枸橼酸托法替布片联合仙灵骨葆胶囊对类风湿性关节炎合并骨质疏松患者血清炎症细胞因子、骨强度及骨代谢水平影响

摘要 目的：探讨枸橼酸托法替布片联合仙灵骨葆胶囊对类风湿性关节炎（RA）合并骨质疏松患者血清炎症细胞因子、骨强度及骨代谢水平影响。方法：纳入2021年8月至2022年8月期间徐州医科大学附属连云港医院诊治的80例RA合并骨质疏松患者。根据随机数字表法将患者分为对照组（雷公藤多苷片联合仙灵骨葆胶囊治疗）和实验组（枸橼酸托法替布片联合仙灵骨葆胶囊治疗）,各为40例。对比两组疗效、炎症细胞因子、骨强度及骨代谢指标,观察两组不良反应发生率。结果：实验组的临床总有效率高于对照组（P<0.05）。实验组治疗后巨噬细胞集落刺激因子（M-CSF）、白细胞介素-1β（IL-1β）、环氧合酶-2（COX-2）低于对照组同期（P<0.05）。实验组治疗后横截面积（CSA）、横截面转动惯量（CSMI）、截面系数（Z）、皮质厚度（CT）高于对照组同期（P<0.05）。实验组治疗后骨钙素N端中分子（N-MID）、总Ⅰ型胶原氨基端延长肽（T-PINP）、骨钙素（BGP）、Ⅰ型胶原羧基端前肽（PICP）高于对照组同期,β-胶原降解产物（β-CTX）低于对照组同期（P<0.05）。两组治疗后腰椎骨密度和股骨颈骨密度较治疗前升高,且实验组高于对照组同期（P<0.05）。两组治疗后血沉（ESR）、C反应蛋白（CRP）、类风湿关节炎患者病情（DAS28）评分下降,且实验组低于对照组同期（P<0.05）。两组不良反应发生率组间对比无统计学差异（P>0.05）。结论：枸橼酸托法替布片联合仙灵骨葆胶囊应用于RA合并骨质疏松患者,可有效调节骨代谢水平,增强骨强度,降低血清炎症细胞因子水平。     

外泌体miR-338对骨质疏松大鼠骨代谢水平、骨小梁微结构和骨生物力学的影响

摘要 目的：探讨外泌体miR-338对骨质疏松大鼠骨代谢水平、骨小梁微结构和骨生物力的影响。方法：采用健康成年SPF级SD雄性大鼠进行骨髓间充质干细胞（BMSCs）分离。采用双侧卵巢摘除手术方法构建了骨质疏松大鼠模型。采用qRT-PCR法检测miR-338的表达水平;检测大鼠的骨密度,骨小梁微结构和骨生物力学指标。结果：与空白对照组相比,OP模型组、OP+ ExoBMSCs、抑制组和过表达组miR-338的表达水平明显更高（P＜0.05）;抑制组的miR-338的表达水平低于OP模型组、OP+ExoBMSCs和过表达组（P＜0.05）;与空白对照组相比,OP模型组、OP+ ExoBMSCs、抑制组和过表达组OC、PINP、BALP的表达水平明显更低（P＜0.05）;抑制组的OC、PINP、BALP的表达水平明显高于OP模型组、OP+ ExoBMSCs和过表达组（P＜0.05）;与空白对照组相比,OP模型组、OP+ ExoBMSCs、抑制组和过表达组BV/TV、Th.N、Tb.Th、Conn.D水平更低,而Tb.Sp、SMI明显更高（P＜0.05）;抑制组组的BV/TV、Th.N、Tb.Th、Conn.D水平明显高于OP模型组、OP+ ExoBMSCs和过表达组,而Tb.Sp、SMI更低（P＜0.05）;与空白对照组相比,OP模型组、OP+ ExoBMSCs、抑制组和过表达组BMD、最大荷载、最大应力、最大位移、刚度水平更低（P＜0.05）;抑制组的BMD、最大荷载、最大应力、最大位移、刚度水平高于OP模型组、OP+ExoBMSCs和过表达组（P＜0.05）。结论：BMSCs源性的miR-338可影响骨质疏松大鼠骨代谢、骨小梁微结构和骨生物力学状态。     

Pharmacological studies of the large-scaled purified genistein from Huaijiao (Sophora japonica – Leguminosae) on anti-osteoporosis

In this report, we used genistein that was extracted from a Chinese herbal medicine Huaijiao (Sophora japonica – Leguminosae) to evulate its pharmacological function on anti-osteoporosis. This genistein is purified in a large-scale production from Huaijiao by a state-of-art method as described by Tian et al. [2004. The preparation of genistein and LC-MS/MS on-line analysis. Drug Devel. Res. 61, 6–12]. Chemical structure of the isolated genistein was examined by using various techniques including nuclear magnetic resonant spectrum, infrared absorption spectrum, ultraviolet absorption spectrum and mass spectrum, and was proved to be identical to those purified from soybean in a small scale as previously reported. We randomly divided female SD rats into 6 groups, including control, ovariectomized model, Nilestriol-treated, and three level of dosages of genistein-treated. We evaluated the pharmacological effects of genistein against osteoporosis by measuring the bone density of femur and bone mineral group including calcium, phosphorous, and magnesium. The consequences of genistein treatment on bone histology and morphology were also determined by measuring the trabcular area, thickness and number. Our results indicated that treatment with a 4.5 or 9 mg/kg dosage of genistein could also prevent osteoporosis significantly at the 4th week after treatment. In comparison with the anti-osteoporosis effects of soybean genistein, the genistein extracted from Huaijiao has the same beneficial effect on anti-osteoporosis.     

基于“心与小肠相表里”理论探讨肠道微生态与骨质疏松症的关系

近年来相关研究显示,肠道微生态在骨质疏松症的发生发展中起着重要作用。中医脏腑理论密切关注脏腑之间的生理病理关系,以中医经典《内经》“心与小肠相表里”理论为基础,探讨心、小肠、肠道微生态与骨质疏松症之间的关系。研究发现肠道微生态可能是心系疾病导致骨质疏松症的途径之一,这一发现可能为骨质疏松症的研究与防治提供一定的理论依据。     

阿仑膦酸钠与钙尔奇D分别联合二甲双胍治疗2型糖尿病合并骨质疏松症的疗效对比研究

摘要 目的：对比阿仑膦酸钠与钙尔奇D分别联合二甲双胍治疗2型糖尿病（T2DM）合并骨质疏松症的疗效。方法：选取我院于2016年4月~2019年1月期间收治的109例T2DM合并骨质疏松症患者,根据乱数表法将患者分为钙尔奇D组（n=54,钙尔奇D）和阿仑膦酸钠组（n=55,阿仑膦酸钠）。比较两组患者临床疗效、血糖指标、骨代谢相关指标、腰椎L2~L4及股骨颈的骨密度值。结果：阿仑膦酸钠组治疗1个月后的临床总有效率为83.64%（46/55）,高于钙尔奇D组的62.96%（34/54）（P<0.05）。两组治疗1个月后腰椎L2~ L4、股骨颈的骨密度值均升高,且阿仑膦酸钠组高于钙尔奇D组（P<0.05）。两组治疗1个月后骨钙素（BGP）升高,且阿仑膦酸钠组高于钙尔奇D组（P<0.05）;血清I型胶原C末端肽（s-CTX）、碱性磷酸酶（BAP）、人抗酒石酸酸性膦酸酶 5b（TRAP-5b）则降低,且阿仑膦酸钠组低于钙尔奇D组（P<0.05）。两组治疗1个月后空腹血糖（FPG）、糖化血红蛋白（HbA1c）均降低（P<0.05）,但两组治疗1个月后组间比较无统计学差异（P>0.05）。两组不良反应发生率对比无统计学差异（P >0.05）。结论：与钙尔奇D联合二甲双胍治疗比较,阿仑膦酸钠联合二甲双胍治疗T2DM合并骨质疏松症患者,疗效显著,可有效改善骨代谢指标及骨密度,且不影响降糖效果,具有一定的临床应用价值。     

Influence of bone mineral density in circulating adipokines among postmenopausal Arab women

Osteoporosis and osteopenia has a significant link with substantial fracture risk. Epidemiological data revealed a protective role of adipose tissue on bone biology in postmenopausal osteoporosis. The current study assessed the associations between select adipokines and bone mineral density (BMD) in postmenopausal women. A total of 175 Saudi postmenopausal women were selected and categorized based on their BMD (normal & low-BMD). Circulating levels of select adipokines (adiponectin, resistin, leptin, and adipsin), insulin, 25(OH)D and RANKl were determined using commercially available assay kits. BMD was measured by dual-energy X-ray absorptiometry (DXA). Overall and among low-BMD subjects, adiponectin consistently showed a significant inverse association with BMD (overall −0.34, p < 0.01; low BMD group −0.34, p < 0.01). In multiple regression, adiponectin (−0.29 ± 0.06, p < 0.00) and resistin (−0.08 ± 0.04, p < 0.05) were inversely significant with BMD overall, but after stratification the significance was lost for resistin (−0.05 ± 0.04, p < 0.224) whereas adiponectin remained (−0.22 ± 0.07, p < 0.02) in low-BMD subjects. Adipsin, leptin and lipocalin-2 showed no significant associations. Findings of the present study revealed that only adiponectin showed a significantly strong inverse association with low BMD, suggesting that insulin sensitivity may influence bone health in Arab postmenopausal women.     

Two new secondary metabolites isolated from Avena sativa L. (Oat) seedlings and their effects on osteoblast differentiation

Seedlings of natural crops are valuable sources of pharmacologically active phytochemicals. In this study, we aimed to identify new active secondary metabolites in Avena sativa L. (oat) seedlings. Two new compounds, avenafuranol (1) and diosgenoside (2), along with eight known compounds (3–10) were isolated from the A. sativa L. seedlings. Their chemical structures were elucidated via 1D and 2D NMR spectroscopy, high-resolution ESIMS, IR spectroscopy, optical rotation analysis, and comparisons with the reported literature. The effect of each isolated compound on alkaline phosphatase (ALP) activity for osteoblast differentiation induced by bone morphogenetic protein-2 (BMP-2) was investigated using the C2C12 immortal mouse myoblast cell line. Compounds 1, 4, 6, 8, and 9 induced dose-dependent increases in ALP expression relative to ALP expression in cells treated with only BMP-2, and no cytotoxicity was observed. These results suggest that A. sativa L. seedlings are a natural source of compounds that may be useful for preventing bone disorders.     

Induced osteoblast differentiation by amide derivatives of stilbene: The possible osteogenic agents

A series of amide derivatives of stilbene was synthesized and investigated for osteogenic activity. Out of sixteen, seven compounds viz 19c, 19g, 19i, 24b, 25a, 25c and 26a showed significant osteoblast differentiation within 1 pM–1 µM concentrations. Amongst all, 26a was identified as most active molecule which presented effective mineralization of osteoblasts and expression of mRNA of osteogenic marker gene such as BMP-2, ALP, and Runx-2 at 1 pM. In estrogen-deficient balb/c mice, 26a showed significant osteogenic activity at 5 mg-kg⁻¹ body weight dose. The protein expression study for estrogen receptors α and β (ER-α & ER-β) using mouse calvarial osteoblasts (MCOs) and molecular docking analyses showed preferential expression of ER-β by 26a indicating the possibility of ER-β mediated osteogenic activity of 26a.     

大豆异黄酮对骨质疏松大鼠模型的作用探讨

目的研究大豆异黄酮促进骨质疏松大鼠骨形成的作用及其肠道微生态的变化。方法从60只SPF级SD雌性大鼠中随机挑选50只建立去卵巢骨质疏松大鼠模型,余下10只为假手术组。将建模成功的大鼠随机分为5组,模型组、大豆异黄酮高、中、低剂量组(320 mg/kg、160 mg/kg、80 mg/kg的大豆异黄酮)、阿仑膦酸钠组(1 mg/kg阿仑膦酸钠),每日1次,治疗10周。比较治疗前后大鼠骨密度、血清1型前胶原N端前肽(P1NP)、骨碱性磷酸酶(BALP)、血清骨钙素(BGP)水平和肠道微生物变化。结果治疗后,模型组大鼠骨密度、血清P1NP、BALP、BGP水平均低于假手术组(P<0.05),阿仑膦酸钠组和大豆异黄酮高、中、低剂量组均高于模型组(P<0.05)。治疗后,阿仑膦酸钠组和大豆异黄酮高、中、低剂量与模型组比较股骨组织病变减轻;厚壁菌门、梭菌纲、芽孢杆菌纲、毛螺菌科、乳杆菌科、普氏菌科、肠球菌科、毛螺菌属、乳杆菌属、罗氏菌属、布劳特氏菌属、粪球菌属、普氏菌属水平相对丰度模型组均低于假手术组(P<0.05),阿仑膦酸钠组和大豆异黄酮高、中、低剂量组均高于模型组(P<0.05)。拟杆菌门、变形菌门、拟杆菌纲、γ变形菌纲、毛菌纲、拟杆菌科、肠杆菌科、拟杆菌属、别样棒菌属、肠杆菌属模型组均高于假手术组(P<0.05),阿林磷酸钠组和大豆异黄酮高、中、低剂量组均低于模型组(P<0.05)。LEfSe分析结果显示,与模型组比较,阿仑膦酸钠组和大豆异黄酮高、中、低剂量组治疗后丁酸球菌属、放线菌属、拟杆菌科、拟杆菌属水平降低,消化球菌科、韦荣氏菌科、普氏菌属水平升高。结论大豆异黄酮可提高骨密度,提高血清骨形成指标水平,促进骨质疏松大鼠骨形成,还可改善大鼠肠道菌群。     

Use of biochemical markers to monitor changes in bone turnover in cynomolgus monkeys

The ovariectomized old cynomolgus monkey is a recognized model of human osteoporosis, and the same species can be used for the assessment of the efficacy and potential toxicity of agents intended to prevent or treat osteoporosis. Several assays have been developed that can measure the same biochemical markers of bone turnover as are used in human patients for the diagnosis and treatment follow-up of bone-related diseases, including osteoporosis. The aim of the present study was to describe the results obtained with these assays in normal control monkeys, their variations with age and sex, and their sensitivity in monitoring the bone turnover induced by ovariectomy in old skeletally mature cynomolgus monkeys. Seven old cynomolgus monkeys were bilaterally ovariectomized and 13 age-matched monkeys were sham-operated. Bone mineral density and biochemical markers were measured before and at regular intervals after surgery for up to 20 months. Total alkaline phosphatase (total ALP), bone-specific alkaline phosphatase isoenzyme (bone ALP) and osteocalcin (OC) were highly correlated to the decrease in bone mineral density (BMD) induced by ovariectomy. Deoxypyridinoline (DPD) measured by enzyme-linked immunoassay was insensitive to the bone resorption induced by ovariectomy, but cross-linked N-telopeptide (NTX-I) was higher in ovariectomized monkeys than in control monkeys. These results demonstrate that reliable biochemical parameters are available to adequately monitor and provide insight into osteoclastic bone resorption and osteoblastic bone formation, the two components of bone turnover in this animal model, and can thus be used to assess the efficacy and toxicity of potential therapeutic agents.