April - 2012 > Anti-aging Discoveries > Anti-aging Developments - April 2012

Guidelines on Glucocorticoid-induced osteoporosis published

Oral glucocorticoids which are often the drug of choice for illnesses including obstructive pulmonary disease, inflammatory bowel disease and rheumatoid arthritis, unfortunately have a serious side effect. In the first months of therapy they often provoke rapid bone loss, leading to fragility fractures.

Glucocorticoid-induced osteoporosis (GIO) has grown in recent often goes under-diagnosed and under-treated, leaving patients at at risk of potentially serious fractures.

The International Osteoporosis Foundation (IOF) and the European Calcified Tissue Society (ECTS) have recently published a document which provides a framework for the development of national assessment and treatment guidelines.

Professor Juliet Compston, chair of the Guidelines Working Group and lead author of the paper, warns that "Clinicians need to be aware that bone loss occurs rapidly in the first three to six months after glucocorticoid therapy is initiated. To prevent fragility fractures in their patients, doctors must make primary prevention a priority in high-risk individuals."

Management of patients may include reducing the dose of glucocorticoids, or using alternative treatments and immunosuppressive agents, increasing levels of dietary calcium and vitamin D, appropriate physical activity, and advising patients to give up smoking and limit alcohol consumption. Regular monitoring is also advised, including regular BMD and height testing and vertebral fracture assessment and assessment of compliance with therapy.

Stressing the need for the implementation of these guidelines, Professor Bente Langdahl, president of the European Calcified Tissue Society, stated, "In a multinational study of more than 60,000 postmenopausal women, as many as 4.6% were reported as currently taking oral glucocorticoids."

The paper, authored by 26 experts from 17 countries, has been published in the journal Osteoporosis International. It also includes Information about the management of GIO in younger men and pre-menopausal women.

New Study Offers Hope for Future Treatment of Osteoporosis

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According to Science Daily, a new technique to stimulate the bodies own stem cells to promote new bone growth has recently been tested successfully on mice by a team led by UC Davis Health System scientists and published on-line in the "Nature Health". The study shows that the molecule increases bone density and prevents bone loss associated with aging and estrogen deficiency.

"There are many stem cells, even in elderly people, but they do not readily migrate to bone," said Wei Yao, the principal investigator and lead author of the study. "Finding a molecule that attaches to stem cells and guides them to the targets we need is a real breakthrough."

This technique uses a hybrid molecule developed by a research team led by Kit Lam, professor and chair of the UC Davis Department of Biochemistry and Molecular Medicine. When injected into the bloodstream this molecule has the ability to direct the patient’s stem cells to the bones where they differentiate into bone-forming cells and synthesize proteins to enhance bone growth. "Our study confirms that stem-cell-binding molecules can be exploited to direct stem cells to therapeutic sites inside an animal," said Lam, who also is an author of the on-line article. "It represents a very important step in making this type of stem cell therapy a reality."

The study has only been conducted on mice for the time being and clinical trials will be necessary before it can be authorized for use in humans.

"These results are very promising for translating into human therapy," said Jan Nolta, professor of internal medicine, an author of the study and director of the UC Davis Institute for Regenerative Cures. "We have shown this potential therapy is effective in rodents, and our goal now is to move it into clinical trials."

Researchers are currently exploring stem cells as possible treatments for a wide range of conditions including peripheral artery disease and macular degeneration and for the treatment of blood disorders, skin wounds and diseased organs. Directing stem cells to travel and adhere to the surface of bone for bone formation has been among the elusive goals in regenerative medicine.

Funding for the study came from the Endowment on Healthy Aging and the National Institutes of Health. The California Institute for Regenerative Medicine has given the team a planning grant to develop a proposal for human clinical trials.

"This research was a collaboration of stem cell biologists, biochemists, translational scientists, a bone biologist and clinicians," said Lane. "It was a truly fruitful team effort with remarkable results." > Anti-aging Discoveries > Anti-aging Developments - April 2012

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