Cinacalcet Improves Bone Parameters Through Regulation of Osteoclast Endoplasmic Reticulum Stress, Autophagy, and Apoptotic Pathways in Chronic Kidney Disease–Mineral and Bone Disorder

• Published in: Journal of bone and mineral research Vol. 37; no. 2; pp. 215 - 225
• Main Authors: Chiu, Hui‐Wen, Hou, Yi‐Chou, Lu, Chien‐Lin, Lu, Kuo‐Cheng, Liu, Wen‐Chih, Shyu, Jia‐Fwu, Chang, Jia‐Feng, Zheng, Cai‐Mei
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2022; Wiley Subscription Services, Inc
• Subjects: Adenosine kinase; AKT protein; AMP; Animals; Apoptosis; AUTOPHAGY; Body weight; Bone diseases; Caspase; Cell Differentiation; Chronic Kidney Disease-Mineral and Bone Disorder - drug therapy; Chronic Kidney Disease-Mineral and Bone Disorder - metabolism; CHRONIC KIDNEY DISEASE‐MINERAL AND BONE DISORDER; CINACALCET; Cinacalcet - pharmacology; Cinacalcet - therapeutic use; Computed tomography; Endoplasmic reticulum; ENDOPLASMIC RETICULUM STRESS; Kidney diseases; Kinases; Mechanical properties; Mice; OSTEOCLASTS; Osteoclasts - metabolism; OSTEOCLASTSAPOPTOSIS; RANK Ligand - metabolism; Rapamycin; Signal transduction; TOR protein; TRANCE protein; X-Ray Microtomography; CHRONIC KIDNEY DISEASE-MINERAL AND BONE DISORDER; OSTEOCLASTS; AUTOPHAGY; CINACALCET; ENDOPLASMIC RETICULUM STRESS; OSTEOCLASTSAPOPTOSIS
• ISSN: 0884-0431; 1523-4681
• DOI: 10.1002/jbmr.4459

ABSTRACT The possible mechanisms underlying the quantitative and qualitative effects of cinacalcet on bone were explored in a chronic kidney disease–mineral and bone disorder (CKD‐MBD) mouse model in relation to the influence of the interactions among the osteoclast (OC) endoplasmic reticulum (ER) stress, autophagy and apoptosis pathways on OC differentiation. Body weight and biochemical parameters improved significantly in the CKD + cinacalcet groups compared to the CKD group. Micro–computed tomography (μCT) revealed both cortical and trabecular parameters deteriorated significantly in the CKD group and were reversed by cinacalcet in a dose‐dependent manner. Nanoindentation analysis of bone quality proved that both cortical hardness and elastic modulus improved significantly with high dose cinacalcet treatment. In vitro studies revealed that cinacalcet inhibited receptor activator of NF‐κB ligand (RANKL)/receptor activator of NF‐κB (RANK)–induced OC differentiation in a concentration‐dependent manner through a close interaction between activation of caspase‐related apoptosis, reversal of OC autophagy through the protein kinase B (Akt)/mammalian target of rapamycin (mTOR) and adenosine monophosphate–activated protein kinase (AMPK) pathways, and attenuation of the OC ER stress/CREBH/NFATc1 signaling pathway. Cinacalcet improves both bone quantity and bone quality in CKD mouse model and inhibits OC differentiation through regulation of the interactions among the apoptosis, ER stress, and autophagy pathways within OCs. © 2021 American Society for Bone and Mineral Research (ASBMR).