Sayak Banerjee, Amity University Kolkata
Rheumatoid Arthritis and osteoporosis:
Rheumatoid Arthritis (RA) is a chronic systemic inflammatory disease that mostly occurs in synovial joints. Its symptoms are local bone loss depicted by juxta-articular osteoporosis, and systemic bone loss depicted by generalized osteoporosis. Among these two symptoms, generalized osteoporosis is more common in patients with RA than in the general population, and this is often brought upon the risk of increased chances of fracture. The physiopathology of systemic inflammation of osteoporosis in RA and its treatment involving glucocorticoid (GC) are two chief determinants of bone loss. There are several regulators taking part in the pathogenesis of bone changes in RA, and these are modulated by GC. GC-induced bone loss is associated with the hindrance towards bone formation which in turn leads to the increase of bone adhesion related to the dysregulation of the osteoprotegerin (OPG) system.
Data analysis of Glucocorticoid treatment and bone quality:
There are only a few data available that observe changes in the bone during RA since a large number of patients with RA develop osteoporosis while the disease is in progression. The researchers from the Rheumatology Clinic of the University of Foggia, have mentioned their findings in their paper. They used Dual X-Ray absorptiometry (DXA) for the measurement of bone mineral density (BMD), although it is not sufficient to evaluate the parameters required to define bone strength. The trabecular bone score (TBS) is the structural index acquired from the DXA image analysis which enables the indirect assessment of bone microarchitecture implying bone quality. It has been seen that TBS provides further details concerning the changes in bone quality associated with GC treatment. It might be an essential tool for the evaluation of bone microarchitecture irrespective of BMD. A higher value of TBS corresponds to a better bone microarchitecture, whereas lower TBS is associated with poorer bone microarchitecture despite their BMD being identical.
GC has a prime role in the treatment of RA despite its negative effects on BMD. Osteoporotic fractures take place with higher BMD values in patients treated with GC in comparison to untreated patients. The scientists have found that there is a considerable decrease of TBS in the patients being treated with GC when compared to the reduction of BMD. The data that was presented, exhibited a significant decrease in BMD in early symptoms of RA both at the hip and spine after one tear from the onset of the disease. No significant reduction was observed in hip and spine BMD between low and high GC treated patients, whereas TBS values at the end of one year were extensively lower in patients receiving a high dose of GC.
The Result from their Findings:
Thus, the findings suggested that exposure to Glucocorticoid (GC) has a significant influence on bone microarchitecture mediated by the modulation of the OPG system. Additionally, the data depicts the potential of TBS involving the role of determining the early changes of bone quality. This bone score could give supplementary details regarding bone status in RA in addition to BMD. Further research is needed to determine the relationship between TBS changes and GC treatment, and the possible roles of other parameters that could affect TBS.
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Reference:
- Corrado, A., Rotondo, C., Mele, A. et al. Influence of glucocorticoid treatment on trabecular bone score and bone remodeling regulators in early rheumatoid arthritis. Arthritis Res Ther 23, 180 (2021). https://doi.org/10.1186/s13075-021-02562-3
Author info:
Sayak Banerjee is a 3rd-year Biotechnology Engineering Student with a great interest in Immunology and Molecular genetics. He is a creative scientific writer in Bioxone with an inclination towards gaining knowledge regarding various sections of Biotechnology and emphasizing himself in various wet lab skills.
Publications:
- https://bioxone.in/news/worldnews/car-t-cells-scientists-discover-on-off-switches-for-cell-immunotherapy/
- https://bioxone.in/news/worldnews/neutrophil-derived-nanovesicles-a-novel-drug-delivery-system/
- https://bioxone.in/news/worldnews/pig-to-human-heart-transplantation-a-solution-to-the-rarity-of-donor-organs/
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