Histomorphometric Analysis Reveals Reduced Bone Mass and Bone Formation in Patients With Quiescent Crohn's Disease

Oostlander, A.E.; Bravenboer, Nathalie; Sohl, E.; Holzmann, P.; Woude, C. Janneke van der; Dijkstra, Gerard; Stokkers, Pieter; Oldenburg, Bas; Netelenbos, J. C.; Hommes, Daniël W.; Bodegraven, Ad A. van; Lips, Paul

doi:10.1053/j.gastro.2010.09.007

Cited by 43 publications

(34 citation statements)

References 23 publications

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“…Bone biopsies were obtained during implant surgery as previously described [37]. Trephines were split and opened in order to secure the orientation of the biopsies.…”

Section: Methodsmentioning

confidence: 99%

The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times

et al. 2017

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BackgroundThis study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time.MethodsA unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with healing times of 9 and 12 months respectively. Clinical and radiological parameters were measured up to 5 years postoperatively. Biopsy retrieval was carried out during dental implants placement. Histology and histomorphometry were performed on 5-μm sections of undecalcified bone biopsies.ResultsThe MSFE procedure with BCP showed uneventful healing in all cases. All dental implants appeared to be well osseointegrated after 3 months. Radiological evaluation showed less than 1 mm tissue height loss from MSFE to the 5-year follow-up examination. No signs of inflammation were detected on histological examination. Newly formed mineralized tissue was found cranially from the native bone. The BCP particles were surrounded by connective tissue, osteoid islands, and newly formed bone. Mineralized bone tissue was in intimate contact with the BCP particles. After 12 months, remnants of BCP were still present. The newly formed bone had a trabecular structure. Bone maturation was demonstrated by the presence of lamellar bone. Histomorphometric analysis showed at 9 and 12 months respectively an average vital bone volume/total volume of 35.2 and 28.2%, bone surface/total volume of 4.2 mm2/mm3 and 8.3 mm2/mm3, trabecular thickness of 224.7 and 66.7 μm, osteoid volume/bone volume of 8.8 and 3.4%, osteoid surface/bone surface (OS/BS) of 42.4 and 8.2%, and osteoid thickness of 93.9 and 13.6 μm.ConclusionsMFSE with BCP resulted in new bone formation within the augmented sinus floor and allowed the osseointegration of dental implants in both groups. From a histological and histomorphometric perspective, a 9-month healing time for this type of BCP may be the optimal time for placement of dental implants.

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“…Bone biopsies were obtained during implant surgery as previously described [37]. Trephines were split and opened in order to secure the orientation of the biopsies.…”

Section: Methodsmentioning

confidence: 99%

The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times

et al. 2017

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“…Bone, being a dynamic tissue, is continuously renewed through a complex process of bone resorption by osteoclasts and subsequent bone formation by osteoblasts. An imbalance in this process can result in bone loss, as shown in a previous study on bone histomorphometry in patients with quiescent CD [Oostlander et al, 2011]. For bone degradation to occur, osteoclast progenitor cells differentiate into mature, multinucleated osteoclasts.…”

mentioning

confidence: 86%

T cell‐mediated increased osteoclast formation from peripheral blood as a mechanism for crohn's disease‐associated bone loss

Oostlander¹,

Everts²,

Schoenmaker³

et al. 2011

J of Cellular Biochemistry

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The pathophysiology of osteoporosis in patients with Crohn's disease (CD) is still not completely elucidated. In this study, we evaluated osteoclastogenesis from peripheral blood cells of CD patients and studied the role of lymphocytes and inflammatory cytokines in this process. Peripheral blood mononuclear cells from seven patients with quiescent CD and matched healthy controls were isolated, and separated into T cells, B cells, and a T- and B-cell depleted fraction. In various culture combinations, osteoclast formation in the absence of the osteoclastogenic factors RANKL and M-CSF was assessed by scoring the number of tartrate-resistant acid phosphatase (TRACP) positive multinucleated cells (MNCs). Cytokine levels in culture supernatants were measured. Formation of heterogeneous cell clusters in culture was noticed; a process that was inhibited by anti-LFA-1. In CD cultures, mean cluster area was up to threefold higher than in control cultures, and shown to be induced by T cells. Over tenfold higher numbers of TRACP(+) MNCs were found in CD cultures, but exclusively in cultures containing T cells. Formation of cell clusters correlated strongly with formation of TRACP(+) MNCs. Both cell cluster formation and osteoclast formation were related to IL-17 levels in vitro. In conclusion, osteoclastogenesis, preceded by cell cluster formation, is T cell-mediated and increased in patients with quiescent CD. Our findings suggest heterotypic interactions between osteoclast precursors and T cells to be a triggering step in osteoclast formation in CD. Furthermore, our results propose a possible role for IL-17 in osteoclastogenesis in CD patients, and as such in CD-associated bone loss.

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“…These comprised reduction in bone mass due to trabecular thinning and reduced bone formation 13. Subsequent experiments showed that bone cells from patients with CD had a reduced growth potential and an impeded maturation, and increased potential to generate osteoclasts from peripheral blood 32 33.…”

Section: Discussionmentioning

confidence: 99%

“…Quality of bone, assessed by bone histomorphometry, could only be assessed in a relatively small subgroup 13. We did not measure risedronate concentrations in serum to ascertain treatment compliance, but calculated the number of tablets returned to the investigators at follow-up visits.…”

Section: Discussionmentioning

confidence: 99%

Treatment of bone loss in osteopenic patients with Crohn's disease: a double-blind, randomised trial of oral risedronate 35 mg once weekly or placebo, concomitant with calcium and vitamin D supplementation

Bodegraven

Bravenboer

Witte

et al. 2013

Gut

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Histomorphometric Analysis Reveals Reduced Bone Mass and Bone Formation in Patients With Quiescent Crohn's Disease

Cited by 43 publications

References 23 publications

The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times

The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times

T cell‐mediated increased osteoclast formation from peripheral blood as a mechanism for crohn's disease‐associated bone loss

Treatment of bone loss in osteopenic patients with Crohn's disease: a double-blind, randomised trial of oral risedronate 35 mg once weekly or placebo, concomitant with calcium and vitamin D supplementation

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