Pharmacotherapy of Bone Diseases

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 7980

Special Issue Editor


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Guest Editor
Department of Korean Medicine, Kyung Hee University, Seoul, Korea
Interests: researching on natural products to treat osteoporosis and fractures; osteoporosis and fractures; osteoclast; osteoblasts; ovariectomized osteoporosis animal model; femoral-fractured rat model; other bone-related diseases

Special Issue Information

Dear Colleagues,

Today, the prevalence of various metabolic bone diseases (osteopenia, osteoporosis, osteomalacia, rickets, etc.) is increasing due to the increase in life expectancy and healthy life expectancy through the development of medical technology and economic growth. In addition, the number of fracture patients is increasing due to an increase in the leisure population and traffic accidents. Recently, the importance of bone health has been emphasized and various therapeutic agents have been developed, but they have several limitations (such as the impossibility of long-term treatment due to side effects and high cost of the treatment). To overcome these limitations, deciphering the underlying cellular and molecular mechanisms that control the induction and improvement of bone diseases may help to lay a pharmacological basis for bone diseases. In this Special Issue, we hope to improve our understanding of the various ways of improving bone disease. We invite papers covering a variety of topics, from the discussion of new therapeutic mechanisms, to the proposal of chemical and botanical drugs that can improve various bone diseases, to nutritional recommendations to improve bone diseases.

Dr. Jae-Hyun Kim
Guest Editor

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Keywords

  • metabolic bone disease
  • bone metabolism
  • chronic diseases
  • human health and pharmacotherapy
  • molecular and physiological mechanisms

Published Papers (6 papers)

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Research

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17 pages, 4053 KiB  
Article
Dolichos Lablab Linné Inhibits Bone Density Loss and Promotes Bone Union in Senile Osteoporosis through Osteogenesis
by Minsun Kim, Jae-Hyun Kim, Sooyeon Hong, Sumin Lee, Seung Hoon Lee, Jun Won Choi, Hyuk-Sang Jung and Youngjoo Sohn
Pharmaceuticals 2023, 16(10), 1350; https://doi.org/10.3390/ph16101350 - 25 Sep 2023
Viewed by 862
Abstract
As populations continue to age, osteoporosis has emerged as an increasingly critical concern. Most advancements in osteoporosis treatment are predominantly directed toward addressing abnormal osteoclast activity associated with menopause, with limited progress in developing therapies that enhance osteoblast activity, particularly in the context [...] Read more.
As populations continue to age, osteoporosis has emerged as an increasingly critical concern. Most advancements in osteoporosis treatment are predominantly directed toward addressing abnormal osteoclast activity associated with menopause, with limited progress in developing therapies that enhance osteoblast activity, particularly in the context of aging and fractures, and serious side effects associated with existing treatments have highlighted the necessity for natural-product-based treatments targeting senile osteoporosis and fractures. Dolichos lablab Linné (DL) is a natural product traditionally used for gastrointestinal disorders, and its potential role in addressing bone diseases has not been extensively studied. In this research, we investigated the anti-osteoporosis and bone-union-stimulating effects of DL using the SAMP6 model, a naturally aged mouse model. Additionally, we employed MC3T3-E1 cells to validate DL’s osteoblast-promoting effect and to assess the involvement of core mechanisms such as the BMP-2/Smad and Wnt/β-catenin pathways. The experimental results revealed that DL promoted the formation of osteoblasts and calcified nodules by upregulating both the BMP-2/Smad and Wnt/β-catenin mechanisms. Based on its observed effects, DL demonstrated the potential to enhance bone mineral density in aged osteoporotic mice and promote bone union in fractured mice. These findings indicate the promising therapeutic potential of DL for the treatment of osteoporosis and bone-related conditions, thus warranting further investigation and potential clinical applications. Full article
(This article belongs to the Special Issue Pharmacotherapy of Bone Diseases)
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12 pages, 2489 KiB  
Article
Concurrent Imaging and Clinical Study of the Efficacy of Hyaluronic Acid Injection for Knee Osteoarthritis: A Synovial Membrane Investigation with Ultrasound Imaging
by Chien-Chih Wang, Tsung-Ming Hu, Chien-Lung Chen, Chung-Chih Hong, Yu-Hui Chang and Chung-Lan Kao
Pharmaceuticals 2023, 16(8), 1186; https://doi.org/10.3390/ph16081186 - 21 Aug 2023
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Abstract
We investigated whether hyaluronic acid (HA) injections can ameliorate ultrasound-detected synovitis in knee osteoarthritis (OA). We recruited 103 patients with symptomatic knee OA and ultrasound-detected synovitis and performed two ultrasound-guided fluid drainage procedures, followed by the administration of a low-molecular-weight HA injection (2.5 [...] Read more.
We investigated whether hyaluronic acid (HA) injections can ameliorate ultrasound-detected synovitis in knee osteoarthritis (OA). We recruited 103 patients with symptomatic knee OA and ultrasound-detected synovitis and performed two ultrasound-guided fluid drainage procedures, followed by the administration of a low-molecular-weight HA injection (2.5 mL) in the subpatellar bursa, at a 2-week interval. Knee ultrasound imaging evaluations were performed before injection (baseline) and at 1 and 6 months after the second injection and included the measurements of synovial vascularity by using color Doppler ultrasound, synovial fluid depth over the suprapatellar bursa (SF), and synovial hypertrophy (SH). Initial clinical assessments included a visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). VAS scores decreased significantly at both 1-month and 6-month evaluations (p < 0.001). WOMAC scores also significantly decreased at 1 month (p < 0.001), but not at 6 months (p = 0.23). The ultrasound parameters did not significantly change, except color Doppler grading, which tended to decrease at the 6-month evaluation (p = 0.059). Our findings revealed that two ultrasound-guided HA injections following fluid drainage improved pain and knee function but did not considerably influence imaging-detected synovitis in patients with knee OA. Full article
(This article belongs to the Special Issue Pharmacotherapy of Bone Diseases)
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Review

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22 pages, 411 KiB  
Review
Pathophysiology and Therapeutic Management of Bone Loss in Patients with Critical Illness
by Taejin Kim and Hyojin Kim
Pharmaceuticals 2023, 16(12), 1718; https://doi.org/10.3390/ph16121718 - 11 Dec 2023
Viewed by 1210
Abstract
Patients with critical illnesses are at higher risk of comorbidities, which can include bone mineral density loss, bone turnover marker increase, and fragility fractures. Patients admitted to intensive care units (ICUs) have a higher risk of bone fractures. Since hypermetabolism is a characteristic [...] Read more.
Patients with critical illnesses are at higher risk of comorbidities, which can include bone mineral density loss, bone turnover marker increase, and fragility fractures. Patients admitted to intensive care units (ICUs) have a higher risk of bone fractures. Since hypermetabolism is a characteristic of ICU patients, such patients are often rapidly affected by systemic deterioration, which often results in systemic wasting disease. Major risk factors for ICU-related bone loss include physical restraint, inflammation, neuroendocrine stress, malnutrition, and medications. A medical history of critical illness should be acknowledged as a risk factor for impaired bone metabolism. Bone loss associated with ICU admission should be recognized as a key component of post-intensive care syndrome, and further research that focuses on treatment protocols and prevention strategies is required. Studies aimed at maintaining gut integrity have emphasized protein administration and nutrition, while research is ongoing to evaluate the therapeutic benefits of anti-resorptive agents and physical therapy. This review examines both current and innovative clinical strategies that are used for identifying risk factors of bone loss. It provides an overview of perioperative outcomes and discusses the emerging novel treatment modalities. Furthermore, the review presents future directions in the treatment of ICU-related bone loss. Full article
(This article belongs to the Special Issue Pharmacotherapy of Bone Diseases)
24 pages, 1426 KiB  
Review
Mechanism and Prospect of Gastrodin in Osteoporosis, Bone Regeneration, and Osseointegration
by Yi Li and Fenglan Li
Pharmaceuticals 2022, 15(11), 1432; https://doi.org/10.3390/ph15111432 - 18 Nov 2022
Cited by 5 | Viewed by 2238
Abstract
Gastrodin, a traditional Chinese medicine ingredient, is widely used to treat vascular and neurological diseases. However, recently, an increasing number of studies have shown that gastrodin has anti-osteoporosis effects, and its mechanisms of action include its antioxidant effect, anti-inflammatory effect, and anti-apoptotic effect. [...] Read more.
Gastrodin, a traditional Chinese medicine ingredient, is widely used to treat vascular and neurological diseases. However, recently, an increasing number of studies have shown that gastrodin has anti-osteoporosis effects, and its mechanisms of action include its antioxidant effect, anti-inflammatory effect, and anti-apoptotic effect. In addition, gastrodin has many unique advantages in promoting bone healing in tissue engineering, such as inducing high hydrophilicity in the material surface, its anti-inflammatory effect, and pro-vascular regeneration. Therefore, this paper summarized the effects and mechanisms of gastrodin on osteoporosis and bone regeneration in the current research. Here we propose an assumption that the use of gastrodin in the surface loading of oral implants may greatly promote the osseointegration of implants and increase the success rate of implants. In addition, we speculated on the potential mechanisms of gastrodin against osteoporosis, by affecting actin filament polymerization, renin–angiotensin system (RAS) and ferroptosis, and proposed that the potential combination of gastrodin with Mg2+, angiotensin type 2 receptor blockers or artemisinin may greatly inhibit osteoporosis. The purpose of this review is to provide a reference for more in-depth research and application of gastrodin in the treatment of osteoporosis and implant osseointegration in the future. Full article
(This article belongs to the Special Issue Pharmacotherapy of Bone Diseases)
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Other

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10 pages, 776 KiB  
Case Report
Case Report and Literature Review: Bisphosphonate, Sirolimus, and Atenolol Treatment in a 4-Year-Old Child Diagnosed with Gorham–Stout Disease
by Su Jin Park, Jae Won Yoo and Moon Bae Ahn
Pharmaceuticals 2023, 16(10), 1504; https://doi.org/10.3390/ph16101504 - 23 Oct 2023
Viewed by 761
Abstract
We report a 4-year-old with Gorham–Stout disease (GSD) who was treated with a combination of bisphosphonate, sirolimus, and atenolol. A previously healthy 4-year-old girl presented with back pain after falling on her back 2 months prior. Thoracolumbar spine X-ray revealed diffuse compression spinal [...] Read more.
We report a 4-year-old with Gorham–Stout disease (GSD) who was treated with a combination of bisphosphonate, sirolimus, and atenolol. A previously healthy 4-year-old girl presented with back pain after falling on her back 2 months prior. Thoracolumbar spine X-ray revealed diffuse compression spinal fractures in T9-L2. Magnetic resonance imaging (MRI) confirmed multiple compression fractures at T9-L5 and revealed a paraspinal mass along the T1-L1 level. Based on clinical, radiological, and histopathological findings, Gorham–Stout disease was diagnosed. Treatment with sirolimus (0.5 mg twice daily, 1.6 mg/m2) was initiated and intravenous bisphosphonate (pamidronate, 1 mg/kg for 3 days, total 3 mg/kg every 4 months) was added for back pain; she had immediate improvement in back pain. After 9 months with this treatment, she had a mild increase in paraspinal lymphangiomatosis and aggravation in T9-L5 compression fractures; atenolol was administered. The patient underwent 11 months of combination treatment with bisphosphonate, sirolimus, and atenolol, and MRI showed mild degree of reduction in the paraspinal lesions at L1-L5. The patient is currently in stable condition with no back pain or side effects. The triple combination treatment with bisphosphonate, sirolimus, and atenolol may be helpful in stabilizing the disease course of GSD. Full article
(This article belongs to the Special Issue Pharmacotherapy of Bone Diseases)
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17 pages, 3273 KiB  
Systematic Review
Effect of Growth Hormone and Estrogen Replacement Therapy on Bone Mineral Density in Women with Turner Syndrome: A Meta-Analysis and Systematic Review
by Weronika Szybiak, Barbara Kujawa, Miłosz Miedziaszczyk and Katarzyna Lacka
Pharmaceuticals 2023, 16(9), 1320; https://doi.org/10.3390/ph16091320 - 19 Sep 2023
Cited by 1 | Viewed by 1104
Abstract
Osteoporosis is a serious implication of Turner syndrome (TS). Common methods for the treatment of TS are growth hormone (GHT) and estrogen replacement therapy (ERT). We examined the relationship between the treatment of TS and bone mineral density (BMD) of the lumbar spine. [...] Read more.
Osteoporosis is a serious implication of Turner syndrome (TS). Common methods for the treatment of TS are growth hormone (GHT) and estrogen replacement therapy (ERT). We examined the relationship between the treatment of TS and bone mineral density (BMD) of the lumbar spine. The purpose of our study was to show the currency of BMD states among patients with TS for treatment with GHT and ERT. We searched databases for studies published from inception to April 2023. The articles were related to TS, osteoporosis, ERT, GHT, BMD and treatment patients with TS. We applied the selection criteria: lumbar spine values at L1–L4; dual-energy X-ray absorptiometry (DXA); treatment which was applied: one group of articles: ERT and two group of articles: GHT; results performed as means ± SD. In total, 79 articles were analyzed, of which 20 studies were included and 5 were considered for meta-analysis. The total number of women in the articles selected was 71. Based on the results of the meta-analysis, the effect of ERT on BMD demonstrated a significant increase in BMD (the standardized mean difference in the random model was 0.593 g/cm2, 95% CI: 0.0705 to 1.116; p = 0.026), which showed that treatment with estrogen particularly increases bone mass during treatment, which contributes to reducing the risk of fractures. The effect of GHT on BMD demonstrated a non-significant decrease in BMD in patients with TS. The results for growth hormone show that this therapy does not improve bone density. However, our review emphasizes the beneficial effect of supplementing growth hormone (GH) on the clinical presentation of TS. Full article
(This article belongs to the Special Issue Pharmacotherapy of Bone Diseases)
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