Administration of low intensity vibration and a RANKL inhibitor, alone or in combination, reduces bone loss after spinal cord injury-induced immobilization in rats

Bone Reports, 2024 · DOI: https://doi.org/10.1016/j.bonr.2024.101808 · Published: October 2, 2024

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

This study investigates methods to combat bone loss following spinal cord injury (SCI) in rats. It focuses on low-intensity vibration (LIV) and a RANKL inhibitor, both separately and combined. The research demonstrates that LIV, especially when combined with a RANKL inhibitor, can effectively protect against bone loss after SCI. This is achieved by promoting bone formation and reducing bone resorption. The combined approach offers a potential non-invasive and cost-effective treatment strategy for bone loss associated with SCI and severe immobilization.

Study Duration

8 weeks

Participants

Male Sprague Dawley rats

Evidence Level

Not specified

Key Findings

1
LIV stimulates bone formation and improves osteoblast differentiation potential of bone marrow stromal stem cells.
2
LIV inhibits osteoclast differentiation potential of marrow hematopoietic progenitors to reduce bone resorption.
3
The combination of LIV and RANKL antibody reduces SCI-related bone loss more than each intervention alone.

Research Summary

This study demonstrates that a prolonged course of LIV that initiated at 2 weeks post-injury and continued for 8 weeks can protect against bone loss after SCI in rats. LIV stimulates bone formation and improves osteoblast differentiation potential of bone marrow stromal stem cells while inhibiting osteoclast differentiation potential of marrow hematopoietic progenitors to reduce bone resorption. Our findings that LIV is efficacious in maintaining sublesional bone mass suggests that such physical-based intervention approach would be a noninvasive, simple, inexpensive and practical intervention to treat bone loss after SCI.

Practical Implications

Clinical Protocols

The study suggests the development of future clinical protocols based on physical activity (e.g., LIV) and pharmacological (e.g., RANKL inhibitor) approaches to prevent or reverse bone loss after SCI or other conditions associated with severe immobilization.

Treatment of Osteoporosis

The combined administration of LIV and RANKL inhibition provides a potential greater therapeutic efficacy for treating osteoporosis after SCI or other conditions associated with severe immobilization.

Non-Pharmacological Intervention

LIV is highlighted as a noninvasive, simple, inexpensive, and practical intervention to treat bone loss after SCI, offering an alternative or complementary approach to pharmacological treatments.

Study Limitations

1
RANKL inhibition may be immuno-suppression.
2
The study was only conducted on male rats.
3
Study design did not allow for examination of morphological substrates (e.g., lesion size, spared whiter matter)

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