Summary
The bone histomorphometric effects of intermittent phosphate and calcitonin therapy during 1 year were analyzed in 15 involutional osteoporotic patients. Phosphate was administered continuously (1.5 g/day) and calcitonin was injected during 5 days every third week (50 IU/day). The bone cell response was analyzed in two separate groups, according to the amount of trabecular bone present in the iliac bone biopsy: patients with trabecular bone volume (TBV) beyond the histomorphometric spontaneous fracture threshold (0.16 mm3/mm3) (group 1; 11 patients) and patients with TBV above this threshold (group 2; 4 patients). In group 1, the treatment significantly increased TBV from 0.113±0.025 to 0.156±0.046 mm3/mm3 by thickening the existing trabeculae rather than by creating new trabeculae; stimulation of bone formation rate (+50%) and significant reduction in active trabecular resorption surfaces (from 0.021±0.013 to 0.010±0.006 mm2/mm2;P<.05) may have led to positive bone balance. In group 2, TBV was not changed because of the treatment's relative inefficiency for reducing the bone-resorbing cell activity, leading to likely persistent negative bone balance. Cortical thickness did not change in either group. This study confirms the positive effectiveness of continuous treatment with phosphate and intermittent calcitonin during 1 year on bone balance in involutional osteoporosis with low amount of bone. The lack of response in patients with normal amount of bone must be verified before raising the hypothesis of different bone cell activity and before anticipating the therapeutic response according to local bone mass besides bone remodeling status in osteoporosis.
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References
Ringgs BL, Melton LJ, III (1986) Involutional osteoporosis. N Engl J Med 314:1676–1686
Parfitt AM (1982) The coupling of bone formation to resorption: a critical analysis of the concept and its relevance to the pathogenesis of osteoporosis. Metab Bone Dis Rel Res 4:1–6
Meunier PJ, Sellami S, Briancon D, Edouard C (1981) Histological heterogeneity of apparently idiopathic osteoporosis. In: De Luca HF (ed) Osteoporosis: recent advances in pathogenesis and treatment. University Park Press, Baltimore, pp 293–301
Riggs BL, Melton LJ, Wahner HW (1983) Heterogeneity of involutional osteoporosis: evidence for two distinct osteoporosis syndromes. In Frame B, Potts JT (eds) Clinical disorders of bone and mineral metabolism, Detroit, pp 337–342
Parfitt AM, Mathews CHE, Villanueva AR (1983) Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. J Clin Invest 72:1396–1409
Briancon D, Meunier PJ (1981) Treatment of osteoporosis with fluoride, calcium and vitamin D. Clin North Am 12:629–648
Slovik DM, Neer RM, Potts JF (1981) Short-term effects of synthetic human parathyroid hormone (1–34) administration on bone mineral metabolism in osteoporotic patients. J Clin Invest 68:1261–1271
Frost HM (1979) Treatment of osteoporosis by manipulation of coherent bone cell populations. Clin Orthop Rel Res 143:227–244
Rasmussen H, Bordier P, Marie P, Auquier L, Eisinger JB, Kuntz D, Caulin F, Argemi B, Gueris J, Julien A (1980) Effect of combined therapy with phosphate and calcitonin on bone volume in osteoporosis. Metab Bone Dis Rel Res 2:107–111
Marie PJ, Caulin F (1986) Mechanisms underlying the effects of phosphate and calcitonin on bone histology in postmenopausal osteoporosis. Bone 7:17–22
Berthel M, Moyses B, Kuntzman F, Methlin G, Julien D, Caulin F (1984) Treatment of post-menopausal osteoporosis with phosphate and intermittent calcitonin: effect on cortical bone. In: Christiansen C and al. (eds) Osteoporosis. Glasturp Hosp, Copenhagen, pp 651–652
Goldsmith RS, Jowsey J, Dube WJ, Riggs BL, Arnaud CD, Kelley PJ (1976) Effects of phosphorus supplementation on serum parathyroid hormone and bone morphology in osteoporosis. J Clin Endocrinol Metab 43:523–532
Holtrop ME, Raisz LG, Simmons HA (1974) The effects of parathyroid hormone, colchicine and calcitonin on the ultrastructure and the activity of osteoclasts in organ culture. J Cell Biol 60:346–355
Chappard D, Alexandre C, Bousquet G, Riffat G (1983) Nouvelles modifications du trocart de Bordier pour la biopsie osseuse. Rev Rhum 50:307–308
Chappard D, Alexandre C, Camps M, Montheard JP, Riffat G (1984) Embedding iliac bone biopsies at low temperature using glycol and methyl methacrylates. Stain Technol 58:299–308
Chappard D, Alexandre C, Riffat G (1983) Histochemical identification of osteoclasts in undecalcified human bone biopsies. Reappraisal of a simple procedure for routine diagnosis. Bas Appl Histochem 27:75–85
Courpron P, Lepine P, Arlot M, Lips P, Meunier PJ (1980) Mechanisms underlying the reduction with age of the mean wall thickness of trabecular basic structural units in human iliac bone. Metab Bone Dis Rel Res 25:323–329
Frost HM (1966) The bone dynamics in osteoporosis and osteomalacia. Charles C. Thomas (ed) Springfield
Meunier P, Courpron P (1976) Iliac trabecular bone volume in 236 controls. Representativeness of iliac samples. In: Jaworski ZFG (ed) Bone morphometry. University of Ottawa Press, Ottawa, pp 100–105
Meunier P, Chavassieux P (1985) L'histomorphométrie: moyen d'évaluation de la masse osseuse. Rev Rhum 52:669–673
Meunier P, Vignon G, Pansu D, Edouard C, Courpron P (1972) L'apport de la radiologie dans l'appréciation d'une déminéralisation rachidienne. Cah Med Lyon 48:4115–4122
Vost A (1963) Osteoporosis: a necropsic study of vertebral and iliac crests. Am J Pathol 43:143–151
Frost HM (1985) The pathomechanics of osteoporoses. Clin Orthop Rel Res 200:198–225
Chavassieux PM, Arlot ME, Meunier PJ (1985) Intersample variation in bone histomorphometry: comparison between parameter values measured on two contiguous transiliac bone biopsies. Calcif Tissue Int 37:345–350
Whyte MP, Bergfeld MA, Murphy WA, Avioli LV, Teitelbaum SL (1982) Post-menopausal osteoporosis. A heterogeneous disorder as assessed by histomorphometric analysis of iliac crest bone from untreated patients. Am J Med 72:193–202
Sainte Marie LG, Charhon SA, Meunier PJ (1983) Le test d'hypocalcémie à la calcitonine a-t-il une utilité dans les ostéoporoses? Presse Méd 12:2883–2884
Judy MM, Leconey TR, Matthews JL, Jee WSS (1980) Measurement of trabecular spacing and orientation by optical diffraction. In: Jee WSS, Parfitt AM (eds) Bone histomorphometry. Armour Montagu, Paris, pp 291–295
Mazess RB, Vetter J (1985) The influence of marrow on measurement of trabecular bone using computer tomography. Bone 6:349–351
Alexandre C, Chappard D (1986) Sequential use of phosphate and diphosphonate in the treatment of osteoporosis. Priliminary results. J Bone Min Res 1:S1–256.
Harris WH, Heaney IA, Davis EH, Weinberg RD, Coutts RD, Shiller AL (1976) Stimulation of bone formation in vivo by phosphate supplementation. Calcif Tissue Int 22:85–98
Toccafondi R, Zonefrati R, Galli G, Gennari C, Avioli LV (1986) Effect of L-lysine on growth and collagen synthesis in osteoblastlike cells. In: IXth Intl Conf on Calcium-Regulating Hormones and Bone Metabolism, October 25–November 1, 1986, Nice, France
Gruber HE, Ivey JL, Baylink DJ, Matthews M, Nelp WB, Sisom K, Chesnut CH (1984) Long-term calcitonin therapy in post-menopausal osteoporosis. Metabolism 33:295–303
Aloia JF, Vaswani A, Meunier PJ, Edouard CM, Arlot ME, Yeh JK, Cohn SH (1987) Coherence treatment of postmenopausal osteoporosis with growth hormone and calcitonin. Calcif Tissue Int 40:253–259
Marie PJ, Rasmussen H, Kuntz D, Gueris J, Caulin F (1984) Treatment of postmenopausal osteoporosis with phosphate and intermittent calcitonin. In: Christiansen C (ed) Osteoporosis. Glostrup Hosp, Copenhagen, pp 575–580
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Alexandre, C., Chappard, D., Caulin, F. et al. Effects of a one-year administration of phosphate and intermittent calcitonin on bone-forming and bone-resorbing cells in involutional osteoporosis: A histomorphometric study. Calcif Tissue Int 42, 345–350 (1988). https://doi.org/10.1007/BF02556351
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DOI: https://doi.org/10.1007/BF02556351