联合应用重组人骨保护素和二膦酸盐抑制破骨细胞及治疗骨质疏松的实验研究
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摘要
骨保护素(Osteoprotegerin,OPG)是破骨细胞局部抑制因子,已成为极具潜力的治疗骨吸收类疾病药物。它作为破骨细胞分化和活性关键因子RANKL(Receptor Activator of Nuclear Factor-κB Ligand,核因子—κB受体激活因子配基)的可溶性假受体,竞争性抑制RANKL与破骨细胞及前体细胞胞膜受体RANK(Receptor Activator of Nuclear Factor-κB)结合,影响破骨细胞及前体细胞的信号传导过程,从而抑制破骨细胞活性。在治疗骨质疏松的动物实验和临床应用中,OPG均表现出卓越的抗骨吸收效能。
     虽然OPG抑制破骨细胞效果显著,但其价格较昂贵(例如,酵母表达OPG目前市价约为$4.2/mg),若长期大量使用患者花费较高。而且由于人类遗传多态性的缘故,长期使用OPG有引发异常免疫反应的可能。为降低OPG生产成本、减轻患者负担并减少可能发生的副作用,本研究一方面构建新OPG-Fc表达菌株,希望减少蛋白发酵过程的降解;另一方面试图找到一种能够与OPG联合使用的药物,从而更有效的联合抑制破骨细胞。
     本实验采用酵母菌SMD1168构建新的OPG-Fc表达菌株——SMD1168/OPG-Fc,并且进行了两种表达菌株(X33/OPG-Fc和SMD1168/OPG-Fc)的发酵时程和OPG-Fc产量方面的对比研究。证明X33/OPG-Fc在更短的时间内使OPG-Fc产量达到要求;而SMD1168/OPG-Fc虽发酵过程较慢,但产生的杂蛋白较少,发酵获得的OPG-Fc纯度更高。X33/OPG-Fc和SMD1168/OPG-Fc发酵获得的OPG-Fc经纯化后均可有效发挥抑制破骨细胞的活性。
     在此基础上本实验进行了联合应用OPG和阿伦膦酸钠(alendronate,ALN)抑制破骨细胞的研究。二膦酸盐(bisphosphonate,BPs)类药物,如ALN可抑制破骨细胞的甲羟戊酸途径(mevalonate Pathway)中FPP合成酶(farnesyl diphosphate synthase)从而有效地抑制破骨细胞分化并引起破骨细胞凋亡。体外细胞实验显示:联合应用rhOPG-Fc和ALN可更强烈地抑制破骨细胞前体细胞分化,更有效地抑制成熟破骨细胞及原代骨巨细胞瘤多核巨细胞的骨吸收功能。这两种药物在抑制破骨细胞分化和功能方面都表现出明显地交互作用,且联合应用1/2剂量的rhOPG-Fc+ALN的抑制破骨细胞和原代骨巨细
Osteoprotegerin is an inhibitory factor of Osteoclasts. It has been the potential treatment for osteoporosis. OPG is a key factor acting as a negative regulator against osteoclasts' differentiation and activation, through competitive inhibition of RANKL's binding to its membrane receptor - Receptor Activator of Nuclear Factor-κB (RANK). In that way, OPG interferes with the signal pathway of Osteoclasts and their ancestor, and showing excellent effect of inhibiting bone resorption function not only in animal experiments but also in clinical application.Although it can inhibit Osteoclasts, OPG is expensive (For example, the market price of OPG expressed by yeast is $ 4.2/mg). It will cost a lot of monkey for the patients if they use OPG for a long period of time. On the other hand, abnormal allery immunologic reaction could be found in those patients who use the OPG for a long time. For lighting the economic load of patients and lowering the side effect, we reconstructed a new OPG-Fc yeast expression system and try to combine OPG and some other drugs to enhance the effect of inhibiting the Osteoclasts.In this study, we used the methylotrophic yeast Pichia pastoris-SMD1168 to rebuild SMD1168/OPG-Fc system. Comparing with the former system we had already built--X33/OPG-Fc, SMD1168 grow slower but express less non-target protein. And the OPG-Fc produced by both SMD1168 and X33 has inhibited Osteoclasts function.In the experiment, we accessed combined effect of rhOPG-Fc and Alendronate (ALN) on osteoclasts. ALN can inhibite farnesyl diphosphate synthase of Mevalonate Pathway of osteoclast, and induce these cells' apoptosis. The results showed that combination of rhOPG-FC and ALN had the great inhibition effect on mature osteoclasts and their precursor cells' differentiation. And half dose of OPG + ALN had greater effect on inhibiting the Osteoclast than using OPG or ALN only. In an other experiment, OPG + ALN also showed the
引文
1. Simonet WS, Lacey DL, Dunstan CR, et al. Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell, 1997, 89: 309-319.
    2. Hofbauer LC, Kuhne CA, Viereck V. The OPG/RANKL/RANK system in metabolic bone diseases. J Musculoskelet Neuronal Interact, 2004, 4: 268-275.
    3. Lee CK, Lee EY, Chung SM, Mun SH, Yoo B, Moon HB. Effects of disease-modifying antirheumatic drugs and antiinflammatory cytokines on human osteoclastogenesis through interaction with receptor activator of nuclear factor kappaB, osteoprotegerin, and receptor activator of nuclear factor kappaB ligand. Arthritis Rheum. 2004, 50: 3831-3843.
    4. Theoleyre S, Wittrant Y, Tat SK, Fortun Y, Redini F, Heymann D. The molecular triad OPG/RANK/RANKL: involvement in the orchestration of pathophysiological bone remodeling. Cytokine Growth Factor Rev. 2004, 15: 457-475.
    5. Mizuno A., Amizuka N., Irie K., et al. Severe Osteoporosis in mice lacking osteoclastogenesis inhibitory factor/ osteoprotegerin. Biochem Biophs Res Commun, 1998, 247: 610-615.
    6. Miho Shimizu-Ishiura, Fumi Kawana and Takahisa Sasaki. Osteoprotegerin administration reduces femural bone loss in ovariectomized mice via impairment of osteoclast structure and function. Journal of Electron Microscopy 2002, 51: 315-325
    7. Bekker PJ, Holloway D, Nakanishi A, et al. The effect of a single dose of osteoprotegerin in postmenopausal women J Bone Miner Res, 2001, 16: 348-360
    8. Bergstrom, J. D., Bostedor, R. G., Masarachia, P. J., Reszka, A. A., and Rodan, G. Alendronate is a specific, nanomolar inhibitor of farnesyl diphosphate synthase. Arch. Biochem. Biophys. 2000, 373: 231-241.
    9. Simonet WS, Lacey DL, Dunstan CR, et al. Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell, 1997, 89: 309-319.
    10. Anderson MA, Maraskovasky E, Billingsley WL, et al. A homologue of the TNF receptor and its ligand enhance T2cell growth and dendritic-cell function. Nature, 1997, 390: 175-179.
    11. Udagawa N , Takahashi N , Matsuzaki K, et al. Osteoblasts/stromal cells activate osteoclase function through osteoclast different ion factor(ODF). Second joint meeting of the ASBMR and the IBMS. San Francisco, CA, 1998. s220.
    12.刘继中、陈苏民、李毅、胡蕴玉等.人骨保护素在毕赤酵母中的分泌表达及表达产物的生物活性分析.中国生物化学与分子生物学报,2003,19: 566-571
    13.杨旭,杨庆铭,邓廉夫.重组人骨保护素对体外培养兔破骨细胞的影响.中华骨科杂志,2003,23:365-368
    14.张忠荣,王爱民,王晓军等.人骨保护素重组腺病毒抑制去势骨质疏松大鼠骨吸收作用的研究.中国临床康复,2004,8:8267-8269
    15. Simonet WS, Lacey DL, Dunstan CR, et al. Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell, 1997, 89: 309-319.
    16. Yasuda H, Shina N, Nakagawa N, et al. Identity of osteoclastogenesis inhibitory factor(OCIF) and osteoprotegerin(OPG): a mechanism by which OPG/OCIF inhibits osteoclastogenesis in vitro. Endocrinology, 1998, 139: 1329-1337
    17. Bekker PJ, Holloway D, Nakanishi A, et al. The effect of a single dose of osteoprotegerin in postmenopausal women J Bone Miner Res 2001, 16: 348-360
    18. Bergstrom J. D., Bostedor, R. G., Masarachia, P. J., Reszka, A. A., and Rodan, G. Alendronate is a specific, nanomolar inhibitor of farnesyl diphosphate synthase. Arch. Biochem. Biophys. 2000, 373: 231-241.
    19. Bone HG, Hosking D, Devogelaer J-P et al. Ten year's experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med, 2004, 350: 1189-1199
    20 Riffault S, Carrat C, van Reeth K, Pensaert M, Charley B. Interferon-alpha-producing cells are localized in gut-associated lymphoid tissues in transmissible gastroenteritis virus (TGEV) infected piglets, Vet Res, 2001, 32: 71-79.
    21 Hiroyuki Takai, Masahiro Kanematsu, Kauki Yano, et al. Transforming growth factor-β stimulates production of Osteoprotegerin/Osteoclastgenesis inhibitory factor by bone marrow stromal cells. J Biological chemistry, 1998, 273: 7091-7096.
    22 Helena Brandstrom, Kenneth B. Jonsson, Olle Vidal, et al. Tumor Necrosis Factor-α andβ upregulate the levels of Osteoprptegerin mRNA in human osteosarcoma mg-63 cells. Biochemical and Biophysical Research Communications, 1998, 248: 454-457.
    23 Lorenz C. Hofbauer, Sundeep Khosla, Colin R. Dunstan, et al. Estrogen stimulates gene expression and protein production of osteoprotegerin in human osteoblastic cells. Endocrinology, 1999, 140: 4367-4370.
    24 Sun-Kyeong Lee and Joseph Alorenzo. Parathyroid hormone stimulates TRANCE and inhibits osteoprotegerin messenger ribonucleic acid expression in murine bone marrow culture: Correlation with osteoclast-like cell formation. Endocrinology, 1999, 140: 3552-3561.
    25 L. C. Hofbauer, D. L. Lacey, C. R. Dunstan, et al. Interleukin-1β and tumor necrosis factor-α, but not interleukin-6 stimulate osteoprotegerin ligand gene expression in human osteoblastic cells. Bone, 1999, 25: 255-259.
    26 Olle N. A. Vidal, Klara Sjogren, Bengt I. Eriksson, et al. Osteoprotegerin mRNA is increase by interleukin-1α in the human osteosarcoma cell line mg-63 and in the human osteoblast-like cells. Biochemical Biophysical Research Communications, 1998, 248: 696-700.
    27 Helena Brandstrom, Kenneth B. Jonson, Claes Ohlsson, et al. Regulation of Osteoprotegerin mRNA Levels by prostaglandin E2 in human bone marrow stroma cells. Biochemical and Biophysical Research Communications, 1998, 247: 338-341.
    28 Lorenz C. Hofbauer, Francesca Gorl, B. Lawrence Riggs, et al. Stimulation of Osteoprotegerin ligand and inhibition of Osteoprotegerin production by glucocorticoids in human osteoblastic lineage cells: potential paracrine mechanisms of glucocoticoid-induced osteoporosis. Endocrinology, 1999, 140: 4382-4389.
    29 Robert S. Weinstein, Robert L. Jilka, A. Michael Parfitt, et al. Inhibition of Osteoblastogenesis and promotion apoptosis of osteoblasts and osteocytes by glucocoticoids. The Journal of Clinical Investigation, 1998, 102: 274-282.
    30 Mizuno A., Amizuka N., Irie K., et al. Severe pstepporosis in mice lacking osteoclastogenesis inhibitory factor/ osteoprotegerin. Biochem Biophs Res Commun, 1998, 247: 610-615.
    31 Bucay N., Sarosi I., Dunstan C. R., et al. Osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. Genes Dev, 1998, 12: 1260-1268
    32 Min H., Morony S., Sarosi I, et al. Osteoprotegerin reverses osteoporosis by inhibiting andosteal osteoclasts and prevents vascular calcification by blocking a process resembling osteoclastogenesis. J Exp Med, 2000, 192: 463-474.
    33 Oliver SG. From DNA sequence to biological function. Nature, 1996, 376: 597-600.
    34 李育阳 主编.基因表达技术.第一版.北京:科学出版社,2001.
    35 Sudbery P E. The expression of recombinant protein in yeasts[J]. Curr Opin Biotech, 1996, 7: 517-524
    36. Dhanabal M, Ramchandran R, Volk R, et al. Endo2 statin: yeast production, mutation, and antitumor effect in renal cell carcinoma [J]. Cancer Res, 1999, 59: 189-197
    37. Xu ZX, Zhu J K, Zhang XG, et al. Expression of human Flt3 ligand in pichia pastoris and its biological characteristics[J]. Acta Biochimica et Biophysica Sinica, 2000, 32: 217-222
    38 杜中军,朱水芳,黄文胜等.毕赤酵母外源基因表达系统研究进展.生物技术通报,2002(4):7-11.
    39 Cregg, JM; Cereghino, JL; Shi, J, et al. Recombinant protein expression in Pichia pastoris. Mol-Biotechnol. 2000, 16: 23-52.
    40 Cereghino JL, Cregg JM. Heterologous protein expression in the methylotrophic yeast Pichia pastoris. FEMS Microbiology Reviews, 2000, 24: 45-66.
    41 王洪复,关本博,林光义.由胎鼠头盖骨培养骨细胞的实验技术和细胞形态观察.上海医科大学学报,1991,18:47-51.
    42 Naoyuki Udagawa, Naoyuki Takahashi, Takuhiko Akatsu, et al. The Bone marrow-derived stromal cell lines MC3T3-G2/PA6 and ST2 support osteoclast-like cell differentiation coculture with mouse spleen cells. Endocrinology, 1989, 125: 1805-1812.
    43 Patricia Ducy, Gerard Karsenty. Genetic control of cell differentiation in the skeleton. Cell Biology, 1998, 10: 614-619.
    44 Jun H. S., Akiko K., Kazunori O. et al. In vitro differentiation of the murine macrophage cell line bdm-1 into osteoclast-like cells. Endocrinology, 1995, 136: 4285-4292.
    45 John E. Horton, Lawrence G. Raisz, Joost J. Oppenheim. Bone resorbing activity supernatant fluid from culture human peripheral blood leukocytes. Science, 1972, 177: 793-795.
    46 Naoyuki Takahashi, Nobuyuki Udagawa, Takuhiko Akatsu, et al. Deficiency of Osteoclast in osteopetrotic mice is due to a defect in local microenvironment provided by osteoblastic cells. Endocrinology, 1991, 128: 1792-1796.
    47 Whitaker KB, Cox TM, Moss DW. An immunoassay of human band 5 ("tartrate-resistant") acid phosphotatase that involves the use of anti-porcine uteroferrin antibodies. Clin Chem, 1989, 35: 86-89.
    48 Yam LT. Clinical significance of the human acid phosphatases. Am J Med, 1974, 56: 604-617.
    49 Mona SC, David RE, Caren MG. Molecular basis and clinical application of biological markers of bone turnover. Endocrine Reviews, 1996, 17: 333-368.
    50 于明香,金慰芳,王洪复,等.破骨细胞体外培养与形态观察.上海医科大学学报,1996,23:52-54.
    51 王洪复主编.骨细胞图谱与骨细胞体外培养技术,第一版,上海科学技术出版社,2001.P55
    52 Takahashi N., Udagawa N., Suda T. Osteoblastic cells are involve in osteoclast formation. Endocrinology, 1988, 123: 2600-2602.
    53 Naoyuki Takahashi, Takuhiko Akatsu, Nobuyuki Udagawa, et al. Osteoblast cells are involved osteoclast formation. Endocrinology, 1988, 123: 2600-2602.
    54 Hisataka Yasuda, Nobuyuki Shima, Nobuki Nakagawa, et al. Osteoclast Differentiation Factor is a Ligand For Osteoprotegerin/Osteoclastgenesis-Inhibitory Factor and is identical to TRANCE/RANKL. Cell Biology, 1998, 95: 3597-3602.
    55 Udagawa N, Takahashi N, Jimi E, Matsuzaki K, Tsurukai T, Itoh K, Nakagawa N, Yasuda H, Goto M, Tsuda E, Higashio K, Gillespie MT, Martin TJ, Suda T. Osteoblasts/stromal cells stimulate osteoclast activation through expression of osteoclast differentiation factor/RANKL but not macrophage colony-stimulating factor: receptor activator of NF-kappa B ligand. Bone, 1999, 25: 517-523.
    56 John E. Horton, Lawrence G. Raisz, Joost J. Oppenheim. Bone Resorbing Activity Supernatant Fluid from Culture Human Peripheral Blood Leukocytes. Science, 1972, 177: 793-795.
    57 Rodan G. A., Martin T. J. Role of osteoblasts in hormonal control of bone resportion: a hypothesis. Calcif Tissue Int, 1981, 33: 349-351.
    58 Hisahiro Yoshida, Shin-Ichi Hayashi, Takahiro Kunisada, et al. The Murine Mutation Osteopetrosis is in the Coding Region of the Macrophage Colony Stimulating Factor Gene. Nature, 1990, 345: 442-444.
    59 Kiyoko S. Akagawa, Naomi Takasuka, Yuko Nozaki, et al. Generation of CD1+RelB+ Dendritic Cells and Tartrate-Resistant Acid Phosphatase-Positive Osteoclast-Like Multinucleated Giant Cells From Human Monocytes. Blood, 1996, 88: 4029-4039.
    60 Patricia Ducy, Gerard Karsenty. Genetic Control of Cell Differentiation in the Skeleton. Cell Biology, 1998, 10: 614-619
    61 W. S. Simonet, D.L.Lacey, C.RCunstan, et al. Osetoprotegerin: A Novel Secreted Protein Involved in the Regulation of Bone Density. Cell, 1997, 89: 309-319.
    62 Morony S., Caparelli C, Lee R., et al. A chimeric form of osteoprotegerin inhibits hypercalcemia and bone resorption inhibited by IL-1 beta, TNF-alpha, PTH, PTHrP, and 1,25(OH)2D3. J Bone Miner Res, 1999, 14: 1478-1485.
    63 W. S. Simonet, D.L.Lacey, C.R.Cunstan, et al. Osetoprotegerin: A Novel Secreted Protein Involved in the Regulation of Bone Density. Cell, 1997, 89: 309-319.
    64 Rliwinski L, Janiec W, Pytlik M, ect.Effect of administration of alendronate sodium and retinol on the mechanical properties of the femur in ovariectomized rats. Pol J Pharmacol. 2004, 56:817-824.
    65 Hofbauer LC, Kuhne CA, Viereck V. The OPG/RANKL/RANK system in metabolic bone diseases. J Musculoskelet Neuronal Interact. 2004, 4: 268-275.
    66 Lee CK, Lee EY, Chung SM, Mun SH, Yoo B, Moon HB.Effects of disease-modifying antirheumatic drugs and antiinflammatory cytokines on human osteoclastogenesis through interaction with receptor activator of nuclear factor kappaB, osteoprotegerin, and receptor activator of nuclear factor kappaB ligand. Arthritis Rheum, 2004 ,50: 3831-3843.
    67 Theoleyre S, Wittrant Y, Tat SK, Fortun Y, Redini F, Heymann D.The molecular triad OPG/RANK/RANKL: involvement in the orchestration of pathophysiological bone remodeling. Cytokine Growth Factor Rev, 2004, 15: 457-475.
    68 Mizuno A., Amizuka N., Irie K., et al. Severe pstepporosis in mice lacking osteoclastogenesis inhibitory factor/ osteoprotegerin. Biochem Biophs Res Commun, 1998,247:610-615.
    69 Bucay N., Sarosi I., Dunstan C.R., et al. Osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. Genes Dev, 1998, 12: 1260-1268
    70 Min H., Morony S., Sarosi I, et al. Osteoprotegerin reverses osteoporosis by inhibiting andosteal osteoclasts and prevents vascular calcification by blocking a process resembling osteoclastogenesis. J Exp Med, 2000, 192: 463-474.
    71 Fleisch, Graham R, Russell G, et al. Diphosponates inhibit hydroxyapatite dissolution in vitro and bone resorption in tissue culture and in in vivo. Science,
     1969, 165: 1262-1265.
    72 Black DM, Reiss TF, Neitt MC, et al. Design of the fracture intervene trial. Osteoporosis Int, 1993, 3 (suppl 3): S29.
    73 Wasnich RD, et al. Skeletal benefits of alendonate treatment are similar for early poetmenopausal assian and Caucasian women. Osteoporosis Int, 1999, 9: 445-460.
    74 Rliwinski L, Janiec W, Pytlik M, ect. Effect of administration of alendronate sodium and retinol on the mechanical properties of the femur in ovariectomized rats. Pol J Pharmacol, 2004, 56: 817-824.
    75 Sawka AM, Thabane L, Papaioannou A, Gafni A, Hanley DA, Adachi JD. A systematic review of the effect of alendronate on bone mineral density in men. J Clin Densitom, 2005, 8: 7-13.
    76 薛延,李东,王芊.不同剂量阿仑膦酸钠对卵巢切除大鼠骨丢失和骨质量的影响.中国药学杂志,2002,37:272-275
    77 Fleisch H. Bisphosphonate: mechanism of action. Endocrine Rev, 1998, 19: 80.
    78 Yong Hee Kim, Gwan-Shik Kim, Jeong-Hwa Baek. Inhibitory action of bisphosphonates on bone resorption does not involve the regulation of RANKL and OPG expression. EXPERIMENTAL and MOLECULAR MEDICINE, 2002, 34: 145-151
    79 Dahlin DC. Bone tumors: general aspects and data on 6221 cases. Springfield: Charies C Thomas, 1978.
    80 Dahlin DC, Cupps RE and Johnson EW JR. Giant cell tumor. A study of 195 cases. Cancer, 1970, 25: 1061-1069.
    81 徐万鹏,冯传汉主编.骨科肿瘤学,第一版.北京:人民军医出版社,2001.
    82 Huvos AG. Bone tumor: Diagnosis, treatment and prognosis. Philadephia: WB. Sanders, 1979.
    83 Jaffe JL, Lichtenstein L and Portis RB. Giant call tumor of bone: Its pathological appearance, grading, supposed variants, and treatment. Arch Pathol, 1940, 30: 993.
    84 Huang L, Xu J, Wood DJ, Zheng MH, AM J. Gene expression of osteoprotegerin ligand, osteoprotegerin, and receptor activator of NF-λB in giant cell tumor of bone: Possible involvement in tumor cell-induced osteoclast-like cell formation. American Journal of Pathology, 2000, 156: 761-767.
    85 Atkins GJ, Haynes DR, Graves SE, Evdokiou A, Hay S, Bouralexis S, Findlay DM. Expression of osteoclast differentiation signals by stromal elements of giant cell tumors. Journal of Bone and Mineral Research. 2000; 15: 640-649.
    86 崔伟,刘成林,使之祯等.卵巢切除大鼠血清甲状旁腺素、降钙素变化与骨质量降低.中国骨质疏松杂志,1996,2:22-26
    87 王以进,王介麟主编.骨科生物力学:第一版.北京:人民军医出版社,1989.156
    88 Tuner CH, Akhter MP, Heaney RP. The effect of fluoridated water on bone strength. J Orthop Res, 1992, 10: 581
    89 Katsumata T, Nakamura T, Ohnishi H, et al. Intermittent cyclical etidronate treatment maintains the mass, structure and the mechanical property of bone in ovariectomized rats. J Bone Miner Res, 1995, 10: 9212931.
    90.孟迅吾.骨质疏松症防治药物与循证医学.中华内科学杂志,2003,42:4.
    91 Chinese Statistic Bureau Data, 1996.
    92 Ray NF, Chan JK. Medical expenditures for the treatment of osteoporotic fractures in the United States In 1995: Report from the National Osteoporosis Foundation. J Bone Miner Res, 12: 24-35.
    93 徐叔云,卞如濂,陈修.药理实验方法学[M]第3版,北京:人民卫生出版社,2002,1560-1565.
    94 郭世绂,罗先正,邱贵兴.骨质疏松基础与临床[M].天津:天津科学技术出版社,2001.221
    95 Lorenz C. H., Sundeep K., Colin R. D., et al. Estrogen stimulates gene expression and protein production of osteoprotegerin in human osteoblastic cell. Endocrinology, 1999, 140: 4367-4370.
    96 张忠荣,王爱民,王晓军等.人骨保护素重组腺病毒抑制去势骨质疏松大鼠骨吸收作用的研究.中国临床康复,2004,8:8267-8269.
    97 Simonet WS, Lacey DL, Dunstan CR, et al. Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell, 1997, 89: 309-319.
    98 Yasuda H, Shina N, Nakagawa N, et al. Identity of osteoclastogenesis inhibitory factor(OCIF) and osteoprotegerin(OPG): a mechanism by which OPG/OCIF inhibits osteoclastogenesis in vitro. Endocrinology, 1998, 139: 1329-1337.
    99 Bekker PJ, Holloway D, Nakanishi A, et al. The effect of a single dose of osteoprotegerin in postmenopausal women J Bone Miner Res, 2001, 16: 348-360.
    100 Thompson DD, Simmons HA, Pirie CM, Ke HZ. 1995 FDA guidelines and animal models for osteoporosis. Bone, 1997, 17: 125S-133S.
    101 赵文国,贺宝玲1骨质疏松症的药物治疗新进展.中国综合临床,2003,19:131
    102n 杨华章,邝建,吴文等.降钙素治疗骨质疏松性疼痛.中国新药与临床杂志,2001,20:761
    103 Cornish J, Callon KE, Bava U, et al. Effects of calcitonin, amylin, and calcitonin gene-related peptide on osteoclast development. Bone, 2001, 29: 162-168.
    104 卓铁军,周明秀,申志祥.降钙素治疗老年性骨质疏松症45例临床观察.实用老年医学,2000,14:1481
    105 Nicholson GC, Moseley JM, Sexton PM, et al. Abundant calcitonin receptors in isolated rat osteoclasts. Biochemical and autoradiographic characterization. J Clin Invest, 1986, 78: 355-360.
    106 MasseyHM, FlanaganAM. Human osteoclasts derive from CD14-positive monocytes. Br J Haematol, 1999, 106: 167-170.
    107 章振林,孟迅吾,周学瀛等.北京地区汉族妇女维生素D受体基因和降钙素受体基因多态性与骨密度的关系.中华内分泌代谢杂志,2002,18:90-94.
    108 张秀珍,韩峻峰,钱国峰.降钙素对体外培养破骨细胞功能的影响.中华内分泌代谢杂志,2004,20:158-160.
    109 A. M. Parfit. Targeted and nontargeted bone remodeling: relationship to basic multicellular unit origination and progression. Bone, 2002, 30: 5-7.
    110 D. B. Burr. Targeted and nontargeted remodeling. Bone, 2002, 30: 2-4.
    111 Jeroen A, Steven B, Geert L, Jan D. Interspecies differences in bone composition, density, and quanlity: potential implications for in vivo bone research. Endocrinology, 1998, 139: 663-670.
    112. Swaminathan R. Biochemical markers of bone turnover. Clin Chim Acta, 2001, 313: 95-105.
    113. Rogers A, Hannon RA, Eastell R. Biochemical markers as predictors of rates of bone loss after menopause. J Bone Miner Res, 2000, 15: 1398-1404.
    114. Chaki O, Yoshikata I, Kikuchi R, Nakayama M, Uchiyama Y, Hirahara F, Gorai I. The predictive value of biochemical markers of bone turnover for bone mineral density in postmenopausal Japanese women. J Bone Miner Res, 2000, 15: 1537-1544.
    115. Tromp AM, Ooms ME, Popp-Snijders C, Roos JC, Lips P. Predictors of fractures in elderly women. Osteoporos Int, 2000, 11: 134-140.
    116. Garnero P, Sornay-Rendu E, Claustrat B, Delmas PD. Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J Bone Miner Res. 2000, 15: 1526-1536.
    117 Tanko LB, Felsenberg D, Czerwinski E, Burdeska A, Jonkanski I, Hughes C, Christiansen C; Oral Ibandronate Group. Oral weekly ibandronate prevents bone loss in postmenopausal women. J Intern Med. 2003, 254: 159-167.
    118 Morabito N, Crisafulli A, Vergara C, Gaudio A, Lasco A, Frisina N, D'Anna R, Corrado F, Pizzoleo MA, Cincotta M, Altavilla D, Ientile R, Squadrito F. Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women: a randomized double-blind placebo-controlled study. J Bone Miner Res, 2002, 17: 1904-1912.
    119. Liao EY, Wu XP, Luo XH, Zhang H, Dai RC, Huang G, Wang WB. Establishment and evaluation of bone mineral density reference databases appropriate for diagnosis and evaluation of osteoporosis in Chinese women. J Bone Miner Metab, 2003, 21: 184-192.
    120 Brown JP, Delmas PD, Malaval L, et al. Serum bone Gla protein: aspecific marker for bone formatin in postmenopausal osteoporosis. Lancet, 1984, 1: 1091-1093.
    121 孟昭亨.骨钙素及其临床意义.中华内分泌代谢杂志,1992,8:41
    122 林燕萍,马建华,冯尔宥.健骨颗粒对去卵巢大鼠骨质疏松症预防作用的研究.中国中西医结合杂志,2002,22:369-371.
    123 Iki M, Kajita E, Dohi Y, Nishino H, Kusaka Y, Tsuchida C, Yamamoto K, Ishii Y. Age, menopause, bone turnover markers and lumbar bone loss in healthy Japanese women. Maturitas. 1996, 25: 59-67.
    124 Minisola S, Rosso R, Romagnoli E, D' Erasmo E, Manfredi G, Damiani C, De Antoni F, Mazzuoli G. Serum osteocalcin and bone mineral density at various skeletal sites: a study performed with three different assays. J Lab Clin Med. 1997, 129: 422-429.
    125 Khosla S, Melton LJ 3rd, Atkinson EJ, O'Fallon WM, Klee GG, Riggs BL. Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen. J Clin Endocrinol Metab, 1998, 83: 2266-2274.
    126 Tucci JR, Tonino RP , Emkey RD, et al . Effect of three-years of oral alendronate treatment in postmenopausal women with osteoporosis. Am J Med, 1996, 101: 488.
    127 Bone HG, Hosking D, Devogelaer J-P et al. Ten year's experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med, 2004, 350: 1189-1199.
    128.杨定焯.骨定量手段诊断骨质疏松的进展.实用老年医学,2000,14:121.
    129 Frost HM. On the estrogen-bone relationship and postmenopausal bone loss: a new model. J Bone Miner Res, 1999, 14: 1473.
    130 Genant H, Engelke K, Fuerst T, et al. Noninvasive assessment of bone mineral and structure: state of the art. J Bone Miner Res, 1996, 11: 707.
    131. Frost H. Relationsh ip between muscle strength and bone strength. Biomechanics, 1999, 33: 231.
    132.阮祥燕.体重及骨峰值对骨质疏松诊断的影响.当代医学,2000,6:47.
    133. Kanis JA, Melton LJ A, Christiansen C, et al. The diagnosis of osteoporosis. J BoneM iner Res, 1994, 9: 1137.
    134. Genant H, Engelke K, Fuerst T, et al. Noninvasive assessment of bone mineral and structure: state of the art. J Bone M iner Res, 1996, 11: 707.
    135 张光,韩邕,崔琪等.骨密度定量CT测量用固体标准件的研究.中华放射学杂志,1998,32:561.
    136 吴春营,邱明才,李景学等.单能定量CT测定人体骨矿含量的准确性.中华放射学杂志,1990,24:331.
    137 胡侦明,戴戎,朱汉民.卵巢切除对鼠及异常应力鼠骨密度影响的比较研究.中华骨科杂志,1998,18:555.
    138 Cooper C, Campion G, Melton LJ, Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992, 2: 285-289.
    139 崔伟,刘成林.基础骨生物力学.中国骨质疏松杂志,1998,4:90.
    140 Toolan BC, Shea M, Myers ER, et al. Effects of 4-amino-1-hydroxybutylidene bisphosphonate on bone biomechanics in rats. J Bone Miner

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