Protein that can slows down fracture-healing

Researchers have found that a few proteins which are more prevalent in older people prevent the fractured bones from healing.

Duke Scientists hope this discovery will lead to new treatments to help people heal after injuries or surgeries.

“When we decreased the protein level, aging was reversed,” said senior author. “Not only was there more bone and healing happened faster, but it was also structurally more sound.”

The team confirmed that older people have more Apolipoprotein E, ApoE for short, than younger people, reported the study.

They wanted to figure out if and how ApoE affects the multi-step process of bone healing.

When you break a bone, your body sends signals through the bloodstream to recruit cells to fix it.
At last a different kind of cell eats up the cartilage scaffolds and osteoblasts fill those holes with bone.

“Over time, this cartilage will continue to be resorbed and osteoblasts will continue to deposit new bone,” Baht explained. “After a few months of your arm or leg healing, there will be almost no cartilage anymore. And if you were to look at it five years out, there’d be no sign of an injury anymore.”

That’s if the bone healing process works perfectly. But the researchers found that if they added ApoE to a petri dish with skeletal stem cells, fewer cells developed into osteoblasts and the osteoblasts were worse at building bones.

“We wanted to see if the cell population was more or less capable of becoming osteoblasts,” Baht said. “[Normally,] you put these cells down in a petri dish for about a month and the dish becomes so hard that you can’t even scratch the surface because they’ve made two-dimensional bone there. ApoE-treated cells are still able to do this, they just don’t do it as much or as well.”

Next, the researchers created an intervention by injecting a virus which keeps mice from making Apolipoprotein E. Circulating ApoE levels dropped by 75 per cent and the healed bones contained one and a half-times more strong, hard bone tissue than bones of untreated mice.


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6 myths about osteoporosis

Some countries are slowly falling prey to another silent disease, akin to hypertension and heart disease, which is detected only when tests indicate a decreased bone density.

Known as osteoporosis, this disease affects about 80%  women and about 1.5 million men. It is also known as the bone-thinning disease. Responsible for over one and a half million fractures each year, osteoporosis makes the bones weak so much that even a simple fall or bump can cause them to break.

Being a silent disease, the symptoms are not very apparent, until the condition reaches an advanced stage leading to a fracture. Osteoclasts and osteoblasts, two special cells in the normal bone-remodeling cycle, work to keep the bones strong and healthy.

While osteoclasts break down old bones, osteoblasts promotes new bone formation. With age, more bone is broken down than what is reformed. This means that the osteoblasts cannot keep up with the breakage, causing the bones to become thin and fragile.

There are many myths and misconceptions surrounding this disease.

Myth 1: Osteoporosis is caused due to lack of calcium
While calcium is essential for bone health, too much of it is also not good for the body. Many other nutrients are also needed to ensure bone health such as vitamin K, magnesium and strontium. As an example, calcium is absorbed better in the presence of vitamin D. Normally, our body absorbs only 10% to 15% of calcium from the diet.

Myth 2: It is a natural side effect of ageing
Yes; but bone loss including osteoporosis can also affect a person in their younger years. Apart from age, gender and genetic susceptibility are also factors leading to this condition. While age and gender cannot be modified, there are other factors one can control such as lifestyle and diet.

Myth 3: Fractures are inevitable with osteoporosis
Studies have shown that about half of those with thinning bones do not suffer a fracture. Alternatively, people with a normal bone density are also prone to fracture. A fracture risk assessment can be done through a bone density test. This will help a person identify what are the risks of having a fracture.

Myth 4: It is a woman’s disease
It is not true that men do not have to worry about getting this condition. Women naturally have smaller and thinner bones than men and are at a higher risk of bone problems. The belief that it is a woman’s condition also stems from the fact that low estrogen levels cause bone loss. However, men are also prone to this condition, particularly those with low levels of Vitamin D.

Myth 5: Osteoporosis is not linked to other conditions
Increasingly, there has been research to show that osteoporosis has a connection with other health conditions too. A person with improved body strength, metabolic fitness, and muscle strength will have stronger bones. He/she will also, therefore, have regulated blood pressure and good cardiovascular health. It is, therefore, imperative to aim at overall health and lead a balanced lifestyle.

Myth 6: Bone density test is painful
Bone density test is very simple and comfortable. A bone densitometer measures bone density using a small amount of radiation (DeXA scan) or ultrasound (portable units). A person lies on their back with their arms and legs positioned appropriately. The test hardly takes 10 minutes and is not painful.
Get enough calcium as per age through sources such as milk and milk products and green vegetables. Your body will require Vitamin D to absorb the calcium.

This can be adequately obtained from sunlight and other sources like mushrooms. Get good sun exposure for 10 to 15 minutes on the arms and face for at least 2 to 3 times a week.

Quit smoking as this is known to weaken the bones. Avoid excess alcohol intake. Lead an active lifestyle with about 30 minutes of some physical activity every day. This will help in strengthening the muscles and bones.

These lifestyle changes can go a long way in preventing osteoporosis and helping those already diagnosed with the condition. 

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Malaria infection can cause chronic bone loss

A new study has found that malaria infection can cause chronic bone loss due to sustained accumulation of parasite products even after the disease is cured.

Malaria is an infectious disease caused by Plasmodium parasites that kills at least half a million people annually while causing over 200 million new infections.

In some cases, complications can quickly develop such as cerebral malaria, respiratory distress and severe anaemia, often leading to death.

The majority of patients recover from disease, however, there is increasing evidence to suggest that survivors experience long-term 'hidden' pathologies due to infection that are as yet poorly defined.

Researchers  have used mouse malaria models to show that robust immune activation and invasion of parasite by-products into the bone marrow during and after infection leads to an adverse balance in bone homeostasis by bone forming osteoblasts and bone resorbing osteoclasts.

Professor, corresponding author of the study said, "Even after a one time malaria infection (it does not matter if the disease is completely cured or chronic low level infection continues), substantial chronic bone loss occurs."

The first author of the study said,"We found that Plasmodium products continuously accumulate in the bone marrow niche which turns the bone noticeably black in colour, and results in it being "eaten-up" by bone reabsorbing cells known as osteoclasts, eventually disrupting bone homeostasis."

These products induce MyD88-dependent inflammatory responses in osteoclast and osteoblast precursors, leading to increased RANKL expression - a key molecule inducing osteoclast differentiation - and over-stimulation of osteoclastogenesis favouring bone resorption.

The team infected mice with a mutant Plasmodium parasite producing less by-products such as hemozoin, and discovered in this case bone loss did not occur, thereby confirming their findings.

He said,"Although chronic inflammatory conditions are known to facilitate bone disorders, our study - for the first time - shows that malaria can do the same thing, with hallmark 'signatures' left in the bone tissue, a very unique feature of malaria infection."

He added,"One may think that the infection has been completely cured by anti-malarial treatment, and be feeling fully recovered, however, sustained long-term accumulation of parasite by-products leave the bone in a state of chronic inflammation, leading to long term bone loss."

He said,"This is particularly worrisome in the young of age, where it may cause growth problems and osteoporotic, fragile bones."

The study shows that there is a simple way to reverse the side effects of malaria infection on bone.

Oral supplementation with alfacalcidol, a vitamin D3 analogue, could completely prevent bone loss.

Anti-malarials coupled with bone therapy may be beneficial in improving bone health in malaria-infected individuals.

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