Published online 13 March 2009
Haematologica, Vol 94, Issue 5, 725-728 doi:10.3324/haematol.2008.000893
Copyright © 2009 by Ferrata Storti Foundation
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Thalassemia Syndromes

Serum Dickkopf-1 is increased and correlates with reduced bone mineral density in patients with thalassemia-induced osteoporosis. Reduction post-zoledronic acid administration

Ersi Voskaridou1, Dimitrios Christoulas2, Charoula Xirakia1, Konstantinos Varvagiannis1, Georgios Boutsikas2, Antonios Bilalis1, Efstathios Kastritis3, Athanasios Papatheodorou2, Evangelos Terpos2

1 Thalassemia Center, Laikon General Hospital, Athens
2 Department of Medical Research, 251 General Air Force Hospital, Athens
3 Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece

Correspondence: Evangelos Terpos, Department of Medical Research, 252 General Air Force Hospital, 3 Kanellopoulou street, GR-11526, Athens, Greece. E-mail:eterpos{at}hotmail.com

Dickkopf-1 is an inhibitor of Wnt signaling, which is crucial for osteoblast differentiation. We evaluated serum levels of Dickkopf-1 in 66 patients with thalassemia-induced osteoporosis who received therapy with zoledronic acid in a placebo-controlled, randomized trial. At baseline, thalassemia patients had increased serum levels of Dickkopf-1 that correlated with reduced bone mineral density of the lumbar spine and the distal radius. High Dickkopf-1 also correlated with increased bone resorption and reduced bone formation markers. Zoledronic acid produced a reduction in serum Dickkopf-1, which was associated with bone mineral density increase after 12 months of therapy. On the contrary, placebo group showed a borderline increase of Dickkopf-1, which was higher in patients who showed deterioration in pain scores. These results suggest that Dickkopf-1 is implicated in the pathogenesis of osteoporosis in thalassemia and reveal Dickkopf-1 as a possible target for the development of novel agents for the management of thalassemia-induced osteoporosis (ClinicalTrials. govIdentifier: NCT00346242).

Key words: thalassemia, osteoporosis, Dickkopf-1, osteoblast, zoledronic acid.




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Haematologica, August 1, 2009; 94(8): 1182 - 1182.
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