| The Changes of Cytokines and Bone Mineral Density after Bone Marrow Transplantation |
| 조혈모세포이식 후 사이토카인과 골밀도의 변화 및 상관관계 |
| 백기현,이원영,오은숙,김혜수,한제호,강무일,이광우,손호영,강성구,김춘추1 |
| 가톨릭대학교 의과대학 내과학교실, 조혈모세포이식센터1 |
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| Abstract |
Background
Low bone mineral density has been reported in patients after bone marrow transplantation. High dose chemotherapy, cyclosporine therapy and glucocorticoids all predispose to osteopenia by suppressing bone formation and increasing bone resorption in post BMT patients. Furthermore, sex hormone deficiency increases bone loss in its own right, and occurs commonly in women after BMT. We recently reported that the progressive increase of bone resorption after BMT is related with the increase of bone marrow IL-6. We prospectively studied bone mineral density in a group of subjects following allogenic BMT to examine whether cytokine changes influence bone loss.
Methods
Forty six subjects who had received allogenic BMT were examined. Bone turnover markers and serum cytokines (IL-6, TNF-) were measured before and 1, 2, 3, 4 week and 3 months after BMT. We measured BMD before BMT and post BMT 1 year. The correlation between cytokine changes and BMD changes was analyzed.
Results
Serum ICTP, bone resorption marker, increased progressively until 4 weeks after BMT and then decreased thereafter. Serum osteocalcin, bone formation marker, decreased progressively until 3 weeks after BMT and then increased thereafter. There was a negative correlation between serum IL-6 levels at the post-BMT 3 weeks and changes of lumbar spine BMD from baseline (r=-0.59, p=0.01). Negative correlation was also found between serum TNF- levels at the post-BMT 3 weeks and changes of lumbar spine BMD from baseline (r=-0.54, p<0.05). There was a significant negative correlation between the cumulative steroid dose and the percent changes from baseline in bone mineral density at lumbar spine and proximal femur (r=-0.61, p<0.01, r=-0.55, p=0.01).
Conclusion
Our data suggest that the bone loss after BMT is related to both steroid dose and the increase of IL-6 and TNF- which are potent stimulators of bone resorption in vivo.
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| Key Words:
Bone marrow transplantation, Osteoporosis, Cytokines, Bone mineral density |
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