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Morsing NV, Andreasen CM, Rasmussen TA, Moll LT. Cutaneous leishmaniasis in a patient with psoriatic arthritis treated with tumour necrosis factor-α inhibitor. Scand J Rheumatol 2024; 53:158-159. [PMID: 38275137 DOI: 10.1080/03009742.2023.2295627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024]
Affiliation(s)
- N V Morsing
- Department of Internal Medicine, Regional Hospital Gødstrup, Herning, Denmark
| | - C M Andreasen
- Department of Internal Medicine, Regional Hospital Gødstrup, Herning, Denmark
| | - T A Rasmussen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - L T Moll
- Department of Internal Medicine, Regional Hospital Gødstrup, Herning, Denmark
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Hegarty-Cremer SGD, Borggaard XG, Andreasen CM, van der Eerden BCJ, Simpson MJ, Andersen TL, Buenzli PR. How osteons form: A quantitative hypothesis-testing analysis of cortical pore filling and wall asymmetry. Bone 2024; 180:116998. [PMID: 38184100 DOI: 10.1016/j.bone.2023.116998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/08/2024]
Abstract
Osteon morphology provides valuable information about the interplay between different processes involved in bone remodelling. The correct quantitative interpretation of these morphological features is challenging due to the complexity of interactions between osteoblast behaviour, and the evolving geometry of cortical pores during pore closing. We present a combined experimental and mathematical modelling study to provide insights into bone formation mechanisms during cortical bone remodelling based on histological cross-sections of quiescent human osteons and hypothesis-testing analyses. We introduce wall thickness asymmetry as a measure of the local asymmetry of bone formation within an osteon and examine the frequency distribution of wall thickness asymmetry in cortical osteons from human iliac crest bone samples from women 16-78 years old. Our measurements show that most osteons possess some degree of asymmetry, and that the average degree of osteon asymmetry in cortical bone evolves with age. We then propose a comprehensive mathematical model of cortical pore filling that includes osteoblast secretory activity, osteoblast elimination, osteoblast embedment as osteocytes, and osteoblast crowding and redistribution along the bone surface. The mathematical model is first calibrated to symmetric osteon data, and then used to test three mechanisms of asymmetric wall formation against osteon data: (i) delays in the onset of infilling around the cement line; (ii) heterogeneous osteoblastogenesis around the bone perimeter; and (iii) heterogeneous osteoblast secretory rate around the bone perimeter. Our results suggest that wall thickness asymmetry due to off-centred Haversian pores within osteons, and that nonuniform lamellar thicknesses within osteons are important morphological features that can indicate the prevalence of specific asymmetry-generating mechanisms. This has significant implications for the study of disruptions of bone formation as it could indicate what biological bone formation processes may become disrupted with age or disease.
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Affiliation(s)
- Solene G D Hegarty-Cremer
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia; Department of Mathematics and Statistics, The University of Montreal, Montreal, Canada
| | - Xenia G Borggaard
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | - Christina M Andreasen
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | | | - Matthew J Simpson
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Thomas L Andersen
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark; Dept. of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Pascal R Buenzli
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia.
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Sørensen NN, Andreasen CM, Jensen PR, Hauge EM, Bollerslev J, Delaissé JM, Kassem M, Jafari A, Diaz-delCastillo M, Andersen TL. Disturbed bone marrow adiposity in patients with Cushing's syndrome and glucocorticoid- and postmenopausal- induced osteoporosis. Front Endocrinol (Lausanne) 2023; 14:1232574. [PMID: 37881495 PMCID: PMC10597666 DOI: 10.3389/fendo.2023.1232574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023] Open
Abstract
Background Skeletal stem/progenitor cells (SSPCs) in the bone marrow can differentiate into osteoblasts or adipocytes in response to microenvironmental signalling input, including hormonal signalling. Glucocorticoids (GC) are corticosteroid hormones that promote adipogenic differentiation and are endogenously increased in patients with Cushing´s syndrome (CS). Here, we investigate bone marrow adiposity changes in response to endogenous or exogenous GC increases. For that, we characterize bone biopsies from patients with CS and post-menopausal women with glucocorticoid-induced osteoporosis (GC-O), compared to age-matched controls, including postmenopausal osteoporotic patients (PM-O). Methods Transiliac crest bone biopsies from CS patients and healthy controls, and from postmenopausal women with GC-O and matched controls were analysed; an additional cohort included biopsies from women with PM-O. Plastic-embedded biopsies were sectioned for histomorphometric characterization and quantification of adipocytes. The fraction of adipocyte area per tissue (Ad.Ar/T.Ar) and marrow area (Ad.Ar/Ma.Ar), mean adipocyte profile area (Ad.Pf.Ar) and adipocyte profile density (N.Ad.Pf/Ma.Ar) were determined and correlated to steroid levels. Furthermore, the spatial distribution of adipocytes in relation to trabecular bone was characterized and correlations between bone marrow adiposity and bone remodeling parameters investigated. Results Biopsies from patients with CS and GC-O presented increased Ad.Ar/Ma.Ar, along with adipocyte hypertrophy and hyperplasia. In patients with CS, both Ad.Ar/Ma.Ar and Ad.Pf.Ar significantly correlated with serum cortisol levels. Spatial distribution analyses revealed that, in CS, the increase in Ad.Ar/Ma.Ar near to trabecular bone (<100 µm) was mediated by both adipocyte hypertrophy and hyperplasia, while N.Ad.Pf/Ma.Ar further into the marrow (>100 µm) remained unchanged. In contrast, patients with GC-O only presented increased Ad.Ar/Ma.Ar and mean Ad.Pf.Ar>100 µm from trabecular bone surface, highlighting the differential effect of increased endogenous steroid accumulation. Finally, the Ad.Ar/Ma.Ar and Ad.Ar/T.Ar correlated with the canopy coverage above remodeling events. Conclusion Increased cortisol production in patients with CS induces increased bone marrow adiposity, primarily mediated by adipocyte hypertrophy. This adiposity is particularly evident near trabecular bone surfaces, where hyperplasia also occurs. The differential pattern of adiposity in patients with CS and GC-O highlights that bone marrow adipocytes and their progenitors may respond differently in these two GC-mediated bone diseases.
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Affiliation(s)
- Nina N. Sørensen
- Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Christina M. Andreasen
- Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Danish Spatial Imaging Consortium (DanSIC), Denmark
| | - Pia R. Jensen
- Clinical Cell Biology (KCB), Vejle/Lillebaelt Hospital, Institute of Regional Health Research (IRS), University of Southern Denmark, Vejle, Denmark
| | - Ellen M. Hauge
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Bollerslev
- Section of Specialized Endocrinology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jean-Marie Delaissé
- Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Moustapha Kassem
- Department of Cellular and Molecular Medicine, Novo Nordisk Foundation Center for Stem Cell Biology (DanStem), University of Copenhagen, Copenhagen, Denmark
- Molecular Endocrinology & Stem Cell Research Unit (KMEB), Department of Endocrinology and Metabolism, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Abbas Jafari
- Department of Cellular and Molecular Medicine, Novo Nordisk Foundation Center for Stem Cell Biology (DanStem), University of Copenhagen, Copenhagen, Denmark
- Molecular Endocrinology & Stem Cell Research Unit (KMEB), Department of Endocrinology and Metabolism, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Marta Diaz-delCastillo
- Danish Spatial Imaging Consortium (DanSIC), Denmark
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Thomas L. Andersen
- Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Danish Spatial Imaging Consortium (DanSIC), Denmark
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
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Borggaard XG, Roux JP, Delaisse JM, Chavassieux P, Andreasen CM, Andersen TL. Alendronate prolongs the reversal-resorption phase in human cortical bone remodeling. Bone 2022; 160:116419. [PMID: 35413490 DOI: 10.1016/j.bone.2022.116419] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 01/18/2023]
Abstract
Despite their ability to reduce fracture-risk and increase Bone Mineral Density (BMD) in osteoporotic women, bisphosphonates are reported to reduce formation of new bone. Reduced bone formation has been suggested to lead to accumulation of microfractures and contribute to rare side effects in cortical bone such as atypical femur fractures. However, most studies are limited to trabecular bone. In this study, the cortical bone remodeling in human iliac bone specimens of 65 non-treated and 24 alendronate-treated osteoporotic women was investigated using a new histomorphometric classification of intracortical pores. The study showed that only 12.4 ± 11% of the cortical pore area reflected quiescent pores/osteons in alendronate-treated patients versus 8.5 ± 5% in placebo, highlighting that new cortical remodeling events remain to be activated. The percent and size of eroded pores (events in resorption-reversal phase) remained unchanged, but their contribution to total pore area was 1.4-fold higher in alendronate versus placebo treated patients (66 ± 22% vs 48 ± 22%, p < 0.001). On the other hand, the mixed eroded-formative pores (events with mixed resorption-reversal-formation phases) was 2-fold lower in alendronate versus placebo treated patients (19 ± 14% vs 39 ± 23% of total pore area, p < 0.001), and formative pores (event in formation phase) was 2.2-fold lower in alendronate versus placebo treated patients (2.1 ± 2.4% vs 4.6 ± 3.6%, p < 0.01), and their contribution to total pore area was 2.4-fold lower (1.3 ± 2.1% vs 3.1 ± 4.4%, p < 0.05). Importantly, these differences between alendronate and placebo treated patients were significant in patients after 3 years of treatment, not after 2 years of treatment. Collectively, the results support that cortical remodeling events activated during alendronate treatment has a prolonged reversal-resorption phase with a delayed transition to formation, becoming increasingly evident after 3-years of treatment. A potential contributor to atypical femur fractures associated with long-term bisphosphonate treatment.
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Affiliation(s)
- Xenia G Borggaard
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark.
| | | | - Jean-Marie Delaisse
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | | | - Christina M Andreasen
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | - Thomas L Andersen
- Molecular Bone Histology Team, Clinical Cell Biology, Research Unit of Pathology, Dept. of Clinical Research and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark; Dept. of Forensic Medicine, Aarhus University, Aarhus, Denmark.
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Borggaard XG, Nielsen MH, Delaisse JM, Andreasen CM, Andersen TL. Spatial Organization of Osteoclastic Coupling Factors and Their Receptors at Human Bone Remodeling Sites. Front Mol Biosci 2022; 9:896841. [PMID: 35775083 PMCID: PMC9239410 DOI: 10.3389/fmolb.2022.896841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
The strictly regulated bone remodeling process ensures that osteoblastic bone formation is coupled to osteoclastic bone resorption. This coupling is regulated by a panel of coupling factors, including clastokines promoting the recruitment, expansion, and differentiation of osteoprogenitor cells within the eroded cavity. The osteoprogenitor cells on eroded surfaces are called reversal cells. They are intermixed with osteoclasts and become bone-forming osteoblast when reaching a critical density and maturity. Several coupling factors have been proposed in the literature, but their effects and expression pattern vary between studies depending on species and experimental setup. In this study, we investigated the mRNA levels of proposed secreted and membrane-bound coupling factors and their receptors in cortical bone remodeling events within the femur of healthy adolescent human controls using high-sensitivity RNA in situ hybridization. Of the proposed coupling factors, human osteoclasts showed mRNA-presence of LIF, PDGFB, SEMA4D, but no presence of EFNB2, and OSM. On the other hand, the osteoblastic reversal cells proximate to osteoclasts presented with LIFR, PDGFRA and PLXNB1, but not PDGFRB, which are all known receptors of the proposed coupling factors. Although EFNB2 was not present in mature osteoclasts, the mRNA of the ligand-receptor pair EFNB2:EPHB4 were abundant near the central blood vessels within intracortical pores with active remodeling. EPHB4 and SEMA4D were also abundant in mature bone-forming osteoblasts. This study highlights that especially LIF:LIFR, PDGFB:PDGFRA, SEMA4D:PLXNB1 may play a critical role in the osteoclast-osteoblast coupling in human remodeling events, as they are expressed within the critical cells.
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Affiliation(s)
- Xenia G. Borggaard
- Research Unit of Pathology, Department of Clinical Research and Department of Molecular Medicine, Molecular Bone Histology Team, Clinical Cell Biology, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
- *Correspondence: Xenia G. Borggaard, orcid.org/0000-0002-4922-2478 Thomas L. Andersen,
| | - Malene H. Nielsen
- Research Unit of Pathology, Department of Clinical Research and Department of Molecular Medicine, Molecular Bone Histology Team, Clinical Cell Biology, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Jean-Marie Delaisse
- Research Unit of Pathology, Department of Clinical Research and Department of Molecular Medicine, Molecular Bone Histology Team, Clinical Cell Biology, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Christina M. Andreasen
- Research Unit of Pathology, Department of Clinical Research and Department of Molecular Medicine, Molecular Bone Histology Team, Clinical Cell Biology, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Thomas L. Andersen
- Research Unit of Pathology, Department of Clinical Research and Department of Molecular Medicine, Molecular Bone Histology Team, Clinical Cell Biology, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
- *Correspondence: Xenia G. Borggaard, orcid.org/0000-0002-4922-2478 Thomas L. Andersen,
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Hansen RB, Sayilekshmy M, Sørensen MS, Jørgensen AH, Kanneworff IB, Bengtsson EKE, Grum-Schwensen TA, Petersen MM, Ejersted C, Andersen TL, Andreasen CM, Heegaard AM. Neuronal Sprouting and Reorganization in Bone Tissue Infiltrated by Human Breast Cancer Cells. Front Pain Res 2022; 3:887747. [PMID: 35712449 PMCID: PMC9197453 DOI: 10.3389/fpain.2022.887747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPain is a common complication for patients with metastatic bone disease. Animal models suggest that the pain, in part, is driven by pathological sprouting and reorganization of the nerve fibers innervating the bone. Here, we investigate how these findings translate to humans.MethodsBone biopsies were collected from healthy volunteers (n = 7) and patients with breast cancer and metastatic bone disease (permissions H-15000679, S-20180057 and S-20110112). Cancer-infiltrated biopsies were from patients without recent anticancer treatment (n = 10), patients with recent anticancer treatment (n = 10), and patients with joint replacement surgery (n = 9). Adjacent bone sections were stained for (1) protein gene product 9.5 and CD34, and (2) cytokeratin 7 and 19. Histomorphometry was used to estimate the area of bone marrow and tumor burden. Nerve profiles were counted, and the nerve profile density calculated. The location of each nerve profile within 25 μm of a vascular structure and/or cancer cells was determined.ResultsCancer-infiltrated bone tissue demonstrated a significantly higher nerve profile density compared to healthy bone tissue. The percentage of nerve profiles found close to vascular structures was significantly lower in cancer-infiltrated bone tissue. No difference was found in the percentage of nerve profiles located close to cancer between the subgroups of cancer-infiltrated bone tissue. Interestingly, no correlation was found between nerve profile density and tumor burden.ConclusionsTogether, the increased nerve profile density and the decreased association of nerve profiles to vasculature strongly suggests that neuronal sprouting and reorganization occurs in human cancer-infiltrated bone tissue.
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Affiliation(s)
- Rie B. Hansen
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Manasi Sayilekshmy
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Michala S. Sørensen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Astrid H. Jørgensen
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Ida B. Kanneworff
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Emma K. E. Bengtsson
- Clinical Cell Biology Group, Department of Pathology, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Tomas A. Grum-Schwensen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Michael M. Petersen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Ejersted
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Thomas L. Andersen
- Clinical Cell Biology Group, Department of Pathology, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Christina M. Andreasen
- Clinical Cell Biology Group, Department of Pathology, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Anne-Marie Heegaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Anne-Marie Heegaard
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Thomsen LK, Kejser MI, Sørensen LL, Jensen PR, Hauge EM, Bollerslev J, Boel LW, Delaissé JM, Andreasen CM, Andersen TL. Glucocorticoids prolong the reversal-resorption phase delaying bone formation in intracortical remodelling compared to postmenopausal and osteoporotic women. Bone Rep 2021. [DOI: 10.1016/j.bonr.2021.100799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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8
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Kjærgaard K, Ding M, Jensen C, Bragdon C, Malchau H, Andreasen CM, Ovesen O, Hofbauer C, Overgaard S. Vitamin E-doped total hip arthroplasty liners show similar head penetration to highly cross-linked polyethylene at five years: a multi-arm randomized controlled trial. Bone Joint J 2020; 102-B:1303-1310. [PMID: 32993343 PMCID: PMC7517722 DOI: 10.1302/0301-620x.102b10.bjj-2020-0138.r1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Aims The most frequent indication for revision surgery in total hip arthroplasty (THA) is aseptic loosening. Aseptic loosening is associated with polyethylene liner wear, and wear may be reduced by using vitamin E-doped liners. The primary objective of this study was to compare proximal femoral head penetration into the liner between a) two cross-linked polyethylene (XLPE) liners (vitamin E-doped (vE-PE)) versus standard XLPE liners, and b) two modular femoral head diameters (32 mm and 36 mm). Methods Patients scheduled for a THA were randomized to receive a vE-PE or XLPE liner with a 32 mm or 36 mm metal head (four intervention groups in a 2 × 2 factorial design). Head penetration and acetabular component migration were measured using radiostereometric analysis at baseline, three, 12, 24, and 60 months postoperatively. The Harris Hip Score, University of California, Los Angeles (UCLA) Activity Score, EuroQol five-dimension questionnaire (EQ-5D), and 36-Item Short-Form Health Survey questionnaire (SF-36) were assessed at baseline, three, 12, 36, and 60 months. Results Of 220 screened patients, 127 were included in this study. In all, 116 received the allocated intervention, and 94 had their results analyzed at five years. Head penetration was similar between liner materials and head sizes at five years, vE-PE versus XLPE was -0.084 mm (95% confidence interval (CI) -0.173 to 0.005; p = 0.064), and 32 mm versus 36 mm was -0.020 mm (95% CI -0.110 to 0.071; p = 0.671), respectively. No differences were found in acetabular component migration or in the patient-reported outcome measures. Conclusion No significant difference in head penetration was found at five years between vE-PE and XLPE liners, nor between 32 mm and 36 mm heads. Cite this article: Bone Joint J 2020;102-B(10):1303–1310.
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Affiliation(s)
- Kristian Kjærgaard
- Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ming Ding
- Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Carsten Jensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Orthopaedic Surgery, Kolding Hospital, Kolding, Denmark
| | - Charles Bragdon
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Henrik Malchau
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Christina M Andreasen
- Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ole Ovesen
- Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
| | | | - Søren Overgaard
- Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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El-Masri BM, Kejser MI, Sørensen LL, Borggaard XG, Nielsen MH, Boel LW, Laursen KS, Thomsen JS, Andreasen CM, Andersen TL. Prolongation of the reversal-resorption phase leads to increased cortical porosity in men and women. Bone Rep 2020. [DOI: 10.1016/j.bonr.2020.100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Andreasen CM, Jurik AG, Deleuran BW, Horn HC, Folkmar TB, Herlin T, Hauge EM. Pamidronate in chronic non-bacterial osteomyelitis: a randomized, double-blinded, placebo-controlled pilot trial. Scand J Rheumatol 2020; 49:312-322. [PMID: 32484386 DOI: 10.1080/03009742.2020.1724324] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This is the first randomized double-blinded, placebo-controlled pilot trial to investigate the efficacy of pamidronate in reducing radiological and clinical disease activity in chronic non-bacterial osteomyelitis (CNO). METHOD Patients received pamidronate or placebo at baseline and weeks 12 and 24. Whole-body magnetic resonance imaging was performed at baseline and weeks 12 and 36, and computed tomography of the anterior chest wall (ACW) at baseline and week 36. Radiological disease activity was systematically scored in the ACW and spine. Patient-reported outcomes [visual analogue scale (VAS) pain, VAS global health, Health Assessment Questionnaire (HAQ), EuroQol-5 Dimensions (EQ-5D), and 36-item Short-Form Health Survey (SF-36)] and biomarkers of bone turnover and inflammation were assessed at baseline and weeks 1, 4, 12, 24, and 36. Data are expressed as median [interquartile range]. RESULTS Fourteen patients were randomized and 12 were analysed. From baseline to week 36, the radiological disease activity score in the ACW decreased from 5 [4-7] to 2.5 [1-3] in the pamidronate group, but did not change in the placebo group (p = 0.04). From baseline to week 36, VAS pain and VAS global health tended to decrease more in the pamidronate than in the placebo group (p = 0.11, p = 0.08). Physical functioning (HAQ) and health-related quality of life (EQ-5D, SF-36) did not change. Biomarkers of bone turnover decreased only in the pamidronate group (p ≤ 0.02). CONCLUSION Pamidronate may improve radiological and clinical disease activity in CNO. Methods to score radiological disease activity in adult CNO were suggested. Clinical Trials: NCT02594878.
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Affiliation(s)
- C M Andreasen
- Department of Rheumatology, Aarhus University Hospital , Aarhus, Denmark
| | - A G Jurik
- Department of Radiology, Aarhus University Hospital , Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University , Aarhus, Denmark
| | - B W Deleuran
- Department of Rheumatology, Aarhus University Hospital , Aarhus, Denmark.,Department of Biomedicine, Aarhus University , Aarhus, Denmark
| | - H C Horn
- Department of Rheumatology, Odense University Hospital , Odense, Denmark
| | - T B Folkmar
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital , Aarhus, Denmark
| | - T Herlin
- Department of Clinical Medicine, Aarhus University , Aarhus, Denmark.,Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital , Aarhus, Denmark
| | - E M Hauge
- Department of Rheumatology, Aarhus University Hospital , Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University , Aarhus, Denmark
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Frost M, Rahbek ET, Ejersted C, Høilund-Carlsen PF, Bygum A, Thomsen JS, Andreasen CM, Andersen TL, Frederiksen AL. Modeling-based bone formation transforms trabeculae to cortical bone in the sclerotic areas in Buschke-Ollendorff syndrome. A case study of two females with LEMD3 variants. Bone 2020; 135:115313. [PMID: 32151766 DOI: 10.1016/j.bone.2020.115313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 12/11/2022]
Abstract
Buschke-Ollendorff syndrome is a rare autosomal dominant condition caused by pathogenic variants in LEMD3 and characterized by connective tissue nevi and sclerotic bone abnormalities known as osteopoikilosis. The bone phenotype in Buschke-Ollendorff syndrome including osteopoikilosis remains unclear. We investigated bone turnover markers, pelvis and crura X-rays; lumbar spine and femoral neck DXA; bone activity by NaF-PET/CT, bone structure by μCT and dynamic histomorphometry in adults with Buschke-Ollendorff syndrome. Two women aged 25 and 47 years with a BMI of 30 and 32 kg/m2, respectively, were included in the investigation. Bone turnover markers were within normal range. aBMD Z-scores were comparable to that of controls in the lumbar spine and increased at the hip. Radiographies exposed spotted areas in crura and pelvis, and NaF-PET/CT exposed abnormal pattern of irregular shaped NaF uptake in the entire skeleton. In both biopsies, μCT showed trabecular structure comparable to that of controls with stellate shaped sclerotic noduli within the cavity and on the endocortex. Histomorphometric analyses of the sclerotic lesions revealed compact lamellar bone with a normal bone remodeling rate, but partly replaced by modeling-based bone formation. Woven bone was not observed in the nodules. Therefore, while bone turnover and BMD were largely within normal reference range in patients with the Buschke-Ollendorff syndrome, osteosclerotic lesions appear to emerge due to modeling-based bone formation with secondary bone remodeling. These observations indicate that LEMD3 may be important for the activation of bone lining cells leading to modeling-based bone formation.
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Affiliation(s)
- M Frost
- Dept. of Endocrinology, Odense University Hospital, J.B. Winsloews Vej 4, DK-5000 Odense C, Denmark; Steno Diabetes Center Odense, J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark; Dept. of Clinical Research, Faculty of Health, University of Southern Denmark, J.B. Winsloews vej 19, DK-5000 Odense C, Denmark.
| | - E T Rahbek
- Dept. of Clinical Genetics, Odense University Hospital, J.B. Winsloews Vej 4, DK-5000 Odense C, Denmark.
| | - C Ejersted
- Dept. of Endocrinology, Odense University Hospital, J.B. Winsloews Vej 4, DK-5000 Odense C, Denmark.
| | - P F Høilund-Carlsen
- Dept. of Clinical Research, Faculty of Health, University of Southern Denmark, J.B. Winsloews vej 19, DK-5000 Odense C, Denmark; Dept. of Nuclear Medicine, Odense University Hospital, J.B. Winsloews Vej 4, DK-5000 Odense C, Denmark.
| | - A Bygum
- Dept. of Clinical Research, Faculty of Health, University of Southern Denmark, J.B. Winsloews vej 19, DK-5000 Odense C, Denmark; Dept. of Dermatology and Allergy Centre, Odense University Hospital, J.B. Winsloews Vej 4, DK-5000 Odense C, Denmark.
| | - J S Thomsen
- Dept. of Biomedicine, Aarhus University, Wilhelm Meyers Allé, DK-8000 Aarhus C, Denmark..
| | - C M Andreasen
- Clinical Cell Biology, Pathology Research Unit, Odense University Hospital, J. B Winsloews Vej 25, DK-5000 Odense C, Denmark; Dept. of Molecular Medicine, University of Southern Denmark, J. B Winsloews Vej 25, DK-5000 Odense C, Denmark; Dept. of Clinical Research, University of Southern Denmark, J. B Winsloews Vej 25, DK-5000 Odense C, Denmark.
| | - T L Andersen
- Clinical Cell Biology, Pathology Research Unit, Odense University Hospital, J. B Winsloews Vej 25, DK-5000 Odense C, Denmark; Dept. of Molecular Medicine, University of Southern Denmark, J. B Winsloews Vej 25, DK-5000 Odense C, Denmark; Dept. of Forensic Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark; Dept. of Clinical Research, University of Southern Denmark, J. B Winsloews Vej 25, DK-5000 Odense C, Denmark.
| | - A L Frederiksen
- Dept. of Clinical Research, Faculty of Health, University of Southern Denmark, J.B. Winsloews vej 19, DK-5000 Odense C, Denmark; Dept. of Clinical Genetics, Odense University Hospital, J.B. Winsloews Vej 4, DK-5000 Odense C, Denmark.
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Ross RD, Anderson K, Davison R, El-Masri BM, Andreasen CM, Andersen TL, Sumner DR. Osteoporosis Treatments Affect Bone Matrix Maturation in a Rat Model of Induced Cortical Remodeling. JBMR Plus 2020; 4:e10344. [PMID: 32258964 PMCID: PMC7117844 DOI: 10.1002/jbm4.10344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/19/2020] [Indexed: 11/20/2022] Open
Abstract
To test how osteoporosis drugs affect bone matrix maturation during cortical bone remodeling, 72 pregnant rats were switched from a 0.4% to a 0.01% calcium diet at parturition for a 23‐day lactation period. At weaning, eight dams were sacrificed to establish baseline values, while the remaining dams were returned to 0.4% calcium and treated with vehicle (saline), sodium fluoride (NaF), zoledronic acid (ZA), or sclerostin antibody (Scl‐Ab) for either 7 or 28 days (eight animals per group per time point). Femora were examined by μCT, dynamic histomorphometry, Fourier transform infrared imaging, and three‐point bending of notched specimens. Cortical porosity decreased in all groups from baseline to day 28. Intracortical mineralizing surface (MS/BS) and mineral apposition rate (MAR), as well as the mineral‐to‐matrix ratio were unaffected by treatment, but intracortical crystallinity was increased in the ZA group at day 10 compared with vehicle. Cortical area increased in all groups over 28 days mainly because of an addition of bone at the endocortical surface. Endocortical MS/BS did not vary among the groups, but endocortical MAR was suppressed in the NaF group at day 2 and elevated in the Scl‐Ab group at day 4 compared with vehicle. Endocortical mineral‐to‐matrix ratio was increased at days 5 and 10 following NaF treatment and endocortical crystallinity was increased at day 5 following ZA treatment compared with vehicle. Fracture toughness did not differ among the groups. Thus, the treatments affected matrix maturation more strongly at the endocortical then intracortical envelope. In this model of induced remodeling, the bone formation phase is synchronized at multiple sites, facilitating study of the effects of drugs or other bone‐targeting agents on matrix maturation independent of their effects on the initiation of remodeling. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Ryan D Ross
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA.,Department of Orthopedic Surgery Rush University Medical Center Chicago IL USA
| | - Kyle Anderson
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA
| | - Reid Davison
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA
| | - Bilal M El-Masri
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research University of Southern Denmark, and Department of Pathology, Odense University Hospital Odense Denmark.,Department of Molecular Medicine University of Southern Denmark Odense Denmark
| | - Christina M Andreasen
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research University of Southern Denmark, and Department of Pathology, Odense University Hospital Odense Denmark.,Department of Molecular Medicine University of Southern Denmark Odense Denmark
| | - Thomas L Andersen
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research University of Southern Denmark, and Department of Pathology, Odense University Hospital Odense Denmark.,Department of Molecular Medicine University of Southern Denmark Odense Denmark
| | - Dale R Sumner
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA.,Department of Orthopedic Surgery Rush University Medical Center Chicago IL USA
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Frost M, Tencerova M, Andreasen CM, Andersen TL, Ejersted C, Svaneby D, Qui W, Kassem M, Zarei A, McAlister WH, Veis DJ, Whyte MP, Frederiksen AL. Absence of an osteopetrosis phenotype in IKBKG (NEMO) mutation-positive women: A case-control study. Bone 2019; 121:243-254. [PMID: 30659980 PMCID: PMC6457251 DOI: 10.1016/j.bone.2019.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/12/2018] [Accepted: 01/14/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND NF-κB essential modulator (NEMO), encoded by IKBKG, is necessary for activation of the ubiquitous transcription factor nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB). Animal studies suggest NEMO is required for NF-κB mediated bone homeostasis, but this has not been thoroughly studied in humans. IKBKG loss-of-function mutation causes incontinentia pigmenti (IP), a rare X-linked disease featuring linear hypopigmentation, alopecia, hypodontia, and immunodeficiency. Single case reports describe osteopetrosis (OPT) in boys carrying hypomorphic IKBKG mutations. METHOD We studied the bone phenotype in women with IP with evaluation of radiographs of the spine and non-dominant arm and leg; lumbar spine and femoral neck aBMD using DXA; μ-CT and histomorphometry of trans-iliac crest biopsy specimens; bone turnover markers; and cellular phenotype in bone marrow skeletal (stromal) stem cells (BM-MSCs) in a cross-sectional, age-, sex-, and BMI-matched case-control study. X-chromosome inactivation was measured in blood leucocytes and BM-MSCs using a PCR method with methylation of HpaII sites. NF-κB activity was quantitated in BM-MSCs using a luciferase NF-κB reporter assay. RESULTS Seven Caucasian women with IP (age: 24-67 years and BMI: 20.0-35.2 kg/m2) and IKBKG mutation (del exon 4-10 (n = 4); c.460C>T (n = 3)) were compared to matched controls. The IKBKG mutation carriers had extremely skewed X-inactivation (>90:10%) in blood, but not in BM-MSCs. NF-κB activity was lower in BM-MSCs from IKBKG mutation carriers (n = 5) compared to controls (3094 ± 679 vs. 5422 ± 1038/μg protein, p < 0.01). However, no differences were identified on skeletal radiographics, aBMD, μ-architecture of the iliac crest, or bone turnover markers. The IKBKG mutation carriers had a 1.7-fold greater extent of eroded surfaces relative to osteoid surfaces (p < 0.01), and a 2.0-fold greater proportion of arrested reversal surface relative to active reversal surface (p < 0.01). CONCLUSION Unlike mutation-positive males, the IKBKG mutation-positive women did not manifest OPT.
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Affiliation(s)
- Morten Frost
- Department of Clinical Research, Faculty of Health, University of Southern Denmark (SDU), Winsløwparken 19. 3, DK-5000 Odense C, Denmark; Steno Diabetes Center Odense, Odense University Hospital (OUH), J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark; Department of Endocrinology, Molecular Endocrinology Unit, OUH, J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark.
| | - Michaela Tencerova
- Department of Endocrinology, Molecular Endocrinology Unit, OUH, J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark.
| | - Christina M Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, OUH, J.B. Winsløws Vej 15, DK-5000 Odense C, Denmark; Department of Clinical Cell Biology, Vejle Hospital, Beridderbakken 4, DK-7100 Vejle, Denmark.
| | - Thomas L Andersen
- Department of Clinical Cell Biology, Vejle Hospital, Beridderbakken 4, DK-7100 Vejle, Denmark.
| | - Charlotte Ejersted
- Department of Endocrinology, Molecular Endocrinology Unit, OUH, J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark.
| | - Dea Svaneby
- Department of Clinical Genetics, Vejle Hospital, Beridderbakken 4, DK-7100 Vejle, Denmark.
| | - Weimin Qui
- Department of Endocrinology, Molecular Endocrinology Unit, OUH, J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark
| | - Moustapha Kassem
- Department of Endocrinology, Molecular Endocrinology Unit, OUH, J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark.
| | - Allahdad Zarei
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA.
| | - William H McAlister
- Department of Pediatric Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine at St. Louis Children's Hospital, St. Louis, MO, USA.
| | - Deborah J Veis
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA; Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA.
| | - Michael P Whyte
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA; Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA.
| | - Anja L Frederiksen
- Department of Clinical Research, Faculty of Health, University of Southern Denmark (SDU), Winsløwparken 19. 3, DK-5000 Odense C, Denmark; Department of Clinical Genetics, Odense University Hospital, J.B. Winsløws Vej 4, DK-5000 Odense C, Denmark.
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14
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Bakalova LP, Andreasen CM, Thomsen JS, Brüel A, Hauge EM, Kiil BJ, Delaisse JM, Andersen TL, Kersh ME. Intracortical Bone Mechanics Are Related to Pore Morphology and Remodeling in Human Bone. J Bone Miner Res 2018; 33:2177-2185. [PMID: 30048570 DOI: 10.1002/jbmr.3561] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/11/2018] [Accepted: 07/20/2018] [Indexed: 01/06/2023]
Abstract
During aging and in osteoporosis, cortical bone becomes more porous, making it more fragile and susceptible to fractures. The aim of this study was to investigate the intracortical compression- induced strain energy distribution, and determine whether intracortical pores associated with high strain energy density (SED) in the surrounding bone matrix have a different morphology and distribution, as well as different remodeling characteristics than matrix with normal SED. Fibular diaphyseal specimens from 20 patients undergoing a jaw reconstruction (age range 41 to 75 years; 14 men and 6 women) were studied. Bone specimens were µCT-scanned, plastic embedded, and sectioned for histology. Three-dimensional microfinite element models of each specimen were tested in compression, and the SED of the bone immediately surrounding the intracortical pores was calculated within a plane of interest corresponding to the histological sections. The SED of a pore, relative to the distribution of the SED of all pores in each specimen, was used to classify pores as either a high or normal SED pore. Pores with high SED were larger, less circular, and were located closer to the endosteal surface of the cortex than normal SED pores (p < 0.001). Histological analysis of the remodeling events generating the pores revealed that the high SED pores compared with normal SED pores had 13.3-fold higher odds of being an erosive (70%) or formative (7%) pore versus a quiescent pore (p < 0.001), 5.9-fold higher odds of resulting from remodeling upon existing pores (type 2 pore) versus remodeling generating new pores (type 1 pore) (p < 0.001), and 3.2-fold higher odds of being a coalescing type 2 pore versus a noncoalescing type 2 pore (p < 0.001). Overall, the study demonstrates a strong relationship between cortical bone mechanics and pore morphology, distribution, and remodeling characteristics in human fibular bone. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Lydia P Bakalova
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Christina M Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Denmark
| | | | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Birgitte Jul Kiil
- Department of Plastic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Jean-Marie Delaisse
- Department of Clinical Cell Biology (KCB), Vejle Hospital-Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Thomas Levin Andersen
- Department of Clinical Cell Biology (KCB), Vejle Hospital-Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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15
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Andreasen CM, Delaisse JM, van der Eerden BCJ, van Leeuwen JPTM, Ding M, Andersen TL. Understanding age-induced cortical porosity in women: Is a negative BMU balance in quiescent osteons a major contributor? Bone 2018; 117:70-82. [PMID: 30240959 DOI: 10.1016/j.bone.2018.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/10/2018] [Accepted: 09/16/2018] [Indexed: 01/18/2023]
Abstract
Cortical bone is remodeled by intracortical basic multicellular units (BMUs), whose end result can be observed as quiescent osteons in histological sections. These osteons offer a unique opportunity to investigate the BMU balance between the magnitude of bone resorption and subsequent bone formation at the BMU level. Our main objective was to investigate whether the latter parameters change between defined categories of osteons and with age, and to which extend these changes contribute to age-induced cortical porosity. Cortices of iliac bone specimens from 35 women (aged 16-78 years) with a higher porosity with age were investigated. A total of 3084 quiescent osteons reflecting 75% of the intracortical pores were histological examined. The osteons diameter, pore diameter, wall thickness, prevalence and contribution to the porosity were highly variable, but unchanged with age. Next, the osteons were categorized according to whether they reflected the remodeling of existing canals (type 2Q osteons) or the generation of new canals (type 1Q osteons). Type 2Q osteons versus type 1Q osteons: (i) had more frequently a pore diameter > 75 μm (7.4 vs. 1.3%; p < 0.001); (ii) had a larger mean pore diameter (40 ± 10 vs. 25 ± 4 μm; p < 0.001), osteon diameter (120 ± 21 vs. 94 ± 21 μm; p < 0.001) and wall thickness (40 ± 10 vs. 35 ± 9; p < 0.05); (iii) had a larger contribution to the cortical porosity (29 ± 18 vs. 8 ± 8%; p < 0.001); (iv) were more prevalent (44 ± 10 vs. 31 ± 11%; p < 0.001); and (v) were more prevalent with age. Collectively, this study demonstrates that quiescent osteons with age more frequently result from remodeling of existing canals, which in some cases had a more negative BMU balance. Still, the osteons showed no overall age-related change in their pore diameter i.e. BMU balance. In contrast to conventional wisdom, these data show that non-quiescent pores, not pores of quiescent osteons, were the main contributor to a higher cortical porosity.
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Affiliation(s)
- Christina M Andreasen
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark; Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Jean-Marie Delaisse
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
| | - Bram C J van der Eerden
- Laboratory for Calcium and Bone Metabolism, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | - Johannes P T M van Leeuwen
- Laboratory for Calcium and Bone Metabolism, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Thomas L Andersen
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
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Andreasen CM, Ding M, Andersen TL, Overgaard S. Effects of substitute coated with hyaluronic acid or poly‐lactic acid on implant fixation: Experimental study in ovariectomized and glucocorticoid‐treated sheep. J Tissue Eng Regen Med 2017; 12:e1122-e1130. [DOI: 10.1002/term.2447] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/16/2017] [Accepted: 05/04/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Christina M. Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology O, Odense University Hospital, Department of Clinical ResearchUniversity of Southern Denmark Odense Denmark
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology O, Odense University Hospital, Department of Clinical ResearchUniversity of Southern Denmark Odense Denmark
| | - Thomas L. Andersen
- Department of Clinical Cell Biology (KCB), Vejle Hospital – Lillebaelt Hospital, Department of Regional Health ResearchUniversity of Southern Denmark Vejle Denmark
| | - Søren Overgaard
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology O, Odense University Hospital, Department of Clinical ResearchUniversity of Southern Denmark Odense Denmark
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17
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Andreasen CM, Henriksen SS, Ding M, Theilgaard N, Andersen TL, Overgaard S. The efficacy of poly-d,l-lactic acid- and hyaluronic acid-coated bone substitutes on implant fixation in sheep. J Orthop Translat 2016; 8:12-19. [PMID: 30035089 PMCID: PMC5987050 DOI: 10.1016/j.jot.2016.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/15/2016] [Accepted: 07/25/2016] [Indexed: 11/18/2022] Open
Abstract
Background/Objective The present study investigated the efficacy of poly-d,l-lactic acid (PDLLA) and hyaluronic acid (HyA) on implant fixation when coated onto hydroxyapatite/beta-tri-calcium phosphate (HA/βTCP) granules. Methods The effect was assessed in a clinically relevant in vivo gap model in sheep. Thus, four titanium implants combined with either allograft (control), pure HA/βTCP, HyA infiltrated HA/βTCP, or PDLLA reinforced HA/βTCP granules were bilaterally inserted into the trabecular bone of the distal femurs in eight sheep. The insertion created a 2-mm peri-implant gap. After 12 weeks, histomorphometry and push-out test was used for quantification of newly formed bone in the gap, bone-implant contact, and implant fixation. Results The histomorphometric analysis revealed the presence of newly formed bone in all groups, though substitute groups showed fragments of nonabsorbed substitute material. A significant larger bone volume was found in the allograft group versus the HA/βTCP-PDLLA group (Zone 1), and in Zone 2 a statistically significantly larger bone volume was found in the allograft compared with the HA/βTCP group. The mechanical properties and the bone-implant contact revealed no statistically significant differences between the groups. Conclusion This study demonstrates that HA/βTCP granules coated with PDLLA and HyA have similar bone ingrowth and implant fixation as those with allograft, and with mechanical properties resembling those of allograft in advance, they may be considered as alternative substitute materials for bone formation in sheep.
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Affiliation(s)
- Christina M. Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
- Corresponding author. Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark.
| | - Susan S. Henriksen
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
| | - Naseem Theilgaard
- Danish Technological Institute, Gregersensvej 1, 2630 Taastrup, Denmark
| | - Thomas L. Andersen
- Department of Clinical Cell Biology (KCB), Vejle Hospital—Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Kabbeltoft 25, DK-7100 Vejle, Denmark
| | - Søren Overgaard
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 Ground floor, DK-5000 Odense C, Denmark
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18
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Merrild DM, Pirapaharan DC, Andreasen CM, Kjærsgaard-Andersen P, Møller AM, Ding M, Delaissé JM, Søe K. Pit- and trench-forming osteoclasts: a distinction that matters. Bone Res 2015; 3:15032. [PMID: 26664853 PMCID: PMC4665108 DOI: 10.1038/boneres.2015.32] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 10/06/2015] [Accepted: 10/13/2015] [Indexed: 11/09/2022] Open
Abstract
Osteoclasts (OCs) seeded on bone slices either drill round pits or dig long trenches. Whereas pits correspond to intermittent resorption, trenches correspond to continuous and faster resorption and require a distinct assembly of the resorption apparatus. It is unknown whether the distinction between pits and trenches has any biological relevance. Using OCs prepared from different blood donors, we found that female OCs achieved increased resorption mainly through pit formation, whereas male OCs did so through trench formation. Trench formation went along with high collagenolytic activity and high cathepsin K (CatK) expression, thereby allowing deeper demineralization. A specific CatK inhibitor abrogated the generation of trenches, while still allowing the generation of pits. OCs obtained from bone marrow were more prone to generate trenches than those obtained from blood. Scanning electron microscopy of bone surfaces eroded in vivo showed trenches and pits of similar size as those made by OCs in culture. We conclude that the distinction between trench- and pit-forming OCs is relevant to the differences among OCs from different skeletal sites, different individuals, including gender, and results from differences in collagenolytic power. This indicates a biological relevance and highlights the importance of discriminating between pits and trenches when assessing resorption.
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Affiliation(s)
- Ditte Mh Merrild
- Department of Clinical Cell Biology, Vejle Hospital/Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark , Vejle, Denmark
| | - Dinisha C Pirapaharan
- Department of Clinical Cell Biology, Vejle Hospital/Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark , Vejle, Denmark
| | - Christina M Andreasen
- Orthopaedic Research Laboratory, Department of Orthopedic Surgery and Traumatology, Odense University Hospital, University of Southern Denmark , Odense C, Denmark
| | | | - Anaïs Mj Møller
- Department of Clinical Cell Biology, Vejle Hospital/Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark , Vejle, Denmark
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopedic Surgery and Traumatology, Odense University Hospital, University of Southern Denmark , Odense C, Denmark
| | - Jean-Marie Delaissé
- Department of Clinical Cell Biology, Vejle Hospital/Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark , Vejle, Denmark
| | - Kent Søe
- Department of Clinical Cell Biology, Vejle Hospital/Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark , Vejle, Denmark
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Andreasen CM, Ding M, Overgaard S, Bollen P, Andersen TL. A reversal phase arrest uncoupling the bone formation and resorption contributes to the bone loss in glucocorticoid treated ovariectomised aged sheep. Bone 2015; 75:32-9. [PMID: 25689083 DOI: 10.1016/j.bone.2015.02.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/09/2015] [Indexed: 01/08/2023]
Abstract
Large animals as sheep are often used as models for human osteoporosis. Our aim was therefore to determine how glucocorticoid treatment of ovariectomised sheep affects the cancellous bone, determining the cellular events within the bone remodelling process that contributes to their bone loss. Twenty female sheep were assigned for two groups; an untreated control group and an ovariectomised group treated with glucocorticoids (0.6 mg/kg/day, 5 times weekly) for 7 months. At 7 months the glucocorticoid-treated ovariectomised sheep showed a significant change in the bone microstructure revealed by a decreased trabecular bone volume and thickness compared to the control sheep. The treatment led to a temporary elevation of the bone resorption marker CTX (c-terminal collagen telopeptide), while the bone formation marker osteocalcin remained suppressed all 7 months. Histomorphometrically, the treated sheep had a complete absence of osteoid surfaces, and a 5-fold increase in the extent of eroded/reversal surfaces after 7 months. Most of these reversal surfaces were actually arrested reversal surfaces, defined as reversal surfaces without the presence of neighbouring osteoid surfaces or osteoclasts, which is classically observed next to active reversal surfaces. As in humans, these arrested reversal surfaces had compared to active reversal surfaces a reduced canopy coverage, a significantly decreased cell density, and a decreased immunoreactivity for the osteoblastic markers osterix, runx2 and smooth muscle actin in the mononuclear reversal cells colonising the surfaces. In conclusion, glucocorticoid treatment of ovariectomised sheep induced a significant bone loss, caused by an arrest of the reversal phase, resulting in an uncoupling of the bone formation and resorption during the reversal phase, as recently demonstrated in postmenopausal women with glucocorticoid-induced osteoporosis. This supports the relevance of the sheep model to the pathophysiology of glucocorticoid-induced osteoporosis in postmenopausal women, making it a relevant preclinical model for orthopaedic implant and biomaterial research.
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Affiliation(s)
- Christina M Andreasen
- Orthopaedic Research Laboratory, Department of Orthopaedics and Traumatology O, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 ground floor, DK-5000 Odense C, Denmark.
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedics and Traumatology O, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 ground floor, DK-5000 Odense C, Denmark.
| | - Søren Overgaard
- Orthopaedic Research Laboratory, Department of Orthopaedics and Traumatology O, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J. B. Winsloewsvej 15 ground floor, DK-5000 Odense C, Denmark.
| | - Peter Bollen
- Biomedical Laboratory, University of Southern Denmark, J. B. Winsloewsvej 23, DK-5000 Odense C, Denmark.
| | - Thomas L Andersen
- Department of Clinical Cell Biology (KCB), Vejle Hospital - Lillebaelt Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Kabbeltoft 25, DK-7100 Vejle, Denmark.
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Ding M, Andreasen CM, Dencker ML, Jensen AE, Theilgaard N, Overgaard S. Efficacy of a small cell-binding peptide coated hydroxyapatite substitute on bone formation and implant fixation in sheep. J Biomed Mater Res A 2014; 103:1357-65. [PMID: 25045068 DOI: 10.1002/jbm.a.35281] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 06/12/2014] [Accepted: 07/03/2014] [Indexed: 12/25/2022]
Abstract
Cylindrical critical size defects were created at the distal femoral condyles bilaterally of eight female adult sheep. Titanium implants with 2-mm concentric gaps were inserted and the gaps were filled with one of the four materials: allograft; a synthetic 15-amino acid cell-binding peptide coated hydroxyapatite (ABM/P-15); hydroxyapatite + βtricalciumphosphate+ Poly-Lactic-Acid (HA/βTCP-PDLLA); or ABM/P-15+HA/βTCP-PDLLA. After nine weeks, bone-implant blocks were harvested and sectioned for micro-CT scanning, push-out test, and histomorphometry. Significant bone formation and implant fixation could be observed in all four groups. Interestingly, the microarchitecture of the ABM/P-15 group was significantly different from the control group. Tissue volume fraction and thickness were significantly greater in the ABM/P-15 group than in the allograft group. Bone formation and bone ingrowth to porous titanium implant were not significantly different among the four groups. The ABM/P-15 group had similar shear mechanical properties on implant fixation as the allograft group. Adding HA/βTCP-PDLLA to ABM/P-15 did not significantly change these parameters. This study revealed that ABM/P-15 had significantly bone formation in concentric gap, and its enhancements on bone formation and implant fixation were at least as good as allograft. It is suggested that ABM/P-15 might be a good alternative biomaterial for bone implant fixation in this well-validated critical-size defect gap model in sheep. Nevertheless, future clinical researches should focus on prospective, randomized, controlled trials in order to fully elucidate whether ABM/P-15 could be a feasible candidate for bone substitute material in orthopedic practices.
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Affiliation(s)
- Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
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Wrzesinski K, Magnone MC, Hansen LV, Kruse ME, Bergauer T, Bobadilla M, Gubler M, Mizrahi J, Zhang K, Andreasen CM, Joensen KE, Andersen SM, Olesen JB, Schaffalitzky de Muckadell OB, Fey SJ. HepG2/C3A 3D spheroids exhibit stable physiological functionality for at least 24 days after recovering from trypsinisation. Toxicol Res (Camb) 2013. [DOI: 10.1039/c3tx20086h] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Andreasen CM, Errebo-Knudsen L, Kristensen KA. [Patient information might reduce the use of benzodiazepines in general practice]. Ugeskr Laeger 1989; 151:2968-70. [PMID: 2573968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Information about benzodiazepines was given during a period of three months in a general practice with two doctors and 2,500 patients in group 1 of the Danish Health Insurance (low income group). The number of requests for repeated prescriptions and the number of defined daily doses of benzodiazepines were registered during periods of one month before and three months after the three month period of information with the object of assessing the patients own wishes for repeated prescription. The investigation revealed an average decrease of 35.4% of requests for repeated prescriptions and a decrease of 55.8% in the defined daily doses prescribed as compared with the month before the information period. The social consequences are discussed.
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