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Abstract Number: 1039

Tenofovir Induces Osteopenia and Dipyridamole, an Inhibitor of the Ent-1 Nucleoside Transporter, Reverses the Osteopenic Effect of Tenofovir In Vivo

Francisco Miguel Conesa-Buendia1, Patricia Llamas2, Tuere Wilder3, Raquel Largo4, Gabriel Herrero-Beaumont4, Bruce N. Cronstein5 and Aranzazu Mediero6, 1Bone and Joint Research Unit, IIS-Fundacion Jimenez Diaz- UAM, Madrid, Spain, 2Bone and Joint Research Unit, IIS-Fundacion Jimenez Díaz-UAM, Madrid, Spain, 3Department of Medicine, Division of Rheumatology, NYU School of Medicine, New York, NY, 4Bone and Joint Research Unit, Fundación Jiménez Díaz University Hospital & Health Research Institute, Madrid, Spain, 5Rheumatology, New York University School of Medicine, Division of Rheumatology, New York, NY, 6Joint and Bone Research Unit, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Adenosine receptors, Animal models, Drug toxicity, osteoporosis and treatment

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Session Information

Date: Monday, October 22, 2018

Session Title: Osteoarthritis and Joint Biology – Basic Science Poster I

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

Osteopenia and fragility fractures have been associated with HIV infection. Tenofovir, one of the most commonly used antivirals in HIV, also leads to increases in bone catabolism markers and decreased bone mineral density (BMD) in children and young adults. In murine models and human cell lines, Tenofovir inhibits ATP release and decreases extracellular adenosine levels. Adenosine, acting at its adenosine A2A and A2B receptors, inhibits osteoclast formation, and increasing local adenosine concentration with Dipyridamole, an agent that blocks adenosine cellular uptaken, stimulates new bone formation as well as rhBMP-2 by an A2A receptor-dependent effect. We hypothesized that Tenofovir regulates bone resoprtion by diminishing endogenous adenosine levels and determined whether Dipyridamole could counteract the deleterious effects of Tenofovir on bone.

Methods: Male C57Bl/6 mice were treated as follows: IP injection of saline (control), Tenofovir 75mg/Kg/day, Dipyridamole 25mg/Kg/day, combination Tenofovir/Dipyridamole (n=10, 4 weeks). Female C57Bl/6 mice were ovariectomized and treated as follow: sham (no surgery), saline (control), Tenofovir 75mg/Kg/day, Dipyridamole 25mg/Kg/day, combination Tenofovir/Dipyridamole (n=10, 5 weeks). Weekly weight was annotated. DXA scanning was performed before sacrifice. Calcein/AlizarinRed-labelling of newly formed bone was used, and long bones were prepared for microCT/histology.

Results:

Male mice treated with Tenofovir lost nearly 10% of body weight (p<0.001). DXA scanning showed a decrease in BMD in mice treated with Tenofovir that was reversed with Dipyridamole. microCT revealed decreased BMD and diminished trabecular bone in Tenofovir-treated mice and reversal by Dipyridamole treatment. TRAP-staining showed increased osteoclasts in Tenofovir-treated mice (p<0.005) an effect reversed by Dipyridamole. Similar results were obtained for Cathepsin K and CD68. RANKL-positive-cells were increased in Tenofovir-treated mice whereas OPG-positive-cells decreased, and both effects were reversed by Dipyridamole. In the case of female OVX mice, Tenofovir treatment also produced a decreased in body weight (p<0.05) that was reversed with Dipyridamole. DXA scanning showed decreased BMD in Tenofovir-treated mice and microCT revealed diminished trabecular bone, similar to findings in male mice. Similar results were found for Cathepsin K, CD68, RANKL and OPG-positive-cells.

Conclusion: These results suggest that treatment with agents that increase local adenosine concentrations, like Dipyridamole, might prevent bone loss following Tenofovir treatment.


Disclosure: F. M. Conesa-Buendia, None; P. Llamas, None; T. Wilder, None; R. Largo, None; G. Herrero-Beaumont, None; B. N. Cronstein, Cantic Biopharma, Regenosine, 1,NIH Arthitis foundation, Astrazeneca, 2,Horizon Pharmaceuticals, Regenosine, 5,Patent issued and pending, 9; A. Mediero, CP15/00053 PI16/0991, 2, 9.

To cite this abstract in AMA style:

Conesa-Buendia FM, Llamas P, Wilder T, Largo R, Herrero-Beaumont G, Cronstein BN, Mediero A. Tenofovir Induces Osteopenia and Dipyridamole, an Inhibitor of the Ent-1 Nucleoside Transporter, Reverses the Osteopenic Effect of Tenofovir In Vivo [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/tenofovir-induces-osteopenia-and-dipyridamole-an-inhibitor-of-the-ent-1-nucleoside-transporter-reverses-the-osteopenic-effect-of-tenofovir-in-vivo/. Accessed March 21, 2023.
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