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Pharmacological inhibition of RANKL signaling and osteoprotegerin-mediated inhibition of osteoclastogenesis have proven effective at preventing osteoclastogenesis in vitro. However, it is unclear if treatment with RANKL inhibitors also has clinical efficacy. To address this issue, we measured the ability of RANKL inhibitors to prevent trabecular bone loss in the mouse femur following femoral osteotomy. We found that the RANKL inhibitors produced a dose-dependent effect on trabecular bone volume. This effect was associated with the inhibition of osteoclastogenesis as shown by a significant reduction in the number of TRAP+ osteoclasts. Bone marrow BFU-E colonies from mice treated with RANKL inhibitors also displayed a decreased capacity for self-renewal. Consequently, these results demonstrate that pharmacological inhibition of RANKL signaling is an effective means of inhibiting trabecular bone loss in vivo.
Bisphosphonates (BPs) are synthetic analogues of inorganic pyrophosphate with a primary effect of inhibiting osteoclast-mediated bone resorption. BPs have been demonstrated to reduce bone fracture and to improve bone mineral density (BMD) in patients with osteoporosis. In this study, we used micro-CT to measure BMD in the femoral neck of elderly men and women treated with alendronate or clodronate. Treatment with BPs resulted in a 1.3% increase in BMD compared with baseline. However, women treated with alendronate had a greater increase in BMD (2.3%) than men (1.3%). In addition, BPs were associated with improved trabecular microarchitecture in both sexes. Osteoclasts in the elderly show a lower capacity for resorption in vitro. To determine if this is also true in vivo, we compared the capacity of intact osteoclasts to resorb bone from aged mice to those from young mice. Osteoclasts from the aged mice resorbed bone at a lower rate than those from the young mice. The resorption rate remained constant as long as drug treatment was maintained. These results indicate that age is a major factor in the in vivo resorptive capacity of osteoclasts, and that this capacity can be improved by treatment with BPs.
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