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1.
Bone ; 30(4): 567-73, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11934647

RESUMO

Recent studies have shown that stimulation of osteoclastogenesis in cocultures of osteoblasts and spleen cells in response to prostaglandin E2 (PGE2) is markedly decreased when the osteoblasts are derived from cells lacking either the EP2 or the EP4 receptor. Induction of osteoclast formation requires upregulation of receptor activator of nuclear factor-kappaB ligand (RANKL) on cells of the osteoblastic lineage, which then binds to the RANK receptor on cells of the osteoclast lineage. Osteoprotegerin (OPG) is a decoy receptor for RANKL that can block its interaction with RANK. In addition, macrophage-colony stimulating factor (M-CSF) is essential for osteoclast formation. Finally, PGE2 can increase interleukin-6 (IL-6), which may further enhance osteoclastogenesis. To study the relative influence of the EP2 and EP4 receptors on response of these factors to PGE2, we examined mRNA levels for RANKL, OPG, M-CSF, and IL-6 in primary osteoblastic cell cultures derived from two lines of EP2 knockout mice (EP2-/-) and one line of EP4 knockout mice (EP4-/-) and the relevant wild-type controls (EP2+/+ and EP4+/+). The responses of cells from wild-type animals of all three lines were similar. After PGE2 treatment, RANKL mRNA levels were increased at 2 h, and this was sustained over 72 h. Basal RANKL expression was moderately reduced in EP2-/- cells and markedly reduced in EP4-/- cells. PGE2 increased RANKL mRNA in EP2-/- cells and EP4-/- cells, but the levels were significantly reduced compared with wild-type cells. There were no consistent changes in expression of M-CSF or OPG in the different genotypes or with PGE2 treatment. IL-6 mRNA was variably increased by PGE2 in both wild-type and knockout cells, although the absolute levels were somewhat lower in both EP2-/- and EP4 -/- cultures. Parathyroid hormone (PTH) increased RANKL and IL-6 and decreased OPG mRNA levels similarly in both wild-type and EP2-/- or EP4-/- cells. The major defect in the response to PGE2 in animals lacking either EP2 or EP4 receptors is a reduction in basal and stimulated RANKL levels. Loss of EP4 receptor appears to have a greater effect on basal RANKL expression than EP2.


Assuntos
Dinoprostona/farmacologia , Osteoblastos/fisiologia , Receptores de Prostaglandina E/genética , Animais , Proteínas de Transporte/genética , Células Cultivadas , Expressão Gênica/efeitos dos fármacos , Glicoproteínas/genética , Interleucina-6/genética , Fator Estimulador de Colônias de Macrófagos/genética , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Osteoblastos/citologia , Osteoprotegerina , Hormônio Paratireóideo/farmacologia , Ligante RANK , RNA Mensageiro/análise , Receptor Ativador de Fator Nuclear kappa-B , Receptores Citoplasmáticos e Nucleares/genética , Receptores de Prostaglandina E Subtipo EP2 , Receptores de Prostaglandina E Subtipo EP4 , Receptores do Fator de Necrose Tumoral
2.
Bone ; 30(1): 159-63, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11792579

RESUMO

Prostaglandin estradiol (PGE(2)) stimulates bone resorption by a cyclic AMP (cAMP)-dependent mechanism that involves prostaglandin E receptors of the EP2 and EP4 subtypes. We tested a potent selective EP4 antagonist (EP4RA), which blocks PGE(2) binding to EP4 receptors. We examined the effects of EP4RA on osteoclastogenesis in murine marrow cultures, on cAMP production in primary osteoblastic (POb) cell cultures, and on bone resorption in organ cultures. EP4RA (1 micromol/L) decreased the number of tartrate-resistant acid phosphatase-positive multinucleated cells (TRAP(+) MNC) by 46%-48% in cultures treated with 0.1-1.0 micromol/L PGE(2) and by 96% in cultures treated with 0.01 micromol/L PGE(2). EP4RA also decreased TRAP(+) MNC formation by 60% in 1,25-dihydroxyvitamin D (1,25D)-treated cultures and by 62% in parathyroid hormone (PTH)-treated cultures. A chemically related analog of EP4RA that lacks antagonist activity did not inhibit TRAP(+) MNC formation. EP4RA decreased cAMP production in PGE(2)-treated POb by 44% but did not block cAMP response to PTH. EP4RA inhibited the increase in receptor activator of NF-kappaB ligand (RANKL) mRNA levels produced by PGE(2). In fetal rat long bone cultures, EP4RA decreased 45Ca release from control, unstimulated cultures by 12%-25% and from PGE(2)-stimulated cultures by 22%-37%. Because EP4RA partially inhibited osteoclastogenesis not only in response to PGE(2) but also in response to 1,25D and PTH, these results suggest that activation of the EP4 receptor may play a general role in osteoclastic bone resorption. EP4RA showed partial inhibition of PGE(2)-stimulated osteoclastogenesis at 1 micromol/L, but almost complete inhibition at 0.01 micromol/L PGE(2). This could be due to the limited efficacy of the antagonist at high concentrations of PGE(2), or an alternative pathway, such as activation of the EP2 receptor.


Assuntos
Reabsorção Óssea/induzido quimicamente , Osteoclastos/efeitos dos fármacos , Receptores de Prostaglandina E/antagonistas & inibidores , Fosfatase Ácida/metabolismo , Animais , Células da Medula Óssea/citologia , Células da Medula Óssea/efeitos dos fármacos , Células da Medula Óssea/metabolismo , Reabsorção Óssea/metabolismo , Reabsorção Óssea/patologia , Proteínas de Transporte/genética , AMP Cíclico/biossíntese , Dinoprostona/farmacologia , Expressão Gênica/efeitos dos fármacos , Técnicas In Vitro , Isoenzimas/metabolismo , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Osteoclastos/citologia , Osteoclastos/metabolismo , Hormônio Paratireóideo/farmacologia , Ligante RANK , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , Receptor Ativador de Fator Nuclear kappa-B , Receptores de Prostaglandina E Subtipo EP4 , Fosfatase Ácida Resistente a Tartarato
3.
Endocrinology ; 141(6): 2054-61, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10830290

RESUMO

Prostaglandin E2 (PGE2) stimulates the formation of osteoclast-like tartrate-resistant acid phosphatase-positive multinucleated cells (TRAP + MNC) in vitro. This effect likely results from stimulation of adenylyl cyclase, which is mediated by two PGE2 receptors, designated EP2 and EP4. We used cells from mice in which the EP2 receptor had been disrupted to test its role in the formation of TRAP + MNC. EP2 heterozygous (+/-) mice in a C57BL/6 x 129/SvEv background were bred to produce homozygous null (EP2 -/-) and wild-type (EP2 +/+) mice. PGE2, PTH, or 1,25 dihydroxyvitamin D increased TRAP+ MNC in 7-day cultures of bone marrow cells from EP2 +/+ mice. In cultures from EP2 -/- animals, responses to PGE2, PTH, and 1,25 dihydroxyvitamin D were reduced by 86%, 58%, and 50%, respectively. A selective EP4 receptor antagonist (EP4RA) further inhibited TRAP+ MNC formation in both EP2 +/+ and EP2 -/- cultures. In cocultures of spleen and calvarial osteoblastic cells, the response to PGE2 or PTH was reduced by 92% or 85% when both osteoblastic cells and spleen cells were from EP2 -/- mice, by 88% or 68% when only osteoblastic cells were from EP2 -/- mice and by 58% or 35% when only spleen cells were from EP2 -/- mice. PGE2 increased receptor activator of nuclear factor (NF)-kappaB ligand (RANKL) messenger RNA expression in osteoblastic and bone marrow cell cultures from EP2 +/+ mice 2-fold but had little effect on cells from EP2 -/- mice. Spleen cells cultured with RANKL and macrophage colony stimulating factor produced TRAP+ MNC. PGE2 increased the number of TRAP+ MNC in spleen cell cultures from EP2 +/+ mice but not in cultures from EP2 -/- mice. EP4RA had no effect on the PGE2 response in spleen cell cultures. PGE2 decreased the expression of messenger RNA for granulocyte-macrophage colony stimulating factor in spleen cell cultures from EP2 +/+ mice but had little effect on cells from EP2 -/- mice. These data demonstrate that the prostaglandin EP2 receptor plays a role in the formation of osteoclast-like cells in vitro. A major defect in EP2 -/- mice appears to be in the capacity of osteoblastic cells to stimulate osteoclast formation. In addition, there appears to be a defect in the response of cells of the osteoclastic lineage to PGE2 in EP2 -/- mice.


Assuntos
Osteoclastos/fisiologia , Receptores de Prostaglandina E/fisiologia , Fosfatase Ácida/análise , Animais , Células da Medula Óssea/metabolismo , Calcitriol/farmacologia , Proteínas de Transporte/genética , Células Cultivadas , Técnicas de Cocultura , Dinoprostona/farmacologia , Feminino , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Isoenzimas/análise , Masculino , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Osteoblastos/metabolismo , Hormônio Paratireóideo/farmacologia , Ligante RANK , Receptor Ativador de Fator Nuclear kappa-B , Receptores de Prostaglandina E/deficiência , Receptores de Prostaglandina E/genética , Receptores de Prostaglandina E Subtipo EP2 , Baço/metabolismo , Fosfatase Ácida Resistente a Tartarato
4.
J Bone Miner Res ; 15(6): 1138-46, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10841183

RESUMO

Interleukin-1 (IL-1) stimulates prostaglandin production in bone by a rapid and transient activation of prostaglandin G/H synthase 2 (PGHS-2) gene expression. In osteoblastic MC3T3-E1 cells, IL-1 caused a transient increase in PGHS-2 messenger RNA (mRNA), which peaked at 2 h. IL-1 caused a 2- to 4-fold activation of a 371-base pair (bp) murine PGHS-2 promoter/luciferase construct in stable transfectants. This response mapped to a proximal promoter element(s) located between -150 and -40 bp. This region contains a putative CCAAT enhancer binding protein (C/EBP) site (centered at -135 bp), which shows enhanced binding of C/EBPbeta and C/EBPdelta by mobility shift analysis after IL-1 treatment. A transient cotransfection approach was used to examine the effects of C/EBPbeta and C/EBPdelta overexpression. IL-1 caused a maximal 3- to 7-fold stimulation of PGHS-2 promoter activity after 2.5 h. Overexpression of murine C/EBPbeta and C/EBPdelta caused a dose-dependent increase in basal and IL-1-stimulated luciferase activity. C/EBPdelta caused a greater enhancement of basal and IL-1-stimulated promoter activity than C/EBPbeta, suggesting that C/EBPdelta is a stronger transactivator. Overexpression of p20C/EBPbeta, a dominant negative inhibitor of C/EBP function, blocked the stimulation of PGHS-2 promoter activity by IL-1 and blocked the ability of overexpressed C/EBPbeta and C/EBPdelta to increase basal and IL-1-stimulated promoter activity. Mutagenesis of the C/EBP site reduced, but did not abolish, the stimulation of PGHS-2 promoter activity by IL-1 and blunted the effect of overexpressed C/EBPdelta on basal and IL-1-stimulated promoter activity. These results suggest an essential role for C/EBPbeta and C/EBPdelta in the induction of PGHS-2 gene expression by IL-1 in osteoblastic cells.


Assuntos
Proteínas de Ligação a DNA/metabolismo , Interleucina-1/metabolismo , Isoenzimas/genética , Proteínas Nucleares/metabolismo , Osteoblastos/metabolismo , Prostaglandina-Endoperóxido Sintases/genética , Fatores de Transcrição/metabolismo , Animais , Proteínas Estimuladoras de Ligação a CCAAT , Linhagem Celular , Ciclo-Oxigenase 2 , Proteínas de Ligação a DNA/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Interleucina-1/farmacologia , Proteínas de Membrana , Camundongos , Proteínas Nucleares/genética , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Osteocalcina/genética , RNA Mensageiro , Elementos de Resposta , Fatores de Transcrição/genética
5.
J Clin Invest ; 105(6): 823-32, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10727451

RESUMO

We examined the effect on osteoclast formation of disrupting the prostaglandin G/H synthase genes PGHS-1 and-2. Prostaglandin E(2) (PGE(2)) production was significantly reduced in marrow cultures from mice lacking PGHS-2 (PGHS-2(-/-)) compared with wild-type (PGHS-2(+/+)) cultures. Osteoclast formation, whether stimulated by 1,25-dihydroxyvitamin D(3) (1,25-D) or by parathyroid hormone (PTH), was reduced by 60-70% in PGHS-2(-/-) cultures relative to wild-type cultures, an effect that could be reversed by providing exogenous PGE(2). Cultures from heterozygous mice showed an intermediate response. PGHS inhibitors caused a similar drop in osteoclast formation in wild-type cultures. Co-culture experiments showed that supporting osteoblasts, rather than osteoclast precursors, accounted for the blunted response to 1,25-D and PTH. This lack of response appeared to result from reduced expression of RANK ligand (RANKL) in osteoblasts. We cultured spleen cells with exogenous RANKL and found that osteoclast formation was 50% lower in PGHS-2(-/-) than in wild-type cultures, apparently because the former cells expressed high levels of GM-CSF. Injection of PTH above the calvaria caused hypercalcemia in wild-type but not PGHS-2(-/-) mice. Histological examination of bone from 5-week-old PGHS-2(-/-) mice revealed no abnormalities. Mice lacking PGHS-1 were similar to wild-type mice in all of these parameters. These data suggest that PGHS-2 is not necessary for wild-type bone development but plays a critical role in bone resorption stimulated by 1,25-D and PTH.


Assuntos
Reabsorção Óssea/enzimologia , Dinoprostona/biossíntese , Isoenzimas/fisiologia , Osteoclastos/enzimologia , Prostaglandina-Endoperóxido Sintases/fisiologia , Animais , Medula Óssea/patologia , Reabsorção Óssea/induzido quimicamente , Osso e Ossos/citologia , Calcitriol/farmacologia , Proteínas de Transporte/biossíntese , Proteínas de Transporte/farmacologia , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Ciclo-Oxigenase 1 , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase/farmacologia , Feminino , Genótipo , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Indometacina/farmacologia , Isoenzimas/deficiência , Isoenzimas/genética , Fator Estimulador de Colônias de Macrófagos/farmacologia , Masculino , Glicoproteínas de Membrana/biossíntese , Glicoproteínas de Membrana/farmacologia , Proteínas de Membrana , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Técnicas de Cultura de Órgãos , Hormônio Paratireóideo/farmacologia , Prostaglandina-Endoperóxido Sintases/deficiência , Prostaglandina-Endoperóxido Sintases/genética , Ligante RANK , Receptor Ativador de Fator Nuclear kappa-B , Reação em Cadeia da Polimerase Via Transcriptase Reversa
6.
J Clin Endocrinol Metab ; 84(1): 179-83, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9920080

RESUMO

Previous studies have shown that treatment with estrogen or calcium decreases bone turnover in older women. The mechanisms by which estrogen and calcium exert their effects are probably different. We therefore examined the possibility of an additive or synergistic effect of combined treatment with calcium and low dose estrogen on bone turnover in older women, using biochemical markers. Thirty-one healthy women over 70 yr of age were randomized to 12 weeks of treatment with either micronized 17beta-estradiol [0.5 mg/day Estrace (E2)] or 1500 mg/day elemental calcium, given as carbonate plus vitamin D (800 IU/day; Ca+D). At the end of the initial 12-week treatment period, both groups received both Ca+D and E2 for an additional 12 weeks. Eleven older women were followed for 36 weeks without any treatment and served as a control group. Serum and urine were collected at baseline, at 12 and 24 weeks on treatment, and at 12 weeks after treatment was terminated for measurement of biochemical markers of bone turnover. Markers of bone formation were bone alkaline phosphatase, osteocalcin, and type I procollagen peptide; markers of bone resorption were urinary cross-linked C-telopeptides and N-telopeptides of type I collagen, serum cross-linked N-telopeptides of type I collagen, urinary free deoxypyridinoline cross-links, and serum bone sialoprotein. Repeated measures ANOVA was used to determine changes in bone turnover measures over time by group. All markers of bone resorption decreased with initial treatment and decreased further with combination therapy (P < 0.001). Markers of bone formation decreased with Ca+D treatment, but not with E2 alone; there was no additional effect of combination therapy on formation markers compared to Ca+D alone. Neither markers of formation nor resorption changed in the control group. These results suggest that there is an additive effect of low dose estrogen and calcium on bone resorption, but not on bone formation, in older women. Thus, the combination of low dose estrogen plus calcium is likely to be more effective in older women than either treatment alone.


Assuntos
Reabsorção Óssea/prevenção & controle , Cálcio/administração & dosagem , Estradiol/administração & dosagem , Idoso , Desenvolvimento Ósseo/efeitos dos fármacos , Calcifediol/sangue , Calcitriol/sangue , Sinergismo Farmacológico , Feminino , Humanos , Cooperação do Paciente
7.
J Bone Miner Res ; 13(7): 1066-75, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9661070

RESUMO

Interleukin-1 (IL-1) is an important factor in bone metabolism, and its actions may be mediated in part via prostaglandins. Prostaglandin G/H synthase (PGHS), a critical enzyme in the synthesis of prostaglandins, has two isoforms, PGHS-1, which is generally constitutively expressed, and PGHS-2, which is inducible. This study examines the effects of IL-1 on PGHS-2 mRNA expression in human osteosarcoma MG-63 cells, the human osteoblast-like initial transfectant (HOBIT) cell line, and primary human osteoblastic (HOB) cells. IL-1 induced PGHS-2 mRNA expression in MG-63 cells within 1 h, and expression was maintained for 24 h. There was a dose-related increase in PGHS-2 mRNA levels with 1-100 ng/ml of IL-1. Induction of PGHS-2 protein and media prostaglandin E2 (PGE2) paralleled induction of PGHS-2 mRNA levels. IL-1 similarly induced PGHS-2 mRNA expression and PGE2 production in HOBIT and HOB cells. Among other potential agonists, phorbol myristate acetate (PMA) was a potent inducer of PGHS-2 expression, while forskolin (FSK), serum, and prostaglandins had little effect. Cycloheximide enhanced effects of both IL-1 and PMA, suggesting that de novo protein synthesis is not required for induction of PGHS-2. Twenty-four hours of PMA pretreatment blocked the induction of PGHS-2 by PMA but not by IL-1, suggesting that IL-1 induction of PGHS-2 mRNA is not dependent on the protein kinase C pathway. Although FSK alone had little effect, it enhanced induction of PGHS-2 mRNA by IL-1. PGHS-1 was constitutively expressed and showed little change with treatment. In summary, we show that IL-1 is a potent inducer of PGHS-2 expression and PGE2 production in human osteosarcoma cells as well as in osteoblastic cells derived from normal human bone.


Assuntos
Interleucina-1/farmacologia , Isoenzimas/biossíntese , Osteoblastos/efeitos dos fármacos , Prostaglandina-Endoperóxido Sintases/biossíntese , Anti-Inflamatórios não Esteroides/farmacologia , Linhagem Celular Transformada , Colforsina/farmacologia , Cicloeximida , Ciclo-Oxigenase 2 , Dinoprostona/análise , Relação Dose-Resposta a Droga , Indução Enzimática/efeitos dos fármacos , Humanos , Isoenzimas/genética , Proteínas de Membrana , Osteoblastos/enzimologia , Osteossarcoma , Prostaglandina-Endoperóxido Sintases/genética , Prostaglandinas/farmacologia , Inibidores da Síntese de Proteínas , RNA Mensageiro/metabolismo , Acetato de Tetradecanoilforbol/farmacologia , Transfecção , Células Tumorais Cultivadas
8.
Endocrinology ; 139(6): 3022-5, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9607815

RESUMO

We measured the effects of ovariectomy on the bone mass of mice that lacked type I interleukin-1 receptor (IL-I R1 -/- mice) in two genetic backgrounds (C57BL/6 x 129/Sv and C57BL/6) to investigate the role of interleukin-1 in the actions of estrogen on bone. At three weeks after surgery, ovariectomized wild-type mice decreased trabecular bone volume in the proximal humerus by 70% in a C57BL/6 x 129/Sv background and 48% in a C57BL/6 background compared to sham-operated controls. In contrast, there was no significant decrease in trabecular bone mass in IL-1 R1 -/- mice after ovariectomy. The estrogen status of all groups was confirmed by measurement of uterine wet weight. These results demonstrate that a functional IL-1 response pathway is required for mice to lose trabecular bone mass after ovariectomy in this model and they imply that IL-1 is an important mediator of the effects of ovariectomy on bone mass. Hence, therapeutic interventions that block the effects of IL-1 on bone may be beneficial for treating diseases of rapid bone loss such as post-menopausal osteoporosis.


Assuntos
Densidade Óssea , Camundongos Knockout/genética , Ovariectomia , Receptores de Interleucina-1/genética , Animais , Feminino , Úmero/metabolismo , Camundongos , Tamanho do Órgão , Período Pós-Operatório , Valores de Referência , Útero/anatomia & histologia
9.
Endocrinology ; 138(9): 3594-600, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9275040

RESUMO

PTH increased PG synthase-2 transcription in osteoblastic MC3T3-E1 cells at 30 min, as assessed by nuclear run-on assays. To determine the signaling pathways used by PTH, the activity of a construct containing the PG synthase-2 gene between nucleotides -963 and +70 linked to a luciferase reporter was analyzed in stably transfected MC3T3-E1 cells. Agents that activate the cAMP-protein kinase A or protein kinase C pathways increased PG synthase-2 promoter activity. In contrast, the calcium ionophore ionomycin was ineffective. The protein kinase A inhibitor H89 blocked PTH stimulation of PG synthase-2 promoter activity, whereas an overnight pre-incubation with phorbol ester to down-regulate protein kinase C did not. PTH-(3-34), a peptide that has greatly reduced ability to activate the cAMP-protein kinase A pathway, did not increase PG synthase-2 transcription or promoter activity. PTH could induce PG synthase-2 messenger RNA accumulation and PG synthase-2 transcription in the presence of cycloheximide. In addition, PTH-stimulated PG synthase-2 transcription was maintained at a high level at 2 h in the presence of cycloheximide. We conclude that PTH rapidly increases PG synthase-2 transcription in MC3T3-E1 cells, mainly through a cAMP-protein kinase A-mediated pathway without the need for protein synthesis. In contrast, the attenuation of increased PG synthase-2 transcription by PTH requires de novo protein synthesis.


Assuntos
AMP Cíclico/metabolismo , Osteoblastos/enzimologia , Hormônio Paratireóideo/farmacologia , Fragmentos de Peptídeos/farmacologia , Prostaglandina-Endoperóxido Sintases/genética , Transcrição Gênica/efeitos dos fármacos , Animais , Cálcio/metabolismo , Linhagem Celular , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Cicloeximida/farmacologia , Indução Enzimática/efeitos dos fármacos , Camundongos , Proteína Quinase C/metabolismo , Inibidores da Síntese de Proteínas/farmacologia , RNA Mensageiro/metabolismo , Transdução de Sinais , Transfecção
10.
J Bone Miner Res ; 12(8): 1198-203, 1997 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9258749

RESUMO

The production of prostaglandins by osteoblasts is an important mechanisms for the regulation of bone turnover. Bone cells contain both inducible and constitutive prostaglandin G/H synthase (PGHS-2 and PGHS-1) and these are differentially regulated. Nonsteroidal anti-inflammatory drugs (NSAIDs), which selectively inhibit one of these enzymes, would be useful in assessing their relative roles in bone metabolism. By Northern analysis, only PGHS-2 is expressed by the immortalized rat osteoblastic cell line, Py1a, while only PGHS-1 is expressed by the rat osteosarcoma cell line, ROS 17/2.8. We tested the relative inhibitory potency (IC50) of seven different NSAIDs on these two cell lines. A recently described selective inhibitor of PGHS-2, NS-398, was approximately 30 times more potent in inhibiting PGHS-2 than PGHS-1, and diclofenac was approximately 10 times more potent. Both had IC50's of approximately 3 nM for PGHS-2 in Py1a cells. Indomethacin, flurbiprofen, naproxen, and piroxicam were relatively nonselective with IC50's ranging from 30 nM to 1 microM, while 6-methoxy-2 naphthyl acetic acid, the active metabolite of nabumetone, was inhibitory only at concentrations greater than 1 microM. These results indicate that the presently available NSAIDs are unlikely to distinguish completely between effects mediated by PGHS-2 or PGHS-1. However, the cell systems employed could provide a model for the analysis of new compounds with greater selective activity.


Assuntos
Anti-Inflamatórios não Esteroides/toxicidade , Osso e Ossos/efeitos dos fármacos , Isoenzimas/biossíntese , Osteoblastos/efeitos dos fármacos , Prostaglandina-Endoperóxido Sintases/biossíntese , Animais , Northern Blotting , Neoplasias Ósseas/patologia , Osso e Ossos/citologia , Osso e Ossos/enzimologia , Linhagem Celular , Células Cultivadas , Colágeno/biossíntese , Ciclo-Oxigenase 1 , Ciclo-Oxigenase 2 , Indução Enzimática/efeitos dos fármacos , Ensaio de Imunoadsorção Enzimática , Isoenzimas/genética , Proteínas de Membrana , Osteoblastos/citologia , Osteoblastos/patologia , Osteossarcoma/patologia , Prostaglandina-Endoperóxido Sintases/genética , Prostaglandinas/biossíntese , Prostaglandinas/fisiologia , Biossíntese de Proteínas , RNA Mensageiro/biossíntese , Ratos , Relação Estrutura-Atividade , Células Tumorais Cultivadas
11.
Endocrinology ; 138(6): 2372-9, 1997 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9165025

RESUMO

Interleukin-6 (IL-6) induces osteoclast-like cell (osteoclast) formation in a dose-dependent fashion in cocultures of mouse bone marrow cells and osteoblastic cells when soluble IL-6 receptor (sIL-6R) is present. Simultaneous treatment with submaximal doses of IL-1alpha and IL-6 with sIL-6R caused marked induction of osteoclast formation and PGE2 synthesis. These effects were suppressed by adding neutralizing antibodies against IL-1alpha or IL-6R and were totally abolished by adding nonsteroidal antiinflammatory drugs, such as indomethacin and a selective cyclooxygenase-2 (COX-2) inhibitor (NS398). In mouse osteoblastic cells, both IL-1alpha and IL-6 with sIL-6R markedly induced messenger RNA expression of COX-2, but not COX-1, as determined by Northern blot analysis, and luciferase activity in cells stably transfected with a COX-2 promoter-luciferase fusion construct. IL-6 and sIL-6R, when added separately, did not stimulate COX-2 messenger RNA expression. Simultaneous addition of IL-1alpha and IL-6 with sIL-6R to osteoblast cultures cooperatively induced transcription of COX-2, which was associated with a marked increase in COX activity measured by the conversion of arachidonic acid into PGE2. The increased PGE2 synthesis by osteoblasts may play an important role in osteoclastogenesis induced by submaximal doses of IL-1 and IL-6.


Assuntos
Interleucina-6/farmacologia , Isoenzimas/biossíntese , Osteoblastos/enzimologia , Osteoclastos/fisiologia , Prostaglandina-Endoperóxido Sintases/biossíntese , Transcrição Gênica/efeitos dos fármacos , Envelhecimento , Animais , Animais Recém-Nascidos , Anti-Inflamatórios não Esteroides/farmacologia , Antígenos CD/fisiologia , Northern Blotting , Células da Medula Óssea , Células Cultivadas , Técnicas de Cocultura , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase/farmacologia , Primers do DNA , Dinoprostona/metabolismo , Indução Enzimática , Indometacina/farmacologia , Interleucina-1/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos , Nitrobenzenos/farmacologia , Osteoblastos/efeitos dos fármacos , Osteoclastos/citologia , Osteoclastos/efeitos dos fármacos , Reação em Cadeia da Polimerase , Regiões Promotoras Genéticas , Receptores de Interleucina/fisiologia , Receptores de Interleucina-6 , Sulfonamidas/farmacologia
12.
J Bone Miner Res ; 12(1): 45-51, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9240724

RESUMO

Bone tissue responds to mechanical stress with adaptive changes in mass and structure. Mechanical stress produces flow of fluid in the osteocyte lacunar-canalicular network, which is likely the physiological signal for bone cell adaptive responses. We examined the effects of 1 h pulsating fluid flow (PFF; 0.7 +/- 0.02 Pa, 5 Hz) on prostaglandin (PG) E2, PGI2, and PGF2alpha production and on the expression of the constitutive and inducible prostaglandin G/H synthases, PGHS-1, and PGHS-2, the major enzymes in the conversion of arachidonic acid to prostaglandins, using mouse calvarial bone cell cultures. PFF treatment stimulated the release of all three prostaglandins under 2% serum conditions, but with a different time course and to a different extent. PGF2alpha was rapidly increased 5-10 minutes after the onset of PFF. PGE2 release increased somewhat more slowly (significant after 10 minutes), but continued throughout 60 minutes of treatment. The response of PGI2 was the slowest, and only significant after 30 and 60 minutes of treatment. In addition, PFF induced the expression of PGHS-2 but not PGHS-1. One hour of PFF treatment increased PGHS-2 mRNA expression about 2-fold relative to the induction by 2% fresh serum given at the start of PFF. When the addition of fresh serum was reduced to 0.1%, the induction of PGHS-2 was 8- to 9-fold in PFF-treated cells relative to controls. This up-regulation continued for at least 1 h after PFF removal. PFF also markedly increased PGHS activity, measured as the conversion of arachidonic acid into PGE2. One hour after PFF removal, the production of all three prostaglandins was still enhanced. These results suggest that prostaglandins are important early mediators of the response of bone cells to mechanical stress. Prostaglandin up-regulation is associated with an induction of PGHS-2 enzyme mRNA, which may subsequently provide a means for amplifying the cellular response to mechanical stress.


Assuntos
Osso e Ossos/metabolismo , Líquido Intracelular/fisiologia , Isoenzimas/biossíntese , Prostaglandina-Endoperóxido Sintases/biossíntese , Prostaglandinas/metabolismo , Análise de Variância , Animais , Northern Blotting , Osso e Ossos/citologia , Osso e Ossos/enzimologia , Células Cultivadas , Ciclo-Oxigenase 1 , Ciclo-Oxigenase 2 , DNA/metabolismo , Dinoprosta/metabolismo , Dinoprostona/metabolismo , Epoprostenol/metabolismo , Feminino , Regulação Enzimológica da Expressão Gênica/genética , Isoenzimas/genética , Proteínas de Membrana , Camundongos , Peroxidases/biossíntese , Peroxidases/genética , Gravidez , Prostaglandina-Endoperóxido Sintases/genética , Fluxo Pulsátil/fisiologia , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Transdução de Sinais/fisiologia , Estresse Mecânico
14.
Prostaglandins ; 54(4): 713-25, 1997 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9440134

RESUMO

Prostaglandin E2 (PGE2) is a potent local mediator of cell growth and differentiation in various tissues. The receptors for PGE2 have been classified into four pharmacological subtypes, EP1, EP2, EP3, and EP4, based on the responses to selective agonists and antagonists. We have cloned a functional cDNA for the rat EP2 receptor subtype from a rat lung cDNA library. The rat EP2 receptor cDNA encodes 357 amino acid residues having high homology with the human and mouse EP2 receptors and containing seven putative transmembrane domains. In COS-7 cells transfected with rat EP2 cDNA, specific [3H]PGE2 binding was found with a dissociation constant of 14.9 nM, and this binding was inhibited by unlabeled PGE2 and PGE2 alpha. PGE2 and butaprost, an EP2 selective agonist, were effective in increasing the cAMP level in the COS-7 cell transfectants. Northern blot and RT-PCR analysis showed widespread distribution of the EP2 receptor in various tissues. Higher EP2 expression was found in fetal long bones and calvariae than in adult by RT-PCR and in situ hybridization, suggesting a role for this receptor in rapidly growing skeletal tissue.


Assuntos
Receptores de Prostaglandina E/genética , Receptores de Prostaglandina E/metabolismo , Alprostadil/análogos & derivados , Alprostadil/farmacologia , Sequência de Aminoácidos , Animais , Sequência de Bases , Northern Blotting , Desenvolvimento Ósseo/fisiologia , Células COS/metabolismo , Clonagem Molecular , AMP Cíclico/metabolismo , Humanos , Camundongos , Dados de Sequência Molecular , Ratos , Receptores de Prostaglandina E/efeitos dos fármacos , Receptores de Prostaglandina E Subtipo EP2 , Homologia de Sequência de Aminoácidos , Crânio/embriologia , Crânio/metabolismo , Distribuição Tecidual , Transfecção
15.
J Bone Miner Res ; 11(12): 1926-34, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8970895

RESUMO

Interleukin-6 (IL-6) has been implicated as a mediator of postmenopausal bone loss. In vitro studies of bone and bone marrow cells have suggested that estrogen regulates bone turnover by controlling the production of IL-6, a potent stimulator of osteoclastogenesis and bone resorption. To investigate this hypothesis in an in vivo model, we examined the effect of ovariectomy or estrogen replacement on IL-6 mRNA and protein expression in adult mouse bone and bone marrow in vivo and in marrow stromal cell cultures. Eight-week-old CD-1 mice were sham-operated (SHAM), ovariectomized (OVX), or ovariectomized and subcutaneously implanted with 21-day slow-release pellets containing 10 micrograms of 17 beta-estradiol (O + E). Placebo pellets were implanted in the SHAM and OVX mice. Uterine weights at 1, 2, or 3 weeks after surgery were significantly decreased (68-76%) in OVX animals compared with SHAM or O + E. In mice sacrificed at 1 or 3 weeks after surgery, we found by nonquantitative reverse transcribed polymerase chain reaction (RT-PCR), that SHAM, OVX, and O + E calvariae (CALV) constitutively expressed IL-6 mRNA. In contrast, IL-6 mRNA was either barely detectable or absent in the tibia (TIB) and bone marrow (BM). In the mice sacrificed 3 weeks after surgery, we determined by quantitative RT-PCR that IL-6 mRNA in the CALV from the OVX and O + E groups were decreased by 81 and 92%, respectively, compared with SHAM. IL-6 protein levels in the flushed bone marrow (BMSups) were detectable and were not significantly different among the groups. In bone marrow cells that were cultured for 1 week, basal levels of IL-6 protein were low and did not differ significantly among the SHAM, OVX, or O + E groups sacrificed 1, 2, or 3 weeks after surgery. After the addition of hrIL-1 alpha, IL-6 protein levels increased 100- to 1300-fold over control. IL-6 levels in cells from animals sacrificed 2 weeks after surgery were significantly lower in the hrIL-1 alpha-stimulated OVX and O + E groups than in hrIL-1 alpha-stimulated SHAM cell cultures. In conclusion, in this model we could find no increase in IL-6 production with in vivo estrogen withdrawal in calvaria, long bones, bone marrow, or marrow stromal cell cultures. If increases in IL-6 expression are involved in the effects of estrogen withdrawal on bone, the magnitude of these changes are relatively small and below the limits of detection of the assays that we employed.


Assuntos
Medula Óssea/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Estradiol/farmacologia , Interleucina-6/genética , Ovário/fisiologia , Animais , Medula Óssea/metabolismo , Células da Medula Óssea , Osso e Ossos/citologia , Osso e Ossos/metabolismo , Células Cultivadas , Ensaio de Imunoadsorção Enzimática , Feminino , Interleucina-6/biossíntese , Camundongos , Camundongos Endogâmicos , Ovariectomia , Reação em Cadeia da Polimerase/métodos , RNA Mensageiro/biossíntese , Células Estromais/efeitos dos fármacos , Células Estromais/metabolismo , Transcrição Gênica , Útero/efeitos dos fármacos
16.
Endocrinology ; 137(12): 5435-40, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8940368

RESUMO

Prostaglandin G/H synthase (PGHS), a central enzyme for PG synthesis, is encoded by the constitutively expressed PGHS-1 and the inducible PGHS-2. The goal of this project was to study the regulation of PGHS-2 gene expression by PTH and its possible signaling pathways in osteoblastic MC3T3-E1 cultures. Bovine PTH-(1-34) at 0.01-10 nM increased PGHS-2, but not PGHS-1, messenger RNA (mRNA) levels. The effect of PTH was maximal at 1 h and decreased almost to control levels by 6 h. Phorbol myristate acetate (PMA), forskolin, and 8-bromo-cAMP increased PGHS-2 mRNA levels, whereas ionomycin had no effect. PTH, forskolin, and PMA increased the release of PGE2 into the culture medium. Pretreatment of cells with 0.1 microM PMA for 16 h blocked the induction of PGHS-2 mRNA levels by PMA, but did not alter the effects of PTH and forskolin. However, treatment of cells with 30 microM H-89, a protein kinase A inhibitor, significantly reduced the ability of PTH and forskolin to induce PGHS-2 mRNA levels. Moreover, PTH-(3-34) at 0.1-100 nM did not induce PGHS-2 mRNA levels. Our results show that PTH can rapidly and transiently induce PGHS-2 mRNA levels in osteoblastic MC3T3-E1 cells, primarily via the cAMP-protein kinase A signal transduction pathway. Induction of PGHS-2 may play a key role in mediating some actions of PTH on bone metabolism and gene expression.


Assuntos
AMP Cíclico/fisiologia , Osteoblastos/enzimologia , Hormônio Paratireóideo/farmacologia , Prostaglandina-Endoperóxido Sintases/metabolismo , Animais , Bovinos , Linhagem Celular , Camundongos , Prostaglandina-Endoperóxido Sintases/genética , Proteína Quinase C/fisiologia , RNA Mensageiro/metabolismo , Transdução de Sinais
17.
J Bone Miner Res ; 11(3): 358-66, 1996 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8852946

RESUMO

We have shown previously that prostaglandin (PG) production in 7-day-old neonatal mouse calvarial cultures is regulated largely by changes in prostaglandin G/H synthase-2 (PGHS-2) expression and to a lesser extent by changes in arachidonic acid (AA) release. In this study, we examined the effects of interleukin-4 (IL-4), and its interactions with other cytokines and with parathyroid hormone (PTH), on mRNA levels of PGHS-2, PGHS-1, and cytosolic phospholipase A2 (cPLA2) and on medium protaglandin E2 (PGE2) levels in calvarial cultures. IL-1 and tumor necrosis factor-alpha (TNF-alpha), both at 1-100 ng/ml, and PTH at 0.1-10 nM increased PGHS-2 and cPLA2 mRNA and medium PGE2 levels dose-dependently after 4 h of treatment. IL-6 and IL-11 at 1-100 ng/ml did not affect mRNA or PGE2 levels. IL-4 at 1-100 ng/ml decreased PGHS-2 and cPLA2 mRNA and PGE2 levels in control as well as IL-1, TNF-alpha, and PTH-stimulated cultures. The inhibition of PGHS-2 and cPLA2 mRNA expression by IL-4 (10 ng/ml) was present at 1 h, reached a maximum at 4 h, and persisted for 24 h. The effects were maintained in the presence of cycloheximide. IL-4 also decreased PGHS-2 protein levels in control and IL-1-stimulated cultures. PGHS-1 mRNA levels were not stimulated by any of the factors studied nor inhibited by IL-4. IL-4 partially inhibited control and PTH-stimulated 45Ca release from prelabeled mouse calvariae at 4 days. However, neither the inhibition of resorption by IL-4 nor the stimulation by IL-1 and PTH were altered by indomethacin (1 microM). We conclude that (1) IL-1, TNF-alpha, and PTH, but not IL-6 nor IL-11, can increase the expression of PGHS-2, cPLA2, and PGE2 production in cultured mouse calvariae; (2) IL-4 inhibits PGE2 production in both control and stimulated calvarial cultures by inhibiting PGHS-2 and cPLA2; and (3) IL-4 has an inhibitory effect on bone resorption which is independent of PG production.


Assuntos
Citosol/enzimologia , Interleucina-4/farmacologia , Osso Parietal/enzimologia , Fosfolipases A/metabolismo , Prostaglandina-Endoperóxido Sintases/metabolismo , Análise de Variância , Animais , Northern Blotting , Western Blotting , Reabsorção Óssea/metabolismo , Citosol/efeitos dos fármacos , Dinoprostona/metabolismo , Indução Enzimática/efeitos dos fármacos , Inibidores Enzimáticos/farmacologia , Interleucina-1/farmacologia , Interleucina-11/farmacologia , Interleucina-6/farmacologia , Camundongos , Técnicas de Cultura de Órgãos , Hormônio Paratireóideo/farmacologia , Osso Parietal/efeitos dos fármacos , Fosfolipases A/genética , Fosfolipases A2 , Prostaglandina-Endoperóxido Sintases/genética , RNA Mensageiro/metabolismo , Ratos
18.
J Cell Physiol ; 166(2): 370-9, 1996 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8591997

RESUMO

We examined the distribution of insulin-like growth factor binding proteins (IGFBPs) in cultured neonatal mouse calvariae. IGFBP-3 and -4 were predominantly found in the conditioned medium. IGFBP-2 was partitioned between conditioned medium and bone and extracellular matrix (BECM), while intact (31-kDa) IGFBP-5 was most abundant in BECM extracts. After treatment with parathyroid hormone (PTH, 10(-8) M) or prostaglandin E2 (PGE2, 10(-6) M), immunoreactive IGFBP-5 accumulated in the conditioned medium in a 21-kDa form which did not bind IGF-I on Western ligand blots. PTH and PGE2 did not alter the level of steady-state IGFBP-5 mRNA, nor markedly stimulate IGFBP-5 synthesis in the calvariae, and thus accumulation of 21-kDa IGFBP-5 was largely due to release from BECM. This accumulation of truncated IGFBP-5 in the conditioned medium was not dependent on osteoclastic bone resorption, since it was not blocked by calcitonin or a bisphosphonate which inhibited PTH- and PGE2-stimulated 45Ca-release. The conditioned medium from PTH- or PGE2-treated cultures degraded recombinant human IGFBP-5 into lower molecular weight fragments. Addition of IGF-1 at 10(-8) M into the culture resulted in accumulation of native 31-kDa IGFBP-5. However, even in the presence of IGF-1, the native IGFBP-5 was degraded and the 21-kDa product accumulated in the culture medium. These results suggested a possible proteolytic mechanism for 21-kDa IGFBP-5 accumulation, responsive to PTH and PGE2. Aprotinin, leupeptin, cystatin, and bestatin did not inhibit the effects of PTH and PGE2 in the cultures. The localization of IGFBP-5 in BECM and its release and proteolysis induced by PTH and PGE2 could play a role in the local regulation of bone metabolism.


Assuntos
Matriz Óssea/metabolismo , Osso e Ossos/metabolismo , Dinoprostona/farmacologia , Proteína 5 de Ligação a Fator de Crescimento Semelhante à Insulina/metabolismo , Hormônio Paratireóideo/farmacologia , Animais , Animais Recém-Nascidos , Meios de Cultivo Condicionados/química , Técnicas de Cultura , Endopeptidases/metabolismo , Proteína 5 de Ligação a Fator de Crescimento Semelhante à Insulina/análise , Proteína 5 de Ligação a Fator de Crescimento Semelhante à Insulina/biossíntese , Proteína 5 de Ligação a Fator de Crescimento Semelhante à Insulina/genética , Camundongos , Fragmentos de Peptídeos/metabolismo , Biossíntese de Proteínas , RNA Mensageiro/metabolismo , Crânio/metabolismo , Solubilidade
19.
Osteoporos Int ; 6(4): 314-9, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-8883121

RESUMO

Calcium and vitamin D (1200 mg/day + 800 IU) has been shown to reduce hip fracture incidence in older women living in long-term care facilities who had borderline low vitamin D levels. We examined the effect of a short course of calcium and vitamin D on biochemical markers of bone turnover in older community-living women. Twelve community-living women (mean age 75 years) in good general health, without diseases or on medications known to affect bone, were entered into the study. All women were treated with calcium citrate (1500 mg/day of elemental calcium) and vitamin D3 (1000 IU/day) (Ca + D) for 6 weeks. Biochemical markers of bone turnover were measured in serum and urine collected at baseline (two samples), 5 and 6 weeks on Ca + D, and 5 and 6 weeks after termination of Ca + D. Markers of bone formation were osteocalcin, bone alkaline phosphatase and type I procollagen peptide. Markers of bone resorption were urinary hydroxyproline, free pyridinoline and deoxypyridinoline crosslinks, and N-telopeptides of type I collagen. Parathyroid hormone (PTH) and 25-hydroxyvitamin D were also measured at baseline, 6 weeks on treatment and 6 weeks after termination of treatment. All markers of bone resorption decreased on Ca + D and returned to baseline after termination of Ca + D (p < 0.05). Markers of bone formation did not change with Ca + D treatment. PTH decreased on Ca + D and returned to baseline after treatment, and 25-hydroxyvitamin D increased with treatment and remained elevated 6 weeks after the end of treatment. We conclude that Ca + D reduces bone resorption in older women, possibly by suppressing PTH levels.


Assuntos
Envelhecimento/metabolismo , Osso e Ossos/metabolismo , Cálcio/uso terapêutico , Vitamina D/uso terapêutico , Idoso , Aminoácidos/metabolismo , Osso e Ossos/efeitos dos fármacos , Terapia de Reposição de Estrogênios , Feminino , Humanos , Hormônio Paratireóideo/sangue , Fatores de Tempo
20.
J Clin Endocrinol Metab ; 80(11): 3287-91, 1995 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-7593440

RESUMO

This study examined the effects of tamoxifen (TAM) on biochemical markers of bone turnover in healthy women, 20-30 yr past menopause. Ten women (mean age, 75 yr; range, 70-85 yr) were given TAM (20 mg/day) for 10 weeks. Serum and urine were collected twice at baseline, at weeks 9 and 10 of TAM treatment, and at weeks 9 and 10 post-TAM. Markers of bone formation were serum osteocalcin, total alkaline phosphatase, bone-specific alkaline phosphatase, and type I procollagen peptide. Markers of bone resorption were fasting urinary calcium, hydroxyproline, pyridinoline, and deoxypyridinoline, all corrected for urinary creatinine. Total cholesterol, triglycerides, and high density lipoproteins were measured; low density lipoprotein levels were calculated. Pyridinoline and deoxypyridinoline decreased during therapy by 23% and 25% and returned to baseline posttherapy (F = 37.01; P = 0.001), with no significant changes in urinary calcium and hydroxyproline. Markers of bone formation declined 17-36%, with a variable return toward baseline (F = 85.56; P < 0.001). Ionized calcium decreased 5% (P < 0.001) and PTH increased 21% (P = 0.05) during TAM treatment. Total cholesterol decreased 15% (P < 0.001), and calculated low density lipoprotein cholesterol decreased 22% (P < 0.001); levels of triglycerides and high density lipoprotein did not change significantly. We conclude that short term TAM treatment inhibits bone turnover in women over 70 yr of age.


Assuntos
Envelhecimento/fisiologia , Reabsorção Óssea/tratamento farmacológico , Osteogênese/efeitos dos fármacos , Tamoxifeno/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Biomarcadores/urina , Reabsorção Óssea/sangue , Reabsorção Óssea/urina , Feminino , Humanos , Fatores de Tempo , Resultado do Tratamento
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