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. 1993 Jun;91(6):2479–2487. doi: 10.1172/JCI116483

Loss of cancellous bone mass and connectivity in ovariectomized rats can be restored by combined treatment with parathyroid hormone and estradiol.

V Shen 1, D W Dempster 1, R Birchman 1, R Xu 1, R Lindsay 1
PMCID: PMC443308  PMID: 8514860

Abstract

To evaluate the potential use of a combination of antiresorption and bone formation-promoting agents as a treatment for postmenopausal osteoporosis, we examined the effects of combined and separate administration of estrogen (17 beta-estradiol, 30 micrograms/kg per d, s.c.) and parathyroid hormone (rPTH [1-34], 40 micrograms/kg per d, s.c.) on the proximal tibia of ovariectomized (Ovx) rats. The treatments lasted for 4 wk and were initiated 1, 3, and 5 wk after surgery. Ovx resulted in rapid loss of cancellous bone volume (Cn-BV/TV) as well as trabecular connectivity, as determined by two dimensional strut analysis. When administered in a preventive mode, treatment beginning 1 wk post-Ovx, estrogen or PTH treatment alone preserved Cn-BV/TV and trabecular connectivity, and combined estrogen and PTH treatment caused a 40% increment in Cn-BV/TV while maintaining comparable trabecular connectivity with that seen in the Sham-operated animals. When administered in a curative mode to rats with established osteoporosis, treatments beginning 3 or 5 wk post-Ovx, estrogen or PTH treatment alone prevented further loss of connectivity and Cn-BV/TV, whereas the combined treatment resulted in as much as a 300% improvement in one of the parameters of trabecular connectivity, node to node strut length, and a 106% increase in Cn-BV/TV, with respect to the bone status at the initiation of treatment. The beneficial effects of this combined treatment derive from estrogen's ability to prevent accelerated bone resorption and, simultaneously, PTH's promotion of bone formation. These data demonstrate, in an animal model, that therapies can be devised to cure the skeletal defects associated with established osteoporosis.

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Selected References

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  1. Aitken J. M., Armstrong E., Anderson J. B. Osteoporosis after oophorectomy in the mature female rat and the effect of oestrogen and-or progestogen replacement therapy in its prevention. J Endocrinol. 1972 Oct;55(1):79–87. doi: 10.1677/joe.0.0550079. [DOI] [PubMed] [Google Scholar]
  2. Brown J. P., Delmas P. D., Malaval L., Edouard C., Chapuy M. C., Meunier P. J. Serum bone Gla-protein: a specific marker for bone formation in postmenopausal osteoporosis. Lancet. 1984 May 19;1(8386):1091–1093. doi: 10.1016/s0140-6736(84)92506-6. [DOI] [PubMed] [Google Scholar]
  3. Compston J. E., Mellish R. W., Croucher P., Newcombe R., Garrahan N. J. Structural mechanisms of trabecular bone loss in man. Bone Miner. 1989 Jul;6(3):339–350. doi: 10.1016/0169-6009(89)90039-1. [DOI] [PubMed] [Google Scholar]
  4. Cruess R. L., Hong K. C. The effect of long term estrogen administration on bone metabolism in the female rat. Endocrinology. 1979 Apr;104(4):1188–1193. doi: 10.1210/endo-104-4-1188. [DOI] [PubMed] [Google Scholar]
  5. Delmas P. D., Wahner H. W., Mann K. G., Riggs B. L. Assessment of bone turnover in postmenopausal osteoporosis by measurement of serum bone Gla-protein. J Lab Clin Med. 1983 Oct;102(4):470–476. [PubMed] [Google Scholar]
  6. Fiore C. E., Clementi G., Foti R., Prato A., Grimaldi D. R. Effects of ovariectomy and 17 beta-estradiol on bone GLA protein in growing rats: an indirect evidence for estrogen receptors in bone cells. Exp Clin Endocrinol. 1988 Mar;92(3):335–340. doi: 10.1055/s-0029-1210823. [DOI] [PubMed] [Google Scholar]
  7. Frost H. M., Jee W. S. On the rat model of human osteopenias and osteoporoses. Bone Miner. 1992 Sep;18(3):227–236. doi: 10.1016/0169-6009(92)90809-r. [DOI] [PubMed] [Google Scholar]
  8. Garrahan N. J., Mellish R. W., Compston J. E. A new method for the two-dimensional analysis of bone structure in human iliac crest biopsies. J Microsc. 1986 Jun;142(Pt 3):341–349. doi: 10.1111/j.1365-2818.1986.tb04289.x. [DOI] [PubMed] [Google Scholar]
  9. Garrahan N. J., Mellish R. W., Vedi S., Compston J. E. Measurement of mean trabecular plate thickness by a new computerized method. Bone. 1987;8(4):227–230. doi: 10.1016/8756-3282(87)90169-4. [DOI] [PubMed] [Google Scholar]
  10. Gunness-Hey M., Gera I., Fonseca J., Raisz L. G., Hock J. M. 1,25 dihydroxyvitamin D3 alone or in combination with parathyroid hormone does not increase bone mass in young rats. Calcif Tissue Int. 1988 Nov;43(5):284–288. doi: 10.1007/BF02556637. [DOI] [PubMed] [Google Scholar]
  11. Gunness-Hey M., Hock J. M. Increased trabecular bone mass in rats treated with human synthetic parathyroid hormone. Metab Bone Dis Relat Res. 1984;5(4):177–181. doi: 10.1016/0221-8747(84)90026-2. [DOI] [PubMed] [Google Scholar]
  12. Hayward M. A., Kharode Y. P., Becci M. M., Kowal D. The effect of conjugated equine estrogens on ovariectomy-induced osteopenia in the rat. Agents Actions. 1990 Aug;31(1-2):152–156. doi: 10.1007/BF02003236. [DOI] [PubMed] [Google Scholar]
  13. Hesch R. D., Rittinghaus E. F., Harms H. M., Delling G. Die Frühtherapie der Osteoporose mit (1-38) Parathormon und Calcitonin-Nasalspray. Med Klin (Munich) 1989 Oct 15;84(10):488–498. [PubMed] [Google Scholar]
  14. Hock J. M., Gera I. Effects of continuous and intermittent administration and inhibition of resorption on the anabolic response of bone to parathyroid hormone. J Bone Miner Res. 1992 Jan;7(1):65–72. doi: 10.1002/jbmr.5650070110. [DOI] [PubMed] [Google Scholar]
  15. Hock J. M., Hummert J. R., Boyce R., Fonseca J., Raisz L. G. Resorption is not essential for the stimulation of bone growth by hPTH-(1-34) in rats in vivo. J Bone Miner Res. 1989 Jun;4(3):449–458. doi: 10.1002/jbmr.5650040321. [DOI] [PubMed] [Google Scholar]
  16. Hodsman A. B., Steer B. M., Fraher L. J., Drost D. J. Bone densitometric and histomorphometric responses to sequential human parathyroid hormone (1-38) and salmon calcitonin in osteoporotic patients. Bone Miner. 1991 Jul;14(1):67–83. doi: 10.1016/0169-6009(91)90103-7. [DOI] [PubMed] [Google Scholar]
  17. Hori M., Uzawa T., Morita K., Noda T., Takahashi H., Inoue J. Effect of human parathyroid hormone (PTH(1-34)) on experimental osteopenia of rats induced by ovariectomy. Bone Miner. 1988 Jan;3(3):193–199. [PubMed] [Google Scholar]
  18. Horowitz J. B., Kaye J., Conrad P. J., Katz M. E., Janeway C. A., Jr Autocrine growth inhibition of a cloned line of helper T cells. Proc Natl Acad Sci U S A. 1986 Mar;83(6):1886–1890. doi: 10.1073/pnas.83.6.1886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ismail F., Epstein S., Fallon M. D., Thomas S. B., Reinhardt T. A. Serum bone gla protein and the vitamin D endocrine system in the oophorectomized rat. Endocrinology. 1988 Feb;122(2):624–630. doi: 10.1210/endo-122-2-624. [DOI] [PubMed] [Google Scholar]
  20. Kalu D. N., Echon R., Hollis B. W. Modulation of ovariectomy-related bone loss by parathyroid hormone in rats. Mech Ageing Dev. 1990 Oct;56(1):49–62. doi: 10.1016/0047-6374(90)90114-u. [DOI] [PubMed] [Google Scholar]
  21. Kalu D. N., Liu C. C., Salerno E., Hollis B., Echon R., Ray M. Skeletal response of ovariectomized rats to low and high doses of 17 beta-estradiol. Bone Miner. 1991 Sep;14(3):175–187. doi: 10.1016/0169-6009(91)90021-q. [DOI] [PubMed] [Google Scholar]
  22. Kalu D. N., Salerno E., Liu C. C., Echon R., Ray M., Garza-Zapata M., Hollis B. W. A comparative study of the actions of tamoxifen, estrogen and progesterone in the ovariectomized rat. Bone Miner. 1991 Nov;15(2):109–123. doi: 10.1016/0169-6009(91)90002-h. [DOI] [PubMed] [Google Scholar]
  23. Kalu D. N. The ovariectomized rat model of postmenopausal bone loss. Bone Miner. 1991 Dec;15(3):175–191. doi: 10.1016/0169-6009(91)90124-i. [DOI] [PubMed] [Google Scholar]
  24. Kleerekoper M., Peterson E. L., Nelson D. A., Phillips E., Schork M. A., Tilley B. C., Parfitt A. M. A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. Osteoporos Int. 1991 Jun;1(3):155–161. doi: 10.1007/BF01625446. [DOI] [PubMed] [Google Scholar]
  25. LINDQUIST B., BUDY A. M., MCLEAN F. C., HOWARD J. L. Skeletal metabolism in estrogen-treated rats studied by means of Ca45. Endocrinology. 1960 Jan;66:100–111. doi: 10.1210/endo-66-1-100. [DOI] [PubMed] [Google Scholar]
  26. Lindsay R., Hart D. M., Aitken J. M., MacDonald E. B., Anderson J. B., Clarke A. C. Long-term prevention of postmenopausal osteoporosis by oestrogen. Evidence for an increased bone mass after delayed onset of oestrogen treatment. Lancet. 1976 May 15;1(7968):1038–1041. doi: 10.1016/s0140-6736(76)92217-0. [DOI] [PubMed] [Google Scholar]
  27. Liu C. C., Kalu D. N., Salerno E., Echon R., Hollis B. W., Ray M. Preexisting bone loss associated with ovariectomy in rats is reversed by parathyroid hormone. J Bone Miner Res. 1991 Oct;6(10):1071–1080. doi: 10.1002/jbmr.5650061008. [DOI] [PubMed] [Google Scholar]
  28. Mellish R. W., Ferguson-Pell M. W., Cochran G. V., Lindsay R., Dempster D. W. A new manual method for assessing two-dimensional cancellous bone structure: comparison between iliac crest and lumbar vertebra. J Bone Miner Res. 1991 Jul;6(7):689–696. doi: 10.1002/jbmr.5650060706. [DOI] [PubMed] [Google Scholar]
  29. Mellish R. W., Garrahan N. J., Compston J. E. Age-related changes in trabecular width and spacing in human iliac crest biopsies. Bone Miner. 1989 Jul;6(3):331–338. doi: 10.1016/0169-6009(89)90038-x. [DOI] [PubMed] [Google Scholar]
  30. Mitlak B. H., Williams D. C., Bryant H. U., Paul D. C., Neer R. M. Intermittent administration of bovine PTH-(1-34) increases serum 1,25-dihydroxyvitamin D concentrations and spinal bone density in senile (23 month) rats. J Bone Miner Res. 1992 May;7(5):479–484. doi: 10.1002/jbmr.5650070503. [DOI] [PubMed] [Google Scholar]
  31. Mosekilde L., Søgaard C. H., Danielsen C. C., Tørring O. The anabolic effects of human parathyroid hormone (hPTH) on rat vertebral body mass are also reflected in the quality of bone, assessed by biomechanical testing: a comparison study between hPTH-(1-34) and hPTH-(1-84). Endocrinology. 1991 Jul;129(1):421–428. doi: 10.1210/endo-129-1-421. [DOI] [PubMed] [Google Scholar]
  32. Need A. G., Horowitz M., Bridges A., Morris H. A., Nordin B. E. Effects of nandrolone decanoate and antiresorptive therapy on vertebral density in osteoporotic postmenopausal women. Arch Intern Med. 1989 Jan;149(1):57–60. [PubMed] [Google Scholar]
  33. Parfitt A. M., Mathews C. H., Villanueva A. R., Kleerekoper M., Frame B., Rao D. S. Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest. 1983 Oct;72(4):1396–1409. doi: 10.1172/JCI111096. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Preece M. A., O'Riordan J. L., Lawson D. E., Kodicek E. A competitive protein-binding assay for 25-hydroxycholecalciferol and 25-hydroxyergocalciferol in serum. Clin Chim Acta. 1974 Jul 31;54(2):235–242. doi: 10.1016/0009-8981(74)90241-1. [DOI] [PubMed] [Google Scholar]
  35. Reeve J., Davies U. M., Hesp R., McNally E., Katz D. Treatment of osteoporosis with human parathyroid peptide and observations on effect of sodium fluoride. BMJ. 1990 Aug 11;301(6747):314–318. doi: 10.1136/bmj.301.6747.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Reeve J., Meunier P. J., Parsons J. A., Bernat M., Bijvoet O. L., Courpron P., Edouard C., Klenerman L., Neer R. M., Renier J. C. Anabolic effect of human parathyroid hormone fragment on trabecular bone in involutional osteoporosis: a multicentre trial. Br Med J. 1980 Jun 7;280(6228):1340–1344. doi: 10.1136/bmj.280.6228.1340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Reinhardt T. A., Horst R. L., Orf J. W., Hollis B. W. A microassay for 1,25-dihydroxyvitamin D not requiring high performance liquid chromatography: application to clinical studies. J Clin Endocrinol Metab. 1984 Jan;58(1):91–98. doi: 10.1210/jcem-58-1-91. [DOI] [PubMed] [Google Scholar]
  38. Riggs B. L., Seeman E., Hodgson S. F., Taves D. R., O'Fallon W. M. Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. Comparison with conventional therapy. N Engl J Med. 1982 Feb 25;306(8):446–450. doi: 10.1056/NEJM198202253060802. [DOI] [PubMed] [Google Scholar]
  39. Saville P. D. Changes in skeletal mass and fragility with castration in the rat; a model of osteoporosis. J Am Geriatr Soc. 1969 Feb;17(2):155–166. doi: 10.1111/j.1532-5415.1969.tb03169.x. [DOI] [PubMed] [Google Scholar]
  40. Schepmoes G., Breen E., Owen T. A., Aronow M. A., Stein G. S., Lian J. B. Influence of dexamethasone on the vitamin D-mediated regulation of osteocalcin gene expression. J Cell Biochem. 1991 Oct;47(2):184–196. doi: 10.1002/jcb.240470212. [DOI] [PubMed] [Google Scholar]
  41. Slovik D. M., Rosenthal D. I., Doppelt S. H., Potts J. T., Jr, Daly M. A., Campbell J. A., Neer R. M. Restoration of spinal bone in osteoporotic men by treatment with human parathyroid hormone (1-34) and 1,25-dihydroxyvitamin D. J Bone Miner Res. 1986 Aug;1(4):377–381. doi: 10.1002/jbmr.5650010411. [DOI] [PubMed] [Google Scholar]
  42. Stock J. L., Coderre J. A., Mallette L. E. Effects of a short course of estrogen on mineral metabolism in postmenopausal women. J Clin Endocrinol Metab. 1985 Oct;61(4):595–600. doi: 10.1210/jcem-61-4-595. [DOI] [PubMed] [Google Scholar]
  43. Storm T., Thamsborg G., Steiniche T., Genant H. K., Sørensen O. H. Effect of intermittent cyclical etidronate therapy on bone mass and fracture rate in women with postmenopausal osteoporosis. N Engl J Med. 1990 May 3;322(18):1265–1271. doi: 10.1056/NEJM199005033221803. [DOI] [PubMed] [Google Scholar]
  44. Tada K., Yamamuro T., Okumura H., Kasai R., Takahashi H. Restoration of axial and appendicular bone volumes by h-PTH(1-34) in parathyroidectomized and osteopenic rats. Bone. 1990;11(3):163–169. doi: 10.1016/8756-3282(90)90210-p. [DOI] [PubMed] [Google Scholar]
  45. Takano-Yamamoto T., Rodan G. A. Direct effects of 17 beta-estradiol on trabecular bone in ovariectomized rats. Proc Natl Acad Sci U S A. 1990 Mar;87(6):2172–2176. doi: 10.1073/pnas.87.6.2172. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Tam C. S., Heersche J. N., Murray T. M., Parsons J. A. Parathyroid hormone stimulates the bone apposition rate independently of its resorptive action: differential effects of intermittent and continuous administration. Endocrinology. 1982 Feb;110(2):506–512. doi: 10.1210/endo-110-2-506. [DOI] [PubMed] [Google Scholar]
  47. Vesterby A., Gundersen H. J., Melsen F. Star volume of marrow space and trabeculae of the first lumbar vertebra: sampling efficiency and biological variation. Bone. 1989;10(1):7–13. doi: 10.1016/8756-3282(89)90140-3. [DOI] [PubMed] [Google Scholar]
  48. Wakamatsu E., Sissons H. A. The cancellous bone of the iliac crest. Calcif Tissue Res. 1969;4(2):147–161. doi: 10.1007/BF02279116. [DOI] [PubMed] [Google Scholar]
  49. Wronski T. J., Lowry P. L., Walsh C. C., Ignaszewski L. A. Skeletal alterations in ovariectomized rats. Calcif Tissue Int. 1985 May;37(3):324–328. doi: 10.1007/BF02554882. [DOI] [PubMed] [Google Scholar]
  50. Wronski T. J., Walsh C. C., Ignaszewski L. A. Histologic evidence for osteopenia and increased bone turnover in ovariectomized rats. Bone. 1986;7(2):119–123. doi: 10.1016/8756-3282(86)90683-6. [DOI] [PubMed] [Google Scholar]
  51. Wronski T. J., Yen C. F., Scott K. S. Estrogen and diphosphonate treatment provide long-term protection against osteopenia in ovariectomized rats. J Bone Miner Res. 1991 Apr;6(4):387–394. doi: 10.1002/jbmr.5650060410. [DOI] [PubMed] [Google Scholar]

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