Best
Osteoporosis Defense
May Be a Good Offense
Excerpt
by Ed Edelson,
HealthScoutNews
(HealthScoutNews) -- A genetic discovery has opened the way to
a revolutionary way of treating osteoporosis, the bone-weakening
condition that affects millions of older Americans.
Studies have identified a gene that is intimately involved in the
buildup and breakdown of bones. Now, a group led by Drs. Karl Insogna
and Richard P. Lifton at Yale University says it has identified
a protein-gene interaction that is "a potential target for
the prevention or treatment of osteoporosis."
All existing treatments for osteoporosis aim to reduce bone
loss. The new genetic finding may make it possible to develop
therapy that actually increases bone buildup.
The story began just last year, when researchers at Case Western
University reported that if a mutation knocks out function of
the gene, which is designated LRP5, people who carry the mutated
gene develop severe bone loss at an early age, says Lifton, a
professor of genetics and medicine at Yale.
"This raised the question in our minds whether a different
mutation in the same gene could cause unusually high bone density,"
Lifton says. "We identified a family in which a mutation
in a single gene causes them to have massive bone density. So
there are two mutations, one that knocks out the gene and causes
lower bone density, the other that increases gene activity and
raises bone density."
A key to the way the gene controls bone density is a protein
designated Dkk-1, Lifton says. When Dkk-1 locks onto the LRP5
gene, the result is decreased activity of the gene.
"This suggests for the first time that if we inhibit the
ability of Dkk-1 to reduce LRP5 activity, we can raise bone density
in normal individuals," Lifton says. "We would predict
that this would not have other adverse consequences, because the
people who have such a mutation do not have other abnormalities."
The most notable abnormality other than increased bone density
associated with the LRP5 mutation is torus palatinus, a bony growth
of the hard palate that occurs in 20 percent to 25 percent of
the general population.
One obvious strategy is to find a molecule that locks onto the
Dkk-1 protein and prevents it from functioning.
"But I would be reserved about interfering with Dkk-1 because
it might be doing a number of other things," Lifton says.
"If we target LRP5 instead, that would do the trick."
A number of research groups, including some in the pharmaceutical
industry, are looking for such compounds, Lifton says.
One researcher working in that area is Dr. Gerard Karsenty,
a professor of genetics and medicine at Baylor College of Medicine
and co-author of an editorial accompanying the report in tomorrow's
issue of the New England Journal of Medicine.
Rather than looking directly at the Dkk-l/LRP5 interaction,
Karsenty is studying the chain of molecular events that is triggered
by that interaction.
"We are looking for interactions within the cell, from
the gene downstream," he says.
One great surprise is that LRP5 has such an important role in
bone regulation, Karsenty says. "It is expressed almost everywhere
all the time, and is not controlled by any of the hormones we
know about," he says.
What To Do: You can learn what we know about osteoporosis
and its treatment from the National
Library of Medicine or the National
Osteoporosis Foundation.
Reference
Source 101
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