Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
Lunenfeld-Tanenbaum Research Institute, Mount Sinai Health System, Toronto, ON, Canada.
Calcif Tissue Int. 2018 Sep;103(3):311-323. doi: 10.1007/s00223-018-0423-3. Epub 2018 Apr 24.
Duchenne muscular dystrophy (DMD) results from genetic mutations of the gene encoding dystrophin, leading to muscle inflammation and degeneration that is typically treated with glucocorticoids. DMD and its treatment with glucocorticoids result in poor bone health and high risk of fractures. Insufficient levels of 25-hydroxyvitamin D (25-hydroxy D) that may contribute to weakened bone are routinely found in DMD patients. To determine the effect of 25-hydroxy D deficiency, this study examined the effects of low vitamin D dietary intake with and without glucocorticoids on the musculoskeletal system of the Mdx mouse model of DMD. At 10 weeks of age, Mdx mice on control diet had low trabecular bone mineral density of distal femurs and lumbar vertebrae with increased osteoclast numbers compared to wild-type mice. Low vitamin D intake resulted in 25-hydroxy D deficiency but had no effect on trabecular or cortical bone. Cortical bone loss and bone weakness were induced by glucocorticoids while they improved muscle grip strength in Mdx mice. 25-hydroxy D deficiency did not result in any significant effects on growing bone or muscle in the Mdx mice. In combination with glucocorticoid treatment, low 25-hydroxy D resulted in no change in cortical bone mineral density but bone ductility was significantly increased suggesting lower bone mineralization.
杜氏肌营养不良症(DMD)是由于编码肌营养不良蛋白的基因突变导致的,肌肉炎症和退化,通常采用糖皮质激素治疗。DMD 及其糖皮质激素治疗会导致骨骼健康状况不佳和骨折风险增加。DMD 患者通常会出现 25-羟维生素 D(25-羟 D)水平不足,这可能导致骨骼脆弱。为了确定 25-羟 D 缺乏的影响,本研究探讨了低维生素 D 饮食摄入对 DMD 模型 Mdx 小鼠骨骼肌肉系统的影响,有无糖皮质激素的作用。在 10 周龄时,与野生型小鼠相比,接受对照饮食的 Mdx 小鼠的远端股骨和腰椎的小梁骨矿物质密度较低,破骨细胞数量增加。低维生素 D 摄入导致 25-羟 D 缺乏,但对小梁骨或皮质骨没有影响。皮质骨丢失和骨强度降低是由糖皮质激素引起的,而它们改善了 Mdx 小鼠的握力。25-羟 D 缺乏在 Mdx 小鼠中对生长中的骨骼或肌肉没有任何显著影响。与糖皮质激素治疗相结合,低 25-羟 D 对皮质骨矿物质密度没有改变,但骨韧性显著增加,表明骨矿化程度降低。