Changes in the serum sex steroids, IL-7 and RANKL-OPG system after bone marrow transplantation: Influences on bone and mineral metabolism
Changes in the serum sex steroids, IL-7 and RANKL-OPG system after bone marrow transplantation: Influences on bone and mineral metabolism
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DOI：
10.1016/j.bone.2006.06.011
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发表时间：
2006-12-01
期刊：
影响因子：
4.1
通讯作者：
Kang, Moo Il
中科院分区：
文献类型：
--
作者：
Baek, Ki Hyun;Oh, Ki Won;Kang, Moo Il
本研究前瞻性研究了骨髓移植（BMT）患者血清中性类固醇、白细胞介素7（IL-7）、可溶性核因子κ B受体激活因子配体（sRANKL）和骨保护素（OPG）水平的变化。本研究还通过相关性分析来研究这些细胞因子水平和性类固醇的变化是否真的影响骨转换和BMT后骨丢失。分析了39例患者（33.6 ± 6.4岁，19例男性和20例女性）的数据，这些患者在BMT前和BMT后1年进行了DXA。结果显示，移植前后腰椎和股骨近端平均骨丢失率分别为5.9%（P < 0.01）和11.3%（P < 0.01）。在骨髓移植后即刻，骨形成减少，而骨吸收增加。对于女性受者，雌二醇水平在BMT后1周下降，并且没有恢复到基础水平。对于男性受体，睾酮水平在1周时下降，然后上升到基线水平。IL-7水平在1周时达到最大值，然后在3个月时下降到基线水平。血清sRANKL、OPG水平及sRANKL/OPG比值均在移植后3周达到峰值，平均日剂量的类固醇激素与骨形成抑制、骨吸收增强及sRANKL水平升高有关。在骨髓移植后1周和3周，IL-7水平与ICTP水平呈正相关，或与骨钙素水平呈负相关。腰椎和股骨近端的骨丢失受到性类固醇减少和IL-7水平增加的影响。在观察期间，IL-7水平与sRANKL水平及sRANKL/OPG比值呈正相关。女性患者骨髓移植后1周和3周血清IL-7水平与雌二醇水平呈负相关，提示IL-7在骨髓移植后骨丢失中起重要作用，可能通过RANKL途径实现。这些数据还表明，在骨髓移植后早期IL-7的上调可能是由于雌激素缺乏。(c)2006年爱思唯尔公司All rights reserved.
This study prospectively investigated the changes of the serum levels of the sex steroids, IL-7, soluble receptor activator of nuclear factor kappa B ligand (sRANKL) and osteoprotegerin (OPG) in bone marrow transplantation (BMT) recipients. This study also examined whether the changes of these cytokine levels and sex steroids actually influence bone turnover and post-BMT bone loss by correlation analysis. Data were analyzed from 39 patients (33.6 +/- 6.4 years, 19 men and 20 women) who had DXA performed before BMT and at 1 year after BMT. The bone turnover markers, sex steroids and the cytokine levels were measured before BMT and serially after BMT.The mean bone loss in the lumbar spine and the total proximal femur was 5.9% (P < 0.01) and 11.3% (P < 0.01), respectively. During the immediate post-BMT period, bone formation decreased, whereas the bone resorption increased. For the female recipients, the estradiol levels declined at 1 week after BMT, and they did not recover to the basal levels. For the male recipients, the testosterone levels decreased at 1 week and then it increased to its baseline level. The IL-7 levels reached their maximum at 1 week and then declined to baseline level by 3 months. The serum sRANKL, OPG levels and the sRANKL/OPG ratio showed their peak at post-BMT 3 weeks.The mean daily dose of steroid was associated with suppressed bone formation, enhanced bone resorption and increased sRANKL levels. The IL-7 levels were also noted to be either positively correlated with the levels of ICTP or they were negatively correlated with the levels of osteocalcin at 1 and 3 weeks after BMT. Bone loss at the lumbar spine and the proximal femur was influenced by the decreased sex steroids and increased IL-7 levels. During the observation period, the IL-7 levels showed positive correlations with the sRANKL levels and the sRANKL/OPG ratio. For the female patients, the serum IL-7 levels were negatively associated with the estradiol levels at 1 and 3 weeks after BMT.All these findings suggest that IL-7 plays an important role for post-BMT bone loss, and this possibly happens via the RANKL pathway. These data also suggest that the up-regulation of IL-7 during the early post-BMT period may result from a deficiency of estrogen. (c) 2006 Elsevier Inc. All rights reserved.