Bauss Frieder, Schenk Robert K, Hört Stefan, Müller-Beckmann Bernd, Sponer Gisbert
Roche Diagnostics GmbH, Pharma Research Penzberg, Germany.
J Pharmacol Toxicol Methods. 2004 Jul-Aug;50(1):25-34. doi: 10.1016/j.vascn.2003.11.003.
Given that bisphosphonates reduce bone turnover, it is important to establish that their long-term administration does not impair bone quality. This paper describes a new model for simulation of fracture repair to evaluate several aspects of bone quality following long-term administration (34 or 36 weeks) of ibandronate in full-grown beagle dogs.
The treatment schedule consisted of continuous daily subcutaneous administration of a pharmacologically active dose (1 microg/kg/day) and two cyclical intermittent regimens providing a similar total dose per animal at the end of the experiment. Seven or 8 weeks before study end, 10 holes were drilled in the left tibia and bone marrow ablation was performed in the ipsilateral femur. Serial measurements for blood biochemistry (osteocalcin and iso-alkaline phosphatase) and bone mineral density (BMD; whole body and L1-L7) by dual-energy X-ray absorptiometry (DEXA) were performed during the experiment. Bone quality was determined at the end of the experiment by assessing early and late stage defect healing and structural, cellular, and dynamic histomorphometry (femur, tibia, and lumbar vertebrae L3 and L4).
Healing of the drill hole defects, which simulate the first stage of fracture healing, was neither qualitatively nor quantitatively influenced by ibandronate. The same was true for the activation of cortical remodeling that occurs in the later stage of fracture healing, which started in Week 4 after surgery and declined after Week 8 in all groups. Additionally, no difference was found between the various regimens and the controls with respect to DEXA analyses, trabecular bone volume, cancellous bone tissue area, cancellous bone perimeter, osteoclast count, serum osteocalcin, or bone-specific alkaline phosphatase.
In conclusion, the presence of the first and second steps of fracture healing and the fact that the histological features closely resemble those of fracture repair validate the development and characterization of a new model for simulation of fracture repair. A long-term study with a therapeutically active dose of ibandronate shows that ibandronate does not impair BMD, bone structure, bone repair, coupling, and serum parameters for bone formation and turnover after long-term administration.
鉴于双膦酸盐可降低骨转换,确定其长期给药不会损害骨质量很重要。本文描述了一种用于模拟骨折修复的新模型,以评估成年比格犬长期(34或36周)给予伊班膦酸钠后骨质量的几个方面。
治疗方案包括连续每日皮下给予药理活性剂量(1微克/千克/天)以及两种周期性间歇给药方案,在实验结束时每只动物的总剂量相似。在研究结束前7或8周,在左胫骨上钻10个孔,并在同侧股骨进行骨髓消融。实验期间通过双能X线吸收法(DEXA)对血液生化指标(骨钙素和同工碱性磷酸酶)以及骨密度(全身和L1-L7)进行系列测量。实验结束时通过评估早期和晚期缺损愈合以及结构、细胞和动态组织形态计量学(股骨、胫骨以及腰椎L3和L4)来确定骨质量。
模拟骨折愈合第一阶段的钻孔缺损愈合在质量和数量上均未受到伊班膦酸钠的影响。骨折愈合后期发生的皮质重塑激活情况也是如此,所有组在术后第4周开始,第8周后下降。此外,在DEXA分析、小梁骨体积、松质骨组织面积、松质骨周长、破骨细胞计数、血清骨钙素或骨特异性碱性磷酸酶方面,不同给药方案与对照组之间未发现差异。
总之,骨折愈合第一步和第二步的存在以及组织学特征与骨折修复非常相似这一事实,验证了一种用于模拟骨折修复的新模型的开发和特性描述。一项使用治疗活性剂量伊班膦酸钠的长期研究表明,长期给药后,伊班膦酸钠不会损害骨密度、骨结构、骨修复、耦合以及骨形成和转换的血清参数。