Short time administration of antirheumatic drugs - Methotrexate as a strong inhibitor of osteoblast´s proliferation in vitro

Introduction: Due to increasing use of disease modifying antirheumatic drugs (DMARDs) as first line therapy in rheumatic diseases, dental and maxillofacial practitioner should be aware of drug related adverse events. Especially effects on bone-metabolism and its cells are discussed controversially....

Authors: Annussek, Tobias
Kleinheinz, Johannes
Szuwart, Thomas
Joos, Ulrich
Wermker, Kai
Division/Institute:FB 05: Medizinische Fakultät
Document types:Article
Media types:Text
Publication date:2012
Date of publication on miami:10.03.2013
Modification date:23.01.2020
Edition statement:[Electronic ed.]
Source:Head & Face Medicine 8 (2012) 26
Subjects:Antirheumatic drugs; Methotrexate; Osteoblast; In vitro; Bone metabolism
DDC Subject:610: Medizin und Gesundheit
License:CC BY 3.0 DE
Language:English
Notes:Finanziert durch den Open-Access-Publikationsfonds 2012/2013 der Deutschen Forschungsgemeinschaft (DFG) und der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format:PDF document
URN:urn:nbn:de:hbz:6-07369586959
Permalink:http://nbn-resolving.de/urn:nbn:de:hbz:6-07369586959
Other Identifiers:DOI: 10.1186/1746-160X-8-26
Digital documents:1746-160X-8-26.pdf

Introduction: Due to increasing use of disease modifying antirheumatic drugs (DMARDs) as first line therapy in rheumatic diseases, dental and maxillofacial practitioner should be aware of drug related adverse events. Especially effects on bone-metabolism and its cells are discussed controversially. Therefore we investigate the in vitro effect of short time administration of low dose methotrexate (MTX) on osteoblasts as essential part of bone remodelling cells. Methods: Primary bovine osteoblasts (OBs) were incubated with various concentrations of MTX, related to tissue concentrations, over a period of fourteen days by using a previously established standard protocol. The effect on cell proliferation as well as mitochondrial activity was assessed by using 3-(4, 5-dimethylthiazol-2-yl) 2, 5-diphenyltetrazolium bromide (MTT) assay, imaging and counting of living cells. Additionally, immunostaining of extracellular matrix proteins was used to survey osteogenic differentiation. Results: All methods indicate a strong inhibition of osteoblast`s proliferation by short time administration of low ose MTX within therapeutically relevant concentrations of 1 to 1000nM, without affecting cell differentiation of middle-stage differentiated OBs in general. More over a significant decrease of cell numbers and mitochondrial activity was found at these MTX concentrations. The most sensitive method seems to be the MTT-assay. MTX-concentration of 0,01nM and concentrations below had no inhibitory effects anymore. Conclusion: Even low dose methotrexate acts as a potent inhibitor of osteoblast’s proliferation and mitochondrial metabolism in vitro, without affecting main differentiation of pre-differentiated osteoblasts. These results suggest possible negative effects of DMARDs concerning bone healing and for example osseointegration of dental implants. Especially the specifics of the jaw bone with its high vascularisation and physiological high tissue metabolism, suggests possible negative effects of DMARD therapy concerning oral and cranio-maxillofacial bone surgery as could be seen in a similar way in bisphosphonate related osteonecrosis of the jaw.