Ozmen Bilgin, Kirmaz Cengiz, Aydin Kadir, Kafesciler Sabriye O, Guclu Feyzullah, Hekimsoy Zeliha
Celal Bayar University, Medical Faculty, Department of Internal Medicine, Division of Endocrinology and Metabolism, Manisa, Turkey.
Eur Cytokine Netw. 2007 Sep;18(3):148-53. doi: 10.1684/ecn.2007.0097. Epub 2007 Sep 7.
BACKGROUND: Osteoporosis that is encountered frequently in postmenopausal women, may cause an increased incidence of vertebral and iliac fractures that are associated with excess morbidity. Raloxifene hydrochloride, a selective oestrogen receptor modulator, has been shown to increase bone mineral density and decrease biochemical markers of bone turnover in postmenopausal women, without stimulatory effects on breast or uterus. Levels of proinflammatory cytokines, including IL-6, and TNF-alpha and TGF-beta1 which are important cytokines involved in remodeling, have been evaluated previously in in vitro studies of osteoporosis. However, there seems to be a paucity of in vivo research concerned with changes in these cytokines in osteoporosis. OBJECTIVE: In this study, we evaluated the effects of raloxifene (Evista); Lilly Pharmaceutical Co. USA, 60 mg/day) on biochemical bone turnover markers, serum parathyroid hormone, and 25-OH vitamin D, as well as the serum levels of IL-6, TNF-alpha and TGF-beta1, in 22 postmenopausal, osteoporotic women before and after 12 weeks of raloxifene treatment. METHODS: Well-matched, postmenopausal, non-osteoporotic control subjects were also enrolled in the study. Serum levels of all the parameters were measured in postmenopausal, osteoporotic women at baseline and end of the study. RESULTS: It was found that serum osteocalcin and parathyroid hormone, and urine deoxypyridinoline levels decreased to normal levels with treatment. Serum 25-OH vitamin D levels after treatment in the patient group were higher than those in the control group. Serum IL-6, TNF-alpha and TGF-beta1 levels did not change significantly with treatment. However, serum levels of IL-6 and TGF-beta1 in the patient group after treatment, decreased to levels lower than those found in the control group. Serum TNF-alpha levels in the patient group before and after treatment, were lower than those in the control group. CONCLUSION: Raloxifene treatment reduces bone turnover biochemical markers, parathyroid hormone and induces 25-OH vitamin D in postmenopausal women. Moreover, it also affects some serum cytokine levels in the postmenopausal period.
背景：绝经后女性中常见的骨质疏松症可能会导致椎体和髂骨骨折的发生率增加，而这些骨折与发病率过高相关。盐酸雷洛昔芬是一种选择性雌激素受体调节剂，已被证明可增加绝经后女性的骨矿物质密度，并降低骨转换的生化标志物，且对乳腺或子宫无刺激作用。包括白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和转化生长因子-β1（TGF-β1）在内的促炎细胞因子水平，这些是参与重塑的重要细胞因子，此前已在骨质疏松症的体外研究中进行了评估。然而，关于骨质疏松症中这些细胞因子变化的体内研究似乎很少。 目的：在本研究中，我们评估了雷洛昔芬（易维特；美国礼来制药公司，60毫克/天）对22名绝经后骨质疏松女性在雷洛昔芬治疗12周前后的骨转换生化标志物、血清甲状旁腺激素和25-羟基维生素D，以及血清IL-6、TNF-α和TGF-β1水平的影响。 方法：匹配良好的绝经后非骨质疏松对照受试者也纳入了该研究。在绝经后骨质疏松女性的基线和研究结束时测量所有参数的血清水平。 结果：发现治疗后血清骨钙素和甲状旁腺激素以及尿脱氧吡啶啉水平降至正常水平。患者组治疗后的血清25-羟基维生素D水平高于对照组。治疗后血清IL-6、TNF-α和TGF-β1水平无显著变化。然而，患者组治疗后的血清IL-6和TGF-β1水平降至低于对照组的水平。患者组治疗前后的血清TNF-α水平低于对照组。 结论：雷洛昔芬治疗可降低绝经后女性的骨转换生化标志物、甲状旁腺激素，并诱导产生25-羟基维生素D。此外，它还会影响绝经后时期的一些血清细胞因子水平。
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