Drugs like prednisone can weaken our bones and so can aging, and scientists working to prevent both have some of the first evidence that the best target may not be the logical one.
In a new study from the Medical College of Georgia, researchers found that in aging bone, the mineralocorticoid receptor, better known for its role in blood pressure regulation, is a key factor in bone health.
And drugs that block the receptor, like the hypertension medications spironolactone and eplerenone, may help protect bone cells.
Drugs like prednisone are glucocorticoids, which are better known for their roles in reducing inflammation and suppressing the immune response, which is why they work so well for problems like irritable bowel syndrome and arthritis.
But, like aging, they can also disrupt the healthy, ongoing dynamic of bone being made and being destroyed.
Our natural glucocorticoid levels increase with age, and bone, at least when we are young, has more glucocorticoid receptors than mineralocorticoid receptors.
Glucocorticoids can actually coax stem cells to make bone-forming osteoblasts, but it also causes those osteoblasts to store more fat, and too much fat in the bone, like anywhere on our body, is probably not good and typically correlates with bone loss.
So reducing the impact of glucocorticoid receptors seemed like a logical way to protect bone.
In the study, the team found that when the glucocorticoid receptor was blocked, older mice also experienced more fat accumulation in the bone marrow and worsening bone disease.
They also found that the mice had a smaller muscle mass, chose to move around less than mice typically do and had higher blood pressure.
Another surprise was that when they used drugs to inhibit the mineralocorticoid receptor, many of the problems were reversed.
The researchers already have some evidence that bone’s expression of mineralocorticoid receptors goes up, potentially significantly, as you age.
The whole body impact they saw from their manipulation of receptors, like a higher blood pressure from deleting the glucocorticoid receptor, also is evidence of bone’s importance as an endocrine organ.
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The study is published in the Journal of Bone and Mineral Research and was conducted by Dr. Meghan E. McGee-Lawrence et al.
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