Hosla works with biomechanical experts mayo

When it comes to the bones and makes them break down, Mayo Clinic researchers have a habit of destroying common sense. It was Mayo researchers in the early 1970's, first identified osteoporosis as prevent and treat the disorder, not an inevitable consequence of aging. Further investigation of osteoporosis focus on women and estrogen, a hormone that regulates the metabolism of women's bones. Testosterone, the primary male lasix fluid pill sex hormone, it is supposed to regulate bone metabolism in men. But ten years ago, endocrinologist, made another profound discovery that estrogen regulates bone metabolism in men and women. In addition, lower levels of estrogen can lead to osteoporosis in older men as well as in postmenopausal women. [

J. Clin. Invest. (2000) 106 (12), 1553-1560]. Dr. Khoslas to the conclusion that men have to estradiol, the primary form of estrogen, drew attention to osteoporosis in men. Now, working with other researchers Mayo, Dr. Khoslas laboratory teams disclosure decisions. This fact leads to some important changes in our diagnostic assessment and possibly treatment approaches for people with osteoporosis, the doctor says Hosla. Although many doctors continue to focus on testosterone levels in men with symptoms of osteoporosis, we really should look at the level of estradiol in these men, says Dr. Hosla. Measurement of estradiol in older men may be a useful tool to identify those at increased risk of bone loss and fractures. Translation of basic science, such as Dr. Khoslas study of estrogen in the treatment of patients is the cornerstone of Mayos approach to medicine. Laboratory discoveries lead to innovative therapies, patients need to raise questions about cell structure and making recommendations to improve visualization technology. In such diseases as osteoporosis treated with all these angles, the results are amazing. Progress in the last 10 to 15 years has been enormous, says Dr. Hosla. Our understanding of how bone is regulated exploded, and with this came a number of new treatments. Theres a great excitement in osteoporosis. Although aging men have only about one-third fracture rate in postmenopausal women, the number of men affected is still high. About one in eight men over age 50 will suffer osteoporotic fractures. In addition, the consequences can be serious in men, they are twice as likely than women to die in the hospital after hip fracture. About 20 percent of people with hip fracture die within one year after injury. Dr. Hosla believes that his team results in osteoporosis in men among the most significant works. After the first discovery, the researchers want to know exactly how estrogen regulates bone metabolism. They studied the knockout mice in which estrogen receptors, which promote bone growth, could not bind to DNA. Blocking estrogen receptors were very strong effect on bone, especially in men, says Dr. Hosla. In contrast, postmenopausal women, most men feel DONT sharp decline in estrogen levels. However, subgroups of men may be estrogen-deficient, such as patients with prostate cancer. Treatment of prostate cancer requires the suppression of testosterone production. Since the majority of estrogen in men converted from testosterone, suppression of testosterone and lowers estrogen. Low estrogen can cause compression fractures of vertebral and hip fractures, which in turn can lead to severe disability and even death from complications of the fracture. Thus, although suppression of testosterone treat patients with prostate cancer, you really affect their quality of life, the doctor says Hosla. At Mayo, patients with prostate cancer is often called osteoporosis specialists. There are many reasons to have their bone density can be treated, says the Mayo Clinic urologist R. Jeffrey Karnes, MD when they were active, they do not develop symptoms. Its a phenomenon that really begins to weave its way into the tissue therapy of advanced prostate cancer. In women with osteoporosis, are often seen together with a group of drugs known as selective estrogen receptor modulators. SERMs stimulate estrogen-like action in tissues. Because too much estrogen can cause feminization of male effects such as breast augmentation, FDA has not approved SERMs for use in men. But Dr. Khoslas team conducted the first study SERM in males, and the results were significant: The drug, called raloksifen had a protective effect on bone without the side effects of feminization. The results show that estrogen-deficient treatment of men with selective estrogen receptor modulators have been useful option. Research Raloxafine gave another interesting result. The drug has little effect on bone density in men with normal levels of estradiol, reducing bone breakdown was seen mainly in estrogen-deficient men. Thus, above a certain threshold, adding estrogenic activity as treatment does not help, says Dr. Hosla. But if you're really low in estrogen, and then giving estrogen-like compounds is, in fact, help. Find this threshold is important not only for patients but also in containing health care costs. There are going to be many treatment options for patients with osteoporosis. But some of them are quite expensive, says Dr. Hosla. So you really need to identify those at greatest risk, and target them for these expensive treatments. Another help identify patients at risk, as male and female, better visualization technology. Currently, a method called DEXA (dual energy x-ray absorbtsiometriya) measures bone density, but can assess bone structure or strength. If you're going to put a bridge across the chasm, and you used only two-dimensional board, which may be analogous to DEXA, says scientist and biomedical engineer computer Mayo. If you raise the bridge from the columns and cross-levels and supports a much more three-dimensional structure that may be analogous to bone volume CT. Dr. Robbie collaborating with Hosla laboratory for development and analysis of high-tech 3D-images. The bridge analogy is particularly appropriate because, like bridges, bone strength is related to its three-dimensional structure. We look at the entire volume of the bone, Dr. Robbie says, including external and internal cortex trabekulyarnoy tissue, as both play an important role in bone strength. Using mathematical algorithms and finite element models such as those that engineers use to predict the strength of cities, Dr. Robbsu team can quantify volumetric bone density and calculate the biomechanical parameters related to risk of fractures due to age, sex and hormonal. We can simulate patient specific 3D-scanning information and calculate the risk of fractures, Dr. Robbie says. Another diagnostic tool computer simulation of various types of falls. Dr. Hosla works with biomechanical experts Mayo to create these models can help researchers determine how bones break. If you can understand that, then maybe you can understand what types of treatment should be targeted to specific defects in the bone, the doctor says Hosla. Cooperation between engineers and doctors is common in Mayo. It is interesting to be scientific or engineer working in Mayo, doctor says Robbie. Theres just a natural ability to communicate with doctors and surgeons in the building decisions were mutually interested during all patient care a lot of basic science and technology. Indeed, the list of colleagues Dr. Khoslas study reads as a catalog of scientific and medical departments: biomedical engineering, biomechanics, cell biology and radiology, to name only some. If you like to do what I do, that looking at issues such as osteoporosis at various levels, you just do not have the skills to do it all. No one doctor says Hosla. He quickly credit young scientists, who managed his laboratory on a daily basis, allowing him time to treatment and control laboratories of numerous projects. For Dr. Hosla, dual role of doctor and researcher inseparable. I love that their patients. That's why I became a doctor, he says. In addition, the interaction is essential for my research. It keeps me in tune with current clinical issues. Thats, and what makes work fun for Mayo, he adds. The environment is very difficult to play. There's no place else I can work as efficiently as I do here. Barbara Toman, December 2009.