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高剂量利塞膦酸盐治疗在长期废用期间部分保留了松质骨量和微结构。

High-dose risedronate treatment partially preserves cancellous bone mass and microarchitecture during long-term disuse.

作者信息

Yang Li Chao, Majeska Robert J, Laudier Damien M, Mann Richard, Schaffler Mitchell B

机构信息

Leni and Peter W. May Department of Orthopaedics, Mount Sinai School of Medicine, Box 1188, One Gustave L. Levy Place, New York, NY 10029, USA.

出版信息

Bone. 2005 Sep;37(3):287-95. doi: 10.1016/j.bone.2005.04.041.

Abstract

Disuse induces rapid and severe bone loss in larger mammals as a result of greatly elevated osteoclastic resorption. In this study, we tested whether risedronate (RIS), a potent inhibitor of osteoclastic activity, would effectively prevent cancellous bone loss in female beagles (5-7 years old, N = 28) subjected to single forelimb immobilization (IM) for 12 months. Age-matched, non-IM dogs served as controls (Con). Half the animals from each group received RIS 1 mg/kg p.o. daily (Con + RIS, IM + RIS). Remaining dogs received sterile water (Con, IM). Histomorphometry showed that IM caused a dramatic reduction in cancellous bone mass (-71%) of distal 2nd metacarpals, characterized by marked decreases in trabecular width (-51%) and number (-41%), and 4-fold increases in the indices of bone resorption (eroded surface, osteoclast number, and surface). Bone formation indices (calcein-labeled surface, osteoid surface, and bone formation rate) were also significantly higher in IM than in controls. Activation frequency in IM increased about 4-fold beyond control level. RIS treatment reduced, but did not abolish cancellous bone loss due to immobilization. IM animals treated with RIS lost nearly 50% of cancellous bone mass, while trabecular width and number were reduced by 31% and 25%, respectively. In both RIS-treated control and IM animals, overall bone formation parameters (mineralized bone surface fraction and bone formation rate) remained roughly at intact control levels; however, mineral apposition rate relative to intact control was reduced 40% in RIS-treated control and 86% in RIS-treated IM animals. These results indicate that high-dose RIS treatment might suppress osteoblastic function, especially under long-term disuse. Interestingly, bone resorption parameters in RIS-treated IM animals reached levels even higher than in vehicle-treated IM animals; values for eroded surface, osteoclast number, and surface were 84%, 53%, and 83% above vehicle-treated IM values, respectively. Our data indicate that risedronate treatment is partially effective in preventing cancellous bone loss during long-term disuse. Moreover, our results suggest that bisphosphonates can impair the ability of mature osteoclasts to resorb bone, but cannot overcome the strong stimulus for osteoclast recruitment caused by long-term disuse.

摘要

废用会导致大型哺乳动物因破骨细胞吸收大幅增加而出现快速且严重的骨质流失。在本研究中,我们测试了利塞膦酸盐(RIS),一种有效的破骨细胞活性抑制剂,是否能有效预防雌性比格犬(5 - 7岁,N = 28)在前肢单肢固定(IM)12个月后出现的松质骨流失。年龄匹配的未进行IM的犬作为对照(Con)。每组动物中有一半每天口服1 mg/kg的RIS(Con + RIS,IM + RIS)。其余的犬接受无菌水(Con,IM)。组织形态计量学显示,IM导致第二掌骨远端的松质骨量显著减少(-71%),其特征为骨小梁宽度(-51%)和数量(-41%)明显降低,以及骨吸收指标(侵蚀表面、破骨细胞数量和表面)增加了4倍。IM组的骨形成指标(钙黄绿素标记表面、类骨质表面和骨形成率)也显著高于对照组。IM组的激活频率比对照水平增加了约4倍。RIS治疗减少了因固定导致的松质骨流失,但并未消除。接受RIS治疗的IM动物的松质骨量损失了近50%,而骨小梁宽度和数量分别减少了31%和25%。在接受RIS治疗的对照动物和IM动物中,总体骨形成参数(矿化骨表面分数和骨形成率)大致保持在完整对照水平;然而,相对于完整对照,接受RIS治疗的对照动物的矿物质沉积率降低了40%,接受RIS治疗的IM动物降低了86%。这些结果表明,高剂量RIS治疗可能会抑制成骨细胞功能,尤其是在长期废用的情况下。有趣的是,接受RIS治疗的IM动物的骨吸收参数甚至高于接受赋形剂治疗的IM动物;侵蚀表面、破骨细胞数量和表面的值分别比接受赋形剂治疗的IM动物的值高出84%、53%和83%。我们的数据表明,利塞膦酸盐治疗在预防长期废用期间的松质骨流失方面部分有效。此外,我们的结果表明,双膦酸盐可以损害成熟破骨细胞的骨吸收能力,但无法克服长期废用引起的破骨细胞募集的强烈刺激。

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