Osteotropic β-cyclodextrin for local bone regeneration

Alendronate is an aminobisphosphonate that inhibits bone resorption in osteoporotic humans and rats but does not induce osteomalacia. Several bisphosphonates, including alendronate, also have direct positive actions on osteoblasts, bone formation, and mineralization. We studied the effects of alendronate on skeletal development in adolescent male rats during chronic alcohol intake. Four groups of age- and weight-matched male Sprague-Dawley rats (35 days of age) were fed the Lieber-DeCarli diet containing 36% of calories as EtOH (E), the EtOH diet plus 60 mg/kg alendronate (EA) every other day intraperitoneally (ip), an isocaloric diet (I), or the isocaloric diet plus 60 mg/kg alendronate (IA) every other day ip. Body weight, femur length, serum levels of osteocalcin (OC), insulin-like growth factor 1 (IGF-1), testosterone, and luteinizing hormone (LH); femur distal metaphyseal and middiaphyseal bone mineral density (BMD) and tibial metaphyseal gene expression for alpha-1-type I collagen (Col I), OC, and bone alkaline phosphatase (AP); and femur strength by four-point bending to failure were measured after 28 days of feeding and alendronate injections. Serum alcohol levels at death were 156 +/- 13 mg/dl (E) and 203 +/- 40 mg/dl (EA). Alendronate given to alcohol-fed rats increased metaphyseal BMD by more than 3-fold over rats fed alcohol alone. Alendronate given to isocaloric pair-fed rats increased metaphyseal BMD by more than 2.5-fold over rats fed the isocaloric diet alone. Cortical BMD was reduced by alcohol but was increased by alendronate. Alcohol consumption reduced serum IGF-1 levels, and alendronate increased IGF-1 levels in alcohol-fed rats. Serum OC, testosterone, and LH were unaffected by alcohol and alendronate. Quantitative dot blot hybridization using rat complementary DNA (cDNA) probes and normalization against 18S subunit ribosomal RNA (rRNA) levels revealed no changes in tibial metaphyseal gene expression for type I collagen, osteocalcin, or alkaline phosphatase. Alcohol significantly reduced the biomechanical properties of the femurs that were partially compensated by alendronate. Chronic alcohol consumption uncouples formation from ongoing resorption, and resorption is inhibited by alendronate. However, alendronate's positive effects on osteoblast-mediated mineralization during chronic alcohol consumption point to the potential use of bisphosphonates in the treatment of decreased bone formation secondary to alcohol-induced diminished osteoblast function.

SUMMARYAnthrax, an uncommon disease in humans, is caused by a large bacterium, Bacillus anthracis. The risk of inhalation infection is the main indication for anthrax vaccination. Pre-exposure vaccination is provided by an acellular vaccine (anthrax vaccine adsorbed or AVA), which contains anthrax toxin elements and results in protective immunity after 3 to 6 doses. Anthrax vaccine precipitated (AVP) is administered at primovaccination in 3 doses with a booster dose after 6 months. To evoke and maintain protective immunity, it is necessary to administer a booster dose once at 12 months. In Russia, live spore vaccine (STI) has been used in a two-dose schedule. Current anthrax vaccines show considerable local and general reactogenicity (erythema, induration, soreness, fever). Serious adverse reactions occur in about 1% of vaccinations. New second-generation vaccines in current research programs include recombinant live vaccines and recombinant sub-unit vaccines.

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The single crystals of a binary organic 1:1 molecular complex were grown from different solvents. The single crystal x-ray diffraction study revealed that the binary material has crystallized with a noncentrosymmetric space group (P21) entirely different from that of the parent components. Second harmonic generation measurement on polycrystalline material shows green light emission with the molecular complex. The differential scanning calorimeter and the thermogravimetric analysis show eminent higher melting point and decomposition temperature, respectively for the binary molecular complex compared to that of urea and m-nitrobenzoic acid. The optical spectrum of newly grown crystal shows the cutoff wavelength (398 nm) near the UV region, and the micro hardness measurement confirmed the greater hardness of the binary crystal.

The phase diagrams of the binary systems of picric acid with naphthalene, anthracene and phenanthrene, and of α-naphthol withp-toluidine, determined by the thaw-melt method, show the formation of a molecular complex and two eutectics in each system. The heats of the pure components, eutectics and molecular complexes were determined by differential scanning calorimetry. Comparison of the experimental heats of fusion with the theoretical values calculated via the mixture law suggests cluster formation in the melts. The entropy of fusion, enthalpy of mixing and excess thermodynamic functions were also calculated from the heat of fusion data.

Effect of Systemic Oxytocin Administration on the Healing of Mandibular Fractures.

Dietary protein content and the diet’s net acid load: opposing effects on bone health

Recovery of bone loss is one of the active research issues in bone medicine due to the need for efficient measures for bone gain. We examined here a novel drug delivery system using a nanogel of cholesterol-bearing pullulan (CHP) in combination with prostaglandin E2 (PGE2). PGE2 or PGE2/CHP, vehicle (saline containing 0.06% ethanol and 0.02% Tween 80) or CHP were injected on to the calvariae of mice once every day for 5 days per week for 4 weeks. Low dosage of PGE2 (0.6 microg) alone or CHP alone did not induce new bone formation in this system. In contrast, PGE2 (0.6 microg)/CHP induced new bone formation. Bone formation activities of PGE2 was enhanced by CHP nanogels only at the site of injection (calvaria) but not in the distant sites of the skeleton, showing that PGE2/CHP could avoid systemic effects. In spite of the fact that previously reported animal models of bone formation by PGE2 were associated with loss of body weight, bone formation based on PGE2/CHP did not associate with loss of body weight. Furthermore, only a single application of PGE2 in combination with nanogel cross-linking hydrogel sphere (PGE2/CHP-PEO) induced new bone formation. Thus, nanogel-based delivery system is an efficient delivery system of bone anabolic agent, PGE2.

Analysis of the bone fracture targeting properties of osteotropic ligands

Grafting β-tricalcium phosphate (TCP) is a well-established method for restoring bone defects; however, there is concern that the mechanical stability of the grafted β-TCP is not maintained during bone translation. Teriparatide has an anabolic effect, stimulating bone formation and increasing bone mineral density for the treatment of osteoporosis. The aim of the present study was to evaluate the effect of intermittent teriparatide treatment on changes in bone grafted with β-TCP using a rabbit bone defect model. Bone defects (5×15 mm) were created in the distal femoral condyle of Japanese white rabbits, and β-TCP granules of two different total porosities were manually grafted. Teriparatide (40 µg/kg) or 0.2% rabbit serum albumin solution as a vehicle control was subcutaneously injected three times per week following the surgery. At 4 or 8 weeks post-surgery, serum samples were obtained and the levels of γ-carboxylated osteocalcin (Gla-OC) were quantified using ELISA. Histomorphometry was also performed using sections of graft sites following staining for tartrate resistant acid phosphatase. Activity and mechanical strength (maximum shear strength, maximum shear stiffness and total energy absorption) were evaluated using an axial push-out load to failure test. Teriparatide treatment significantly increased (P<0.05) the serum levels of Gla-OC, a specific marker for bone formation, suggesting that teriparatide enhances bone formation in β-TCP-grafted rabbits. Furthermore teriparatide increased the degradation of β-TCP by bone remodeling (P<0.05) and promoted the formation of new bone following application of the graft compared with the control group (P<0.01). Furthermore, teriparatide suppressed the reduction in mechanical strength (P<0.05) during bone translation in bone defects grafted with β-TCP. The results of the present study demonstrate that teriparatide is effective in maintaining the mechanical stability of grafted β-TCP, possibly by promoting new bone formation.

We previously described a new osteogenic growth factor, osteolectin/Clec11a, which is required for the maintenance of skeletal bone mass during adulthood. Osteolectin binds to Integrin α11 (Itga11), promoting Wnt pathway activation and osteogenic differentiation by leptin receptor+ (LepR+) stromal cells in the bone marrow. Parathyroid hormone (PTH) and sclerostin inhibitor (SOSTi) are bone anabolic agents that are administered to patients with osteoporosis. Here we tested whether osteolectin mediates the effects of PTH or SOSTi on bone formation. We discovered that PTH promoted Osteolectin expression by bone marrow stromal cells within hours of administration and that PTH treatment increased serum osteolectin levels in mice and humans. Osteolectin deficiency in mice attenuated Wnt pathway activation by PTH in bone marrow stromal cells and reduced the osteogenic response to PTH in vitro and in vivo. In contrast, SOSTi did not affect serum osteolectin levels and osteolectin was not required for SOSTi-induced bone formation. Combined administration of osteolectin and PTH, but not osteolectin and SOSTi, additively increased bone volume. PTH thus promotes osteolectin expression and osteolectin mediates part of the effect of PTH on bone formation.

Disclosure: S. Marino: None. N. Akel: None. S. Li: None. M. Cregor: None. B. Perez: None. G. Troncoso: None. J. Meeks: None. S. Stuart: None. A. Sato: None. I. Nookaew: None. T. Bellido: None. Treatments for skeletal fragility in diabetes are sorely needed as antiresorptive agents, the current standard of care, stop bone loss but do not rebuild bone nor restore the deteriorated bone microarchitecture. Herein, we demonstrate bone restoration in a preclinical model of established diabetes by two bone anabolic pathways: activation of the PTH1 receptor, with equimolar doses of either PTH (1-34) or Abaloparatide/ABL (100/95 µg/kg/day), and neutralization of the osteocyte-derived inhibitor of bone formation sclerostin with romosozumab/Scl-Ab (100mg/kg/w). Type 2 diabetes (T2D) was induced in skeletally mature male C57BL/6J mice by high fat diet combined with streptozotocin; and, after established diabetes, mice were treated for 4 weeks with the bone anabolic agents. At the end of the study, T2D mice exhibited decreased total (−5%), femoral (−7%) and spinal (−11%) BMD vs nondiabetic mice. PTH/ABL restored the bone lost and increased BMD to a similar extent: total 8%, femoral 11% and spinal 9% vs vehicle-treated T2D mice. Scl-Ab also increased BMD at all sites, but the effects were superior: total 24%, femoral 26%, and spinal 40%. T2D mice exhibited low bone formation (BF) and high bone resorption (BR) circulating markers throughout the disease progression. However, at the tissue level BF and BR were suppressed as evidenced by histomorphometric indexes (BFR −70%; Oc.S/BS -34%) and bone transcriptome GO profiles. PTH/ABL increased BF (BFR ∼700% and P1NP 130/244%) as well as BR (Oc.S/BS unchanged/34%; TRAP5b ∼200%) and corrected the diabetic low bone remodeling signature towards high bone remodeling with bone gain. In contrast, Scl-Ab increased formation (BFR 500% and P1NP 50%) but drastically decreased resorption (TRAP5b −190% and Oc.S/BS −500%). T2D mice exhibited damaged bone microarchitecture. The reduced femoral and spinal cancellous bone BV/TV (−22 and −10%) was corrected by ABL (40 and 42%), Scl-Ab (130 and 83%), and PTH only in the spine (43%). Further, femoral and spinal trabecular thickness were increased equally by PTH/ABL (35 and 24%) and also by Scl-Ab (60 and 66%). Moreover, the decreased cortical thickness (−7%) and BA/TA (−5%) at the femoral mid-diaphysis of T2D mice were corrected and further increased by PTH/ABL (10 and 11%) and Scl-Ab (23 and 19%). Yet, whereas PTH reduced marrow area, ABL increased tissue area TA, and Scl-Ab exerted both effects, resulting in advantageous bone distribution by ABL and Scl-Ab leading to increased energy to ultimate load (60 and 90%) and toughness (50 and 82%). Nevertheless, all agents corrected the low stiffness of T2D bone (-19%) and also increased ultimate load. These findings demonstrate the therapeutic value of bone anabolic agents to treat diabetes-induced bone disease by increasing bone formation and improving bone microarchitecture and show the benefit of simultaneously inhibiting resorption to achieve superior bone gain and strength. Presentation: Thursday, June 15, 2023

RETRACTED: Pretreatment with flurbiprofen axetil, flurbiprofen axetil preceded by venous occlusion, and a mixture of flurbiprofen axetil and propofol in reducing pain on injection of propofol in adult Japanese surgical patients: A prospective, randomized, double-blind, placebo-controlled study

Eldecalcitol (ELD), an active form of vitamin D analog approved for the treatment of osteoporosis in Japan, increases lumbar spine bone mineral density (BMD), suppresses bone turnover markers, and reduces fracture risk in patients with osteoporosis. We have previously reported that treatment with ELD for 6months improved the mechanical properties of the lumbar spine in ovariectomized (OVX) cynomolgus monkeys. ELD treatment increased lumbar BMD, suppressed bone turnover markers, and reduced histomorphometric parameters of both bone formation and resorption in vertebral trabecular bone. In this study, we elucidated the effects of ELD on bone quality (namely, mineralization, microarchitecture, microdamage, and bone collagen crosslinks) in OVX cynomolgus monkeys in comparison with OVX-vehicle control monkeys. Density fractionation of bone powder prepared from lumbar vertebrae revealed that ELD treatment shifted the distribution profile of bone mineralization to a higher density, and backscattered electron microscopic imaging showed improved trabecular bone connectivity in the ELD-treated groups. Higher doses of ELD more significantly reduced the amount of microdamage compared to OVX-vehicle controls. The fractionated bone powder samples were divided according to their density, and analyzed for collagen crosslinks. Enzymatic crosslinks were higher in both the high-density (≥2.0mg/mL) and low-density (<2.0mg/mL) fractions from the ELD-treated groups than in the corresponding fractions in the OVX-vehicle control groups. On the other hand, non-enzymatic crosslinks were lower in both the high- and low-density fractions. These observations indicated that ELD treatment stimulated the enzymatic reaction of collagen crosslinks and bone mineralization, but prevented non-enzymatic reaction of collagen crosslinks and accumulation of bone microdamage. Bone anti-resorptive agents such as bisphosphonates slow down bone remodeling so that bone mineralization, bone microdamage, and non-enzymatic collagen crosslinks all increase. Bone anabolic agents such as parathyroid hormone decrease bone mineralization and bone microdamage by stimulating bone remodeling. ELD did not fit into either category. Histological analysis indicated that the ELD treatment strongly suppressed bone resorption by reducing the number of osteoclasts, while also stimulating focal bone formation without prior bone resorption (bone minimodeling). These bidirectional activities of ELD may account for its unique effects on bone quality.

Odanacatib (ODN) is a bone resorption inhibitor which differs from standard antiresorptives by its ability to reduce bone resorption without decreasing bone formation. What is the reason for this difference? In contrast with other antiresorptives, such as alendronate (ALN), ODN targets only the very last step of the resorption process. We hypothesize that ODN may therefore modify the remodeling events immediately following osteoclastic resorption. These events belong to the reversal phase and include recruitment of osteoblasts, which is critical for connecting bone resorption to formation. We performed a histomorphometric study of trabecular remodeling in vertebrae of estrogen-deficient rabbits treated or not with ODN or ALN, a model where ODN, but not ALN, was previously shown to preserve bone formation. In line with our hypothesis, we found that ODN treatment compared to ALN results in a shorter reversal phase, faster initiation of osteoid deposition on the eroded surfaces, and higher osteoblast recruitment. The latter is reflected by higher densities of mature bone forming osteoblasts and an increased subpopulation of cuboidal osteoblasts. Furthermore, we found an increase in the interface between osteoclasts and surrounding osteoblast-lineage cells. This increase is expected to favor the osteoclast–osteoblast interactions required for bone formation. Regarding bone resorption itself, we show that ODN, but not ALN, treatment results in shallower resorption lacunae, a geometry favoring bone stiffness. We conclude that, compared to standard antiresorptives, ODN shows distinctive effects on resorption geometry and on reversal phase activities which positively affect osteoblast recruitment and may therefore favor bone formation.