Effects of monthly intravenous ibandronate on bone mineral density and microstructure in patients with primary osteoporosis after teriparatide treatment: The MONUMENT study

Purpose: To investigate the effects of sequential therapy with monthly intravenous ibandronate on bone mineral density (BMD) and microstructure in patients with primary osteoporosis who received teriparatide treatment. Methods: Sixty-six patients with primary osteoporosis who had undergone teriparatide treatment for more than 12 months (mean 18.6 months) received sequential therapy with 1 mg/month intravenous ibandronate for 12 months. The patients were evaluated using dual-energy X-ray absorptiometry (DXA), quantitative ultrasound, bone turnover markers, and high-resolution peripheral quantitative computed tomography (HR-pQCT) at baseline and 6 and 12 months after beginning administration. Results: At 12 months after beginning sequential therapy,the bone resorption marker, tartrate-resistant acid phosphatase-5b, decreased by 39.5%, with 82.3% of the patients exhibiting levels within the normal limit. DXA revealed that the BMD of the lumbar spine increased by 3.2%, with 79.0% of the patients exhibiting a response, and 40.3% experiencing an increase in BMD over 5%. HR-pQCT revealed that the cortical thickness of the distal tibia was increased by 2.6%. The cortical area increased by 2.5%, and the buckling ratio (an index of cortical instability) decreased by 2.5%. Most parameters of the trabecular bone showed no significant changes. These changes in the cortical bone were observed in both the distal radius and tibia and appeared beginning 6 months after treatment initiation. Conclusions: Sequential therapy with monthly intravenous ibandronate increased the BMD and improved the cortical bone microstructure of osteoporotic patients who had undergone teriparatide treatment

Randomized controlled trial of daily teriparatide, weekly high-dose teriparatide, or bisphosphonate in patients with postmenopausal osteoporosis: The TERABIT study

Purpose: The effects of daily teriparatide (20 μg) (D-PTH), weekly high-dose teriparatide (56.5 μg) (W-PTH), or bisphosphonates (BPs) on areal bone mineral density (aBMD), bone turnover markers (BTMs), volumetric BMD (vBMD), microarchitecture, and estimated strength were investigated in postmenopausal osteoporosis patients.Methods: The study participants were 131 women with a history of fragility fractures. They were randomized to receive D-PTH, W-PTH, or BPs (alendronate or risedronate) for 18 months. Dual-energy X-ray absorptiometry (DXA), BTMs, and high-resolution peripheral quantitative CT (HR-pQCT) parameters were evaluated at baseline and after 6 and 18 months of treatment. The primary endpoint was the change (%) in cortical thickness (Ct.Th) after 18 months\u27 treatment compared with baseline.Results: DXA showed that D-PTH, W-PTH, and BPs increased lumbar spine aBMD (+12.0%, +8.5%, and +6.8%) and total hip aBMD (+3.0%, +2.1%, and +3.0%), but D-PTH and W-PTH decreased 1/3 radius aBMD (− 4.1%, − 3.0%, − 1.4%) after 18 months. On HR-pQCT, D-PTH increased trabecular vBMD (Tb.vBMD) at the distal radius and tibia after 18 months (+6.4%, +3.7%) compared with the BPs group, decreased cortical volumetric tissue mineral density (Ct.vTMD) (− 1.8%, − 0.9%) compared with the other groups, increased Ct.Th (+1.3%, +3.9%), and increased failure load (FL) (+4.7%, +4.4%). W-PTH increased Tb.vBMD (+5.3%, +1.9%), maintained Ct.vTMD (− 0.7%, +0.2%) compared with D-PTH, increased Ct.Th (+0.6%, +3.6%), and increased FL (+4.9%, +4.5%). The BPs increased Tb.vBMD only in the radius (+2.0%, +0.2%), maintained Ct.vTMD (− 0.6%, +0.3%), increased Ct.Th (+0.5%, +3.4%), and increased FL (+3.9%, +2.8%).Conclusions: D-PTH and W-PTH comparably increased Ct.Th, the primary endpoint. D-PTH had a strong effect on trabecular bone. Although D-PTH decreased Ct.vTMD, it increased Ct.Th and total bone strength. W-PTH had a moderate effect on trabecular bone, maintained Ct.vTMD, and increased Ct.Th and total bone strength to the same extent as D-PTH

Efficient and Reproducible Myogenic Differentiation from Human iPS Cells: Prospects for Modeling Miyoshi Myopathy In Vitro

効率よく、再現性高くヒトiPS細胞から筋肉細胞を作製 -筋肉疾患の創薬プラットフォームの開発に向けて-. 京都大学プレスリリース. 2013-04-24.The establishment of human induced pluripotent stem cells (hiPSCs) has enabled the production of in vitro, patient-specific cell models of human disease. In vitro recreation of disease pathology from patient-derived hiPSCs depends on efficient differentiation protocols producing relevant adult cell types. However, myogenic differentiation of hiPSCs has faced obstacles, namely, low efficiency and/or poor reproducibility. Here, we report the rapid, efficient, and reproducible differentiation of hiPSCs into mature myocytes. We demonstrated that inducible expression of myogenic differentiation1 (MYOD1) in immature hiPSCs for at least 5 days drives cells along the myogenic lineage, with efficiencies reaching 70–90%. Myogenic differentiation driven by MYOD1 occurred even in immature, almost completely undifferentiated hiPSCs, without mesodermal transition. Myocytes induced in this manner reach maturity within 2 weeks of differentiation as assessed by marker gene expression and functional properties, including in vitro and in vivo cell fusion and twitching in response to electrical stimulation. Miyoshi Myopathy (MM) is a congenital distal myopathy caused by defective muscle membrane repair due to mutations in DYSFERLIN. Using our induced differentiation technique, we successfully recreated the pathological condition of MM in vitro, demonstrating defective membrane repair in hiPSC-derived myotubes from an MM patient and phenotypic rescue by expression of full-length DYSFERLIN (DYSF). These findings not only facilitate the pathological investigation of MM, but could potentially be applied in modeling of other human muscular diseases by using patient-derived hiPSCs

Generation of chimpanzee iPSCs with the TS12KOS vector.

<p>(<b>a</b>) Summary of chimpanzee iPSC generation. iPSCs were generated from the blood cells of two chimpanzee individuals with TS12KOS or the conventional SeV vectors. (<b>b</b>) Effect of the T lymphocyte stimulation on iPSC generation. Experiments were conducted in triplicate (mean ± SD). *<i>P</i><0.01, PHA versus anti-CD3 antibody or Con A stimulations, Student's t-test. (<b>c</b>) Colony morphology and AP staining of iPSCs from stimulated T lymphocytes. (<b>d</b>) Phase contrast images, immunofluorescence for pluripotency markers, and alkaline phosphatase (AP) staining of chimpanzee iPSC lines. C101, C201, C205, and C402 are described in <b>Fig. 3a</b>. Scale bars, 200 µm. (<b>e</b>) RT-PCR analysis of SeV and human ES cell markers. SeV, first RT-PCR for SeV; nested, nested RT-PCR for SeV; 201B7, control human iPSC line; SeV(+), Day 7 SeV-infected human fibroblasts. (<b>f</b>) PCR products with primers that can distinguish chimpanzee and human genomes. Chimpanzee PCR products; 782, 472 and 504 bps, Human PCR products; 203, 245, 278 bps. (<b>g</b>) Chromosomal analyses of chimpanzee iPSC lines generated with the TS12KOS vector. (<b>h</b>) TCR gene recombination. Genes from the chimpanzee iPSC lines were digested with the indicated enzymes and hybridized with the TCR probes by Southern blotting. Arrows indicate the germ bands of TCR genes. HeLa and 201B7: human cell lines, MT4: human T cell line, HSP-239: chimpanzee T cell line.</p

Characterization of human iPSCs generated by the TS12KOS vector.

<p>(<b>a</b>) iPSC generation from human peripheral blood cells. Experiments were conducted in triplicate (mean ± SD). N1, N2, and N3 indicate individual healthy volunteers. *<i>P</i><0.01, TS12KOS vector versus conventional vectors, Student's t-test. (<b>b</b>) Nested RT-PCR analysis of the elimination of SeV vectors after the temperature shift from 37°C to 38°C. (<b>c</b>) Phase contrast images, immunofluorescence for pluripotency markers, and alkaline phosphatase (AP) staining of iPSC lines. The iPSC lines N2-1 and BN2-1 and BN2-2 were derived from the skin-derived fibroblasts and blood cells of N2 healthy volunteer, respectively. Scale bars, 200 µm. (<b>d</b>) RT-PCR analysis of Sendai virus and human ES cell markers. SeV, first RT-PCR for SeV; nested, nested RT-PCR for SeV; 201B7, control human iPSC line; SeV(+), Day 7 SeV-infected human fibroblasts. (<b>e</b>) Chromosomal analyses of iPSC lines generated with the TS12KOS vector. (<b>f</b>) Tissue morphology of a representative teratoma derived from iPSC lines generated with the TS12KOS vector. G, glandular structure (endoderm); C, cartilage (mesoderm); MP, melanin pigment (ectoderm). Scale bars, 100 µm.</p