Abstract

BackgroundCyclosprin A (CsA) has been widely used clinically to treat the patients who have undergone organ transplantation or acquired autoimmune disease. The purpose of this study is to determine the effects of three different doses of CsA (1.5, 7.5, 15 mg/kg body weight) on the skeletal biomechanical proprieties at different anatomic sites in rats.MethodsFifty-six male 3-month-old Wistar rats were divided into five groups. Eight rats were randomly chosen as the basal group, while the others were randomly distributed into four groups of 12 animals each. One group was used as controls and received daily subcutaneous injection of 1 ml of saline solution; another three experimental groups were injected subcutaneously with CsA in a daily dose of 1.5, 7.5, and 15 mg/kg body weight respectively for 60 days. The bone biomechanical proprieties, the bone mineral density, as well as the trabecular bone architecture were measured at different anatomic sites, i.e. the lumbar vertebra, the middle femur shaft, and the proximal femur.ResultsCsA therapy at 7.5 and 1.5 mg/kg can significantly reduce the ultimate force, the ultimate stress and the energy absorption per unit of bone volume of the lumbar vertebra, with no effect on the middle femur. CsA therapy at 7.5 mg/kg can significantly reduce the ultimate force, the ultimate stress and the Young's modulus of the femoral neck, but not CsA at 1.5 mg/kg. Furthermore, CsA therapy at 7.5 and 1.5 mg/kg can significantly reduce the bone mineral density of the lumber vertebra and the proximal femur, but have no effect on the middle femur. CsA therapy at 7.5 and 1.5 mg/kg can also significantly reduce the bone volume fraction of the proximal tibia and the lumber vertebra, but has no effect on the cortical thickness of the middle femoral shaft. In the 15 mg/kg CsA group only one rat survived, and the kidney and liver histology of the survived rat showed extensive tissue necrosis.ConclusionLong-term use of CsA can weaken the biomechanical properties and thus increase the fracture rate of the lumbar vertebra and the proximal femur. However, CsA therapy has less effect on the middle femur shaft. The effects of CsA on skeleton are site-specific.

Highlights

  • Cyclosprin A (CsA) has been widely used clinically to treat the patients who have undergone organ transplantation or acquired autoimmune disease

  • Bone mineral density and bone length measurement As we reported in our previous study [19], the L1-5 vertebra and the total femur were removed off the soft tissue, and the bone mineral density (BMD) of the L1-5 vertebra, the femur mid-diaphseal region and the proximal femur region were measured using dual-energy X-ray absorptiometry (Hologic QDR4000, USA)

  • The present study showed that the CsA therapy at 7.5 mg/kg significantly reduced the BMD, the ultimate force and the ultimate stress of the lumbar vertebra and the proximal femur

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Summary

Introduction

Cyclosprin A (CsA) has been widely used clinically to treat the patients who have undergone organ transplantation or acquired autoimmune disease. Some in-vivo studies have demonstrated that CsA in the rats can induce high-turnover bone loss, resulting in an uncoupling of the dynamic bone remodeling cycle with resorption exceeding formation and leading to an ultimate loss of trabecular bone [6,7,8]. Bone histomorphometry in these studies shows increased osteoclast number, increased parameters of bone formation, and decreased percent trabecular bone volume [6,7,8]. Epstein et al founded that PTH may not be essential for CsA-induced bone loss, and Buchinsky et al suggested that T lymphocytes appeared to be a prerequisite for the development of CsA-induced bone loss [14,15]

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