Impact of Magnetic Resonance Imaging on Treatment-Related Decision Making for Osteoporotic Vertebral Compression Fracture: A Prospective Randomized Trial.

BACKGROUND The aim of this study was to analyze the impact and usefulness of characteristic signal change of a linear black signal on magnetic resonance imaging (MRI) on treatment-related decision making. MATERIAL AND METHODS Forty-one patients with a linear black signal on MRI were enrolled in this prospective study. They were randomly divided into the percutaneous kyphoplasty (PKP) group (n=24) and the conservative treatment group (n=17). Clinical measures, including visual analog scale (VAS) and short-form 36 (SF-36) questionnaire, were analyzed. Radiographic measures, including anterior vertebral body height, kyphosis angle and rate of bone-union, were evaluated. RESULTS VAS scores were significantly lower in the PKP group than in the conservative treatment group post-treatment and at one-year follow-up. After one year of treatment, the values for physical functioning, physical health, and body pain were significantly higher in the PKP group than in the conservative treatment group (p<0.05). The PKP group had a significantly higher anterior vertebral body height, rate of bone-union, and lower kyphosis angle than the conservative treatment group at one-year follow-up (p<0.05). CONCLUSIONS In patients with a linear black signal detected on MRI, the first-choice treatment should be PKP rather than conservative treatment.

Development and assessment of the efficacy and safety of human lung-targeting liposomal methylprednisolone crosslinked with nanobody.

Glucocorticoid (GC) hormone has been commonly used to treat systemic inflammation and immune disorders. However, the side effects associated with long-term use of high-dose GC hormone limit its clinical application seriously. GC hormone that can specifically target the lung might decrease the effective dosage and thus reduce GC-associated side effects. In this study, we successfully prepared human lung-targeting liposomal methylprednisolone crosslinked with nanobody (MPS-NSSLs-SPANb). Our findings indicate that MPS-NSSLs-SPANb may reduce the effective therapeutic dosage of MPS, achieve better efficacy, and reduce GC-associated side effects. In addition, MPS-NSSLs-SPANb showed higher efficacy and lower toxicity than conventional MPS.

Surfactant protein-A nanobody-conjugated liposomes loaded with methylprednisolone increase lung-targeting specificity and therapeutic effect for acute lung injury.

The advent of nanomedicine requires novel delivery vehicles to actively target their site of action. Here, we demonstrate the development of lung-targeting drug-loaded liposomes and their efficacy, specificity and safety. Our study focuses on glucocorticoids methylprednisolone (MPS), a commonly used drug to treat lung injuries. The steroidal molecule was loaded into functionalized nano-sterically stabilized unilamellar liposomes (NSSLs). Targeting functionality was performed through conjugation of surfactant protein A (SPANb) nanobodies to form MPS-NSSLs-SPANb. MPS-NSSLs-SPANb exhibited good size distribution, morphology, and encapsulation efficiency. Animal experiments demonstrated the high specificity of MPS-NSSLs-SPANb to the lung. Treatment with MPS-NSSLs-SPANb reduced the levels of TNF-α, IL-8, and TGF-ß1 in rat bronchoalveolar lavage fluid and the expression of NK-κB in the lung tissues, thereby alleviating lung injuries and increasing rat survival. The nanobody functionalized nanoparticles demonstrate superior performance to treat lung injury when compared to that of antibody functionalized systems.