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Fructooligosaccharides act on the gut-bone axis to improve bone independent of Tregs and alter osteocytes in young adult C57BL/6 female mice. 果寡糖作用于肠道-骨骼轴,改善年轻成年 C57BL/6 雌性小鼠的骨骼,而与 Tregs 无关,并改变骨细胞。
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-02-21 eCollection Date: 2024-05-01 DOI: 10.1093/jbmrpl/ziae021
Proapa Islam, John A Ice, Sanmi E Alake, Pelumi Adedigba, Bethany Hatter, Kara Robinson, Stephen L Clarke, Ashlee N Ford Versypt, Jerry Ritchey, Edralin A Lucas, Brenda J Smith

Targeting the gut-bone axis with probiotics and prebiotics is considered as a promising strategy to reduce the risk of osteoporosis. Gut-derived short chain fatty acids (SCFA) mediate the effects of probiotics on bone via Tregs, but it is not known whether prebiotics act through a similar mechanism. We investigated how 2 different prebiotics, tart cherry (TC) and fructooligosaccharide (FOS), affect bone, and whether Tregs are required for this response. Eight-wk-old C57BL/6 female mice were fed with diets supplemented with 10% w/w TC, FOS, or a control diet (Con; AIN-93M) diet, and they received an isotype control or CD25 Ab to suppress Tregs. The FOS diet increased BMC, density, and trabecular bone volume in the vertebra (~40%) and proximal tibia (~30%) compared to the TC and control diets (Con), irrespective of CD25 treatment. Both prebiotics increased (P < .01) fecal SCFAs, but the response was greater with FOS. To determine how FOS affected bone cells, we examined genes involved in osteoblast and osteoclast differentiation and activity as well as genes expressed by osteocytes. The FOS increased the expression of regulators of osteoblast differentiation (bone morphogenetic protein 2 [Bmp2], Wnt family member 10b [Wnt10b] and Osterix [Osx]) and type 1 collagen). Osteoclasts regulators were unaltered. The FOS also increased the expression of genes associated with osteocytes, including (Phex), matrix extracellular phosphoglycoprotein (Mepe), and dentin matrix acidic phosphoprotein 1 (Dmp-1). However, Sost, the gene that encodes for sclerostin was also increased by FOS as the number and density of osteocytes increased. These findings demonstrate that FOS has a greater effect on the bone mass and structure in young adult female mice than TC and that its influence on osteoblasts and osteocytes is not dependent on Tregs.

用益生菌和益生元来靶向肠道-骨骼轴被认为是降低骨质疏松症风险的一种有前途的策略。肠道衍生的短链脂肪酸(SCFA)通过Tregs介导益生菌对骨骼的影响,但目前还不清楚益生元是否通过类似的机制发挥作用。我们研究了酸樱桃(TC)和果寡糖(FOS)这两种不同的益生元如何影响骨骼,以及这种反应是否需要Tregs。八周龄的 C57BL/6 雌性小鼠喂食补充了 10% w/w TC、FOS 或对照组饮食(Con;AIN-93M)的饮食,并接受同型对照或 CD25 Ab 以抑制 Tregs。与TC和对照饮食(Con)相比,FOS饮食增加了脊椎骨(约40%)和胫骨近端(约30%)的BMC、密度和骨小梁体积,与CD25治疗无关。两种益生元都能增加粪便中的 SCFAs(P .01),但 FOS 的反应更大。为了确定 FOS 如何影响骨细胞,我们检测了参与成骨细胞和破骨细胞分化和活性的基因以及骨细胞表达的基因。FOS 增加了成骨细胞分化调节因子(骨形态发生蛋白 2 [Bmp2]、Wnt 家族成员 10b [Wnt10b] 和 Osterix [Osx])和 1 型胶原蛋白的表达。)破骨细胞调节因子则没有变化。FOS 还增加了与成骨细胞相关的基因的表达,包括 Phex、基质细胞外磷酸化蛋白(Mepe)和牙本质基质酸性磷酸化蛋白 1(Dmp-1)。不过,随着成骨细胞数量和密度的增加,FOS 也会增加编码硬骨素的基因 Sost。这些研究结果表明,与TC相比,FOS对年轻成年雌性小鼠骨质和骨结构的影响更大,而且其对成骨细胞和骨细胞的影响并不依赖于Tregs。
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引用次数: 0
Structural differences contributing to sex-specific associations between FN BMD and whole-bone strength for adult White women and men. 导致成年白人女性和男性 FN BMD 与全骨强度之间性别特异性关联的结构差异。
IF 3.4 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-30 eCollection Date: 2024-04-01 DOI: 10.1093/jbmrpl/ziae013
Karl J Jepsen, Erin M R Bigelow, Robert W Goulet, Bonnie T Nolan, Michael A Casden, Kathryn Kennedy, Samantha Hertz, Chandan Kadur, Gregory A Clines, Aleda M Leis, Carrie A Karvonen-Gutierrez, Todd L Bredbenner

Hip areal BMD (aBMD) is widely used to identify individuals with increased fracture risk. Low aBMD indicates low strength, but this association differs by sex with men showing greater strength for a given aBMD than women. To better understand the structural basis giving rise to this sex-specific discrepancy, cadaveric proximal femurs from White female and male donors were imaged using nano-CT and loaded in a sideways fall configuration to assess strength. FN pseudoDXA images were generated to identify associations among structure, aBMD, and strength that differ by sex. Strength correlated significantly with pseudoDXA aBMD for females (R2 = 0.468, P < .001) and males (R2 = 0.393, P < .001), but the elevations (y-intercepts) of the linear regressions differed between sexes (P < .001). Male proximal femurs were 1045 N stronger than females for a given pseudoDXA aBMD. However, strength correlated with pseudoDXA BMC for females (R2 = 0.433, P < .001) and males (R2 = 0.443, P < .001) but without significant slope (P = .431) or elevation (P = .058) differences. Dividing pseudoDXA BMC by FN-width, total cross-sectional area, or FN-volume led to significantly different associations between strength and the size-adjusted BMC measures for women and men. Three structural differences were identified that differentially affected aBMD and strength for women and men: First, men had more bone mass per unit volume than women; second, different cross-sectional shapes resulted in larger proportions of bone mass orthogonal to the DXA image for men than women; and third, men and women had different proportions of cortical and trabecular bone relative to BMC. Thus, the proximal femurs of women were not smaller versions of men but were constructed in fundamentally different manners. Dividing BMC by a bone size measure was responsible for the sex-specific associations between hip aBMD and strength. Thus, a new approach for adjusting measures of bone mass for bone size and stature is warranted.

髋关节平均骨密度(aBMD)被广泛用于识别骨折风险增加的个体。低 aBMD 意味着低强度,但这种关联因性别而异,在给定 aBMD 的情况下,男性比女性显示出更大的强度。为了更好地了解造成这种性别差异的结构基础,我们使用纳米 CT 对来自白人女性和男性捐献者的尸体股骨近端进行了成像,并以侧向坠落配置加载以评估强度。生成了 FN pseudoDXA 图像,以确定结构、aBMD 和强度之间因性别而异的关联。女性的力量与伪 DXA aBMD 有明显的相关性(R2 = 0.468,P R2 = 0.393,P y-截距),线性回归的性别差异(P R2 = 0.433,P R2 = 0.443,P P = .431)或海拔差异(P = .058)。将假 DXA BMC 除以 FN 宽度、总横截面积或 FN 容积会导致女性和男性的力量与尺寸调整后的 BMC 测量值之间存在显著不同的关联。研究发现,有三种结构差异会对女性和男性的 aBMD 和力量产生不同影响:首先,男性单位体积的骨量比女性多;其次,横截面形状的不同导致男性骨量与 DXA 图像正交的比例比女性大;第三,相对于 BMC,男性和女性的皮质骨和小梁骨比例不同。因此,女性的股骨近端并不是男性的缩小版,而是以根本不同的方式构建的。将 BMC 除以骨量是髋部 aBMD 和力量之间存在性别特异性关联的原因。因此,需要一种新的方法来根据骨大小和身材调整骨量的测量。
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引用次数: 0
Response rates for lumbar spine, total hip, and femoral neck bone mineral density in men treated with abaloparatide: results from the ATOM study. 阿巴帕肽治疗男性腰椎、全髋和股骨颈骨矿物质密度的应答率:ATOM 研究的结果。
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-27 eCollection Date: 2024-02-01 DOI: 10.1093/jbmrpl/ziae009
Ruban Dhaliwal, David Kendler, Kenneth Saag, Steven W Ing, Andrea Singer, Robert A Adler, Leny Pearman, Yamei Wang, Bruce Mitlak

Osteoporosis in men is an underappreciated public health issue, accounting for approximately 30% of the societal burden of osteoporosis. Although the prevalence of osteoporosis in men is lower, fracture-related morbidity and mortality rates exceed those of women. Abaloparatide is a synthetic, 34-amino acid peptide with homology to human parathyroid hormone-related protein (PTHrP), which favors bone formation by selective activation of PTH receptor type 1. In the Abaloparatide for the Treatment of Men With Osteoporosis (ATOM; NCT03512262) trial, 228 men with primary or hypogonadism-associated osteoporosis were randomized to receive subcutaneous injections of abaloparatide 80 μg or placebo. Abaloparatide significantly improved LS, TH, and FN BMD when compared with placebo. In this prespecified analysis, the proportion of men with a percent change from baseline of >0%, >3%, and > 6% in BMD at the LS, TH, and FN at 3, 6, and 12 mo and/or a shift in T-score category (based on LS and TH T-scores) at 12 mo was compared between the abaloparatide and placebo groups in ATOM. There were significantly more men with a BMD gain of >3% at all 3 anatomical sites in the abaloparatide than placebo group at month 6 (18/122 [14.8%] vs 1/70 [1.4%], P = .002) and at month 12 (38/119 [31.9%] vs 1/66 [1.5%], P < .0001). At month 3, more men treated with abaloparatide than placebo had a > 3% BMD increase at the LS (82/134 [61.2%] vs 21/68 [30.9%], P < .0001). A greater proportion of men treated with abaloparatide had an improvement in T-score category from osteoporosis to low BMD or normal when compared with placebo. In conclusion, use of abaloparatide compared with placebo for 12 mo resulted in significant and rapid improvements in BMD in men with osteoporosis from the ATOM study.

男性骨质疏松症是一个未得到充分重视的公共健康问题,约占骨质疏松症社会负担的 30%。虽然男性骨质疏松症的发病率较低,但与骨折相关的发病率和死亡率却超过了女性。阿巴帕肽是一种合成的 34 氨基酸肽,与人类甲状旁腺激素相关蛋白(PTHrP)具有同源性,可通过选择性激活 PTH 受体 1 型来促进骨形成。在阿巴拉帕肽治疗男性骨质疏松症(ATOM;NCT03512262)试验中,228名患有原发性或性腺功能低下相关性骨质疏松症的男性被随机分配接受阿巴拉帕肽80微克或安慰剂的皮下注射。与安慰剂相比,阿巴拉帕肽能明显改善LS、TH和FN BMD。在这项预设分析中,比较了 ATOM 中阿巴帕肽组与安慰剂组之间在 3、6 和 12 个月时 LS、TH 和 FN BMD 与基线相比变化百分比大于 0%、大于 3% 和大于 6% 的男性比例,以及/或在 12 个月时 T 评分类别发生变化(基于 LS 和 TH T 评分)的男性比例。在第 6 个月时(18/122 [14.8%] vs 1/70 [1.4%],P = .002)和第 12 个月时(38/119 [31.9%] vs 1/66 [1.5%],P 3%),阿巴帕肽组在所有 3 个解剖部位的 BMD 增幅均大于安慰剂组的男性人数(82/134 [61.2%] vs 21/68 [30.9%],P = .002)。
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引用次数: 0
Sex-specific effects of Fat-1 transgene on bone material properties, size, and shape in mice Fat-1转基因对小鼠骨骼材料特性、大小和形状的性别特异性影响
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-10 DOI: 10.1093/jbmrpl/ziad011
Beatriz Bermudez, Kenna Brown, G. Vahidi, Ana C F Ruble, Chelsea M Heveran, Cheryl L Ackert-Bicknell, Vanessa Sherk
Western diets are becoming increasingly common around the world. Western diets have high omega 6 (ω-6) and omega 3 (ω-3) fatty acids and are linked to bone loss in humans and animals. Dietary fats are not created equal; therefore, it is vital to understand the effects of specific dietary fats on bone. We aimed to determine how altering the endogenous ratios of ω-6:ω-3 fatty acids impacts bone accrual, strength, and fracture toughness. To accomplish this, we used the Fat-1 transgenic mice, which carry a gene responsible for encoding an ω-3 fatty acid desaturase that converts ω-6 to ω-3 fatty acids. Male and female Fat-1 positive mice (Fat-1) and Fat-1 negative littermates (WT) were given either a high-fat diet (HFD) or low-fat diet (LFD) at 4 weeks of age for 16 weeks. The Fat-1 transgene reduced fracture toughness in males. Additionally, male bone mineral density (BMD), measured from dual-energy x-ray absorptiometry (DXA), decreased over the diet duration for HFD mice. In males, neither HFD feeding nor the presence of the Fat-1 transgene impacted cortical geometry, trabecular architecture, or whole-bone flexural properties, as detected by main group effects. In females, Fat-1-LFD mice experienced increases in BMD compared to WT-LFD mice, however, cortical area, distal femur trabecular thickness, and cortical stiffness were reduced in Fat-1 mice compared to pooled WT controls. However, reductions in stiffness were caused by a decrease in bone size and were not driven by changes in material properties. Together, these results demonstrate that the endogenous ω-6:ω-3 fatty acid ratio influences bone material properties in a sex-dependent manner. In addition, Fat-1 mediated fatty acid conversion was not able to mitigate the adverse effects of HFD on bone strength and accrual.
西式饮食在全世界越来越普遍。西方饮食中含有大量欧米伽 6(ω-6)和欧米伽 3(ω-3)脂肪酸,与人类和动物的骨质流失有关。膳食脂肪并不完全相同;因此,了解特定膳食脂肪对骨骼的影响至关重要。我们的目的是确定改变ω-6:ω-3 脂肪酸的内源性比例会如何影响骨骼的累积、强度和断裂韧性。为了实现这一目标,我们使用了携带ω-3脂肪酸去饱和酶编码基因的Fat-1转基因小鼠,该基因可将ω-6脂肪酸转化为ω-3脂肪酸。雌雄Fat-1阳性小鼠(Fat-1)和Fat-1阴性同窝小鼠(WT)在4周龄时被给予高脂饮食(HFD)或低脂饮食(LFD),持续16周。Fat-1转基因降低了雄性动物的骨折韧性。此外,通过双能X射线吸收测定法(DXA)测量的雄性骨矿物质密度(BMD)在HFD小鼠的饮食持续时间内有所下降。在雄性小鼠中,HFD喂养和Fat-1转基因的存在都不会影响皮质几何形状、骨小梁结构或全骨挠曲特性,这是由主组效应检测到的。在雌性小鼠中,与 WT-LFD 小鼠相比,Fat-1-LFD 小鼠的 BMD 增加了,但与 WT 对照组相比,Fat-1 小鼠的皮质面积、股骨远端小梁厚度和皮质硬度降低了。然而,刚度的降低是由骨骼尺寸的减小引起的,而不是由材料特性的变化引起的。总之,这些结果表明,内源性ω-6:ω-3 脂肪酸比例以性别依赖的方式影响骨材料特性。此外,Fat-1介导的脂肪酸转换并不能减轻高密度脂蛋白胆固醇对骨质强度和累积的不利影响。
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引用次数: 0
Loss of the auxiliary α2δ1 voltage sensitive Calcium Channel subunit impairs bone formation and anabolic responses to mechanical loading 辅助α2δ1电压敏感钙通道亚基的缺失会损害骨形成和对机械负荷的合成代谢反应
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-10 DOI: 10.1093/jbmrpl/ziad008
Madison M Kelly, Karan Sharma, Christian S. Wright, Xin Yi, Perla C. Reyes Fernandez, Aaron T Gegg, Taylor A Gorrell, Megan L. Noonan, A. Baghdady, Jacob A Sieger, Annette C Dolphin, Stuart J Warden, Padmini J. Deosthale, Lilian I Plotkin, Uma Sankar, J. Hum, A. Robling, M. Farach-Carson, William R. Thompson
Voltage sensitive calcium channels (VSCCs) influence bone structure and function, including anabolic responses to mechanical loading. While the pore-forming (α1) subunit of VSCCs allows Ca2+ influx, auxiliary subunits regulate the biophysical properties of the pore. The α2δ1 subunit influences gating kinetics of the α1 pore and enables mechanically induced signaling in osteocytes; however, the skeletal function of α2δ1 in vivo remains unknown. In this work, we examined the skeletal consequences of deleting Cacna2d1, the gene encoding α2δ1. Dual energy X-ray absorptiometry (DEXA) and microcomputed tomography (μCT) imaging demonstrated that deletion of α2δ1 diminished bone mineral content and density in both male and female C57BL/6 mice. Structural differences manifested in both trabecular and cortical bone for males, while the absence of α2δ1 affected only cortical bone in female mice. Deletion of α2δ1 impaired skeletal mechanical properties in both sexes, as measured by three-point bending to failure. While no changes in osteoblast number or activity were found for either sex, male mice displayed a significant increase in osteoclast number, accompanied by increased eroded bone surface and upregulation of genes that regulate osteoclast differentiation. Deletion of α2δ1 also rendered the skeleton insensitive to exogenous mechanical loading in males. While previous work demonstrates that VSCCs are essential for anabolic responses to mechanical loading, the mechanism by which these channels sense and respond to force remained unclear. Our data demonstrate that the α2δ1 auxiliary VSCC subunit functions to maintain baseline bone mass and strength through regulation of osteoclast activity, and also provides skeletal mechanotransduction in male mice. These data reveal a molecular player in our understanding of the mechanisms by which VSCCs influence skeletal adaptation.
电压敏感钙通道(VSCC)影响骨的结构和功能,包括对机械负荷的合成代谢反应。电压敏感钙通道的孔形成亚基(α1)允许 Ca2+ 流入,而辅助亚基则调节孔的生物物理特性。α2δ1亚基影响α1孔的门控动力学,并使机械诱导的信号传导在骨细胞中得以实现;然而,α2δ1在体内的骨骼功能仍然未知。在这项工作中,我们研究了删除编码α2δ1的基因Cacna2d1对骨骼的影响。双能 X 射线吸收测定(DEXA)和微计算机断层扫描(μCT)成像显示,缺失α2δ1 会降低雄性和雌性 C57BL/6 小鼠的骨矿物质含量和骨密度。结构差异表现在雄性小鼠的骨小梁和皮质骨上,而缺失α2δ1只影响雌性小鼠的皮质骨。缺失α2δ1会损害雌雄小鼠的骨骼机械性能,以三点弯曲至失效来衡量。虽然雌雄小鼠的成骨细胞数量或活性均未发生变化,但雄性小鼠的破骨细胞数量显著增加,同时侵蚀的骨表面增加,调控破骨细胞分化的基因上调。α2δ1的缺失也使雄性小鼠的骨骼对外源机械负荷不敏感。尽管之前的研究表明,VSCCs 对于机械负荷下的合成代谢反应至关重要,但这些通道感知和响应力的机制仍不清楚。我们的数据表明,α2δ1 辅助 VSCC 亚基通过调节破骨细胞的活性来维持基线骨量和骨强度,同时还提供雄性小鼠骨骼的机械传导功能。这些数据揭示了我们对 VSCC 影响骨骼适应机制的理解中的一个分子角色。
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引用次数: 0
Rapamycin does not alter bone microarchitecture or material properties quality in young-adult and aged female C57BL/6 mice 雷帕霉素不会改变年轻成年和老年雌性 C57BL/6 小鼠的骨微结构或材料特性质量
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-10 DOI: 10.1093/jbmrpl/ziae001
Connor Devine, Kenna Brown, Kat O Patton, Chelsea M Heveran, Stephen A Martin
Advancing age is the strongest risk factor for osteoporosis and skeletal fragility. Rapamycin is an FDA approved immunosuppressant that inhibits the mechanistic target of rapamycin (mTOR) complex, extends lifespan, and protects against aging-related diseases in multiple species; however, the impact of rapamycin on skeletal tissue is incompletely understood. We evaluated the effects of a short-term, low-dosage, interval rapamycin treatment on bone microarchitecture and strength in young-adult (3-months-old) and aged female (20-months-old) C57BL/6 mice. Rapamycin (2 mg/kg body mass) was administered via intraperitoneal injection 1x/5 days for a duration of 8 weeks; this treatment regimen has been shown to induce geroprotective effects while minimizing the side-effects associated with higher rapamycin dosages and/or more frequent or prolonged delivery schedules. Aged femurs exhibited lower cancellous bone mineral density, volume, trabecular connectivity density and number, higher trabecular thickness and spacing, and lower cortical thickness compared to young-adult mice. Rapamycin had no impact on assessed microCT parameters. Flexural testing of the femur revealed yield strength and ultimate strength were lower in aged mice compared to young-adult mice. There were no effects of rapamycin on these or other measures of bone biomechanics. Age, but not rapamycin, altered local and global measures of bone turnover. These data demonstrate a short-term, low-dosage, interval, rapamycin treatment does not negatively or positively impact the skeleton of young-adult and aged mice.
年龄的增长是导致骨质疏松症和骨骼脆弱的最主要风险因素。雷帕霉素是美国 FDA 批准的一种免疫抑制剂,可抑制雷帕霉素机理靶点(mTOR)复合物,延长寿命,并在多种物种中预防衰老相关疾病;然而,人们对雷帕霉素对骨骼组织的影响还不完全了解。我们评估了短期、低剂量、间歇性雷帕霉素治疗对幼年(3 个月大)和老年雌性(20 个月大)C57BL/6 小鼠骨骼微结构和强度的影响。雷帕霉素(2 毫克/千克体重)通过腹腔注射给药,1 次/5 天,持续 8 周;这种治疗方案已被证明具有老年保护作用,同时最大限度地减少了雷帕霉素剂量较大和/或给药频率较高或时间较长所带来的副作用。与青壮年小鼠相比,老年股骨表现出较低的松质骨矿物质密度、体积、骨小梁连接密度和数量,较高的骨小梁厚度和间距,以及较低的皮质厚度。雷帕霉素对评估的显微CT参数没有影响。股骨弯曲测试显示,与青壮年小鼠相比,老年小鼠的屈服强度和极限强度较低。雷帕霉素对这些或其他骨骼生物力学指标没有影响。年龄(而非雷帕霉素)会改变局部和整体的骨转换指标。这些数据表明,短期、低剂量、间歇性雷帕霉素治疗不会对年轻成年小鼠和老年小鼠的骨骼产生负面或正面影响。
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引用次数: 0
Open-label extension of a randomized trial investigating safety and efficacy of rhPTH(1–84) in hypoparathyroidism 研究rhPTH(1-84)对甲状旁腺功能减退症的安全性和有效性的随机试验的开放标签扩展研究
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-05 DOI: 10.1093/jbmrpl/ziad010
Aliya A Khan, Lisa G Abbott, Intekhab Ahmed, O. Ayodele, Claudia Gagnon, Richard D Finkelman, Emese Mezosi, Lars Rejnmark, Istvan Takacs, Shaoming Yin, Steven W Ing
Hypoparathyroidism is a rare disease, often inadequately controlled by conventional treatment. PARALLAX was a mandatory post-marketing trial assessing pharmacokinetics and pharmacodynamics of different dosing regimens of recombinant human parathyroid hormone 1–84 (rhPTH[1–84]) for treating hypoparathyroidism. The present study (NCT03364738) was a Phase 4, 1-year open-label extension of PARALLAX. Patients received only two doses of rhPTH(1–84) in PARALLAX and were thus considered treatment-naive at the start of the current study. rhPTH(1–84) was initiated at 50 μg once daily, with doses adjusted based on albumin-corrected serum calcium levels. Albumin-corrected serum calcium (primary outcome measure), health-related quality of life (HRQoL), adverse events, and healthcare resource utilization (HCRU) were assessed. The mean age of the 22 patients included was 50.0 years; 81.8% were women, and 90.9% were White. By end of treatment (EOT), 95.5% of patients had albumin-corrected serum calcium values in the protocol-defined primary endpoint range of 1.88 mmol/L to the upper limit of normal. Serum phosphorus was within the healthy range, and albumin-corrected serum calcium-phosphorus product was below the upper healthy limit throughout, while mean 24-hour urine calcium excretion decreased from baseline to EOT. Mean supplemental doses of calcium and active vitamin D were reduced from baseline to EOT (2402–855 mg/day and 0.8–0.2 μg/day, respectively). Mean serum bone turnover markers, bone-specific alkaline phosphatase, osteocalcin, procollagen type I N-terminal propeptide, and type I collagen C-telopeptide increased 2–5 fold from baseline to EOT. HCRU, disease-related symptoms and impact on HRQoL improved numerically between baseline and EOT. Nine patients (40.9%) experienced treatment-related adverse events; no deaths were reported. Treatment with rhPTH(1–84) once daily for 1 year improved HRQoL, maintained eucalcemia in 95% of patients, normalized serum phosphorus, and decreased urine calcium excretion. The effects observed on urine calcium and the safety profile are consistent with previous findings.
甲状旁腺功能减退症是一种罕见疾病,常规治疗往往无法控制病情。PARALLAX是一项上市后强制试验,评估了重组人甲状旁腺激素1-84(rhPTH[1-84])治疗甲状旁腺功能减退症的不同剂量方案的药代动力学和药效学。本研究(NCT03364738)是PARALLAX的一项为期1年的第四期开放标签扩展研究。在PARALLAX研究中,患者只接受了两次rhPTH(1-84)治疗,因此在本研究开始时被视为未接受过治疗。对白蛋白校正血清钙(主要结局指标)、健康相关生活质量(HRQoL)、不良事件和医疗资源利用率(HCRU)进行了评估。22名患者的平均年龄为50.0岁,81.8%为女性,90.9%为白人。治疗结束(EOT)时,95.5% 的患者白蛋白校正血清钙值在方案定义的主要终点范围(1.88 mmol/L 至正常值上限)内。血清磷在健康范围内,白蛋白校正血清钙磷乘积始终低于健康上限,而平均 24 小时尿钙排泄量从基线到 EOT 均有所下降。从基线到 EOT,钙和活性维生素 D 的平均补充剂量有所减少(分别为 2402-855 毫克/天和 0.8-0.2 微克/天)。平均血清骨转换标志物、骨特异性碱性磷酸酶、骨钙素、I型胶原蛋白N末端前肽和I型胶原蛋白C-三肽从基线到EOT增加了2-5倍。从基线到 EOT,HCRU、疾病相关症状和对 HRQoL 的影响在数值上有所改善。九名患者(40.9%)出现了与治疗相关的不良事件;无死亡报告。rhPTH(1-84)治疗1年,每天1次,改善了患者的HRQoL,维持了95%患者的白细胞减少,使血清磷恢复正常,减少了尿钙排泄。观察到的对尿钙的影响和安全性与之前的研究结果一致。
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引用次数: 0
Adaptations of bone and bone vasculature to muscular stretch training 骨骼和骨血管对肌肉拉伸训练的适应性
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-04 DOI: 10.1093/jbmrpl/ziad019
Julia Eazer, Mina‐Michael Barsoum, Cole Smith, Kazuki Hotta, Brad Behnke, Christina Holmes, Jacob Caldwell, Payal Ghosh, Emily Reid‐Foley, Hyerim Park, Michael Delp, Judy Muller-Delp
The magnitude of bone formation and remodeling is linked to both the magnitude of strain placed on the bone and the perfusion of bone. It was previously reported that an increase in bone perfusion and bone density occurs in the femur of old rats with moderate aerobic exercise training. This study determined the acute and chronic effects of static muscle stretching on bone blood flow and remodeling. Old male Fischer 344 rats were randomized to either a naïve or stretch-trained group. Static stretching of ankle flexor muscles was achieved by placement of a dorsiflexion splint on the left ankle for 30 min/day, 5d/wk for 4wks. The opposite hindlimb served as a contralateral control (nonstretched) limb. Bone blood flow was assessed during and after acute stretching in naïve rats, and at rest and during exercise in stretch-trained rats. Vascular reactivity of the nutrient artery of the proximal tibia was also assessed in stretch-trained rats. MicroCT analysis was used to assess bone volume and micro-architecture of the trabecular bone of both tibias near that growth plate. In naïve rats, static stretching increased blood flow to the proximal tibial metaphasis. Blood flow to the proximal tibial metaphysis during treadmill exercise was higher in the stretched limb after 4 weeks of daily stretching. Daily stretching also increased tibial bone weight and increased total volume in both the proximal and distal tibial metaphyses. In the trabecular bone immediately below the proximal tibial growth plate, total volume and bone volume increased, but bone volume/total volume was unchanged and trabecular connectivity decreased. In contrast, intravascular volume increased in this region of the bone. These data suggest that blood flow to the tibia increases during bouts of static stretching of the hindlimb muscles, and that 4 weeks of daily muscle stretching leads to bone remodeling and an increase in intravascular volume of the tibial bone.
骨骼形成和重塑的程度与骨骼承受的应变程度和骨骼灌注有关。之前有报道称,通过适度的有氧运动训练,老龄大鼠股骨的骨灌注量和骨密度都会增加。本研究确定了静态肌肉拉伸对骨血流和重塑的急性和慢性影响。老年雄性费舍尔 344 大鼠被随机分为原始组和拉伸训练组。在左踝关节上放置背屈夹板,每天 30 分钟,每周 5 天,持续 4 周,实现踝关节屈肌的静态拉伸。对侧后肢作为对照组(未拉伸)肢体。在急性拉伸过程中和之后,对新手大鼠的骨血流进行评估;在休息时和运动时,对经过拉伸训练的大鼠的骨血流进行评估。还评估了拉伸训练大鼠胫骨近端营养动脉的血管反应性。显微 CT 分析用于评估两只大鼠胫骨生长板附近骨小梁的骨量和微观结构。在天真大鼠中,静态拉伸增加了流向胫骨近端骺端的血流量。每天拉伸 4 周后,在跑步机运动中被拉伸肢体的胫骨近端干骺端血流量更高。每日拉伸还增加了胫骨重量,并增加了胫骨近端和远端骨骺的总体积。在紧靠胫骨近端生长板下方的骨小梁中,总体积和骨量增加,但骨量/总体积不变,骨小梁连接性降低。与此相反,该区域骨骼的血管内容量增加了。这些数据表明,在对后肢肌肉进行静态拉伸时,流向胫骨的血流量会增加,而每天进行 4 周的肌肉拉伸会导致骨重塑和胫骨血管内体积的增加。
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引用次数: 0
Osteoclast-specific Plastin 3 knockout in mice fail to develop osteoporosis despite dramatic increased osteoclast resorption activity 破骨细胞特异性 Plastin 3 基因敲除的小鼠尽管破骨细胞的再吸收活性急剧增加,却不会患骨质疏松症
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-04 DOI: 10.1093/jbmrpl/ziad009
Ilka Maus, M. Dreiner, Sebastian Zetzsche, F. Metzen, Bryony C Ross, D. Mählich, M. Koch, Anja Niehoff, Brunhilde Wirth
PLS3 loss-of-function mutations in humans and mice cause X-linked primary osteoporosis. However, it remains largely unknown how PLS3 mutations cause osteoporosis and which function PLS3 plays in bone homeostasis. A recent study showed that the ubiquitous Pls3 KO in mice results in osteoporosis with decreased bone thickness and stiffness. In these mice, mainly osteoclasts were impacted in their function, exhibiting increased resorptive activity and altered podosome formation through a misregulation of the NFκB pathway. Specifically, Pls3 KO caused the decreased nuclear localization of its interaction partner NFκB repressing factor, NKRF, thereby augmenting Nfatc1 transcription. However, it has not been proven if, indeed, the osteoclasts are the major cell type affected and responsible for the osteoporosis development in ubiquitous Pls3 KO mice. Here, we generated osteoclast-specific Pls3 KO female (Pls3fl/fl; LysMCretg/0) and male (Pls3fl;LysMCretg/0) mice and demonstrate specific PLS3 loss in cultured osteoclasts. In addition, we developed a novel polyclonal PLS3 antibody that showed for the first time specific PLS3 loss in immunofluorescence staining of osteoclasts in contrast to previously available antibodies against PLS3 that failed to show PLS3-specificity in mouse cells. Moreover, we demonstrate that the osteoclast-specific Pls3 KO causes a dramatic increase in the resorptive activity of osteoclasts in vitro. Despite this pronounced effect on osteoclast resorption activity, osteoclast-specific Pls3 KO in vivo failed to cause any osteoporotic phenotype in 12-, 24-, and 48-week-old mice as proven by micro-CT and three-point bending test. These results demonstrate that the pathomechanism of PLS3-associated osteoporosis is highly complex and cannot be reproduced in a system singularly focused on one cell type, leading us to conclude that the loss of PLS3 in alternative bone cell types, such as osteoblasts and osteocytes contributes to the osteoporosis phenotype in ubiquitous Pls3 KO mice.
人类和小鼠的 PLS3 功能缺失突变会导致 X 连锁原发性骨质疏松症。然而,人们对 PLS3 突变如何导致骨质疏松症以及 PLS3 在骨稳态中发挥何种功能仍然知之甚少。最近的一项研究表明,小鼠中无处不在的 Pls3 KO 会导致骨质疏松症,骨厚度和硬度下降。在这些小鼠中,主要是破骨细胞的功能受到影响,表现出更强的吸收活性,并通过 NFκB 通路的误调改变了荚膜体的形成。具体来说,Pls3 KO导致其相互作用伙伴NFκB抑制因子NKRF的核定位减少,从而增强了Nfatc1的转录。然而,尚未证实破骨细胞是否是受影响的主要细胞类型,以及是否是导致无处不在的 Pls3 KO 小鼠发生骨质疏松症的原因。在这里,我们产生了破骨细胞特异性 Pls3 KO 雌性(Pls3fl/fl; LysMCretg/0)和雄性(Pls3fl;LysMCretg/0)小鼠,并在培养的破骨细胞中证明了特异性 PLS3 缺失。此外,我们还开发了一种新型多克隆 PLS3 抗体,该抗体首次在破骨细胞的免疫荧光染色中显示出特异性 PLS3 缺失,而之前可用的 PLS3 抗体未能在小鼠细胞中显示出 PLS3 特异性。此外,我们还证明,破骨细胞特异性 Pls3 KO 会导致体外破骨细胞的吸收活性急剧增加。尽管对破骨细胞的吸收活性有明显的影响,但通过显微 CT 和三点弯曲试验证明,体内破骨细胞特异性 Pls3 KO 在 12 周龄、24 周龄和 48 周龄的小鼠中均未导致任何骨质疏松表型。这些结果表明,与 PLS3 相关的骨质疏松症的病理机制非常复杂,无法在一个只关注一种细胞类型的系统中再现,因此我们得出结论,在其他骨细胞类型(如成骨细胞和骨细胞)中 PLS3 的缺失导致了无处不在的 Pls3 KO 小鼠的骨质疏松症表型。
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引用次数: 0
A protocol for the prospective study of urinary cadmium with risk of fracture, bone loss, and muscle loss 尿镉与骨折、骨质流失和肌肉流失风险的前瞻性研究方案
IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-04 DOI: 10.1093/jbmrpl/ziad006
Christopher de la Bastide, Lissa Soares, L. Lui, James Harrington, Peggy Cawthon, Eric Orwoll, Deborah Kado, Jaymie Meliker
Cadmium (Cd) is a heavy metal and natural element found in soil and crops with increasing concentrations linked to phosphate fertilizers and sewage sludge applied to crop lands. A large fraction of older U.S men and woman have documented Cd exposure. Cd exposure has proven health concerns such as risk of lung cancer from inhalation and impaired renal function, however, growing evidence suggests it also influences bone and muscle health. Given that low levels of Cd could affect bone and muscle, we have designed prospective studies using the two largest and most detailed U.S. studies of bone health in older men and women: The Osteoporotic Fractures in Men (MrOS) Study and the Study of Osteoporotic Fractures (SOF). We are investigating the association of urinary cadmium (U-Cd), as a surrogate for long term cadmium exposure, with bone and muscle health. Building off suggestive evidence from mechanistic and cross-sectional studies, this will be the first well-powered prospective study of incident fracture outcomes, bone loss, and muscle loss in relation to U-Cd, an established biomarker of long-term Cd exposure. The following is a proposed protocol for the intended study; if successful the proposed studies could be influential in directing future U.S policy to decrease Cd exposure in the U.S population similar to recent policies adopted by the European Union to limit Cd in fertilizers.
镉(Cd)是一种重金属,是土壤和农作物中的天然元素,其浓度的增加与施用磷肥和农田污水污泥有关。据记录,美国大部分老年男性和女性都接触过镉。事实证明,接触镉会引起健康问题,如吸入镉会导致肺癌风险和肾功能受损,但越来越多的证据表明,镉还会影响骨骼和肌肉健康。鉴于低水平的镉可能会影响骨骼和肌肉,我们设计了前瞻性研究,利用美国两项规模最大、最详细的老年男性和女性骨骼健康研究:男性骨质疏松性骨折(MrOS)研究和骨质疏松性骨折(SOF)研究。尿镉(U-Cd)是长期镉暴露的替代物,我们正在研究尿镉(U-Cd)与骨骼和肌肉健康的关系。在机理研究和横断面研究的提示性证据的基础上,这将是第一项关于骨折事件、骨质流失和肌肉流失与尿镉的关系的有力的前瞻性研究,尿镉是长期镉暴露的既定生物标志物。以下是拟进行的研究的拟议方案;如果成功,拟议的研究可能会对指导美国未来的政策产生影响,以减少美国人口的镉暴露量,类似于欧盟最近通过的限制化肥中镉含量的政策。
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引用次数: 0
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