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      Cyclosporine A impairs bone repair in critical defects filled with different osteoconductive bone substitutes

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          Abstract

          Abstract The aim of this study was to assess the influence of cyclosporine administration on the repair of critical-sized calvaria defects (CSDs) in rat calvaria filled with diverse biomaterials. Sixty animals were divided into two groups: the control (CTR) group (saline solution) and the cyclosporine (CCP) group (cyclosporine, 10 mg/kg/day). These medications were administered daily by gavage, beginning 15 days before the surgical procedure and lasting until the day the animals were euthanized. A CSD (5 mm Ø) was made in the calvaria of each animal, which was allocated to one of 3 subgroups, according to the biomaterial used to fill the defect: coagulum (COA), deproteinized bovine bone (DBB), or biphasic calcium phosphate ceramics of hydroxyapatite and β-phosphate tricalcium (HA/TCP). Euthanasia of the animals was performed 15 and 60 days after the surgical procedure (n = 5 animals/period/subgroup). Bone repair (formation) assessment was performed through microtomography and histometry, while the analyses of the expression of the BMP2, Osteocalcin, and TGFβ1 proteins were performed using immunohistochemistry. The CSDs not filled with biomaterials demonstrated lower bone formation in the CCP group. At 15 days, less bone formation was observed in the CSDs filled with DBB, a smaller volume of mineralized tissue was observed in the CSDs filled with HA/TCP, and the expression levels of BMP2 and osteocalcin were lower in the CCP group compared to the CTR group. The use of cyclosporine impaired bone repair in CSD, and this effect can be partially explained by the suppression of BMP2 and osteocalcin expression.

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          New insights into the biology of osteocalcin.

          Osteocalcin is among the most abundant proteins in bone and is produced exclusively by osteoblasts. Initially believed to be an inhibitor of bone mineralization, recent studies suggest a broader role for osteocalcin that extends to the regulation of whole body metabolism, reproduction, and cognition. Circulating undercarboxylated osteocalcin, which is regulated by insulin, acts in a feed-forward loop to increase β-cell proliferation as well as insulin production and secretion, while skeletal muscle and adipose tissue respond to osteocalcin by increasing their sensitivity to insulin. Osteocalcin also acts in the brain to increase neurotransmitter production and in the testes to stimulate testosterone production. At least one putative receptor for osteocalcin, Gprc6a, is expressed by adipose, skeletal muscle, and the Leydig cells of the testes and appears to mediate osteocalcin's effects in these tissues. In this review, we summarize these new discoveries, which suggest that the ability of osteocalcin to function both locally in bone and as a hormone depends on a novel post-translational mechanism that alters osteocalcin's affinity for the bone matrix and bioavailability. This article is part of a Special Issue entitled Bone and diabetes.
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            Rituximab and intravenous immune globulin for desensitization during renal transplantation.

            Few options for transplantation currently exist for patients highly sensitized to HLA. This exploratory, open-label, phase 1-2, single-center study examined whether intravenous immune globulin plus rituximab could reduce anti-HLA antibody levels and improve transplantation rates. Between September 2005 and May 2007, a total of 20 highly sensitized patients (with a mean [+/-SD] T-cell panel-reactive antibody level, determined by use of the complement-dependent cytotoxicity assay, of 77+/-19% or with donor-specific antibodies) were enrolled and received treatment with intravenous immune globulin and rituximab. We recorded rates of transplantation, panel-reactive antibody levels, cross-matching results at the time of transplantation, survival of patients and grafts, acute rejection episodes, serum creatinine values, adverse events and serious adverse events, and immunologic factors. The mean panel-reactive antibody level was 44+/-30% after the second infusion of intravenous immune globulin (P<0.001 for the comparison with the pretreatment level). At study entry, the mean time on dialysis among recipients of a transplant from a deceased donor was 144+/-89 months (range, 60 to 324). However, the time to transplantation after desensitization was 5+/-6 months (range, 2 to 18). Sixteen of the 20 patients (80%) received a transplant. At 12 months, the mean serum creatinine level was 1.5+/-1.1 mg per deciliter (133+/-97 micromol per liter), and the mean survival rates of patients and grafts were 100% and 94%, respectively. There were no infusion-related adverse events or serious adverse events during the study. Long-term monitoring for infectious complications and neurologic problems revealed no unanticipated events. These findings suggest that the combination of intravenous immune globulin and rituximab may prove effective as a desensitization regimen for patients awaiting a transplant from either a living donor or a deceased donor. Larger and longer trials are needed to evaluate the clinical efficacy and safety of this approach. (ClinicalTrials.gov number, NCT00642655.) 2008 Massachusetts Medical Society
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              Critical molecular switches involved in BMP-2-induced osteogenic differentiation of mesenchymal cells.

              Bone morphogenetic protein (BMP)-2 strongly induces bone formation. Introduction of the protein in muscle tissue results in ectopic bone formation. Similarly, BMP-2 treatment also stimulates the in vitro transdifferentiation of myogenic cells to osteogenic cells. The establishment of an in vitro model system has enabled the investigation of intracellular events including BMP receptor activation, BMP-2-induced R-Smad activation, and kinase activation, and the role of osteogenic transcription factors, such as Runx2, Osx, Dlx5, and Msx2. Many reviews have addressed events downstream of BMP-receptor binding but few deal with molecular cascades involved in BMP-2-induced osteogenesis. We focus on critical molecular switches, especially transcription factors, and several kinase pathways involved in osteogenic differentiation.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                bor
                Brazilian Oral Research
                Braz. oral res.
                Sociedade Brasileira de Pesquisa Odontológica - SBPqO (São Paulo, SP, Brazil )
                1806-8324
                1807-3107
                2020
                : 34
                : e007
                Affiliations
                [2] Uberlândia Minas Gerais orgnameUniversidade Federal de Uberlândia orgdiv1Dental School orgdiv2Department of Periodontology Brazil
                [3] Aarhus Central Denmark orgnameAarhus University orgdiv1Department of Dentistry and Oral Health orgdiv2Section of Oral Radiology Denmark
                [4] Malmö orgnameMalmo University orgdiv1Department of Community Dentistry and Periodontology Sweden
                [1] Araraquara SP orgnameUniversidade Estadual de São Paulo orgdiv1School of Dentistry Araraquara orgdiv2Department of Diagnosis and Surgery Brazil
                Article
                S1806-83242020000100205 S1806-8324(20)03400000205
                10.1590/1807-3107bor-2020.vol34.0007
                98cf240c-716a-4242-87da-cc082426a785

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 03 April 2019
                : 01 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 0
                Product

                SciELO Brazil

                Categories
                Original Research

                Immunosuppression,Bone Regeneration,Bone Substitutes

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