O presente trabalho avaliou a formacao de tecido osseo ao redor de implantes osseointegraveis de titanio, apos realizacao de defeitos osseos, utilizando diferentes tipos de substitutos osseos. Foram utilizados 5 caes de raca indeterminada, os pre molares e molares mandibulares foram extraidos, passados 12 semanas, os caes foram submetidos a um novo procedimento cirurgico aonde foram realizadas as perfurações preconizados pelo fabricante dos implantes, o osso vestibular da mandibula foi desgastado ate que parte da perfuracao fosse exposta, os implantes entao foram colocados nas respectivas perfuracoes, ficando com 4 espiras expostas. Esses defeitos foram preenchidos aleatoriamente com Bioglass® 45S5, Biosilicato® , Osso autogeno, e sem nenhum material de preenchimento. 18 semanas depois da colocacao dos implantes os caes foram mortos e suas hemi-mandibulas contendo os implantes removidas e submetidas aos analises histologiaos e histomorfometricas, os dados obtidos foram submetidos ao teste de Kruskal-Wallis. A histologia dos 4 grupos estudados revelaram a presenca de tecido osseo maduro em contato com os implantes, porem sem ralacao direta com os vidros bioativos e osso autogeno. A porcentagem de contato osso implante, matriz ossea mineralizada ao redor da espira, e area de espelho, nao mostraram diferencas estatisticas significantes entre os 4 materiais testados. Os resultados indicam que a presenca de substitutos osseos nao interfere com a formacao ossea ao redor dos implantes nesse modelo experimental. E existe resposta tecidual muito semelhante entre o osso autogeno, Bioglass® 45S5 e Biosilicato. / The aim of the present study was to investigate the amount of bone formation on Ti implants in sites with intra-bony defects filled with different bone substitutes. Mandibular premolars and first molars were extracted from 5 dogs, and after 12 weeks 3 implants were bilaterally placed in sites with intra-bony defects and each implantation site randomly received the following treatment: Biosilicate®, Bioglass® 45S5, aoutologous bone or no treatment. At 18 weeks after implantation, the hemi-mandibles containing the implants were removed and processed for morphological and histomorphometric analysis. Data were submitted to Kruskal-Wallis and Fishers test. The histological sections of the 4 experimental groups exhibited mature bone tissue in contact with implants, but not related with bioactive glasses or autologous bone used. The percentage of bone-implant contact, mineralized bone matrix between implant threads, and mineralized bone matrix within mirror area in the treated or non-treated sites were not statistically different among the 4 experimental groups. These results indicates that the presence of the bone substitutes evaluated here did not interfere with bone formation on Ti implants in sites with intra-bony defects. In addition, tissue response to Biosilicate® was similar to that of Bioglass® 45S5 and autologous bone.

Made available in DSpace on 2017-07-24T19:22:04Z (GMT). No. of bitstreams: 1 Fabio Goiris.pdf: 7029571 bytes, checksum: 63e1790a8a36324e4ac324716fcd8ddd (MD5) Previous issue date: 2017-02-15 / The objective of this study was to evaluate in vivo two new biomaterials for bone substitution – pure hydroxyapatite and collagen hydroxyapatite – aiming at determining their biocompatibility in soft tissues and their ability to enable bone neoformation in critical size defects in rats’ calvaria. Both types of synthetic hydroxyapatite were developed by the Chemistry department of the State University of Ponta Grossa – Pure hydroxyapatite (HaP) and Hydroxyapatite with collagen (HCol). The third synthetic hydroxyapatite used as a comparing element was the commercial hydroxyapatite Alobone® (HaAl), which is available in the Brazilian market. Experiment 1 was carried out with the animals’ dorsal connective tissue and used 45 Wistar female rats, divided randomly into three groups of 15 animals each (HaP, HaCol and HaAl) which were euthanized after 7, 15 and 30 days of operation.The histomorphometric exam after 30 days revealed the absence of inflammatory cell characteristic infiltrates and the presence of non-inflammatory collagen fibers. These results show the biocompatibility of the material implanted. Experiment 2 used 60 Wistar rats divided randomly into 4 groups (Group 1, HaP; Group 2, HaCol; Group 3, HaAl and Group 4, Control). Critical size defects of 8mm were performed in the calvaria and the three biomaterials were implanted. All groups also received collagen membrane. On day 30, inflammatory response on the defect was practically absent in all groups, mainly when compared to the period of 7 days. Some areas of bone neoformation were seen. There was predominance of osteoblasts, osteocytes and macrophages in lower amount. Regarding the radiographic aspect, after 30 days our study confirmed a marked biodegradation of the hydroxyapatite and signs of bone neoformation. The histomorphometric results of the synthetic hydroxyapatite implant demonstrated the probable occurrence of intramembranous ossification from the granulation tissue with the presence of bone-resident macrophages. It was possible to conclude that the results of our study in vivo can be used as a preliminary source of information about biocompatibility, biodegradability and bone neoformation from the implant of new biomaterials in vivo. / O objetivo desta pesquisa foi avaliar in vivo dois novos biomateriais de substituição óssea - hidroxiapatita pura e hidroxiapatita com colágeno - visando determinar a sua biocompatibilidade em tecidos moles e a sua capacidade de possibilitar a neoformação óssea em defeitos críticos em calvária de ratas. As duas formas de hidroxiapatitas sintéticas – Hidroxiapatita pura (HaP) e Hidroxiapatita com colágeno (HACol) - foram desenvolvidas pelo departamento de Química da Universidade Estadual de Ponta Grossa. A terceira hidroxiapatita sintética utilizada como elemento de comparação foi a hidroxiapatita comercial Alobone® (HaAl), disponível no mercado brasileiro. O experimento 1 realizado em conjuntivo de dorso de animais, utilizou 45 ratas fêmeas da espécie Wistar, divididos aleatoriamente em três grupos de 15 (HaP, HaCol e HaAl) e que sofreram eutanásia aos 7, 15 e 30 dias do pósoperatório. O exame histomorfométrico aos 30 dias verificou-se ausência do infiltrado característico de células inflamatórias e presença de fibras colágenas não inflamatórias. Estes resultados significam biocompatibilidade dos materiais implantados. O Experimento 2 utilizou 60 ratas Wistar divididos aleatoriamente em 4 grupos (Grupo 1, HaP; Grupo 2 HaCol, Grupo 3 HaAl) e Grupo 4, Controle). Realizaram-se defeitos críticos de 8 mm em calvária e a seguir colocaram-se os três tipos de biomateriais. Todos os grupos receberam também membrana de colágeno. Aos 30 dias, observou-se praticamente uma ausência da resposta inflamatória no local do defeito em todos os grupos, especialmente quando comparado ao período de 7 dias. Verificaram-se áreas de neoformação óssea. Houve predominância de osteoblastos, osteócitos e macrófagos em menor quantidade. No aspecto radiográfico, em 30 dias, a nossa pesquisa confirmou uma marcada biodegradação das hidroxiapatitas e sinais de neoformação óssea. Os resultados histomorfométricos da implantação de hidroxiapatitas sintéticas demonstraram a ocorrência de uma ossificação intramembranosa a partir do tecido de granulação com a participação de macrófagos ósseo-residentes. É possível concluir que os resultados dessa pesquisa podem ser utilizados como recurso preliminar de informações sobre biocompatibilidade, biodegradabilidade e neoformação óssea a partir da implantação de novos biomateriais in vivo.

O objetivo do presente estudo foi comparar a eficácia da implantação de biomateriais porosos na neoformação óssea e reparo de defeitos cervicais mandibulares em cães, com ou sem a técnica de regeneração óssea guiada (ROG). Bio-Oss Block® (BB), Bio-Oss Collagen® (BC), Bio-Oss® em grânulos (BG), osso autógeno (Ab) e coágulo (Cg) foram utilizados nas mesmas situações experimentais. Para o grupo com membrana foi utilizado o BioGide®. Doze cães foram submetidos a extrações dos pré-molares e primeiros molares mandibulares bilateralmente. Quatro meses após cinco defeitos ósseos (6 mm de diâmetro/4 mm de profundidade) foram confeccionados em um lado. Implantes de 3,3 x 10 mm foram instalados na mesial de cada defeito, proporcionando um \"gap\" distal de 2,7 mm. Os defeitos foram aleatoriamente preenchidos com Ab, Cg, BB, BC e BG. Os mesmos procedimentos foram executados no lado oposto após oito semanas. A membrana foi utilizada para recobrir os defeitos em metade dos lados. Os animais foram sacrificados após oito semanas. A estabilidade dos implantes foi aferida pelo Osstell Mentor®, na instalação do implante e no sacrifício. Os espécimes (n=60, sendo 3 de cada grupo) foram escaneados em micro-tomógrafo Skyscan® 1172. Após aquisição das imagens, o volume de interesse de 3,0 x 6,0 x 4,0 mm foi estabelecido e os parâmetros relativos à formação óssea foram avaliados. Todos os biomateriais foram escaneados in vitro para avaliação da porosidade. Utilizando a técnica de cortes por desgaste, lâminas histológicas foram confeccionadas para a avaliação histológica e histométrica de cada espécimen. As análises histométricas revelaram que o BC apresentou formação óssea semelhante ao Ab em 8 semanas sem BGd. O Cg mostrou a maior formação óssea entre os tratamentos testados em 16 semanas com BGd, e foi superior ao BB e BG em 8 semanas sem BGd (p<0,05). O BB exibiu pior formação óssea entre os tratamentos (8 e 16 semanas, com ou sem membrana). O BC obteve o melhor desempenho dentre os biomateriais. Todos os biomateriais foram parcialmente reabsorvidos de 8 a 16 semanas, no entanto, o BB foi encontrado em maior quantidade em comparação com os demais biomateriais (p<0,05). Em relação à análise da crista alveolar, o BB apresentou a menor reabsorção entre os tratamentos, com e sem BGd a 8 e 16 semanas (p<0,05). A aplicação da BGd proporcionou maior ISQ em 16 semanas, independentemente do material testado (p<0,05). A análise micro-tomográfica mostrou que quando a BGd não foi utilizada, o BG proporcionou a maior quantidade de osso no interior do defeito, seguido pelo BC (p<0,05). Quando o defeito foi coberto com BGd, o Ab rendeu superior formação óssea (p>0,05). A análise de superfície óssea mostrou valores aumentados em sítios tratados com BG, seguido por BC em 8 semanas sem BGd, e Ab em 8 semanas com BGd (p<0,05). O BC apresentou superfície/volume ósseo superior a 8 (com e sem BGd) e 16 semanas com BGd (p<0,05). O BB apresentou os menores valores em 16 semanas (sem BGd). O Cg em 16 semanas (com BGd) foi o pior entre os tratamentos aplicados (p<0,05). Em relação à espessura trabecular, Ab e BB apresentaram respectivamente valores maior e menor (p<0,05), independente do tempo experimental avaliado ou uso de membrana. A análise da porosidade dos biomateriais revelou que o BG apresentou maiores números, volume e superfície de poros fechados. O BB apresentou maiores valores de volume de poros abertos, porosidade aberta e porosidade total em comparação com os outros materiais. Conclui-se que a implantação de bloco de alta porosidade (BB) falhou em proporcionar maior reparo ósseo no interior do defeito e foi o tratamento que mais reduziu a reabsorção da crista óssea alveolar distal. Biomateriais com menor porosidade (BC e BG) apresentaram superior ou semelhante formação óssea e estabilidade dos implantes em comparação ao osso autógeno. A utilização da técnica de ROG melhorou o padrão de formação óssea em todos os tratamentos e períodos testados e reduziu a presença de tecido mole no interior do defeito. Uma relação inversa entre a porosidade dos biomateriais e a formação óssea in vivo foi observada no modelo experimental adotado. / The aim of this study was to compare the effectiveness of porous biomaterials in bone formation and repair of cervical mandibular defects in dogs, with or without Guided Bone Regeneration (GBR) technique. Bio-Oss Block® (BB), Bio-Oss Collagen® (BC), Bio-Oss® in granules (BG), autogenous bone (Ab) and coagulum (Cg) were used under the same experimental conditions. For the membrane group, BioGide® was used. Twelve dogs underwent bilateral extractions of mandibular premolars and first molars. After four months five bone defects (6 mm long / 4 mm deep) were prepared at one side. Implants of 3.3 x 10 mm were installed on each of mesial defect, providing a distal gap of 2.7 mm. The defects were randomly filled with Ab, Cg, BB, BC and BG. The same procedures were performed in the opposite side after eight weeks. A membrane was used to cover the defects in half of the sides. Animals were sacrificed after eight weeks. Implant stability was measured by Osstell Mentor®, at implant installation and sacrifice. The specimens (n=60, 3 in each group) were scanned in Skyscan® 1172 micro-CT scanner. A volume of interest of 3.0 x 6.0 x 4.0 mm was established and the parameters related to bone formation were evaluated. All used biomaterials were also scanned for in vitro porosity evaluation. Using Exakt® system, ground section of each specimen were prepared for histological and histometric assessment. Histometric analysis revealed that BC presented similar bone formation to Ab in 8 weeks without BGd. Cg showed greater bone formation between treatments at 16 weeks with BGd, and was superior to BG and BB at 8 weeks without BGd (p<0.05). BB exhibited worse bone formation within treatments (8 and 16 weeks, with or without membrane). BC had the best performance among biomaterials. All biomaterials were partially resorbed from 8 to 16 weeks. However, BB was found in greater amounts in comparison with other biomaterials (p<0.05). Regarding the alveolar crest analysis, BB had the lowest resorption between treatments with and without BGd at 8 and 16 weeks (p<0,05). The BGd use promoted higher final ISQ values at 16 weeks, regardless the tested treatment (p<0.05). Micro-CT analysis showed that when BGd was not used, BG yielded the highest amount of bone within the defect, followed by BC (p<0.05). When the defect was covered with BGd, Ab yielded higher bone formation (p>0.05). Bone surface area analysis showed that increased values in sites treated with BG, followed by BC without BGd at 8 weeks, and Ab at 8 weeks with BGd (p<0.05). The BC presented greater Bone Surface Area/Bone volume at 8 (with and without BGd) and 16 weeks with BGd (p<0.05). BB had the lowest values at 16 weeks (without BGd). Cg presented the worst performance among treatments at 16 weeks (with BGd) (p<0.05). Regarding the Trabecular Thickness, Ab and BB showed the highest and lowest values, respectively (p<0.05), regardless of the time point or membrane use. In biomaterials porosity analysis, BG showed higher numbers, volume, and surface area of closed pores. BB had the highest volume of open pores, open porosity and total porosity compared with the other treatments. It can be concluded the use of a high porosity block (BB) failed to provide greater bone formation within the defect area and it was the treatment that better reduced distal alveolar crest resorption. Biomaterials with lower porosity (BC and BG) showed higher or similar bone formation and implant stability if compared to autogenous bone. The appliance of BGd improved bone formation in all treatments and tested periods and reduced soft tissue presence within the defect. An inverse relationship between biomaterials\' in vitro porosity and in vivo bone formation was observed in the experimental model used.

O alcoolismo é considerado um redutor da formação óssea, podendo levar a distúrbios osteometabólicos, já a rhBMP-2 é uma proteína morfogenética conhecida por desempenhar um papel importante nos processos de reparação e indução da formação óssea. O objetivo deste estudo foi investigar a ação do alcoolismo e a resposta do reparo em defeitos ósseos (DO) na calvária de ratos, após a aplicação da rhBMP-2, pura e combinada a uma matriz de colágeno. Foram utilizados 80 ratos divididos em 8 grupos, cada um deles com um período de espera até o sacrifício de 4 e 6 semanas, após a criação cirúrgica do defeito ósseo na calvária de 5 mm. Os grupos foram divididos em G1) água \"ad libitum\" + DO, G2) álcool \"ad libitum\" + DO, G3) água + DO + 5&mu;g rhBMP-2 pura, G4) álcool + DO + 5&mu;g rhBMP-2 pura, G5) água + DO + carreador esponja de colágeno, G6) álcool + DO + carreador esponja de colágeno, G7) água e + DO + 5&mu;g rhBMP- 2/esponja de colágeno, G8) álcool + DO + 5&mu;g rhBMP-2/esponja de colágeno. Os dados radiográficos e os dados para a análise de fibras colágena tipo I e III foram submetidos à análise estatística Kruskal-Wallis e Dunn\'s Multiple, os dados histológicos ao teste de análise de variância (ANOVA) e Tukey. O resultado encontrado para a análise radiográfica no tempo de 6 semanas demonstrou que os grupos tratados com rhBMP-2 independente da utilização do carreador e do etanol apresentaram maior neoformação óssea (p<0,05), para o tempo de 4 semanas não foi encontrada diferença estatística. Para a análise imunoistoquímica, a ostecalcina (OC) e sialoproteína óssea (BPS) foram predominantes nos grupos tratados com rhBMP-2. Para a análise histológica, a quantificação de fibras colágenas tipo I apresentou diferença estatística entre os grupos (p<0,05), com aumento destas fibras principalmente nos grupos tradados com rhBMP-2 associado a esponja de colágeno; e na análise quantitativa por estereologia, o volume de tecido ósseo neoformado foi maior para os grupos tratados com rhBMP-2 pura ou associada ao carreador, porém para os grupos tratados com etanol, houve maior neoformação óssea para o grupo tratado com rhBMP-2 associado ao carreador nos períodos de 4 e 6 semanas (p<0,001). Concluiu-se neste modelo experimental que, o carreador foi efetivo na bioliberação da rhBMP-2, mesmo na presença do etanol. / Alcoholism is considered a reducer for new bone formation, may leading to osteometabolic disturbance, considering that the rhBMP-2 is a morphogenetic protein known to play an important role in the bone healing processes. The aim of this study was to investigate the action of alcoholism and its effect on the repair of bone defects (DO) performed in rat calvaria after the rhBMP-2 application, pure or combined with a collagen matrix. We used 80 rats divided into eight groups, each one with a waiting period for sacrifice of 4 and 6 weeks after the bone defect (5mm) delineation in the rat skull. The groups were divided into: G1) water \"ad libitum\" + DO, G2) alcohol \"ad libitum\" + DO, G3) water + DO + 5&mu;g pure rhBMP-2, G4) alcohol + DO + 5&mu;g pure rhBMP-2, G5 ) DO + water + collagen sponge carrier, G6) alcohol + DO + collagen sponge carrier, G7) and water + DO + 5&mu;g rhBMP-2/collagen sponge, G8) alcohol + DO + 5&mu;g of rhBMP-2/collagen sponge. The radiographic data were submitted to statistical analysis Kruskal-Wallis and Dunn\'s Multiple, histological data to analysis of variance (ANOVA) and Tukey test. Radiographically, it was found after 6 weeks that the groups treated with rhBMP-2, independently of the carrier use and ethanol administration, more new bone formation (p<0.05), at 4 weeks it was not found statistical difference. For immunohistochemical analysis, ostecalcin (OC), and bone sialoprotein (BPS) were predominant in groups treated with rhBMP-2. For histological quantification of collagen type I fibers, statistical difference between groups was found (p<0.05) with the increasing of these fibers in the groups treated with rhBMP-2 combined with collagen sponge; and quantitative by stereology, aiming to calculate the volume of new bone, it was found higher values for the groups treated with rhBMP-2 pure or combined to the carrier; but for the groups treated with ethanol, it was found higher bone formation in the groups treated with rhBMP-2 associated to the carrier in the periods of 4 and 6 weeks (p <0.001). It was concluded in this experimental model that the carrier was effective for rhBMP-2 delivery, even in the presence of ethanol.

Todo indivíduo nasce com um potencial genético de crescimento, que poderá ou não ser atingido, dependendo das condições de vida a que esteja submetido. Pode-se dizer que o crescimento sofre influência de fatores intrínsecos (genéticos e metabólicos) e extrínsecos (fatores ambientais como a alimentação, a saúde, a higiene, a habitação e o acesso aos serviços de saúde). Entre fatores nutricionais destacam-se as deficiências de vitaminas e oligoelementos que podem associar-se à desnutrição ou depender da absorção insuficiente dos mesmos. Sendo o cálcio um dos principais componentes do tecido mineral ósseo, podemos sugerir que este seja o principal nutriente para a adequada formação óssea e, considerando que a vitamina D desempenha papel importante no metabolismo do cálcio, uma dieta insuficiente nestes nutrientes pode influenciar a formação do esqueleto. Esta revisão da literatura visa enfatizar a importância nutricional do cálcio e vitamina D no processo de crescimento e desenvolvimento, auxiliando profissionais da área da saúde na atualização quanto às recomendações e fontes dietéticas de ambos nutrientes. Assim, em crianças e adolescentes, a baixa ingestão ou baixa absorção de cálcio e vitamina D pode limitar seu desenvolvimento estatural, sendo necessário fornecer quantidades suficientes de ambos na fase critica do crescimento. / Every individual is born with a genetic potential for growth, which may or not be attained, depending on their living conditions. It could be said that growth is influenced by intrinsic (genetic and metabolic) and extrinsic factors (environmental factors such as diet, health, hygiene, housing and access to health services). Outstanding among the nutritional factors are vitamin and oligoelement deficiencies which may be associated with malnutrition or depend on insufficient absorption. Since calcium is the one of main mineral bone tissue component, we suggest that this is the main nutrient for adequate bone formation and, considering that vitamin D plays an important role in calcium metabolism, a diet with an insufficient amount of these nutrients can influence the formation of the skeleton. This review of the literature aims to emphasize the nutritional importance of calcium and vitamin D in the growth and development process, helping health care professionals update the recommendations and dietary sources of both nutrients. Thus, in children and adolescents, the low intake or low absorption of calcium and vitamin D may limit their stature development, and it will be necessary to supply sufficient amounts of both during the critical growth phase.

Vascular calcification is a prominent cardiovascular condition found worldwide. This condition is predominantly found in the elderly population, and patients who suffer from chronic kidney disease, due to an imbalance of serum phosphate and calcium levels. For many years, vascular calcification was believed to be a passive pathological process which develops with ageing and/or lifestyle. Little has been documented about the disease until the 20th century, when interest in cardiovascular research grew amongst scientists. Indeed, vascular calcification underpins severe clinical outcomes and cardiovascular diseases have been labelled the global leading cause of death. Calcific aortic valve diseases (CAVD) is a progressive degenerative condition characterised by the development of lipo-calcification around the aortic valve leaflets leading to severe aortic stenosis and aortic regurgitation, which may ultimately lead to heart failure. At present there are no pharmaceutical therapies that can stop its progression and its molecular mechanisms are not fully understood. Recent findings have suggested that vascular smooth muscle cell (VSMC) calcification shares many common features with physiological skeletogenesis via the release of matrix vesicles (MVs), which are specialised structures that initiate mineralisation during bone formation. The ability for MVs to nucleate calcium and phosphate highly depend on their protein composition, as this may vary depending on active cell signalling and the microenvironment. This mechanism involving MV-regulated calcification has yet to be examined in CAVD. In this study, examined whether calcium and/or phosphate regulate VIC-derived MVs to induce calcification in the aortic valve. I used a primary rat valve interstitial cell (VIC) model, coupled with stenotic human valve tissues to characterise and study the mechanisms underpinning CAVD. X-ray fluorescence and diffraction analysis showed the mineral found in calcified human aortic valves to be hydroxyapatite (HA), the main component in bone. Additional imaging studies employing transmission electron microscopy (TEM) revealed particles that were similar in size and morphology to skeletal MVs. To further characterise VIC-derived MVs in vitro, I harvested MVs from rat VICs, and subsequently studied their protein composition using Isobaric tag for relative and absolute quantitation (iTRAQ) mass spectrometry. The data obtained from the proteomics analysis was compared to previous published studies on MV proteins derived from osteoblasts and VSMCs. The results showed the upregulation of numerous calcification regulators in MVs isolated from all 3 cell types, in particular, the Annexin family, which are known calcium binding proteins. Further studies conducted with Annexin 6, an established calcium regulator in arterial calcification, revealed its colocalisation with MV-enriched areas in calcified human aortic valve tissue suggesting it may play an important role in calcium regulation during CAVD.

Rosiglitazone (RSG) is an insulin-sensitizing drug used to treat Type 2 Diabetes Mellitus (T2DM). Clinical trials show that women taking RSG experience more limb fractures than patients taking other T2DM drugs. The purpose of this study is to understand how RSG (3mg/kg/day and 10mg/kg/day) and the bisphosphonate alendronate (0.7mg/kg/week) alter bone quality in the male, female and female ovariectomized (OVX) Zucker fatty rat model over a 12 week period. Bone quality was evaluated by mechanical testing of cortical and trabecular bone. Microarchitecture, bone mineral density (BMD), cortical bone porosity, bone formation/resorption and mineralization were also measured. Female OVX RSG10mg/kg rats had significantly lower vertebral BMD and compromised trabecular architecture versus OVX controls. Increased cortical porosity and decreased mechanical properties occurred in these rats. ALN treatment prevented these negative effects in the OVX RSG model. Evidence of reduced bone formation and excess bone resorption was detected in female RSG-treated rats.

Rosiglitazone (RSG) is an insulin-sensitizing drug used to treat Type 2 Diabetes Mellitus (T2DM). Clinical trials show that women taking RSG experience more limb fractures than patients taking other T2DM drugs. The purpose of this study is to understand how RSG (3mg/kg/day and 10mg/kg/day) and the bisphosphonate alendronate (0.7mg/kg/week) alter bone quality in the male, female and female ovariectomized (OVX) Zucker fatty rat model over a 12 week period. Bone quality was evaluated by mechanical testing of cortical and trabecular bone. Microarchitecture, bone mineral density (BMD), cortical bone porosity, bone formation/resorption and mineralization were also measured. Female OVX RSG10mg/kg rats had significantly lower vertebral BMD and compromised trabecular architecture versus OVX controls. Increased cortical porosity and decreased mechanical properties occurred in these rats. ALN treatment prevented these negative effects in the OVX RSG model. Evidence of reduced bone formation and excess bone resorption was detected in female RSG-treated rats.

Patients with inflammatory or infectious conditions such as periodontitis, peri-implantitis, osteomyelitis, rheumatoid arthritis, septic arthritis and loosened joint prosthesis display varying severity of destruction in the adjacent bone tissue. Bone loss in inflammatory diseases is considered a consequence of cytokine induced RANKL and subsequent enhanced osteoclast formation. Hence, osteotropic cytokines and their receptors have been suggested to be important for the pathogenesis of inflammation-induced osteolysis. It is, here, suggested that bacterial components, so called “pathogen associated molecular patterns=PAMPs”, may also be involved. Varieties of cells express receptors for PAMPs, including Toll-like receptors (TLRs) which are the first line of defence in the innate immune system. LPS (lipopolysaccharide), fimbria and lipoproteins from pathogenic bacteria such as P. gingivalis, S. aureus are ligands for TLR2 and flagellin from pathogenic flagellated bacteria like S. typhimurium is a ligand for TLR5.   Since the susceptibility to, or the severity of inflammation-associated bone diseases are likely related to differences in the tissue response, and the mechanisms by which PAMPs interact with bone cells are not fully understood, we aimed to elucidate the importance of different TLRs for inflammation induced bone loss by conducting in vitro and in vivo investigations. Activation of TLR2 and TLR5 in organ cultured mouse parietal bones increased bone resorption in a time- and concentration-dependent manner by a process inhibited by OPG and bisphosphonate, showing the crucial role of RANKL-induced osteoclast formation. In addition, the number of osteoclasts, expression of osteoclastic genes and osteoclastogenic transcription factors were increased. In the bones and in osteoblasts isolated from the bones, TLR2 agonists increased the expression of RANKL without affecting OPG, while TLR5 activation resulted in enhanced RANKL and decreased OPG. Activation of both TLR2 and TLR5 stimulated the expression in both bones and osteoblasts of prostaglandins and pro-inflammatory cytokines, known to stimulate RANKL. By blocking the cytokines and prostaglandin, we showed that TLR2 and TLR5 induced bone resorption and RANKL expression are independent of these molecules. Activation of TLR2, but not TLR5, in mouse bone marrow macrophage cultures inhibited RANKL-induced osteoclast formation, an effect not observed in committed pre-osteoclasts. Local administration in vivo of TLR2 and TLR5 agonists on the top of mouse skull bones enhanced local and systemic osteoclast formation and bone resorption. Using knockout mice, we showed that the effects by LPS from P. gingivalis (used as TLR2 agonist) and flagellins (used as TLR5 agonists) are explicit for TLR2 and TLR5 ex vivo and in vivo, respectively. These data show that stimulation of TLR2 and TLR5 results in bone resorption in vitro and in vivo mediated by increased RANKL in osteoblasts and thus may be one mechanism for developing inflammatory bone loss. Interestingly, histological analyses of skull bones of mice treated locally with TLR2 and TLR5 agonists revealed that the bones not only reacted with locally increased osteoclastogenesis (osteoclast formation), but also with locally increased new bone formation. This was observed on both periosteal and endosteal sides of the bones, as well as in the bone marrow compartment. The formation of new bone was seen close to osteoclasts in some parts, but also in other areas, distant from these cells. The response was associated with active, cuboidal osteoblasts, extensive cell proliferation and increased expression of genes coding for bone matrix proteins and osteoblastic transcription factors. In conclusion, activation of TLR2 and TLR5 in osteoblasts results in bone loss associated with enhanced osteoclast formation and bone resorption, as well as with increased osteoblast differentiation and new bone formation, indicating that inflammation causes bone modeling. The data provide an explanation why LPS from P. gingivalis and flagellin from flagella-expressing bacteria can stimulate bone loss. Since TLR2 and TLR5 can be activated not only by bacterial components, but also by endogenous ligands produced in inflammatory processes, the data also contribute to the understanding of inflammation induced bone loss in autoimmune diseases. Hopefully, these findings will contribute to the development of treatment strategies for inflammation induced bone loss.

Bone defects treatment and reconstructive surgery continues to increase at a significant rate. Current bone defect treatments are autotransplantation, allograft, and xenografts create many problems such as, inflammation, infection and chronic pain. Moreover, allografts and xenografts arouse immune rejection. These problems have led to development of controlled release system for use as alternatives to autografts, allografts and xenografts in bone repair. There have been many approaches for sustained drug delivery in local bone regeneration using biodegradable polymers and osteotropic biomolecules. This dissertation presents new approaches that apply intermittent drug delivery for local bone regeneration. In the first, the osteotropic molecules simvastatin (Sim) or parathyroid hormone (PTH) were released with intermittent profiles. In the second, alternating delivery of Sim and PTH as well as alternating release of the antimicrobial agent cecropin B (CB) with Sim or PTH. An association polymer system of cellulose acetate phthalate (CAP) and Pluronic F-127 (PF-127) was used for the delivery vehicle. Each device showed discrete peaks in release profiles and lasted more than 10 days. Release profiles could be controlled by altering surface area exposed to aqueous environment, number of layers, loading, and blending ratios. Cells were cultured with sustained or intermittent exposure to Sim or PTH at various concentrations, and alternating exposure to CB and Sim or PTH and to Sim and PTH at different concentrations. Low dose Sim and PTH treatments stimulated higher osteoblastic activity than observed in control cultures. Furthermore, intermittent delivery was more effective than sustained exposure. In vivo, newly formed bone was found in animals implanted with both blank Sim-loaded devices. However, a greater anabolic effect was seen for Sim release devices. Further, intermittent release devices stimulated the greatest woven bone thickness, total bone area, and lamellar bone area. These results suggest that intermittent release devices containing a single molecule, Sim or PTH, and alternating release devices containing multiple molecules, CB with Sim or PTH, possess promising potential as a treatment for local bone regeneration.