Abrahamsen B, Shalhoub V, Larson E K, Eriksen E F, Beck-Nielsen H, Marks S C
Department of Endocrinology, Odense University Hospital, Denmark.
Bone. 2000 Feb;26(2):137-45. doi: 10.1016/s8756-3282(99)00260-4.
The cytokines interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), and IL-6 induce osteoclast formation and may contribute to the development of postmenopausal osteoporosis. Cross-sectional studies have suggested that both IL-1 and IL-1ra secretion increase on estrogen withdrawal, and that postmenopausal osteoporosis is associated with an inadequate increase in monocyte IL-1ra secretion with age. We measured cytokine mRNA (IL-1beta, IL-1ra, IL-6, and TNF-alpha) directly in bone biopsies from early postmenopausal women to determine if a lower compensatory increase in IL-1ra mRNA could be demonstrated in women with rapid bone loss after the menopause. Biopsies were obtained from 23 early postmenopausal women (mean age 53.9 years) who participated in a randomized study of hormone replacement therapy (HRT) and risk factors for osteoporosis. Bone mineral density was assessed by duel energy X-ray absorptiometry at 0, 1, 2, and 5 years. Women in the control group were recruited to the biopsy study based on their observed rate of bone loss (upper or lower tertile). Consent was also obtained from 11 participants receiving HRT. Biopsies were taken at 2 years, frozen in nitrogen, and homogenized. Cytokine mRNA was measured by competitive reverse transcriptase polymerase chain reaction. The IL-1ra/IL-1beta mRNA slope for the slow-loss group was steeper (deltaF = 23.3, p < 0.01) than that observed in the fast-loss group, indicating that slower bone loss was associated with higher IL-1ra mRNA levels relative to IL-1beta. During HRT, the IL-1beta mRNA level was inversely correlated with serum estradiol (log r2 = 0.77, p < 0.01), and women with a serum estradiol below 200 pmol/L during HRT had IL-1beta, mRNA levels identical to the control group. In contrast, IL-1ra mRNA was independent of serum estradiol. Histomorphometric analysis revealed weak correlations between IL-1beta mRNA and activation frequency (r2 = 0.26, p = 0.06) and between IL-1ra and volume referent bone resorption rate (r2 = 0.19, p = 0.11). TNF-alpha was not associated with the bone loss rates or with serum estradiol, and only three samples were positive for IL-6 mRNA. The findings support the hypothesis that IL-1beta production within bone increases with declining estrogen levels, and that an increase in II-1ra protects against accelerated bone loss.
细胞因子白细胞介素 -1β(IL -1β)、肿瘤坏死因子 -α(TNF -α)和IL -6可诱导破骨细胞形成,并可能导致绝经后骨质疏松症的发生。横断面研究表明,雌激素撤退时IL -1和IL -1受体拮抗剂(IL -1ra)的分泌均增加,且绝经后骨质疏松症与单核细胞IL -1ra分泌随年龄增长而增加不足有关。我们直接在绝经后早期女性的骨活检组织中测量细胞因子mRNA(IL -1β、IL -1ra、IL -6和TNF -α),以确定在绝经后骨量快速流失的女性中,是否能证明IL -1ra mRNA的代偿性增加较低。活检组织取自23名绝经后早期女性(平均年龄53.9岁),她们参与了一项激素替代疗法(HRT)和骨质疏松症危险因素的随机研究。在0、1、2和5年时通过双能X线吸收法评估骨密度。根据观察到的骨丢失率(上三分位数或下三分位数)将对照组女性纳入活检研究。还获得了11名接受HRT的参与者的同意。在2年时进行活检,在液氮中冷冻并匀浆。通过竞争性逆转录聚合酶链反应测量细胞因子mRNA。慢流失组的IL -1ra/IL -1β mRNA斜率比快流失组更陡(ΔF = 23.3,p < 0.01),表明相对于IL -1β,较慢的骨丢失与较高的IL -1ra mRNA水平相关。在HRT期间,IL -1β mRNA水平与血清雌二醇呈负相关(log r2 = 0.77,p < 0.01),且在HRT期间血清雌二醇低于200 pmol/L的女性,其IL -1β mRNA水平与对照组相同。相比之下,IL -1ra mRNA与血清雌二醇无关。组织形态计量学分析显示,IL -1β mRNA与激活频率之间存在弱相关性(r2 = 0.26,p = 0.06),IL -1ra与体积参照骨吸收速率之间存在弱相关性(r2 = 0.19,p = 0.11)。TNF -α与骨丢失率或血清雌二醇无关,且只有三个样本的IL -6 mRNA呈阳性结果。这些发现支持以下假设:随着雌激素水平下降,骨内IL -1β的产生增加,而IL -1ra的增加可防止骨丢失加速。