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The Wolff’s Law On Bone Remodeling And Transformation, Part II

Sorry for the recent absence of new posts for the last 3-4 days. I took an extended break from the website but I am back now and will be getting more posts out. This post is the 2nd of two major articles I will use to talk about the Wolff’s Law of bone remodeling.

This article I have found and will post below shows that the old law of Wolff is not as scientifically valid as I thought. The article was written for the  AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY in 2006.

The critical thing about this article as that it completely objectively looks at how correct Wolff’s Law applies to actual bone loading. The hind leg loading of rodents are looked at again and we can see that this article can be used to analyze the feasibility and effectiveness of the Lateral Synovial Joint Loading technique.

The Link to the Document HERE. As always, I will highlight the most important parts of the article.


Who’s Afraid of the Big Bad Wolff?: ‘‘Wolff’s Law’’ and Bone Functional Adaptation

Christopher Ruff,1* Brigitte Holt,2 and Erik Trinkaus3

1Center for Functional Anatomy and Evolution, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
2Department of Anthropology, University of Massachusetts, Amherst, Massachusetts 01003 3Department of Anthropology, Washington University, St. Louis, Missouri 63130-4899

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ABSTRACT ‘‘Wolff’s law’’ is a concept that has some- times been misrepresented, and frequently misunder- stood, in the anthropological literature. Although it was originally formulated in a strict mathematical sense that has since been discredited, the more general concept of ‘‘bone functional adaptation’’ to mechanical loading (a designation that should probably replace ‘‘Wolff’s law’’) is supported by much experimental and observational data. Objections raised to earlier studies of bone functional adaptation have largely been addressed by more recent and better-controlled studies. While the bone morpholog- ical response to mechanical strains is reduced in adults relative to juveniles, claims that adult morphology reflects only juvenile loadings are greatly exaggerated. Similarly, while there are important genetic influences on bone development and on the nature of bone’s response to mechanical loading, variations in loadings themselves are equally if not more important in deter- mining variations in morphology, especially in compari- sons between closely related individuals or species. The correspondence between bone strain patterns and bone structure is variable, depending on skeletal location and the general mechanical environment (e.g., distal vs. proximal limb elements, cursorial vs. noncursorial ani- mals), so that mechanical/behavioral inferences based on structure alone should be limited to corresponding skele- tal regions and animals with similar basic mechanical designs. Within such comparisons, traditional geometric parameters (such as second moments of area and section moduli) still give the best available estimates of in vivo mechanical competence. Thus, when employed with appropriate caution, these features may be used to reconstruct mechanical loadings and behavioral differ- ences within and between past populations.

The idea that bone form reflects in some way its mechanical loading history during life is fundamental to many paleontological and bioarchaeological studies of skeletal material. While physical context and material culture give clues to past behavior, analysis of the skele- tons themselves is the most direct way to reconstruct individual behavior, and to explore intra- and interpopu- lational differences in behavior (e.g., Larsen, 1997; Drucker and Henry-Gambier, 2005; Scott et al., 2005). Reconstructions of body size and shape from skeletal remains are also dependent to some degree on assumed relationships between mechanical loadings and bone morphology (Ruff, 1995, 2003; Delson et al., 2000; Auer- bach and Ruff, 2004). The phenomenon of bone adapta- tion to imposed mechanical loadings is often loosely referred to as ‘‘Wolff’s law,’’ although as noted by others (Bertram and Swartz, 1991; Cowin, 2001b; Pearson and Lieberman, 2004; and see below), there are problems with this representation. Regardless of semantic issues, the general concept that bone adapts to its mechanical environment during life, and therefore that differences in morphology can be used to investigate differences in past mechanical environments, is widely accepted among paleoanthropologists and bioarchaeologists.

Several recent studies, however, beginning with the often-cited review by Bertram and Swartz (1991), called into question at least portions of ‘‘Wolff’s law’’ as it is generally understood (Forwood and Burr, 1993; Demes et al., 1998, 2001; Lovejoy et al., 2002, 2003; Ohman and Lovejoy, 2003; Lieberman et al., 2004; Pearson and Lie- berman, 2004). A number of issues have been raised, including the precise meaning of the ‘‘law,’’ the validity of the experimental evidence for bone functional adapta- tion, correspondence between in vivo strain measure- ments and bone structure, the genetic vs. environmental determinants of bone form, age dependency of bone func- tional response to loading, and whether skeletal mor- phology is mechanically ‘‘ideal.’’ Because the general con- cept of bone functional adaptation is so pervasive in bio- logical anthropology and indeed biology (Roesler, 1987), it is important to carefully evaluate these issues/objec- tions and their implications for current research approaches. We do so here, and attempt to clarify both the limits and potential of bone structural analyses. The emphasis here is on cortical bone distribution in long bone diaphyses, in part because most of the above stud- ies also focused on this aspect of skeletal form, and because this has been a very active area of anthropologi- cal research over the past several decades (e.g., Endo and Kimura, 1970; Kimura, 1971; Lovejoy et al., 1976; Jungers and Minns, 1979; Lovejoy and Trinkaus, 1980; Ruff and Hayes, 1983; Schaffler et al., 1985; Trinkaus and Ruff, 1989; Demes and Jungers, 1993; Ruff et al., 1993; Runestad, 1997; Trinkaus et al., 1999; Stock and Pfeiffer, 2001; Holt, 2003; Weiss, 2003; Beauval et al., 2005; Carlson, 2005). This list is not exhaustive; in fact, we make no attempt here to provide an encyclopedic review of recent literature on this general topic, which is voluminous (e.g., Martin et al., 1998; Cowin, 2001a; Pearson and Lieberman, 2004). Rather, we confine our- selves to key works that are specifically relevant to addressing the issues posed above and that provide his- torical context for the ideas of concern.

‘‘WOLFF’S LAW’’ VS. BONE FUNCTIONAL ADAPTATION

As noted by Cowin (2001b, p. 30–31), current usage of the term ‘‘Wolff’s law’’ usually involves only the general concept that ‘‘over time, the mechanical load applied to living bone influences the structure of bone tissue.’’ How- ever, he went on to point out that Wolff actually had something much more specific in mind, namely the for- mulation of strict mathematical rules governing this process, particularly with respect to the development of trabecular orientation in long bones (the ‘‘trajectorial theory’’), most famously expressed in the proximal femur. Wolff himself nicely summarized this argument in the introduction to his 1892 treatise (Wolff, 1892; translation in Wolff, 1986, p. 1): ‘‘Thus the law of bone remodeling is the law according to which alterations of the internal architecture clearly observed and following mathematical rules, as well as secondary alterations of the external form of the bone following the same mathematical rules, occur as a consequence of primary changes in the shape and stressing or in the stressing of the bones.’’

Many authors criticized Wolff ’s mathematical treat- ment of bone modeling/remodeling, which involved both engineering and biological misconceptions (for historical reviews, see Roesler, 1981, 1987; Martin et al., 1998; Cowin, 2001b). The ‘‘false premise in Wolff’s law’’ dis- cussed by Cowin (2001b) involves modeling real bones as solid, homogeneous, and isotropic structures subjected to static applied loads, which is strictly incorrect. However, neither Cowin (2001b) nor any of the other recent authors who critiqued Wolff’s law denied the importance of mechanical loading in the development of bone form, i.e., the more ‘‘general’’ version. This is an important point, since the two versions have sometimes been confused. For example, the critique by Cowin (2001b) (of the strict version) was cited by Currey (2002, p. 159) (again with reference to the strict version), who in turn was quoted by Ohman and Lovejoy (2003) in their more general critique of Wolff’s law. This confounding of the more general with the more specific version of the ‘‘law’’ unnecessarily con- fuses the issue: like many others, neither Cowin (2001b) nor Currey (2002) intended their critiques to imply a nega- tion of the general version; both authors have, in fact, spent most of their careers refining our knowledge of mechanically adaptive mechanisms in bone.

Given this potential confusion, it may be better to sim- ply discard the term ‘‘Wolff’s law’’ in its more general sense, as recommended recently by several authors (Martin et al., 1998; Cowin, 2001b; Pearson and Lieber- man, 2004). Following the original lead of Roux (1881), taken up by more recent investigators (Churches and Howlett, 1982; Cowin et al., 1985; Lanyon and Rubin, 1985), the term ‘‘bone functional adaptation’’ seems appropriate for this more general meaning. As summar- ized by Roesler (1981), the writings of Roux (1881) incor- porated two important principles: 1) organisms possess the ability to adapt their structure to new living condi- tions, and 2) bone cells are capable of responding to local mechanical stresses. Although not without their own problems (Roesler, 1981), the ideas of Roux (1881) encap- sulate much of the more general concept of bone func- tional adaptation as understood today. (In fact, as noted by Cowin (2001b), some researchers suggest renaming the more general version of Wolff’s law ‘‘Roux’s law.’’)

Figure 1 is a schematic diagram, taken from Lanyon (1982), of perhaps the simplest representation of bone functional adaptation in a more modern sense (see also Lanyon and Skerry, 2001). The bone modeling/remodel- ing stimulus is based on strain (not stress)—the actual physical deformation of the bone tissue—and acts through feedback loops. Increased strain (e.g., through an increase in activity level) leads to deposition of more bone tissue, which then reduces strain to its original ‘‘optimum customary level.’’ Decreased strain (e.g., through inactivity) leads to resorption of bone tissue, which again restores the original strain levels. Many other authors have embraced the general idea of a ‘‘cus- tomary’’ or ‘‘equilibrium’’ strain level window above which bone deposition is stimulated and below which resorption is stimulated (e.g., Carter, 1984; Frost, 1987; Turner, 1998), although there are many qualifications to and variations on this general model. One of the most important qualifications is that the ‘‘customary strain level’’ to which bone tissue is adapted is apparently not constant, but varies by skeletal location (Carter, 1984; Hsieh et al., 2001; Lanyon and Skerry, 2001; Lieberman et al., 2001; Currey, 2002) as well as by systemic factors such as age, disease state, hormonal status, and genetic background (Frost, 1987; Lee et al., 2003; Pearson and Lieberman, 2004; Suuriniemi et al., 2004). Also, the type of strain (its frequency and other characteristics), as well as the loading history of the bone cells, are important variables influencing the magnitude of bone response (Turner, 1998; Burr et al., 2002).

These complexities suggest that the general model shown in Figure 1 must be interpreted carefully and within specific contexts (e.g., comparisons between simi- lar skeletal regions in genetically similar animals), and that disentangling the effects of different loading compo- nents, such as load magnitude vs. frequency, may be very difficult from morphology alone. But increased com- plexity does not invalidate application of the general model, which is supported by much experimental evi- dence, reviewed below, with suitable caution (Lanyon and Skerry, 2001). In any event, arguments regarding the validity of the ‘‘strict’’ version of Wolff’s law must be distinguished from those concerning the nature of bone functional adaptation in general.

EXPERIMENTAL EVIDENCE FOR BONE FUNCTIONAL ADAPTATION

A series of now-classic papers from the 1960s through the 1980s appeared to provide clear evidence for bone functional adaptation to mechanical loading and unload- ing, using various experimental animal models (e.g., Saville and Smith, 1966; Hert et al., 1969; Liskova and Hert, 1971; Chamay and Tschantz, 1972; Uhthoff and Jaworski, 1978; Goodship et al., 1979; Jaworski et al., 1980a; Woo et al., 1981; Churches and Howlett, 1982; Lanyon et al., 1982; Lanyon and Rubin, 1984), as well as observations of human athletes (e.g., Nilsson and West- lin, 1971; Jones et al., 1977) (for a comprehensive review, see Meade, 1989). However, in their critique, Bertram and Swartz (1991, p. 23) argued that much of this evi- dence was inherently flawed because of problems in experimental design: ‘‘While accepting that mechanical load has substantial influence on the development of form in bone, we argue that to date there is no direct evidence of its influence on the healthy mature appen- dicular skeleton that is not seriously compromised by complications arising from indirect effects of the investi- gative procedures on other aspects of the organism’s physiology.’’ The ‘‘complications’’ that Bertram and Swartz (1991) referred to involve inflammatory re- sponses due to surgical treatment, and repair phenom- ena (regeneration of injured tissue, or repair of stress fractures), none of which they considered to properly fall under ‘‘Wolff’s law.’’ With regard to the first of these fac- tors, it should first be noted that the studies above that included surgical intervention generally included surgi- cal controls, i.e., bones in which all surgical procedures except the change in mechanical loading had been car- ried out, although as Bertram and Swartz (1991) and others pointed out, it is still difficult to completely con- trol for all related effects. There is also some question as to whether woven bone, a typical response (at least at first) to sudden mechanical overload, is ‘‘normal’’ or ‘‘pathological’’ (see also Frost, 1988). However, with regard to this latter issue, Burr et al. (1989, p. 232), in a carefully controlled experiment that intentionally incor- porated some features of earlier experimental work, demonstrated that ‘‘woven bone can be a normal adap- tive response to an intense mechanical challenge, even in the absence of trauma or fatigue-induced damage.’’

Partly in response to such criticisms, a series of inves- tigators beginning in the early 1990s developed new ani- mal models that did not involve invasive surgical proce- dures (Turner et al., 1991; Torrance et al., 1994; Forwood et al., 1998). These models have since been used exten- sively to study various aspects of bone modeling/remodel- ing under altered mechanical loadings (e.g., Hsieh et al., 2001; Burr et al., 2002; Robling et al., 2002).

shows the results of one such experiment (Robling et al., 2002). In this experiment, the forearms of 6-month-old rats were dynamically loaded in compression, which cre- ates bending stresses in the midproximal region of the bone due to its natural curvature. At this age, the rats can be considered ‘‘adults,’’ since no further growth in bone length occurred over the 16-week experimental period. The extra loading produced an increase of 70– 100% in bending rigidity (second moment of area) in the plane of bending compared to control limbs, through increased periosteal bone apposition in regions under the highest bone strain (Fig. 2). Bone strength determined through direct mechanical testing after sacrifice in- creased 64–165%, depending on the loading schedule and strength parameter. Interestingly, these gains were not well-represented by changes in bone mineral content (BMC) or bone mineral density (BMD), the two most commonly measured outcomes of human exercise stud- ies. Conversely, changes in the relevant second moment of area (a geometric property) explained 92% of the var- iance in strength (ultimate force). Similar results were obtained by Warden et al. (2005), who also demonstrated greatly increased fatigue resistance after experimentally increased loading in the same animal model. These stud- ies noninvasively reproduced and extended similar results of earlier studies (e.g., Lanyon et al., 1982) demonstrat- ing the specificity of bone adaptation to changes in strain distributions, and also the primacy of geometric changes in such adaptations (Woo et al., 1981).

Bertram and Swartz (1991) also argued that much of the change in bone dimensions observed in human ath- letes, and commonly attributed to increased mechanical loading, was actually a repair process in response to ‘‘chronic fatigue damage,’’ and as such did not qualify as support for ‘‘Wolff’s law.’’ It could be debated whether repair of fatigue-induced microcracks is actually outside the realm of ‘‘normal’’ bone mechanical adaptation, since such repair has been hypothesized to be an important component of bone remodeling throughout life (Martin et al., 1998). Other more recent studies of human athletes and volunteers in exercise intervention studies also showed clear evidence of adaptive bone modeling/ remodeling without evidence of fatigue (or stress) frac- tures, as reviewed below. The varying response of bone to applied loading is probably best viewed as a contin- uum, involving in some cases rapid deposition of woven bone (which can subsequently be remodeled into lamellar bone), in some cases repair of microcracks, and in other cases direct deposition of lamellar bone, depending on the severity and suddenness with which the loading schedule is implemented (Rubin et al., 1995). Also, not all bone fea- tures may react similarly to applied loading: in Robling et al. (2002), the distal ulnar articulations of experimentally loaded groups developed osteophytic reactions, which is perhaps not surprising given the very ‘‘abnormal’’ way in which the carpus was loaded (Fig. 2), and possible con- straints on articular remodeling (Ruff et al., 1991; Lieber- man et al., 2001) (what this might indicate regarding mechanisms underlying osteoarthritis was not addressed by the authors). However, the response in the diaphysis was ‘‘normal’’ in terms of bone tissue appearance (Fig. 4 in Turner and Robling, 2004). In summary, while experi- mental and observational studies have their limitations, such studies have clearly demonstrated that functionally adaptive changes in bone structure can be brought about by manipulation of mechanical loadings, supporting the general model shown in Figure 1.

IN VIVO STRAINS AND FUNCTIONAL ADAPTATION

Given that bone adaptation to mechanical loadings very likely involves a response to strains (deformations) engendered by such loadings, direct measurement of bone strains in vivo using strain gauges can provide important information in evaluating adaptive mecha- nisms (e.g., Fig. 2B, although in this case, strains were calculated in a simulated in vivo loading) (Robling et al., 2002). Three recent studies documented in vivo strains in the long bones of macaques (Demes et al., 1998, 2001) and sheep (Lieberman et al., 2004), and concluded that strain patterns were not well-correlated with cross-sec- tional geometry of the bones, thereby casting doubt on whether cross-sectional geometry could be used to recon- struct mechanical loading history. Specifically, the bend- ing axes generally did not match well with the neutral axes of sections, or conversely, sections were not rein- forced in regions of maximum strain (Lieberman et al., 2004) made a number of other points, which are ad- dressed below). It should be noted that none of these studies examined the effects of exercise per se on bone modeling/remodeling, but rather the normal patterns of strain during locomotion in laboratory animals.

The fact that long bone diaphyses may be customarily bent in planes that are not equivalent to their directions of greatest bending rigidity or strength was noted previ- ously (Lanyon and Rubin, 1985). Together with the observation that long bone curvature often seems to increase rather than decrease strains in vivo, this formed the basis for theories that bone structure may be designed in some cases to confine strains to more pre- dictable patterns, rather than strictly to minimize strains (Lanyon and Rubin, 1985; Bertram and Biewener, 1988). This is not inconsistent with the model shown in Figure 1: some degree of bending could actually be beneficial to bone tissue by maintaining strains within the ‘‘optimum customary’’ window (Lanyon and Rubin, 1985). At the same time, potentially catastrophic strains in ‘‘unusual’’ orientations could be avoided. Because of their more read- ily available surfaces for attaching strain gauges, the dis- tal limb elements of cursorial animals (horses, sheep, and dogs) were most often used in these experiments (see also Lieberman et al., 2004). These skeletal locations are rela- tively ‘‘unprotected’’ medially and laterally by muscle ten- dons (one reason that they are more accessible for strain gauges) (e.g., see Piotrowski et al., 1983; Thomason, 1985). Thus, any unusual bending in the mediolateral plane (e.g., due to turning or walking over uneven ground) is probably less able to be modified by muscles, making this a more ‘‘dangerous’’ loading orientation for the bones. In these situations, it is not unreasonable to postulate a genetically selected difference in strain sensitivity thresh- olds that would favor the development of an elliptical cross section oriented to increase mediolateral (M-L) bending strength (Lanyon et al., 1982; Piotrowski et al., 1983; Nunamaker et al., 1989; Lieberman et al., 2004).

Of course, postulating genetic mechanisms that alter the ‘‘optimum customary’’ strain sensitivity of bone tis- sue argues against making comparisons between species that are not closely related, and for whom genetic selec- tion histories may have been significantly different: one would not want to use differences in cross-sectional shape between a human and horse long bone to recon- struct behavioral differences between them! In this respect, we fully concur with the caution by Demes et al. (2001, p. 264) ‘‘against broad behavioral conclusions derived from long bone cross-sectional shape.’’ However, comparisons within species or between closely related species who share the same basic body design and evolu- tionary history are much less likely to be confounded by such factors (see also Lieberman et al., 2004). In this regard, it is interesting that even in highly cursorial ani- mals, activity patterns appear to affect long bone cross- sectional geometry in predictable ways. Thoroughbred and standard-bred horses differ in cross-sectional geome- try of the third metacarpal (cannon bone), such that thoroughbreds, who are subjected to more rigorous train- ing of a type that specifically engenders high strains in the anteroposterior (A-P) plane, have more A-P strength- ened bones (Nunamaker et al., 1990). McCarthy and Jeffcoat (1992, p. 35), in an experimental study of young (yearling) thoroughbreds, also documented a site-specific effect of exercise in these animals: ‘‘In the unexercised group periosteal bone apposition occurred uniformly around the third metacarpal without selective enlarge- ment of any cortex. The increased thickness of the dorsal cortex in the exercised horses means that the bone is bet- ter able to withstand loading of this cortex where very high compressive strains can occur during locomotion.’’2 These results are consistent with the view that there is a basic structural model, in part genetically determined, of the horse third metacarpal that can then be modified by specific environmental (mechanical) stimuli (for a very similar argument, see Turner, 1998). This is very much analogous to comparisons of the same skeletal element within or between human populations with different behavioral characteristics (e.g., Ruff, 1987; Stock and Pfeiffer, 2001): because the basic underlying model is sim- ilar, variations in morphology are more likely to reflect variations in applied loading throughout life.

The above reasoning also argues for caution in extrap- olating results of strain gauge experiments between skel- etal locations or species with very different body plans and evolutionary histories. There is evidence that strain distributions in bones/species that are less specialized for cursorial locomotion more closely match traditional expectations of greater bone strength in directions of higher strain, especially during vigorous movement. Fig- ure 3 shows some of the results of Demes et al. (2001) on strains in the macaque tibial mid-diaphysis during walk- ing and galloping, and of Szivek et al. (1992) on strains in the greyhound femoral mid-diaphysis at various speeds (although the greyhound is certainly well-adapted for cursorial locomotion, its femur is surrounded by muscles in much the same way as a noncursorial ani- mal). In both cases, anterior and posterior strains in- creased with increasing speed. In the macaque tibia, the bending axis (the axis around which the bone is bent) during galloping moved to within 198 of the M-L axis, and to within about 138 of the neutral axis of the section (the axis about which bending rigidity is greatest) (Fig. 3A). That is, the greatest strains during galloping were experienced in almost the same direction as that of maxi- mum bending rigidity. In the greyhound femur, the bend- ing axis similarly rotated to a more M-L orientation (228 from the M-L axis) as speed increased from 0.61 to 2.44 m/sec, the former a slow walk and the latter a trot (Rubin and Lanyon, 1982) (Fig. 3B). While the neutral axes of sections were not calculated in this study, Szivek et al. (1992, p. 105–106) noted that during running, ‘‘the peak strain regions shifted to the anterior and posterior aspects of the bone… The shape of the cross section of the grey- hound femur at the mid-diaphysis (i.e., oblong) may be a result of this strain distribution while the dog performs.’’ Carter et al. (1981; see their Fig. 6) obtained very similar results for a mixed-breed dog moving at a speed between the two higher speeds shown in Figure 3B.

It should also be noted that in both of the studies depicted in Figure 3, the magnitude of maximum strain increased substantially in moving from a walk to a trot or gallop, as would be expected (Rubin and Lanyon, 1982). Because the stimulus for bone functional adaptation is dependent on strain rate, which in turn is dependent on strain magnitude and frequency (Turner, 1998), it is likely that more dynamic activities are far more osteogenic than slow walking (although small strains may also be osteo- genic; see Fritton et al., 2000). As observed by Rubin and Lanyon (1982, p. 206) in their now-classic review of in vivo strain gauge results, ‘‘The association which natu- rally exists between high peak strains and high strain rates will therefore result in bone architecture being pref- erentially influenced by the strains encountered during periods of vigorous, rather than more sedentary, activity’’ (see also Mikic and Carter, 1995). This is closely related to the ‘‘cellular accommodation’’ theory of Turner (1999), whereby bone cells are only stimulated by more ‘‘unusual’’ loadings. It can be presumed that galloping or trotting in the macaques and dogs included in Demes et al. (2001) and Szivek et al. (1992) was a relatively unusual, although certainly not unknown, activity compared to walking. The fact that the cross-sectional shape of both bones better corresponded with strains engendered during running may be a product of the higher strains produced by this more unusual, but still ‘‘characteristic’’ loading. This suggests that bone structure is correlated with activ- ity, and primarily vigorous activity.

In the other study by Demes et al. (1998; see also Demes et al., 2001), maximum strains in the macaque ulnar midshaft were always located closer to the medial and lateral cortices, regardless of speed of locomotion (although the location of peak strain moved slightly toward the anterior and posterior cortices during gallop- ing), while the bones were slightly stronger in the A-P direction. This would seem contrary to the scenario pre- sented above. However, unlike the tibia, the macaque ulna is part of a more ‘‘multifunctional’’ (Schaffler et al., 1985) forelimb complex that serves in a greater variety of roles, both locomotor and nonlocomotor, than do the hindlimb bones. Even during locomotion, the macaque forelimb experiences significant changes in applied load- ings, depending on substrate (Schmitt, 2003). Significant load-sharing with the radius, which is actually stronger than the ulna in cercopithecoids (Ruff, 2002), further complicates interpretations. In many ways, then, the loading environment of the macaque tibia is probably simpler and more predictable than that of the ulna, with more stereotypical positioning of the limb, muscle recruitment, and resultant strain patterns (e.g., peak strains in the macaque ulna actually declined from walking to galloping (Demes et al., 1998), which has not been reported in studies of other bones/species). In terms of behavioral reconstructions, interpretations of forelimb bone cross-sectional shape will be similarly complex, although overall forelimb relative to hindlimb strength proportions are still informative regarding general loco- motor behavior (Stock and Pfeiffer, 2001; Ruff, 2002).

We should also remember that, in adults at least, strain gauges measure deformations in bones that have already adapted to mechanical loading. As noted above, if the most osteogenic strains are those that occur under vigorous loadings such as running, the bone will adapt by altering its geometry accordingly, following the gen- eral model in Figure 1. The strains developed during less vigorous (but more common) loadings such as walking would thus be, in effect, ‘‘residual’’ strains that are insuf- ficient to stimulate modeling/remodeling (Turner, 1999). This could lead to misinterpretations of strain gauge data in terms of in vivo loadings. For example, if large A-P bending loads of certain limb bones occur during running that create large strains on the anterior and posterior surfaces, which in turn stimulate bone deposi- tion on those surfaces, then during walking (where A-P bending loads are probably much smaller), anterior and posterior surface strains will be small, and medial and lateral surface strains relatively larger. This does not, however, indicate that bending loads (even in walking) are typically larger in the mediolateral direction. Thus, one must be careful in extrapolating from strains to loads.

The strain gauge study in sheep by Lieberman et al. (2004) addressed two other issues relevant to interpreta- tions of long bone cross-sectional geometry: does the axis of bending of a long bone pass through the section cen- troid, and does this axis remain in a similar position throughout locomotion (stance)? Both questions were answered in the negative. The first result is similar to that obtained by other researchers or implied by their results (e.g., Carter et al., 1981; Rubin and Lanyon, 1982; Szivek et al., 1992). Because of the superimposi- tion of axial compressive on bending loads in most long bones, overall compressive strains are higher than ten- sile strains; the axis of bending (0 strain) correspond- ingly shifts toward the tensile side, thereby no longer passing through the section centroid (Fig. 3B; see also Fig. 2 in Lieberman et al., 2004). This is significant because geometric section properties that reflect bending rigidity and strength (second moments of area and sec- tion moduli) are typically calculated around axes that pass through the section centroid (e.g., Ruff and Hayes, 1983; Sumner et al., 1985). Thus, rigidity or strength estimates based on such properties will be in error, by as much as 30–50% (Lieberman et al., 2004). It should be noted, first, that these results do not affect past interpre- tations of the pure bending rigidity/strength of long bones; second moments of area and section moduli, as traditionally calculated, are still valid representations of such properties. What is strictly invalid is the implied assumption that in vivo loadings are, in fact, pure bend- ing loads. In studies that can be used to directly assess this assumption in vivo, the degree of deviation of bend- ing axes from section centroids can be quite variable, even at the same skeletal location and within the same species: between different phases of the stance cycle, dif- ferent animals, right and left limbs of the same animal, and even in repeated trials of the same limb of the same animal (e.g., Figs. 2 and 5 in Szivek et al., 1992). The bending axis may shift from one side of the section cen- troid to the other, depending on these factors (Szivek et al., 1992; Demes et al., 2001). In other words, there is no consistent ‘‘correction’’ factor that can be incorporated into section property analyses to account for these varia- ble deviations.

This is closely related to the second of the results of Lieberman et al. (2004): because of changes in ground reaction forces, limb positioning, and muscle forces dur- ing locomotion, bending axes cannot remain in exactly the same position relative to the cross section. This is clearly implied by earlier studies, such as Carter (1978), based on work originally reported by Lanyon et al. (1975), of strains in the human tibia during walking and jogging, in which longitudinal strains on one surface of the cortex shifted between tensile and compressive within one gait cycle. Because in this study, strain data were collected on only one surface (anteromedial), strain distributions cannot be determined; however, these results necessitate a major shift in the bending axis across the tibial cortex during gait. This is perhaps not surprising, given the variable position of the human tibia relative to the body’s center of gravity and chang- ing muscle actions during gait (Inman et al., 1981).

Thus, even with in vivo strain gauge data in hand, it is not possible to precisely define the position of the bending axis of a long bone section, because it varies constantly during use of the limb, both between and within individuals. Therefore, it is not possible to factor this into bone structural analyses, except perhaps in a general sense (Griffin and Richmond, 2005). In fact, it might be counterproductive to attempt to do so, at least quantitatively, because the particular choice of bending axis could bias results in unpredictable ways. Thus, it is probably advisable to continue to report section proper- ties (second moments of area and section moduli) relative to centroidal axes, with the understanding that these are only approximations of true bending rigidity and strength in vivo. In this respect, it is reassuring that Lieberman et al. (2004) obtained correlations of about 0.9 or better between section properties measured to centroidal axes and those measured to an average bending axis deter- mined experimentally. Also, since the main interest of many anthropological and paleontological studies is the relative importance of different types of mechanical load- ings, deviation of absolute estimated rigidities or strengths from actual values (even if such values were constant and could be determined) is of less concern, provided that the basic mechanical model is similar between the individuals being compared (see above).

Finally, as recognized by the investigators themselves, strains measured in laboratory animals moving on a treadmill at constant (and usually fairly low) speeds and in a straight line are not representative of the full range of variability present during normal activities (Lieberman et al., 2004), and only occasionally measure strains at the more important (see above) higher gait velocities. As noted by Dickinson et al. (2000, p. 105) in a wide-ranging review of animal locomotion, ‘‘In nature, unlike in the lab- oratory, straight-line, steady-speed locomotion is the exception rather than the rule.’’ Variable directionality of movement may explain, for example, why bones subjected primarily to A-P bending in typical treadmill exercises are still reinforced mediolaterally (Fig. 3, and see above). Mikic and Carter (1995, p. 465) were more explicit:

‘‘One difficulty that is encountered when using bone strain data in studies of functional adaptation is that reported data are often far from a complete record of strain over an experimental period. On the contrary, the reported results generally consist of a few average cyclic strain parameters that are extracted from a short period of recordings while an animal performs a very restricted task. Most inves- tigators agree, however, that a much more complete record of strain history is required to relate bone biology and morphology to strain. Such records should include the many diverse activities of the animal, including cage activity.’’

This is admittedly a very difficult task, and may not be totally achievable, even for animals in a controlled laboratory environment (but see Fritton et al., 2000, for example). Thus, researchers have turned to theoretical modeling approaches (extrapolated from available in vivo data) in an attempt to determine the influence of overall loading history on bone morphology (e.g., Carter, 1987; Beaupre et al., 1990; van der Meulen et al., 1993; Mikic and Carter, 1995). However, these observations empha- size some of the problems inherent in using data of this kind.

This is not to say that in vivo strain gauge studies cannot provide very valuable information: strain studies in animals have been critical in investigating general bone adaptive mechanisms (e.g., Fig. 2), and the few in vivo studies of strain in human (Lanyon et al., 1975; Burr et al., 1996; Aamodt et al., 1997; Carter, 1978) and nonhuman primate (Swartz et al., 1989; Demes et al., 1998, 2001) long bones helped clarify mechanical load- ings of these skeletal elements. Any morphological stud- ies should carefully consider such evidence and its impli- cations for reconstructing behavior. However, we also need to carefully consider the limitations of such data when applied to ‘‘real life’’ situations, i.e., the total load- ing history of a bone.

GENETIC DETERMINATION OF BONE MORPHOLOGY

The pace of discovery of new genetic mechanisms underlying bone growth and development has increased dramatically over the past several decades (for recent reviews in the anthropological literature, see Chiu and Hamrick, 2002; Lovejoy et al., 2003; Pearson and Lieber- man, 2004). Building on these discoveries, Lovejoy et al. (2002, 2003) argued forcefully for the importance of genetic mechanisms in the determination of bone mor- phology, and conversely, the relative insignificance of ‘‘mechanoanabolism,’’ or the functional adaptation of bone to perceived mechanical stimuli during life. These arguments tend to dichotomize genetic and environmen- tal effects: ‘‘The most relevant issue for anthropologists is the degree to which adult bone structure is indicative of genetic background versus its history of load trans- duction’’ (Lovejoy et al., 2003, p. 101), with genetic influ- ences argued to be paramount: ‘‘External bone morphol- ogy now appears to be largely dictated by an integrated system of sequentially expressed gene arrays’’ (Lovejoy et al., 2002, p. 99). While we fully agree that a better understanding of bone developmental genetics is impor- tant for explaining the evolution of skeletal morphologi- cal variation (e.g., Shubin et al., 1997; Hallgrimsson et al., 2002; Hamrick, 2003), we believe that this rather polarized view is counterproductive: because genetic mechanisms are important does not mean that direct environmental stimuli are not; in fact, in certain respects, the two may be inseparable (Martin et al., 1998, p. 270–271; also see below). As shown above, it is obvious that mechanical loading during life can have a strong effect on variation in bone morphology. Minimiz- ing the importance of mechanical effects artificially restricts the scope of inquiry, and hinders attempts to provide a complete explanation for this variation.

Another factor that must be carefully considered in this context is variability between different types of skel- etal features in the extent to which they are environ- mentally modifiable during life. For example, long bone articular size appears to be less affected by changes in mechanical loading than cross-sectional diaphyseal size (Ruff et al., 1991; Lieberman et al., 2001). The great majority of developmental genetic studies of the skeleton examined variation in gross morphological features (e.g., patterns of limb element organization); bone ‘‘size’’ fea- tures such as mass, volume, and length; or bone ‘‘den- sity’’ (usually not true tissue density). Heritability esti- mates for bone mineral content (BMC) and bone mineral density (BMD), the most commonly measured bone parameters, average about 60–70% in humans, but if covariation with body mass is accounted for, this falls to about 50% (for an excellent review, see Prentice, 2001). However, such skeletal traits do not provide estimates of mechanically relevant parameters (Sievanen et al., 1996; van der Meulen et al., 2001). Volkman et al. (2003, 2004) carried out a more relevant study in which they assessed genetic effects on cross-sectional geometric and other mechanical properties of the mouse femur, using quanti- tative trait loci (QTL) analysis. They found evidence for complex genetic control of these characteristics, but at a low level: genetic markers accounted for only 3–22% of trait variances. They discussed several possible path- ways through which genes may influence bone structure: 1) a direct influence on bone size and shape (i.e., directed activity of osteoblasts and osteoclasts); 2) an indirect effect on factors such as body weight, muscle strength, and activity level, which in turn alter mechanical load and thus bone structure; and 3) an effect on responsive- ness of bone to applied mechanical loading (i.e., ‘‘set points’’ in a ‘‘mechanostat’’-like mechanism; see Frost, 1987; Martin et al., 1998, p. 270–271). The interaction between genetic and environmental effects is prominent in the second two of these proposed mechanisms. Other investigators, in fact, demonstrated varying mechano- sensitivity in different mouse strains (Kodama et al., 2000; Robling and Turner, 2002).

Many other recent studies found evidence for some heritability of various bone structural traits, sometimes sex-linked (e.g., Peacock et al., 2005, and references therein). It is important to note that these studies do not provide estimates of actual genetic determination of traits, however (Prentice, 2001), and that as noted above, final adult morphology is likely to be a complex product of genetic-environmental interactions. A good example of this is the interaction between the gene(s) encoding for the estrogen receptor a (ER-a) and physical exercise: both the receptor and increased mechanical loading are necessary to increase bone mass (Lee et al., 2003; Suuriniemi et al., 2004). As Lanyon and Skerry (2001, p. 1938) pointed out, ‘‘although systemic influ- ences may modify mechanically adaptive processes, they cannot substitute for them,’’ i.e., regardless of genetic background, appropriate mechanical loading is necessary to develop normal adult form. This was demonstrated in experiments early in the last century in which bones iso- lated from mechanical loading during growth still devel- oped the general features of their normal counterparts, but not the specific morphological details (Murray, 1936). The major evolutionary features of skeletal morphology (e.g., what makes a horse skeleton different from a human skeleton) may be principally genetic, but what makes one horse (or one human) skeleton different from another is likely to be a product of both genetics and environment, with different skeletal features more or less environmentally modifiable. Thus, understanding both genetic and environmental influences is critical to understanding morphological variation.

AGE-DEPENDENCE OF BONE FUNCTIONAL ADAPTATION

Another issue discussed by Bertram and Swartz (1991) was the apparent age-specificity of bone response to changes in mechanical loading, particularly a reduction in mechanical loading (e.g., Jaworski et al., 1980b), which might argue against a universally applicable ‘‘Wolff’s law.’’ Bertram and Swartz (1991, p. 267) also noted a distinction between modification of growth pat- terns and functional adaptation in the ‘‘mature’’ skele- ton: ‘‘It appears to us that many of the adjustments of bone form associated with mechanical loads result from the interaction of load with the developmental/growth process, which in bone normally persists into young adulthood (mid-20’s or later in human studies).’’ It is important to recognize that the ‘‘growth’’ period, as they defined it here, includes early adulthood, extending be- yond adolescence as usually defined. This would corre- spond to the ‘‘positive’’ period of skeletal growth where bone mass is normally increasing, even though growth in bone length has largely ceased (Riggs and Melton, 1992).

Forwood and Burr (1993) reviewed earlier animal and human exercise studies across different age groups. They concluded that while the main function of mechanical loading in the adult skeleton was to conserve or main- tain existing bone, ‘‘exercise can, in fact, add small amounts to bone mass of the adult skeleton,’’ on the order of a few percent, although this adaptation ‘‘is mod- est when compared with that in growing bone’’ (Forwood and Burr, 1993, p. 100). They also noted that very inten- sive exercise can stunt growth in growing bones. Pearson and Lieberman (2004) reviewed the evidence for a reduc- tion in osteogenic potential on a cellular level with aging. It should be noted, however, that the most drastic reductions occur in aged or senescent adult cells, so this factor may not be as applicable to comparisons between juveniles and young adults.

With respect to anthropological reconstructions of past behavior, the key question raised by these studies is: to what extent is the morphology of adult bones indicative of the mechanical loading of these bones during adult- hood? This question can be subdivided into two related questions: first, can mechanical loading significantly change bone morphology after the childhood and adoles- cent years, and second, regardless of the answer to the first question, is adult bone morphology still informative with regard to adult loadings?

The first question can be answered in the affirmative, although it is also apparent that the bone response to mechanical stimuli is more marked in juveniles than in adults (Forwood and Burr, 1993; Turner et al., 2003). Part of the problem with evaluating bone sensitivity to mechanical loading in adults is that the response is probably slower than in juveniles; thus, long-term longi- tudinal studies may be necessary to clearly document effects. Many prospective exercise studies of human adults also have problems in study design, including nonrandomization of subjects, poor compliance, small samples, failure to control for other confounding effects, and failure to measure effects at the actual site of skele- tal loading (Kerr et al., 1996), all of which may contrib- ute to inconsistency of results across studies (Pearson and Lieberman, 2004). One of the best-controlled studies in older adults was by Kerr et al. (1996), who examined the effects of weight-training on BMD at several skeletal sites in postmenopausal women (mean age, 58 years at start of program) over a period of 1 year. The weight- training, three times per week, was carried out on either the right or left upper and lower limbs, with the opposite limb serving as an internal control, thus inherently accounting for systemic variables such as genetic influ- ences, diet, hormonal status, and body weight. Their results for the distal radius are shown in Figure 4. As with many such studies in adults, the effects were rela- tively small (an average gain of 2.4% on the exercised side, compared to a loss of 1.4% on the control side), but significant. Statistically significant positive effects of exer- cise were also seen in the hip region. Interestingly, exer- cises aimed at increasing strength (higher weights, lower number of repetitions) had a more positive effect than those aimed at increasing endurance (lower weights, more repetitions). This suggested that the magnitude of loading (or rate of change in magnitude of loading) was more important than the number of loading cycles, which agrees with some animal experimental results (see refer- ences above).

Another observation apparent in Figure 4 is that a shorter-term study of a few months would not have picked up the significant effect of the exercise treatment. This factor should be kept in mind when evaluating results of shorter-term exercise studies in humans, or in other large, relatively long-lived mammals. Because of variable exigencies such as subject compliance and reten- tion (in human studies) and caretaking expenses (in ani- mal studies), these investigations are commonly carried out over short periods relative to total lifespan. This also has more general implications regarding interpretations of mechanical loading effects in adults: response to load- ing may be slower than in juveniles, but the total adult period available for functional adaptation is longer; thus, cumulative effects (positive or negative) may be larger than would be predicted by short-term studies.

This point was emphasized in a recent long-term longi- tudinal study of young adult female soccer players (Valdimarsson et al., 2005). The subjects averaged 18 years of age at the beginning of the study and were fol- lowed for 8 years, a long time period compared to most prospective studies. Bone mineral content and density of the whole body and BMD at various anatomical locations were evaluated using dual X-ray absorptiometry (DXA) at baseline and at follow-up. A control group of non- athletes of similar age was also followed over the same time period. In players who remained active throughout the period, BMC and BMD increased, and differences from controls increased (from 4% greater at baseline to 9–12% greater at the end in the total body, and from 7% at baseline to 14% greater in the leg; our calculations). Players who had retired from play during the follow-up period began with higher values than controls, but then showed no further increase over controls. Valdimarsson et al. (2005, p. 910) noted that while ‘‘exercise in adult- hood has been described as at best conferring BMD ben- efits of a few percentage points . . . this notion is only  supported by short-term prospective controlled studies spanning, at best, 24 months.’’ The age period evaluated in this study can appropriately be termed ‘‘postadoles- cent’’ (there was no change in height among the active players), but it does fall within the early adult ‘‘develop- mental/growth’’ period as defined by Bertram and Swartz (1991) (see above).

The bilateral asymmetry model used by Kerr et al. (1996) was also exploited in a series of studies of the playing and nonplaying upper limbs of athletes in racket sports. In one such study (Kannus et al., 1995), the age- dependence of exercise effects was specifically addressed by comparing bilateral asymmetry in upper limb BMC of adult ‘‘national-level’’ female tennis and squash players who had started playing at ages varying from young childhood to young adulthood. All individuals had played for at least 5 years, and the number of years of training was not a significant covariate. A progressively greater effect on bilateral asymmetry was seen in individuals who had started playing earlier: in the humeral shaft, the earlier starters averaged 20–24% asymmetry, while the older starters averaged 8–10% asymmetry. This result has been repeatedly cited as providing evidence for the age-specificity of mechanical loading on bone (Fig. 6 in Turner and Robling, 2003; Fig. 12 in Pearson and Lieberman, 2004; but note misattribution of data to another study), and it does appear to demonstrate a declining response after early adolescence. However, it is also noteworthy that even the oldest starters in this study, averaging 34 years of age when they began play- ing, still had about three times greater bilateral asym- metry than the controls included in the study. Thus, even in this age range, increased mechanical loading appears to significantly increase bone mass. Because the study was cross-sectional in design, it is not possible to say for sure how much bone was actually gained during the playing period. However, from an anthropological perspective, the greater asymmetry in the older-starting players would be correctly interpreted as reflecting greater asymmetric use of the upper limbs during adult- hood.

As noted earlier, BMC and BMD are not true mechani- cal characteristics, and their interpretation can be con- founded by nonconcordant and nonlinear changes in sub- periosteal and endosteal breadths during growth and young adulthood (Frisancho et al., 1970; Ruff et al., 1994; Petit et al., 2004). Significant changes in bone strength can occur with relatively small changes in BMC or BMD (Robling et al., 2002; Warden et al., 2005). A number of studies incorporated more mechanically rele- vant properties into evaluations of exercise effects in human subjects, using the upper limb bilateral asymme- try model. Ruff et al. (1994) and Trinkaus et al. (1994) reanalyzed radiographic data originally collected by Jones et al. (1977) for male and female professional ten- nis players (mean age, 25 years; mean starting age, 10 years). Median asymmetry in the polar second moment of area, J (a measure of bending/torsional rigidity), of the mid-distal humeral shaft was 57%, compared to median asymmetries near 10% in recent ‘‘normal’’ popu- lations. We also found an age effect, with players who started playing earlier showing more asymmetry due to greater subperiosteal expansion. However, the individual in the sample who started playing the latest (a male who started playing at age 19 years) still showed asym- metry in J of 31%. Haapasalo et al. (2000), using periph- eral quantitative computed tomography (pQCT), found mean bilateral asymmetries of 39–46% in second moments of area of the humeral midshaft in male Finn- ish ‘‘national top-level’’ tennis players (mean age, 30 years; mean starting age, 10 years). No evidence for any exercise effect on cortical bone density was found, i.e., mechanical adaptation to increased loading appeared to be all geometric (paralleling animal exercise studies, e.g., Woo et al., 1981). Kontulainen et al. (2002), also using pQCT, measured bilateral asymmetry in geometry and bone density of the upper limb bones in a subset of the same sample studied by Kannus et al. (1995). Mean asymmetry in a strength index that combined J and bone density of the humeral midshaft was about 26% in

What Proteins And Genes Are Good Targets For Height Growth? (Tyler Guest Post)

[Me: I have been in contact with Tyler of HeightQuest.Com for almost since the beginning and I have hoped that he could write a guest post for the website to speak about what he has found in his quest for height. Finally he managed to write something for all of us. This is his guest post. I have read it and I feel that this post is a very critical piece in understanding the genetics of growth and height. I wanted to thank Tyler again for his contributions.]


I have a done a lot of analysis on what genes are best for height growth. And there are several genes that are better targets than others.

Estrogen and it’s receptors are highly inefficient targets even though they are involved in height growth. Estrogen receptors have different effects based on differentiation stage and in gender. ERalpha, ERbeta, and GPR30 are the estrogen receptors typically identified with growth. And although GPR30 seems to be the most promising estrogen receptor height increase knockout targets, ERalpha and ERbeta have mixed effects in studies with knockout sometimes increasing and other times decreasing height. There are mutations with estrogen receptors in overgrowth but they are specific receptors.

p-ERK1 phosphorylation and formation of AP-1 complex is another gene target with mixed height increase results. Sometimes ERK1 phosphorylation stimulates chondrogenesis and other times it inhibits. Same with AP-1. Thus even though both ERK1 and AP-1 are important to height growth the conflicting results makes them poor targets.

GH is another poor target. Although IGF-1 is a good target for height growth, based on transgenic models of IGF-1 showing overgrowth, and it is downstream target of GH, GH is a poor target to try to increase via supplements or other methods to induce overexpression. Several HGH studies have shown no overgrowth and other GH related proteins like Ghrelin and GHRP showed no overgrowth when overexpressed. SOCS2 which is a GH inhibitor causes overgrowth when inhibited and we know GH is important to height growth. However, there are likely negative feedback mechanisms, likely SOCS2, that make GH overexpression not cause overgrowth. There are several studies that associate GH with Gigantism however most of those studies are based purely on phenotype and do not fully quantify what’s going on in the body. The tumor in all likelihood is doing things other than causing GH overexpression.

IGF2 is a very promising height increase target. IGF2 transgenic species show overgrowth. Reduction of IGF2R which reduces free IGF2 causes overgrowth. A specific mutation in H19 which seems to reduce free IGF2 also increases height. PLAG1 which increases IGF2 levels also causes overgrowth. The target of IGF2 and IGF1 is increasing Akt. LSJL increases Akt phosphorylation according to Knee Loading Stimulates Bone Formation in Tail-Suspended Mouse Hindlimb. Loads in this study were 1N at 5Hz for 5min. Same was taken 5 days after initiation of LSJL. One day after loading. Akt1 and phosphorylation of Akt1 is also associated with overgrowth.

CNP is also uniformly associated with height increase. Knockout of the CNP inhibitor FGFR3 increases height. Knockout of the CNP decoy receptor NPR3 and upregulation of the CNP actual receptor NPR2 also increases height. CNP and it’s regulators are very promising targets for height increase.

The SHOX genes are another great target with knockout causing short stature and transgenic overexpression causing tall stature.

HMGA2 and it’s regulators are another strong series of genes associated with overgrowth. LSJL upregulates several genes including HMGA2 and Lin28b which downregulates the HMGA2 inhibitor let-7.

Note that these targets will only work with active growth plates. The most likely reason that you can grow taller with chondrocytes and not osteogenic cells is that cartilage can grow interstitially(growth from within) wheres osteogenic cells typically don’t. Thus you need to induce chondrogenesis in the bone to grow taller if you don’t have active plates(LSJL upregulates the three major chondroinductive genes at significant levels Sox9, Aggrecan, and COL2A1). There are several cases of non-invasive/non-tumor ectopic chondrogenesis in the bone but many seem to be in children and I haven’t found any associated with overgrowth. Too bad scientists won’t just induce ectopic chondrogenesis in an adult animal bone to see if it makes the bone grow longer.

But why are you focused on Estrogen and HGH when SOCS2, IGF2, SHOX, CNP, and HMGA2 are much better targets. HGH is a much less harmful target as overexpression has never caused reduced growth. However, knockout of estrogen and receptors have caused reduced growth which makes it a poor target for reduction with aromatase inhibitors. Other genes have much more linear effects and are much better targets.

MECHANISMS IN ENDOCRINOLOGY: Novel genetic causes of short stature.
“We successively discuss disorders in hormone signalling, paracrine factors, matrix molecules, intracellular pathways and fundamental cellular processes, followed by chromosomal aberrations including copy number variants and imprinting disorders associated with short stature. Many novel causes of growth hormone (GH) deficiency as part of combined pituitary hormone deficiency have been uncovered. The most frequent genetic causes of isolated GH deficiency are GH1 and GHRHR defects, but several novel causes have recently been found, such as GHSR, RNPC3 and IFT172 mutations. Besides well-defined causes of GH insensitivity (GHR, STAT5B, IGFALS, IGF1 defects), disorders of NFκB signalling, STAT3 and IGF2 have recently been discovered. Heterozygous IGF1R defects are a relatively frequent cause of prenatal and postnatal growth retardation. TRHA mutations cause a syndromic form of short stature with elevated T3/T4 ratio. Disorders of signalling of various paracrine factors (FGFs, BMPs, WNTs, PTHrP/IHH and CNP/NPR2) or genetic defects affecting cartilage extracellular matrix usually cause disproportionate short stature. Heterozygous NPR2 or SHOX defects may be found in approximately 3% of short children, and also rasopathies (e.g. Noonan syndrome) can be found in children without clear syndromic appearance. Numerous other syndromes associated with short stature are caused by genetic defects in fundamental cellular processes, chromosomal abnormalities, copy number variants and imprinting disorders.”

“IGF-II not only is a mediator of intrauterine development but also contributes to postnatal growth “

Taller People Are More Likely To Develop Cancer

About a year ago (2011) there was a study that was published and spread by the international news groups about the link between the increased height of the general world population and the increase in cancer rates in the world.

I remember once a person on a website saying that technically, cancer is just any type of cell division growth that becomes uncontrollable. The cells can not stop differentiating and multiplying and move from a benign tumor to a malignant tumor. Thus, taller people usually have more mass than shorter people. So they have more cells. That would correlate in a linear way to the fact that with more mass and more cells, there is a higher chance that one of the cells in the taller person’s body will turn malignant and start multiplying without stop.

Of course there are some factors which can increase the possibility go cell mutation into uncontrollable growth, like radiation, electricity, certain chemicals, and even virus. There are also factors which decrease the possibility of cancer like exercise, resveratrol, good food, etc. However, what the guy was making the point was that on average, taller people should have a higher rate of possible cancer, if all other factors are held constant.

I will only post on here the story told by The Telegraph, a news site from the UK (link at the bottom) and the Huffington Post (source HERE). If you wanted to read more about the studies and the news articles published talking about it, refer to the links I have put up at the bottom of the article. As always, the most important parts will be highlighted. Thank you.


Tall people at greater cancer risk

Taller people are more likely to get cancer, a study shows.

7:00AM BST 21 Jul 2011
The likelihood of developing the disease rises 16 per cent for every extra four inches in height among women – and a similar pattern is also seen in men.

Although previous research has linked height with particular tumours – such as breast in women and testicular in men – new findings show the phenomenon is not restricted to any types of the disease.

Dr Jane Green, who led the research, said: “The fact that the link between height and cancer risk seems to be common to many different types of cancer in different people suggests there may be a basic common mechanism, perhaps acting early in peoples’ lives, when they are growing.

“Of course people cannot change their height. And being taller has actually been linked to a lower risk of other conditions, such as heart disease.

Hormone levels related to childhood growth, and in turn to cancer risk in later life, could be behind the phenomenon.

It was also suggested the link could simply be down to the fact that taller people have more cells in their bodies, and so a greater chance of developing cancerous cell changes.

Dr Green said: “One possible reason is fairly obvious – tall people have more cells so there is a greater chance that one of them could mutate.

“But being tall is also related to hormonal growth factors which leads to a higher turnover of cells and this is an interesting possibility.

“There is nothing we can do about our height but these findings may open the door to discovering how some cancers may develop.”

She went on: “Although we carried out our study in women when we compared the results to previous ones involving both sexes we found a similar link between cancer and height in men.

So there is no gender bias and the association seems to apply to a range of cancers – it’s just most studies have been carried out on the more common ones like breast and colorectal.”

Dr Green and colleagues, whose findings are published online in The Lancet Oncology, said previous studies have shown a link between height and cancer risk but their’s extends the findings to more cancers and for women with differing lifestyles and economic backgrounds.

The results also suggest increases in the height of populations over the course of the 20th century might explain some of the changes in cancer incidence over time.

The height of European adults increased by about 1cm (0.39 inches) per decade during the twentieth century, and the study suggests that this may explain around 10-15 per cent of the rise in cancer cases seen over this period.

The researchers assessed the association between height and cancer among 97,000 cases identified from the Million Women Study which included 1.3 million middle-aged women in the UK enrolled between 1996 and 2001.

During an average follow-up time of about ten years the largest study of its kind found the risk rose in tandem with height and included at least ten types of the disease including breast, skin, bowel, leukaemia and ovarian – a wider range than initially thought.

The researchers who looked at women with heights ranging from under 155cm (5ft 1in) to 175cm (5ft 9in) and taller then compared their results with those from ten previous studies involving both men and women and found they were strikingly similar.

Dr Green said: “We showed the link between greater height and increased total cancer risk is similar across many different populations from Asia, Australasia, Europe, and North America.”

Dr Andrew Renehan, of Manchester University, who reviewed the study for the journal, said: “In the future, researchers need to explore the predictive capacities of direct measures of nutrition, psychosocial stress and illness during childhood, rather than final adult height.”

Sara Hiom, director of health information at Cancer Research UK, said: “Tall people need not be alarmed by these results.

Most people are not a lot taller (or shorter) than average, and their height will only have a small effect on their individual cancer risk.

“This study confirms the link between height and cancer paving the way for studies to help us understand why this is so.

“On average, people in the UK have a more than one in three chance of developing cancer in their lifetime. So it’s important that everyone is aware of what is normal for their body and go see their doctor as quickly as possible if they notice any unusual changes.

“And while we can’t control our height, there are many lifestyle choices people can make that we know have a greater impact on reducing the risk of cancer such as not smoking, moderating alcohol, keeping a healthy weight and being physically active.”


Tall Women May Have A Greater Cancer Risk

Huffington Post   Amanda Chan First Posted: 07/21/11 02:28 PM ET Updated: 09/20/11 06:12 AM ET

Tall women may be more likely to develop several different cancers than their shorter counterparts, a new study suggests.

Published in the journal Lancet Oncology, the study shows that for every 4-inch increase in height, the risk of 10 different cancers — include leukemia, melanoma, breast, ovarian, bowel and uterine cancer — goes up 16 percent.

“Because height is linked to a wide range of cancersin a wide range of people, [the finding] may give us a clue to basic common mechanisms for cancer,” study researcher Jane Green, a cancer epidemiologist at the University of Oxford, told ABC News.

So what should you do if you’re tall? First, don’t panic. The study found an association, not direct link. And of course, height is something that is largely out of our control — affected by genetics and nutrition.

The results also don’t suggest that tall people need extra cancer screening.

Luckily, it’s not all bad news for tall people — a study published this month in the Journal of Epidemiology and Community Health shows that longer legs seems to be tied with a longer lifespan, the Daily Mailreported.

This isn’t the first study to link physical attributes to cancer risk. Research published last year in the British Journal of Cancer showed that men who have long index fingers have a decreased risk of prostate cancer, because finger length seems to be linked with the amount of testosterone a man produces.

In the new study, the researchers analyzed the health information and height of more than 1 million women who participated in the Million Women Study between 1996 and 2001, none of whom had been diagnosed with cancer at the start of the study. They followed the women for nine years.

The researchers grouped the women into groups by height, with the shortest group consisting of women who are less than 5 feet 1 inch in height, and the tallest group consisting of women who are 5 feet 9 inches or taller.

Even though the researchers found that the taller women seemed to have fewer children and drink more alcohol than the shorter women, they were less likely to be smokers or obese and were more likely to be wealthy and active, the study said. Despite this, the taller women seemed to be more likely to develop cancer.

For every 4 inches of height, cancer risk increased by 32 percent for skin cancer, 29 percent for kidney cancer, 26 percent for leukemia and 16 percent for breast cancer.

The Telegraph UKScienceShotThe Guardian UKTime Healthland – BBC News

The Connection Between Height And Fibroblast Growth Factor FGF

[Note: This is the 3rd guest post by the coworker who has been contributing in writing posts for the website. The previous they wrote about was on statin HERE and bone morphogenic proteins BMPs HERE,  Thanks Nicki.]

FGFs

Fibroblast growth factors (FGFs) and their receptors (FGFRs) negatively regulate longitudinal bone growth. Activating FGFR3 mutations impair growth, causing human skeletal dysplasias, whereas inactivating mutations stimulate growth. Systemic administration of FGF-2 to mice stimulates bone growth at low doses but inhibits growth at high doses. In organ culture, FGF-2 inhibits growth by decreasing growth plate chondrocyte proliferation, hypertrophy and cartilage matrix synthesis. Local FGF-2 infusion accelerates ossification of growth plate cartilage. Thus, FGFs may regulate both growth plate chondrogenesis and ossification.

Fibroblast growth factor (FGF) signaling is essential for endochondral bone formation. Most previous work in this area has focused on embryonic chondrogenesis. To explore the role of FGF signaling in the postnatal growth plate, we quantitated expression of FGFs and FGF receptors (FGFRs) and examined both their spatial and temporal regulation.

Toward this aim, rat proximal tibial growth plates and surrounding tissues were microdissected, and specific mRNAs were quantitated by real-time RT-PCR. To assess the FGF system without bias, we first screened for expression of all known FGFs and major FGFR isoforms. Perichondrium expressed FGFs 1, 2, 6, 7, 9, and 18 and, at lower levels, FGFs 21 and 22. Growth plate expressed FGFs 2, 7, 18, and 22. Perichondrial expression was generally greater than growth plate expression, supporting the concept that perichondrial FGFs regulate growth plate chondrogenesis. Nevertheless, FGFs synthesized by growth plate chondrocytes may be physiologically important because of their proximity to target receptors. In growth plate, we found expression of FGFRs 1, 2, and 3, primarily, but not exclusively, the c isoforms. FGFRs 1 and 3, thought to negatively regulate chondrogenesis, were expressed at greater levels and at later stages of chondrocyte differentiation, with FGFR1 upregulated in the hypertrophic zone and FGFR3 upregulated in both proliferative and hypertrophic zones. In contrast, FGFRs 2 and 4, putative positive regulators, were expressed at earlier stages of differentiation, with FGFR2 upregulated in the resting zone and FGFR4 in the resting and proliferative zones. FGFRL1, a presumed decoy receptor, was expressed in the resting zone.

With increasing age and decreasing growth velocity, FGFR2 and 4 expression was downregulated in proliferative zone. Perichondrial FGF1, FGF7, FGF18, and FGF22 were upregulated.

In summary, we have analyzed the expression of all known FGFs and FGFRs in the postnatal growth plate using a method that is quantitative and highly sensitive. This approach identified ligands and receptors not previously known to be expressed in growth plate and revealed a complex pattern of spatial regulation of FGFs and FGFRs in the different zones of the growth plate. We also found temporal changes in FGF and FGFR expression which may contribute to growth plate senescence and thus help determine the size of the adult skeleton.

The family of FGFs constitutes at least 22 members that interact with at least four receptors (FGFR) and are major regulators of embryonic bone development.Both FGF1 and -2 as well as FGFR1, -2, and -3 are expressed in chondrocytes.In humans, activating mutations in the FGFR3 cause achondroplasia,the most common type of human dwarfism (97% of mutations have a Gly to Arg mutation in codon 380).Other forms of chondrodysplasia due to mutations in the FGFR3 gene include hypochondroplasia, a milder form of dwarfism and two severe types, SADDAN (severe achondroplasia with developmental delay and acanthosis nigricans), and thanatophoric dysplasia.Conversely, mice with an inactivating mutation in the FGFR3 gene demonstrate increased longitudinal growth. In addition, overexpression of FGF2 slows longitudinal growth.Only very recently, mice lacking FGF18 have been generated. These mice demonstrated a phenotype similar to that observed in mice lacking FGFR3, including expanded proliferating and hypertrophic zones, increased proliferation, differentiation, and Ihh signaling.In addition, FGF18 deficiency leads to delayed ossification and decreased expression of osteogenic markers, not seen in the FGFR3 knockout phenotype, which prompted the authors to suggest that FGF18 coordinates chondrogenesis and osteogenesis through FGFR3 and -2, respectively. In addition, FGF18 appeared to act as a physiological ligand for FGFR3 in the growth plate. These studies indicate that FGFR signaling reduces growth by inhibiting proliferation and differentiation.

Mancilla et al.  studied the effects of FGF2 on chondrocyte differentiation in a metatarsal organ culture system and found three growth-inhibiting mechanisms for FGF2: decreased growth plate chondrocyte proliferation, decreased cellular hypertrophy, and at high concentrations, decreased synthesis of cartilage matrix. Recently, a mouse model for thanatophoric dysplasia characterized by severe dwarfism was used to study the relationship between FGF signaling and the Ihh/PTHrP feedback loop. In these newborn mice with an activated FGFR3, Ihh and PTHrP mRNA expression were both down-regulated. In the same study, embryonic metatarsals from wild-type mice were cultured in the presence of FGF2, and similar results were found. Interestingly, FGF inhibited chondrocyte proliferation by down-regulating Ihh expression. Moreover, FGF and PTHrP signals independently inhibited chondrocyte differentiation. It was concluded that FGFR3 and PTHrP/Ihh signals act through two integrated parallel pathways that mediate both overlapping and distinct functions during longitudinal bone growth. In a recent study by Minina et al. , using a limb culture system, it was found that FGF and BMP signaling are antagonistic in the regulation of chondrocyte proliferation and in Ihh expression and the process of hypertrophic differentiation. The balance between the two adjusts the pace of the differentiation process to the proliferation rate.

Abstract

In vivo, fibroblast growth factor-2 (FGF-2) inhibits longitudinal bone growth. Similarly, activating FGF receptor 3 mutations impair growth in achondroplasia and thanatophoric dysplasia. To investigate the underlying mechanisms, we chose a fetal rat metatarsal organ culture system that would maintain growth plate histological architecture. Addition of FGF-2 to the serum-free medium inhibited longitudinal growth. We next assessed each major component of longitudinal growth: proliferation, cellular hypertrophy, and cartilage matrix synthesis. Surprisingly, FGF-2 stimulated proliferation, as assessed by [3H]thymidine incorporation. However, autoradiographic studies demonstrated that this increased proliferation occurred only in the perichondrium, whereas decreased labeling was seen in the proliferative and epiphyseal chondrocytes. FGF-2 also caused a marked decrease in the number of hypertrophic chondrocytes. To assess cartilage matrix synthesis, we measured 35SO4 incorporation into newly synthesized glycosaminoglycans. Low concentrations (10 ng/ml) of FGF-2 stimulated cartilage matrix production, but high concentrations (1000 ng/ml) inhibited matrix production. We conclude that FGF-2 inhibits longitudinal bone growth by three mechanisms: decreased growth plate chondrocyte proliferation, decreased cellular hypertrophy, and, at high concentrations, decreased cartilage matrix production. These effects may explain the impaired growth seen in patients with achondroplasia and related skeletal dysplasias.

Abstract

FGF21

Fibroblast Growth Factor 21 (FGF21) modulates glucose and lipid metabolism during fasting. In addition, previous evidence indicates that increased expression of FGF21 during chronic food restriction is associated with reduced bone growth and Growth Hormone (GH) insensitivity. In light of the inhibitory effects on growth plate chondrogenesis mediated by other FGFs, we hypothesized that FGF21 causes growth inhibition by acting directly at the long bones′ growth plate. We first demonstrated the expression of FGF21, FGFR1 and FGFR3 (two receptors known to be activated by FGF21), and β-klotho (a co-receptor required for the FGF21-mediated receptor binding and activation) in fetal and 3-week old mouse growth plate chondrocytes. We then cultured mouse growth plate chondrocytes in the presence of graded concentrations of rhFGF21 (0.01-10 μg/ml). Higher concentrations of FGF21 (5 and 10 μg/ml) inhibited chondrocyte thymidine incorporation and collagen X mRNA expression. 10 ng/ml GH stimulated chondrocyte thymidine incorporation and collagen X mRNA expression, with both effects being prevented by the addition in the culture medium of FGF21 in a concentration-dependent manner. In addition, FGF21 reduced GH binding in cultured chondrocytes. In cells transfected with FGFR1 siRNA or ERK 1 siRNA, the antagonistic effects of FGF21 on GH action were all prevented, supporting a specific effect of this growth factor in chondrocytes. Our findings suggest that increased expression of FGF21 during food restriction causes growth attenuation by antagonizing the GH stimulatory effects on chondrogenesis directly at the growth plate. In addition, high concentrations of FGF21 may directly suppress growth plate chondrocyte proliferation and differentiation.

Abstract

Endochondral ossification is a major mode of bone formation that occurs as chondrocytes undergo proliferation, hypertrophy, cell death, and osteoblastic replacement. We have identified a role for fibroblast growth factor receptor 3 (FGFR-3) in this process by disrupting the murine Fgfr-3 gene to produce severe and progressive bone dysplasia with enhanced and prolonged endochondral bone growth. This growth is accompanied by expansion of proliferating and hypertrophic chondrocytes within the cartilaginous growth plate. Thus, FGFR-3 appears to regulate endochondral ossification by an essentially negative mechanism, limiting rather than promoting osteogenesis. In light of these mouse results, certain human disorders, such as achondroplasia, can be interpreted as gain-of-function mutations that activate the fundamentally negative growth control exerted by the FGFR-3 kinase.

Conclusion: It appears that the Fibroblast Growth Factors, The FGF 1,2,3,4 all regulate the endochondral ossification process. There are a few studies that showed low rates of the FGF seems to increase longitudinal growth of the growth plates on the perineum outer layer but at high levels, all of the FGFs seems to inhibit the bone lengthening and slow down the growth process. As stated above

“”We conclude that FGF-2 inhibits longitudinal bone growth by three mechanisms: decreased growth plate chondrocyte proliferation, decreased cellular hypertrophy, and, at high concentrations, decreased cartilage matrix production””

The mechanism that is guessed to inhibit it is by down-regulating Ihh expression. The FGF21 does the same thing.

Increase Height And Grow Taller Using Nitric Oxide

Another compound that I have seen a lot of talk on the Impartial Height Increase Boards was the talk of either trying to increase the release of Nitric Oxide into the system. Here is what I found on the compound.

From source link HERE

Me: It turns out Nitric Oxide is derived from the amino acid Arginine. The production of Nitric Oxide occurs when the amino acid L-arginine is converted into L-citruline through an enzyme group known as Nitric Oxide Synthase (NOS). Apparently you can increase the release of NO in the system by either exercising, takin orally amino acid supplements, and such. Interestingly, in my searching it seems HeightQuest also wrote a post suggesting that NO might possibly be used to increase height located HERE. Tyler states that NO seems to be able to only lengthen the flat, irregular, and short bones but not the long bones since NO seems to only affects to osteoblasts (at least claimed by him). I would that since the effect of NO is basically to relax the body and make blood vessels increase in diameter, leading to better cell communication, it can only help in any type of cellular mechanisms.

From the website Nutrition Express

What is nitric oxide and how does it work?

by Jason Clark, BSc, MSc
What Is nitric oxide and how does it work?
Some people think it’s the gas that makes us laugh at the dentist office. Some think it’s the fuel racecar drivers use to speed up their cars. But it’s neither. Nitric oxide is a molecule that our body produces to help its 50 trillion cells communicate with each other by transmitting signals throughout the entire body.

Nitric oxide has been shown to be important in the following cellular activities:

• help memory and behavior by transmitting information between nerve cells in the brain
• assist the immune system at fighting off bacteria and defending against tumors
• regulate blood pressure by dilating arteries
• reduce inflammation
• improve sleep quality
• increase your recognition of sense (i.e. smell)
• increase endurance and strength
• assist in gastric motilityThere have been over 60,000 studies done on nitric oxide in the last 20 years and in 1998, The Nobel Prize for Medicine was given to three scientists that discovered the signaling role of nitric oxide.

Nitric oxide and heart disease 
Nitric oxide has gotten the most attention due to its cardiovascular benefits. Alfred Nobel, the founder of the Nobel Prize, was prescribed nitroglycerin over 100 years ago by his doctor to help with his heart problems. He was skeptical, knowing nitroglycerin was used in dynamite, but this chemical helped with his heart condition. Little did he know nitroglycerin acts by releasing nitric oxide which relaxes narrowed blood vessels, increasing oxygen and blood flow.

The interior surface (endothelium) of your arteries produce nitric oxide. When plaque builds up in your arteries, called atherosclerosis, you reduce your capacity to produce nitric oxide, which is why physicians prescribe nitroglycerin for heart and stroke patients.

Nitric oxide and erectile dysfunction 

Viagra and other impotence medications work due to their action on nitric oxide. One cause of impotence is unhealthy and aged arteries that feed blood to the sexual organs. Viagra works by creating more nitric oxide, causing a cascade of enzymatic reactions magnifying and extending nitric oxide, causing more blood flow and better erections.

How to increase nitric oxide in your body 

The most common way to increase nitric oxide is through exercise. When you run or lift weights, your muscles need more oxygen which is supplied by the blood. As the heart pumps with more pressure to supply the muscles with blood, the lining in your arteries releases nitric oxide into the blood, which relaxes and widens the vessel wall, allowing for more blood to pass though. As we age, our blood vessels and nitric oxide system become less efficient due to free radical damage, inactivity, and poor diet, causing our veins and arteries to deteriorate. Think of a fire hose as water rushes through it to put out a fire – it needs to expand enough to handle the pressure, still keeping enough force to put out the fire. Athletes and youth have the most optimal nitric oxide systems, reflecting their energy and resilience.

Diagram 1Another way to increase nitric oxide is through diet, most notably by consuming the amino acids L-arginine and L-citrulline. Arginine, which can be found in nuts, fruits, meats and dairy, directly creates nitric oxide and citrulline inside the cell (diagram 1).(6) Citrulline is then recycled back into arginine, making even more nitric oxide. Enzymes that convert arginine to citrulline, and citrulline to arginine need to function optimally for efficient nitric oxide production. We can protect those enzymes and nitric oxide by consuming healthy foods and antioxidants, like fruit, garlic, soy, vitamins C and E, Co-Q10, and alpha lipoic acid, allowing you to produce more nitric oxide. Nitric oxide only lasts a few seconds in the body, so the more antioxidant protection we provide, the more stable it will be and the longer it will last. Doctors are utilizing this science by coating stents (mesh tubes that prop open arteries after surgery) with drugs that produce nitric oxide.

Nitric oxide for athletes and bodybuilders 
Increasing nitric oxide has become the new secret weapon for athletes and bodybuilders. Athletes are now taking supplements with L-arginine and L-citrulline to increase the flow of blood and oxygen to the skeletal muscle which can augment strength and endurance. They also use them to facilitate the removal of exercise-induced lactic acid build-up which reduces fatigue and recovery time. Since arginine levels become depleted during exercise, the entire arginine-nitric oxide – citrulline loop can lose efficiency, causing less-than-ideal nitric oxide levels and higher lactate levels. Supplements can help restore this loop allowing for better workouts and faster recovery from workouts.With nitric oxide deficiencies due to aging, inactivity, smoking, high cholesterol, fatty diets, and lack of healthy foods, increasing your nitric oxide levels can help increase your energy, vitality and overall wellness. The basic adage of eating well and staying active all makes sense now.

WARNING: If you have an existing heart condition or abnormal blood pressure, please consult your healthcare professional before taking supplements to increase nitric oxide levels.

The Bone Growth Pill From Zymogenetics

More than a decade ago the biotech company Zymogenetics located in Seattle had apparently found 3 types of compounds (2 synthetic, and 1 natural) which had shown that they can stimulate osteoblasts, such as parathyroid hormone and bone morphogenic proteins (BMPs). After some research, I discovered the natural compound was statin, the compound most commonly known for being in the Lipitor drug used to lower cholesterol. My coworker had actually written her first post on the possibility of using Statin to possibly increase height and grow taller.

If you really wanted to know what the other two synthetic compounds are, then click on the links below which are old patents that have passed their time limit

Patent Link 1 (# 7951380) – Title: “Methods of stimulating bone growth using ZVEGF4 polypeptides” –

Patent Link 2(# AU1998057981) – Title: “COMPOSITIONS AND METHODS FOR STIMULATING BONE GROWTH

The drugs that they were testing never got any more news about what happened to them. From working in the past in the pharmaceutical industry, I would guess there was not enough funding or interest in getting the drugs out to market. It was indeed an absolute breakthrough for the medical community and especially for people suffering from osteoporosis.

The thing to note that the drug was never intended to be used to extend the actual form in our bodies, but to increase the body density in our bones. So technically, the drugs indeed did promote bone growth, but did not grow bones in the way us height increasers had been hoping for.

The article I will be posting below is from the Science Daily website HERE. Note that it was written in 1999, such a long time ago. Another article written by the BBC is located HERE.


New Chemicals Could Lead To First Bone Growth Pill

ScienceDaily (Mar. 22, 1999) — ANAHEIM, Calif., March 21 — New chemicals that, if successful, could become the first osteoporosis treatment to stimulate new bone growth — rather than merely retard bone loss — were described here today at a national meeting of the American Chemical Society, the world’s largest scientific society. Researchers from the Seattle biotechnology company ZymoGenetics Incorporated said their new compounds are showing positive results in animals and, unlike other bone-growth candidates, can be put in a pill.

In humans, bone undergoes continuous remodeling, with cells called osteoclasts “eating up”old bone as osteoblast cells replace it with new bone. Osteoporosis, which affects some 15-20 million Americans, is caused by increased bone breakdown without new bone formation. The result is a loss of bone mass and increased susceptibility to fractures, most commonly in those age 45 and older. The cost of treatments associated with osteoporosis in the U.S. has been estimated at $3.8 billion annually.

Current treatments, including estrogens, all act to decrease bone loss. They can’t do anything about bone that is already gone and, therefore, are not helpful to everyone. “Our new bone forming agents may have better and more widespread utility for treatment of osteoporosis,” said ZymoGenetics senior scientist Nand Baindur, Ph.D.

There are currently no drugs available to help grow bone. Researchers have tried giving patients proteins that the body naturally uses to stimulate osteoblasts, such as parathyroid hormone and bone morphogenic proteins (BMPs). But, according to Dr. Baindur, those clinical trials have been mostly unsuccessful or inconclusive. Furthermore, he explains that proteins are big molecules which can usually be given only by injection and don’t hold up well in the body. Even if such treatments worked, he adds, the proteins are generally difficult to formulate and manufacture, tending to eventually make them expensive.

Instead of using the proteins themselves, Dr. Baindur’s laboratory screened tens of thousands of compounds for the ability to stimulate BMPs. They have selected three — two synthetic chemicals and one natural product — for pre-clinical development, and early indications look promising. “This is the first report of small molecule drug-like compounds which have been shown to stimulate the formation of new bone in animals,” says Dr. Baindur.

Such small molecule compounds are not only relatively inexpensive and easily made, but usually quite stable. Dr. Baindur adds that they can also be easily modified or formulated as the need arises. The new compounds should be able to be put into pill form. While no human tests have yet been conducted, Dr. Baindur says “these compounds are predicted to be useful in the clinical treatment of osteoporosis and related bone-deficit conditions, including bone fractures. As bone formation agents, they can potentially be given alone or in combination with agents which decrease bone loss.”

While bone regenerating pills are probably years away from the market, there is the possibility that one of the new compounds might have a head start in clinical trials. The natural product candidate is part of a chemical class called statins, some of which are already in use for the treatment of heart disease.