Romatizmal hastalıklarda osteoporozun etiyopatogenezi

ESMAEİLZADEH, Sina; Şen, Ekin İlke; SİNDEL, Dilşad

Romatizmal hastalıklarda osteoporozun etiyopatogenezi

Dilşad SİNDEL, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye)

Sina ESMAEİLZADEH, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye)

Ekin İlke ŞEN (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye)

Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi

1 0

Yıl: 2012 Cilt: 58 Sayı: 4 Sayfa Aralığı: 319 - 325 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Romatizmal hastalıklarda osteoporozun etiyopatogenezi

Öz:

Romatoid artrit, ankilozan spondilit, sistemik lupus eritematozus gibienflamatuvar hastalıkların başta osteoporoz olmak üzere kas iskelet sistemiile ilgili komplikasyonları mevcuttur. Bu hastalıklar enflamatuvar hastalıklarda yaygın olarak görülen azalmış fiziksel aktivite, beslenmebozukluğu, D vitamini eksikliği, kalsiyum alımında yetersizlik,glukokortikoid tedavisi gibi risk faktörlerinden bağımsız olarak osteoporozve artmış kırık riski ile ilişkilidir. Bu hastalıklarda görülen osteoporozunpatogenezinde birçok faktör etkilidir. İmmün sistem ve kemik arasındakiilişkilerin giderek anlaşılır hale gelmesi ile osteoimmünoloji kavramı önemkazanmıştır. Osteoklast, makrofaj koloni stimule edici faktör veproenflamatuvar sitokinler enflamasyon ve osteoporoz arasındaki ilişkiyi açıklamaktadır. Bu derlemede amacımız romatoid artrit, ankilozan spondilit, sistemik lupus eritematozus gibi enflamatuvar hastalıklardaenflamatuvar kemik kaybının etiyopatogenezini güncel literatürler eşliğinde tartışmaktır.

Anahtar Kelime:

Konular: Rehabilitasyon Romatoloji

Etiopathogenesis of osteoporosis in rheumatic diseases

Öz:

Various inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematosus are associated with musculoskeletal complications including osteoporosis. They are related to osteoporosis and increased risk of fractures independent of other risk factors like low physical activity, nutritional deficiency, hypovitaminosis D and inadequate calcium intake, as well as glucocorticoid treatment. The pathogenesis of osteoporosis in inflammatory diseases is multifactorial. The concept of osteoimmunology is based on growing insights into the relationship between the immune system and bone. The association between inflammation and osteoporosis can be explained by the link between osteoclast, macrophage colony stimulating factor and proinflammatory cytokines. Here we discuss the etiopathogenesis underlying the inflammatory loss of bone in rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematosus.

Anahtar Kelime:

Konular: Rehabilitasyon Romatoloji

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Deal C. Bone loss in rheumatoid arthritis: systemic, periarticular, and focal. Curr Rheumatol Rep 2012;14:231-7.
2. Roux C. Osteoporosis in inflammatory joint diseases. Osteoporos Int 2011;22:421-33.
3. Kim SY, Schneeweiss S, Liu J, Daniel GW, Chang CL, Garneau K, et al. Risk of osteoporotic fracture in a large population-based cohort of patients with rheumatoid arthritis. Arthritis Res Ther 2010;12:R154.
4. van Staa TP Geusens P Bijlsma JW, Leufkens HG, Cooper C. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum 2006;54:3104-12.
5. Ursum J, Britsemmer K, van Schaardenburg D, Lips PT, Dijkmans BA, Lems W. High prevalence of vertebral deformities in elderly patients with early rheumatoid arthritis. Ann Rheum Dis 2009;68:1512-3.
6. Kanis JA, McCloskey EV, Johansson H, Oden A, Ström O, Borgström F Development and use of FRAX in osteoporosis. Osteoporos Int 2010;21(Suppl 2):407-13.
7. Takayanagi H. Osteoimmunology and the effects of the immune system on bone. Nat Rev Rheumatol 2009;5:667-76.
8. Geusens P The role of RANK ligand/osteoprotegerin in rheumatoid arthritis. Ther Adv Musculoskelet Dis 2012;4:225-33.
9. Xu S, Wang Y, Lu J, Xu J. Osteoprotegerin and RANKL in the pathogenesis of rheumatoid arthritis induced osteoporosis. Rheumatol Int 2012;32:3397-403.
10. Bultink IE, Vis M, van der Horst-Bruinsma IE, Lems WF Inflammatory rheumatic disorders and bone. Curr Rheumatol Rep 2012;14:224-30.
11. Bejarano V, Hensor E, Green M, Haugeberg G, Brown AK, Buch MH, et al. Relationship between early bone mineral density changes and long- term function and radiographic progression in rheumatoid arthritis. Arthritis Care Res (Hoboken) 2012;64:66-70.
12. de Rooy DP Kälvesten J, Huizinga TW, van der Helm-van Mil AH. Loss of metacarpal bone density predicts RA development in recent-onset arthritis. Rheumatology (Oxford) 2012;51:1037-41.
13. Dirven L, Güler-Yüksel M, de Beus WM, Ronday HK, Speyer I, Huizinga TW, et al. Changes in hand bone mineral density and the association with the level of disease activity in patients with rheumatoid arthritis: bone mineral density measurements in a multicenter randomized clinical trial. Arthritis Care Res (Hoboken) 2011;63:1691-9.
14. Güler-Yüksel M, Allaart CF Goekoop-Ruiterman YP de Vries-Bouwstra JK, van Groenendael JH, Mallée C, et al. Changes in hand and generalised bone mineral density in patients with recent-onset rheumatoid arthritis. Ann Rheum Dis 2009;68:330-6.
15. Edwards CJ, Williams E. The role of interleukin-6 in rheumatoid arthritis- associated osteoporosis. Osteoporos Int 2010;21:1287-93.
16. Engvall IL, Svensson B, Tengstrand B, Brismar K, Hafström I; Better Anti- Rheumatic FarmacO Therapy Study Group. Impact of low-dose prednisolone on bone synthesis and resorption in early rheumatoid arthritis: experiences from a two-year randomized study. Arthritis Res Ther 2008;10:R128.
17. Haugeberg G, Strand A, Kvien TK, Kirwan JR. Reduced loss of hand bone density with prednisolone in early rheumatoid arthritis: results from a randomized placebo-controlled trial. Arch Intern Med 2005;165:1293-7.
18. Redlich K, Smolen JS. Inflammatory bone loss: pathogenesis and therapeutic intervention. Nat Rev Drug Discov 2012;11:234-50.
19. Braun T, Zwerina J. Positive regulators of osteoclastogenesis and bone resorption in rheumatoid arthritis. Arthritis Res Ther 2011;13:235.
20. Ding C, Parameswaran V, Udayan R, Burgess J, Jones G. Circulating levels of inflammatory markers predict change in bone mineral density and resorption in older adults: a longitudinal study. J Clin Endocrinol Metab 2008;93:1952-8.
21. Cauley JA, Danielson ME, Boudreau RM, Forrest KY, Zmuda JM, Pahor M, et al. Inflammatory markers and incident fracture risk in older men and women: the Health Aging and Body Composition Study. J Bone Miner Res 2007;22:1088-95.
22. Charactcharoenwitthaya N, Khosla S, Atkinson EJ, McCready LK, Riggs BL. Effect of blockade of TNF-alpha and interleukin-1 action on bone resorption in early postmenopausal women. J Bone Miner Res 2007;22:724-9.
23. Polzer K, Joosten L, Gasser J, Distler JH, Ruiz G, Baum W, et al. Interleukin- 1 is essential for systemic inflammatory bone loss. Ann Rheum Dis 2010;69:284-90.
24. Vis M, Havaardsholm EA, Haugeberg G, Uhlig T, Voskuyl AE, van de Stadt RJ, et al. Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NFkappaB ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis. Ann Rheum Dis 2006;65:1495-9.
25. Deodhar A, Dore RK, Mandel D, Schechtman J, Shergy W, Trapp R, et al. Denosumab-mediated increase in hand bone mineral density associated with decreased progression of bone erosion in rheumatoid arthritis patients. Arthritis Care Res (Hoboken) 2010;62:569-74.
26. Güler-Yüksel M, Allaart CF Watt I, Goekoop-Ruiterman YP de Vries- Bouwstra JK, van Schaardenburg D, et al. Treatment with TNF-a inhibitor infliximab might reduce hand osteoarthritis in patients with rheumatoid arthritis. Osteoarthritis Cartilage 2010;18:1256-62.
27. Axmann R, Herman S, Zaiss M, Franz S, Polzer K, Zwerina J, et al. CTLA-4 directly inhibits osteoclast formation. Ann Rheum Dis 2008;67:1603-9.
28. Schett G. Osteoimmunology in rheumatic diseases. Arthritis Res Ther 2009;11:210.
29. Kitamura T, Murase T, Hashimoto J, Tomita T, Arimitsu S, Yoshikawa H, et al. Radiographic study on the pattern of wrist joint destructi on in rheumatoid arthritis. Clin Rheumatol 2011;30:353-9.
30. Carter S, Lories RJ. Osteoporosis a paradox in ankylosing spondylitis. Curr Osteoporos Rep 2011;9:112-5.
31. Magrey M, Khan MA. Osteoporosis in ankylosing spondylitis. Curr Rheumatol Rep 2010;12:332-6.
32. Arends S, Spoorenberg A, Bruyn GA, Houtman PM, Leijsma MK, Kallenberg CG, et al. The relation between bone mineral density, bone turnover markers, and vitamin D status in ankylosing spondylitis patients with active disease: a cross-sectional analysis. Osteoporos Int 2011;22:1431-9.
33. Ghozlani I, Ghazi M, Nouijai A, Mounach A, Rezqi A, Achemlal L, et al. Prevalence and risk factors of osteoporosis and vertebral fractures in patients with ankylosing spondylitis. Bone 2009;44:772-6.
34. Wendling D. Bone loss in ankylosing spondylitis: can we put the puzzle together? J Rheumatol 2005;32:1184-5.
35. Walsh NC, Gravallese EM. Bone loss in inflammatory arthritis: mechanisms and treatment strategies. Curr Opin Rheumatol 2004;16:419-27.
36. Korczowska I, Przepiera-Bedzak H, Brzosko M, Lacki JK, Trefler J, Hrycaj P Bone tissue metabolism in men with ankylosing spondylitis. Adv Med Sci 2011;56:264-9.
37. Visvanathan S, van der Heijde D, Deodhar A, Wagner C, Baker DG, Han J, et al. Effects of infliximab on markers of inflammation and bone turnover and associations with bone mineral density in patients with ankylosing spondylitis. Ann Rheum Dis 2009;68:175-82.
38. Briot K, Gossec L, Kolta S, Dougados M, Roux C. Prospective assessment of body weight, body composition, and bone density changes in patients with spondyloarthropathy receiving anti-tumor necrosis factor-alpha treatment. J Rheumatol 2008;35:855-61.
39. Anandarajah AP Schwarz EM. Bone loss in the spondyloarthropathies: Role of osteoclast, RANKL, RANK and OPG in the spondyloarthropathies. In: López-Larrea C, Díaz-Peña R, editors. Molecular mechanisms of spondyloarthropathies. Volume 649, Springer; 2009. p. 85-99.
40. Stupphann D, Rauner M, Krenbek D, Patsch J, Pirker T, Muschitz C, et al. Intracellular and surface RANKL are differentially regulated in patients with ankylosing spondylitis. Rheumatol Int 2008;28:987-93.
41. Kim HR, Lee SH, Kim HY. Elevated serum levels of soluble receptor activator of nuclear factors-kappaB ligand (sRANKL) and reduced bone mineral density in patients with ankylosing spondylitis (AS). Rheumatology (Oxford) 2006;45:1197-200.
42. Rauner M, Stupphann D, Haas M, Fert I, Glatigny S, Sipos W, et al. The HLA-B27 transgenic rat, a model of spondyloarthritis, has decreased bone mineral density and increased RANKL to osteoprotegerin mRNA ratio. J Rheumatol 2009;36:120-6.
43. Franck H, Meurer T, Hofbauer LC. Evaluation of bone mineral density, hormones, biochemical markers of bone metabolism, and osteoprotegerin serum levels in patients with ankylosing spondylitis. J Rheumatol 2004;31:2236-41.
44. Lubberts E, van den Bersselaar L, Oppers-Walgreen B, Schwarzenberger P Coenen-de Roo CJ, Kolls JK, et al. IL-17 promotes bone erosion in murine collagen-induced arthritis through loss of the receptor activator of NF-kappa B ligand/osteoprotegerin balance. J Immunol 2003;170:2655-62.
45. Mermerci Başkan B, Pekin Doğan Y, Sivas F Bodur H, Ozoran K. The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis. Rheumatol Int 2010;30:375-81.
46. Obermayer-Pietsch BM, Lange U, Tauber G, Frühauf G, Fahrleitner A, Dobnig H, et al. Vitamin D receptor initiation codon polymorphism, bone density and inflammatory activity of patients with ankylosing spondylitis. Osteoporos Int 2003;14:995-1000.
47. Kamen DL, Alele JD. Skeletal manifestations of systemic autoimmune diseases. Curr Opin Endocrinol Diabetes Obes 2010;17:540-5.
48. Almehed K, Forsblad d'Elia H, Kvist G, Ohlsson C, Carlsten H. Prevalence and risk factors of osteoporosis in female SLE patients-extended report. Rheumatology (Oxford) 2007;46:1185-90.
49. Mendoza-Pinto C, García-Carrasco M, Sandoval-Cruz H, Muñoz- Guarneros M, Escárcega RO, Jiménez-Hernández M, et al. Risk factors of vertebral fractures in women with systemic lupus erythematosus. Clin Rheumatol 2009;28:579-85.
50. Schmajuk G, Yelin E, Chakravarty E, Nelson LM, Panopolis P Yazdany J. Osteoporosis screening, prevention, and treatment in systemic lupus erythematosus: application of the systemic lupus erythematosus quality indicators. Arthritis Care Res (Hoboken) 2010;62:993-1001.
51. Bultink IE. Osteoporosis and fractures in systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2012;64:2-8.
52. Furukawa M, Kiyohara C, Horiuchi T, Tsukamoto H, Mitoma H, Kimoto Y, et al. Prevalence and risk factors of vertebral fracture in female Japanese patients with systemic lupus erythematosus. Mod Rheumatol 2012. Epub ahead of print Aug 19.
53. Mok CC, Ying SK, To CH, Ma KM. Bone mineral density and body composition in men with systemic lupus erythematosus: a case control study. Bone 2008;43:327-31.
54. Lee C, Almagor O, Dunlop DD, Chadha AB, Manzi S, Spies S, et al. Association between African American race/ethnicity and low bone mineral density in women with systemic lupus erythematosus. Arthritis Rheum 2007;57:585-92.
55. Fangtham M, Petri M. Predictors of osteoporotic fracture in SLE [abstract]. Arthritis Rheum 2009;60 (Suppl):S110.
56. Mok CC, Wong SN, Ma KM. Childhood-onset disease carries a higher risk of low bone mineral density in an adult population of systemic lupus erythematosus. Rheumatology (Oxford) 2012;51:468-75.
57. Alele JD, Kamen DL. The importance of inflammation and vitamin D status in SLE-associated osteoporosis. Autoimmun Rev 2010;9:137-9.
58. Carmona-Fernandes D, Santos MJ, Perpétuo IP Fonseca JE, Canhão H. Soluble receptor activator of nuclear factor κB ligand/osteoprotegerin ratio is increased in systemic lupus erythematosus patients. Arthritis Res Ther 2011;13:R175.
59. Paulo Gustavo Sampaio L., Maria Lucia Fleiuss de F Osteoporosis and inflammation. Arq Bras Endocrinol Metab 2010;54:2.
60. Moerman EJ, Teng K, Lipschitz DA, Lecka-Czernik B. Aging activates adipogenic and suppresses osteogenic programs in mesenchymal marrow stroma/stem cells: the role of PPAR-gamma2 transcription factor and TGF-beta/BMP signaling pathways. Aging Cell 2004;3:379-89.
61. Breslin LC, Magee PJ, Wallace JM, McSorley EM. An evaluation of vitamin D status in individuals with systemic lupus erythematosus. Proc Nutr Soc 2011;70:399-407.
62. Toloza SM, Cole DE, Gladman DD, Ibanez D, Urowitz MB. Vitamin D insufficiency in a large female SLE cohort. Lupus 2010;19:13-9.
63. Bonakdar ZS, Jahanshahifar L, Jahanshahifar F Gholamrezaei A.Vitamin D deficiency and its association with disease activity in new cases of systemic lupus erythematosus. Lupus 2011;20:1155-60.
64. Ruiz-Irastorza G, Egurbide MV, Olivares N, Martinez-Berriotxoa A, Aguirre C. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology (Oxford) 2008;47:920-3.
65. Mok CC, Birmingham DJ, Leung HW, Hebert LA, Song H, Rovin BH. Vitamin D levels in Chinese patients with systemic lupus erythematosus: relationship with disease activity, vascular risk factors and atherosclerosis. Rheumatology (Oxford) 2012;51:644-52.
66. Carvalho JF Blank M, Kiss E, Tarr T, Amital H, Shoenfeld Y. Anti-vitamin D, vitamin D in SLE: preliminary results. Ann N Y Acad Sci 2007;1109:550-7.
67. Rhew EY, Lee C, Eksarko P Dyer AR, Tily H, Spies S, et al. Homocysteine, bone mineral density, and fracture risk over 2 years of followup in women with and without systemic lupus erythematosus. J Rheumatol 2008;35:230-6.
68. García-Carrasco M, Mendoza-Pinto C, Escárcega RO, Jiménez-Hernández M, Etchegaray Morales I, Munguía Realpozo P et al. Osteoporosis in patients with systemic lupus erythematosus. Isr Med Assoc J 2009;11:486-91.
69. Mok CC, Mak A, Ma KM. Bone mineral density in postmenopausal Chinese patients with systemic lupus erythematosus. Lupus 2005;14:106-12.
70. Boyanov M, Robeva R, Popivanov P Bone mineral density changes in women with systemic lupus erythematosus. Clin Rheumatol 2003;22:318-23.
71. Jacobs J, Korswagen LA, Schilder AM, van Tuyl LH, Dijkmans BA, Lems WF et al. Six-year follow-up study of bone mineral density in patients with systemic lupus erythematosus. Osteoporos Int 2012. Epub ahead of print Oct 3.

APA	SİNDEL D, ESMAEİLZADEH S, Şen E (2012). Romatizmal hastalıklarda osteoporozun etiyopatogenezi. , 319 - 325.
Chicago	SİNDEL Dilşad,ESMAEİLZADEH Sina,Şen Ekin İlke Romatizmal hastalıklarda osteoporozun etiyopatogenezi. (2012): 319 - 325.
MLA	SİNDEL Dilşad,ESMAEİLZADEH Sina,Şen Ekin İlke Romatizmal hastalıklarda osteoporozun etiyopatogenezi. , 2012, ss.319 - 325.
AMA	SİNDEL D,ESMAEİLZADEH S,Şen E Romatizmal hastalıklarda osteoporozun etiyopatogenezi. . 2012; 319 - 325.
Vancouver	SİNDEL D,ESMAEİLZADEH S,Şen E Romatizmal hastalıklarda osteoporozun etiyopatogenezi. . 2012; 319 - 325.
IEEE	SİNDEL D,ESMAEİLZADEH S,Şen E "Romatizmal hastalıklarda osteoporozun etiyopatogenezi." , ss.319 - 325, 2012.
ISNAD	SİNDEL, Dilşad vd. "Romatizmal hastalıklarda osteoporozun etiyopatogenezi". (2012), 319-325.

APA	SİNDEL D, ESMAEİLZADEH S, Şen E (2012). Romatizmal hastalıklarda osteoporozun etiyopatogenezi. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 58(4), 319 - 325.
Chicago	SİNDEL Dilşad,ESMAEİLZADEH Sina,Şen Ekin İlke Romatizmal hastalıklarda osteoporozun etiyopatogenezi. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 58, no.4 (2012): 319 - 325.
MLA	SİNDEL Dilşad,ESMAEİLZADEH Sina,Şen Ekin İlke Romatizmal hastalıklarda osteoporozun etiyopatogenezi. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, vol.58, no.4, 2012, ss.319 - 325.
AMA	SİNDEL D,ESMAEİLZADEH S,Şen E Romatizmal hastalıklarda osteoporozun etiyopatogenezi. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2012; 58(4): 319 - 325.
Vancouver	SİNDEL D,ESMAEİLZADEH S,Şen E Romatizmal hastalıklarda osteoporozun etiyopatogenezi. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2012; 58(4): 319 - 325.
IEEE	SİNDEL D,ESMAEİLZADEH S,Şen E "Romatizmal hastalıklarda osteoporozun etiyopatogenezi." Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 58, ss.319 - 325, 2012.
ISNAD	SİNDEL, Dilşad vd. "Romatizmal hastalıklarda osteoporozun etiyopatogenezi". Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 58/4 (2012), 319-325.