阿仑膦酸盐治疗 Brtl/+ 骨形成不全小鼠模型中的骨折愈合。

Fracture healing with alendronate treatment in the Brtl/+ mouse model of osteogenesis imperfecta.

机构信息

Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.

出版信息

Bone. 2013 Sep;56(1):204-12. doi: 10.1016/j.bone.2013.06.003. Epub 2013 Jun 14.

Abstract

Osteogenesis imperfecta (OI) is a heritable bone dysplasia characterized by increased skeletal fragility. Patients are often treated with bisphosphonates to attempt to reduce fracture risk. However, bisphosphonates reside in the skeleton for many years and long-term administration may impact bone material quality. Acutely, there is concern about risk of non-union of fractures that occur near the time of bisphosphonate administration. This study investigated the effect of alendronate, a potent aminobisphosphonate, on fracture healing. Using the Brtl/+ murine model of type IV OI, tibial fractures were generated in 8-week-old mice that were untreated, treated with alendronate before fracture, or treated before and after fracture. After 2, 3, or 5 weeks of healing, tibiae were assessed using microcomputed tomography (μCT), torsion testing, quantitative histomorphometry, and Raman microspectroscopy. There were no morphologic, biomechanical or histomorphometric differences in callus between untreated mice and mice that received alendronate before fracture. Alendronate treatment before fracture did not cause a significant increase in cartilage retention in fracture callus. Both Brtl/+ and WT mice that received alendronate before and after fracture had increases in the callus volume, bone volume fraction and torque at failure after 5 weeks of healing. Raman microspectroscopy results did not show any effects of alendronate in wild-type mice, but calluses from Brtl/+ mice treated with alendronate during healing had a decreased mineral-to-matrix ratio, decreased crystallinity and an increased carbonate-to-phosphate ratio. Treatment with alendronate altered the dynamics of healing by preventing callus volume decreases later in the healing process. Fracture healing in Brtl/+ untreated animals was not significantly different from animals in which alendronate was halted at the time of fracture.

摘要

成骨不全症(OI)是一种遗传性骨发育不良,其特征为骨骼脆弱度增加。患者通常接受双膦酸盐治疗以降低骨折风险。然而,双膦酸盐在骨骼中存在多年,长期给药可能会影响骨材料质量。急性情况下,人们担心在接受双膦酸盐治疗时发生的骨折的不愈合风险。本研究调查了阿仑膦酸钠(一种强效的氨基双膦酸盐)对骨折愈合的影响。使用 Brtl/+型 IV 型 OI 小鼠模型,在 8 周龄的小鼠中生成胫骨骨折,这些小鼠未接受治疗、在骨折前接受阿仑膦酸钠治疗或在骨折前后接受治疗。在 2、3 或 5 周的愈合后,使用微计算机断层扫描(μCT)、扭转测试、定量组织形态计量学和拉曼微光谱对胫骨进行评估。未接受治疗的小鼠和在骨折前接受阿仑膦酸钠治疗的小鼠的骨痂之间在形态、生物力学或组织形态计量学上没有差异。在骨折骨痂中,阿仑膦酸钠治疗前不会导致软骨保留显著增加。在骨折前后均接受阿仑膦酸钠治疗的 Brtl/+和 WT 小鼠,在 5 周的愈合后,骨痂体积、骨体积分数和失效扭矩均增加。拉曼微光谱结果显示,野生型小鼠中没有阿仑膦酸钠的任何影响,但在愈合过程中接受阿仑膦酸钠治疗的 Brtl/+小鼠的骨痂中,矿物质与基质的比例降低、结晶度降低、碳酸盐与磷酸盐的比例增加。阿仑膦酸钠的治疗通过防止愈合过程后期骨痂体积减少来改变愈合的动态。未经治疗的 Brtl/+ 动物的骨折愈合与在骨折时停止使用阿仑膦酸钠的动物没有显著差异。

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