http://www.cnr.it/ontology/cnr/individuo/prodotto/ID26918
Bone Turnover and the Osteoprotegerin-RANKL Pathway in Tumor-Induced Osteomalacia: A Longitudinal Study of Five Cases (Articolo in rivista)
- Type
- Label
- Bone Turnover and the Osteoprotegerin-RANKL Pathway in Tumor-Induced Osteomalacia: A Longitudinal Study of Five Cases (Articolo in rivista) (literal)
- Anno
- 2009-01-01T00:00:00+01:00 (literal)
- Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
- 10.1007/s00223-009-9275-1 (literal)
- Alternative label
- Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
- Rendina D.; De Filippo G.; Tauchmanovà L.; Insabato L.; Muscariello R.; Gianfrancesco F.; Esposito T.; Cioffi M.; Colao A.; Strazzullo P.; Mossetti G. (literal)
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- ISI Web of Science (WOS) (literal)
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- Department of Clinical and Experimental Medicine, Federico II University, via Sergio Pansini, 5, 80131 Naples, Italy;
Pediatric Endocrinology Unit, Gaetano Rummo Hospital, Benevento, Italy;
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy;
Department of Functional and Morphological Sciences--Section of Pathology, Federico II University, Naples, Italy;
Institute of Genetics and Biophysics ''Adriano Buzzati-Traverso'', Italian National Research Council, Naples, Italy;
Department of Clinical Pathology, Second University of Naples, Naples, Italy (literal)
- Titolo
- Bone Turnover and the Osteoprotegerin-RANKL Pathway in Tumor-Induced Osteomalacia: A Longitudinal Study of Five Cases (literal)
- Abstract
- To evaluate serum levels of osteoprotegerin (OPG), soluble receptor activator of the nuclear factor-kappa B (RANKL), and their relationship with FGF-23, lumbar bone mineral density (BMD), and bone turnover markers, five patients with tumor-induced osteomalacia (TIO) and 40 healthy controls were studied. TIO patients were followed for 360 days after surgical removal of underlying tumor (n = 2) or beginning of therapy with phosphate and calcitriol when surgical treatment was impossible (n = 3). At diagnosis, TIO patients had higher levels of FGF-23 and bone-specific alkaline phosphatase (bALP) and lower levels of cathepsin K (CathK), RANKL, and RANKL/OPG ratio compared to controls. During the follow-up, FGF-23 decreased significantly only in patients who underwent a surgical excision, while phosphate and BMD increased in all patients. The increases in BMD, phosphate, and renal phosphate reabsorption rate were directly related. In the first 60 days of follow-up, we observed a prolonged inhibition of RANKL, CathK, and bone resorption markers associated with a persistence of TIO symptoms and an increase in bALP. From day 60, levels of bone turnover markers returned progressively within the normal range and a clinical remission was observed. The inhibition of the RANKL/OPG pathway and the uncoupling of bone formation and resorption observed in patients with active TIO may be a compensatory mechanism, attempting to reduce worsening of osteomalacia. The BMD increase during TIO treatment is related to the improvement of phosphate rather than FGF-23 levels. A \"hungry bone\"-like syndrome was observed after surgical or pharmacological treatment. (literal)
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