Stuermer Ewa K, Komrakova Marina, Sehmisch Stephan, Tezval Mohammad, Dullin Christian, Schaefer Nadine, Hallecker Jan, Stuermer Klaus M
Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Cologne, Germany; Department of Trauma Surgery and Reconstructive Surgery, University of Goettingen, Robert-Koch 40, 37075 Goettingen, Germany.
Department of Trauma Surgery and Reconstructive Surgery, University of Goettingen, Robert-Koch 40, 37075 Goettingen, Germany.
Bone. 2014 Jul;64:187-94. doi: 10.1016/j.bone.2014.04.008. Epub 2014 Apr 13.
Current osteoporosis therapies aim to delay bone destruction and have additional anabolic effects. While they have demonstrated some positive effects on bone healing, more progress is needed in this area. This study used the well-known osteoporotic agents estrogen (E) and raloxifene (R) in conjunction with biomechanical whole body vibration (WBV) at a frequency of 70 Hz twice daily for six weeks to stimulate bone healing. Eighty-four 3-month old female Sprague-Dawley rats (12 per group) were bilaterally ovariectomized to develop osteopenia within eight weeks. Osteotomy of the metaphyseal tibiae was performed and fracture healing was then studied using mechanical tests, histomorphometry, computed tomography (μCT), and gene analysis. We found that E and R improved the structure of osteopenic bones as did WBV alone, although significant levels for WBV were seldom reached. Combination treatments significantly enhanced stiffness (R+WBV; p<0.05), endosteal bone (R+WBV; p<0.01), and trabecular density (E+WBV; p<0.05, R+WBV; p<0.05). In addition, the expression of osteoclast-specific Trap was significantly reduced after treatment with E, R, or their combination with WBV (p<0.01). The effects were additive and not inhibitory, leading us to conclude that the combined applications of WBV with E or R may improve the healing of osteopenic bones. The therapies studied are all currently approved for human use, suggesting ready applicability to clinical practice. To better understand the effects of WBV on osteopenic bones, the ideal vibration regime will require further study.
目前的骨质疏松症治疗旨在延缓骨质破坏并具有额外的合成代谢作用。虽然它们已在促进骨愈合方面显示出一些积极效果,但该领域仍需取得更多进展。本研究使用了著名的骨质疏松症治疗药物雌激素(E)和雷洛昔芬(R),并结合频率为70Hz的生物力学全身振动(WBV),每天两次,持续六周,以刺激骨愈合。84只3个月大的雌性Sprague-Dawley大鼠(每组12只)双侧卵巢切除,在八周内形成骨质减少。对胫骨干骺端进行截骨术,然后使用力学测试、组织形态计量学、计算机断层扫描(μCT)和基因分析研究骨折愈合情况。我们发现,E和R以及单独的WBV都改善了骨质减少骨骼的结构,尽管WBV很少达到显著水平。联合治疗显著提高了硬度(R+WBV;p<0.05)、骨内膜骨(R+WBV;p<0.01)和小梁密度(E+WBV;p<0.05,R+WBV;p<0.05)。此外,用E、R或它们与WBV联合治疗后,破骨细胞特异性抗酒石酸酸性磷酸酶(Trap)的表达显著降低(p<0.01)。这些作用是相加的而非抑制性的,这使我们得出结论,WBV与E或R联合应用可能改善骨质减少骨骼的愈合。所研究的治疗方法目前均已获批用于人类,表明可直接应用于临床实践。为了更好地理解WBV对骨质减少骨骼的影响,理想的振动方案还需要进一步研究。