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01.04.2013 | Original Article

Positive skeletal effects of cladrin, a naturally occurring dimethoxydaidzein, in osteopenic rats that were maintained after treatment discontinuation

verfasst von: K. Khan, K. Sharan, G. Swarnkar, B. Chakravarti, M. Mittal, T. K. Barbhuyan, S. P. China, M. P. Khan, G. K. Nagar, D. Yadav, P. Dixit, R. Maurya, N. Chattopadhyay

Erschienen in: Osteoporosis International | Ausgabe 4/2013

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Abstract

Summary

Effects of cladrin treatment and withdrawal in osteopenic rats were studied. Cladrin improved trabecular microarchitecture, increased lumbar vertebral compressive strength, augmented coupled remodeling, and increased bone osteogenic genes. A significant skeletal gain was maintained 4 weeks after cladrin withdrawal. Findings suggest that cladrin has significant positive skeletal effects.

Introduction

We showed that a standardized extract of Butea monosperma preserved trabecular bone mass in ovariectomized (OVx) rats. Cladrin, the most abundant bioactive compound of the extract, promoted peak bone mass achievement in growing rats by stimulating osteoblast function. Here, we studied the effects of cladrin treatment and withdrawal on the osteopenic bones.

Methods

Adult female Sprague–Dawley rats were OVx and left untreated for 12 weeks to allow for significant estrogen deficiency-induced bone loss, at which point cladrin (1 and 10 mg/kg/day) was administered orally for another 12 weeks. Half of the rats were killed at the end of the treatments and the other half at 4 weeks after treatment withdrawal. Sham-operated rats and OVx rats treated with PTH or 17β-estradiol (E2) served as various controls. Efficacy was evaluated by bone microarchitecture using microcomputed tomographic analysis and fluorescent labeling of bone. qPCR and western blotting measured mRNA and protein levels in bone and uterus. Specific ELISA was used for measuring levels of serum PINP and urinary CTx.

Results

In osteopenic rats, cladrin treatment dose dependently improved trabecular microarchitecture, increased lumbar vertebral compression strength, bone formation rate (BFR), cortical thickness (Cs.Th), serum PINP levels, and expression of osteogenic genes in bones; and reduced expression of bone osteoclastogenic genes and urinary CTx levels. Cladrin had no uterine estrogenicity. Cladrin at 10 mg/kg maintained acquired skeletal gains 4 weeks after withdrawal.

Conclusion

Cladrin had positive skeletal effects in osteopenic rats that were maintained after treatment withdrawal.

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Sharan K, Siddiqui JA, Swarnkar G, Maurya R, Chattopadhyay N (2009) Role of phytochemicals in the prevention of menopausal bone loss: evidence from in vitro and in vivo, human interventional and pharma-cokinetic studies. Curr Med Chem 16:1138–1157PubMedCrossRef

Atmaca A, Kleerekoper M, Bayraktar M, Kucuk O (2008) Soy isoflavones in the management of postmenopausal osteoporosis. Menopause 15:748–757PubMedCrossRef

Taku K, Melby MK, Takebayashi J, Mizuno S, Ishimi Y, Omori T, Watanabe S (2010) Effect of soy isoflavone extract supplements on bone mineral density in menopausal women: meta-analysis of randomized controlled trials. Asia Pac J Clin Nutr 19:33–42PubMed

Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289PubMedCrossRef

Melton LJ 3rd (1996) Epidemiology of hip fractures: implications of the exponential increase with age. Bone 18:121S–125SPubMedCrossRef

Adlercreutz H, Mazur W (1997) Phyto-oestrogens and Western diseases. Ann Med 29:95–120PubMed

Ross PD, Norimatsu H, Davis JW, Yano K, Wasnich RD, Fujiwara S, Hosoda Y, Melton LJ 3rd (1991) A comparison of hip fracture incidence among native Japanese, Japanese Americans, and American Caucasians. Am J Epidemiol 133:801–809PubMed

Salari Sharif P, Nikfar S, Abdollahi M (2011) Prevention of bone resorption by intake of phytoestrogens in postmenopausal women: a meta-analysis. Age 33:421–431PubMedCrossRef

Ricci E, Cipriani S, Chiaffarino F, Malvezzi M, Parazzini F (2010) Soy isoflavones and bone mineral density in perimenopausal and postmenopausal Western women: a systematic review and meta-analysis of randomized controlled trials. J Women's Health 19:1609–1617CrossRef

10.

Gallagher JC, Satpathy R, Rafferty K, Haynatzka V (2004) The effect of soy protein isolate on bone metabolism. Menopause 11:290–298PubMedCrossRef

11.

Arjmandi BH, Lucas EA, Khalil DA, Devareddy L, Smith BJ, McDonald J, Arquitt AB, Payton ME, Mason C (2005) One year soy protein supplementation has positive effects on bone formation markers but not bone density in postmenopausal women. Nutr J 4:8PubMedCrossRef

12.

Brink E, Coxam V, Robins S, Wahala K, Cassidy A, Branca F (2008) Long-term consumption of isoflavone-enriched foods does not affect bone mineral density, bone metabolism, or hormonal status in early postmenopausal women: a randomized, double-blind, placebo controlled study. Am J Clin Nutr 87:761–770PubMed

13.

Kovacs AB (1994) Efficacy of ipriflavone in the prevention and treatment of postmenopausal osteoporosis. Agents Actions 41:86–87PubMedCrossRef

14.

Agnusdei D, Gennari C, Bufalino L (1995) Prevention of early postmenopausal bone loss using low doses of conjugated estrogens and the non-hormonal, bone-active drug ipriflavone. Osteoporos Int 5:462–466PubMedCrossRef

15.

Moscarini M, Patacchiola F, Spacca G, Palermo P, Caserta D, Valenti M (1994) New perspectives in the treatment of postmenopausal osteoporosis: ipriflavone. Gynecol Endocrinol 8:203–207PubMedCrossRef

16.

Alexandersen P, Toussaint A, Christiansen C, Devogelaer JP, Roux C, Fechtenbaum J, Gennari C, Reginster JY (2001) Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 285:1482–1488PubMedCrossRef

17.

Melis GB, Paoletti AM, Bartolini R et al (1992) Ipriflavone and low doses of estrogens in the prevention of bone mineral loss in climacterium. Bone Miner 19(Suppl 1):S49–56PubMedCrossRef

18.

Agnusdei D, Crepaldi G, Isaia G, Mazzuoli G, Ortolani S, Passeri M, Bufalino L, Gennari C (1997) A double blind, placebo-controlled trial of ipriflavone for prevention of postmenopausal spinal bone loss. Calcif Tissue Int 61:142–147PubMedCrossRef

19.

Gennari C, Agnusdei D, Crepaldi G, Isaia G, Mazzuoli G, Ortolani S, Bufalino L, Passeri M (1998) Effect of ipriflavone—a synthetic derivative of natural isoflavones—on bone mass loss in the early years after menopause. Menopause 5:9–15PubMedCrossRef

20.

Katase K, Kato T, Hirai Y, Hasumi K, Chen JT (2001) Effects of ipriflavone on bone loss following a bilateral ovariectomy and menopause: a randomized placebo-controlled study. Calcif Tissue Int 69:73–77PubMedCrossRef

21.

Jia TL, Wang HZ, Xie LP, Wang XY, Zhang RQ (2003) Daidzein enhances osteoblast growth that may be mediated by increased bone morphogenetic protein (BMP) production. Biochem Pharmacol 65:709–715PubMedCrossRef

22.

Setchell KD, Lydeking-Olsen E (2003) Dietary phytoestrogens and their effect on bone: evidence from in vitro and in vivo, human observational, and dietary intervention studies. Am J Clin Nutr 78:593S–609SPubMed

23.

Sugimoto E, Yamaguchi M (2000) Stimulatory effect of daidzein in osteoblastic MC3T3-E1 cells. Biochem Pharmacol 59:471–475PubMedCrossRef

24.

Rassi CM, Lieberherr M, Chaumaz G, Pointillart A, Cournot G (2002) Down-regulation of osteoclast differentiation by daidzein via caspase 3. J Bone Miner Res 17:630–638PubMedCrossRef

25.

Picherit C, Chanteranne B, Bennetau-Pelissero C, Davicco MJ, Lebecque P, Barlet JP, Coxam V (2001) Dose-dependent bone-sparing effects of dietary isoflavones in the ovariectomised rat. Br J Nutr 85:307–316PubMedCrossRef

26.

Mora A, Paya M, Rios JL, Alcaraz MJ (1990) Structure–activity relationships of polymethoxyflavones and other flavonoids as inhibitors of non-enzymic lipid peroxidation. Biochem Pharmacol 40:793–797PubMedCrossRef

27.

Walle T (2007) Methylation of dietary flavones greatly improves their hepatic metabolic stability and intestinal absorption. Mol Pharm 4:826–832PubMedCrossRef

28.

Choi SY, Ha TY, Ahn JY, Kim SR, Kang KS, Hwang IK, Kim S (2008) Estrogenic activities of isoflavones and flavones and their structure–activity relationships. Planta Med 74:25–32PubMedCrossRef

29.

Mathey J, Mardon J, Fokialakis N et al (2007) Modulation of soy isoflavones bioavailability and subsequent effects on bone health in ovariectomized rats: the case for equol. Osteoporos Int 18:671–679PubMedCrossRef

30.

Fujioka M, Uehara M, Wu J, Adlercreutz H, Suzuki K, Kanazawa K, Takeda K, Yamada K, Ishimi Y (2004) Equol, a metabolite of daidzein, inhibits bone loss in ovariectomized mice. J Nutr 134:2623–2627PubMed

31.

Setchell KD, Brown NM, Lydeking-Olsen E (2002) The clinical importance of the metabolite equol-a clue to the effectiveness of soy and its isoflavones. J Nutr 132:3577–3584PubMed

32.

Yuan JP, Wang JH, Liu X (2007) Metabolism of dietary soy isoflavones to equol by human intestinal microflora—implications for health. Mol Nutr Food Res 51:765–781PubMedCrossRef

33.

Jiang Q, Payton-Stewart F, Elliott S et al (2010) Effects of 7-O substitutions on estrogenic and anti-estrogenic activities of daidzein analogues in MCF-7 breast cancer cells. J Med Chem 53:6153–6163PubMedCrossRef

34.

Pandey R, Gautam AK, Bhargavan B et al (2010) Total extract and standardized fraction from the stem bark of Butea monosperma have osteoprotective action: evidence for the nonestrogenic osteogenic effect of the standardized fraction. Menopause 17:602–610PubMed

35.

Lakshmi Manickavasagam SG, Mishra S, Maurya R, Chattopadhyay N, Jain GK (2011) LC–MS/MS method for simultaneous analysis of cladrin and equol in rat plasma and its application in pharmacokinetics study of cladrin. Med Chem Res 20:1566–1572CrossRef

36.

Gautam AK, Bhargavan B, Tyagi AM et al (2011) Differential effects of formononetin and cladrin on osteoblast function, peak bone mass achievement and bioavailability in rats. J Nutr Biochem 22:318–327PubMedCrossRef

37.

Maurya R, Yadav DK, Singh G, Bhargavan B, Narayana Murthy PS, Sahai M, Singh MM (2009) Osteogenic activity of constituents from Butea monosperma. Bioorg Med Chem Lett 19:610–613PubMedCrossRef

38.

RJ B (1976) Synthesis of chromones by cyclization of 2-hydroxyphenyl ketones with boron trifluoride—diethyl ether and methanesulphonyl chloride. J Chem Soc Chem Commun 78-79

39.

Sharan K, Mishra JS, Swarnkar G, Siddiqui JA, Khan K, Kumari R, Rawat P, Maurya R, Sanyal S, Chattopadhyay N (2011) A novel quercetin analogue from a medicinal plant promotes peak bone mass achievement and bone healing after injury and exerts an anabolic effect on osteoporotic bone: the role of aryl hydrocarbon receptor as a mediator of osteogenic action. J Bone Miner Res: Official J Am Soc Bone Miner Res 26:2096–2111CrossRef

40.

Siddiqui JA, Swarnkar G, Sharan K et al (2011) A naturally occurring rare analog of quercetin promotes peak bone mass achievement and exerts anabolic effect on osteoporotic bone. Osteoporos Int 22:3013–3027PubMedCrossRef

41.

Malviya Rishabha SP, Kumar U, Bhargava CS, Kumar SP (2010) Formulation and comparison of suspending properties of different natural polymers using paracetamol suspension. Int J Drug Dev’t Res 2:886–891

42.

Nasir O, Artunc F, Saeed A, Kambal MA, Kalbacher H, Sandulache D, Boini KM, Jahovic N, Lang F (2008) Effects of gum arabic (Acacia senegal) on water and electrolyte balance in healthy mice. J Ren Nutr 18:230–238PubMedCrossRef

43.

Sato M, Zeng GQ, Turner CH (1997) Biosynthetic human parathyroid hormone (1-34) effects on bone quality in aged ovariectomized rats. Endocrinology 138:4330–4337PubMedCrossRef

44.

Lane NE, Thompson JM, Strewler GJ, Kinney JH (1995) Intermittent treatment with human parathyroid hormone (hPTH[1-34]) increased trabecular bone volume but not connectivity in osteopenic rats. J Bone Miner Res 10:1470–1477PubMedCrossRef

45.

Rhee Y, Won YY, Baek MH, Lim SK (2004) Maintenance of increased bone mass after recombinant human parathyroid hormone (1-84) with sequential zoledronate treatment in ovariectomized rats. J Bone Miner Res 19:931–937PubMedCrossRef

46.

Black LJ, Sato M, Rowley ER et al (1994) Raloxifene (LY139481 HCI) prevents bone loss and reduces serum cholesterol without causing uterine hypertrophy in ovariectomized rats. J Clin Invest 93:63–69PubMedCrossRef

47.

Bain SD, Bailey MC, Celino DL, Lantry MM, Edwards MW (1993) High-dose estrogen inhibits bone resorption and stimulates bone formation in the ovariectomized mouse. J Bone Miner Res: Official J Am Soc Bone Miner Res 8:435–442CrossRef

48.

Trivedi R, Kumar A, Gupta V, Kumar S, Nagar GK, Romero JR, Dwivedi AK, Chattopadhyay N (2009) Effects of Egb 761 on bone mineral density, bone microstructure, and osteoblast function: possible roles of quercetin and kaempferol. Mol Cell Endocrinol 302:86–91PubMedCrossRef

49.

Siddiqui JA, Sharan K, Swarnkar G, Rawat P, Kumar M, Manickavasagam L, Maurya R, Pierroz D, Chattopadhyay N (2011) Quercetin-6-C-beta-D-glucopyranoside isolated from Ulmus wallichiana planchon is more potent than quercetin in inhibiting osteoclastogenesis and mitigating ovariectomy-induced bone loss in rats. Menopause 18:198–207PubMed

50.

Hildebrand T, Ruegsegger P (1997) Quantification of bone microarchitecture with the structure model index. Comput Methods Biomech Biomed Eng 1:15–23CrossRef

51.

Hara K, Kobayashi M, Akiyama Y (2002) Vitamin K2 (menatetrenone) inhibits bone loss induced by prednisolone partly through enhancement of bone formation in rats. Bone 31:575–581PubMedCrossRef

52.

Parfitt AM, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ, Ott SM, Recker RR (1987) Bone histomorphometry: standardization of nomenclature, symbols, and units. Report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res: Official J Am Soc Bone Miner Res 2:595–610CrossRef

53.

Foldes J, Shih MS, Parfitt AM (1990) Frequency distributions of tetracycline-based measurements: implications for the interpretation of bone formation indices in the absence of double-labeled surfaces. J Bone Miner Res: Official J Am Soc Bone Miner Res 5:1063–1067CrossRef

54.

Samnegard E, Iwaniec UT, Cullen DM, Kimmel DB, Recker RR (2001) Maintenance of cortical bone in human parathyroid hormone(1-84)-treated ovariectomized rats. Bone 28:251–260PubMedCrossRef

55.

Mosekilde L, Danielsen CC, Knudsen UB (1993) The effect of aging and ovariectomy on the vertebral bone mass and biomechanical properties of mature rats. Bone 14:1–6PubMedCrossRef

56.

Sharan K, Swarnkar G, Siddiqui JA et al (2010) A novel flavonoid, 6-C-beta-d-glucopyranosyl-(2S,3S)-(+)-3′,4′,5,7-tetrahydroxyflavanone, isolated from Ulmus wallichiana planchon mitigates ovariectomy-induced osteoporosis in rats. Menopause 17:577–586PubMedCrossRef

57.

Chandra V, Fatima I, Saxena R, Kitchlu S, Sharma S, Hussain MK, Hajela K, Bajpai P, Dwivedi A (2011) Apoptosis induction and inhibition of hyperplasia formation by 2-[piperidinoethoxyphenyl]-3-[4-hydroxyphenyl]-2 H-benzo(b)pyran in rat uterus. Am J Obstet Gynecol 205(362):e361–311

58.

Sharan K, Siddiqui JA, Swarnkar G et al (2010) Extract and fraction from Ulmus wallichiana planchon promote peak bone achievement and have a nonestrogenic osteoprotective effect. Menopause 17:393–402PubMedCrossRef

59.

Motoie H, Nakamura T, O'Uchi N, Nishikawa H, Kanoh H, Abe T, Kawashima H (1995) Effects of the bisphosphonate YM175 on bone mineral density, strength, structure, and turnover in ovariectomized beagles on concomitant dietary calcium restriction. J Bone Miner Res 10:910–920PubMedCrossRef

60.

Legrand E, Chappard D, Pascaretti C, Duquenne M, Krebs S, Rohmer V, Basle MF, Audran M (2000) Trabecular bone microarchitecture, bone mineral density, and vertebral fractures in male osteoporosis. J Bone Miner Res 15:13–19PubMedCrossRef

61.

Lane NE, Kumer JL, Majumdar S, Khan M, Lotz J, Stevens RE, Klein R, Phelps KV (2002) The effects of synthetic conjugated estrogens, a (cenestin) on trabecular bone structure and strength in the ovariectomized rat model. Osteoporos Int 13:816–823PubMedCrossRef

62.

Little DG, Ramachandran M, Schindeler A (2007) The anabolic and catabolic responses in bone repair. J Bone Joint Surg Br 89:425–433PubMedCrossRef

63.

Shiraishi A, Takeda S, Masaki T et al (2000) Alfacalcidol inhibits bone resorption and stimulates formation in an ovariectomized rat model of osteoporosis: distinct actions from estrogen. J Bone Miner Res 15:770–779PubMedCrossRef

64.

Lyritis GP, Georgoulas T, Zafeiris CP Bone anabolic versus bone anticatabolic treatment of postmenopausal osteoporosis. Ann N Y Acad Sci 1205: 277-283

65.

Taxel P, Kaneko H, Lee SK, Aguila HL, Raisz LG, Lorenzo JA (2008) Estradiol rapidly inhibits osteoclastogenesis and RANKL expression in bone marrow cultures in postmenopausal women: a pilot study. Osteoporos Int 19:193–199PubMedCrossRef

66.

McDonnell P, McHugh PE, O'Mahoney D (2007) Vertebral osteoporosis and trabecular bone quality. Ann Biomed Eng 35:170–189PubMedCrossRef

67.

O'Neal JM, Diab T, Allen MR, Vidakovic B, Burr DB, Guldberg RE (2010) One year of alendronate treatment lowers microstructural stresses associated with trabecular microdamage initiation. Bone 47:241–247PubMedCrossRef

68.

Liao JM, Li QN, Wu T, Hu B, Huang LF, Li ZH, Zhao WD, Zhang MC, Zhong SZ (2003) Effects of prednisone on bone mineral density and biomechanical characteristics of the femora and lumbar vertebras in rats. Di Yi Jun Yi Da Xue Xue Bao 23:97–100PubMed

69.

Hale LV, Galvin RJ, Risteli J et al (2007) PINP: a serum biomarker of bone formation in the rat. Bone 40:1103–1109PubMedCrossRef

70.

Rissanen JP, Suominen MI, Peng Z, Morko J, Rasi S, Risteli J, Halleen JM (2008) Short-term changes in serum PINP predict long-term changes in trabecular bone in the rat ovariectomy model. Calcif Tissue Int 82:155–161PubMedCrossRef

71.

Weaver CM, Martin BR, Jackson GS, McCabe GP, Nolan JR, McCabe LD, Barnes S, Reinwald S, Boris ME, Peacock M (2009) Antiresorptive effects of phytoestrogen supplements compared with estradiol or risedronate in postmenopausal women using (41)Ca methodology. J Clin Endocrinol Metab 94:3798–3805PubMedCrossRef

72.

Karieb S, Fox SW Phytoestrogens directly inhibit TNF-alpha-induced bone resorption in RAW264.7 cells by suppressing c-fos-induced NFATc1 expression. J Cell Biochem 112:476-487

73.

Marie PJ (2005) Strontium ranelate: a novel mode of action optimizing bone formation and resorption. Osteoporos Int 16(Suppl 1):S7–10PubMedCrossRef

74.

Meunier PJ, Roux C, Seeman E et al (2004) The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350:459–468PubMedCrossRef

75.

Tyagi AM, Srivastava K, Sharan K, Yadav D, Maurya R, Singh D (2011) Daidzein prevents the increase in CD4 + CD28null T cells and B lymphopoesis in ovariectomized mice: a key mechanism for anti-osteoclastogenic effect. PLoS One 6:e21216PubMedCrossRef

76.

Hu M (2007) Commentary: bioavailability of flavonoids and polyphenols: call to arms. Mol Pharm 4:803–806PubMedCrossRef

77.

Arjmandi BH (2001) The role of phytoestrogens in the prevention and treatment of osteoporosis in ovarian hormone deficiency. J Am Coll Nutr 20:398S–402S, discussion 417S-420SPubMed

78.

(2001) Bioavailability of nutrients and other bioactive components from dietary supplements. Proceedings of a conference. January 5–6, 2000. Bethesda, Maryland, USA. J Nutr 131:1329S-1400S

79.

Walle T (2007) Methoxylated flavones, a superior cancer chemopreventive flavonoid subclass? Semin Cancer Biol 17:354–362PubMedCrossRef

Titel: Positive skeletal effects of cladrin, a naturally occurring dimethoxydaidzein, in osteopenic rats that were maintained after treatment discontinuation
verfasst von: K. Khan
K. Sharan
G. Swarnkar
B. Chakravarti
M. Mittal
T. K. Barbhuyan
S. P. China
M. P. Khan
G. K. Nagar
D. Yadav
P. Dixit
R. Maurya
N. Chattopadhyay
Publikationsdatum: 01.04.2013
Verlag: Springer-Verlag
Erschienen in: Osteoporosis International / Ausgabe 4/2013
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-012-2121-8

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