慢性腎不全・血液透析患者の二次性上皮小体機能亢進症における骨形態計測所見とIL-1β

概要

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The pathogenesis of renal osteodystrophy (ROD) in patients with chronic renal failure and dialysis patients have not yet been clearly defined. The complexity of ROD will require both bone morphometric and molecular biological approaches to expand our understanding of this problem. In the present study, the relationship of bone morphometry to interleukin-1β(IL-1β) in hyperpara-thyroidism (HPT) secondary to chronic renal failure was examined. Iliac crest bone biopsies for histomorphometry were taken from 10 patients with II°HPT and from a control group of 10 young women who underwent rotational acetabular osteotomy (RAO). A real-time image analyzer (Lusex F, Nireco Co., Tokyo, Japan) was used for the histomorphometry; reverse transcription polymerase chain reaction (RT-PCR) was used to confirm the mRNA of IL-1β produced by bone marrow cells. We found more massive osteoid tissue, more active cytogenesis of osteoclasts and osteoblasts and a higher turnover rate of bone resorption and formation in the II°HPT group than in the control group. Expression of IL-1β was confirmed in all 10 (100%) II°HPT patients, but in only 2 (20%) of the normal controls. This study suggests that IL-1β may promote active bone resorption in the high serum levels of parathyroid hormone found in dialysis patients.
東京女子医科大学の論文
1998-02-25