Modern analysis of bone loss mechanisms in microgravity

A summary of results of investigations by the author and a brief review of some literature data on human bone tissue deprived of mechanical loading (spaceflight, hypokinesia) is given. The direction and markedness of changes in bone mass--the bone mineral density and the bone mineral content--in different skeletal segments depend on their position relative to the gravity vector. A theoretically expected bone mass reduction was revealed in the trabecular structures of the bones of the lower part of the skeleton (local osteopenia). In the upper part of the skeleton, an increase in the bone mineral content is observed, which is considered as a secondary response and is due to redistribution of body fluids cephalad. The main cause of osteopenia is mechanical unloading. Arguments are presented that osteocyte osteolysis, delayed osteoblast histogenesis, and osteoclast resorption provoked by rearrangement in the hierarchy of the systems of fluid volume and ion regulation, and the endocrine control of calcium homeostasis are the main mechanisms of osteopenia.     

Study of skeleton gravitation physiology and problem of osteoporosis

Main osteoporosis definitions and some results of bone tissue research in Russian astronauts, patients, and healthy subjects, using modern osteodensitometry, are presented. Bone mineral density (BMD) was regularly decreased at lower segments of skeleton. In the skull bone and some other sites of upper part of skeleton, a tendency was revealed for an increase of the bone mineral content (BMC). The mean value of bone loss was within the normal range and not correlated with duration of space flight; it revealed a high individual variability and in some cases was clinically qualified as local osteopenia. On the ground of analysis of own results and animal and bone cultural experiments data in microgravity conditions, the described changes seem to be reflecting a deceleration of bone formation as an adaptive response of bone tissue to the mechanical unloading. The response is realized mainly on the tissue level. It does not exclude bone resorption activity as a result of changes in hierarchy of water and electrolytes metabolism as reflected by body fluid redistribution in cranial direction. The results obtained broaden our notions on pathogenesis of some types of osteoporosis in clinic.     

The human skeletal system in weightlessness: A review of research data,hypotheses, and the possibility of predicting the state in long-term (Interplanetary) missions

The long-term research of human skeletal system during spaceflight on the orbital station Mir and International Space Station (ISS) was summarized. The amount of bone mass and body composition was measured using a noninvasive method, dual-energy X-ray absorbtiometry (DXA) or osteodensitometry. Theoretically expected loss of bone mass in tubular structures of the lower part of the body during space flight with a duration of five to seven months is described by the phenomenon of fast-developing but reversible osteopenia and is considered a manifestation of functional adaptation of bone tissue to the changing mechanical load on the skeleton. A high individual variability of changes and stability of individual nature of the ratio of bone mass changes in different segments of the skeleton independently of the type of orbital station has been demonstrated. A strict dependence of bone mass changes on the flight duration cannot be established, and there are no grounds for calculating the probability of reaching the critical level of demineralization for the duration of flight increased to 1.5–2 years. There is even less probability to predict changes in bone structure (quality), which, together with the loss of bone mass, determine the risk of fracture. The data indicating that the DXA method is insufficient for such prognosis are presented. The main areas of research that would optimize the development of the project of interplanetary mission in terms of preservation of the mechanical function of the skeleton are considered.     

Mechanisms of human osteopenia and some peculiarities of bone metabolism in weightlessness conditions

Systematically results and new analysis data on the investigation of human bone system in space flight, the orbital station Mir and International Space Station, are presented. The bone mineral density, bone mineral content, identified as bone mass and body composition using dual energy X-ray absorptiometry were measured. Theoretically, an expected bone mass loss in trabecular tissue of lower skeletal half may by described as a quickly developing but reversible osteopenia and considered as evidence of functional adaptation of bone tissue to the changing mechanical load. A hypothesis of main mechanisms of osteopenia in microgravity is presented. High individual variability of bone mass losses and stability of individual pattern of correlation between bone mass losses in different skeletal segments were found. It is not possible to identify the relationship between bone mass losses and duration of space missions. Therefore it is not a sufficient ground to calculate the probability of reaching the critical level of bone demineralization by prolonged space flight. The same relates to the probability of prognosis of bone quality changes. There is data about dual energy X-ray absorptiometry that is insufficient for this prognosis. The main direction of investigations is presented which might optimize the interplanetary mission from the point of view of skeletal mechanical functions preservation.     

Perspective: cerebral palsy as a model of bone development in the absence of postnatal mechanical factors

To ensure optimal skeletal development, mechanical loading is imperative. The consequences of the removal of, or complete absence of, mechanical loading are illustrated by the clinical condition of cerebral palsy (CP). Clinical and radiological evaluation of children with CP provides an insight into how the growing skeleton develops when mechanical loading is reduced due to non-physiological muscle function. The poor bone status or "physiologic osteopenia" that these children suffer is multifactorial compromised of both mechanical and non-mechanical effects; primarily it is the lack of normal loading from the musculature which causes the development of a bone incapable of withstanding daily activities. Fractures occur during daily activities such as dressing and handling. Increased bone resorption during periods of immobilisation after fracture or surgery, also increases bone fragility. Trials of physical, nutritional and pharmacological treatments in CP children result in increased bone mineral density. Trials that include fracture prevention as the primary end point are required in this vulnerable group of children.     

Ontogenetic Patterning of Skeletal Fluctuating Asymmetry in Rhesus Macaques and Humans: Evolutionary and Developmental Implications

I address the question of how fluctuating asymmetry (FA)—the distribution of random deviations from bilateral symmetry—varies ontogenetically in the mammalian skeleton. This question is significant because of the light that such patterns can shed on the causes of variation in developmental stability in bone as well as other structures. Based on large ontogenetic skeletal series of Macaca mulatta and Homo sapiens, I report that the FA variances of skeletal metric traits increase ontogenetically. Coupled with the finding that FA variances also accumulate to greater magnitudes in slower growing mammals, this result is consistent with the hypotheses that FA in bone is primarily caused by (a) cumulative effects of asymmetrical mechanical factors, (b) accumulation of variation in the (local) regulation of growth, or (c) a tendency for bone morphology to drift through undirected remodeling. I discuss the implications of these optional explanations for primate evolution and bone development.     

Comparative analysis of changes in the skeleton of cosmonauts in long-term orbital flights and the possibilities of prediction for interplanetary missions

The results of long-term investigations of the bone system of humans during space flights (SFs) on board the Mir orbital station (OS) and international space station (ISS) using osteodensitometry are summarized. Comparative analysis of the results showed the absence of significant differences in changes in the bone mass (BM) in the crew members of both OSs. Theoretically, the expected bone mass losses in the trabecular bone structures of the lower part of the body in the process of a SF (five to seven months) are interpreted in some cases as quickly developing, but reversible, osteopenia and generally interpreted as the evidence of bone functional adaptation to altering mechanical loads on the skeleton. The high individual variability of changes and the stability of the individual character of the BM alteration ratio in different skeletal segments irrespective of the OS type are shown. Owing to the aforementioned individual features, it is not possible to establish a strict relationship between BM changes and the duration of space missions, and, therefore, there is no good reason for calculating the probability of achieving the critical demineralization level when the duration of an SF increases to 1.5–2 years. The probability of prediction of changes in the bone quality (structure) is still less, which, together with BM losses, determines the risk of fractures, and osteodensitometry for such an analysis is insufficient. The main directions of the studies, which could optimize the development of the interplanetary expedition project from the point of view of maintenance of the mechanical function of the skeleton, are considered.     

Fundectomy-evoked osteopenia in pigs is mediated by the gastric-hypothalamic-pituitary axis

The aim of the study was to determine the effects of gastric impairment in pigs on the axial and peripheral skeletal system properties and to test the hypothesis that fundectomy-evoked osteopenia is related to disturbed gastric-hypothalamic-pituitary axis function. Forty-day-old male piglets were subjected to experimental fundectomy (FX group, n = 6) to induce osteopenia, while sham operation was performed in the controls (SHO group, n = 6). At the age of 8 months, serum samples were collected, and the animals were sacrificed to obtain lumbar vertebrae (L1-L6) and right humerus for analysis. Using quantitative computed tomography (QCT) and dual-energy x-ray absorptiometry (DEXA) methods, bone mineral density and bone mineral content of the vertebrae and humerus were measured. The compression and three-point bending tests were applied to determine mechanical properties of lumbar vertebrae and humerus, respectively. Furthermore, geometric properties of humerus were assessed. Serum concentrations of ghrelin, growth hormone (GH), insulin-like growth factor-1 (IGF-1), and selected macro- and microelements were also determined. Performed fundectomy decreased body weight in pigs by 66% compared with pair-fed sham operated pigs (P < 0.0001). Bone weight, bone mineral density, and bone mineral content of the lumbar vertebrae and humerus were significantly decreased in the fundectomized pigs (P < 0.01). Mechanical parameters of the lumbar spine and humerus were decreased after the fundectomy, as well. Serum concentrations of ghrelin, GH, and IGF-1 were lowered by 74.4%, 90.6%, and 54.6% in the fundectomized pigs, respectively (all P < 0.001). Moreover, the serum concentrations of calcium, magnesium, iron and copper in the fundectomized animals were significantly decreased by 15.5%, 45.3%, 26.7%, and 26.2%, respectively (P 相似文献   

Role of Calcitonin Gene-Related Peptide in Functional Adaptation of the Skeleton

Peptidergic sensory nerve fibers innervating bone and periosteum are rich in calcitonin gene-related peptide (CGRP), an osteoanabolic neurotransmitter. There are two CGRP isoforms, CGRPα and CGRPβ. Sensory fibers are a potential means by which the nervous system may detect and respond to loading events within the skeleton. However, the functional role of the nervous system in the response of bone to mechanical loading is unclear. We used the ulna end-loading model to induce an adaptive modeling response in CGRPα and CGRPβ knockout mouse lines and their respective wildtype controls. For each knockout mouse line, groups of mice were treated with cyclic loading or sham-loading of the right ulna. A third group of mice received brachial plexus anesthesia (BPA) of the loaded limb before mechanical loading. Fluorochrome labels were administered at the time of loading and 7 days later. Ten days after loading, bone responses were quantified morphometrically. We hypothesized that CGRP signaling is required for normal mechanosensing and associated load-induced bone formation. We found that mechanically-induced activation of periosteal mineralizing surface in mice and associated blocking with BPA were eliminated by knockout of CGRPα signaling. This effect was not evident in CGRPβ knockout mice. We also found that mineral apposition responses to mechanical loading and associated BPA blocking were retained with CGRPα deletion. We conclude that activation of periosteal mineralizing surfaces in response to mechanical loading of bone is CGRPα-dependent in vivo. This suggests that release of CGRP from sensory peptidergic fibers in periosteum and bone has a functional role in load-induced bone formation.     

Microfibril-associated Glycoprotein-1, an Extracellular Matrix Regulator of Bone Remodeling

MAGP1 is an extracellular matrix protein that, in vertebrates, is a ubiquitous component of fibrillin-rich microfibrils. We previously reported that aged MAGP1-deficient mice (MAGP1Δ) develop lesions that are the consequence of spontaneous bone fracture. We now present a more defined bone phenotype found in MAGP1Δ mice. A longitudinal DEXA study demonstrated age-associated osteopenia in MAGP1Δ animals and μCT confirmed reduced bone mineral density in the trabecular and cortical bone. Further, MAGP1Δ mice have significantly less trabecular bone, the trabecular microarchitecture is more fragmented, and the diaphyseal cross-sectional area is significantly reduced. The remodeling defect seen in MAGP1Δ mice is likely not due to an osteoblast defect, because MAGP1Δ bone marrow stromal cells undergo osteoblastogenesis and form mineralized nodules. In vivo, MAGP1Δ mice exhibit normal osteoblast number, mineralized bone surface, and bone formation rate. Instead, our findings suggest increased bone resorption is responsible for the osteopenia. The number of osteoclasts derived from MAGP1Δ bone marrow macrophage cells is increased relative to the wild type, and osteoclast differentiation markers are expressed at earlier time points in MAGP1Δ cells. In vivo, MAGP1Δ mice have more osteoclasts lining the bone surface. RANKL (receptor activator of NF-κB ligand) expression is significantly higher in MAGP1Δ bone, and likely contributes to enhanced osteoclastogenesis. However, bone marrow macrophage cells from MAGP1Δ mice show a higher propensity than do wild-type cells to differentiate to osteoclasts in response to RANKL, suggesting that they are also primed to respond to osteoclast-promoting signals. Together, our findings suggest that MAGP1 is a regulator of bone remodeling, and its absence results in osteopenia associated with an increase in osteoclast number.     

The Effect of Locomotion on the Mobilization of Minerals from the Maternal Skeleton

Bone is a dynamic tissue from which minerals are deposited or withdrawn according to the body’s demand. During late pregnancy and lactation, female mammals mobilize mineral from bone to support the ossification of offspring skeleton(s). Conversely, in response to mechanical loading, minerals are deposited in bone enabling it to develop a stronger architecture. Despite their central importance to reproductive performance and skeletal integrity, the interactions between these potentially opposing forces remains poorly understood. It is possible that inter-individual differences in the loading imposed by different forms of locomotion may alter the amount of mineral mobilized during reproduction. Here, the impact of vertical versus horizontal locomotion on bone mobilization was examined during reproduction in the laboratory mouse. The vertical, or climbing, group had access to a 60-cm tower, increasing strain on their appendicular skeleton. The horizontal, or tunnel, group had access to a 100-cm tunnel, which encouraged movements within the horizontal plane. Form of locomotion did not impact the amount of bone females mobilized during reproduction or the amount of mineral females deposited in the litter, but maternal bone architecture differed between groups. The climbing group displayed more trabeculae than the tunnel group, whereas the tunnel group displayed greater cortical bone mineral density mid-shaft. Interestingly, pups born to mothers in the climbing group had a higher concentration of total body calcium at 16 days than pups of mothers in the tunnel group. As maternal total body calcium composition and the amount of calcium invested in the full litter were not different between groups, the difference in the relative calcium content of pups between groups is not suspected to reflect difference in mineral allocation. Future research should consider the impact of maternal activity on the efficiency of offspring skeletal ossification via hormones and other bioactive factors transferred in utero and in milk.     

Morpho-functional adaptations in the bone tissue under the space flight conditions

Microgravity in space flight--situation of a maximum deficit of supporting loading on the skeleton and good model for finding-out of osteopenia and osteoporosis development laws, which are wide-spreading now and are "civilization diseases". Most typical for bones in conditions of a microgravitation by changes are: a decrease of intensity growth and osteoplastic processes, osteopenia and osteoporosis, decreasing of a mechanical strength and the risk of breaches arising (Oganov V.S., Schneider V. (1996)). Cytological mechanisms of gravity-dependent reactions in a bone tissue remain in many respects not-clear. By the purpose of our work was the analysis of some ultrastructural changes in bone tissue cells of the monkeys (Macaca mulatta), staying during two weeks onboard the biosatellite BION -11.     

Moderate-Intensity Rotating Magnetic Fields Do Not Affect Bone Quality and Bone Remodeling in Hindlimb Suspended Rats

Abundant evidence has substantiated the positive effects of pulsed electromagnetic fields (PEMF) and static magnetic fields (SMF) on inhibiting osteopenia and promoting fracture healing. However, the osteogenic potential of rotating magnetic fields (RMF), another common electromagnetic application modality, remains poorly characterized thus far, although numerous commercial RMF treatment devices have been available on the market. Herein the impacts of RMF on osteoporotic bone microarchitecture, bone strength and bone metabolism were systematically investigated in hindlimb-unloaded (HU) rats. Thirty two 3-month-old male Sprague-Dawley rats were randomly assigned to the Control (n = 10), HU (n = 10) and HU with RMF exposure (HU+RMF, n = 12) groups. Rats in the HU+RMF group were subjected to daily 2-hour exposure to moderate-intensity RMF (ranging from 0.60 T to 0.38 T) at 7 Hz for 4 weeks. HU caused significant decreases in body mass and soleus muscle mass of rats, which were not obviously altered by RMF. Three-point bending test showed that the mechanical properties of femurs in HU rats, including maximum load, stiffness, energy absorption and elastic modulus were not markedly affected by RMF. µCT analysis demonstrated that 4-week RMF did not significantly prevent HU-induced deterioration of femoral trabecular and cortical bone microarchitecture. Serum biochemical analysis showed that RMF did not significantly change HU-induced decrease in serum bone formation markers and increase in bone resorption markers. Bone histomorphometric analysis further confirmed that RMF showed no impacts on bone remodeling in HU rats, as evidenced by unchanged mineral apposition rate, bone formation rate, osteoblast numbers and osteoclast numbers in cancellous bone. Together, our findings reveal that RMF do not significantly affect bone microstructure, bone mechanical strength and bone remodeling in HU-induced disuse osteoporotic rats. Our study indicates potentially obvious waveform-dependent effects of electromagnetic fields-stimulated osteogenesis, suggesting that RMF, at least in the present form, might not be an optimal modality for inhibiting disuse osteopenia/osteoporosis.     

The IL-1 gene family and bone involvement in celiac disease

Celiac disease (CD) is associated with decreased bone mineral mass. Its pathogenesis is multifactorial since both systemic and local mechanisms may play a role. Our objective was to determine whether single-nucleotide polymorphisms in genes encoding members of the interleukin-1 family are associated with bone damage measured by densitometry in a series of 71 adult CD patients assessed at diagnosis. When compared with non-carrier CD patients, carriers of allele T of the interleukin-1β gene (IL1B-511T) had a significantly lower bone mass at the total skeleton level (p=0.0484) and a greater prevalence of osteopenia/osteoporosis (p=0.0102). To our knowledge, this is the first evidence on the association between a genetic predisposition and low bone mass in CD patients. This finding supports the postulated inflammation-associated bone loss pathogenesis as one of the causes of bone weakness in CD.     

Osteoporosis and Dental Osteopenia in the Elderly1

Osteoporosis is a common, morbid, and expensive disease of the elderly skeleton, particularly in the postmenopausal female, resulting in fractures of the spine, hip, and wrist. Dental osteopenia (inadequate bone mass, particularly of the mandible) is also a condition of significant morbidity for the elderly, associated with loss of teeth and poorly fitting dentures. Questions of immediate concern regarding these disorders are: (1) Are techniques available for quantitating mandibular bone mass? (2) Is dental osteopenia a localized manifestation of a generalized skeletal osteoporosis, with similar etiologies and risk factors, or is it an entirely separate disease process, due primarily to periodontal disease with its associated causal factors? (3) Are therapeutic measures noted to be of benefit in osteoporosis also of benefit in dental osteopenia? Recent studies from our laboratories address these questions and indicate efficiency of the mandibular microdensitometry technique for measuring mandibular bone mass. Also, these studies suggest that dental osteopenia is part of a generalized skeletal osteoporosis of the elderly female, and that therapy for osteoporosis would possibly be of value in the treatment of dental osteopenia.     

Linkage of interleukin 6 locus to human osteopenia by sibling pair analysis

Osteopenia and osteoporosis are common human conditions considered to result from the interplay of multiple genetic and environmental factors. Twin and family studies have yielded strong correlations between levels of bone mass and a number of genetic factors. The genes involved could regulate metabolism, formation and resorption of bone, all processes that determine bone mass. We tested 192 sibling pairs of adult Japanese women from 136 families for genetic linkage between osteopenia and allelic variants of four candidate genes (interleukin-6, interleukin-6 receptor, calcium-sensing receptor, and matrix gla protein) using qualitative and quantitative methods, and using as genetic markers dinucleotide-repeat polymorphisms present in or near each of those loci. The interleukin-6 locus showed evidence of linkage to osteopenia analyzed as a qualitative trait, with mean allele sharing of 0.40 (P=0.0001) in discordant pairs and 0.55 (P=0.04) in concordant affected pairs. Variation at this locus was also linked to decreased bone mineral density measured as a quantitative trait (P=0.02). Analyses limited only to the post-menopausal women showed similar or even stronger results. No other locus among those tested showed any evidence of linkage by either method. The results provided strong evidence that genetic variation at the interleukin-6 locus affects regulation of bone mineral metabolism and confers risk for osteopenia and osteoporosis in adult women.     

The influence of nitric oxide synthase inhibitor L-NAME on bones of male rats with streptozotocin-induced diabetes

The pathophysiological processes underlying the development of diabetic osteopenia has not hitherto been elucidated. Induction of streptozotocin diabetes leads in our experiments to decrease of bone density, ash, mineral content and to thinner cortical width compared to control male rats. In order to investigate the pathogenetic role of bone resorption by osteoclasts in streptozotocin-induced diabetes, we determined the circulating levels of tartrate-resistant acid phosphatase (TRAP), a biochemical marker for bone resorption. Plasma TRAP values in diabetic rats did not differ from their corresponding controls. Streptozotocin diabetes by itself did not have any effect on the weight of seminal vesicles which are highly testosterone-dependent. Low doses of nitric oxide cause bone resorption, but higher doses of NO inhibit bone resorbing activity. We examined the effect of L-NAME (inhibitor of nitric oxide production) after six weeks of administration to diabetic rats. There was no further significant loss of bone mineral density, ash and mineral content or tibia weight in diabetic rats treated with L-NAME. L-NAME itself did not decrease bone metabolism. In our study no evidence of an increased bone resorption was found. Our results have indicated that a predominance of bone resorption over bone formation is not involved in the pathogenesis of diabetes-associated osteopenia. Inhibition of NO neither increased osteoclastic activity (TRAP) nor induced osteopenia in L-NAME-treated rats. This suggests a possibility that NO is not involved in the pathogenesis of diabetic osteopenia.     

Can exercise prevent osteoporosis?

Commonly used definitions of osteoporosis rely upon the measurement of bone mass or bone mineral density and regard the difference between osteopenia and osteoporosis as gradual. An alternative definition has been proposed by Harold Frost, suggesting that osteopenia is the bone's physiological response to disuse. On the contrary, true osteoporoses imply the bone's inability to adapt to the loads imposed on them by their habitual mechanical usage. As a consequence, fractures occur with no or very little trauma in osteoporotic, but not in osteopenic bones. There is now ample evidence that mechanical stimuli can increase strength. Accordingly, exercise, in particular some new forms of it that involve high strain rates, seems to be preventing bone loss and possibly also induces increases in bone mass even at older ages. Hence, exercise may ameliorate osteopenia in the sense of Frost's definition. However, exercise must be feared to facilitate rather than to ameliorate the occurrence of true osteoporoses, e.g., due to microdamage accumulation. This is in sharp contrast to the general 'understanding'.     

Muscle force regulates bone shaping for optimal load-bearing capacity during embryogenesis

The vertebrate skeleton consists of over 200 individual bones, each with its own unique shape, size and function. We study the role of intrauterine muscle-induced mechanical loads in determining the three-dimensional morphology of developing bones. Analysis of the force-generating capacity of intrauterine muscles in mice revealed that developing bones are subjected to significant and progressively increasing mechanical challenges. To evaluate the effect of intrauterine loads on bone morphogenesis and the contribution of the emerging shape to the ability of bones to withstand these loads, we monitored structural and mineral changes during development. Using daily micro-CT scans of appendicular long bones we identify a developmental program, which we term preferential bone growth, that determines the specific circumferential shape of each bone by employing asymmetric mineral deposition and transient cortical thickening. Finite element analysis demonstrates that the resulting bone structure has optimal load-bearing capacity. To test the hypothesis that muscle forces regulate preferential bone growth in utero, we examine this process in a mouse strain (mdg) that lacks muscle contractions. In the absence of mechanical loads, the stereotypical circumferential outline of each bone is lost, leading to the development of mechanically inferior bones. This study identifies muscle force regulation of preferential bone growth as the module that shapes the circumferential outline of bones and, consequently, optimizes their load-bearing capacity during development. Our findings invoke a common mechanism that permits the formation of different circumferential outlines in different bones.