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1.
Phytomedicine ; 80: 153377, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33126167

RESUMO

BACKGROUND: Osteoporosis is a threat to aged people who have excessive osteoclast activation and bone resorption, subsequently causing fracture and even disability. Inhibiting osteoclast differentiation and absorptive functions has become an efficient approach to treat osteoporosis, but osteoclast-targeting inhibitors available clinically remain rare. Kirenol (Kir), a bioactive diterpenoid derived from an antirheumatic Chinese herbal medicine Herba Siegesbeckiae, can treat collagen-induced arthritis in vivo and promote osteoblast differentiation in vitro, while the effects of Kir on osteoclasts are still unclear. PURPOSE: We explore the role of Kir on RANKL-induced osteoclastogenesis in vitro and bone loss in vivo. METHODS: The in vitro effects of Kir on osteoclast differentiation, bone resorption and the underlying mechanisms were evaluated with bone marrow-derived macrophages (BMMs). In vivo experiments were performed using an ovariectomy (OVX)-induced osteoporosis model. RESULTS: We found that Kir remarkably inhibited osteoclast generation and bone resorption in vitro. Mechanistically, Kir significantly inhibited F-actinring formation and repressed RANKL-induced NF-κB p65 activation and p-p38, p-ERK and c-Fos expression. Moreover, Kir inhibited both the expression and nuclear translocation of NFATc1. Ca2+ oscillation and caveolin-1 (Cav-1) were also reduced by Kir during osteoclastogenesis in vitro. Consistent with these findings, 2-10 mg/kg Kir attenuated OVX-induced osteoporosis in vivo as evidenced by decreased osteoclast numbers and downregulated Cav-1 and NFATc1 expression. CONCLUSIONS: Kir suppresses osteoclastogenesis and the Cav-1/NFATc1 signaling pathway both in vitro and in vivo and protects against OVX-induced osteoporosis. Our findings reveal Kir as a potential safe oral treatment for osteoporosis.


Assuntos
Caveolina 1/metabolismo , Diterpenos/farmacologia , Fatores de Transcrição NFATC/metabolismo , Osteogênese/efeitos dos fármacos , Osteoporose/prevenção & controle , Administração Oral , Animais , Reabsorção Óssea/prevenção & controle , Cálcio/metabolismo , Diferenciação Celular/efeitos dos fármacos , Diterpenos/administração & dosagem , Feminino , Macrófagos/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Osteoclastos/efeitos dos fármacos , Osteoporose/etiologia , Ovariectomia/efeitos adversos , Ligante RANK/metabolismo , Ligante RANK/farmacologia , Transdução de Sinais/efeitos dos fármacos
2.
Vnitr Lek ; 66(7): 432-436, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33380122

RESUMO

Inflammatory Bowel Disease encompasses Crohns Disease, which is capable of affecting the entire GI tract, although usually favors the ileocolonic and perianal areas, and Ulcerative Colitis, which is limited to the colon. The pathophysiology is not fully understood but is thought to be caused by a complex interplay among gut microbiota, dysregulation of the hosts immune system, genetic susceptibility and environmental factors. Osteopenia and osteoporosis are considered to be extraintestinal manifestations of inflammatory bowel disease. Osteoporosis is usually diagnosed by dual-energy X-ray absortiometry. Early interventions to treat active CD and preventative treatment strategies to reduce excessive bone loss might prevent long term consequences of bone loss, including fractures. The immune response in IBD includes increased production of variety of proinflammatory cytokines such as IL1β, TNFα, IL6 a IL1 from T cells and macrophages. These have both direct and indirect effects on bone turnover. Vitamin D is vital in mantenance of bone strenght, mineralisation and fracture prevention. Vitamin Ds physiological importance has also been implicated in a number of inflammatory diseases, mainly asthma, atherosclerosis and autoimmune disease.


Assuntos
Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Osteoporose , Densidade Óssea , Humanos , Doenças Inflamatórias Intestinais/complicações , Osteoporose/etiologia
3.
Vnitr Lek ; 66(7): 3-7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33380127

RESUMO

Inflammatory Bowel Disease encompasses Crohns Disease, which is capable of affecting the entire GI tract, although usually favors the ileocolonic and perianal areas, and Ulcerative Colitis, which is limited to the colon. The pathophysiology is not fully understood but is thought to be caused by a complex interplay among gut microbiota, dysregulation of the hosts immune system, genetic susceptibility and environmental factors. Osteopenia and osteoporosis are considered to be extraintestinal manifestations of inflammatory bowel disease. Osteoporosis is usually diagnosed by dual-energy X-ray absortiometry. Early interventions to treat active CD and preventative treatment strategies to reduce excessive bone loss might prevent long term consequences of bone loss, including fractures. The immune response in IBD includes increased production of variety of proinflammatory cytokines such as IL1β, TNFα, IL6 a IL1 from T cells and macrophages. These have both direct and indirect effects on bone turnover. Vitamin D is vital in mantenance of bone strenght, mineralisation and fracture prevention. Vitamin Ds physiological importance has also been implicated in a number of inflammatory diseases, mainly asthma, atherosclerosis and autoimmune disease.


Assuntos
Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Osteoporose , Densidade Óssea , Humanos , Doenças Inflamatórias Intestinais/complicações , Osteoporose/etiologia
4.
Int J Nanomedicine ; 15: 8983-8998, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33239873

RESUMO

Background: Relying on surface topography alone to enhance the osteointegration of implants is still inadequate. An effective way to combine long-term ion release and surface topography to enhance osteogenic property is urgently needed. Purpose: The objective of this study is to fabricate a long-term strontium ion release implant system and confirm the biological function in vitro and in vivo. Methods: The biomimic surface was fabricated through alkali-heat treatment and magnetron sputtering. The in vitro biological function assays were determined by MTT, fluorescence staining, alkaline phosphatase activity, extracellular mineralization, and quantitative real-time polymerase chain reaction assays. The in vivo experiments were detected by micro-CT, HE staining and Masson staining. Results: The biomimic surface structure has been successfully fabricated. The in vitro cell assays determined that AH-Ti/Sr90 possessed the best biological function. The in vivo experiments demonstrated that AH-Ti/Sr90 could promote osteointegration significantly under both in normal and osteoporotic conditions. Conclusion: We determined that AH-Ti/Sr90 possesses the best osteogenic property, long-term ion release capacity and osteointegration promotion ability. It has potential clinic application prospects.


Assuntos
Nanoestruturas/química , Osseointegração , Próteses e Implantes , Estrôncio/química , Animais , Interface Osso-Implante , Linhagem Celular , Feminino , Regulação da Expressão Gênica , Camundongos , Osseointegração/efeitos dos fármacos , Osteogênese/genética , Osteoporose/etiologia , Ratos Sprague-Dawley , Crânio/citologia , Propriedades de Superfície , Titânio/química , Microtomografia por Raio-X
5.
Arch Osteoporos ; 15(1): 143, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32929613

RESUMO

INTRODUCTION: Iron overload, a state with excessive iron storage in the body, is a common complication in thalassemia patients which leads to multiple organ dysfunctions including the bone. Iron overload-induced bone disease is one of the most common and severe complications of thalassemia including osteoporosis. Currently, osteoporosis is still frequently found in thalassemia even with widely available iron chelation therapy. STUDY SELECTION: Relevant publications published before December 2019 in PubMed database were reviewed. Both pre-clinical studies and clinical trials were obtained using iron overload, thalassemia, osteoporosis, osteoblast, and osteoclast as keywords. RESULTS: Increased ROS production is a hallmark of iron overload-induced impaired bone remodeling. At the cellular level, oxidative stress affects bone remodeling by both osteoblast inhibition and osteoclast activation via many signaling pathways. In thalassemia patients, it has been shown that bone resorption was increased while bone formation was concurrently reduced. CONCLUSION: In this review, reports on the cellular mechanisms of iron overload-associated bone remodeling are comprehensively summarized and presented to provide current understanding this pathological condition. Moreover, current treatments and potential interventions for attenuating bone remodeling in iron overload are also summarized to pave ways for the future discoveries of novel agents that alleviate this condition.


Assuntos
Remodelação Óssea , Sobrecarga de Ferro/sangue , Osteoporose/etiologia , Talassemia/complicações , Humanos , Osteoclastos
6.
PLoS One ; 15(9): e0237984, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881882

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV) infected individuals may have osteoporosis. We aimed to evaluate the bone mineral density (BMD) in naïve antiretroviral (ARV) treated HIV positive patients comparing native Italian group (ItG) to a Migrants group (MiG) upon arrival in Italy. METHODS: We conducted a cross-sectional study on 83 HIV patients less than 50 years old. We used the dual-energy X-ray absorptiometry (DXA) within six months from the HIV diagnosis. Participants were categorized as having low BMD if the femoral neck or total lumbar spine Z-score was- 2 or less. RESULTS: MiG showed low BMD more often than ItG (37.5% vs.13.6%), especially for the female gender (16.7% vs. 0.0%). A low CD4 rate (<200 cells/µl) was most often detected in MiG than ItG. In particular, we found most often male Italians with abnormal CD4 than male migrants (67.8% vs. 33.3%) and vice versa for females (30.5% vs. 66.7%). We found an abnormal bone mineral density at the lumbar site. Low BMD at the lumbar site was more frequently observed in female migrants than female Italians. Both male and female migrants had a Z-score value significantly lower than male and female Italians, respectively. By logistic regression low vitamin-D level was positively correlated to low BMD in ItG only. All data were verified and validated using a triple code identifier. CONCLUSIONS: Both DXA and vitamin-D evaluation should be offered after the diagnosis of HIV infection. Lumbar site low BMD is an initial condition of bone loss in HIV young patients, especially in female migrants. Vitamin D levels and supplementation may be considered after HIV diagnosis independently of age to improve bone health. HIGHLIGHTS: This study evaluates the frequency of bone mineral density in HIV positive patients naive to antiretroviral therapy. It compares the density of the native Italian population with that of HIV Migrants upon arrival in Italy. The results show that HIV positive migrants, even if younger than 50 years of age, are at risk for osteoporosis, especially if they are female.


Assuntos
Densidade Óssea/fisiologia , Infecções por HIV/diagnóstico , Absorciometria de Fóton , Adulto , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Itália , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Osteoporose/etnologia , Osteoporose/etiologia , Osteoporose/patologia , Fatores Sexuais , Migrantes , Vitamina D/sangue
7.
Top Spinal Cord Inj Rehabil ; 26(2): 128-133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760192

RESUMO

Individuals with spinal cord injury/disorder (SCI/D) are at high risk for developing secondary osteoporosis. Bone loss after neurologic injury is multifactorial and is dependent on the time from and extent of neurologic injury. Most bone loss occurs in the first year after complete motor paralysis, and fractures occur most commonly in the distal femur and proximal tibia (paraplegic fracture). The 2019 International Society for Clinical Densitometry Position Statement in SCI establishes that dual-energy X-ray absorptiometry (DXA) can be used to both diagnose osteoporosis and predict lower extremity fracture risk in individuals with SCI/D. Pharmacologic treatments used in primary osteoporosis have mixed results when used for SCI/D-related osteoporosis. Ambulation, standing, and electrical stimulation may be helpful at increasing bone mineral density (BMD) in individuals with SCI/D but do not necessarily correlate with fracture risk reduction. Clinicians caring for individuals with spinal cord-related paralysis must maintain a high index of suspicion for fragility fractures and consider referral for surgical evaluation and management.


Assuntos
Fraturas Ósseas/etiologia , Fraturas Ósseas/terapia , Osteoporose/etiologia , Osteoporose/terapia , Atenção Primária à Saúde , Traumatismos da Medula Espinal/complicações , Absorciometria de Fóton , Densidade Óssea , Humanos
8.
Actual. osteol ; 16(2): [104]-[115], mayo.-ago. 2020. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-1129698

RESUMO

La fosfatasa alcalina baja o hipofosfatasemia, ya sea debida a causas genéticas (hipofosfatasia) o secundarias, presenta correlato clínico. Nuestro objetivo es estimar la prevalencia de hipofosfatasemia crónica persistente y describir sus hallazgos osteometabólicos. Se realizó una búsqueda electrónica de afiliados adultos al Hospital Italiano de Buenos Aires, entre 2013 y 2017, con al menos 2 determinaciones de fosfatasa alcalina igual a 30 UI/l o menor y ninguna mayor de 30 UI/l (rango de referencia 30-100 UI/l). Se excluyeron aquellos con causas secundarias diagnosticadas y se analizaron los correlatos clínico y bioquímico. Se detectó hipofosfatasemia crónica persistente en 78 de 105.925, 0,07% (0,06-0,09) de los afiliados. Solo uno fue excluido por tener causa secundaria. Eran 61,1% mujeres de 44 (34-56) años, fosfatasa alcalina 24 (20-27) UI/L, fosfatemia 4,1 (3,8-4,6) mg/dl. Se observaron osteoartritis, calcificaciones vasculares y fracturas, menos frecuentemente litiasis renal, calcificación del ligamento longitudinal común anterior, pérdida dental y convulsiones. El 63,6% tenían al menos una de las características clínico-radiológicas evaluadas, pero en solo 5,2% fue mencionado el diagnóstico de hipofosfatasemia en la historia clínica. La densitometría evidenció algún grado de afección (osteopenia u osteoporosis) en 76,2%. Se constataron 19 fracturas, con predominio en radio. La prevalencia de hipofosfatasemia fue similar a lo previamente reportado. El reconocimiento fue bajo; sin embargo, se observaron variadas manifestaciones músculo-esqueléticas, similares a las descriptas en la hipofosfatasia del adulto, por lo cual ­ante una hipofosfatasemia sin causa secundaria­ se sugiere considerar este diagnóstico. (AU)


Low alkaline phosphatase (ALP) or hypophosphatasemia either due to genetic (hypophosphatasia) or secondary causes, presents a clinical correlate. Our objectives are to estimate the prevalence of persistent hypophosphatasemia and to describe the clinical findings. We performed a search using the electronic medical records of the members of the Hospital Italiano de Buenos Aires health care system, between 2013 and 2017. Adult members with ≥ 2 ALP ≤ 30 IU/l, no ALP >30 IU/l (normal range 30-100 UI/l) and without diagnosed secondary causes were analyzed. Persistent hypophosphatasemia was detected in 78 of 105.925, 0.07% (0.06-0.09) of members. Only one was excluded due to a secondary cause, 61.1% were women, 44 (34-56) year-old, ALP 24 (20-27) IU/l and phosphatemia 4.1 (3.8-4.6) mg/dl. Osteoarthritis, vascular calcifications and fractures were detected, and nephrolithiasis, DISH (Diffuse idiopathic skeletal hyperostosis), tooth loss, and seizures were less frequently observed. At least one of the mentioned characteristics were present in 63.6 %, but only 5.2% had hypophosphatasemia registered in their clinical record. Densitometry showed osteopenia or osteoporosis in 76.2%. There were 19 fractures, most of them in radius. The prevalence of hypophosphatasemia was similar to what has been previously reported. Hypophosphatasemia finding in medical records was low, but far from being asymptomatic, clinical manifestations were observed. In the presence of hypophosphatasemia without a secondary cause, adult hypophosphatasia should be uspected. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Músculo Esquelético/patologia , Hipofosfatasia/etiologia , Osteoporose/etiologia , Doenças Ósseas Metabólicas/etiologia , Densidade Óssea , Prevalência , Estudos Transversais , Hipofosfatemia/diagnóstico , Hipofosfatemia/etiologia , Difosfonatos/uso terapêutico , Fosfatase Alcalina/deficiência , Fosfatase Alcalina/fisiologia , Fosfatase Alcalina/sangue , Fraturas por Osteoporose/etiologia , Hipofosfatasia/diagnóstico , Hipofosfatasia/genética
9.
J Am Acad Orthop Surg ; 28(16): e716-e728, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32769720

RESUMO

Improvements in cancer treatment have led to prolonged survival and increased rates of cure. An estimated 14 million cancer survivors live in the United States. The cornerstones of cancer treatment, including radiation, chemotherapy, and surgery, give rise to a host of chronic health conditions, some of which affect the musculoskeletal system. As survivorship continues to improve, orthopaedic surgeons across all subspecialties will be tasked with managing these complications of treatment. This article reviews orthopaedic health concerns secondary to cancer treatment that are likely to present to orthopaedic surgeons for evaluation, such as osteoporosis, osteonecrosis, secondary malignancies, radiation-associated fractures, exercise tolerance, and perioperative evaluation.


Assuntos
Antineoplásicos/efeitos adversos , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/terapia , Neoplasias/terapia , Radioterapia/efeitos adversos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Sobreviventes de Câncer/estatística & dados numéricos , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/etiologia , Fraturas Ósseas/prevenção & controle , Fraturas Ósseas/terapia , Humanos , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/prevenção & controle , Neoplasias/complicações , Osteonecrose/diagnóstico , Osteonecrose/etiologia , Osteonecrose/prevenção & controle , Osteonecrose/terapia , Osteoporose/diagnóstico , Osteoporose/etiologia , Osteoporose/prevenção & controle , Osteoporose/terapia
10.
Curr Opin Endocrinol Diabetes Obes ; 27(4): 248-252, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32618637

RESUMO

PURPOSE OF REVIEW: An increase in awareness of vegetarian and vegan (plant-based) diets has brought forth numerous studies on their effects on health. The study of nutrition-based factors affecting bone health is difficult, given the length of time before clinical effects are evident. Furthermore, population-based studies must account for strong confounding influences as effects may be because of association, not causality. Yet, it is highly plausible that dietary factors affect bone remodeling in multiple ways. Plant-based diets may alter macronutrient and micronutrient balance, may cause differences in prebiotic and probiotic effects on gut microbiota, and may subtly change the inflammatory and immune response. RECENT FINDINGS: Several recent studies have looked at plant-based nutrition and markers of bone health, using measures such as bone turnover markers, bone mineral density, or fracture rates. Although population based and cross-sectional studies can be prone to confounding effects, a majority did not show differences in bone health between vegetarians/vegans and omnivores as long as calcium and vitamin D intake were adequate. A few prospective cohort or longitudinal studies even demonstrate some benefit to a plant-based diet, but this claim remains unproven. SUMMARY: There is no evidence that a plant-based diet, when carefully chosen to maintain adequate calcium and vitamin D levels, has any detrimental effects on bone health. Theoretical findings suggest a long-term plant-based diet may reduce the risk of osteoporosis, through mechanisms that are currently speculative.


Assuntos
Densidade Óssea/fisiologia , Osso e Ossos/fisiologia , Dieta Vegana , Dieta Vegetariana , Remodelação Óssea/fisiologia , Cálcio/sangue , Dieta Vegana/efeitos adversos , Dieta Vegana/estatística & dados numéricos , Dieta Vegetariana/efeitos adversos , Dieta Vegetariana/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/prevenção & controle , Humanos , Estado Nutricional/fisiologia , Osteoporose/epidemiologia , Osteoporose/etiologia , Osteoporose/prevenção & controle , Fatores de Risco , Vitamina D/sangue
11.
PLoS One ; 15(7): e0236891, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730332

RESUMO

Signal Transducer and Activator of Transcription 3 (STAT3) has recently been shown to be involved in bone development and has been implicated in bone diseases, such as Job's Syndrome. Bone growth and changes have been known for many years to differ between sexes with male bones tending to have higher bone mass than female bones and older females tending to lose bone mass at faster rates than older males. Previous studies using conditional knock mice with Stat3 specifically deleted from the osteoblasts showed both sexes exhibited decreased bone mineral density (BMD) and strength. Using the Cre-Lox system with Cathepsin K promotor driving Cre to target the deletion of the Stat3 gene in mature osteoclasts (STAT3-cKO mice), we observed that 8-week old STAT3-cKO female femurs exhibited significantly lower BMD and bone mineral content (BMC) compared to littermate control (CN) females. There were no differences in BMD and BMC observed between male knock-out and male CN femurs. However, micro-computed tomography (µCT) analysis showed that both male and female STAT3-cKO mice had significant decreases in bone volume/tissue volume (BV/TV). Bone histomorphometry analysis of the distal femur, further revealed a decrease in bone formation rate and mineralizing surface/bone surface (MS/BS) with a significant decrease in osteoclast surface in female, but not male, STAT3-cKO mice. Profiling gene expression in an osteoclastic cell line with a knockdown of STAT3 showed an upregulation of a number of genes that are directly regulated by estrogen receptors. These data collectively suggest that regulation of STAT3 differs in male and female osteoclasts and that inactivation of STAT3 in osteoclasts affects bone turnover more in females than males, demonstrating the complicated nature of STAT3 signaling pathways in osteoclastogenesis. Drugs targeting the STAT3 pathway may be used for treatment of diseases such as Job's Syndrome and osteoporosis.


Assuntos
Reabsorção Óssea/patologia , Osso e Ossos/patologia , Osteoclastos/patologia , Osteogênese , Osteoporose/patologia , Fator de Transcrição STAT3/fisiologia , Animais , Densidade Óssea , Remodelação Óssea , Reabsorção Óssea/etiologia , Osso e Ossos/metabolismo , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Osteoclastos/metabolismo , Osteoporose/etiologia
12.
PLoS One ; 15(7): e0235042, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639966

RESUMO

Poverty may be a barrier to acquiring adequate nutrient levels for the prevention of osteoporosis. Age and nutritional intake are major factors that contribute to osteoporosis prevalence. This study examined the relationship between markers of poverty with calcium / vitamin D intake and osteoporosis. A cross-sectional analysis of the United States population was performed using National Health and Nutrition Examination Survey (NHANES) data from 2007-2010 and 2013-2014 for older US adults (n = 3,901 participants, 50 years old and older). Odds of inadequate calcium / vitamin D intake and dietary supplement use and risk of probable osteoporosis were calculated in order to determine the relative difference and possible associations between household income, the Family Monthly Poverty Level Index, food security, and participation in the Supplemental Nutrition Assistance Program (SNAP). A sub-analysis of ethnic disparities and biological sex was also performed. In general, women age 50 and older consistently have inadequate calcium intake, regardless of economic level including poverty. While inadequate calcium intake has a larger prevalence among women, markers of poverty increased the risk of inadequate calcium intake in all men and risk of osteoporosis among some subgroups, with the exception of SNAP program participation. Over one fourth of Non-Hispanic black men in the US are below the poverty line. Approximately half of this population has inadequate calcium (58.9%) and vitamin D (46.7%) intake. Typically, osteoporosis risk is relatively low for Non-Hispanic Black males, however considering poverty status, risk is significantly increased (Relative Risk Ratio [RR]: 2.057 ± 0.012) for those with low income suggesting that calcium and vitamin D supplementation may be of benefit for this population.


Assuntos
Cálcio na Dieta , Estado Nutricional , Osteoporose/etiologia , Vitamina D , Cálcio na Dieta/uso terapêutico , Estudos Transversais , Suplementos Nutricionais , Feminino , Abastecimento de Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/prevenção & controle , Pobreza , Fatores de Risco , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico
13.
Curr Opin Crit Care ; 26(4): 379-385, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32520810

RESUMO

PURPOSE OF REVIEW: There is growing evidence that bone health is impacted during and after critical illness in multiple ways. In this review, we provide a practical update on postcritical care bone loss with an insight on identification of persons at risk, prevention and treatment strategies. RECENT FINDINGS: Critical illness is associated with an increase in bone turnover and with an uncoupling between bone resorption and bone formation. This results in loss of bone mass, as highlighted by changes in bone marker serum levels and in bone mineral density. Data suggest that ICU survivors are at an increased risk of bone fractures, but this is not completely quantifiable. A key driving factor for ICU-related bone loss, beside inflammation, undernutrition and vitamin D deficiency, is immobilization. Bone health and muscle health are closely related, through myokines and osteokines. Even if not completely proven in the context of critical care, it is likely that preserving muscle mass and strength helps reducing bone loss. SUMMARY: A history of critical illness should be considered as a strong risk factor for osteopenia and osteoporosis. ICU-related bone loss should be part of the postintensive care syndrome, and should be targeted by prevention and treatment strategies. Optimized and individualized protein and micronutrient provision (with specific attention to calcium, vitamin D and selenium), associated with physiotherapy and muscle training, should be implemented early after ICU admission and continued after ICU discharge. Antiresorptive agents such as biphosphonates should be considered on an individualized basis.


Assuntos
Estado Terminal , Fraturas Ósseas , Osteoporose , Densidade Óssea , Cuidados Críticos , Fraturas Ósseas/etiologia , Humanos , Osteoporose/etiologia
15.
Arch Osteoporos ; 15(1): 94, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32583122

RESUMO

INTRODUCTION: The pregnancy and lactation-associated osteoporosis (PLO) is a rare disease whose precise pathophysiological mechanisms remain mostly unknown. CASE REPORT: We reported here a case of PLO that occurred in the early postpartum period and led to multiple compression fractures. Combination therapy with alendronate, calcium carbonate, and vitamin D was used to treat the patient and a marked but gradual increase in the density of bone mineral was observed. Moreover, no further fractures have occurred. CONCLUSION: PLO is a very rare type of osteoporosis associated with severe chronic back pain. Increased bone resorption significantly increases the risk of bone fractures in women with PLO. Early diagnosis, stopping breastfeeding, treatment of calcium and vitamin D, bisphosphonates, or other antiosteoporosis medicine and regular follow-ups of these cases are particularly important in the prevention of fractures and to increase the quality of life of patients.


Assuntos
Lactação , Osteoporose/diagnóstico , Osteoporose/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Adulto , Alendronato/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/uso terapêutico , Carbonato de Cálcio/uso terapêutico , Quimioterapia Combinada , Feminino , Fraturas por Compressão/etiologia , Humanos , Osteoporose/etiologia , Gravidez , Qualidade de Vida , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico
16.
Internist (Berl) ; 61(6): 549-557, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32377774

RESUMO

Testosterone is a natural hormone which is essential to maintaining physical and emotional wellbeing in men, regardless of age. Male hypogonadism is an endocrine condition of testosterone deficiency with the potential to cause multiple morbidities and psychosocial problems. The condition can be of primary (testicular), secondary (hypothalamic-pituitary) or so-called functional origin (as a result of inflammatory conditions, obesity or chronic illness). Testosterone deficiency can cause symptoms of a sexual nature, foster metabolic dysfunction and impair physical abilities as well as cause osteopenia/osteoporosis and anemia. Testosterone replacement therapy should not be initiated in the case of desired paternity, unclear processes of the prostate or mammary gland and high hematocrit. Diagnosis and treatment as well as monitoring of hypogonadism treatment are clearly regulated by international guidelines and replacement therapy is proven to be effective in ameliorating the above-mentioned symptoms when performed according to these guidelines. In functional hypogonadism, which is most often, but not exclusively, found in older men, treatment of the underlying condition/co-morbidity is mandatory prior to starting testosterone substitution.


Assuntos
Androgênios/uso terapêutico , Terapia de Reposição Hormonal , Hipogonadismo/tratamento farmacológico , Osteoporose/prevenção & controle , Testosterona/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Androgênios/administração & dosagem , Disfunção Erétil/etiologia , Humanos , Hipogonadismo/diagnóstico , Hipogonadismo/etiologia , Masculino , Obesidade , Osteoporose/etiologia , Testosterona/administração & dosagem , Testosterona/efeitos adversos
17.
Sci Rep ; 10(1): 7786, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32385316

RESUMO

Patients with ß-thalassemia have an increased risk of developing chronic kidney disease which is associated with osteoporosis and periodontitis. The purpose of this study was to evaluate mandibular and femoral bone change in heterozygous ß-globin knockout (BKO) mice following 5/6 nephrectomy (Nx). Female and male BKO mouse blood smears demonstrated microcytic hypochromic anemia. Serum urea nitrogen, creatinine, calcium, and phosphorus levels were not changed in BKO mice. Nx increased the serum levels of urea nitrogen in both wild type (WT) and BKO mice and the level was much higher in BKO males. Serum level of creatinine was increased in Nx WT but not BKO mice. However, serum calcium and phosphorus levels were not altered. Nx induced comparable renal fibrosis in BKO mice and WT controls. Bone loss was observed in mandibular cancellous bone but not cortical bone of both male and female BKO mice. Nx decreased cancellous bone volume and cortical thickness in WT. Interestingly, BKO mice were resistant to Nx-induced cancellous bone loss. However, cortical thickness and cortical bone mineral density were reduced in Nx male BKO mice. Nx increased mRNA levels of type I collagen, Osx and Trap in WT but not BKO mice. Similarly, Nx reduced cancellous bone volume in femurs and increased osteoblast number and osteoclast number in WT not BKO mice. Serum FGF23 and erythropoietin levels were markedly increased in BKO mice. Nx decreased serum erythropoietin but not FGF23 levels. Since WT treated with erythropoietin exhibited a significant reduction in cancellous bone volume, it was possible that lower level of erythropoietin in Nx BKO mice prevented the Nx-induced cancellous bone loss.


Assuntos
Osso Esponjoso/patologia , Nefrectomia/efeitos adversos , Osteoporose/etiologia , Osteoporose/patologia , Talassemia/complicações , Animais , Biomarcadores , Densidade Óssea , Osso Esponjoso/diagnóstico por imagem , Osso Esponjoso/metabolismo , Modelos Animais de Doenças , Eritrócitos/metabolismo , Eritrócitos/patologia , Fêmur , Fibrose , Nefropatias/etiologia , Nefropatias/metabolismo , Nefropatias/patologia , Camundongos , Camundongos Knockout , Nitrogênio/urina , Osteoblastos/metabolismo , Osteoclastos/metabolismo , Osteoporose/metabolismo , Microtomografia por Raio-X , Talassemia beta/sangue , Talassemia beta/complicações , Talassemia beta/diagnóstico , Talassemia beta/genética
18.
Ann Hematol ; 99(8): 1873-1882, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32451708

RESUMO

Bone turnover markers (BTMs) are useful parameters for assessing fracture risk and unlike bone mineral density (BMD), can be measured at any institution. However, BTM values have not been established in patients post-allogeneic hematopoietic stem cell transplantation (allo-HSCT). We investigated the practicality of BTMs in patients who underwent allo-HSCT by measuring levels of the serum bone resorption marker, tartrate-resistant acid phosphatase-5b (TRACP-5b), and the bone formation marker, bone-specific alkaline phosphatase (BAP), together with BMD, 1 month before and 6 months after allo-HSCT. Patients were classified into either the alendronate group (n = 14) if alendronate treatment (35 mg orally per week) was administered before allo-HSCT or within 1 month after allo-HSCT, or the control group (n = 16), in which patients did not receive alendronate treatment. Despite the high frequency of corticosteroids users in the alendronate group (71.4 vs. 18.9%; p < 0.01), the mean percentage changes in BMD at the lumbar spine (- 2.9 vs. - 3.1%; p = 0.44) and femoral neck (- 3.2 vs. - 4.1%; p = 1.00), TRACP-5b levels (- 4.8 vs. 9.9%; p = 0.45), and BAP levels (6.9 vs. 1.0%; p = 0.85) during 6 months did not differ significantly between the alendronate and control groups. Additionally, the percentage changes in BMD at the lumbar spine were negatively associated with the TRACP-5b levels 6 months after allo-HSCT (p = 0.03, r = 0.40). Our results indicate the possible effectiveness of alendronate treatment in allo-HSCT patients. BTM levels could be useful to monitor the BMD changes.


Assuntos
Fosfatase Alcalina/sangue , Densidade Óssea , Remodelação Óssea , Transplante de Células-Tronco Hematopoéticas , Osteoporose/sangue , Fosfatase Ácida Resistente a Tartarato/sangue , Adulto , Idoso , Alendronato/administração & dosagem , Aloenxertos , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/tratamento farmacológico , Osteoporose/etiologia
19.
Zhongguo Gu Shang ; 33(4): 356-62, 2020 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-32351091

RESUMO

OBJECTIVE: To establish and evaluate the model of chronic obstructive pulmonary disease (COPD) with osteoporosis induced by elastase in mice. METHODS: Twenty four healthy female 8-week-old C57BL / 6 mice (weighing about 18 g) were randomly divided into three groups. The control group was given intratracheal drip of normal saline, the experimental group 1 and the experimental group 2 were given intratracheal drip of elastase, the control group and the experimental group 1 were kept for 8 weeks and then killed, the experimental group 2 was kept for 12 weeks and then killed. HE staining was used to evaluate the histopathological changes of lung and tibia in the control and experimental groups. The levels of serum inflammatory factors and broncho alveolar lavage factors (BALF) were detected by ELISA. Micro CT was used to detect the bone mass related parameters of mouse femur. The expression of osteoclastic and osteogenic genes was detected by real-time fluorescence quantitative PCR. RESULTS: Lung histopathology showed that the structure of alveoli in the experimental group was disordered, the walls of alveoli became thin or broken, and the alveoli cavity expanded. IL-6 and TNF-α in BALF were significantly higher than those in control group (P<0.001), while IL-1ß and TNF-α in serum inflammatory factors were significantly higher than those in control group (P<0.001). BV / TV(bone volume fraction), TB.Th(average bone trabecular thickness) and TB.N(average bone trabecular number) in the experimental group were significantly lower than those in the control group (P<0.05), TB.Sp (average bone trabecular separation) and BS / BV (bone surface area fraction) in the experimental group were significantly higher than those in the control group (P<0.01). Compared with the control group, the expression of osteoclast related marker genes increased in the experimental group (P<0.05), but decreased in the experimental group(P<0.05). The results of experiment 1 and experiment 2 were time-dependent. CONCLUSION: In this study, elastase was used to construct a COPD model with osteoporosis successfully, which provides a suitable animal model for the future study of the pathogenesis of COPD with osteoporosis.


Assuntos
Osteoporose , Doença Pulmonar Obstrutiva Crônica , Animais , Densidade Óssea , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Osteoporose/etiologia , Elastase Pancreática , Doença Pulmonar Obstrutiva Crônica/complicações
20.
Nutrients ; 12(4)2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32252359

RESUMO

Chronic stress and low-grade chronic inflammation (LGCI) are key underlying factors formany diseases, including bone and body composition impairments. Objectives of this narrativereview were to examine the mechanisms by which chronic stress and LGCI may influenceosteosarcopenic adiposity (OSA) syndrome, originally named as ostoesarcopenic obesity (OSO).We also examined the crucial nutrients presumed to be affected by or cause of stress andinflammation and compared/contrasted them to those of our prehistoric ancestors. The evidenceshows that stress (particularly chronic) and its related inflammatory processes, contribute toosteoporosis, sarcopenia, and adiposity ultimately leading to OSA as a final and most derangedstate of body composition, commencing at the mesenchymal cell lineage disturbance. Thefoods/nutrients consumed by modern humans, as well as their altered lifestyle, also contribute tostress, LGCI and subsequently to OSA. The processes can also go in opposite direction when stressand inflammation impact nutritional status, particularly some micronutrients' levels. Whilenutritional management of body composition and LGCI have been studied, the nutrients (and theirquantities) most affected by stressors and those which may act toward the alleviation of stressfulstate, ultimately leading to better body composition outcomes, need to be elucidated.


Assuntos
Composição Corporal , Dieta , Sarcopenia/etiologia , Estresse Fisiológico/imunologia , Doença Crônica , Humanos , Inflamação , Estilo de Vida , Obesidade/etiologia , Osteoporose/etiologia
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