雌激素、利塞膦酸盐或降低剂量的人甲状旁腺激素 [hPTH(1-84)] 对去卵巢大鼠松质骨的维持作用
Maintenance of cancellous bone in ovariectomized, human parathyroid hormone [hPTH(1-84)]-treated rats by estrogen, risedronate, or reduced hPTH.
作者信息
Iwaniec U T, Samnegård E, Cullen D M, Kimmel D B
机构信息
Osteoporosis Research Center, Creighton University, Omaha, NE, USA.
出版信息
Bone. 2001 Oct;29(4):352-60. doi: 10.1016/s8756-3282(01)00582-8.
This study compares effects of maintenance doses of human parathyroid hormone [hPTH(1-84)], 17beta-estradiol (E2), and risedronate on distal femur bone mineral density and proximal tibia cancellous bone histomorphometry in ovariectomized (ovx), osteopenic rats previously administered a higher dose of hPTH. Nine groups (n = 8) of 3.5-month-old ovx or intact Sprague-Dawley rats were left untreated for 11 weeks to allow for the development of cancellous osteopenia in the ovx groups. Next, the ovx rats received subcutaneous injections of hPTH (75 microg/kg per day, three times per week) or vehicle for 12 weeks. Treatments were then changed to E2 (10 microg/kg per day, two times per week), risedronate (Ris; 3 microg/kg per day, three times per week), low-dose hPTH(1-84) (LowPTH; 25 microg/kg per day, three times per week), or vehicle, and administered for 36 weeks. The intact control group remained untreated for the duration of study. Femora and tibiae were collected at weeks -11 (baseline); 0 (ovx effect); 12 (hPTH effect), and 24, 36, and 48 (maintenance effects). Endpoints evaluated included distal femur bone mineral density (BMD) and proximal tibia cancellous bone volume (BV/TV), osteoclast surface (Oc.S), mineralizing surface (MS), mineral apposition rate (MAR), and bone formation rate (BFR). Ovariectomy had a negative effect on distal femur BMD and proximal tibia BV/TV. Treatment of ovx rats with hPTH for 12 weeks resulted in higher BMD in comparison to intact controls, and higher cancellous BV/TV in comparison to ovx controls. Discontinuation of hPTH resulted in loss of gained BMD within 24 weeks and loss of gained BV/TV within 12 weeks. Treatment of ovx rats with hPTH for 12 weeks followed by E2 treatment left BMD and BV/TV similar to vehicle-treated ovx rats by week 48 (36 weeks after commencement of the E2 maintenance treatment). Maintenance treatment with risedronate resulted in BMD and BV/TV similar to that of intact controls. Maintenance treatment with low-dose hPTH resulted in greater BMD and similar BV/TV in comparison to intact controls. MS and BFR were highest after low-dose hPTH administration. MS and BFR were lowest after E2 or risedronate, whereas Oc.S was lowest after risedronate administration. Thus, in osteopenic rats, the increment in distal femur BMD and proximal tibia BV/TV gained by 12 weeks of hPTH treatment was lost within 24 and 12 weeks of treatment termination, respectively. Low-dose hPTH maintained BMD and BV/TV after hPTH treatment by stimulating bone formation, whereas risedronate maintained BMD and BV/TV by reducing bone resorption. E2 in a maintenance dose failed to maintain BMD and BV/TV after withdrawal of hPTH treatment.
本研究比较了人甲状旁腺激素[hPTH(1 - 84)]、17β - 雌二醇(E2)和利塞膦酸盐维持剂量对曾接受较高剂量hPTH治疗的去卵巢(ovx)骨质疏松大鼠股骨远端骨矿物质密度及胫骨近端松质骨组织形态计量学的影响。将9组(每组n = 8)3.5月龄的去卵巢或完整的斯普拉格 - 道利大鼠不进行处理11周,以使去卵巢组发生松质骨减少。接下来,去卵巢大鼠皮下注射hPTH(75微克/千克/天,每周3次)或赋形剂,持续12周。然后将治疗改为E2(10微克/千克/天,每周2次)、利塞膦酸盐(Ris;3微克/千克/天,每周3次)、低剂量hPTH(1 - 84)(LowPTH;25微克/千克/天,每周3次)或赋形剂,并持续给药36周。完整对照组在研究期间一直不进行处理。在第 - 11周(基线)、0周(去卵巢效应)、12周(hPTH效应)以及24、36和48周(维持效应)收集股骨和胫骨。评估的终点指标包括股骨远端骨矿物质密度(BMD)、胫骨近端松质骨体积(BV/TV)、破骨细胞表面(Oc.S)、矿化表面(MS)、矿化沉积率(MAR)和骨形成率(BFR)。去卵巢对股骨远端BMD和胫骨近端BV/TV有负面影响。与完整对照组相比,用hPTH治疗去卵巢大鼠12周可使BMD升高,与去卵巢对照组相比,松质骨BV/TV升高。停止hPTH治疗后,在24周内获得的BMD丢失,在12周内获得的BV/TV丢失。用hPTH治疗去卵巢大鼠12周后再进行E2治疗,到第48周(E2维持治疗开始后36周)时,BMD和BV/TV与用赋形剂治疗的去卵巢大鼠相似。用利塞膦酸盐维持治疗使BMD和BV/TV与完整对照组相似。与完整对照组相比,用低剂量hPTH维持治疗可使BMD更高,BV/TV相似。低剂量hPTH给药后MS和BFR最高。E2或利塞膦酸盐治疗后MS和BFR最低,而利塞膦酸盐给药后Oc.S最低。因此,在骨质疏松大鼠中,hPTH治疗12周所增加的股骨远端BMD和胫骨近端BV/TV分别在治疗终止后的24周和12周内丢失。低剂量hPTH通过刺激骨形成在hPTH治疗后维持BMD和BV/TV,而利塞膦酸盐通过减少骨吸收维持BMD和BV/TV。撤掉hPTH治疗后,维持剂量的E2未能维持BMD和BV/TV。