京都大学 / 新制・課程博士 / 博士(医学) / 甲第23801号 / 医博第4847号 / 新制||医||1058(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 小林 恭, 教授 竹内 理, 教授 金子 新 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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名古屋大学博士学位論文 学位の種類 : 博士(医学)(課程) 学位授与年月日:平成25年1月31日 匠原龍太郎氏の博士論文として提出された

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During our lifetime, our bones constantly go through remodelling to maintain the skeletal system. This is done by osteoblasts that deposit new bone tissue, osteoclasts that remove the bone matrix and mechanosensing osteocytes. In case of bone implants, increased resorption by osteoclasts due to inflammation (inflammatory osteolysis) leads to aseptic implant loosening. This study focuses on how to detect these inflammatory resorbing cells at an early stage and prevent their activity with appropriate medication. To achieve this, we differentiated classical monocytes into macrophage-like cells, osteoclasts(OCs) and foreign body giant cells (FBGC) and their secretome was studied to identify specific biomarkers. Previously, tartrate resistant acid phosphatase (TRAP) was studied as an important biomarker for OCs and macrophages. An ELISA to separate and quantitate the two TRAP isoforms was used to distinguish the resorbing OCs from inflammatory FBGCs on the basis of the isoform ratio. This assay gave high levels of 5b isoform for osteoclastic stimulation and high 5a levels for the inflammatory stimulation. Also, different aminothiazole inhibitors were tested which were shown to be efficient drugs in inhibiting inflammatory osteolysis by reducing osteoclast formation and resorption in sub-micromolar concentration. Further to apply this study to patient samples, an immunoassay panel can be developed which will help detect TRAP and multiple biomarkers like CTX specific to aseptic loosening simultaneously. This will help in early, efficient and accurate diagnosis of inflammatory osteolytic bone loss and provide us with an accurate diagnosis and sufficient time for appropriate treatment.

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