Low dose beta‐blocker prevents ovariectomy‐induced bone loss in rats without affecting heart functions

Findings from animal studies have suggested that bone remodeling is under beta‐adrenergic control. However, the level of adrenergic inhibition required to achieve the most favorable effects on the skeleton remains unknown. To address this question, we compared the effects of low (0.1 mg/Kg/day), medium (5 mg/Kg/day) or high (20 mg/Kg/day) doses of propranolol given 5 days per week for 10 weeks in ovariectomized (OVX) rats. Characteristics of bone microarchitecture, biomechanical properties and bone turnover were investigated, whilst heart functions were assessed by echocardiography and catheterization of the left ventricle. We first confirmed the expression of Adrβ2R and the absence of Adrβ1R on osteoblasts by PCR and confocal microscopy. We then showed that low dose propranolol prevented OVX induced bone loss by increasing bone formation (+30% of MAR vs. placebo, P = 0.01) and decreasing bone resorption (−52% of osteoclast surface on bone surface vs. placebo, P = 0.01). Consequently, rats receiving 0.1 mg/kg/day propranolol displayed higher stress (+27%), intrinsic energy (+28.7%) and Young's Modulus in compression versus placebo (all, P < 0.05). No significant effects on heart hemodynamic parameters were found in rats receiving this dose. In contrast, medium and high doses of propranolol had a negative effect on heart functions but no significant protective effects on bone mass in ovariectomized rats. These results, consistent with the dominant nature of the high bone mass phenotype and normal heart function of Adrβ2R‐deficient mice, suggest that low doses of β‐blockers may have a therapeutic utility in the treatment of osteoporosis with high selectivity for bone tissues. J. Cell. Physiol. 217: 819–827, 2008. © 2008 Wiley‐Liss, Inc.

[1]  D. Richardson,et al.  The selectivity of β‐adrenoceptor antagonists on isoprenaline‐induced changes in heart rate, blood pressure, soleus muscle contractility and airways function in anaesthetized cats , 1983, British journal of pharmacology.

[2]  H. Hallberg Blockade of central beta-adrenoceptors attenuates tremor induced by 5-hydroxytryptamine (5-HT)-receptor activation in rats. , 1987, Acta physiologica Scandinavica.

[3]  D. Chappard,et al.  Bone embedding in pure methyl methacrylate at low temperature preserves enzyme activities. , 1987, Acta histochemica.

[4]  M. Drezner,et al.  Bone histomorphometry: Standardization of nomenclature, symbols, and units: Report of the asbmr histomorphometry nomenclature committee , 1987, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[5]  A. Boskey,et al.  Effects of propranolol on bone metabolism in the rat , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[6]  D. Modrowski,et al.  Dynamics of circulating osteocalcin in rats during growth and under experimental conditions. , 1992, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[7]  A. Tashjian,et al.  Characterization of beta-adrenergic receptors on rat and human osteoblast-like cells and demonstration that beta-receptor agonists can stimulate bone resorption in organ culture. , 1993, Bone and mineral.

[8]  C H Turner,et al.  Basic biomechanical measurements of bone: a tutorial. , 1993, Bone.

[9]  P. Rüegsegger,et al.  A new method for the model‐independent assessment of thickness in three‐dimensional images , 1997 .

[10]  T. Nagatsu,et al.  Expression of mRNAs for neuropeptide receptors and β-adrenergic receptors in human osteoblasts and human osteogenic sarcoma cells , 1997, Neuroscience Letters.

[11]  G. Bilbe,et al.  Formoterol and isoproterenol induce c-fos gene expression in osteoblast-like cells by activating beta2-adrenergic receptors. , 1998, Bone.

[12]  P. Rüegsegger,et al.  The ability of three-dimensional structural indices to reflect mechanical aspects of trabecular bone. , 1999, Bone.

[13]  J. Aubin,et al.  Kinetics of osteoprogenitor proliferation and osteoblast differentiation in vitro , 1999, Journal of cellular biochemistry.

[14]  H. Hogan,et al.  The Mechanical Properties of Cancellous Bone in the Proximal Tibia of Ovariectomized Rats , 2000, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[15]  T. Martin,et al.  Therapeutic approaches to bone diseases. , 2000, Science.

[16]  C. Rubin,et al.  Anabolism: Low mechanical signals strengthen long bones , 2001, Nature.

[17]  A. Togari,et al.  Adrenergic stimulation of osteoclastogenesis mediated by expression of osteoclast differentiation factor in MC3T3-E1 osteoblast-like cells. , 2001, Biochemical pharmacology.

[18]  Patricia Ducy,et al.  Leptin Regulates Bone Formation via the Sympathetic Nervous System , 2002, Cell.

[19]  K. Maehara,et al.  Different Effects of Carvedilol, Metoprolol, and Propranolol on Left Ventricular Remodeling After Coronary Stenosis or After Permanent Coronary Occlusion in Rats , 2002, Circulation.

[20]  M. Dalstra,et al.  Parathyroid hormone induces formation of new cancellous bone with substantial mechanical strength at a site where it had disappeared in old rats. , 2002, European journal of endocrinology.

[21]  C. Marcelli,et al.  Sympathetic nervous system as transmitter of mechanical loading in bone. , 2003, Joint, bone, spine : revue du rhumatisme.

[22]  David L. Lacey,et al.  Osteoclast differentiation and activation , 2003, Nature.

[23]  Gideon A. Rodan,et al.  Control of osteoblast function and regulation of bone mass , 2003, Nature.

[24]  A. Togari,et al.  In vivo stimulation of sympathetic nervous system modulates osteoblastic activity in mouse calvaria. , 2003, American journal of physiology. Endocrinology and metabolism.

[25]  R. Schlienger,et al.  Use of β-Blockers and Risk of Fractures , 2004 .

[26]  D. Xie,et al.  Leptin deficiency produces contrasting phenotypes in bones of the limb and spine. , 2004, Bone.

[27]  Carol Smith,et al.  Beta-Blocker Selectivity at Cloned Human Beta1- and Beta2-Adrenergic Receptors , 1999, Cardiovascular Drugs and Therapy.

[28]  R. Schlienger,et al.  Use of beta-blockers and risk of fractures. , 2004, JAMA.

[29]  P. Vestergaard,et al.  Fracture Risk in Perimenopausal Women Treated with Beta-Blockers , 2004, Calcified Tissue International.

[30]  J. Pasco,et al.  β‐Adrenergic Blockers Reduce the Risk of Fracture Partly by Increasing Bone Mineral Density: Geelong Osteoporosis Study , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[31]  G. Roodman Mechanisms of bone metastasis. , 2004, Discovery medicine.

[32]  C. Turner,et al.  Neural regulation of bone and the skeletal effects of serotonin (5-hydroxytryptamine) , 2005, Molecular and Cellular Endocrinology.

[33]  Masaki Noda,et al.  Unloading Induces Osteoblastic Cell Suppression and Osteoclastic Cell Activation to Lead to Bone Loss via Sympathetic Nervous System* , 2005, Journal of Biological Chemistry.

[34]  A. Robling,et al.  Inhibition of the serotonin (5-hydroxytryptamine) transporter reduces bone accrual during growth. , 2005, Endocrinology.

[35]  J. Baker The selectivity of beta-adrenoceptor antagonists at the human beta1, beta2 and beta3 adrenoceptors. , 2005, British journal of pharmacology.

[36]  L. Lanyon,et al.  Sympathetic Nervous System Does Not Mediate the Load‐Induced Cortical New Bone Formation , 2005, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[37]  I. Reid,et al.  Effects of a β-Blocker on Bone Turnover in Normal Postmenopausal Women: A Randomized Controlled Trial , 2005 .

[38]  Masaki Noda,et al.  Leptin regulation of bone resorption by the sympathetic nervous system and CART , 2005, Nature.

[39]  Jillian G. Baker,et al.  The selectivity of β‐adrenoceptor antagonists at the human β1, β2 and β3 adrenoceptors , 2005 .

[40]  I. Reid,et al.  Effects of a beta-blocker on bone turnover in normal postmenopausal women: a randomized controlled trial. , 2005, The Journal of clinical endocrinology and metabolism.

[41]  D. Bauer,et al.  β‐Blocker Use, BMD, and Fractures in the Study of Osteoporotic Fractures , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[42]  I. Goshen,et al.  Depression induces bone loss through stimulation of the sympathetic nervous system , 2006, Proceedings of the National Academy of Sciences.

[43]  C. Benhamou,et al.  Dose Effects of Propranolol on Cancellous and Cortical Bone in Ovariectomized Adult Rats , 2006, Journal of Pharmacology and Experimental Therapeutics.

[44]  M. Bouxsein,et al.  Combined treatment with a beta-blocker and intermittent PTH improves bone mass and microarchitecture in ovariectomized mice. , 2006, Bone.

[45]  N. Bonnet β agonistes et antagonistes, exercice physique et tissu osseux : modifications architecturales, densitométriques, biomécaniques et métaboliques de l'os chez la rate ovariectomisée ou non , 2006 .

[46]  C. Benhamou,et al.  Combined Effects of Exercise and Propranolol on Bone Tissue in Ovariectomized Rats , 2007, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[47]  C. Benhamou,et al.  Doping dose of salbutamol and exercise: deleterious effect on cancellous and cortical bones in adult rats. , 2007, Journal of applied physiology.

[48]  C. Chenu,et al.  Blockade of beta-adrenergic signaling does not influence the bone mechano-adaptive response in mice. , 2007, Bone.

[49]  Wen-ping Zhang,et al.  Beta-blocker and other analogous treatments that affect bone mass and sympathetic nerve activity in ovariectomized rats. , 2007, The American journal of Chinese medicine.

[50]  J. Aubin,et al.  Mineralized bone nodules formedin vitro from enzymatically released rat calvaria cell populations , 1986, Calcified Tissue International.