Bone Isoenzyme Of Alkaline Phosphatase Research Articles

Clinical and biochemical changes and their correction in patients with metabolic phenotype of osteoarthritis and insomnia

BACKGROUND: Currently, OA is considered a polyetiological disease, where several phenotypes are distinguished based on the leading role of a specific risk factor. It is assumed that each clinical phenotype corresponds to its own fundamental changes in various organs and systems. Modern experimental evidence of chondro-osteogenic activity allows us to consider melatonin as a potential drug for various types of osteoarticular pathology.AIM: To study clinical and biochemical changes and effects of melatonin in the metabolic phenotype of OA and insomnia.MATERIALS AND METHODS: The study involved patients with a metabolic phenotype of OA and healthy volunteers. The subjects were collected complaints and anamnesis, as well as general clinical and orthopedic examination. In the blood serum, markers of bone and cartilage metabolism were determined. Patients were asked to answer the questions of clinical scales to assess the quality of sleep, the functional state of the joints and quality of life.RESULTS: The study involved 36 patients. Participants were divided into 3 groups: group health patients — patients without articular pathology, sleep quality disorders and normal body mass index; control group- patients with metabolic phenotype of OA, insomnia and basic treatment for 30 days; experimental group — patients with a metabolic phenotype of OA and insomnia, whose basic treatment included melatonin (Melaxen®) at a dosage of 3 mg for 30 days. Statistically significant differences were observed between the initial levels of acid phosphatase (AP), bone isoenzyme alkaline phosphatase (ALP) and calcium (Ca) in the control and experimental groups. According to the results of screening for the detection of insomnia among patients with the metabolic phenotype of, there were statistically significant insomnological disorders compared to the group health patients, as well as significant differences in terms of pain, symptoms, activity and quality of life in general according to the KOOS and SF-36 scales. Correlation analysis showed moderate correlations with biochemical parameters in patients with OA metabolic phenotype groups. After the treatment there was a certain increase in the level of Ca and a decrease in the activity of ALP and АP in patients of experimental group in comparison with patients of control groups. There was a positive trend in the range of criteria of the KOOS and SF-36 scale in experimental groups, pronounced decrease in pain syndrome (P), symptoms (S) and an increase in the levels of daily activity (A) and the total indicator (Sum) in comparison with patients of control groups. Also as improved sleep quality on all scales in comparison with the control group. In control group, problems with the quality and quantity of sleep remained at the same level.CONCLUSION: In patients with the most pronounced indicators of clinical manifestations of OA, more active processes of bone remodeling. The higher the level of bone resorption markers, the greater the severity of the clinical course in patients with osteoarthritis, and the worse the quality of sleep in general. The addition of melatonin to the treatment regimen was associated with a decrease in serum activity of the bone isoenzyme of alkaline phosphatase, acid phosphatase, an increase in calcium levels, as well as with an improvement in sleep and clinical symptoms ОА.

Clinical-radiological, hematological and biochemical assessment of bone replacement with germanium-doped calcium-phosphate ceramics for fragment fractures of tubular bones in dogs

Abstract. Among surgical pathology in animals, asignificant share is occupied by various traumatic injuries of the skeleton, the consequence of which are bonefractures. The results of X-ray and biochemical indicators of blood for bone fragment fractures in dogs arepresented.The purpose of the work is to clinically, radiologically, and pathochemically justify bone replacementwith germanium-doped calcium-phosphate ceramicsfor bone fragment fractures in dogs.In the injured animals of the experimental group(n=10), bone defects were replaced with germanium-doped calcium-phosphate ceramics (ГТлГег-700),in the control group (n=10) with unalloyed ceramics(ГТг-700). The activity of total alkaline phosphatase (ALP)and its bone isoenzyme (KiLP), tartrate-resistant acidphosphatase (TrKF) was determined in blood serum.Measurements were made with a Stat Fax 4500 spectrophotometer.On the 60th day, in the animals of the experimentalgroup, the filling of the bone defect with regeneratedmaterial of high X-ray density was noted, with the absence of periosteal reaction, which indicated the complete consolidation of the fracture and was the reasonfor the removal of the means of fixation. In the control,the area of the bone tissue defect that was not filledwith regenerate was visualized.The activity of tartrate-resistant acid phosphatase(TRP) in both groups tended to increase. On the 14th day,the animals of the experimental group had a peak activity of TrKf (33.8±0.31), which was 1.3 times (p<0.001)higher than the level in the control group and 1.5 times(p<0.001) of clinically healthy animals, respectively. Onthe 30th day of research, a 1.2-fold (p<0.001) decreasein the level of TrCF was noted in the experimental groupcompared to the control group, in which the indicatorreached peak values at 34.9±0.25 units/l.The maximum activity of the bone isoenzyme alkaline phosphatase (KiLF) in the experimental groupwas observed on the 14th day of reparative osteogenesis and was 41.7±0.43 units/l, which is 1.2 times(p<0.001) higher than the indicator of the controlgroup. On the other hand, in the last group, the peakactivity of the bone isozyme was noted only on the30th day (40.9±0.48 units/l), while the indicator of theexperimental animals decreased dynamically duringthis period.The use of calcium-phosphate ceramics for fragment fractures of the bones of the tibia in dogs helpsto reduce the intensity of the inflammatory-resorptivestage of reparative osteogenesis and accelerates consolidation by 1.4 times. The dynamics of biochemicalmarkers of bone metabolism testifies to the optimizedcourse of reparative osteogenesis during osteoreplacement of bone defects with germanium-doped calcium-phosphate ceramics. Key words: bioceramics, germanium, total alkaline phosphatase, bone isoenzyme of alkaline phosphatase, tartrate-resistant acid phosphatase, bonetissue.

PHYSICAL THERAPY OF PATIENTS WITH POST-TRAUMATIC GONARTHROSIS WITH IMBALANCE OF OSTEO-ASSOCIATED MACRONUTRIENTS

According to modern concepts, bone remodeling disorders that are directly dependent on the imbalanceof osteo-associated trace elements play a key role in the pathogenesis of OA. Therefore, the purpose of ourstudy is to develop the program of physical rehabilitation of patients with post-traumatic gonarthrosisand to investigate its effect on the composition of osteoassociated macronutrients.To determine the metabolic function of bone tissue there were the results of the study of mineralhomeostasis by the level in the peripheral blood of phosphorus and magnesium, total calcium and itsionized form, as well as the amount of urinary calcium excretion. The processes of bone formation wereevaluated by the content of bone isoenzyme of alkaline phosphatase, bone resorption was evaluated bythe level of tartrate-resistant acid phosphatase. 42 patients with post-traumatic osteoarthritis of the kneejoints of I–II stages according to Kellgren-Lowrence were observed.The complex of physical therapy included the educational program, medical gymnastics and massage.The theoretical part of the program included 6 topics covering the main issues related to the risk factorsand prognosis for the disease, the main mechanisms of its progression, as well as the basics of differentphysical therapy use. The practical part of the program was carried out in a small-group way and includedthe gradual application of static, dynamic, active and proprioceptive neuromuscular stretching usingthe exercises with elastic bands and metered loading. As for the massage technology a combinationof segmental massage with Swedish technique was used in the program. The total duration of the complexprogram was 9 months, after which patients were advised to perform independent classes. The applicationof the developed program of physical rehabilitation had a positive effect on the processes of boneremodeling, and allowed to reduce the number of exacerbations during the year.

Prepartum measurement of serum biomarkers reflecting osteoclastic and osteoblastic bone metabolism for predicting the risk of milk fever in dairy cows.

We investigated whether prepartum levels of serum bone biomarkers are related to the degree of parturient hypocalcaemia and risk of milk fever (MF) in dairy cows with advancing parity. A total of 58 late-pregnant cattle were assigned to four groups: nulliparous, primiparous, multiparous in the 2nd lactation and multiparous in the 3rd-5th lactation. The multiparous cows were further assigned to MF and non-MF groups according to the onset of MF. Serum samples were obtained from the cows during the 3 weeks prepartum to 5 d postpartum period for the measurement of serum calcium (Ca) and three bone biomarkers: tartrate-resistant acid phosphatase isoform 5b (TRAP5b), osteoprotegerin (OPG) and bone isoenzyme of alkaline phosphatase (ALP3). The ratios of OPG to TRAP5b (O/T ratio) and ALP3 to TRAP5b (A/T ratio) were calculated. The data from all cattle showed that the severity of hypocalcaemia at parturition increased with advancing parity/age. The MF cows had elevated serum TRAP5b activity and a decreased O/T ratio after parturition, suggesting an increased number of osteoclasts due to osteoclastogenesis, in response to severe hypocalcaemia. The MF cows showed lower serum ALP3 activity during the 3 weeks prepartum than the non-MF cows, therefore, prepartum osteoblast function was likely weak in the MF cows. During the 2-3 weeks prepartum, serum ALP3 activity and the A/T ratio had moderate associations with the serum Ca concentration at day 0 (day of calving) in the multiparous cows, and receiver operating characteristic curve analysis revealed that ALP3 activity had excellent ability to predict MF. In conclusion, prepartum serum ALP3 activity is a promising biomarker to predict MF in multiparous cows.

MINERAL DENSITY AND PROCESSES OF BONE TISSUE REMODELING IN CHILD POPULATION LIVING IN IODINE-DEFICIENT BIOGEOCHEMICAL TERRITORY

The territory of the Republic of Bashkortostan belongs to the regions with natural iodine deficiency in soil and water. The population of the republic is at risk of developing iodine deficiency conditions. The aim of the study was to evaluate the frequency of a decrease in bone mineral density and the level of markers of osteoresorption and bone formation in young schoolchildren and adolescents living in a region with natural iodine deficiency. Materials and methods. The survey covered 288 students of general education schools aged 11–12 and 309 students aged 14–15. Theauthors studiedconcentration of iodine in urine, plasma levels of thyroid hormones (thyroid stimulating hormone, free thyroxine), levels of calcium, magnesium, phosphorus, C-terminal telopeptides of type I collagen, activity of the bone isoenzyme of alkaline phosphatase. The volume of the thyroid gland, the mineral density of the bone tissue of the middle diaphysis of the tibia, the lower third of the radius were determined by ultrasonometry. Results and discussion. It was found that children have a high prevalence of iodine deficiency from 44% to 57.6% and a decrease in the concentration of iodine in the urine, an increase in the content of thyrotropin, calcium and magnesium in the blood plasma. Insufficient iodine supply leads to a slowdown in the intensity and imbalance of remodeling with a decrease in bone formation processes.

CHARACTERISTICS OF CERTAIN INDICES OF MINERAL METABOLISM IN CHILDREN WITH KIDNEY CALCULI

The aim: To study the violations of bone density indices in patients with kidney calculi. Materials and methods: 175 children with different types of kidney calculi were examined and treated in Ivano-Frankivsk Regional Children’s Consultative Polyclinics and Hospital, from 2016 to 2019 inclusively. Comprehensive metabolic panel involved by means of generally accepted biochemical methods. Sonography of the urinary tract was carried out. Voiding cystourethrography and excretory urography were performed. Bone mineral density was evaluated by means of ultrasonic densitometry. Statistical processing of the obtained data was carried out according to standard methods of variation statistics. Results: In patients with kidney calculi, oxaluria and oxalate-calcium nephropathy (60.0% and 30.0%, p <0.05) occurred most frequently. Signs of syndrome of undifferentiated connective tissue dysplasia - postural malformation (50.0%), thoracic kyphosis (25.0%), and stigmas of dysembryogenesis (25.0%) were noticed. In the majority of children with oxalate-calcium nephropathy, levels of the bone alkaline and acid phosphatase isoenzymes in a blood serum were significantly high, indicating severity of the resorption and disorders in development of the bone tissue. In these children, decreased fraction of ionized calcium, hypomagniemia and hypophosphatemia were observed. Conclusions: Children with oxalate-calcium nephropathy are in group of risk for osteopenic syndrome.

The study of the calcium and phosphorus metabolism impact on the development of demineralized enamel areas in adolescents

Relevance. The article presents the current data on the impact of calcium and phosphorus metabolism on the development of demineralized enamel areas in adolescents. The level of vitamin D3, osteocalcin, bone alkaline phosphatase isoenzyme and parathyroid hormone (PTH) in mixed saliva appeared to reflect the risk of the cariogenic situation in the oral cavity and the risk of enamel demineralization development, which are relevant in pediatric dentistry. Purpose – to reveal the relationship between the localized enamel demineralization and the calcium and phosphorus metabolism in teenagers.Materials and methods. In 45 adolescents, the study examined the vulnerability of hard dental tissues, including initial lesions and the mixed saliva mineral metabolism in teenagers. We formed the following groups to study the caries intensity level. Group 1 consisted of 12 adolescents with a DMF index of 3.8. 11 adolescents comprised group 2 and 11 adolescents – group 3 with DMF indices of 4.9 and 6.8, respectively; group 4 contained adolescents without caries.Results. The analysis of caries intensity and permanent enamel demineralization areas in adolescents and the main markers of mixed saliva mineralization revealed a correlation between the activity of the initial carious lesions and the calcium and phosphate metabolism.Conclusions. Evaluating the principal markers of calcium and phosphorus metabolism is relevant for the risk assessment of the cariogenic situation or enamel demineralization development in adolescents and preventive treatment planning.

Effect of implants of hydroxyapatite with tricalcium phosphates alloyed with Si on histomorphological and biochemical parameters in cases of bone defects of rabbits

Complex comminuted fractures are accompanied by development of bone defects and loss of reparative potential of the bone tissue in the region of the trauma. This brings the necessity of using implants with optimum osteoconductive and osteointegration properties. The objective of the study was determining the condition of biochemical bone markers and peculiarities of histomorphological changes under the influence of ceramic hydroxyapatite (HA) implants with various physical-chemical properties in the conditions of diaphyseal bone defects in rabbits. We composed control and experimental groups of rabbits with 10 individuals in each with diaphyseal bone defects (3 mm) of the radial bones formed under general anesthesia. In one experimental group, they were filled with granules of hydroxyapatite with α-tricalcium phosphate, and in the second group – with β-tricalcium phosphate, alloyed with Si. In the control rabbits, the defects healed under a blood clot. Blood was analyzed on the 3rd, 7th, 14th, 21st and 42nd days, and as reference we used biochemical parameters of blood of clinically healthy rabbits (n = 10). Bone biopsied materials were taken on days 21–42 under general anesthesia. When using hydroxyapatite with β-tricalcium phosphate, alloyed with Si, we determined early intensification of the levels of nitrogen oxide, angiogenesis and development of bone regenerate in conditions of shortening of inflammatory resorption phase, which was verified according to the level of tartrate-resistant acid phosphatase. According to the level of bone isoenzyme of alkaline phosphatase in the blood serum of animals of the control group, the reparative osteogenesis developed slowly and peaked on day 42, whereas in animals implanted with α-tricalcium phosphate, its development peaked peaked on days 14–42, and when using Si-alloy – on days 7–14. Histomorphologically, on the 21st day, in the case of replacement of bone defect with hydroxyapatite with α-tricalcium phosphate, coarse-fibered type of bone regenerate developed with no dense contact with the elements of the regenerate, while spongy bone trabeculae occurred when hydroxyapatite was applied with β-tricalcium phosphate alloyed with Si, and the control rabbits were observed to be in the stage of cartilaginous callus. On the 42nd day, under the influence of implants of hydroxyapatite with α-tricalcium phosphate, the spongy bone tissue transformed into compact tissue with further mineralization. With implants alloyed with Si, there occurred compact bone tissue, and bone regenerates of the control animals were regions of coarse-fibered and spongy bone tissue without dense contact with the parent bone. This study revealed that hydroxyapatite with β-tricalcium phosphate alloyed with Si had notable osteoinductive and osteointegrating properties, as indicated by early angiogenesis and osteoblast reaction, positive dynamics of the marker biochemical parameters with faster and better development of bone regenerate as spongy bone trabeculae.

Dynamics of biochemical bone and endothelial parameters during the replacement of bone defects in dogs with hydroxyapatite ceramic doped with silicon

Metal structures for osteosynthesis available in veterinary orthopedics are not able to compensate for the lost elements of bone tissue in complex splinter fractures. It is prompt the use of hydroxyappatite materials that replaced bone defects for maintenance of osteoconductive function, and ideally would combine osteointegration and osteoinductive properties. However, their influence on the biological processes of fracture consolidation which go through a number of successive stages and end with the formation of bone tissue in the fracture zone identical to the maternal, is insufficiently substantiated according to the criteria of the molecular biological phase of reparative osteogenesis. The aim of the study was to investigate the dynamics of biochemical osteotropic parameters and the level of NO using silicon-doped ceramics for fractures heeling in dogs. Materials and methods. The animals suffering of fractures that were admitted to the faculty clinic were divided into control (n=7) and experimental (n=7) groups. In both groups, extracortical osteosynthesis was performed with a support plate from an unalloyed titanium alloy. In the control group, bone defects were left to heal under spontaneous blood clot, and in the experimental group, they were replaced with ceramic based on hydroxyapatite with β-tricalciumphosphate doped with silicon (HA/β-TCP/l-Si–3).Blood samples were taken after the injury no later than the 48th day, and on the 3th, 12th, 21th, 42th and 60th days after osteosynthesis. To increase the objectivity of the biochemical analysis, we additionally formed a group of clinically healthy dogs that were admitted to the clinic for routine vaccination (n=10). It included the spectrophotometric determination of the content of NO, BALP, TRACP, Ca, P, Mg, total protein in blood serum, and fibrinogen in blood plasma. Research results. A clinical study showed that in the case of using HA/β-TCP/l-Si–3for splinter fractures, the stages of reparative osteogenesis are more optimized in time, and their consolidation occurs on average 19 days earlier than in the control group. The results of the biochemical study showed that when using HA/β-TCP/l-Si–3, it is accompanied by a peak NO value already on the third day, which is significantly higher than in the control group and indicates early angiogenesis in the research group. In terms of TRACP, the period of osteoresorption in the control group was permanent with little expressed peaks of activity. However, in the research group, the peak of TRACP activity is limited to 12 and 21 days, which is evidence of an optimized inflammatoryresorptive phase. In parallel with this, the activity of BALP increases, which indicates the consistency of the stages of reparative osteogenesis and provides an optimized and accelerated consolidation of fractures in the research group. Conclusion. The dynamics of NO, BALP and TRACP pathochemically substantiates the optimized reparative osteogenesis when using HA/β-TCP/l-Si–3 for bone defects replacement in cases of splinter fractures of tubular bones. Key words: bone markers, bone isoenzyme of alkaline phosphatase, NO, tartrate-resistant acid phosphatase, fibrinogen, calcium, phosphorus.

Bone Remodeling Markers in Assessing of Sternal Reparative Regeneration in Patients With Carbohydrate Metabolism Disorders After Coronary Bypass Surgery.

Aim To study time-related changes in bone remodeling markers in patients with ischemic heart disease (IHD) associated with type 2 diabetes mellitus (DM) and disorders of carbohydrate metabolism (CM). Also, a possibility was studied of using these markers for evaluation of breast bone reparative regeneration in early and late postoperative periods following coronary bypass (CB).Materials and methods This study included 28 patients with IHD and functional class II-III exertional angina after CB. Patients were divided into 2 groups based on the presence (group 1) and absence (group 2) of CM disorders. Contents of osteocalcin (OC), C-terminal telopeptide (CTTP) of type 1 collagen, deoxypyridinoline (DPD), and alkaline phosphatase bone isoenzyme (ALPBI) were measured by enzyme immunoassay on admission (Т1) and at early (Т2) and late (Т3) postoperative stages. Sternal scintigraphy with a radiopharmaceutical (RP) was performed at stage 3 following sternotomy.Results The content of OC and CTTP was reduced in group 1 compared to the values in the group without CM disorders (р<0.005) at stages Т1 and Т2. There were no significant intergroup differences in concentrations of ALPBI and DPD throughout the study. Time-related changes in OC, CTTP, and DPD had some intergroup differences: the increase in biomarkers was observed in group 1 considerably later, at stage Т3 (р<0.005), while in group 2, it was observed at stage T2 after sternotomy. Scintigraphy revealed significant intergroup differences in the intensity of RP accumulation in sternal tissue.Conclusion The intergroup differences in the content of biomarkers evidenced a disbalance among processes of formation and resorption of bone tissue and delayed remodeling processes in patients with IHD associated with type 2 DM and CM disorders. The study confirmed significance of comprehensive evaluation of time-related changes in markers for bone tissue metabolism and sternal scintigraphy for diagnosis and evaluation of sternal reparative regeneration following sternotomy in patients with IHD associated with type 2 DM and disorders of CM metabolism.

Peripartum changes in serum activities of three major alkaline phosphatase isoenzymes in Holstein dairy cows.

This study investigated changes in serum levels of hepatic, bone, and intestinal alkaline phosphatase (ALP) isoenzymes (ALP2, ALP3, and ALP5, respectively) in Holstein cows around parturition. Tartrate-resistant acid phosphatase 5b (TRAP5b) activity and calcium (Ca) concen-trations were also measured. We analyzed blood samples from 11 late-pregnant heifers (primipa-rous group) and 13 multiparous (2-4 lactations; multiparous group) cows at 3 weeks (18-24 days prepartum; -3 weeks), 2 weeks (17-11 days prepartum; -2 weeks), and 1 week (10-4 days prepar-tum; -1 weeks) before parturition; the day of calving (within 12 h post-calving; day 0); and 5 days postpartum (5 days). ALP3 activity was significantly higher in the primiparous group than in the multiparous group, whereas the activities decreased significantly in both groups after 5 days. ALP2 and ALP5 activities did not change, whereas ALP2 activity was significantly higher in the primiparous group than in the multiparous group. TRAP5b activity was significantly higher in the primiparous group than in the multiparous group and showed a transient significant increase at day 0. Ca concentration significantly decreased at day 0 in both groups; the Ca level at day 0 was significantly higher in the primiparous group than in the multiparous group. These data show that ALP3 activity in serum may indicate a change in osteoblastic bone forma-tion after calving, but further study is needed to determine the clinical application for measuring ALP isoenzymes in bovine medicine.

CHANGES IN THE BLOOD SERUM CONTENT OF BONE BIOMARKERS AND CYTOKINES IN CHILDREN WITH COMBINED TRAUMA

Twenty-nine children (mean age of 12.6 ± 2.3 years) with combined bone trauma were examined. The reference group consisted of 20 conditionally healthy children (mean age of 11.8 ± 2.7 years) without the pathology of the locomotor system. The content of bone biomarkers - osteoprotegerin (OPG), bone isoenzyme of alkaline phosphatase (AP), osteocalcin (OC), hyaluronic acid (HA), as well as matrix metalloproteinases (MMPs) and cytokines - TGF-β, MCP-1 and MIP-1β in serum was determined by the enzyme immunoassay in dynamics: on the 1-3rd, 7-th, 14-th and 30-th days after the trauma. Remodeling of bone tissue after a combined trauma at the stage of formation of the regenerate was established to be characterized by diverse changes in the serum content of bone biomarkers, which are not substantially dependent on the severity of the trauma. At the same time, a significant increase in the concentrations of OPG, AP and HA was combined with a pronounced decrease in the content of OC. At 7-14th days after the injury OC levels were lower by more than 3 times compared with the control, indicating a slowdown in the mineralization of the osteoid and a disturbance in the formation of bone tissue during this period. By 30 days after trauma serum concentrations of gelatinases (MMP-2, MMP-9) and collagenases (MMP-8) increased significantly, stromelysin levels (MMP-3) did not change. By 30th day after the injury serum concentrations of gelatinases (MMP-2, MMP-9) and collagenases (MMP-8) increased significantly, stromelysin levels (MMP-3) did not change, and the TIMP-1 content declined. Early detection of changes in blood levels of bone biomarkers during the process of the recovery after combined trauma in children makes it possible to ensure timely correction of disturbances and choice of optimal individual treatment tactics for the management of a particular patient, taking into account the peculiarities of his bone metabolism

Diagnostic value of serum osteomarkers in moderate and severe periodontal disease

The purpose of the study was to establish the diagnostic informative value of the concentration of osteomarkers in the serum to assess the severity of the osteodestructive component in chronic generalized periodontitis (HGP) prior to surgery and the prognosis of the effectiveness of surgical treatment of the disease. 187 patients with moderate and severe HGP who underwent bone and plastic insertion during the patch operations were examined. In the blood serum, the concentration of osteoprotegerin, ligand of the soluble activator of the kappa B nucleation factor (sRANKL) was initially determined and at 8 and 12 months after the operation, bone isoenzyme of alkaline phosphatase, osteocalcin, C-terminal telopeptides of degradation of mature type 1 collagen (β-CrossLaps). It was found that in assessing the severity of osteodestructive processes in the periodontium in HGP, the serum concentration of sRANKL and β-CrossLaps is informative. When the sRANKL content in the blood serum exceeds 0,48 pmol/l, and β-CrossLaps exceeds 0,795 ng/ml, it is possible to judge the high activity of osteoclasts, which is accompanied by a pronounced risk of irreversibility of the osteodestructive component and the lack of effectiveness of surgical treatment.

Dynamics of bone metabolism markers in oral fluid after surgical treatment of chronic periodontal disease with various osteoplastic materials

The aim of the work was to assess the balance between osteosynthetic and osteodestructive processes in the oral cavity in patients with chronic generalized periodontitis (CGP) of moderate and severe severity in the dynamics of a remote period of patchwork using various bone-plastic materials (BPM) based on xenogeneic hydroxyapatite (HA), β-tricalcium phosphate (TCP). 123 patients with CGP were examined. Depending on the type of BPM, two groups were distinguished by composition in the course of patchwork operations. Patients of group 1 (n=61) received BPM on the basis of xenogeneic HA, 2 groups (n=62) on the basis of β-TCP. Initially and after surgery at 8 and 12 months in the oral fluid, the concentration of osteoprotegerin (OPG), the ligand of the soluble activator of the kappa B nucleation factor (sRANKL), the bone isoenzyme of alkaline phosphatase (BAP), was determined by an immunoenzyme method. As a result of the study, it was found that in patients with moderate-bodied CGP after surgical treatment, restriction of osteoclast activity with a decrease in sRANKL due to an increase in OPG in the oral fluid, an increase in osteoblast activity with BAP secretion is most pronounced when using β-TCP-based BPM at 8 months. After surgery with an average severity of the disease. Less pronounced changes in bone metabolism in the oral cavity are detected with the use of BPM on the basis of HA. In severe CGP, changes in bone homeostasis in the oral cavity after scrappy operations with BPM insertion based on TCP or HA are not expressed and are observed only after 12 months. Thus, the most effective changes in bone metabolism develop with the use of TCP as BPM.

Bone alkaline phosphatase in donkeys obtained by the thermal inactivation method

The bone alkaline phosphatase has clinical importance in pathological orthopedic conditions as a marker of the osteoblastic activity, especially in malignant bone tumors and therapeutic monitoring of osteoporosis and other diseases. The reaction of Roy quantitative and qualitative technique of thermal inactivation was applied to obtain bone alkaline phosphatase isoenzyme of male and female donkeys, without defined breed (SRD) aged from seven to 14 months, subjected to the same diet, divided into two groups, composed of five animals each, being the group 1 (G1) kept in confinement and the Group 2 (G2) in traction activity. Blood samples were collected in eight times with an interval of 90 days, during 21 months. The percentage of thermostable isoenzyme was 35 for the G1 and 32 for the G2. It was concluded that the measurements of bone alkaline phosphatase by the thermal inactivation method showed no changes when compared among the groups, demonstrating that the activity of animal traction exerted by the donkeys do not interfere in bone metabolism of these animals.

Physical activity and bone turnover in women with osteopenia

Background/Aim. Osteoporosis is a systemic disease of the skeleton characterized by a decrease in bone mass and changes in the bone structure. An increased tendency of the bone tissue for fractures occurs as a consequence of these changes. The initial phase of physiological aging of the bones that gradually leads to osteoporosis is osteopenia. This paper tracks the effects of a specific kind of physical exercise program in women with osteopenia. The aim was to quantify the impact of this program on: the concentration of bone metabolism blood markers, muscle strength, aerobic capacity, and physical dimensions. Methods. The sample consisted of 26 women in postmenopause (age 46?58) divided into two groups ? experimental group (n = 15) and control group (n = 11). A combined program of exercise consisting of aerobic activities and strength training was applied in the experimental group, while the control group did not join in the exercise program. The program lasted for 7 weeks, three times a week with a break day between the trainings. The intensity of the aerobic training was in the span of 60% to 70% of heart rate reserve (HRR), and the intensity of the strength training was in the span of 60% to 85% of one repetitive maximum (1RM). Osteopenia was diagnosed prior to the experiment by applying a dual energy X-ray absorptiometry of the lumbar spine and the hip. The following was measured before and after the experiment: the level of biochemical markers in the serum [Beta-aspartic acid ?-cross laps (CTx), total procollagen type 1 N-terminal peptide (tP1NP) and bone isoenzyme of alkaline phosphatase (ALP), 1RM of leg extensors, maximum oxygen consumption (VO2 max), bodily height and mass, and a calculated Body Mass Index (BMI). Results. Significant changes were determined only in the experimental group. During the experimental period, there was a significant increase of muscle strength and VO2 max, with a decrease of Beta-CTx concentration. No statistically significant changes were recorded in the control group. Conclusion. A 7- week period of systematic exercise showed to be sufficient to increase muscle strength and VO2 max, partially also to decrease bone resorption, but insufficient to alter bone volume, bodily mass, and BMI.

Hormonal and bone parameters in pubertal girls.

Here we analyzed associations between muscles mass, total bone mineral content (BMC), lumbar spine bone density (BMD L1-L4) and serum or urine hormones in healthy peripubertal girls. Total BMC and areal BMD L1-L4, muscle mass and fat were measured by dual-energy X-ray absorptiometry (DXA). Muscle force (N) was estimated by a dynamometer. Circulating estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), 25-hydroxy vitamin D, parathyroid hormone (PTH), insulin-like growth factor 1 (IGF-1), leptin, osteocalcin, bone isoenzyme of alkaline phosphatase (bALP) and total calcium and phosphorus were quantified as the nocturnal melatonin and serotonin urinary excretion. Partial correlations adjusted for height, Tanner score and physical activity confirmed positive relationships between BMC or BMD L1-L4 (Z-score) and lean mass or fat. Furthermore, positive relationship was observed between BMC or BMD L1-L4 (Z-score) and serum leptin. After adjustment for Tanner score and physical activity, positive associations were observed between lean mass and IGF-1, leptin levels or muscle force. We proved positive relationships between bone mass and serum leptin in peripubertal girls.

Increased Bone Resorption: A Possible Pathophysiological Link Between Hypovitaminosis D and Peripheral Arterial Disease

Vitamin D deficiency has been associated with the prevalence and severity of peripheral arterial disease (PAD); nevertheless, data on bone turnover in patients with PAD is lacking. The present study investigates a possible relationship between the markers of bone turnover and the presence and severity of PAD. The study examined 143 patients, with a mean±SD age of 75.3±8.5 years (range 50.0-93.0 years), of both sexes, admitted to a department of internal medicine. All patients underwent ankle brachial index (ABI) assessment by Doppler velocimetry. Serum levels of 25(OH) vitamin D and two markers of bone turnover, C-terminal telopeptide of type I collagen (sCTX) and bone isoenzyme of alkaline phosphatase, were measured. The differences between patients with normal ABI and patients with PAD were analyzed. Pearson and Spearman correlation coefficients were calculated and independent predictors were identified through a stepwise linear regression analysis. Odds ratios were calculated with a logistic regression model. Compared with patients with a normal ABI (≥0.90), patients with PAD (ABI<0.90) presented with significantly lower levels of 25(OH) vitamin D (12.2±9.6ng/mL vs. 16.7±8.7ng/mL; p=.006) and a significantly higher concentration of sCTX (1.1±0.7ng/mL vs. 0.6±0.4ng/mL; p<.001). There was a positive correlation between ABI and serum concentration of 25 (OH) vitamin D (r=0.3; p<.001), whereas ABI was inversely correlated with the concentration of sCTX (r=-0.358; p<.001). At logistic regression analysis, age, cigarette smoking, and both vitamin D and sCTX were independent predictors of an ABI<0.90. These results support the hypothesis that hypovitaminosis D and increased bone turnover are risk factors for the presence and severity of PAD. Furthermore, the presence of PAD, even if asymptomatic and diagnosed by a reduced ABI, could identify a population at risk for osteoporosis and osteomalacia.

Assessment of the Parameters of Myeloma Bone Disease Signaling to the Extent of Skeletal Involvement, Bone Mineral Turnover and Activity of Multiple Myeloma

Background: Myeloma bone disease (MBD) is present in up to 80% patients with newly diagnosed multiple myeloma (MM). It is known to be activated by three separate signaling pathways - receptor activator of nuclear factor κB/osteoprotegerin pathway (RANK/OPG), macrophage inflammatory factor pathway (MIP) and Wnt pathway. Except of these, several other factors have been described in relationship to MBD development. The aim of our study was to assess the activity of selected parameters of MBD signaling with respect to macroscopic skeletal changes detectable using imaging techniques, and in comparison with markers of bone turnover and the activity of MM.Patients and methods: We assessed 92 patients with monoclonal gammopathies: 56 patients with active multiple myeloma, 12 with smoldering myeloma and 24 individuals with monoclonal gammopathy of undetermined significance (MGUS). Following parameters of MBD signaling were measured in the patients´serum: hepatocyte growth factor (HGF, Human HGF Quantine ELISA), macrophage inflammatory factor alpha (MIP-1α, Human CCL3/MIP-1α Quantikine ELISA), syndecan-1 (Human Syndecan-1 (CD138) ELISA), osteoprotegerin (OPG, Human Osteoprotegerin ELISA), Activin A (Human Activin A Quantikine ELISA), Dickkopf-related protein-1 (DKK1, Human Dkk-1 Quantikine ELISA), Annexin A2 (Human Annexin A2 ELISA kit), nuclear factor kappa B (NF-κB, Human Nuclear factor-kappa B). The extent of skeletal involvement was evaluated using whole body magnetic resonance and low-dose computed tomography. The levels of the selected parameters of MBD signaling were compared to serum levels of Ca, P, PINP, ICTP, CTx, parathormone (PTH), calcitonine (CLC), 25-hydroxyvitamin D2 (D2), 1,25dihydroxyvitamin D3 (D3), bone isoenzyme of alkaline phosphatase (bALP) and sclerostin (SCL). The parameters were measured at the time of diagnosis and then after 4 months. In patients with MM we measured selected parameters of MBD in comparison with the stage of the disease according to Durie-Salmon (DS) and according to International Staging System (ISS). In MGUS we assessed the relationship of the parameters to the risk of transformation to MM based on the Mayo clinic stratification system. For statistical estimation we used Kruskal-Wallis test and Mann-Whitney U post hoc test with Bonferroni correction at p < 0,05.Results: Statistically significant difference between patients with low and high skeletal involvement was found in serum levels of MIP-1α, syndecan-1, DKK-1 and Annexin A2. None of the parameters correlated with the presence of extramedullary disease. With respect to markers of bone turnover we found following significant relationships: HGF to PINP, ICTP, CTx and inverse relationship to D3; MIP-1α to PINP, ICTP, CTx and inverse relationship to D3; Syndecan-1 to ICTP, CTx, and inversely to D2 and D3; OPG to ICTP and SCL; Activin A to PINP, ICTP, CTx and SCL; NF-κB to ICTP and CTx. We found significant differences between MGUS and MM in serum levels of HGF, MIP-1α, syndecan-1, DKK-1 and NF-κB. There was no significant relationship of any of the parameters to DS, however, we found significant relationship of HGF, syndecan-1, OPG and Activin A to ISS. MIP-1α only had a significant relationship to the risk stratification of MGUS. There was no significant change in the parameters in MM patients after 4 months of treatment with respect to treatment response.Conclusions: We confirmed the relationship of MBD signaling to the extent of skeletal changes using imaging techniques. All three signalling pathways were involved in the development of MBD in MM in comparison with MGUS. Signaling involved in osteoclast activation was more activated than the parameters preventing osteoblast differentiation. There was, however, no significant change in any of the parameters in MM patients with respect to treatment response after 4 months, suggesting that bone reparation processes are delayed after hematological response. Significant relationship to the markers of bone turnover and to the activity of MM suggests possible use of the parameters of MBD signaling as tools for early detection of bone marrow changes and timely indication for anti-resorption therapy.Supported by the grant NT 14393. DisclosuresNo relevant conflicts of interest to declare.

The effect of opioid dependence on conventional and novel biochemical parameters of bone metabolism

Background: Opioids influence bone metabolism in several ways and osteoporosis associated with the long-term use of opioids is believed to be multifactorial. Objectives: To investigate the effect of opioid dependence on conventional and novel biochemical parameters of bone metabolism. To evaluate whether the concomitant HCV infection affects these parameters. Methods: Fifty-nine opioid-dependent subjects and 23 healthy volunteers participated in the study. Parameters of bone metabolism were determined in serum. The determined parameters were procollagen type I N-terminal propeptide (PINP), serum Beta-Crosslaps Ι (β-CTX), total calcium (Ca), inorganic phosphorus (P), parathormone (PTH) and alkaline phosphatase bone isoenzyme (ALP). Results: The results of our study show that opioid-dependent subjects exhibit higher values in those biochemical markers that are indicative of increased osteoclast activity, such as β-CTX and ALP, compared to healthy subjects. Furthermore, in opioid-dependent subjects the values of PTH were lower, while those of PINP were higher, in comparison to healthy individuals. No significant difference in the studied parameters was found when opioid-dependent subjects positive for anti-HCV antibodies were compared with opioid-dependent subjects negative for anti-HCV antibodies. Conclusion: Our findings show that there is increased bone turnover (bone metabolism) in opioid-dependent subjects, compared to healthy individuals. Future research on bone mineral density in these patients will help us evaluate whether the bone remodeling process is balanced or not.