Abstract

Immune modulation has been recognized as an effective anti-osteoporosis strategy since the pivotal role of the RANK/RANKL/OPG signaling in bone metabolism and remodeling was discovered. To investigate the potential preventive and/or therapeutic effects of immune modulator protein Ling Zhi-8 (LZ-8) on osteoporosis, the osteoporosis animal model was established in Wistar rats by intramuscular injection of dexamethasone (DEX), namely glucocorticoids-induced osteoporosis (GIOP) rat model. To investigate the potential preventive effect of rLZ-8 on GIOP, we co-treated the rats with DEX and rLZ-8 intraperitoneally during the GIOP modeling stage and analyze the bone mass measured by bone mineral content (BMC) and bone mineral density (BMD), as well as levels of phosphorus (Pi), calcium (Ca2+) and hydroxyproline (HOP) in femur of GIOP rats. Consistently, all results suggested that rLZ-8 could prevent bone loss in the femurs of GIOP rats. Through analyzing the trabeculae morphology and the trabeculae amount by H&E staining, we found rLZ-8 could also improve the structural deterioration in femurs of GIOP rats. In order to further verify the results and its mechanism obtained from bone analysis, multiple biomarkers, including minerals metabolism (Pi and Ca2+), bone formation markers (osteocalcin, ALP and IGF-1), bone resorption markers (TRACP5b, CTX-1 and HOP), cytokines (IL-1β, IL-6 and TNF-α), oxidative stress indicators (GSH-px, SOD and MDA) and hormone molecules (testosterone, estradiol, calcitonin and parathyroid hormone) have been detected in serum or urine of rats. Results of these biomarkers in serum or urine confirmed rLZ-8’s protective effect in GIOP. Through analyzing the relative expression level of OPG and RANKL in femurs via western blot, we foundrLZ-8 could increase OPG/RANKL ratio which could impede osteoclastogenesis process. To test the potential therapeutic effect of rLZ-8 on successfully generated GIOP rats, we administrated rLZ-8 to rats for three weeks starting from the ending day of 7 weeks treatment of DEX. We found rLZ-8 could also reverse the bone loss in GIOP rats. Through the BWs and organ coefficient analysis, we found rLZ-8 has little toxicity to the rats. Our results suggested that rLZ-8 may be developed into promising anti-osteoporosis drug with both preventive and therapeutic properties.

Highlights

  • Glucocorticoids (GCs) have been widely prescribed as effective immunosuppressive agents in the treatment of allergies, inflammatory conditions, or cancer for decades (Vandewalle et al, 2018)

  • Considering that glucocorticoids-induced osteoporosis (GIOP) is caused by disorder of immune regulation by GCs prolonged use, we are very interested in investigating whether Ling Zhi-8 (LZ-8), the immune modulator derived from G. lucidum, has preventive and/or therapeutic effects in treating GIOP

  • Recombinant LZ-8, immune modulator derived from G. lucidum, could prevent bone mass loss measured by bone mineral content (BMC), bone mineral density (BMD), levels of Pi, Ca2+ and HOP in femur of GIOP rats

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Summary

Introduction

Glucocorticoids (GCs) have been widely prescribed as effective immunosuppressive agents in the treatment of allergies, inflammatory conditions, or cancer for decades (Vandewalle et al, 2018). The most widely used anti-osteoporosis medications are anti-resorptive drugs, such as bisphosphonates (alendronate, risedronate, zoledronate, and ibandronate) and RANKL antibodies which are largely limited by the adverse events in high risk of gastrointestinal disturbance and infection respectively (Lorentzon, 2019). Two novel anabolic drugs improving bone formation, teriparatide and romosozumab, which are recombinant human parathyroid hormone and sclerostin monoclonal antibody respectively, provide promising options for osteoporosis treatment with side effects in high risk of transient or persistent hypercalcemia and stroke (Saag et al, 2017; Peugh et al, 2019). Considering that GIOP is caused by disorder of immune regulation by GCs prolonged use, we are very interested in investigating whether LZ-8, the immune modulator derived from G. lucidum, has preventive and/or therapeutic effects in treating GIOP

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