Fan T M, de Lorimier L P, Garrett L D, Lacoste H I
Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802-4714, USA.
J Vet Intern Med. 2008 Mar-Apr;22(2):380-7. doi: 10.1111/j.1939-1676.2008.0046.x. Epub 2008 Mar 10.
Malignant osteolysis is a process whereby cancer cells in concert with osteoclasts erode bone matrix. Aminobisphosphonates (NBPs) such as zoledronate induce osteoclast apoptosis and thereby decrease malignant skeletal destruction, severity of bone pain, and frequency of pathologic fracture.
IV-administered zoledronate will reduce homeostatic bone turnover in healthy dogs and pathologic bone resorption in dogs diagnosed with primary and secondary bone tumors.
Six healthy dogs and 20 dogs with naturally occurring primary or metastatic bone tumors were administered zoledronate IV.
Prospective study: In all dogs, healthy (n = 6) and with malignant osteolysis (n = 20), the bone biologic effects of zoledronate were evaluated by quantifying changes in serum C-telopeptide (CTx) or urine N-telopeptide (NTx) concentrations or both. In dogs with osteosarcoma (OSA) (n = 10), serial changes in tumor relative bone mineral density (rBMD) assessed by dual-energy x-ray absorptiometry were used to characterize zoledronate's antiresorptive effects within the immediate tumor microenvironment. Additionally, the biochemical tolerability of zoledronate was assessed in 9 dogs receiving multiple (> or =2) consecutive treatments.
All dogs had significant reductions in serum CTx or urine NTx concentrations or both after zoledronate administration. In a subset of dogs with appendicular OSA, reduced urine NTx concentrations and increased primary tumor rBMD coincided with improved limb usage as reported by pet owners in dogs treated with zoledronate and concurrent oral analgesics. Multiple zoledronate infusions were not associated with biochemical evidence of toxicosis.
In dogs with skeletal neoplasms, IV-administered zoledronate exerts bone biologic effects, appears safe, and can provide pain relief.
恶性骨溶解是癌细胞与破骨细胞协同作用侵蚀骨基质的过程。唑来膦酸等氨基双膦酸盐可诱导破骨细胞凋亡,从而减少恶性骨破坏、骨痛严重程度及病理性骨折发生率。
静脉注射唑来膦酸将降低健康犬的稳态骨转换,并减少诊断为原发性和继发性骨肿瘤犬的病理性骨吸收。
对6只健康犬和20只患有自然发生的原发性或转移性骨肿瘤的犬静脉注射唑来膦酸。
前瞻性研究:在所有犬中,包括健康犬(n = 6)和患有恶性骨溶解的犬(n = 20),通过定量血清C-末端肽(CTx)或尿N-末端肽(NTx)浓度或两者的变化来评估唑来膦酸的骨生物学效应。在骨肉瘤(OSA)犬(n = 10)中,通过双能X线吸收法评估的肿瘤相对骨矿物质密度(rBMD)的系列变化用于表征唑来膦酸在肿瘤直接微环境中的抗吸收作用。此外,在9只接受多次(≥2次)连续治疗的犬中评估唑来膦酸的生化耐受性。
所有犬在注射唑来膦酸后血清CTx或尿NTx浓度或两者均显著降低。在一组患有附肢OSA的犬中,尿NTx浓度降低和原发性肿瘤rBMD增加与接受唑来膦酸和同时口服镇痛药治疗的犬的宠物主人报告的肢体使用改善相一致。多次唑来膦酸输注与中毒的生化证据无关。
在患有骨骼肿瘤的犬中,静脉注射唑来膦酸具有骨生物学效应,似乎安全,并可缓解疼痛。