Entzündlich rheumatische Erkrankungen und Osteoporose

Zusammenfassung

Osteoporose ist ein häufiges Phänomen bei entzündlich rheumatischen Erkrankungen. Diese Koinzidenz sowie ein frühzeitiges Auftreten im Verlauf rheumatischer Erkrankungen ist durch gemeinsame zelluläre und molekulare Mechanismen der Pathophysiologie erklärbar. In diesem Beitrag werden die Erkenntnisse der zellulären und molekularen Osteoimmunologie kurz skizziert, die Zusammenhänge zwischen Osteoporose und der rheumatoiden Arthritis, der Spondylitis ankylosans und dem systemischen Lupus erythematodes beleuchtet und abschließend ein Überblick über die Therapieoptionen für Osteoporose bei rheumatischen Erkrankungen gegeben.

Summary

Osteoporosis is frequently associated with rheumatic diseases. This association as well as an occurence of osteoporosis early in the course of rheumatic diseases is based on shared cellular and molecular pathophysiological mechanisms. In this chapter, pivotal results of cellular and molecular osteoimmunology will be summarized, the respective relationship between osteoporosis and rheumatoid arthritis, ankylosing spondylitis as well as systemic lupus erythematosus will be described, and finally an overview of possible therapeutic options for ostoporosis in the context of rheumatic diseases will be provided.

Schlüsselwörter

Osteoporose - RANKL - Osteoimmunologie - rheumatoide Arthritis - Spondylitis ankylosans - Kollagenose

Keywords

Osteoporosis - RANKL - osteoimmunology - rheumatoid arthritis - ankylosing spondylitis - connective tissue disease

• Literatur

• 1 Allali F, Breban M, Porcher R. et al. Increase in bone mineral density of patients with spondyloarthropathy treated with anti-tumour necrosis factor alpha. Ann Rheum Dis 2003; 62: 347-349.
• 2 Almehed K, Forsblad d’Elia H, Kvist G. et al. Prevalence and risk factors of osteoporosis in female SLE patients: extended report. Rheumatology 2007; 46: 1185-1190.
• 3 Becker A, Fischer R, Scherbaum WA, Schneider M. Osteoporosis screening in systemic lupus erythematosus: impact of disease duration and organ damage. Lupus 2001; 10: 809-814.
• 4 Boyanov M, Robeva R, Popivanov P. Bone mineral density changes in women with systemic lupus erythematosus. Clin Rheumatol 2003; 22: 318-323.
• 5 Braun T, Schett G. Pathways for Bone Loss in Inflammatory Disease. Curr Osteoporos Rep 2012; 10: 101-108.
• 6 Braun T, Zwerina J. Positive regulators of osteoclastogenesis and bone resorption in rheumatoid arthritis. Arthritis Res Ther 2011; 13: 235-245.
• 7 Briot K, Gossec L, Kolta S. et al. Prospective assessment of body weight, body composition, and bone density changes in patients with spondyloarthropathy receiving anti-tumor necrosis factor-alpha treatment. J Rheumatol 2008; 35: 855-861.
• 8 Bultink IE, Lems WF, Kostense PJ. et al. Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus. Arthritis Rheum 2005; 54: 2044-2050.
• 9 Bultink I, Vis M, Horst-Bruinsma I, Lems W. Inflammatory Rheumatic Disorders and Bone. Curr Rheumatol Rep 2012; 14: 224-230.
• 10 Cohen SB, Dore RK, Lane NE. et al. Denosumab treatment effects on structural damage, bone mineral density, and bone turnover in rheumatoid arthritis: A twelve-month, multicenter, randomized, double-blind, placebo-controlled, phase II clinical trial. Arthritis Rheum 2008; 58: 1299-1309.
• 11 Cooper C, Carbone L, Michet CJ. et al. Fracture risk in patients with ankylosing spondylitis: a population based study. J Rheumatol 1994; 21: 1877-1882.
• 12 Dao H, Do Q, Sakamoto J. Bone mineral density and frequency of osteoporosis among Vietnamese women with early rheumatoid arthritis. Clin Rheumatol 2011; 30: 1353-1361.
• 13 De Rooy D, Kalvesten J, Huizinga T, Van Der Helm-Van Mil A. Loss of metacarpal bone density predicts RA development in recent-onset arthritis. Rheumatology 2012; 51: 1037-1041.
• 14 Dewhirst FE, Stashenko PP, Mole JE, Tsurumachi T. Purification and partial sequence of human osteoclast-activating factor: identity with interleukin 1 beta. J Immunol 1985; 135: 2562-2568.
• 15 Donnelly S, Doyle DV, Denton A. et al. Bone mineral density and vertebral compression fracture rates in ankylosing spondylitis. Annals Rheum Dis 1994; 53: 117-121.
• 16 El Maghraoui A, Borderie D, Cherruau B. et al. Osteoporosis, body composition, and bone turnover in ankylosing spondylitis. J Rheumatol 1999; 26: 2205-2209.
• 17 El Maghraoui A, Rezqi A, Mounach A. et al. Prevalence and risk factors of vertebral fractures in women with rheumatoid arthritis using vertebral fracture assessment. Rheumatology 2010; 49: 1303-1310.
• 18 Feldtkeller E, Vosse D, Geusens P, van der Linden S. Prevalence and annual incidence of vertebral fractures in patients with ankylosing spondylitis. Rheumatol Int 2006; 26: 234-239.
• 19 Forslind K, Keller C, Svensson B, Hafström I. BARFOT Study Group. Reduced bone mineral density in early rheumatoid arthritis is associated with radiological joint damage at baseline and after 2 years in women. J Rheumatol 2003; 30: 2590-2596.
• 20 Geusens PP, Landewé RB, Garnero P. et al. The ratio of circulating osteoprotegerin to RANKL in early rheumatoid arthritis predicts later joint destruction. Arthritis Rheum 2006; 54: 1772-1777.
• 21 Geusens P, Lems W. Osteoimmunology and osteoporosis. Arthritis Res Ther 2011; 13: 242-257.
• 22 Ghozlani I, Ghazi M, Nouijai A. et al. Prevalence and risk factors of osteoporosis and vertebral fractures in patients with ankylosing spondylitis. Bone 2009; 44: 772-776.
• 23 Gilboe IM, Kvien T, Haugeberg G, Husby G. Bone mineral density in systemic lupus erythematosus: comparison with rheumatoid arthritis and healthy controls. Ann Rheum Dis 2000; 59: 110-115.
• 24 Gough AK, Lilley J, Eyre S. et al. Generalised bone loss in patients with early rheumatoid arthritis. Lancet 1994; 344: 23-27.
• 25 Grossman JM, Gordon R, Ranganath VK. et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res 2010; 62: 1515-1526.
• 26 Güler-Yüksel M, Bijsterbosch J, Goekoop-Ruiterman YP. et al. Bone mineral density in patients with recently diagnosed, active rheumatoid arthritis. Annals of the Rheumatic Diseases 2007; 66: 1508-1512.
• 27 Hadjidakis D, Androulakis I. Bone Remodeling. Ann N Y Acad Sci 2006; 1092: 385-396.
• 28 Haugeberg G, Green MJ, Quinn MA. et al. Hand bone loss in early undifferentiated arthritis: evaluating bone mineral density loss before the development of rheumatoid arthritis. Ann Rheum Dis 2006; 65: 736-740.
• 29 Haugeberg G, Lodder MC, Lems W. et al. Hand cortical bone mass and its associations with radiographic joint damage and fractures in 50–70 year old female patients with rheumatoid arthritis: cross sectional Oslo-Truro-Amsterdam (OSTRA) collaborative study. Ann Rheum Dis 2004; 63: 1331-1334.
• 30 Haugeberg G, Strand A, Kvien TK, Kirwan JR. Reduced loss of hand bone density with prednisolone in early rheumatoid arthritis: results from a randomized placebo-controlled trial. Arch Intern Med 2005; 165: 1293-1297.
• 31 Haugeberg G, Uhlig T, Falch JA. et al. Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County Rheumatoid Arthritis register. Arthritis Rheum 2000; 43: 522-530.
• 32 Haugeberg G, Uhlig T, Falch JA. et al. Reduced bone mineral density in male rheumatoid arthritis patients: frequencies and associations with demographic and disease variables in ninety-four patients in the Oslo County Rheumatoid Arthritis Register. Arthritis Rheum 2000; 43: 2776-2784.
• 33 Haynes D, Crotti T, Weedon H. et al. Modulation of RANKL and osteoprotegerin expression in synovial tissue from patients with rheumatoid arthritis in response to disease-modifying antirheumatic drug treatment and correlation with radiologic outcome. Arthritis Rheum 2008; 59: 911-920.
• 34 Hoff M, Haugeberg G, Kvien TK. Hand bone loss as an outcome measure in established rheumatoid arthritis: 2-year observational study comparing cortical and total bone loss. Arthritis Res Ther 2007; 9: 1-8.
• 35 Hoff M, Haugeberg G, Odegard S. et al. Cortical hand bone loss after 1 year in early rheumatoid arthritis predicts radiographic hand joint damage at 5-year and 10-year follow-up. Ann Rheum Dis 2009; 68: 324-329.
• 36 Horton JE, Raisz LG, Simmons HA. et al. Bone resorbing activity in supernatant fluid from cultured human peripheral blood leukocytes. Science 1972; 177: 793-795.
• 37 Jones HP. Immune cells listen to what stress is saying: neuroendocrine receptors orchestrate immune function. Methods Mol Biol 2012; 934: 77-87.
• 38 Karberg K, Zochling J, Sieper J. et al. Bone loss is detected more frequently in patients with ankylosing spondylitis with syndesmophytes. J Rheumatol 2005; 32: 1290-1298.
• 39 Kim SY, Schneeweiss S, Liu J. et al. Risk of osteoporotic fracture in a large population-based cohort of patients with rheumatoid arthritis. Arthritis Res Ther 2010; 12: R154-R163.
• 40 Kroot EJ, Nieuwenhuizen MG, de Waal Malefijt MC. et al. Change in bone mineral density in patients with rheumatoid arthritis during the first decade of the disease. Arthritis Rheum 2001; 44: 1254-1260.
• 41 Lange U, Teichmann J, Müller-Ladner U, Strunk J. Increase in bone mineral density of patients with rheumatoid arthritis treated with anti-TNF-á antibody: a prospective open-label pilot study. Rheumatology 2005; 44: 1546-1548.
• 42 Li EK, Tam LS, Griffith JF. et al. High prevalence of asymptomatic vertebral fractures in Chinese women with systemic lupus erythematosus. J Rheumatol 2009; 36: 1646-1652.
• 43 Li Y, Toraldo G, Li A. et al. B cells and T cells are critical for the preservation of bone homeostasis and attainment of peak bone mass in vivo. Blood 2007; 109: 3839-3848.
• 44 Lodder MC, Haugeberg G, Lems W et al.. OsloTruro-Amsterdam (OSTRA) Collaborative Study. Radiographic damage associated with low bone mineral density and vertebral deformities in rheumatoid arthritis: the Oslo-Truro-Amsterdam (OSTRA) collaborative study. Arthritis Rheum 2003; 49: 209-215.
• 45 Lodder MC, de Jong Z, Kostense PJ. et al. Bone mineral density in patients with rheumatoid arthritis: relation between disease severity and low bone mineral density. Ann Rheum Dis 2004; 63: 1576-1580.
• 46 Maillefert JF, Aho LS, El Maghraoui A. et al. Changes in bone density in patients with ankylosing spondylitis: a two-year follow-up study. Osteoporos Int 2001; 12: 605-609.
• 47 Martínez-Calatrava MJ, Prieto-Potín I, Roman-Blas JA. et al. RANKL synthesized by articular chondrocytes contributes to juxta-articular bone loss in chronic arthritis. Arthritis Res Ther 2012; 14: R149-R152.
• 48 Mendoza-Pinto C, García-Carrasco M, Sandoval-Cruz H. et al. Risk factors of vertebral fractures in women with systemic lupus erythematosus. Clin Rheumatol 2009; 28: 579-585.
• 49 Mitra D, Elvins DM, Speden DJ, Collins AJ. The prevalence of vertebral fractures in mild ankylosing spondylitis and their relationship to bone mineral density. Rheumatology 2000; 39: 85-89.
• 50 Neumann E, Gay S, Müller-Ladner U. The RANK/RANKL/osteoprotegerin system in rheumatoid arthritis: New insights from animal models. Arthritis Rheum 2005; 52: 2960-2967.
• 51 Ørstavik RE, Haugeberg G, Mowinckel P. et al. Vertebral deformities in rheumatoid arthritis: a comparison with population-based controls. Arch Intern Med 2004; 164: 420-425.
• 52 Ørstavik RE, Haugeberg G, Uhlig T. et al. Vertebral deformities in 229 female patients with rheumatoid arthritis: associations with clinical variables and bone mineral density. Arthritis Rheum 2003; 49: 355-360.
• 53 Peel et al. Risk of vertebral fracture and relationship to bone mineral density in steroid treated rheumatoid arthritis. Ann Rheum Dis 1995; 54: 801-806.
• 54 Petri M. Musculoskeletal complications of systemic lupus erythematosus in the Hopkins Lupus Cohort: an update. Arthritis Care Res. 1995; 8: 137-145.
• 55 Ralston SH, Urquhart GD, Brzeski M, Sturrock RD. Prevalence of vertebral compression fractures due to osteoporosis in ankylosing spondylitis. BMJ 1990; 300: 563-565.
• 56 Redlich K, Smolen J. Inflammatory bone loss: pathogenesis and therapeutic intervention. Nat Rev Drug Discov 2012; 11: 234-250.
• 57 Ross FP, Teitelbaum SL. alphavbeta3 and macrophage colony-stimulating factor: partners in osteoclast biology. Immunol Rev 2005; 208: 88-105.
• 58 Ruiz-Irastorza G, Egurbide MV, Olivares N. et al. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology 2008; 47: 920-923.
• 59 Sambrook PN, Eisman JA, Champion GD. et al. Determinants of axial bone loss in rheumatoid arthritis. Arthritis Rheum 1987; 30: 721-728.
• 60 Shibuya K, Hagino H, Morio Y, Teshima R. Crosssectional and longitudinal study of osteoporosis in patients with rheumatoid arthritis. Clin Rheumatol 2002; 21: 150-158.
• 61 Sinigaglia L, Nervetti A, Mela Q. et al. A multicenter cross sectional study on bone mineral density in rheumatoid arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis. J Rheumatol 2000; 27: 2582-2589.
• 62 Sinigaglia L, Varenna M, Binelli L. et al. Determinants of bone mass in systemic lupus erythematosus: a cross sectional study on premenopausal women. J Rheumatol 1999; 26: 1280-1284.
• 63 Söderström K, Stein E, Colmenero P. et al. Natural killer cells trigger osteoclastogenesis and bone destruction in arthritis. Proc Natl Acad Sci USA 2010; 107: 13028-13033.
• 64 Sun HB. Mechanical loading, cartilage degradation, and arthritis. Ann N Y Acad Sci 2010; 1211: 37-50.
• 65 Takayanagi H. Osteoimmunology: shared mechanisms and crosstalk between the immune and bone systems. Nat Rev Immunol 2007; 7: 292-304.
• 66 Teichmann J, Lange U, Stracke H. et al. Bone metabolism and bone mineral density of systemic lupus erythematosus at the time of diagnosis. Rheumatol Int 1999; 18: 137-140.
• 67 Teitelbaum SL. Osteoclasts: what do they do and how do they do it?. Am J Pathol 2007; 170: 427-435.
• 68 Terpos E, Fragiadaki K, Konsta M. et al. Early effects of IL-6 receptor inhibition on bone homeostasis: a pilot study in women with rheumatoid arthritis. Clin Exp Rheumatol 2011; 29: 921-925.
• 69 Toloza SM, Cole DE, Gladman DD. et al. Vitamin D insufficiency in a large female SLE cohort. Lupus 2010; 19: 13-19.
• 70 Uaratanawong S, Deesomchoke U, Lertmaharit S, Uaratanawong S. Bone mineral density in premenopausal women with systemic lupus erythematosus. J Rheumatol 2003; 30: 2365-2368.
• 71 Ursum J, Britsemmer K, van Schaardenburg D. et al. High prevalence of vertebral deformities in elderly patients with early rheumatoid arthritis. Annals of the Rheumatic Diseases 2009; 68: 1512-1513.
• 72 van Staa TP, Geusens P, Bijlsma JW. et al. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum 2006; 54: 3104-3112.
• 73 Vis M, Haavardsholm E, Bøyesen P. et al. High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5-year follow-up study in postmenopausal women with rheumatoid arthritis. Osteoporos Int 2011; 22: 2413-2419.
• 74 Vis M, Havaardsholm E, Haugeberg G. et al. Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NF B ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis. Ann Rheum Dis 2006; 65: 1495-1499.
• 75 Visvanathan S, van der Heijde D, Deodhar A. et al. Effects of infliximab on markers of inflammation and bone turnover and associations with bone mineral density in patients with ankylosing spondylitis. Ann Rheum Dis 2009; 68: 175-182.
• 76 Vosse D, Landewé R, van der Heijde D. et al. Ankylosing spondylitis and the risk of fracture: results from a large primary care-based nested case-control study. Ann Rheum Dis 2009; 68: 1839-1842.
• 77 Wijbrandts C, Klaasen R, Dijkgraaf M. et al. Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss. Ann Rheum Dis 2009; 68: 373-376.
• 78 Xu S, Wang Y, Lu J, Xu J. Osteoprotegerin and RANKL in the pathogenesis of rheumatoid arthritis-induced osteoporosis. Rheumatol Int 2011; 1-7.
• 79 Yasuda H, Shima N, Nakagawa N. et al. Osteoclast differentiation factor is a ligand for osteoprotegerin/osteoclastogenesis-inhibitory factor and is identical to TRANCE/RANKL. Proc Natl Acad Sci USA 1998; 95: 3597-3602.
• 80 Zhao B, Ivashkiv LB. Negative regulation of osteoclastogenesis and bone resorption by cytokines and transcriptional repressors. Arthritis Res Ther 2011; 13: 234-243.