Further evidence for direct pro-resorptive actions of FSH

We confirm that FSH stimulates osteoclast formation, function and survival to enhance bone resorption. It does so via the activation of a pertussis toxin-sensitive G_i-coupled FSH receptor that we and others have identified on murine and human osteoclast precursors and mature osteoclasts. FSH additionally enhances the production of several osteoclastogenic cytokines, importantly TNFα, likely within the bone marrow microenvironment, to augment its pro-resorptive action. FSH levels in humans rise before estrogen falls, and this hormonal change coincides with the most rapid rates of bone loss. On the basis of accumulating evidence, we reaffirm that FSH contributes to the rapid peri-menopausal and early post-menopausal bone loss, which might thus be amenable to FSH blockade.     

Female reproductive system and bone

The female reproductive system plays a major role in regulating the acquisition and loss of bone by the skeleton from menarche through senescence. Onset of gonadal sex steroid secretion at puberty is the major factor responsible for skeletal longitudinal and radial growth, as well as significant gain in bone density, until peak bone density is achieved in third decade of life. Gonadal sex steroids then help maintain peak bone density until menopause, including during the transient changes in skeletal mineral content associated with pregnancy and lactation. At menopause, decreased gonadal sex steroid production normally leads to rapid bone loss. The most rapid bone loss associated with decreased estrogen levels occurs in the first 8-10 years after menopause, with slower age-related bone loss occurring during later life. Age-related bone loss in women after the early menopausal phase of bone loss is caused by ongoing gonadal sex steroid deficiency, vitamin D deficiency, and secondary hyperparathyroidism. Other factors also contribute to age-related bone loss, including intrinsic defects in osteoblast function, impairment of the GH/IGF axis, reduced peak bone mass, age-associated sarcopenia, and various sporadic secondary causes. Further understanding of the relative contributions of the female reproductive system and each of the other factors to development and maintenance of the female skeleton, bone loss, and fracture risk will lead to improved approaches for prevention and treatment of osteoporosis.     

Dietary nutraceuticals as backbone for bone health

Bone loss or osteoporosis, is a slow-progressing disease that results from dysregulation of pro-inflammatory cytokines. The FDA has approved number of drugs for bone loss prevention, nonetheless all are expensive and have multiple side effects. The nutraceuticals identified from dietary agents such as butein, cardamonin, coronarin D curcumin, diosgenin, embelin, gambogic acid, genistein, plumbagin, quercetin, reseveratrol, zerumbone and more, can modulate cell signaling pathways and reverse/slow down osteoporosis. Most of these nutraceuticals are inexpensive; show no side effect while still possessing anti-inflammatory properties. This review provides various mechanisms of osteoporosis and how nutraceuticals can potentially prevent the bone loss.     

Regulatory T cells as a potent target for controlling bone loss

Metabolic bone diseases, such as rheumatoid arthritis (RA) and osteoporosis, affect hundreds and millions of people worldwide leading causes of long-term pain and disability. Effective clinical treatment for bone destruction in bone diseases is lacking because the knowledge about molecular mechanisms leading to bone destruction are incompletely understood. Recently, it has been confirmed that regulatory T cells (Tregs) play a crucial role in suppressing the immune response in the pathogenesis of various autoimmune diseases. In vitro, Tregs directly inhibit osteoclasts and differentiation and function. In mice, the injection of Tregs into the TNF transgenic results in enhanced systemic bone density. In addition, it has been shown that increase of Tregs numbers by overexpressing the FoxP3 is effective in the prevention of local and systemic bone destruction. In vivo treatment with anti-CD28 superagonist antibody leading to a stronger increase in Tregs numbers protect against TNF-a-induced bone loss in TNF-transgenic mice. In agreement, Tregs can control ovariectomy-induced bone loss in FoxP3-transgenic mice. In this paper, we will briefly discuss the biological features of Tregs and summarize recent advances on the role of Tregs in the pathogenesis and treatment of bone loss in metabolic bone diseases.     

Aging in the musculoskeletal system of rhesus monkeys: III. Bone loss

It is well established that aging of the human skeleton includes the loss of bone mass or density, but little comparative information on age-related osteopenia in other primates is available. In order to determine whether bone loss occurs in normally locomoting nonhuman primates, radiographs of 139 rhesus monkey skeletons from the Cayo Santiago collection were examined, and measures of percent cortical bone (PCT) at the midshaft of second metacarpals, humeri, and femora were calculated. An age-related osteopenia was observed in the metacarpal of adult female macaques, although much individual variation was present. This variability could not be explained by reproductive history (number of offspring), matrilineal affiliation, or degree of osteoarthrosis. However, in a subsample of 15 animals, females who had given birth in the three months prior to death showed lower PCTs than those who had not conceived in the previous mating season. In adult males, PCT did not vary significantly with age, but males that weighed less and those with no/little osteoarthrosis showed lower PCTs than heavier or more arthritic animals, respectively. The multifactorial nature of the variation in PCT observed here suggests that similar processes of bone behavior are involved in the skeletal aging of both humans and rhesus monkeys.     

纳米材料应用于骨质疏松治疗研究进展

骨质疏松症是一种以骨密度减低和骨结构改变为特征的代谢性骨病,目前的治疗方法不能有效解决其引起的骨量减低及其增加的骨折风险。纳米材料由于其独特的性能已被广泛应用于骨组织工程中,本文归纳了几种纳米材料研究的新进展以及其在骨质疏松中的应用前景。     

A left/right comparison of sequential bone loss from the metacarpals of postmenopausal women

The rate of decrease of mean metacarpal cortical width was assessed by sequential radiographic morphometry for each hand separately in a series of 46 right-handed postmenopausal women observed for 222 patient-years. For the left hand, the mean rate was 0.0331 ± 0.0053 mm/year and for the right, 0.0310 ± 0.0060 mm/year. The difference between the hands in the rate of decrease was not significant. It is concluded that the higher work load of the dominant hand has no effect on the rate of bone loss from the metacarpals of postmenopausal women.     

RGD多肽修饰钙磷陶瓷支架材料对骨质疏松兔成骨能力及骨功能影响的机制研究

摘要 目的：探究RGD多肽修饰钙磷陶瓷支架材料对骨质疏松（osteoporosis, OP）兔成骨能力和骨功能的影响极其可能的作用机制。方法：选取40只雌性SPF级新西兰大白兔,随机分为A组（正常对照组）和B组（OP组）,每组各20只,再将A组随机分为A1组：sham组、A2组：sham+HA组、A3组：sham+BCP组、A4组：sham+RGD-BCP组,每组5只;B组随机分为B1组：OP组、B2组：OP+HA组、B3组：OP+BCP组和B4组：OP+RGD-BCP组,每组5只。B组采用去势法制备OP模型,检测相关指标。结果：A组兔术前和术后3个月时BMD无变化（P>0.05）,B组兔术后3个月时的BMD值较术前下降（P<0.05）。自第4 d开始,A组和B组RGD-BCP支架材料组细胞的OD值高于HA和BCP支架材料（P<0.05）,且B组之间的差异较A组更大（P<0.05）。Western Blot分析显示,A、B两组中RGD-BCP中整合素avβ3的表达高于HA和BCP（P<0.05）,且B组之间的差异较A组更大（P<0.05）。B4和A4组p38 MAPK蛋白的相对表达均低于、Wnt5a和β-catenin表达均高于B2、B3和A2、A3组(P<0.05),此外,A4组p38 MAPK蛋白的相对低于、Wnt5a和?茁-catenin表达高于B4组(P<0.05)。结论：RGD-BCP对兔BMSCs具有良好的相容性和吸附作用,对OP模型兔更显著;且RGD-BCP的机制可能与调控p38 MAPK/Wnt5a/β-catenin信号通路有关,为OP合并骨缺损的修复提供了新的思路和理论依据。     

Bilateral asymmetry in bone measurements of the hand and lateral hand dominance

Two hundred thirty–five (235) normal male participants of the Baltimore Longitudinal Study were classified as right handed, left handed, and ambidextrous on the basis of their grip–strength performance. Their left and right hands were also radiographed and the measurements of the second metacarpal bones were evaluated on the basis of hand dominance. The results indicated that, as a rule, the right hand measurements are higher than those of the left hand, regardless of hand dominance. The bilateral differences in total width, length, total area and cortical area are significant among the right hand dominant and nonsignificant among the left hand dominant. Regardless off hand dominance the bilateral differences in medullary width are nonsignificant. These results suggest an inherent tendency of the right second metacarpal to have more bone than the left regardless of hand dominance. Differential stress due to hand dominance will increase the bilateral difference in the right handed and reduce it in the left handed.     

同型半胱氨酸水平与女性绝经期骨质疏松相关性研究

目的:通过分析女性绝经期不同骨密度人群的血浆同型半胱氨酸(HCY)指标,探讨同型半胱氨酸在女性绝经期骨质疏松发生过程中的作用及其潜在的临床价值。方法:收集2014年3月至2016年3月我院体检中心进行体检的女性绝经期妇女(60岁)血样标本共计625例,根据体检的骨密度报告对其进行分组,骨质疏松组215例,骨量减少组309例,骨量正常组101例,测量每组的同型半胱氨酸水平。结果:骨密度程度与同型半胱氨酸水平存在负相关关系(rs=-0.763,P=0.046),三组之间的同型半胱氨酸水平也存在显著差异(F=4.807,P0.016),其中骨质疏松组指标最高,骨量正常组指标最低。结论:同型半胱氨酸是重要的骨代谢指标,在衡量绝经期妇女骨质疏松进展中具有重要的意义。     

The estimation of the cross-sectional area of the ulna and radius

Postero-anterior radiographs of 20 clean, dry ulnae were taken. The width of each bone was measured on its radiograph at 30 sites along the length of the bone. The ulnae were then sectioned at these sites and the cross-sectional areas of the sections were determined. For each measurement site, a regression equation, together with its associated standard error of estimate and correlation coefficient, was derived for the estimation of the cross-sectional area of the bone from its width. A set of 20 clean, dry radii was examined in the same way. The relevance of the results to the assessment of osteoporosis from densitometric scan information is discussed.     

On the track of antitumour ribonucleases

Ribonucleases (RNases) are potential alternatives to non-mutagenic antitumour drugs. Among these enzymes, onconase, bovine-seminal ribonuclease and the Rana catesbeiana and Rana japonica lectins exert a cytotoxic activity that is selective for tumour cells. A model for the mechanism of cytotoxicity of these RNases which involves different steps is generally accepted. The model predicts that cytotoxicity requires interaction of the RNases with the cell membrane and internalisation to occur by endocytosis. Then, at a precise point, the RNases are translocated to the cytosol where they cleave cellular RNA if they have been able to preserve their ribonucleolytic activity. The cleavage of cellular RNA induces apoptosis but there is evidence suggesting that RNase-triggered apoptosis does not entirely result from the inhibition of protein synthesis. How efficiently a particular RNase carries out each of the steps determines its potency as a cytotoxin.     

2型糖尿病与骨质疏松相关因素研究进展

2型糖尿病对骨代谢影响因素众多,除与糖尿病病程、体质、营养状况、种族及遗传等因素有关外,还与年龄、性别、血糖水平、胰岛素水平、糖基化终末化产物、脏器血管和神经病变、肥胖、高胰岛素血症及瘦素、降糖药物、饮食和运动有关。     

Analysis of the independent power of age-related,anthropometric and mechanical factors as determinants of the structure of radius and tibia in normal adults. A pQCT study

To compare the independent influence of mechanical and non-mechanical factors on bone features, multiple regression analyses were performed between pQCT indicators of radius and tibia bone mass, mineralization, design and strength as determined variables, and age or time since menopause (TMP), body mass, bone length and regional muscles’ areas as selected determinant factors, in Caucasian, physically active, untrained healthy men and pre- and post-menopausal women. In men and pre-menopausal women, the strongest influences were exerted by muscle area on radial features and by both muscle area and bone length on the tibia. Only for women, was body mass a significant factor for tibia traits. In men and pre-menopausal women, mass/design/strength indicators depended more strongly on the selected determinants than the cortical vBMD did (p<0.01-0.001 vs n.s.), regardless of age. However, TMP was an additional factor for both bones (p<0.01-0.001). The selected mechanical factors (muscle size, bone lengths) were more relevant than age/TMP or body weight to the development of allometrically-related bone properties (mass/design/strength), yet not to bone tissue “quality” (cortical vBMD), suggesting a determinant, rather than determined role for cortical stiffness. While the mechanical impacts of muscles and bone levers on bone structure were comparable in men and pre-menopausal women, TMP exerted a stronger impact than allometric or mechanical factors on bone properties, including cortical vBMD.     

兰州市1907例不同年龄正常人群骨密度测定综合分析

目的：了解兰州地区正常人群骨密度的变化特点,分析其变化规律,为预防和治疗骨质疏松症提供科学依据。方法：使用天津圣鸿公司SHY-I数字式骨密度测定仪对兰州地区1907人进行检测,其中男1381例,女526例,分别做左前臂尺、桡骨测量。年龄20～85岁,每10岁为一年龄组进行统计分析。结果：男、女组骨密度峰值均在30-39岁,峰值后随年龄增加而骨密度下降,女性下降较男性显著。骨量减少及骨质疏松患病率在40岁后随年龄增长而增高,女性高于男性。老年人骨量减少及骨质疏松患病率高于中青年人,老年女性骨质疏松患病率与老年男性比较有明显差异（P〈0．05）。结论：兰州地区健康人群骨密度随年龄变化,并与性别有关。骨密度的检测在骨质疏松症的早期预防和治疗中具有重要意义。     

骨水泥填充治疗桡骨远端骨质疏松骨折

目的:探讨骨水泥填充治疗桡骨远端骨质疏松骨折的方法。方法:对本科2000以来对8例桡骨远端骨质疏松骨行有限切开、关节面撬拨复位后注入骨水泥填充关节软骨下缺损治疗。结果:全部病例获得随访10-68月,平均22月。所有患者术后1周内肿胀消失,3～4周功能恢复接近正常。X线检查显示骨折愈合良好,无延迟愈合或不愈合。患者自我感觉5例表示满意,2例表示基本满意,1例表示不满意,满意率87.5%。结论:有限切开、关节面撬拨复位后注入骨水泥填充关节软骨下缺损是治疗桡骨远端骨质疏松骨折的有效方法。     

老年女性类风湿关节炎合并骨质疏松症的代谢特点分析

目的:探讨老年女性类风湿关节炎(RA)合并骨质疏松症的代谢特点。方法:选择老年绝经后女性RA患者共59例,检测患者血生化代谢指标如血糖、血脂、CRP等和骨代谢指标如骨钙素(OC)、β-胶原特殊序列(β-Crosslaps)甲状旁腺素(iPTH)等,并进行统计分析。结果:骨质疏松患者的绝经时间、病程长度、OC、β-Crosslaps、iPTH显著高于骨量正常和骨量减少的患者,25羟基维生素D显著低于骨量正常和骨量减少的患者(P均0.05)。RA患者的骨密度水平与是否使用激素和X线分期情况无关。结论:老年女性RA患者易发生骨质疏松,出现骨质疏松的RA女性患者绝经时间更长,可出现脂代谢紊乱及明显的维生素D缺乏,并具有高转换型骨代谢特点。     

Bisphosphonate-loaded bone cement: Background,clinical indications and future perspectives

Bisphosphonates represent an established treatment against bone resorption and osseous loss. Local application could help increase bone mineral density while minimizing their systemic use side-effects. Bone cement, used on a large scale in orthopedic surgery and a historically successful drug carrier, could represent an effective scaffold. The aim of this review was to investigate the alterations produced on the cement’s structure and properties by this mixture, as well as its antiosteoporotic and antitumor effect. After a thorough research of articles, title screening and duplicate removal we retained 51 papers. Two independent authors performed abstract and full-text reading, finally leaving 35 articles included in this review. In the current literature, acrylic and calcium phosphate bone cement have been used as carriers. A combination with nitrogen-containing bisphosphonates, e.g., zoledronic acid, provokes modifications in terms of setting time prolongation and mechanical strength decline within acceptable levels, on the condition that the drug’s quantity stays beneath a certain plateau. Bisphosphonates in bone cement seem to have a powerful anti-osteoclastic and osteogenic local impact as well as a direct cytotoxic effect against several neoplastic lesions. Further investigation on the subject is required, with specifically designed studies focusing on this method’s advantages and potential clinical applications.