Clinical calcium最新文献

Analysis of a mutant mouse exhibiting accelerated aging identified phosphorus as a pro-aging factor in mammals. In the blood, phosphorus exists in the form of phosphate ions and colloidal particles composed of solid-phase calcium-phosphate and serum protein fetuin-A, which are termed calciprotein particles(CPP). Blood CPP levels increase with age and decline of renal function. Because CPP have the ability to induce inflammation and vascular smooth muscle cell calcification in vitro, we hypothesize that CPP may serve as a pathogen that accelerates aging. Therapeutic interventions in phosphate and/or CPP may open a new avenue for practical anti-aging medicine.

Non-canonical Wnt signaling, including planar cell polarity and Ca²⁺ pathways, plays crucial roles in developmental processes, including morphogenesis and tissue-/organo-genesis, in animals. Ror2 receptor tyrosine kinase mediates non-canonical Wnt signaling by acting as a receptor for Wnt5a, which also inhibits canonical Wnt signaling. Dysregulation of Wnt5a-Ror2 signaling causes a wide range of developmental defects and cancer progression. Recently, Ror2-mediated non-canonical Wnt signaling has also been shown to induce formation of filopodia that facilitates transport of Wnt to neighboring cells, thereby activating canonical Wnt signaling there.

Romosozumab is a bone-forming agent with a dual effect of increasing bone formation and decreasing bone resorption by inhibiting sclerostin. In the pivotal Fracture study in postmenopausal women with osteroposis(FRAME)and the extension trial, 12 months of romosozumab led to persistent fracture, especially new vertebral fracture, reduction benefit and ongoing BMD(bone mineral density)gains when follow 24 months of denosumab. The sequence therapy of romosozumab followed by denosumab may be a promising regimen for the treatment of osteoporosis.

One of the major topics of ASBMR in this year was progress in research on "Bone and muscle crosstalk". It has been practically and clinically known that appropriate exercise has good effects on bones strength, however the mechanism is still elusive. In this ASBMR meeting, there were many reports that muscle-derived hormones, e.g. Irisin, β-aminoisobutyric acid(BAIBA)or Myostatin interact with skeletal cells. Especially, the report regarding Irisin was impressive. Moreover, several reports regarding new aspects of osteoblasts and bone formation were also interesting. In this report, we would like to introduce these interesting abstracts.

Pregnancy and child birth are possible even in young females with diseases to be treated with glucocorticoid by controlling disease activity and careful follow-up. There is no description about expectant and nursing mothers in the guide lines for glucocorticoid-induced osteoporosis published in many countries. Obtaining informed consent is more important for understanding the benefit and risk of the pregnancy and child birth during the glucocorticoid treatment in the female patients, to whom getting a child is very meaningful.

Osteoporosis(OP)is associated with high risk for cardiovascular disease(CVD). Concomitant occurrence of both OP and CVD seems to result from common pathological mechanisms between bone system and vascular system. It is expected that therapeutic agent for OP may be effective not only in normalization of bone metabolism but also in reducing vascular calcification. I give an outline with the relationship between bone metabolism and vascular calcification including epidemiology, outbreak mechanism, and effect on vascular calcification of OP treatment.

Acute coronary syndromes are caused by sudden luminal thrombosis due to plaque rupture, plaque erosion, or calcified nodule in coronary atherosclerotic lesions. Coronary calcification is a well-known marker of atherosclerotic plaque burden. Accurate evaluation of coronary calcification is critical for percutaneous coronary intervention(PCI)strategy. Optical coherence tomography(OCT)is a high-resolution(10~20 μm)intravascular imaging technique that uses near infrared light to create images. OCT allows us to identify the details of coronary calcification and assess the effect of cutting balloon angioplasty and rotational atherectomy. Then, OCT is a useful technique to guide PCI in the severe calcified lesions.

Over the past 15 years, many studies have revealed that Wnt signaling has a strong impact on hematopoietic stem cell fate. After a controversy over the interpretation of some results, the current understanding is that an appropriate degree of canonical Wnt signaling induces hematopoietic stem cell self-renewal and that noncanonical Wnt signaling keeps the quiescence. It is also likely that the balance between canonical and noncanonical Wnt pathways regulates the stress response and aging of hematopoietic stem cells.

In the 2018 ASBMR annual meeting, many important results were reported, showing the effects of anti-osteoporotic drugs already focusing on bone quality and the concept of "treat-to-target", although there were few big topics on novel drugs. However, some reports on new drugs, such as probiotics and SARM(selective androgen receptor modulator), did draw attention.

Pregnancy- and lactation-associated osteoporosis is a rare disease. Although researchers have reported a few cases, there are no established diagnostic criteria for pregnancy- and lactation-associated osteoporosis. However, a diagnosis can be easily obtained by an accurate medical interview, physical examination, imaging studies, and laboratory data, including bone mineral density measurement. This disease should be suspected when a woman presents with severe back pain in the late stages of pregnancy or the early postpartum period. An accurate and prompt diagnosis helps with appropriate treatment and prevents the progression of the disease.