Hikata Tomohiro, Hasegawa Tomoka, Horiuchi Keisuke, Fujita Nobuyuki, Iwanami Akio, Watanabe Kota, Ishii Ken, Nakamura Masaya, Amizuka Norio, Matsumoto Morio
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
Department of Orthopedic Surgery, Kitasato Institute Hospital, Tokyo 108-8642, Japan.
Bone Rep. 2016 Oct 13;5:286-291. doi: 10.1016/j.bonr.2016.10.002. eCollection 2016 Dec.
Minimodeling is a type of focal bone formation that is characterized by the lack of precedent bone erosion by osteoclasts. Although this form of bone formation has been described for more than a decade, how anti-osteoporotic agents that are currently used in clinical practice affect the kinetics of minimodeling is not fully understood. We performed a bone morphometric analysis using human vertebral specimens collected from postmenopausal patients who underwent spinal surgery. Patients were divided into three groups according to osteoporosis medication; non-treated, Eldecalcitol (ELD, a vitamin D derivative that has recently been approved to treat patients with osteoporosis in Japan)-treated, and bisphosphonate-treated groups. Five to six patients were enrolled in each group. There was a trend toward enhanced minimodeling in ELD-treated patients and suppressed of it in bisphosphonate-treated patients compared with untreated patients. The differences of minimodeling activity between ELD-treated and bisphosphonate-treated patients were statistically significant. The present study suggests that ELD and bisphosphonates have opposite effects on minimodeling from one another, and show that minimodeling also takes place in vertebrae as has been described for the ilium and femoral head in humans.
微损伤修复性骨形成是一种局灶性骨形成，其特征是缺乏破骨细胞先前造成的骨侵蚀。尽管这种骨形成形式已被描述了十多年，但目前临床实践中使用的抗骨质疏松药物如何影响微损伤修复性骨形成的动力学尚未完全明确。我们使用从接受脊柱手术的绝经后患者收集的人椎体标本进行了骨形态计量分析。根据骨质疏松症药物治疗情况，患者被分为三组：未治疗组、依降钙素（ELD，一种最近在日本被批准用于治疗骨质疏松症患者的维生素D衍生物）治疗组和双膦酸盐治疗组。每组纳入5至6名患者。与未治疗患者相比，依降钙素治疗的患者有微损伤修复性骨形成增强的趋势，而双膦酸盐治疗的患者则有微损伤修复性骨形成受抑制的趋势。依降钙素治疗患者和双膦酸盐治疗患者之间的微损伤修复性骨形成活性差异具有统计学意义。本研究表明，依降钙素和双膦酸盐对微损伤修复性骨形成的作用相反，并且表明微损伤修复性骨形成也发生在椎体中，正如在人类髂骨和股骨头中所描述的那样。
