Discussion:
Bone weakening by PPI meds may not be about calcium absorption but a deeper drug effect.
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trigonometry1972@gmail.com |
2012-04-29 17:00:29 UTC
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The title is my comment on the following article/study.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179281/?tool=pubmed
trigonometry1972@gmail.com |
2012-04-29 17:19:24 UTC
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Post by ***@gmail.com |
The title is my comment on the following article/study.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179281/?tool=pubmed
Of course there is also this suggestion from other researchers:

1. Int J Mol Med. 2010 Dec;26(6):877-83.

Effect of omeprazole on the expression
of transcription factors in osteoclasts
and osteoblasts.

Hyun JJ, Chun HJ, Keum B, Seo YS, Kim YS,
Jeen YT, Lee HS, Um SH, Kim CD, Ryu HS,
Kim SG, Jung WW.

Division of Gastroenterology and Hepatology,
Department of Internal Medicine,
Korea University Anam Hospital,
126-1 Anamdong 5-ga, Seoul, Korea.

The use of proton pump inhibitors (PPIs) seems to be
related to increased fracture risk but the mechanism
is unclear. In an effort to clarify the
mechanism, we evaluated the effect of omeprazole,
a representative of the PPIs,
on the expression of transcription factors in
osteoclasts and osteoblasts. Murine
RAW264.7 and MC3T3-E1 cells were used for osteoclast
and osteoblast analysis, to which various concentrations
of omeprazole were added. RAW264.7 cells with ≥3
nuclei were considered tartrate-resistant acid
phosphatase (TRAP)-positive, i.e. activated osteoclasts.
Expressions of the calcitonin receptor (CTR), c-fos,
nuclear factor of activated T-cells,
cytoplasmic 1 (NFATc1), and matrix
metalloproteinase (MMP)-9 mRNA in osteoclasts
were evaluated. Gene expression of
osteocalcin and of the osteoprotegerin/receptor
activator of NF-κB ligand (OPG/RANKL) ratio in osteoblasts
was examined and Western blotting of NFATc1 was
performed. Treating the osteoclasts with increasing
doses of omeprazole did not affect TRAP positivity,
but significantly decreased the expressions of CTR,
c-fos, NFATc1, and MMP-9 regardless of the
omeprazole concentration. The expression of osteocalcin
and of the OPG/RANKL ratio in osteoblasts was augmented
with increasing omeprazole concentrations.
The result of the Western blot analysis with NFATc1
was similar to that of the expression of NFATc1 mRNA.
Omeprazole decreased the activation of osteoclasts
but increased that of osteoblasts in vitro, in part
causing an osteopetrosis-like effect. Together with
the effect of omeprazole on calcium homeostasis,
increased fracture risk may be
due to the osteopetrorickets-like effect of omeprazole.

PMID: 21042782 [PubMed - indexed for MEDLINE]
trigonometry1972@gmail.com |
2012-04-29 17:10:49 UTC
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Post by ***@gmail.com |
The title is my comment on the following article/study.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179281/?tool=pubmed
additional ideas in the above paper worth thinking about:

This is a quote for the above mentioned:

"PPIs might increase the risk of osteoporotic fracture by several
mechanisms.
PPI use can cause vitamin B12 deficiency,(42) which might indirectly
increase the risk of fracture by causing peripheral neuropathy
and increased falls or by causing high homocysteine levels
with adverse effects on cross-linking of bone collagen.(43–47)
Additionally, PPI therapy might decrease absorption of protein,
(48) with potential long-term adverse effects on bone health.
Bacterial overgrowth also can complicate prolonged
PPI therapy(30,49) and might alter absorption of nutrients,
contributing to fracture risk."

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