ABSTRACT
Este estudo teve como objetivo analisar o processo de formação óssea, bem como a microarquitetura óssea promovido pela associação entre o BioGran® e diferentes concentrações de raloxifeno através do método da sonoquímica em defeitos críticos realizados em calvária de rato. Em um total de doze ratos machos, um defeito crítico de 5 mm de diâmetro foi feito e preenchido com BioGran® 100% (Bg), BioGran® 90% associado à Raloxifeno 10%, e BioGran® 80% associado à Raloxifeno 20%. Aos 14 e 24 dias pós-operatório, foram aplicados os fluorocromos calceína e alizarina, de modo respectivo. A eutanásia ocorreu aos 30 dias após a realização do procedimento cirúrgico para enxertia dos biomateriais. Análise de microtomografia computadorizada (micro-CT) através dos parâmetros de superfiície de intersecção (i.S), fração de volume ósseo (BV/TV) e densidade de conectividade (Conn.Dn) e por microscopia confocal a laser por meio da dinâmica óssea, superfície de mineralização ativa e a taxa de aposição mineral (MAR). Os dados foram analisados através de análise estatística utilizando o teste de normalidade Shapiro-Wilk e o pós teste de Turkey (p<0.05). Para os parâmetros de micro-CT avaliados os menores valores foram encontrados no grupo BG+RL10% (p<0,05), valores similares foram encontrados entre os grupos BG e BG+RL20%. A microscopia confocal evidenciou melhor mineralização óssea e maior taxa de aposição mineral (MAR) para o Grupo BG+RL20% (p<0,05%). Conclusão: A concentração de Raloxifeno a 20% combinado ao BioGran® pelo método da sonoquímica parece ter acelerado o reparo ósseo(AU)
This study aimed to analyze the bone formation process, as well as the bone microarchitecture promoted by the association between BioGran® and different concentrations of raloxifene through the sonochemistry method in critical defects performed in rat calvaria. In a total of twelve male rats, a critical defect of 5 mm in diameter was made and filled with BioGran® 100% (Bg), BioGran® 90% associated with Raloxifene 10%, and BioGran® 80% associated with Raloxifene 20%. At 14 and 24 days postoperatively, the fluorochromes calcein and alizarin were applied, respectively. Euthanasia occurred 30 days after the surgical procedure for grafting biomaterials. Analysis of computed microtomography (microCT) through the parameters of intersection surface (iS), bone volume fraction (BV / TV) and connectivity density (Conn.Dn) and by confocal microscopy through bone dynamics, surface of active mineralization and the mineral apposition rate (MAR). Data were analyzed through statistical using the Shapiro-Wilk normality test and the Turkey post-test (p <0.05). For the me microCT parameters evaluated, the lowest values were found in the BG + RL10% group (p<0.05), similar values were found between the BG and BG + RL20% groups. Confocal microscopy showed better bone mineralization and higher mineral apposition rate (MAR) for the BG + RL20% Group (p < 0.05%). Conclusion: The concentration of Raloxifene at 20% combined with BioGran® by the sonochemistry method seems to have accelerated bone repair(AU)
Subject(s)
Animals , Rats , Bone Regeneration , Sonication , Bone Transplantation , Rats, WistarABSTRACT
Selective estrogen receptor modulators tamoxifen,raloxifene,and bazedoxifene reduce neuronal death through the mechanisms of anti-inflammation,antioxidant stress,and inhibition of glutamate excitotoxicity.They play a neuroprotective role in cerebral ischemia and may become a new neuroprotective agent for the treatment of ischemic stroke.
ABSTRACT
OBJECTIVES: The present mini review aimed to summarize the existing knowledge regarding the beneficial and adverse effects of raloxifene in menopausal women. METHODS: This study is a review of relevant publications about the effects of raloxifene on sleep disorder, depression, venous thromboembolism, the plasma concentration of lipoprotein, breast cancer, and cognitive function among menopausal women. RESULTS: Raloxifene showed no significant effect on depression and sleep disorder. Verbal memory improved with administration of 60 mg/day of raloxifene while a mild cognitive impairment risk reduction by 33% was observed with administration of 120 mg/day of raloxifene. Raloxifene was associated with a 50% decrease in the need for prolapse surgery. The result of a meta-analysis showed a significant decline in the plasma concentration of lipoprotein in the raloxifene group compared to placebo (standardized mean difference, −0.43; 10 trials). A network meta-analysis showed that raloxifene significantly decreased the risk of breast cancer (relative risk, 0.572; 95% confidence interval, 0.327–0.881; P = 0.01). In terms of adverse effects of raloxifene, the odds ratio (OR) was observed to be 1.54 (P = 0.006), indicating 54% increase in the risk of deep vein thrombosis (DVT) while the OR for pulmonary embolism (PE) was 1.05, suggesting a 91% increase in the risk of PE alone (P = 0.03). CONCLUSIONS: Raloxifene had no significant effect on depression and sleep disorder but decreased the concentration of lipoprotein. Raloxifene administration was associated with an increased risk of DVT and PE and a decreased risk of breast cancer and pelvic organ prolapse in postmenopausal women.
Subject(s)
Female , Humans , Breast Neoplasms , Cognition , Depression , Lipoproteins , Memory , Cognitive Dysfunction , Odds Ratio , Pelvic Organ Prolapse , Plasma , Prolapse , Pulmonary Embolism , Raloxifene Hydrochloride , Risk Reduction Behavior , Sleep Wake Disorders , Venous Thromboembolism , Venous ThrombosisABSTRACT
A ocorrência de doenças crônicas e degenerativas é significativamente maior nos organismos durante o envelhecimento, dentre elas, a osteoporose, que resulta em aumento no número de fraturas. As fraturas são as consequências mais dramáticas da osteoporose, sendo que do colo do fêmur é a mais severa, com maior incidência de morbidades e mortalidade. A menor concentração plasmática de estrogênio nas mulheres menopausadas, exerce ação primordial no desenvolvimento desta doença. Desta maneira, o objetivo deste estudo foi estudar a prevenção da osteoporose em decorrência do envelhecimento reprodutivo feminino, especificamente no período de periestropausa, utilizando treinamento de força (TF), raloxifeno (Ral) ou combinação de TF e Ral. Durante 120 dias, ratas Wistar no período do envelhecimento (18 a 21 meses) realizaram TF em escada três vezes por semana, receberam Ral (1mg/Kg/dia) por gavagem, ou realizaram TF associado ao tratamento com Ral. Microarquitetura óssea cortical e trabecular, densidade mineral óssea areal (DMOa), força óssea, imunoistoquímica (OCN, TRAP e SOST) e superfície de osteoclastos do colo do fêmur foram avaliadas, além de PCR (Runx2, Sp7, Alp, Bsp, Ocn, Rank, Rankl, Opg, Trap e Ctsk) e Western Blot (p-ERα e TRAP) do tecido ósseo de todo o fêmur. Os resultados demonstram que os tratamentos modularam o ciclo de remodelamento ósseo de maneiras diferentes: TF estimulou RNAm de marcadores osteoblásticos e osteoclásticos, enquanto Ral diminuiu marcadores osteoclásticos e TF associado a Ral aumentou marcadores osteoblásticos e diminuiu osteoclásticos. Ambos tratamentos resultaram em melhora da microarquitetura trabecular do colo do fêmur de ratas na periestropausa, todavia, apenas o TF foi capaz de melhorar além da microarquitetura trabecular, a cortical e força óssea. Desta maneira, sugerimos que a realização de TF, utilização de Ral ou a associação de TF e Ral durante a periestropausa são intervenções válidas na prevenção de osteoporose em decorrência do envelhecimento reprodutivo feminino, porém os efeitos do TF parecem ser superiores. Levando em consideração que a carga mecânica gerada pelo TF age também em tecidos não esqueléticos, concluímos que TF pode ser intervenção sistêmica para osteoporose. Esses resultados adicionam novas informações à literatura sobre terapêuticas preventivas para osteoporose e fornecem informações relevantes para estudos pré-clínicos(AU)
The association of aging with osteoporosis results in an increased number of fractures. In these fractures, the femoral neck is involved in 75% of affected women and is one of the most dramatic possible consequences. The aim of this study was to prevent female osteoporosis using strength training (ST), raloxifene (Ral) or a combination of ST plus Ral during the natural female aging process, specifically in the periestropause period. For 120 total days, aging female Wistar rats at 18-21 months of age performed ST on three times per week, and Ral was administered daily by gavage (1mg/kg/day). Bone microarchitecture, areal bone mineral density (aBMD), bone strength of the femoral neck, immunohistochemistry, western blotting (p-ERα and TRAP) and RT-PCR were assessed. We found that the treatments modulate the bone remodeling cycle in different ways. Both ST and Ral treatment resulted in improved bone microarchitecture in the femoral neck of rats in late periestropause. However, only ST improved cortical microarchitecture and bone strength in the femoral neck. In addition, ST stimulated mRNA levels of osteoclastic and osteoblastic markers, while Ral decreased mRNA levels of osteoclastic markers. The combined ST plus Ral therapy increased osteoblastic markers and decreased osteoclast markers. In this way, we suggest that SF, the use of Ral or the association of ST and Ral during periestropause are valid interventions in the prevention of osteoporosis due to female reproductive aging, but the effects of ST seem to be superior, taking into account that the mechanical load generated by ST also acts on nonskeletal tissues, we conclude that ST can be a systemic intervention for osteoporosis. These results add new information to the literature on preventive therapies for osteoporosis and provide relevant information for preclinical studies(AU)
Subject(s)
Animals , Rats , Aging , Exercise , Osteoporosis , Raloxifene Hydrochloride , Bone and Bones , Rats, WistarABSTRACT
OBJECTIVES: To evaluate the efficacy of raloxifene in preventing bone loss associated with long term gonadotropin-releasing hormone agonist (GnRH-a) administration. METHODS: Twenty-two premenopausal women with severe endometriosis were treated with leuprolide acetate depot at a dosage of 3.75 mg/4 weeks, for 48 weeks. Bone mineral density (BMD) was evaluated at admission, and after 12 treatment cycles. RESULTS: At cycle 12 of GnRH-a plus raloxifene treatment, lumbar spine, trochanter femoral neck, and Ward's BMD differed from before the treatment. A year after treatment, the lumbar spine and trochanter decreased slightly, but were not significantly different. CONCLUSIONS: Our study shows that the administration of GnRH-a plus raloxifene in pre-menopausal women with severe endometriosis, is an effective long-term treatment to prevent bone loss.
Subject(s)
Female , Humans , Bone Density , Endometriosis , Femur , Femur Neck , Gonadotropin-Releasing Hormone , Leuprolide , Raloxifene Hydrochloride , SpineABSTRACT
BACKGROUND: To assess the cost-effectiveness of drug therapy to prevent osteoporotic fractures in postmenopausal women with osteopenia in Korea. METHODS: A Markov cohort simulation was conducted for lifetime with a hypothetical cohort of postmenopausal women with osteopenia and without prior fractures. They were assumed to receive calcium/vitamin D supplements only or drug therapy (i.e., raloxifene or risedronate) along with calcium/vitamin D for 5 years. The Markov model includes fracture-specific and non-fracture specific health states (i.e. breast cancer and venous thromboembolism), and all-cause death. Published literature was used to determine the model parameters. Local data were used to estimate the baseline incidence rates of fracture in those with osteopenia and the costs associated with each health state. RESULTS: From a societal perspective, the estimated incremental cost-effectiveness ratios (ICERs) for the base cases that had T-scores between -2.0 and -2.4 and began drug therapy at the age of 55, 60, or 65 years were $16,472, $6,741, and -$13,982 per quality-adjusted life year (QALY) gained, respectively. Sensitivity analyses for medication compliance, risk of death following vertebral fracture, and relaxing definition of osteopenia resulted in ICERs reached to $24,227 per QALY gained. CONCLUSIONS: ICERs for the base case and sensitivity analyses remained within the World Health Organization's willingness-to-pay threshold, which is less than per-capita gross domestic product in Korea (about $25,700). Thus, we conclude that drug therapy for osteopenia would be a cost-effective intervention, and we recommend that the Korean National Health Insurance expand its coverage to include drug therapy for osteopenia.