Tibolone Exerts Its Protective Effect on Trabecular Bone Loss Through the Estrogen Receptor
作者:A. G. H. Ederveen、H. J. Kloosterboer
DOI:10.1359/jbmr.2001.16.9.1651
日期:——
Tibolone (Org OD14) has estrogenic, progestogenic, and/or androgenic activity depending on the tissue. In postmenopausal women, tibolone prevents bone loss without stimulating the endometrium. Tibolone is effective in preventing trabecular bone loss from the peripheral and axial skeleton of young and old ovariectomized (OVX) rats by reducing bone turnover, that is, bone resorption, like estrogens. We evaluated the contribution of the various hormonal activities to tibolone's bone‐conserving effect. Three‐month‐old OVX rats received tibolone (125 μg/rat or 500 μg/rat, twice daily), alone or combined with an antiestrogen, antiandrogen, or antiprogestogen, and the effects on trabecular bone mass and bone turnover were evaluated. Sham‐operated and control OVX groups were treated with vehicle. The remaining OVX groups received oral doses of tibolone twice daily, alone or with twice daily (a) antiestrogen ICI 164.384, (b) antiandrogen flutamide, or (c) antiprogestogen Org 31710. For comparison, the effects of 17β‐estradiol and testosterone were examined also. After 4 weeks, trabecular bone mineral density (BMD) in the distal femur, plasma osteocalcin, and urinary deoxypyridinoline/creatinine ratio (Dpyr/Cr) were measured. Tibolone or 17β‐estradiol significantly blocked ovariectomy‐induced loss of trabecular BMD and inhibited bone resorption and bone turnover as judged by reduced Dpyr/Cr ratio and osteocalcin, respectively. These effects of both compounds were counteracted by the antiestrogen. This suggests a major involvement of the estrogen receptor in the action of tibolone on bone metabolism. However, the antiandrogen and the antiprogestogen did not counteract the effects of tibolone, excluding a major role of the androgenic and progestogenic activities of tibolone in its action against trabecular bone loss. The results indicate that tibolone acts on bone almost entirely through activation of the estrogen receptor.
替泊龙(Org OD14)根据组织类型具有雌激素样、孕激素样和/或雄激素样的活性。在绝经后女性中,替泊龙可以防止骨质流失,而不会刺激子宫内膜。替泊龙通过减少骨代谢,即骨吸收,像雌激素一样有效地预防年轻和年老卵巢切除(OVX)大鼠的周围和轴骨的骨小梁流失。我们评估了各种激素活性对替泊龙维持骨骼的贡献。三个月大的OVX大鼠接受替泊龙(每只125微克或500微克,双次每日),单独或与抗雌激素、抗雄激素或抗孕激素联合用药,评估其对骨小梁骨质量和骨代谢的影响。假手术和对照OVX组接受车辆处理。其余OVX组每天口服替泊龙,单独或与(a)抗雌激素ICI 164.384,(b)抗雄激素氟他胺,或(c)抗孕激素Org 31710联合用药。为了比较,17β-雌二醇和睾酮的效果也进行了研究。经过4周的处理后,测定了远端股骨的骨小梁矿物质密度(BMD)、血浆骨钙素和尿液去氧吡啶酮/肌酐比率(Dpyr/Cr)。替泊龙或17β-雌二醇显著阻止了卵巢切除所致的骨小梁BMD减少,并通过降低Dpyr/Cr比率和骨钙素分别抑制了骨吸收和骨代谢。这两种化合物的效果均被抗雌激素所抵消。这表明雌激素受体在替泊龙影响骨代谢中的主要作用。然而,抗雄激素和抗孕激素并未抵消替泊龙的作用,排除了替泊龙的雄激素样和孕激素样活性对其抗骨小梁流失作用的主要角色。结果表明,替泊龙几乎完全通过激活雌激素受体来影响骨骼。