rifampin and Osteolysis

Topics: Animals; Anti-Bacterial Agents; Arthritis, Infectious; Disease Models, Animal; Inflammation; Mice; Osteolysis; Rifampin

Wear particles liberated from the surface of prostheses are considered to be main reason for osteoclast bone resorption and that extensive osteoclastogenesis leads to peri-implant osteolysis and subsequent prosthetic loosening. The aim of this study was to assess the effect of rifampin on osteoclastogenesis and titanium (Ti) particle-induced osteolysis. The Ti particle-induced osteolysis mouse calvarial model and bone marrow-derived macrophages (BMMs) were used. Rifampin, at dose of 10 or 50 mg/kg/day, was respectively given intraperitoneally for 14 days in vivo. The calvariae were removed and processed for Further histological analysis. In vitro, osteoclasts were generated from mouse BMMs with receptor activator of nuclear factor-κB ligand (RANKL) and the macrophage colony stimulating factor. Rifampin at different concentrations was added to the medium. The cell viability, tartrate-resistant acid phosphatase (TRAP) staining, TRAP activity and resorption on bone slices were analysis. Osteoclast-specific genes and RANKL-induced MAPKs signaling were tested for further study of the mechanism. Rifampin inhibited Ti-induced osteolysis and osteoclastogenesis in vivo. In vitro data indicated that rifampin suppressed osteoclast differentiation and bone resorption in a dose-dependent manner. Moreover, rifampin significantly reduced the expression of osteoclast-specific markers, including TRAP, cathepsin K, V-ATPase d2, V-ATPase a3, c-Fos, and nuclear factor of activated T cells (NFAT) c1. Further investigation revealed that rifampin inhibited osteoclast formation by specifically abrogating RANKL-induced p38 and NF-κB signaling. Rifampin had significant potential for the treatment of particle-induced peri-implant osteolysis and other diseases caused by excessive osteoclast formation and function.

Topics: Animals; Cell Differentiation; Dose-Response Relationship, Drug; Gene Expression; Mice; NF-kappa B; Osteogenesis; Osteolysis; p38 Mitogen-Activated Protein Kinases; RANK Ligand; Rifampin; Signal Transduction; Titanium; X-Ray Microtomography

Topics: Antitubercular Agents; Biopsy; Carcinoma; Combined Modality Therapy; Diagnosis, Differential; Ethambutol; Female; Humans; Isoniazid; Lymphatic Diseases; Middle Aged; Mycobacterium tuberculosis; Osteolysis; Osteomyelitis; Pleural Effusion; Pleural Neoplasms; Pyrazinamide; Rifampin; Sputum; Sternum; Tomography, X-Ray Computed; Tuberculosis, Osteoarticular

A 72-year-old man presented with a 6-month history of low back and leg pain. Past medical history revealed transurethral resection of bladder cancer followed by multiple intravesical BCG instillation 12 years ago. Imaging studies of the thoracolumbar spine showed osteolysis of the L3 and L4 vertebrae and the associated intervertebral disc space, and a large soft tissue mass with signal abnormalities suggesting of an abscess. CT-guided needle biopsy showed Mycobacterium bovis infection. A triple anti-tuberculous chemotherapy regimen including isoniazid, rifampicin, and ethambutol was administered for 12 months. Surgical treatment included drainage of the abscess and L2-L5 spinal instrumentation and fusion. Intravesical BCG therapy may be complicated by late disseminated disease to the bone even many years after initial BCG therapy. Patients having BCG therapy should be closely evaluated thereafter for the possibility of hematogenous spread of mycobacteria to distant sites.

Topics: Administration, Intravesical; Aged; Antitubercular Agents; BCG Vaccine; Drug Therapy, Combination; Epidural Abscess; Ethambutol; Humans; Isoniazid; Lumbar Vertebrae; Male; Mycobacterium bovis; Osteolysis; Osteomyelitis; Rifampin; Spinal Fusion; Treatment Outcome; Tuberculosis, Spinal

We identified Mycobacterium tuberculosis DNA using real-time polymerase chain reaction on a specimen from an osteolytic lesion of a femoral condyle, in which the frozen section demonstrated granulomas. The process was much more rapid than is possible with culture. The rapid detection of M tuberculosis and the concomitant exclusion of granulomatous disease caused by nontuberculous mycobacteria or systemic fungi are necessary to appropriately treat skeletal tuberculosis. The detection and identification of M tuberculosis by culture may require several weeks using traditional methods. The real-time polymerase chain reaction method used has been shown to be rapid and reliable, and is able to detect and differentiate both tuberculous and nontuberculous mycobacteria. Real-time polymerase chain reaction may become a diagnostic standard for the evaluation of clinical specimens for the presence of mycobacteria; this case demonstrates the potential utility of this assay for the rapid diagnosis of skeletal tuberculosis.

Topics: Antitubercular Agents; Bacterial Typing Techniques; DNA, Bacterial; Drug Therapy, Combination; Ethambutol; Female; Femur; Humans; Isoniazid; Middle Aged; Mycobacterium tuberculosis; Osteolysis; Pyrazinamide; Reverse Transcriptase Polymerase Chain Reaction; Rifampin; Tuberculosis, Osteoarticular

Isolated tuberculosis of the sacrum in a 43-year-old woman manifested as functional impairment of the right lower limb. Sacral tuberculosis is rare in patients with no history of tuberculosis. Another unusual feature was the tumor-like aspect of the lesion, with diffuse, ill-defined osteolysis of a large part of the sacrum and extension to the presacral soft tissues responsible for rectal displacement.

Topics: Adult; Antitubercular Agents; Chordoma; Diagnosis, Differential; Female; Humans; Isoniazid; Osteolysis; Rifampin; Sacrum; Spinal Cord Neoplasms; Tomography, X-Ray Computed; Tuberculosis, Spinal