Anti-Inflammatories Linked to Pediatric Osteoporosis

New research using mouse models suggests that the use of glucocorticoids such as prednisone for the treatment of inflammation and pain from rheumatoid arthritis and other conditions may contribute to early onset osteoporosis and fracture risk in pediatric patients. Glucocorticoids are frequently administered to children suffering from conditions ranging from acute lymphoblastic leukemia, rheumatoid disorders, and Duchene muscular dystrophy. Between 6% and 10% of children and adolescents who are placed on high-dose glucocorticoids subsequently develop osteoporosis, and up to 45% of those using the therapy already have it. Of the medications, study author Mei Wan, PhD, professor of orthopedic surgery at the Johns Hopkins University School of Medicine, commented, “They work well against painful inflammation, but they also cause pediatric osteoporosis and vertebral fractures. This study brings us closer to understanding why.” The findings were published online in the journal Nature Communications.

The research team examined bone growth in the long bones of mice aged 4 to 8 weeks, roughly spanning early to late puberty. Focusing on a bone region called the primary spongiosa, the presence of senescent mesenchymal stem cells (MSCs), which are associated with a cessation of cellular division and bone growth, was 3 to 4 times greater in the older mice. However, when mice at the younger end of the study group were injected with prednisone, their MSCs were forced into earlier than usual senescence. In the course of their work, the researchers also identified a chemical that enhances pro-growth MSCs and bone mass, and which could become a preventative adjunct for patients who need glucocorticoids. Dr Wan stated “Our results not only shed light on the dynamic cellular changes affecting bone growth during puberty, but also give us a clue as to why glucocorticoids, such as prednisolone, cause osteoporosis and bone fractures in children, and how to prevent it.”

Read more about the study findings.

The journal article may be read here.