Ammann P, Bourrin S, Brunner F, Meyer J-M, Clément-Lacroix P, Baron R, Gaillard M, Rizzoli R
Department of Rehabilitation and Geriatrics, Service of Bone Diseases (WHO Collaborating Center for Osteoporosis Prevention), University Hospital, CH-1211 Geneva 14, Switzerland.
Bone. 2004 Jul;35(1):153-61. doi: 10.1016/j.bone.2004.03.028.
The selective estrogen receptor modulator (SERM) raloxifene has been shown to reduce the risk of vertebral fracture, but without significant effect on nonvertebral fractures. However, there is a need for SERMs capable of improving mechanical competence and reducing the risk of fractures at multiple skeletal sites, with minimal side effects. We investigated the effects of a new steroidal SERM, HMR-3339, compared to raloxifene, on bone strength and its determinants (BMD, microarchitecture, dimensions) at various skeletal sites (lumbar spine, tibia, and femur) of adult ovariectomized rats in both prevention and intervention protocols. In a prevention study, HMR-3339 and raloxifene treatments fully prevented alterations of bone strength. In an intervention protocol, where treatment was started 8 weeks after ovariectomy, HMR-3339 fully restored mechanical properties by influencing both areal BMD and outer diameter. This effect was observed at skeletal sites formed of cancellous and cortical bone or of cortical bone only. In contrast, raloxifene positively influenced structures containing mainly cancellous bone. In HMR-3339-treated rats, IGF-I plasma levels were higher than in ovariectomized controls; this was not observed with raloxifene. In conclusion, these results indicate that HMR-3339 increased not only bone mineral mass, but also restored bone mechanical strength at multiple sites in adult osteoporotic rats. In contrast to raloxifene, HMR-3339 also influenced skeletal sites predominantly formed of cortical bone.
选择性雌激素受体调节剂(SERM)雷洛昔芬已被证明可降低椎体骨折风险,但对非椎体骨折无显著影响。然而,需要一种能够提高力学性能并降低多个骨骼部位骨折风险且副作用最小的SERM。我们研究了一种新型甾体SERM HMR - 3339与雷洛昔芬相比,在预防和干预方案中对成年去卵巢大鼠不同骨骼部位(腰椎、胫骨和股骨)的骨强度及其决定因素(骨密度、微结构、尺寸)的影响。在一项预防研究中,HMR - 3339和雷洛昔芬治疗完全预防了骨强度的改变。在一项干预方案中,即在去卵巢8周后开始治疗,HMR - 3339通过影响面积骨密度和外径完全恢复了力学性能。在由松质骨和皮质骨或仅由皮质骨组成的骨骼部位均观察到了这种效果。相比之下,雷洛昔芬对主要包含松质骨的结构有积极影响。在接受HMR - 3339治疗的大鼠中,血浆胰岛素样生长因子 - I(IGF - I)水平高于去卵巢对照组;雷洛昔芬则未观察到这种情况。总之,这些结果表明,HMR - 3339不仅增加了成年骨质疏松大鼠的骨矿物质含量,还恢复了多个部位的骨力学强度。与雷洛昔芬不同,HMR - 3339还对主要由皮质骨组成的骨骼部位产生影响。