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The influence of corticosteroid treatment on the OPG/RANK/RANKL pathway and osteocalcin in patients with pemphigus.

Chmielnicka M, Woźniacka A, Torzecka JD - Postepy Dermatol Alergol (2014)

Bottom Line: However, the patient group demonstrated a significantly lower concentration of osteocalcin by up to 18.03%.A decreased osteoblast activity stimulates bone loss.The reduced level of osteocalcin, which is regarded as a marker for bone formation, and a simultaneously elevated RANK level reveal the promotion of osteoclast proliferation in patients treated with corticosteroids.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Medical University of Lodz, Lodz, Poland. Head of Department: Prof. Anna Woźniacka MD, PhD.

ABSTRACT

Introduction: Pemphigus is a rare autoimmune blistering disease, which requires prolonged administration of corticosteroids at high doses. Although this therapy improves the health and lives of patients, it may have various side effects, for example osteoporosis.

Aim: To assess the concentration of osteoprotegerin (OPG), the soluble receptor activator of nuclear factor-κβ ligand (sRANKL) and osteocalcin in patients with pemphigus.

Material and methods: The study comprised a group of 29 patients with pemphigus (17 women and 12 men) aged between 23 years and 75 years treated from 1994 to 2009 in the Department of Dermatology and Venereology, Medical University of Lodz, as well as 24 healthy volunteers matched appropriately in terms of gender and age.

Results: In patients with pemphigus, the mean osteoprotegerin concentration was up to 16.46% higher than in the control group. The average RANKL concentration in serum of patients with pemphigus was 26.88% higher. However, the patient group demonstrated a significantly lower concentration of osteocalcin by up to 18.03%.

Conclusions: Under corticosteroid treatment, RANKL, which is released by osteoblasts, links with the RANK specific osteoclast receptor and stimulates osteoclastogenesis. This reaction can be blocked by osteoprotegerin, which is a competitive inhibitor to the same receptor site. A decreased osteoblast activity stimulates bone loss. The reduced level of osteocalcin, which is regarded as a marker for bone formation, and a simultaneously elevated RANK level reveal the promotion of osteoclast proliferation in patients treated with corticosteroids.

No MeSH data available.


Related in: MedlinePlus

Comparison of the mean levels of osteocalcin in females (patients vs. controls) and in males (patients vs. controls)
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Figure 0009: Comparison of the mean levels of osteocalcin in females (patients vs. controls) and in males (patients vs. controls)

Mentions: In corticosteroid-treated patients, the mean level of osteocalcin was 22.14 ng/ml. In comparison to the normal limits (12–41 ng/ml for premenopausal women, 20–48 ng/ml for postmenopausal women and 11–43 ng/ml for men), this protein was found to be below the recommended levels in 7 out of 29 patients: 4 females and 3 males. The mean concentration of the same marker in a group of healthy people was 27.01 ng/ml, and the values were within normal limits for all of the people in this group. The patient group demonstrated a significantly lower concentration of osteocalcin of up to 18.03% (p < 0.05) (Table 7, Figure 7). When taking gender into account, no statistically significant differences in osteocalcin levels were found between men and women in either compared population (Tables 8 and 9, Figure 8). However, in men with pemphigus, average osteocalcin levels were found to be significantly lower than those in the control group (p < 0.004). No similar relations have been demonstrated in women (patients vs. controls) (Figure 9). Taking into account the duration of therapy it has been shown that in group I (treated for 3 months to 2 years) the mean concentration of osteocalcin was 21.85 ng/ml, while in group II (3–13 years) – 22.32 ng/ml, and those differences were not statistically significant (p = 0.97).


The influence of corticosteroid treatment on the OPG/RANK/RANKL pathway and osteocalcin in patients with pemphigus.

Chmielnicka M, Woźniacka A, Torzecka JD - Postepy Dermatol Alergol (2014)

Comparison of the mean levels of osteocalcin in females (patients vs. controls) and in males (patients vs. controls)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4221354&req=5

Figure 0009: Comparison of the mean levels of osteocalcin in females (patients vs. controls) and in males (patients vs. controls)
Mentions: In corticosteroid-treated patients, the mean level of osteocalcin was 22.14 ng/ml. In comparison to the normal limits (12–41 ng/ml for premenopausal women, 20–48 ng/ml for postmenopausal women and 11–43 ng/ml for men), this protein was found to be below the recommended levels in 7 out of 29 patients: 4 females and 3 males. The mean concentration of the same marker in a group of healthy people was 27.01 ng/ml, and the values were within normal limits for all of the people in this group. The patient group demonstrated a significantly lower concentration of osteocalcin of up to 18.03% (p < 0.05) (Table 7, Figure 7). When taking gender into account, no statistically significant differences in osteocalcin levels were found between men and women in either compared population (Tables 8 and 9, Figure 8). However, in men with pemphigus, average osteocalcin levels were found to be significantly lower than those in the control group (p < 0.004). No similar relations have been demonstrated in women (patients vs. controls) (Figure 9). Taking into account the duration of therapy it has been shown that in group I (treated for 3 months to 2 years) the mean concentration of osteocalcin was 21.85 ng/ml, while in group II (3–13 years) – 22.32 ng/ml, and those differences were not statistically significant (p = 0.97).

Bottom Line: However, the patient group demonstrated a significantly lower concentration of osteocalcin by up to 18.03%.A decreased osteoblast activity stimulates bone loss.The reduced level of osteocalcin, which is regarded as a marker for bone formation, and a simultaneously elevated RANK level reveal the promotion of osteoclast proliferation in patients treated with corticosteroids.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Medical University of Lodz, Lodz, Poland. Head of Department: Prof. Anna Woźniacka MD, PhD.

ABSTRACT

Introduction: Pemphigus is a rare autoimmune blistering disease, which requires prolonged administration of corticosteroids at high doses. Although this therapy improves the health and lives of patients, it may have various side effects, for example osteoporosis.

Aim: To assess the concentration of osteoprotegerin (OPG), the soluble receptor activator of nuclear factor-κβ ligand (sRANKL) and osteocalcin in patients with pemphigus.

Material and methods: The study comprised a group of 29 patients with pemphigus (17 women and 12 men) aged between 23 years and 75 years treated from 1994 to 2009 in the Department of Dermatology and Venereology, Medical University of Lodz, as well as 24 healthy volunteers matched appropriately in terms of gender and age.

Results: In patients with pemphigus, the mean osteoprotegerin concentration was up to 16.46% higher than in the control group. The average RANKL concentration in serum of patients with pemphigus was 26.88% higher. However, the patient group demonstrated a significantly lower concentration of osteocalcin by up to 18.03%.

Conclusions: Under corticosteroid treatment, RANKL, which is released by osteoblasts, links with the RANK specific osteoclast receptor and stimulates osteoclastogenesis. This reaction can be blocked by osteoprotegerin, which is a competitive inhibitor to the same receptor site. A decreased osteoblast activity stimulates bone loss. The reduced level of osteocalcin, which is regarded as a marker for bone formation, and a simultaneously elevated RANK level reveal the promotion of osteoclast proliferation in patients treated with corticosteroids.

No MeSH data available.


Related in: MedlinePlus