Abstract
Vascular endothelial growth factor (VEGF), an angiogenic growth factor, has been proved to play a significant role in bone remodeling. It may be involved in the molecular pathogenesis of postmenopausal osteoporosis. The aim of this study was to investigate the expression of VEGF in bone biopsies of postmenopausal osteoporotic patients, assess the relation between the expression of VEGF and bone mineral density (BMD), and to evaluate the association between VEGF, serum estradiol, and bone estrogen receptor-α. This study was carried out on 30 female patients who were further subdivided into three groups: premenopausal, perimenopausal, and postmenopausal. All of them were subjected to full assessment of history, thorough clinical examination, and routine laboratory investigations. Serum estradiol levels were measured using ELISA. BMD was detected using DEXA. Bone biopsies were taken and three sections were obtained from each specimen. One was stained with hematoxylin and eosin stain for bone histomorphometrical assessment. The other two sections were stained immunohistochemically for the detection of VEGF and estrogen receptor-α (ER-α) expression. A highly statistically significant difference was found in VEGF expression between the premenopausal, perimenopausal, and postmenopausal women and also between osteoporotic and nonosteoporotic women. A highly statistically positive correlation was found between VEGF and each of the following: BMD, bone anabolic histomorphometrical parameters E2, and ER-α. However, a highly statistically negative correlation was observed between VEGF and bone histomorphometrical resorption parameters. VEGF expression is decreased in bone of postmenopausal osteoporotic patients and is correlated to BMD. Its release is dependent on E2 and mediated through ER-α. These suggest that bone alterations induced by reduced estrogen in postmenopausal osteoporosis may be partly through decreased VEGF release. This makes it one of the possible targets in the treatment of postmenopausal osteoporosis.
Highlights
The main effects of Vascular endothelial growth factor (VEGF) are on endothelial cells, they bind to VEGF receptors expressed on monocytes, neurons, chondrocytes, and osteoblasts [5]
This study was carried out on 30 female patients who were divided according to their menopausal status into three groups, each including 10 patients: Premenopausal women were included in group I, perimenopausal women were included in group II, and postmenopausal women were included in group III
VEGF expression is decreased in bone of postmenopausal osteoporotic patients and is correlated to bone mineral density (BMD)
Summary
Osteoporosis is a progressive systemic skeletal disorder characterized by low bone mineral density (BMD) and microarchitectural deterioration of bone tissue that reduces bone strength and increases the risk of fractures [1].and arterial capillaries in the bone marrow (BM) and reduced bone perfusion, suggesting the role of a vascular component in the pathogenesis of this disease and confirming what was reported previously, that is, coupling between angiogenesis and osteogenesis was essential for normal bone formation [3].Postmenopausal osteoporosis is mainly caused by increased bone remodeling resulting from estrogen deficiency with induced imbalance between bone formation and resorption such that resorption is favored over formation [2].Bone biopsies from postmenopausal osteoporotic patients were characterized by a reduction in sinusoidalVascular endothelial growth factors (VEGFs) and their corresponding receptors are key regulators in a cascade of molecular and cellular events that lead to angiogenesis [4]. A previous study [7] reported that VEGF exerted a direct effect on osteoprogenitor cells by promoting their differentiation into osteoblasts It could promote mineralization of the bone and increase the bone density. Vascular endothelial growth factor (VEGF), an angiogenic growth factor, has been proved to play a significant role in bone remodeling It may be involved in the molecular pathogenesis of postmenopausal osteoporosis. Aim The aim of this study was to investigate the expression of VEGF in bone biopsies of postmenopausal osteoporotic patients, assess the relation between the expression of VEGF and bone mineral density (BMD), and to evaluate the association between VEGF, serum estradiol, and bone estrogen receptor-α. Its release is dependent on E2 and mediated through ER-α These suggest that bone alterations induced by reduced estrogen in postmenopausal osteoporosis may be partly through decreased VEGF release. This makes it one of the possible targets in the treatment of postmenopausal osteoporosis
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