Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This work aimed the development of polymeric microparticles containing sodium risedronate from Eudragit S100® (MP-EUD) and the blend, Eudragit S100® and Pullulan (MP-EUD-PUL), through spray-drying technique. MP-EUD were obtained with a yield of 54%, encapsulation efficiency of 90%, average particle size of 3.3 μm and presented spherical shape. The moisture content was 8% and the Carr Index and Hausner Factor indicated poor flowability. At pH 1.2 23% risedronate sodium was released after 120 min, while the drug at pH 6.8 took 90 min to reach 99.5%. The mathematical modeling showed that the drug release followed first order kinetics and Fickian diffusion. Tablets prepared by direct compression of MP-EUD using different polyvinylpirrolidone concentrations showed low weight variation, thickness and drug content. Furthermore, they presented low friability and adequate hardness. In vitro studies indicated that no more than 16% of the drug was released in 120 min at pH 1.2. At pH 6.8 the risedronate release was prolonged for 270 min and folowed first order kinetics and Fickian diffusion. Concerning MP-EUD-PUL, three proportions of Eudragit S100® and Pullulan (1:2, 1:1 and 2:1) were studied. Microparticles were obtained with yields ranging from 31% to 42%, encapsulation efficiencies close to 100%, moisture contents lower than 11%, mean particle size in the range of 2.9 μm - 4.8 μm and narrow size distributions. Carr index and Hausner ratio indicated poor flowability. In gastric simulated fluid the microparticles prepared with the highest amount of Eudragit S100® showed the best gastroresistance. In intestinal simulated fluid blend microparticles were able to prolong the drug release. MP-EUD-PUL 2:1 were compressed into tablets with or without a binder. Both tableted microparticles could be obtained with acceptable average weights, drug content close to 100%, sufficient hardness and low friability. In vitro studies showed that tablets maintained the gastroresistance observed for untableted microparticles and were also able to prolong risedronate release. Finally, the formulations developed in this study represent promising alternatives for sodium risedronate oral delivery. / Este trabalho objetivou o desenvolvimento de micropartículas poliméricas contendo risedronato de sódio a partir de Eudragit S100® (MP-EUD) e da blenda, Eudragit S100® e Pullulan (MP-EUD-PUL), através da técnica de secagem por aspersão. As MP-EUD foram obtidas com um rendimento de 54%, eficiência de encapsulamento de 90%, tamanho médio de partícula de 3,3 μm e apresentaram formato esférico. O teor de umidade foi de 8%, o Índice de Carr e o Fator de Hausner indicaram baixa fluidez. Em pH 1,2, 23% do risedronato de sódio foi liberado em 120 min, enquanto que em pH 6,8 o fármaco levou 90 min para ser liberado. A modelagem matemática mostrou que a liberação do fármaco seguiu cinética de primeira ordem e se deu por difusão Fickiana. Comprimidos preparados pela compressão direta das MP-EUD a partir de diferentes concentrações de polivinilpirrolidona apresentaram baixas variações de peso médio, espessura e teor de fármaco. Além disso, apresentaram baixa friabilidade e dureza adequada. Os estudos in vitro mostraram que não mais que 16% do fármaco foi liberado durante 120 min em pH 1,2 enquanto que em pH 6,8 a liberação do fármaco foi prolongada por 270 min, seguindo cinética de primeira ordem e difusão Fickiana. Com relação às MP-EUD-PUL, três proporções de Eudragit S100® e Pullulan (1:2, 1:1 e 2:1) foram estudadas. As micropartículas foram obtidas com rendimento variando entre 31% e 42%, com eficiência de encapsulamento próxima de 100% e umidade abaixo de 11%. O tamanho médio de partícula variou entre 2,9 μm e 4,8 μm com estreita distribuição de tamanho. O Índice de Carr e o Fator de Hausner indicaram baixa fluidez. Em meio gástrico simulado, as micropartículas com maior proporção de Eudragit S100® apresentaram melhor perfil de gastrorresistência, enquanto que em meio intestinal simulado todas foram capazes de prolongar a liberação do fármaco. As MP-EUD-PUL 2:1 sofreram compressão direta na ausência ou na presença de polivilpirrolidona. Os comprimidos microparticulados apresentaram pesos médios aceitáveis, teor de fármaco próximo a 100%, dureza e friabilidade dentro do especificado. Os estudos in vitro mostraram que a gastrorresistência foi mantida e que os comprimidos microparticulados também foram capazes de prolongar a liberação do risedronato. Finalmente, as formulações desenvolvidas neste estudo representam alternativas promissoras para a administração oral do risedronato de sódio.

Made available in DSpace on 2014-06-11T19:27:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-07-14Bitstream added on 2014-06-13T20:57:16Z : No. of bitstreams: 1 rosa_ja_me_sjc.pdf: 1222507 bytes, checksum: 8e280a155a6be944b9cf5f3745c13964 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Esta pesquisa avaliou o efeito do uso local do residronato de sódio, em diferentes concentrações molares, no processo de reparação de defeitos ósseos em fêmures de ratas. Foi confeccionado no fêmur de 60 ratas um defeito ósseo medindo 2,5 mm de diâmetro. Estes animais foram divididos em grupos: controle (C), amido (Am), residronato 0,25 mol (Res 0,25), residronato 0,5 mol (Res 0,50), residronato 0,75 mol (Res 0,75) e residronato 1 mol (Res 1), de acordo com o material de preenchimento utilizado. Nos animais do grupo controle o defeito ficou preenchido apenas pelo coágulo. Os animais foram eutanasiados aos sete e 21 dias, e o fêmur foi removido, fixado e descalcificado, para a confecção de lâminas histológicas. Foram realizadas análises histológica e histomorfométrica, e os dados obtidos foram submetidos à análise estatística ANOVA. Histologicamente, as principais diferenças ocorreram após 21 dias. Os grupos C e Am apresentaram fechamento em extensão do defeito ósseo em todos os espécimes e a maioria dos animais dos grupos tratados com residronato em diferentes concentrações molares não exibiu neoformação óssea na região central do defeito, permanecendo este preenchido por tecido conjuntivo. Nos períodos de sete e 21 dias não houve diferença estatística significante entre os grupos C e Am em relação a neoformação óssea. Estatisticamente, não houve diferença entre os grupos Res 0,25; Res 0,50; Res 0,75 e Res 1 no período de sete dias. Já no período de 21 dias o grupo Res 0,25 apresentou a maior média, mas não diferiu estatisticamente do grupo Res 0,75. Concluiu-se que o residronato de sódio em todas as concentrações molares, prejudicou a reparação óssea nesse modelo experimental. No entanto, foi observada uma neoformação óssea extra-cortical subperiosteal nos grupos que receberam residronato. / This work evaluated the action of sodium residronate, in different molars concentrations, in the repair of bone defects in femurs of rats. A bone defect measuring 2,5 mm in diameter was made in the femur of 60 rats. These animals were divided in groups: control (C), starch (Am), residronate 0,25 mol (Res 0,25), residronate 0,50 mol (Res 0,50), residronate 0,75 mol (Res 0,75), residronate 1 mol (Res 1), in accordance with the material of fill used. In the animals of the control group, the defect was just filled by the clot originating from the defect. The animals were euthanized at seven and 21 days, when the femur was removed, fixed and decalcified, to make histologicals laminae. Histological and histomorphometric analyses were performed and the results obtained were submitted to statistical analysis ANOVA. Histologically, the principal differences occurred after 21 days. The groups C and Am, showed an extension closure of bone defect in every specimen and most animals in groups treated with residronate in different molar concentrations did not show bone neoformation in the central region of the bone defects, which remained filled with connective tissue. After seven and 21 days, there was no significant statistical difference among groups C and Am in relation to bone neoformation. Statistically, there were no differences among the groups Res 0,25; Res 0,50; Res 0,75 e Res 1 in the period of seven days. In the period of 21 days, the group Res 0,25 had the highest average, but did not differ statistically from the Res 0,75. It was concluded that the sodium residronate in all the molar concentrations, harmed the bone repair in this experimental model. However, there was an extracortical subperiosteal bone neoformation in groups receiving residronate.

Made available in DSpace on 2015-03-26T13:46:54Z (GMT). No. of bitstreams: 1 texto completo.pdf: 3782291 bytes, checksum: 1fd6b4960573907eb1e0994ff35f7166 (MD5) Previous issue date: 2010-11-25 / This work was in an assay to study the possible treatment of osteoporosis induced by ovariectomy through the use of isolated and combined, using, in this case, half the doses of the compounds isolated etidronate, risedronate, pravastatin, and ipriflavone, which are agents that have shown positive effects on bone metabolism. Wistar rats, adult, weighing on average 250g were used. The process of induction of osteoporosis was made by surgery when the animals were 5 months old, for retroumbilical incision, giving access to the abdominal cavity under general anesthesia using the combination of ketamine and xylazine at doses of 50 and 5 mg / Kg , respectively, except for animals that constituted the control group (G1). After 12 weeks, was started to drug treatment. The animals were randomly divided into 11 experimental groups, with groups consisting of 6 animals. Group 1 (G1), control, consisted of animals that did not undergo surgery or treatment. In group 2 (G2) there was only surgery. The other groups, besides the surgical process, were treated with medication, group 3 (G3) received etidronate (6 mg / kg), group 4 (G4) risedronate (0.07 mg / kg), group 5 ( G5) pravastatin (0.6 mg / kg), group 6 (G6) ipriflavone (100 mg / kg), group 7 (G7) etidronate and pravastatin (3 mg / kg and 0.3 mg / kg), Group 8 (G8) etidronate and ipriflavone (3 mg / kg and 50 mg / kg), Group 9 (G9) risedronate and pravastatin (0.035 mg / kg and 0.3 mg / kg), group 10 (G10) risedronate and ipriflavone (0.035 mg / kg and 50 mg / kg) and Group 11 (G11) pravastatin and ipriflavone (0.3 mg / kg and 50 mg / kg). All substances were administered orally daily for 30 days. Immediately before the animals were euthanized at 35 days after treatment, blood was collected for serum calcium, phosphorus, albumin and total protein analyzed in the equipment Alizé multiparametric biochemistry and bone alkaline phosphatase analysis equipment Access Immunoassay System chemiluminescence of Beckman Coulter. Then, by the dissection of muscle tissue, the right tibias were collected and frozen for densitometric study using bone densitometry X-ray with Smart Scan DPX-ALPHA, with special software for small animals and the left tibias were collected after of fixed, decalcified and were routinely processed for histomorphometric study, the sections were stained with hematoxylin and eosin for evaluation of trabecular bone density was applied to the calculation method for planimetric point count. The assay was performed according to a randomized design with 11 treatments in six replicates. The results were subjected to analysis of variance. The control groups (G1 and G2) were compared using the F test (p <0.05). Treated groups (G3 to G11) were compared by the Tukey multiple comparison test, the 5% probability. Comparisons were also performed between treated groups and controls G1 and G2, applying Dunnett test at 5% probability. The results showed no significant between the control group (G1) and the osteoporotic group (G2), as well as between the treated groups (G3 to G11) for values of serum calcium, phosphorus, albumin, total protein and bone alkaline phosphatase. By densitometry, and histomorphometry was possible to observe the induction of osteoporosis by ovariectomy. Treated groups compared to the osteoporotic group G2, all treatments showed statistically significant differences, for density and histomorphometry. Thus, the drug etidronate, risedronate, pravastatin, and ipriflavone, used isolated or in combination, showed positive effects on bone metabolism and effective in restoring bone tissue in experimental conditions. Whereas the association of drugs constituted half of the doses used in isolation, the possibility of reduced side effects with the combination becomes a promising alternative for the treatment of osteoporosis. / Este trabalho constituiu em um ensaio biológico com o objetivo de estudar o possível tratamento da osteoporose induzida por ovariectomia, por meio do uso isolado e combinado, utilizando, neste caso, metade das doses dos compostos isolados etidronato, risedronato, pravastatina e ipriflavona, que são agentes que demonstraram efeitos positivos sobre o metabolismo ósseo. Ratas Wistar, adultas, pesando em média 250g foram utilizadas. O processo da indução da osteoporose foi feito por intervenção cirúrgica quando os animais completaram 5 meses de idade, por incisão retroumbilical, dando acesso a cavidade abdominal, sob anestesia geral, utilizando da associação de quetamina e xilazina nas doses de 50 e 5 mg/Kg, respectivamente, à exceção dos animais que constituiu o grupo controle (G1). Após 12 semanas, deu-se início ao tratamento farmacológico. Os animais foram distribuídos aleatoriamente em 11 grupos experimentais, sendo os grupos constituídos de 6 animais. O grupo 1 (G1), controle, foi constituído de animais que não foram submetidos a cirurgia ou ao tratamento. No grupo 2 (G2) houve somente a cirurgia. Os demais grupos, além do processo cirúrgico, foram tratados com os medicamentos; o grupo 3 (G3) recebeu etidronato (6 mg/kg), o grupo 4 (G4) risedronato (0,07 mg/kg), o grupo 5 (G5) pravastatina (0,6 mg/kg), o grupo 6 (G6) ipriflavona (100 mg/kg), o grupo 7 (G7) etidronato e pravastatina (3 mg/kg e 0,3 mg/kg), o grupo 8 (G8) etidronato e ipriflavona (3 mg/kg e 50 mg/kg), o grupo 9 (G9) risedronato e pravastatina (0,035 mg/kg e 0,3 mg/kg), o grupo 10 (G10) risedronato e ipriflavona (0,035 mg/kg e 50 mg/kg) e o grupo 11 (G11) pravastatina e ipriflavona (0,3 mg/ kg e 50 mg/kg). Todas as substâncias foram administradas por via oral, diariamente, durante 30 dias. Imediatamente antes dos animais serem eutanasiados, aos 35 dias, após o tratamento, foram coletados sangue para dosagens de cálcio, fósforo, albumina e proteínas totais, analisados no equipamento multiparamétrico de bioquímica Alizé e fosfatase alcalina óssea analisado no equipamento de quimioluminescência Access Immunoassay System da Beckman Coulter. A seguir, através de dissecção do tecido muscular, as tíbias direitas foram coletadas e congeladas para estudo densitométrico, utilizando densitômetro ósseo de Raio-X com Smart Scan modelo DPX-ALPHA, com software especial para pequenos animais e as tíbias esquerdas foram coletadas, depois de fixadas, foram descalcificadas e processadas rotineiramente para estudo histomorfométrico, os cortes foram corados com hematoxilina e eosina e para avaliação da densidade trabecular óssea foi aplicado o método de cálculo planimétrico por contagem de pontos. O ensaio biológico foi realizado segundo delineamento inteiramente casualizado, com 11 tratamentos em 6 repetições. Os resultados obtidos foram submetidos à análise de variância. Os grupos controles (G1 e G2) foram comparados entre si por meio do teste F (p<0,05). Os grupos tratados (G3 a G11) foram comparados entre si, através do teste de comparação múltipla Tukey, à 5% de probabilidade. As comparações também foram realizadas entre os grupos tratados e os controles G1 e G2, sendo que, para o mesmo, foi aplicado o teste de Dunnett à 5% de probabilidade. Os resultados não mostraram significativos entre o grupo controle (G1) e o grupo osteoporótico (G2), bem como, entre os grupos tratados (G3 a G11) quanto aos valores séricos de cálcio, fósforo, albumina, proteínas totais e fosfatase alcalina óssea. Através da densitometria e histomorfometria foi possível constatar a indução da osteoporose por meio da ovariectomia. Quando comparado grupos tratados ao grupo osteoporótico G2, todos os tratamentos apresentaram diferenças estatisticamente significativas, tanto para densitometria quanto para histomorfometria. Assim, os fármacos etidronato, risedronato, pravastatina e ipriflavona, usados isoladamente ou combinados, apresentaram efeitos positivos sobre o metabolismo ósseo, sendo eficazes em restaurar o tecido ósseo nas condições experimentais. Considerando que a associação dos medicamentos constituiu-se da metade das doses usadas isoladamente, a possibilidade de redução de efeitos colaterais com a associação torna-se uma alternativa promissora na terapêutica da osteoporose.

Os processos de reabsorção radicular externa, geralmente, estão associados aos traumatismos dentários que atingem os tecidos de sustentação e suporte, principalmente a avulsão e a intrusão. A terapia endodôntica nesses casos, deve visar a estabilização ou paralisação deste processo através da utilização de medicação intracanal que possa inibir a atividade osteoclástica, como os bisfosfonatos desde que, esse fármaco seja biocompatível. Neste sentido, o objetivo desse estudo foi analisar a citotoxicidade do alendronato de sódio sobre fibroblastos do ligamento periodontal humano em cultura celular. As células foram cultivadas na densidade de 1 x 10 3 células/placa. Os grupos experimentais foram: G1 (controle) sem alendronato de sódio e G2, G3 e G4 com o alendronato nas concentrações de 10 -5 , 10 -6 e 10 -7 M respectivamente. Nos tempos experimentais de 1, 6, 12 e 24 horas (curto prazo) foi analisada a viabilidade celular e em 2, 4, 6 e 8 dias (longo prazo) a sobrevivência celular. Os resultados em triplicata foram analisados estatisticamente e mostraram que as culturas tratadas com a maior concentração da droga (G2), apresentaram porcentagens de viabilidade celular significantemente menores (p < 0.01), que as dos outros grupos (G1, G3 e G4) nos tempos de 12 e 24 horas. O crescimento celular nos grupos G2 e G3 foram similares. O G2 apresentou crescimento, significantemente menor que dos demais grupos (p < 0.05). Concluiu-se que o alendronato de sódio, em contato direto com fibroblastos de ligamento periodontal humano em cultura, é citotóxico em concentrações mais elevadas (10 -5 e 10 -6 M) / The external root resorption processes are usually associated with dental trauma, mainly avulsion and intrusion. In such cases, the endodontic therapy aims the process stabilization and paralysation, through utilization of medications that can inhibit the osteoclastic activity, like bisphosphonates, since this drug would be biocompatible. The aim of this study was to analyze the sodium alendronate citotoxicity on human periodontal ligament fibroblasts. Cells were plated in a density of 1 X 10 3 cells/dish. The experimental groups were: GI (control) no sodium alendronate, and GII, GIII and GIV with sodium alendronate at the concentrations of 10 -5 , 10 -6 and 10 -7 M, respectively. The experiment times were 1, 6, 12 and 24 hours (short term) for viability and 2, 4, 6 and 8 days (long term) for cell survival. Data in triplicate were statistically analyzed. Cultures treated with the highest alendronate concentration (GII)showed cell viability percentages significantly lower (p < 0.01) than those of the other groups (GI, GIII and GIV), at 12 and 24 hours. Cell growth on GII and GIII groups was similar. GII presented smaller growth than the other groups (p < 0.05). We concluded that sodium alendronate, on direct contact with human periodontal ligament fibroblasts, is citotoxic in concentrations higher than of 10 -6 M

Introdução: Pacientes com tumores de cabeça e pescoço (CP) podem apresentar algumas complicações orais decorrentes do tratamento radioterápico. A osteorradionecrose (ORN) pode ser um dos efeitos colaterais tardios desse tipo de tratamento. Na literatura, análises retrospectivas em que foram coletados dados sobre a ocorrência da ORN são vistas com maior frequência. Entretanto, ainda não foram realizados estudos que correlacionem dados como o tipo de irradiação, a dose utilizada para tratamento do tumor, as características clínicas e o tratamento da ORN em pacientes que foram irradiados em região de CP e que fizeram uso de bisfosfonatos (BF). Objetivo: O objetivo deste estudo foi descrever a prevalência da ORN dos maxilares, assim como avaliar suas características clínicas, radiográficas, fatores causadores, utilização de medicações e tratamentos realizados. Materiais e Métodos: Foi realizado o levantamento de dados de todos os pacientes que foram irradiados em região de CP e que desenvolveram ORN atendidos no A.C. Camargo Cancer Center, São Paulo, Brasil, em um período de 10 anos. 98 pacientes com ORN foram alocados em 2 grupos: Grupo I (pacientes com ORN e que não fizeram uso do BF, n=83) e Grupo II (pacientes com ORN e que fizeram uso do BF, n=15). Resultados: A análise comparativa entre os grupos sugere menor tempo para a ocorrência da ORN no Grupo II. A região posterior da mandíbula foi a mais acometida pela ORN e a maioria dos casos foi classificada clinicamente como Estágio II (52,6%). A apresentação radiográfica mais frequente foi de uma área osteolítica irregular. Procedimentos cirúrgicos realizados após a RT foram os principais fatores relacionados da ocorrência da ORN e em relação à resolução da necrose, a maioria dos pacientes do Grupo I (52,2%) teve a ORN resolvida, enquanto que no Grupo II 46,7% estavam livres da necrose. Conclusões: Devido ao nosso estudo englobar pacientes que realizaram radioterapia (RT) e utilizaram BF, não se pode afirmar qual a etiologia da necrose neste Grupo e tampouco se a necrose foi causada isoladamente pelo dano da RT ou pelo uso do BF. Nosso estudo concluiu que pacientes que realizaram RT em região de CP e utilizaram BF apresentaram menor tempo para desenvolver a ORN e tiveram mais dificuldade para a resolução da mesma. / Introduction: Patients with head and neck tumor (HN) may present some oral complications due to radiotherapy (RT). The osteoradionecrosis (ORN) may be one of the latest side effects of such treatment. In literature, retrospective analyzes in wich data were collected, the occurrence of ORN are seen more often. However, no further studies relating data such as type of irradiation and used dose for tumor treatment and the clinical features and treatment of ORN in patients who were irradiated in the HN region, whom used of bisphosphonates (BP). Objective: The objective of this study was to describe jaws prevalence of ORN and to evaluate its clinical and radiographic features, causative factors, used medications and performed treatments. Materials and Methods: We performed a survey of data from all patients who were irradiated in HN area and developed ORN treated at A.C. Camargo Cancer Center, São Paulo, Brazil, in 10 years. 98 patients with ORN were divided into 2 groups: Group I (patients with ORN and who did not use the BP, n = 83) and Group II (patients with ORN and used BP, n = 15). Results: The comparative analysis between the groups suggests less time for the occurrence of ORN in Group II. Posterior of the mandible was the most affected area by the ORN, the majority of cases were classified as Stage II (52.6%) and radiographic presentation most common was an irregular osteolytic area. Surgical procedures performed after RT were the main factors related to the development of ORN and about the resolution of necrosis, most of Group I patients had ORN resolved (52,2%), whereas in Group II 46.7% are free from necrosis. Conclusions: Due to our study include patients who underwent RT and used BP we can not state the etiology of necrosis in this Group or if the necrosis was caused solely by the damage of the RT or the use of BP. Our study found that patients who underwent RT in HN area and used BP had less time to develop ORN and had more difficulty for the resolution of it.

Background: Using a nude rat model of site-specific metastatic bone disease (MBD), we developed a semiquantitative histological score for rapid assessment of lytic lesions in bone. This provides additional information to conventional histological measurement by clarifying the extent and location of metastatic infiltration and the tumor growth pattern. The score can also be used to assess the action of bisphosphonates on bone metastases. Materials and Methods: Male nude rats (n = 12 per group) were inoculated with the human breast cancer cell line MDA-MB-231 via the femoral artery. Following appearance of radiographically visible osteolytic lesions on day 18, the animals received phosphate-buffered saline (PBS; controls) or ibandronate (IBN, 10 µg P/kg) daily until day 30. Whole body radiographs were obtained on days 18 and 30, and osteolytic areas (OA) were determined by radiographic computer-based analysis (CBA). On day 30, MBD was assessed in both tibias using conventional histological CBA and the new scoring system. Results: Metastatic tumor area correlated with the total sum of the new score in both PBS- (r = 0.762) and IBN-treated animals (r = 0.951; p < 0.001). OA correlated well with the total sum in both groups (r = 0.845 and 0.854, respectively; p < 0.001). Conclusion: Significant reduction of bone marrow and cortical infiltration of tumor cells with IBN suggested local control of metastases. / Hintergrund: Mit Hilfe eines etablierten Tiermodells zur Erzeugung lokalisationsspezifischer Knochenmetastasen in der Nacktratte wurde ein semiquantitatives histologisches Graduierungssystem zur schnellen Bewertung osteolytischer Knochenmetastasen entwickelt. Das Graduierungssystem liefert hinsichtlich der Metastasenlokalisation, deren Ausmaß und Infiltrationsmuster wertvolle Zusatzinformationen zu den konventionellen histologischen Untersuchungsmethoden. Damit kann beispielsweise auch die pharmakologische Wirkung von Bisphosphonaten auf die Knochenmetastasierung beurteilt werden. Material und Methoden: Männlichen Nacktratten (n = 12 pro Gruppe) wurden Zellen der humanen Brustkrebszellinie MDA-MB-231 in die Oberschenkelarterie inokuliert. Ab dem Auftreten radiologisch erkennbarer Osteolysen 18 Tage nach Inokulation erhielten die Tiere bis zum Studienende (Tag 30) täglich entweder eine subkutane Applikation einer Phosphat-Puffer-Lösung (Kontrollgruppe) oder Ibandronat (IBN, 10 µg P/kg; Behandlungsgruppe). Konventionelle Röntgenaufnahmen wurden an den Tagen 18 und 30 nach Tumorinokulation angefertigt und die Osteolysenflächen mittels Computerauswertung bestimmt. Nach Studienende wurde der Metastasenbefall in beiden Tibiae sowohl konventionell histologisch als auch mittels des neuen Graduierungssystems ausgewertet. Ergebnisse: Die Metastasenfläche korrelierte mit der kummulativen Punktsumme des Graduierungssystems sowohl in der Kontrollgruppe (r = 0,762; p < 0,001) als auch in der Ibandronat- Gruppe (r = 0,951; p < 0,001). Ebenso war die Osteolysenfläche eng mit der Punktesumme in beiden Gruppen korreliert (r = 0,845 und 0,854; p < 0,001). Schlussfolgerung: Die signifikante Reduktion von Knochenmark- und Kortikalisbefall durch IBN deuten auf eine gute lokale Kontrolle des Metastasenwachstums hin. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Dans des études animales, nous avons étudié le développement des métastases osseuses, leur vascularisation ainsi que des biomatériaux de comblement ou pouvant cibler l'angiogenèse. Nous avons utilisé le poly 2-hydroxyéthyl méthacrylate (pHEMA) connu pour sa biocompatibilité, pour fabriquer des microbilles fluorescentes portant à leur surface des charges anioniques ou cationiques. Les microbilles ont été incubées avec une lignée de cellules endothéliales qui internalisent de préférence les microbilles portant une charge anionique. Un silicone radio-opaque a été utilisé pour caractériser l'architecture en 3D des vaisseaux sanguins à différents stades d'évolution des métastases osseuses chez le rat. Nous avons montré au niveau des os tumoraux une hypervascularisation et une désorganisation importante de l'architecture vasculaire avec un réseau très dense de micro vaisseaux à l'aspect tortueux s'étendant dans toute la zone trabéculaire, envahissant la corticale et la diaphyse en sens rétrograde. Dans une autre étude, l'acide zolédronique, un puissant bisphosphonate ayant aussi un effet anti-angiogénique, a été utilisé de façon préventive dans un modèle de métastase osseuse chez le rat. Il permet la conversion des métastases du carcinome MatLyLu, initialement ostéolytiques, en formes ostéocondensantes en limitant les perforations corticales. Enfin, chez le lapin, dans un modèle de comblement osseux par le bêta tricalcium phosphate (β−TCP), nous avons montré que des anti-inflammatoires non stéroïdiens, utilisés en chirurgie osseuse, ne retardent pas l'ostéogenèse au contact du biomatériau. La vascularisation joue un rôle important dans le remodelage osseux normal mais aussi dans les ostéopathies bénignes et malignes ainsi que dans l'ostéointégration des biomatériaux utilisés pour le traitement des pertes de substance osseuse.

Thesis written in co-mentorship with director: Nelly Huynh; co-directors: Frank Rauch and Jean-Marc Retrouvey; collaborators: Clarice Nishio, Duy-Dat Vu and Nathalie Alos / Introduction - L'ostéogenèse imparfaite (OI) est une maladie osseuse héréditaire qui affecte la production du collagène de type I et le remodelage osseux. Les biphosphonates sont administrés aux enfants atteints d'OI dans le but d’augmenter la masse osseuse et de réduire les fractures osseuses. Les patients atteints d’OI ont des malocclusions sévères qui affectent leur qualité de vie. Plusieurs processus biologiques de remodelage osseux qui sont nécessaires pour un mouvement dentaire orthodontique sont affectés chez les gens atteints d’OI. L'objectif de cette étude est d'évaluer le mouvement dentaire orthodontique dans un modèle de souris avec OI et traitées aux biphosphonates. Matériels et méthodes - Vingt-quatre souris femelles âgées de 10 semaines ont été divisés en 4 groupes : 1 - OI traitées par zolédronate (n=6); 2 - OI non traitées (n=6); 3 - Type sauvage traitées par zolédronate (n=6); 4 – Type sauvage non traitées (n=6) Un ressort de nickel-titane activé à 10 g de force a été cimenté entre les incisives et la 1ère molaire maxillaire droite. Le côté contralatéral a été utilisé comme témoin. Une dose de 0,05 mg de zolédronate a été administrée par voie sous-cutanée un jour avant la chirurgie. Sept jours après l'intervention, les souris ont été euthanasiées et la distance entre la 1ère et la 2e molaire a été mesurée par analyse microtomographique. Résultats - Le mouvement dentaire orthodontique était significativement plus important chez les souris OI que celles de types sauvages dans les groupes non traités (p < 0,05). Le traitement par zolédronate n'a eu aucun effet significatif sur le mouvement dentaire orthodontique au sein des groupes OI et type sauvages. Conclusions - Ces résultats suggèrent une augmentation du mouvement dentaire orthodontique chez les souris avec l’ostéogenèse imparfaite. / INTRODUCTION - Osteogenesis imperfecta (OI) is a heritable bone disorder that affects collagen type I production and bone remodeling. Orthodontic tooth movement (OTM) involves the underlying process of alveolar bone remodeling. The objective of this study is to evaluate OTM in a mouse model of OI. METHODS - Twenty four, 10 week-old female mice were divided into 4 groups: 1- OI treated with zoledronate, 2- OI untreated, 3- Wild-type (WT) treated with zoledronate and 4- WT untreated. A nickel-titanium closed coil spring (10 g) was attached between the incisors and the right maxillary 1st molar. The contralateral side was used as control. Zoledronate (0.05mg/kg) was administered sub-cutaneously 1 day prior to surgery. Seven days after the procedure, the distance between 1st – 2nd molars was measured by micro-CT. RESULTS - OI mice presented significantly more OTM than WT mice when comparing within untreated groups (p<0.05). Zoledronate treatment had no significant effect on OTM within OI and WT groups. CONCLUSIONS - These results suggest increased OTM in mice with OI. The dose of zoledronate administrated 1 day prior to surgery had no significant effect on OTM.

Farnesyl pyrophosphate synthase (FPPS) is a key branch point enzyme in the mevalonate pathway and the main molecular target of nitrogen-containing bisphosphonates (N-BPs), potent inhibitors of osteoclastic activity and the leading drug of choice for conditions characterized by excessive bone resorption. The main aim of this thesis is to investigate the interaction of N-BPs with FPPS in order to gain further insights into the mechanism of drug inhibition. Kinetic and crystallographic studies following site-directed mutagenesis of FPPS reveal key residues involved in stabilization of carbocation intermediate, substrate binding and formation of a tight enzyme-inhibitor complex. The aromatic ring of Tyr204 is involved in N-BP binding but not in the catalytic mechanism, where the hydroxyl moiety plays an important role. Lys200 is implicated in regulation of substrate binding, product specificity and enzyme isomerization which leads to a tight binding inhibition. Phe239 is considered important for the FPPS C-terminal switch which stabilizes substrate binding and promotes the inhibitor induced isomerized state. The highly conserved Arg112, Asp103 and Asp107 are pivotal for catalysis. Successful purification of the full length of Rab geranylgeranyl transferase (RGGT) complex downstream of the FPPS in the mevalonate pathway was achieved and may lead to co-crystallization with BP analogues and identification of the putative site of drug binding. Investigation of the in vitro effect of N-BPs on osteoclastogenesis suggest a correlation with FPPS inhibition kinetics for the most potent N-BPs but indicate an alternative mechanism of the disruption of bone resorption by alendronate. Together these results highlight the importance of the multiple interactions of N-BPs with side-chain residues of FPPS which dictate their strength of binding and advance the understanding of their pharmacophore effect.

Osteoporosis and depression are prevalent among older postmenopausal women 65 years or older. Bisphosphonates (BPs) and selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) are commonly used medications to treat these conditions. Inhibitory effects of BPs on osteoclasts are responsible for the reduction in fracture risk. SSRIs, however, are associated with increased fracture risk through decreasing osteoblasts and increasing osteoclastic activity. These effects of SSRIs could attenuate the beneficial effects of BPs. This dissertation describes the concomitant use of BPs and SSRIs among postmeopausa women and reports findings from examining the association between concomitant use of BPs and SSRIs and fracture risk. Separate cross-sectional analyses were performed using data from the 2004-2008 Medical Expenditure Panel Survey (MEPS) and Medicare Part D prescriptions claims data (2008-2010) to examine usage patterns of BPs and SSRIs/SNRIs for women aged ≥45 years and ≥65 years, respectively. For our second objective, a nested-case control was conducted using Medicare claims data (2008-2010). Data from Medicare inpatient claims were linked to Medicare Part D data for all female BP users 65 years or older. We used Cox proportional hazards model to assess the increased risk of osteoporotic-related fractures among propensity score matched (1:1 ratio) cohorts of concomitant users of BPs and SSRIs and BP alone users. Concomitant use of BPs and SSRIs was prevalent and increased with age for each timeframe examined. Findings showed that approximately 12% (using MEPS) and 28% (using Medicare data) of women on BPs were also on SSRIs. For the second objective, 4,214 propensity score matched pairs (average age=80.4 years) of subjects were analyzed. Findings showed that concomitant use of BPs and SSRIs was associated with statistically significant increased risk for any fracture (HR=1.29, 95% CI, 1.07-1.57), but statistically non-significant increased risk for hip (HR=1.16, 95% CI, 0.92-1.47) and vertebral fractures (HR=1.55, 95% CI, 0.97-2.48). Current findings indicate that concomitant use of BPs and SSRIs is not uncommon among postmenopausal women and suggest potential attenuation of antifracture efficacy of BPs by SSRIs. Further studies are needed to understand the clinical impact of concomitant use of these medications among older postmenopausal women.