Teriparatide increases the maturation of circulating osteoblast precursors

Osteoporos Int. 2012 Apr;23(4):1245-53. doi: 10.1007/s00198-011-1666-2. Epub 2011 May 27.

Abstract

This study shows that teriparatide promotes the circulating osteoblast (OB) precursor degree of maturation in patients affected by postmenopausal osteoporosis.

Introduction: Anabolic treatment with teriparatide has proven effective for the therapy of postmenopausal osteoporosis and significantly reduces the risk of non-vertebral fragility fractures. The aim of this study was to investigate the effect of teriparatide on circulating OB precursors.

Methods: We evaluated by flow cytometry and real-time PCR the expression of OBs typical markers in peripheral blood mononuclear cells during treatment with teriparatide plus calcium and vitamin D, raloxifene plus calcium and vitamin D or calcium and vitamin D alone at various time points. Serum bone alkaline phosphatase and osteocalcin (OC) were measured as markers of bone turnover.

Results: Our results show that circulating OB precursors are more numerous and more immature in patients affected by fragility fractures than in osteoporotic patients without fractures. We also show that teriparatide treatment increases the expression of alkaline phosphatase and of OC in OB precursors; thus, it increases their degree of maturation.

Conclusions: We suggest that teriparatide acts as anabolic agents also by promoting the maturation of OB precursors.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alkaline Phosphatase / blood
  • Biomarkers / blood
  • Bone Density Conservation Agents / pharmacology*
  • Bone Density Conservation Agents / therapeutic use
  • Calcium / pharmacology
  • Calcium / therapeutic use
  • Cell Differentiation / drug effects
  • Drug Therapy, Combination
  • Female
  • Humans
  • Mesenchymal Stem Cells / drug effects
  • Middle Aged
  • Osteoblasts / drug effects*
  • Osteoblasts / pathology
  • Osteocalcin / blood
  • Osteoporosis, Postmenopausal / blood*
  • Osteoporosis, Postmenopausal / complications
  • Osteoporosis, Postmenopausal / drug therapy
  • Osteoporotic Fractures / blood
  • Osteoporotic Fractures / etiology
  • Osteoporotic Fractures / prevention & control
  • Raloxifene Hydrochloride / pharmacology
  • Raloxifene Hydrochloride / therapeutic use
  • Secondary Prevention
  • Teriparatide / pharmacology*
  • Teriparatide / therapeutic use
  • Vitamin D / pharmacology
  • Vitamin D / therapeutic use

Substances

  • Biomarkers
  • Bone Density Conservation Agents
  • Osteocalcin
  • Teriparatide
  • Vitamin D
  • Raloxifene Hydrochloride
  • Alkaline Phosphatase
  • Calcium