the expression of Notch-1, cleaved PARP, Bcl-2 and Bcl-xl, and increased the expression of cleaved caspase-3, CDKN1A and ID1. When the breast cancer cells were transfected with specific siRNA against Notch-1, the combination of ZA and PL markedly increased the expression of Bcl-2. CONCLUSION Combination of ZA and PL synergistically suppresses human breast cancer MDA-MB-231SArfp cells in vitro. PL can inhibit ZA-induced activation of the Notch-1 signaling pathway and subsequently reduce the expression of Bcl-2, thus potentiating cancer cell apoptosis.
Collapse
|
30
|
Extracellular matrix networks in bone remodeling. Int J Biochem Cell Biol 2015; 65:20-31. [DOI: 10.1016/j.biocel.2015.05.008] [Citation(s) in RCA: 188] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 04/18/2015] [Accepted: 05/08/2015] [Indexed: 01/21/2023]
|
31
|
Skripitz R, Kurth A, Roth A. [Supportive drugs for improved implant healing]. DER ORTHOPADE 2015; 44:703-709. [PMID: 26160658 DOI: 10.1007/s00132-015-3136-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Improvement of implant healing in orthopedic and trauma surgery serves to improve the life expectancy of the implant. Good primary stability by clamping is a prerequisite for secondary stability and for the actual integration and healing of the implant. RESULTS Possible causes of implant loosening are abrasive particles, which arrive at non-integrated implants at the unsealed prosthesis-bone interface and provoke a macrophage-mediated foreign body reaction, resulting in periprosthetic osteolysis. Numerous animal studies have already described the use of bisphosphonates to inhibit osteolysis induced by abrasion and secondary instability. In patients with total knee arthroplasty, a decrease in prosthetic migration under the influence of bisphosphonates could be shown. The stimulation of bone formation around the implants and the resulting implant healing was demonstrated both in animal experiments for bone morphogenetic proteins (BMP) and in case reports for intermittent parathyroid hormone administration. CONCLUSION By using supportive drugs, it is possible to achieve an improvement in the osseointegration of implants; thus, more rapid secondary stability and load-bearing are expected.
Collapse
Affiliation(s)
- R Skripitz
- Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057, Rostock, Deutschland.
| | - A Kurth
- Themistocles Gluck Hospital, Ratingen, Deutschland
| | - A Roth
- Bereich Endoprothetik/Orthopädie, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinik Leipzig AöR, Leipzig, Deutschland
| |
Collapse
|
32
|
Rice N, Polyzois I, Ekanayake K, Omer O, Stassen LF. The management of osteoradionecrosis of the jaws – A review. Surgeon 2015; 13:101-9. [DOI: 10.1016/j.surge.2014.07.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 07/02/2014] [Accepted: 07/04/2014] [Indexed: 01/10/2023]
|
33
|
Nepal M, Li L, Bae TS, Kim BI, Soh Y. Evaluation of Osseointegration around Tibial Implants in Rats by Ibandronate-Treated Nanotubular Ti-32Nb-5Zr Alloy. Biomol Ther (Seoul) 2014; 22:563-9. [PMID: 25489426 PMCID: PMC4256038 DOI: 10.4062/biomolther.2014.111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/14/2014] [Accepted: 10/30/2014] [Indexed: 11/29/2022] Open
Abstract
Materials with differing surfaces have been developed for clinical implant therapy in dentistry and orthopedics. This study was designed to evaluate bone response to titanium alloy containing Ti-32Nb-5Zr with nanostructure, anodic oxidation, heat treatment, and ibandronate coating. Rats were randomly assigned to two groups for implantation of titanium alloy (untreated) as the control group and titanium alloy group coated with ibandronate as the experimental group. Then, the implants were inserted in both tibiae of the rats for four weeks. After implantation, bone implant interface, trabecular microstructure, mechanical fixation was evaluated by histology, micro-computed tomography (μCT) and the push-out test, respectively. We found that the anodized, heat-treated and ibandronate-coated titanium alloy triggered pronounced bone implant integration and early bone formation. Ibandronate-coated implants showed elevated values for removal torque and a higher level of BV/TV, trabecular thickness and separation upon analysis with μCT and mechanical testing. Similarly, higher bone contact and a larger percentage bone area were observed via histology compared to untreated alloy. Furthermore, well coating of ibandronate with alloy was observed by vitro releasing experiment. Our study provided evidences that the coating of bisphosphonate onto the anodized and heat-treated nanostructure of titanium alloy had a positive effect on implant fixation.
Collapse
Affiliation(s)
- Manoj Nepal
- Department of Dental Pharmacology, School of Dentistry, and Institute of Oral Bioscience, Brain Korea 21 Project
| | - Liang Li
- Department of Dental Pharmacology, School of Dentistry, and Institute of Oral Bioscience, Brain Korea 21 Project
| | - Tae Sung Bae
- Department of Dental Biomaterials, School of Dentistry, Chonbuk National University, Jeon-Ju 561-756
| | - Byung Il Kim
- Department of Future Plan and New Material Engineering, Sunchon National University, Suncheon 540-742, Republic of Korea
| | - Yunjo Soh
- Department of Dental Pharmacology, School of Dentistry, and Institute of Oral Bioscience, Brain Korea 21 Project
| |
Collapse
|
34
|
Larson-Casey JL, Murthy S, Ryan AJ, Carter AB. Modulation of the mevalonate pathway by akt regulates macrophage survival and development of pulmonary fibrosis. J Biol Chem 2014; 289:36204-19. [PMID: 25378391 DOI: 10.1074/jbc.m114.593285] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Protein kinase B (Akt) is a key effector of multiple cellular processes, including cell survival. Akt, a serine/threonine kinase, is known to increase cell survival by regulation of the intrinsic pathway for apoptosis. In this study, we found that Akt modulated the mevalonate pathway, which is also linked to cell survival, by increasing Rho GTPase activation. Akt modulated the pathway by phosphorylating mevalonate diphosphate decarboxylase (MDD) at Ser(96). This phosphorylation in macrophages increased activation of Rac1, which enhanced macrophage survival because mutation of MDD (MDDS96A) induced apoptosis. Akt-mediated activation in macrophages was specific for Rac1 because Akt did not increase activity of other Rho GTP-binding proteins. The relationship between Akt and Rac1 was biologically relevant because Akt(+/-) mice had significantly less active Rac1 in alveolar macrophages, and macrophages from Akt(+/-) mice had an increase in active caspase-9 and -3. More importantly, Akt(+/-) mice were significantly protected from the development of pulmonary fibrosis, suggesting that macrophage survival is associated with the fibrotic phenotype. These observations for the first time suggest that Akt plays a critical role in the development and progression of pulmonary fibrosis by enhancing macrophage survival via modulation of the mevalonate pathway.
Collapse
Affiliation(s)
| | - Shubha Murthy
- the Department of Internal Medicine, Carver College of Medicine, and
| | - Alan J Ryan
- the Department of Internal Medicine, Carver College of Medicine, and
| | - A Brent Carter
- From the Department of Radiation Oncology and Program in Free Radical and Radiation Biology, the Department of Internal Medicine, Carver College of Medicine, and the Department of Human Toxicology, College of Public Health, University of Iowa, Iowa City, Iowa 52242 and the Iowa City Veterans Affairs Health Care System, Iowa City, Iowa 52242
| |
Collapse
|
35
|
Di Bari R, Grippaudo C, Deli R. Bifosfonati e terapia ortodontica: implicazioni cliniche. DENTAL CADMOS 2014. [DOI: 10.1016/s0011-8524(14)70228-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
36
|
|
37
|
Abstract
Total joint replacement surgery is being performed on an increasingly large part of the population. Clinical longevity of implants depends on their osseointegration, which is influenced by the load, the characteristics of the implant and the bone-implant interface, as well as by the quality and quantity of the surrounding bone. Aseptic loosening due to periprosthetic osteolysis is the most frequent known cause of implant failure. Wear of prosthetic materials results in the formation of numerous particles of debris that cause a complex biological response. Dual-energy X-ray Absorptiometry (DXA) is regarded as an accurate method to evaluate Bone Mineral Density (BMD) around hip or knee prostheses. Further data may be provided by a new device, the Bone Microarchitecture Analysis (BMA), which combines bone microarchitecture quantification and ultra high resolution osteo-articular imaging. Pharmacological strategies have been developed to prevent bone mass loss and to extend implant survival. Numerous trials with bisphosphonates show a protective effect on periprosthetic bone mass, up to 72 months after arthroplasty. Strontium ranelate has been demonstrated to increase the osseointegration of titanium implants in treated animals with improvement of bone microarchitecture and bone biomaterial properties.
Collapse
Affiliation(s)
- Loredana Cavalli
- Department of Surgery and Translational Medicine, University of Florence, Florence, 50139, Italy
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, Florence, 50139, Italy
| |
Collapse
|
38
|
Abstract
Pain is a widespread clinical symptom in companion animals with cancer, and its aggressive management should be a priority. Education and skills can be acquired by health care professionals and caregivers to better understand, recognize, and treat cancer-associated pain. The early and rational institution of multimodality analgesic protocols can be highly effective and maximize the chances of improving quality of life in dogs and cats with cancer. This article describes the pathophysiology of pain in companion animals diagnosed with cancer. The foundational causes of cancer-associated pain and treatment strategies for alleviating discomfort in companion animals with cancer are discussed.
Collapse
|
39
|
Shobeiri N, Adams MA, Holden RM. Phosphate: an old bone molecule but new cardiovascular risk factor. Br J Clin Pharmacol 2014; 77:39-54. [PMID: 23506202 PMCID: PMC3895346 DOI: 10.1111/bcp.12117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 02/21/2013] [Indexed: 12/24/2022] Open
Abstract
Phosphate handling in the body is complex and involves hormones produced by the bone, the parathyroid gland and the kidneys. Phosphate is mostly found in hydroxyapatite. however recent evidence suggests that phosphate is also a signalling molecule associated with bone formation. Phosphate balance requires careful regulation of gut and kidney phosphate transporters, SLC34 transporter family, but phosphate signalling in osteoblasts and vascular smooth muscle cells is likely mediated by the SLC20 transporter family (PiT1 and PiT2). If not properly regulated, phosphate imblanace could lead to mineral disorders as well as vascular calcification. In chronic kidney disease-mineral bone disorder, hyperphosphataemia has been consistently associated with extra-osseous calcification and cardiovascular disease. This review focuses on the physiological mechanisms involved in phosphate balance and cell signalling (i.e. osteoblasts and vascular smooth muscle cells) as well as pathological consequences of hyperphosphataemia. Finally, conventional as well as new and experimental therapeutics in the treatment of hyperphosphataemia are explored.
Collapse
Affiliation(s)
- Navid Shobeiri
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | | | | |
Collapse
|
40
|
Maria SM, Prukner C, Sheikh Z, Mueller F, Barralet JE, Komarova SV. Reproducible quantification of osteoclastic activity: characterization of a biomimetic calcium phosphate assay. J Biomed Mater Res B Appl Biomater 2013; 102:903-12. [PMID: 24259122 DOI: 10.1002/jbm.b.33071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 07/31/2013] [Accepted: 10/13/2013] [Indexed: 11/12/2022]
Abstract
Osteoclasts are responsible for bone and joint destruction in rheumatoid arthritis, periodontitis, and osteoporosis. Animal tusk slice assays are standard for evaluating the effect of therapeutics on these cells. However, in addition to batch-to-batch variability inherent to animal tusks, their use is clearly not sustainable. Our objective was to develop and characterize a biomimetic calcium phosphate assay based on the use of phase pure hydroxyapatite coated as a thin film on the surface of culture plates, to facilitate the reproducible quantification of osteoclast resorptive activity. Osteoclasts were formed from RAW 264.7 mouse monocyte cell line using a pro-resorptive cytokine RANKL (50 ng/mL). No change in substrate appearance was noted after culture with media without cells, or undifferentiated monocytes. Only in the presence of osteoclasts localized areas of calcium phosphate dissolution were observed. The total area resorbed positively correlated with the osteoclast numbers (R(2) = 0.99). The resorbed area was significantly increased by the addition of RANKL, and decreased after application of known inhibitors of osteoclast resorptive activity, calcitonin (10 μM), or alendronate (100 μM). Thus, calcium phosphate coated substrates allow reliable monitoring of osteoclast resorptive activity and offer an alternative to animal tusk slice assays.
Collapse
Affiliation(s)
- Salwa M Maria
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; Shriners Hospital for Children-Canada, Montreal, Quebec, Canada
| | | | | | | | | | | |
Collapse
|
41
|
Koo TH, Borah JS, Xing ZC, Moon SM, Jeong Y, Kang IK. Immobilization of pamidronic acids on the nanotube surface of titanium discs and their interaction with bone cells. NANOSCALE RESEARCH LETTERS 2013; 8:124. [PMID: 23497321 PMCID: PMC3602675 DOI: 10.1186/1556-276x-8-124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/27/2013] [Indexed: 05/28/2023]
Abstract
Self-assembled layers of vertically aligned titanium nanotubes were fabricated on a Ti disc by anodization. Pamidronic acids (PDAs) were then immobilized on the nanotube surface to improve osseointegration. Wide-angle X-ray diffraction, X-ray photoelectron microscopy, and scanning electron microscopy were employed to characterize the structure and morphology of the PDA-immobilized TiO2 nanotubes. The in vitro behavior of osteoblast and osteoclast cells cultured on an unmodified and surface-modified Ti disc was examined in terms of cell adhesion, proliferation, and differentiation. Osteoblast adhesion, proliferation, and differentiation were improved substantially by the topography of the TiO2 nanotubes, producing an interlocked cell structure. PDA immobilized on the TiO2 nanotube surface suppressed the viability of the osteoclasts and reduced their bone resorption activity.
Collapse
Affiliation(s)
- Tae-Hyung Koo
- Department of Polymer Science and Engineering, Kyungpook National University, Daegu, 702-701, South Korea
| | - Jyoti S Borah
- Department of Polymer Science and Engineering, Kyungpook National University, Daegu, 702-701, South Korea
| | - Zhi-Cai Xing
- Department of Polymer Science and Engineering, Kyungpook National University, Daegu, 702-701, South Korea
| | - Sung-Mo Moon
- Department of Surface Technology, Korea Institute of Material Science, Changwon-si, 642-831, South Korea
| | - Yongsoo Jeong
- Department of Surface Technology, Korea Institute of Material Science, Changwon-si, 642-831, South Korea
| | - Inn-Kyu Kang
- Department of Polymer Science and Engineering, Kyungpook National University, Daegu, 702-701, South Korea
| |
Collapse
|
42
|
Abstract
Bisphosphonates are synthetic analogues of pyrophosphate that inhibit bone resorption by their action on osteoclasts. In recent years, bisphosphonates have been used in children for treatment of a growing number of disorders associated primarily with generalized or localized osteoporosis, genetic and acquired metabolic bone diseases, heterotopic calcifications in soft tissues, and for hypercalcemia. In this review, the authors address the role of and experience with bisphosphonate therapy in disorders of childhood.
Collapse
|
43
|
Cattalini JP, Boccaccini AR, Lucangioli S, Mouriño V. Bisphosphonate-based strategies for bone tissue engineering and orthopedic implants. TISSUE ENGINEERING. PART B, REVIEWS 2012; 18:323-40. [PMID: 22440082 PMCID: PMC3458621 DOI: 10.1089/ten.teb.2011.0737] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Accepted: 03/20/2012] [Indexed: 01/24/2023]
Abstract
Bisphosphonates (BPs) are a group of well-established drugs that are applied in the development of metabolic bone disorder-related therapies. There is increasing interest also in the application of BPs in the context of bone tissue engineering, which is the topic of this review, in which an extensive overview of published studies on the development and applications of BPs-based strategies for bone regeneration is provided with special focus on the rationale for the use of different BPs in three-dimensional (3D) bone tissue scaffolds. The different alternatives that are investigated to address the delivery and sustained release of these therapeutic drugs in the nearby tissues are comprehensively discussed, and the most significant published approaches on bisphosphonate-conjugated drugs in multifunctional 3D scaffolds as well as the role of BPs within coatings for the improved fixation of orthopedic implants are presented and critically evaluated. Finally, the authors' views regarding the remaining challenges in the fields and directions for future research efforts are highlighted.
Collapse
Affiliation(s)
- Juan Pablo Cattalini
- Department of Pharmaceutical Technology, Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Aldo R. Boccaccini
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Silvia Lucangioli
- National Science Research Council (CONICET), Buenos Aires, Argentina
- Department of Pharmaceutical Technology, Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Viviana Mouriño
- National Science Research Council (CONICET), Buenos Aires, Argentina
- Department of Pharmaceutical Technology, Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
44
|
Leopoldino AM, Squarize CH, Garcia CB, Almeida LO, Pestana CR, Sobral LM, Uyemura SA, Tajara EH, Silvio Gutkind J, Curti C. SET protein accumulates in HNSCC and contributes to cell survival: antioxidant defense, Akt phosphorylation and AVOs acidification. Oral Oncol 2012; 48:1106-13. [PMID: 22739068 DOI: 10.1016/j.oraloncology.2012.05.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 04/27/2012] [Accepted: 05/09/2012] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Determination of the SET protein levels in head and neck squamous cell carcinoma (HNSCC) tissue samples and the SET role in cell survival and response to oxidative stress in HNSCC cell lineages. MATERIALS AND METHODS SET protein was analyzed in 372 HNSCC tissue samples by immunohistochemistry using tissue microarray and HNSCC cell lineages. Oxidative stress was induced with the pro-oxidant tert-butylhydroperoxide (50 and 250μM) in the HNSCC HN13 cell lineage either with (siSET) or without (siNC) SET knockdown. Cell viability was evaluated by trypan blue exclusion and annexin V/propidium iodide assays. It was assessed caspase-3 and -9, PARP-1, DNA fragmentation, NM23-H1, SET, Akt and phosphorylated Akt (p-Akt) status. Acidic vesicular organelles (AVOs) were assessed by the acridine orange assay. Glutathione levels and transcripts of antioxidant genes were assayed by fluorometry and real time PCR, respectively. RESULTS SET levels were up-regulated in 97% tumor tissue samples and in HNSCC cell lineages. SiSET in HN13 cells (i) promoted cell death but did not induced caspases, PARP-1 cleavage or DNA fragmentation, and (ii) decreased resistance to death induced by oxidative stress, indicating SET involvement through caspase-independent mechanism. The red fluorescence induced by siSET in HN13 cells in the acridine orange assay suggests SET-dependent prevention of AVOs acidification. NM23-H1 protein was restricted to the cytoplasm of siSET/siNC HN13 cells under oxidative stress, in association with decrease of cleaved SET levels. In the presence of oxidative stress, siNC HN13 cells showed lower GSH antioxidant defense (GSH/GSSG ratio) but higher expression of the antioxidant genes PRDX6, SOD2 and TXN compared to siSET HN13 cells. Still under oxidative stress, p-Akt levels were increased in siNC HN13 cells but not in siSET HN13, indicating its involvement in HN13 cell survival. Similar results for the main SET effects were observed in HN12 and CAL 27 cell lineages, except that HN13 cells were more resistant to death. CONCLUSION SET is potential (i) marker for HNSCC associated with cancer cell resistance and (ii) new target in cancer therapy.
Collapse
Affiliation(s)
- Andréia M Leopoldino
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Av. Café, s/n, 14040-930 Ribeirão Preto, SP, Brazil.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Chung ME, Lee JI, Im S, Park JH. Ischemic stroke in rats enhances bone resorption in vitro. J Korean Med Sci 2012; 27:84-8. [PMID: 22219619 PMCID: PMC3247780 DOI: 10.3346/jkms.2012.27.1.84] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 11/04/2011] [Indexed: 11/20/2022] Open
Abstract
We hypothesized that the formation and differentialtion of osteoclasts are accelerated and the potential of bone resorption is increased in the hemiplegic bone marrow in the early stage of stroke. We randomly divided white female Sprague-Dawley (SD) rats (n = 30) into two groups, stroke (n = 15) and sham group (n = 15). On the 7th day after stroke, after cutting away the epiphyses of the femurs and tibias, diaphyseal channels were flushed using α-minimum essential medium (α-MEM) and bone marrow cells were collected. Bone marrow stem cells, which were extracted from the femur and tibia, were cultured on the 7th day after middle cerebral artery occlusion. We then estimated the ratio of non-adherent cells to total bone marrow cells that included osteoclast precursor cells. After culturing these cells separately, cells that tested positive on the tartrate resistant acid phosphatase (TRAP) were counted and bone resorption was evaluated by using the OAAS™ plate. In comparison to the control group, the stroke group showed a higher increase of non-adherent cells in the hemiplegic side bone marrow. In addition, after the primary culture, the stroke group showed an increased number of TRAP positive cells and a higher degree of bone resorption estimated by OAAS™ plate. As a result, osteoclastogenesis and osteoclast differentiation are accelerated and the potential of bone resorption is increased in the hemiplegic bone marrow and these changes are detected as early as within the first week after middle cerebral artery occlusion in SD rats.
Collapse
Affiliation(s)
- Myung Eun Chung
- Department of Rehabilitation Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong In Lee
- Deparment of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Im
- Deparment of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Joo Hyun Park
- Deparment of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
46
|
Schwartz Z, Hyzy SL, Moore MA, Hunter SA, Ronholdt CJ, Sunwoo M, Boyan BD. Osteoinductivity of demineralized bone matrix is independent of donor bisphosphonate use. J Bone Joint Surg Am 2011; 93:2278-86. [PMID: 22258774 PMCID: PMC3234347 DOI: 10.2106/jbjs.j.01469] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Demineralized bone matrix is commonly used as a bone graft substitute, either alone or to supplement an osteoconductive material, because of its osteoinductive properties. The aging of the population has led to an increase in the number of prospective donors of demineralized bone matrix who have taken bisphosphonates to prevent osteoclast-mediated bone resorption. The aim of this study was to determine whether oral bisphosphonate usage affects the osteoinductivity of demineralized bone matrix from donors. METHODS Sex-matched and age-matched pairs of samples were provided by four tissue banks (three or four pairs per bank). Demineralized bone matrix donors without bisphosphonate treatment had a mean age (and standard deviation) of 69.1 ± 2.5 years, and donors with bisphosphonate treatment had a mean age of 68.9 ± 2.0 years. Each pair included one donor known to have taken bisphosphonates and one who had not taken bisphosphonates. Demineralized bone matrix previously confirmed as osteoinductive was the positive control, and heat-inactivated demineralized bone matrix was the negative control. Demineralized bone matrix incubated with 1 mL of phosphate-buffered saline solution containing 0, 0.002, 2.0, or 2000 ng/mL of alendronate was also tested. Gelatin capsules containing 15 mg of demineralized bone matrix were implanted bilaterally in the gastrocnemius muscle of male nude mice (eight implants per group). The mice were killed thirty-five days after implantation, and hind limbs were recovered and processed for histological analysis. Osteoinductivity was measured with use of a qualitative score and by histomorphometry. RESULTS Nine of fifteen samples from donors who had had bisphosphonate treatment and ten of fifteen samples from patients who had not had bisphosphonate treatment were osteoinductive. Qualitative mean scores were comparable (1.7 ± 0.4 for those without bisphosphonates and 1.9 ± 0.7 for those with bisphosphonates). Osteoinductive demineralized bone matrix samples produced ossicles of comparable size, regardless of bisphosphonate usage. Histomorphometric measurements of the area of new bone formation and residual demineralized bone matrix were also comparable. The addition of alendronate to control demineralized bone matrix did not affect its osteoinductivity. CONCLUSIONS Demineralized bone matrix samples from donors treated with bisphosphonates and donors not treated with bisphosphonates have the same ability to induce bone formation. However, it is not known if the quality of the new bone is affected, with subsequent consequences affecting bone remodeling.
Collapse
Affiliation(s)
- Zvi Schwartz
- Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive N.W., Atlanta, GA 30332-0363. E-mail address for B.D. Boyan:
| | - Sharon L. Hyzy
- Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive N.W., Atlanta, GA 30332-0363. E-mail address for B.D. Boyan:
| | - Mark A. Moore
- LifeNet Health, Bio-Implants Division, 1864 Concert Drive, Virginia Beach, VA 23453. E-mail address:
| | - Shawn A. Hunter
- Community Tissue Services, Center for Tissue Innovation and Research, 2900 College Drive, Kettering, OH 45420. E-mail address:
| | - Chad J. Ronholdt
- LABS Inc., 6933-B South Revere Parkway, Centennial, CO 80112. E-mail address:
| | - MoonHae Sunwoo
- Musculoskeletal Transplant Foundation, 125 May Street, Edison, NJ 08837. E-mail address:
| | - Barbara D. Boyan
- Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive N.W., Atlanta, GA 30332-0363. E-mail address for B.D. Boyan:
| |
Collapse
|
47
|
Jeong J, Lee KS, Choi YK, Oh YJ, Lee HD. Preventive effects of zoledronic acid on bone metastasis in mice injected with human breast cancer cells. J Korean Med Sci 2011; 26:1569-75. [PMID: 22147993 PMCID: PMC3230016 DOI: 10.3346/jkms.2011.26.12.1569] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 10/19/2011] [Indexed: 12/03/2022] Open
Abstract
Bisphosphonates are used routinely to reduce bone-related events in breast cancer patients with bone metastasis. We evaluated the effects of zoledronic acid, a third generation, nitrogen-containing bisphosphonate, to prevent bone metastasis in breast cancer. Zoledronic acid or vehicle alone was administered to nude mice either simultaneously or after intracardiac injection of human breast cancer MDA-MB-231 cells. Nude mice treated with zoledronic acid at early time points showed a lower incidence of bone metastases than did vehicle-treated nude mice, but these differences were not statistically significant. Only 37.5% of mice treated with zoledronic acid at the time of tumor cell inoculation developed bone metastases compared to over 51.8% of mice receiving vehicle alone (P = 0.304). Cell count of apoptosis confirmed by immunohistochemical staining in metastatic bone tissue significantly increased in the zoledronic acid-treated groups compared to non-treated group (1,018.3 vs 282.0; P = 0.046). However, metastatic tumor cells, which invade soft tissue around the bone, did not show extensive apoptosis; there were no differences between the zoledronic acid-treated and control groups. These results suggest that zoledronic acid increases apoptosis of metastatic breast tumor cells in the bone and could therefore reduce metastatic tumor burden. These results support the use of zoledronic acid to reduce the incidence of bone metastasis in breast cancer.
Collapse
Affiliation(s)
- Joon Jeong
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Korea
| | - Kyung Sun Lee
- Department of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Yang-Kyu Choi
- Department of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Young Ju Oh
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Korea
| | - Hy-De Lee
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Korea
| |
Collapse
|
48
|
Abstract
The first full publications on the biological effects of the diphosphonates, later renamed bisphosphonates, appeared in 1969, so it is timely after 40years to review the history of their development and their impact on clinical medicine. This special issue of BONE contains a series of review articles covering the basic science and clinical aspects of these drugs, written by some of many scientists who have participated in the advances made in this field. The discovery and development of the bisphosphonates (BPs) as a major class of drugs for the treatment of bone diseases has been a fascinating story, and is a paradigm of a successful journey from 'bench to bedside'. Bisphosphonates are chemically stable analogues of inorganic pyrophosphate (PPi), and it was studies on the role of PPi as the body's natural 'water softener' in the control of soft tissue and skeletal mineralisation that led to the need to find inhibitors of calcification that would resist hydrolysis by alkaline phosphatase. The observation that PPi and BPs could not only retard the growth but also the dissolution of hydroxyapatite crystals prompted studies on their ability to inhibit bone resorption. Although PPi was unable to do this, BPs turned out to be remarkably effective inhibitors of bone resorption, both in vitro and in vivo experimental systems, and eventually in humans. As ever more potent BPs were synthesised and studied, it became apparent that physico-chemical effects were insufficient to explain their biological effects, and that cellular actions must be involved. Despite many attempts, it was not until the 1990s that their biochemical actions were elucidated. It is now clear that bisphosphonates inhibit bone resorption by being selectively taken up and adsorbed to mineral surfaces in bone, where they interfere with the action of the bone-resorbing osteoclasts. Bisphosphonates are internalised by osteoclasts and interfere with specific biochemical processes. Bisphosphonates can be classified into at least two groups with different molecular modes of action. The simpler non-nitrogen containing bisphosphonates (such as etidronate and clodronate) can be metabolically incorporated into non-hydrolysable analogues of ATP, which interfere with ATP-dependent intracellular pathways. The more potent, nitrogen-containing bisphosphonates (including pamidronate, alendronate, risedronate, ibandronate and zoledronate) are not metabolised in this way but inhibit key enzymes of the mevalonate/cholesterol biosynthetic pathway. The major enzyme target for bisphosphonates is farnesyl pyrophosphate synthase (FPPS), and the crystal structure elucidated for this enzyme reveals how BPs bind to and inhibit at the active site via their critical N atoms. Inhibition of FPPS prevents the biosynthesis of isoprenoid compounds (notably farnesol and geranylgeraniol) that are required for the post-translational prenylation of small GTP-binding proteins (which are also GTPases) such as rab, rho and rac, which are essential for intracellular signalling events within osteoclasts. The accumulation of the upstream metabolite, isopentenyl pyrophosphate (IPP), as a result of inhibition of FPPS may be responsible for immunomodulatory effects on gamma delta (γδ) T cells, and can also lead to production of another ATP metabolite called ApppI, which has intracellular actions. Effects on other cellular targets, such as osteocytes, may also be important. Over the years many hundreds of BPs have been made, and more than a dozen have been studied in man. As reviewed elsewhere in this issue, bisphosphonates are established as the treatments of choice for various diseases of excessive bone resorption, including Paget's disease of bone, the skeletal complications of malignancy, and osteoporosis. Several of the leading BPs have achieved 'block-buster' status with annual sales in excess of a billion dollars. As a class, BPs share properties in common. However, as with other classes of drugs, there are obvious chemical, biochemical, and pharmacological differences among the various BPs. Each BP has a unique profile in terms of mineral binding and cellular effects that may help to explain potential clinical differences among the BPs. Even though many of the well-established BPs have come or are coming to the end of their patent life, their use as cheaper generic drugs is likely to continue for many years to come. Furthermore in many areas, e.g. in cancer therapy, the way they are used is not yet optimised. New 'designer' BPs continue to be made, and there are several interesting potential applications in other areas of medicine, with unmet medical needs still to be fulfilled. The adventure that began in Davos more than 40 years ago is not yet over.
Collapse
Affiliation(s)
- R Graham G Russell
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Oxford NIHR Biomedical Research Unit, The Oxford University Institute of Musculoskeletal Sciences, The Botnar Research Centre, Headington, Oxford, UK.
| |
Collapse
|
49
|
Rogers MJ, Crockett JC, Coxon FP, Mönkkönen J. Biochemical and molecular mechanisms of action of bisphosphonates. Bone 2011; 49:34-41. [PMID: 21111853 DOI: 10.1016/j.bone.2010.11.008] [Citation(s) in RCA: 353] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 11/08/2010] [Accepted: 11/09/2010] [Indexed: 11/26/2022]
Abstract
This review describes the key discoveries over the last 15 years that have led to a clearer understanding of the molecular mechanisms by which bisphosphonate drugs inhibit bone resorption. Once released from bone mineral surfaces during bone resorption, these agents accumulate intracellularly in osteoclasts. Simple bisphosphonates such as clodronate are incorporated into non-hydrolysable analogues of adenosine triphosphate, which induce osteoclast apoptosis. The considerably more potent nitrogen-containing bisphosphonates are not metabolised but potently inhibit farnesyl pyrophosphate (FPP) synthase, a key enzyme of the mevalonate pathway. This prevents the synthesis of isoprenoid lipids necessary for the post-translational prenylation of small GTPases, thereby disrupting the subcellular localisation and normal function of these essential signalling proteins. Inhibition of FPP synthase also results in the accumulation of the upstream metabolite isopentenyl diphosphate, which is incorporated into the toxic nucleotide metabolite ApppI. Together, these properties explain the ability of bisphosphonate drugs to inhibit bone resorption by disrupting osteoclast function and survival. These discoveries are also giving insights into some of the adverse effects of bisphosphonates, such as the acute phase reaction that is triggered by inhibition of FPP synthase in peripheral blood monocytes.
Collapse
|
50
|
Complete Restoration of Refractory Mandibular Osteoradionecrosis by Prolonged Treatment with a Pentoxifylline-Tocopherol-Clodronate Combination (PENTOCLO): A Phase II Trial. Int J Radiat Oncol Biol Phys 2011; 80:832-9. [DOI: 10.1016/j.ijrobp.2010.03.029] [Citation(s) in RCA: 197] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 02/08/2010] [Accepted: 03/10/2010] [Indexed: 11/22/2022]
|