Effects of thyroxine on cortical bone remodeling in adult dogs: a histomorphometric study.

The effects of thyroxine on cortical bone remodeling were studied under conditions of normal and accelerated remodeling induced by surgical elevation of the periosteum. Six adult female beagle dogs were administered orally 1.0 mg of L-thyroxine per kg body weight daily for 60 days. Static and dynamic changes were evaluated using tetracycline and DCAF (2,4-bis-N,N'-dicarboxymethyl aminomethyl fluorescein) in vivo double labeling of rib specimens taken before treatment and after 60 days. Thyroxine administered in moderate pharmacologic doses increased the activation frequency, number of bone-forming and -resorbing sites, and the osteoid seam circumference in unaltered bone. Thyroxine, by activating skeletal remodeling, increased bone turnover and both formation and resorption at the tissue level. In ribs with periosteal elevation and accelerated remodeling, thyroxine increased the activation frequency, number of bone resorption and formation sites, and ratio of bone resorptive-to-formative surfaces. In addition, thyroxine under these conditions resulted in an increase in the osteoid seam circumference, radial closure rate, and bone formation rate at the tissue level but decreased the osteon formation time. Under conditions of accelerated remodeling, thyroxine increased osteoblastic and resorptive activity to a greater degree than in unaltered bone and resulted in bone changes similar to that described in human beings with thyrotoxicosis. The increased serum calcium and phosphorus levels and urinary hydroxyproline excretion at several intervals during thyroxine administration were consistent with the morphometric evidence of increased bone turnover and resorption. These findings suggest that thyroxine is a potent activator of skeletal remodeling under conditions of both normal and accelerated remodeling.     

Selective deficiency of 1,25-dihydroxycholecalciferol. A cause of isolated skeletal resistance to parathyroid hormone.

To investigate the role of vitamin D metabolites in the pathogenesis of pseudohypoparathyroidism, we studied an elderly man with a unique variant of the disease, which was characterized by hypocalcemia, elevated serum parathyroid hormone (513 +/- 13 pg per milliliter, mean +/- S.E.M., normal, less than 450) but normal renal responses (phosphate and cyclic AMP) to exogenous parathyroid extract. Treatment with parathyroid extract did not produce a calcemic effect, suggesting an isolated skeletal hyporesponsiveness to parathyroid hormone. Although 25-hydroxyvitamin D levels were not reduced, levels of 1,25-dihydroxycholecalciferol were extremely low (0.52 ng per deciliter; normal 3.3 +/- 0.06, S.D.). Treatment with 1,25-dihydroxycholecalciferol (1 microgram by mouth per day for four days) increased circulating levels to normal (4.60 ng per deciliter) and restored to normal the calcemic response to parathyroid (change in calcium 3.0 mg per deciliter). These data suggest that 1,25-dihydroxycholecalciferol deficiency may explain the skeletal resistance, but not the renal resistance, often present in classic pseudohypoparathyroidism.     

The effect of parathyroid hormone, 1,25-dihydroxycholecalciferol and prostaglandins on the cytoplasmic activity of isolated osteoclastsxs

Osteoclasts were isolated on glass or plastic substrates and the effect of bone-active hormones and prostaglandins on their behaviour was observed. Untreated osteoclasts migrate across the substratum, actively extending pseudopodia which show intense “rippling” activity. Addition of parathyroid hormone (PTH), 1,25-dihydroxycholecalciferol (1,25-(OH)₂D₃), prostaglandins (PG) F_2α, E₂ and thromboxane B₂ caused no change in the behaviour or morphology of these osteoclasts. Prostacyclin, however, caused rapid cessation of cytoplasmic rippling activity followed by gradual pseudopodial retraction in a manner indistinguishable from that previously observed in the presence of calcitonin. The cytoplasmic quiescence induced by prostacyclin was seen at concentrations of 10^?9M and above. Quiescence was reversible and its duration depended upon the dose of the compound administered (prostacyclin decays rapidly). No such effect was observed on the behaviour of the other cell types contaminating the osteoclast cultures, nor on purified populations of osteoblasts or peritoneal macrophages. We also tested the ability of PTH, 1,25-(OH)₂D₃ and PGs to reverse calcitonin-induced osteoclast quiescence. We found that even high doses showed no detectable stimulation of quiescent isolated osteoclasts. This suggests that the undoubted ability of these hormones to stimulate osteoclastic activity in vivo is mediated indirectly, following a primary hormonal interaction with another cell type. We propose a model for the control of osteoclasis based on these observations. Prostacyclin may play the role of a local-acting hormone, produced by osteoblasts, which terminates osteoclasis when the requirements of local bone morphogenesis are fulfilled. Calcitonin exerts a direct inhibitory action on isolated osteoclasts and we suggest that this is opposed in vivo by an osteoclastic stimulator, released by osteoblasts. The hormones PTH, 1.25-(OH)₂,D₃, and PGE₂, stimulate osteoclastic activity indirectly following a primary interaction with osteoblasts, and may do so either by reducing the release of prostacyclin by osteoblasts or increasing formation of the unknown stimulator, or both.     

Star volume in bone research. A histomorphometric analysis of trabecular bone structure using vertical sections

Conventional bone histomorphometry performed on iliac crest biopsies does not generally provide unbiased stereological estimates of parameters related to bone structure due to the anisotropy of trabecular bone; this, however, can be obtained with vertical sections, which are anisotropic sections, in combination with an anisotropic test system. A practical procedure for obtaining vertical sections from bone is described. The new stereological parameter, the star volume, can provide an unbiased estimation of the absolute mean size of the marrow space and thus give an indirect estimate of the connectivity of trabecular bone structure. The marrow space star volume of vertebral bodies and iliac crest increases with age in both sexes demonstrating that the structural bone changes which occur with age is a topological one with changes in trabecular connectivity. The practical procedure including sampling efficiency for marrow space star volume is described. © 1993 Wiley-Liss, Inc.     

Morphology and biochemistry of bone remodeling: possible control by vitamin D, parathyroid hormone, and other substances

The effects of PTH and vitamin D on bone are the result of their direct and indirect effects on the functional cells of bone remodeling units and their precursors. These effects are probably modified or controlled by growth factors, cytokines, and PGs generated locally by the process of bone remodeling. Bone remodeling includes resorptive and bone forming phases, each with a longitudinal and a radial component of progression in time and space. Longitudinal resorption is rapid, prolonged and is probably carried out by osteoclasts utilizing hydrogen ions and lysosomal enzymes to remove mineral and organic components of bone in a highly localized and directed fashion. Individual osteoclasts are probably long-lived cells with a nuclear and perhaps a cytoplasmic turnover rate of 8%/day, with replenishment coming from preosteoclasts in the reversal zone. Radial resorption is slower and shorter than longitudinal resorption. It is carried out by reversal phase monocytes whose exact relationship to osteoclasts is not clear. Activated collagenase diffusing from osteogenic cells in the reversal zone could also play a role. The longitudinal rate of bone formation is probably a measure of the rate of proliferation and differentiation of osteogenic cells at the site at which they were activated. The radial rate of bone formation is a measure of how rapidly osteoblasts synthesize and mineralize bone matrix once they reach the resorption surface. PTH and vitamin D have no direct effects on mature osteoclasts. They may have direct stimulatory effects on proliferation and differentiation of osteoclast precursors and their fusion with osteoclasts but this is not clear because the ontogeny of osteoclasts vis a vis monocytes and other phagocytic cells is still not clear. It is likely that their effects to increase osteoclast precursors involve interactions among lymphocytes, monocytes, and hematopoietic stem cells at a distance from bone remodeling units and are mediated by 1,25(OH)2 vitamin D3 induced synthesis of cytokines and colony-stimulating factors. Stimulatory effects of PTH, vitamin D, PGs, and cytokines on osteoclasts are mediated by as yet undefined factors produced by osteoblasts. Osteoblasts stimulated by PTH could also inhibit osteoclasts by synthesizing and releasing PGs. PTH and vitamin D have diverse and often contradictory effects on the functional activity of osteoblast-like cells in vitro that are difficult to interpret because the relationship of these cells to osteoblasts in vivo is not clear.(ABSTRACT TRUNCATED AT 400 WORDS)     

Bone marrow ablation demonstrates that excess endogenous parathyroid hormone plays distinct roles in trabecular and cortical bone

Mice null for Cyp27b1, which encodes the 25-hydroxyvitamin D-1α-hydroxylase [1α(OH)ase(-/-) mice], lack 1,25-dihydroxyvitamin D [1,25(OH)(2)D] and have hypocalcemia and high parathyroid hormone (PTH) secretion. Intermittent, exogenous PTH is anabolic for bone. To determine the effect of the chronic excess endogenous PTH on osteogenesis and bone turnover, bone marrow ablations (BMX) were performed in tibiae and femurs of 6-week-old 1α(OH)ase(-/-) mice and in wild-type (WT) controls. Newly formed bone tissue was analyzed at 1, 2, and 3 weeks after BMX. BMX did not alter the higher levels of PTH in 1α(OH)ase(-/-) mice. In the marrow cavity, trabecular volume, osteoblast number, alkaline phosphatase-positive areas, type I collagen-positive areas, bone formation-related genes, and protein expression levels all increased significantly after BMX in 1α(OH)ase(-/-) mice, compared with WT. Osteoclast numbers and surface and ratio of RANKL/OPG-relative mRNA levels decreased significantly after BMX in 1α(OH)ase(-/-) mice, compared with WT. In the cortex, alkaline phosphatase-positive osteoblasts and osteoclast numbers increased significantly after BMX in 1α(OH)ase(-/-) mice, compared with WT. These results demonstrate that chronic excess endogenous PTH exerts an anabolic role in trabecular bone by stimulating osteogenic cells and reducing bone resorption, but plays a catabolic role in cortical bone by enhancing bone turnover with an increase in resorption.     

Hypomagnesaemia-induced hypocalcaemia: concentrations of parathyroid hormone, prolactin and 1,25-dihydroxyvitamin D during magnesium replenishment.

Three patients with hypomagnesaemia-induced hypocalcaemia were investigated during the phase of magnesium replenishment. Before treatment, serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were at the lower limit of normal. In spite of a rapid rise of parathyroid hormone (PTH) after intravenous administration of magnesium, a reactive increase in 1,25-dihydroxyvitamin D in serum was absent or delayed. The increase of serum calcium into the normal range occurred before any consistent change in the concentrations of this vitamin D metabolite. The rise of serum prolactin in response to the increase in PTH was blunted or absent, and is a further example of a transient PTH resistance during the phase of magnesium replenishment.     

The association of bone mineral density and parathyroid hormone with serum magnesium in adult patients with sickle-cell anaemia

Introduction

Bone disorders including osteopenia and osteoporosis are a frequent cause of morbidity in sickle-cell disease (SCD). Magnesium (Mg) regulates some biological processes important in bone remodelling. We aimed to investigate whether serum Mg levels (sMg) may have an impact on bone mineral density (BMD) in sickle-cell anaemia (SCA).

Material and methods

Sixty adults with SCA in steady-state and 20 age- and race-matched healthy blood donors were included in the study. The BMD was evaluated with respect to minerals and biochemical indices of bone metabolism. Multivariate analysis was performed to determine the factors influencing BMD.

Results

The mean sMg concentration was 0.64 ±0.06 (reference range 0.7-1.2 mmol/l) for 34% of the population, and 0.86 ±0.08 mmol/l for 66%. There were significant differences between Mg groups and controls in BMD, phosphorus (PO₄), parathyroid hormone (PTH) (p = 0.011, p = 0.011 and p = 0.0001 respectively) and osteocalcin (OC) (p = 0.030) levels. The sMg was found to be associated positively with serum calcium (Ca), PTH and OC (r = 0.585; r = 0.436; r = 0.351 respectively, all at p < 0.05), and negatively with PO₄ (r = –0.312; p < 0.05). Multivariate analysis demonstrated that only PTH (p < 0.05) was an independent factor for BMD. Moreover, it identified sMg, OC, and CTX as independent factors for PTH (all p < 0.05).

Conclusions

These results indicate that serum Mg may be a co-contributing factor in causing low BMD. However, other possible aetiologies including decreased PTH and increased bone turnover certainly play a role. Based on the present data, it is prudent to monitor sMg routinely in this patient population and treat the condition whenever possible.     

The control of bone growth by parathyroid hormone,leptin, & statins

There is a need for anabolic drugs that can stimulate bone growth, improve bone microarchitecture, accelerate fracture healing and thus restore bone strength to oteoporotics. The anabolic agents currently leading the way to the clinic are the parathroid hormone (PTH) and some of its adenylyl cyclase-stimulating fragments. Here we discuss what is known about the genes and their products that are stimulated by PTHR1 receptor signals and in four ways cause a large accumulation of bone-building osteoblasts. We will also discuss the currently controversial anabolic activity of the cholesterol-lowering statins and outline a possible mechanism by which they might stimulate BMP-2 expession and bone growth. Finally, we will present the growing evidence for the body's "fat-o-stat" cytokine-leptin-indirectly restraining bone growth via a hypothalamic factor and at the same serving as a local autocrine/paracrine stimulator of osteoblast activity via IGF-I and an inhibitor of osteoclast generation by stimulating osteoblastic cells' antiosteoclast OPG (osteoprotegerin) expression and reducing their proosteoclast RANKL expression.     

Renal handling of calcium: influence of parathyroid hormone and 1,25-dihydroxyvitamin D3.

The influence of parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on the renal Ca handling was studied in vitamin D-replete rats. The relation between plasma concentration ([Ca]P) and urinary Ca (UCaV/ml GF) was ascertained by clearance techniques over the [Ca]P range of 1.4-3.4 mM varied by infusion of Ca gluconate. Chronic thyroparathyroidectomy (TPTX) decreased the plasma Ca threshold from about 2.3 to 1.5 mM. Between [Ca]P 1.4 and 3.4 mM there was a linear increase in UCaV/ml GF corresponding to 35-50% of the increment in filtered load. In TPTX, PTH (2.5 IU/h i.v.) shifted the Ca threshold from 1.5 to 2.3 mM, without changing the slope of UCaV/ml GF on [Ca]P. The effect of TPTX on the renal Ca handling was not corrected by doses of 1,25(OH)2D3, which increased the intestinal Ca absorption of TPTX rats to normal level. In intact and TPTX rats disodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) given at doses which inhibit the production of 1,25(OH)2D3 did not change the tubular Ca handling. Furthermore, 1,25(OH)2D3 had no effect in EHDP-treated TPTX rats. Therefore, tubular Ca handling does not appear to be altered in response to chronic endogenous variation or physiologic supplementation of 1,25(OH)2D3 in vitamin D-replete rats. This is in contrast to the marked alteration observed after TPTX or PTH administration.     

The effects of PRGF on bone regeneration and on titanium implant osseointegration in goats: a histologic and histomorphometric study

The effect of local application of scaffold-like preparation rich in growth factors (PRGF) on bone regeneration in artificial defects and the potential effect of humidifying titanium dental implants with liquid PRGF on their osseointegration were investigated. The PRGF formulations were obtained from venous blood of three goats and applied either as a 3D fibrin scaffold (scaffold-like PRGF) in the regeneration of artificial defects or as liquid PRGF via humidifying the implants before their insertion. Initially, 12 defects were filled with scaffold-like PRGF and another 12 were used as controls. The histological analysis at 8 weeks revealed mature bone trabeculae when PRGF was used, whereas the control samples showed mainly connective tissue with incipient signs of bone formation. For the second set of experiments, 26 implants (13 humidified with liquid PRGF) were placed in the tibiae of goats. Histological and histomorphometric results demonstrated that application of liquid PRGF increased the percentage of bone-implant contact in 84.7%. The whole surface of the PRGF-treated implants was covered by newly formed bone, whereas only the upper half was surrounded in control implants. In summary, PRGF can accelerate bone regeneration in artificial defects and improve the osseointegration of titanium dental implants.     

Skeletal alterations in hypophysectomized rats: II. A histomorphometric study on tibial cortical bone

Background: Pituitary hormones play an important role in bone growth, modeling, and remodeling. The purpose of this study is to examine the effect of hypophysectomy (HX) on tibial cortical bone with histomorphometry. Methods: Forty-Five female Sprague-Dawiey rats, at 3 months of age, were hypophysectomized or served as intact controls. They were sacrificed at 0, 2, and 5 weeks after the surgery. Cortical bone histomorphometry was performed on double-fluorescent-labeled 30-mcm-thick sections of the tibial shaft. Results: The dry weight and density of tibial diaphysis and the cortical bone area of the tibial shaft in the HX rats were significantly lower (P<0.05) than that of the age-matched intact rats, but did not differ between the HX and basal control rats. The dynamic data show that the bone formation parameters (labeled surface, mineral apposition rate, and bone formation rate) were profoundly decreased (P<0.01) on both the periosteal and endocortical surfaces in the HX rats as compared with the age-matched intact rats at the 2 and 5 weeks. However, the decrease in the labeled surface was much less on the endocortical envelope than on the periosteal envelope in the HX rats. Although no significant change was detected in the medullar size between the HX and age-matched intact rats, the eroded surface on the endocortical surface was greater (P<0.05) in the HX rats than in the intact rats at either time point. Conclusions: Hypophysectomy-suppressed, radial growth-dependent bone gain without a bone loss in the tibial shaft of the young rat. This is associated with decreased modeling-dependent bone formation. A greater eroded surface on the endosteum did not affect the marrow size at 5 weeks after hypophysectomy. © 1995 Wiley-Liss, Inc.     

Skeletal alterations in hypophysectomized rats: I. A histomorphometric study on tibial cancellous bone

Background: Hypophysectomy (HX) results in a cessation of bone growth and a decrease in bone metabolism. The purpose of this study is to examine the effect of HX on the static and dynamic histomorphometry of cancellous bone in the secondary spongiosa of the proximal tibial metaphysis in rats. Methods: Female rats, at 2 or 3 months of age, were HX and sacrificed at 0, 5 days, 2 and 5 weeks after the surgery. Age-matched intact rats served as controls. Cancellous bone histomorphometry was performed on doublefluorescent labeled, 30-um-thick sections of the proximal tibia. Tartrateresistant acid phosphatase histomorphometry was performed at 5 days on HX and control rats to evaluate the resorption in the metaphyseal bone. Results: Although the intact rats gained in body weight, tibial length, tibial weight, and density after 5 weeks, these changes did not occur following HX. As compared to the basal group, HX resulted in a decrease in the density and dry weight of the metaphysis. The histomorphometric data showed that the cancellous bone volume and trabecular number of the secondary spongiosa were decreased and the separation was increased in the HX rats. The dynamic results showed that HX significantly decreased longitudinal growth rate and tissue-based bone formation and resorption. However, the bone surface-based eroded surface, labeled surface, the mineral apposition rate, and the bone formation rate did not differ between the intact and the HX rats at either the 2 or 5 weeks study. Five days after HX, the bone surface and tissue-based osteoclast surfaces were significantly lower in the HX than in the intact rats. Conclusions: Pituitary hormone deficiency results in cancellous bone loss. The bone loss is due primarily to the suppression of longitudinal growth-dependent bone gain and the inhibition of tissue-based bone turnover with a lower bone formation relative to bone resorption. The surfacebased bone turnover is not affected. © 1995 Wiley-Liss, Inc.     

A histomorphometric determination of iliac bone remodeling in patients with recurrent renal stone formation and idiopathic hypercalciuria

33 normocalcemic patients (22 males and 11 females) aged 20-68 years with recurrent renal stone formation and idiopathic hypercalciuria were compared to 33 approximately sex- and age-matched normal controls. Quantitative histomorphometric analysis of iliac crest biopsies were performed after intravital tetracycline double labeling in the patients and in 30 sex- and age-matched normal controls. No difference was found between patients and controls in albumin adjusted serum calcium levels. Serum phosphorus was significantly reduced (p less than 0.01) in the patient group whereas the urinary phosphorus/creatinine ratio was increased (p less than 0.01). The serum calcium phosphate product (S-CaxS-P) was significantly reduced in the patients (p less than 0.05). As expected, the urinary calcium/creatinine ratio was higher in the patient group than in the controls (p less than 0.001). Serum parathyroid hormone was normal. The histomorphometric analysis revealed signs of a moderate mineralization defect (reduced adjusted appositional rate (p less than 0.05), prolonged mineralization lag time (p less than 0.05) and prolonged formation (p less than 0.05)), and an increased extension of eroded surfaces (P less than 0.05) in the patients. The amount of trabecular bone and the balance between the thickness of bone resorbed and later formed per remodeling cycle and all other histomorphometric parameters were found normal in the patients. The combined histomorphometric and biochemical data are best explained by a primary renal phosphate leak leading to hypophosphataemia and a slight mineralization defect. The hypercalciuria may be explained by an enhanced renal production of 1.25-dihydroxyvitamin D secondary to the reduced serum levels of phosphorus. No signs of secondary or primary hyperparathyroidism were observed.     

Remodelling of subchondral bone in osteoarthritis: a histomorphometric study.

AIMS: To determine whether remodelling of subchondral bone in osteoarthritis is related to anatomical and mechanical factors operating on the joint surface. METHODS: Ten femoral heads were examined. Patients due to have the femoral head removed because of osteoarthritis were given a double tetracycline label before surgery. The specimens were divided in three roughly equal parts, corresponding to the medial, central (weight bearing), and lateral aspects of the femoral heads. Undecalcified methylmethacrylate embedded sections were prepared. The subchondral bone was assessed for appositional bone formation by ultraviolet light microscopy, for resorptive activity by osteoclast count, and for trabecular bone volume by semiautomatic computerised image analysis. Appositional bone rate was also correlated with the presence or absence of overlying cartilage. RESULTS: Bone density was reduced in the medial aspect of the femoral heads but there was no significant difference between the appositional bone rate or the resorptive activity in the three areas. Nor was there any correlation between appositional bone rate in the subchondral bone and the presence or absence of overlying cartilage. CONCLUSION: Remodelling of subchondral bone in osteoarthritis, at least in the short term, is fairly constant and is not related to weight bearing.