Osteoporosis International

, Volume 22, Issue 11, pp 2869–2877 | Cite as

Bone and bone marrow pro-osteoclastogenic cytokines are up-regulated in osteoporosis fragility fractures

  • P. D’Amelio
  • I. Roato
  • L. D’Amico
  • L. Veneziano
  • E. Suman
  • F. Sassi
  • G. Bisignano
  • R. Ferracini
  • G. Gargiulo
  • F. Castoldi
  • G. P. Pescarmona
  • G. C. Isaia
Original Article



This study evaluates cytokines production in bone and bone marrow of patients with an osteoporotic fracture or with osteoarthritis by real time PCR, Western blot and immunohistochemistry. We demonstrate that the cytokine pattern is shifted towards osteoclast activation and osteoblast inhibition in patients with osteoporotic fractures.


Fragility fractures are the resultant of low bone mass and poor bone architecture typical of osteoporosis. Cytokines involved in the control of bone cell maturation and function are produced by both bone itself and bone marrow cells, but the roles of these two sources in its control and the amounts they produce are not clear. This study compares their production in patients with an osteoporotic fracture and those with osteoarthritis.


We evaluated 52 femoral heads from women subjected to hip-joint replacement surgery for femoral neck fractures due to low-energy trauma (37), or for osteoarthritis (15). Total RNA was extracted from both bone and bone marrow, and quantitative PCR was used to identify the receptor activator of nuclear factor kB Ligand (RANKL), osteoprotegerin (OPG), macrophage colony stimulating factor (M-CSF), transforming growth factor β (TGFβ), Dickoppf-1 (DKK-1) and sclerostin (SOST) expression. Immunohistochemistry and Western blot were performed in order to quantify and localize in bone and bone marrow the cytokines.


We found an increase of RANKL/OPG ratio, M-CSF, SOST and DKK-1 in fractured patients, whereas TGFβ was increased in osteoarthritic bone. Bone marrow produced greater amounts of RANKL, M-CSF and TGFβ compared to bone, whereas the production of DKK-1 and SOST was higher in bone.


We show that bone marrow cells produced the greater amount of pro-osteoclastogenic cytokines, whereas bone cells produced higher amount of osteoblast inhibitors in patients with fragility fracture, thus the cytokine pattern is shifted towards osteoclast activation and osteoblast inhibition in these patients.




Funding sources

This study was supported by the Stroeder-SIOMMMS Young Investigator Award, by a grant from the Cassa di Risparmio di Torino (CRT) and by a grant from the Ministry for Education, the Universities and Research (MIUR).

PD and FS were supported by a fellowship from the Regione Piemonte.

Conflicts of interest


Supplementary material

198_2010_1496_MOESM1_ESM.ppt (466 kb)
Supplemental figure Proteins expression in bone and bone marrow from fractured and OA patients. a Western blot analyses display of RANKL, TGFβ, M-CSF, SOST, OPG and DKK-1 expression in samples from fractured (lanes 1 to 5) and OA (lanes 6 to 10). Actin was used as control. The shown blot was obtained in bone marrow samples. b Graph represents the expression of measured cytokines in fractured and OA patients' bone marrow. Bars represent mean and SD expressed as optical density (O.D.). Asterisk is a p value = 0.000 and was calculated by means of Student's T test. c As in b, cytokines measured in bone, Single asterisk is a p value = 0.001. d As in b, cytokines measured in bone compared to those measured in bone marrow, white circle is a p value = 0.03 (PPT 465 kb)
198_2010_1496_MOESM2_ESM.doc (27 kb)
Supplemental table Gene probe and primer sequences. P, probe; F, forward; R, reverse. All the probes were labeled at the 5′ end with 6-carboxy fluorescein (FAM) and the 3′ end with 6-carboxy-tetramethyl rhodamine (TAMRA), the annealing temperature was always 58°C (DOC 27 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2010

Authors and Affiliations

  • P. D’Amelio
    • 1
  • I. Roato
    • 2
  • L. D’Amico
    • 2
  • L. Veneziano
    • 1
  • E. Suman
    • 1
  • F. Sassi
    • 1
  • G. Bisignano
    • 1
  • R. Ferracini
    • 2
    • 3
  • G. Gargiulo
    • 3
  • F. Castoldi
    • 4
  • G. P. Pescarmona
    • 2
    • 5
  • G. C. Isaia
    • 1
  1. 1.Gerontology Section, Department of Surgical and Medical DisciplinesUniversity of TorinoTorinoItaly
  2. 2.CeRMS (Center for Research and Medical Studies)San Giovanni Battista HospitalTorinoItaly
  3. 3.Department of OrthopaedicsSan Giovanni Battista HospitalTorinoItaly
  4. 4.Department of Orthopaedics and TraumatologyUniversity of TorinoTorinoItaly
  5. 5.Department of Genetics, Biology and BiochemistryUniversity of TorinoTorinoItaly

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