Biomarkers of Bone Turnover after a Short Period of Steroid Therapy in Elderly Men

Paglia, Federica; Dionisi, S.; Geronimo, Simona De; Rosso, R.; Romagnoli, Elisabetta; Raejentroph, Natalia; Ragno, Alessandro; Celi, Massimiliano; Pepe, Jessica; D'Erasmo, E; Minisola, Salvatore

doi:10.1093/clinchem/47.7.1314

Cited by 32 publications

(17 citation statements)

References 12 publications

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“…In patients receiving long‐term GC therapy, histomorphology of bone has shown thinned rather than perforated trabeculae 13,18. On the other hand, there are studies in vitro and in vivo that suggest increased bone resorption 41–43. The rate of bone loss following GC administration is admittedly biphasic with rapid diminution of bone mineral density (BMD) in the first months of therapy, followed by a smaller decline in the following months 13.…”

Section: Discussionmentioning

confidence: 99%

Interactions between Glucocorticoids and Cytokines in the Bone Microenvironment

Angeli

Dovio

Sartori

et al. 2002

Annals of the New York Academy of Sciences

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Cytokines belonging to the so-called interleukin-6 (IL-6) or gp130 cytokine family, notably IL-6 and IL-11, are known as pro-resorptive cytokines, in that they promote osteoclastogenesis. Glucocorticoid (GC)-induced osteoporosis is admittedly the most frequent secondary osteoporosis. The pathogenesis still has many unresolved issues. Although the effects of GCs on cytokine production and recognition have been extensively studied, little is known about the effects of cytokines on GC action at the target level. We have focused on the effects of IL-6 and IL-11 on specific binding by type II GC receptors (GRs) in two human osteoblast-like cell lines (Saos-2 and MG-63) that have remarkably different constitutive expression of these cytokines and GRs as well. We have provided evidence that IL-6 upregulates GR binding sites, while IL-11 downregulates these sites, as determined by radioligand binding assay and Scatchard analysis. GR affinity (K(d)) did not change after exposure to both cytokines. A number of experiments were consistent with the view that in human osteoblast-like cells, cytokines of the IL-6 family have autocrine modulatory effects on GRalpha (GRbeta is a variant that does not bind specifically in our method). Complex effects of GCs on the system(s) of proinflammatory/anti-inflammatory cytokines and conversely of these cytokines on GC action could account for the dynamics of bone loss in patients given GCs and conceivably having high concentrations of these cytokines in the bone microenvironment.

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Section: Discussionmentioning

confidence: 99%

Interactions between Glucocorticoids and Cytokines in the Bone Microenvironment

Angeli

Dovio

Sartori

et al. 2002

Annals of the New York Academy of Sciences

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“…Furthermore, concomitant GC use for patients' primary renal disease may also affect bone turnover markers, especially in the early phase of GC therapy, most commonly reducing bone formation markers and increasing bone resorption markers. [37][38][39] Although there is a paucity of longitudinal data correlating bone turnover markers with incident fractures, there are small, cross-sectional studies correlating PTH and BSAP levels with their underlying bone histomorphometry in patients with CKD. 6,40 The conclusion from these studies, and recommendations adopted by the KDIGO, are that PTH levels consistently above 450 pg/mL (multiple by 0.105 to covert to pnmol/L) are unlikely to be associated with the presence of ABD.…”

Section: Diagnosis and Investigationsmentioning

confidence: 99%

Bone health in chronic kidney disease‐mineral and bone disorder: a clinical case seminar and update

Aleksova

Jung

et al. 2018

Internal Medicine Journal

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The metabolic abnormalities affecting bone in the setting of chronic kidney disease (CKD) are complex with overlapping and interacting aetiologies and have challenging diagnostic and management strategies. Disturbances in calcium, phosphate, fibroblast growth factor 23, parathyroid hormone concentrations and vitamin D deficiency are commonly encountered and contribute to the clinical syndromes of bone disorders in CKD, including hyperparathyroidism, osteomalacia, osteoporosis and adynamic bone disease. Mineral and bone abnormalities may also persist or arise de novo post‐renal transplantation. The Kidney Disease Improving Global Outcomes organisation describes these mineral metabolism derangements and skeletal abnormalities as ‘CKD Mineral and Bone Disorder’. Patients with this disorder have an increased risk of fracture, cardiovascular events and overall increased mortality. In light of the recently updated 2017 guidelines from the Kidney Disease Improving Global Outcomes, we present a clinical case‐based discussion to highlight the complexities of investigating and managing the bone health of patients with CKD with a focus on these updates.

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“…In uninfected individuals, even a short duration of corticosteroids (i.e., <1 month) has been shown to negatively affect bone formation and bone resorption. 21 Our data suggest that there may not be an additive negative effect of limited-course corticosteroids on bone health in individuals with advanced immunosuppression in the setting of ART initiation. Importantly, the indication of corticosteroid use was to temper infection-related inflammation, suggesting the possibility that the negative effect of corticosteroids on bone health might have been offset by the overall decrease in inflammation.…”

Section: Discussionmentioning

confidence: 62%

Clinically Indicated Corticosteroids Do Not Affect Bone Turnover During Immune Restoration of Severely Lymphopenic HIV-Infected Patients

Grant

Sheikh

DerSimonian

et al. 2015

AIDS Research and Human Retroviruses

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Bone turnover markers did not differ in severely lymphopenic persons according to corticosteroid receipt. In those with severe lymphopenia, higher IL-6 was associated with higher CTX levels at ART initiation only. HIV-infected patients with severe lymphopenia and OI had lower levels of bone formation and higher levels of bone resorption than those initiating ART at higher CD4. Corticosteroid use, as prescribed during OI, was not associated with bone turnover. In contrast, higher markers of systemic inflammation prior to ART were associated with greater bone resorption.

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Biomarkers of Bone Turnover after a Short Period of Steroid Therapy in Elderly Men

Cited by 32 publications

References 12 publications

Interactions between Glucocorticoids and Cytokines in the Bone Microenvironment

Interactions between Glucocorticoids and Cytokines in the Bone Microenvironment

Bone health in chronic kidney disease‐mineral and bone disorder: a clinical case seminar and update

Clinically Indicated Corticosteroids Do Not Affect Bone Turnover During Immune Restoration of Severely Lymphopenic HIV-Infected Patients

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