Orthopedic and Traumatology Department, Medical University of Lublin, Lublin, Poland.
Int Orthop. 2013 May;37(5):969-74. doi: 10.1007/s00264-013-1816-6. Epub 2013 Feb 13.
Bisphosphonates (BPs) are antiresorptive drugs that provide important effects on bone turnover. The key to the high efficiency of BPs is their affinity for bone tissue, and their chemical structure provides their molecular mechanism of action. BPs are widely used to treat a variety of diseases that cause excess bone resorption, such as bone metastasis, hypercalcaemia due to malignancy and Paget's disease. The goal of this study was to assess whether the bisphosphonate (Pamifos®) present in bone cement has any effect on bone turnover. In this paper, we present changes in cytokine levels in the serum of rats treated surgically.
Research was performed on 40 adult male Wistar rats. The rats were divided into four groups: two control groups (A, B) and two experimental groups (C, D). Bone in rats in the experimental groups was implanted with BP-enriched cement, whereas bone in control-groups rats was implanted with clean cement (without BPs).
We found a higher concentration of tumour necrosis factor alpha (TNF-α) three weeks after surgery in rats implanted with BP-enriched cement compared with rats implanted with clean cement. After six weeks of treatment, TNF-α levels decreased significantly in rats treated with BP-enriched cement, whereas the control group experienced an increase in TNF-α. The concentration of osteoprotegerin ligand (OPG) was higher in rats with BP implants. We found high levels of receptor activator of nuclear factor kappa-B ligand (RANKL) in rats after implantation of cement without BP in both groups.
We conclude that use of bisphosphonate (Pamifos®), which is present in bone cement, has an effect on bone turnover in that BPs stimulate an increase in OPG and a decrease in RANKL in the bone microenvironment and thus may be an important component of mechanisms that reduce bone resorption. Therefore, the use of BP-enriched cement implants appears to be justified.
双膦酸盐（BPs）是抗吸收药物，对骨转换有重要影响。BPs 高效的关键是其对骨组织的亲和力，其化学结构提供了其作用的分子机制。BPs 被广泛用于治疗多种引起骨吸收过度的疾病，如骨转移、恶性肿瘤引起的高钙血症和 Pagets 病。本研究的目的是评估骨水泥中存在的双膦酸盐（Pamifos®）是否对骨转换有影响。本文介绍了手术治疗大鼠血清细胞因子水平的变化。
研究对象为 40 只成年雄性 Wistar 大鼠。将大鼠分为四组：两组对照组（A、B）和两组实验组（C、D）。实验组大鼠的骨内植入富含 BP 的骨水泥，而对照组大鼠的骨内植入无 BP 的清洁骨水泥。
我们发现，植入富含 BP 骨水泥的大鼠在手术后 3 周 TNF-α 浓度更高，与植入清洁骨水泥的大鼠相比。治疗 6 周后，植入富含 BP 骨水泥的大鼠 TNF-α 水平显著下降，而对照组大鼠 TNF-α 水平升高。植入 BP 大鼠的护骨素配体（OPG）浓度更高。我们发现，两组大鼠在植入无 BP 骨水泥后，核因子 kappa-B 受体激活剂配体（RANKL）水平均升高。
我们得出结论，使用含有骨水泥中的双膦酸盐（Pamifos®）会影响骨转换，因为 BPs 刺激骨微环境中 OPG 增加和 RANKL 减少，这可能是减少骨吸收的机制的重要组成部分。因此，使用富含 BP 的骨水泥植入物是合理的。
