Clomipramine causes osteoporosis by promoting osteoclastogenesis via E3 ligase Itch, which is prevented by Zoledronic acid

Sci Rep. 2017 Feb 1:7:41358. doi: 10.1038/srep41358.

Abstract

Patients taking antidepressants, including Clomipramine (CLP), have an increased risk of osteoporotic fracture. However, the effects of CLP on bone metabolism are unknown. Here, we demonstrate that WT mice treated with CLP for 2 weeks had significantly reduced trabecular bone volume and cortical bone thickness, associated with increased osteoclast (OC) numbers, but had no change in osteoblast numbers or bone formation rate. Bone marrow cells from CLP-treated mice had normal OC precursor frequency, but formed significantly more OCs when they were cultured with RANKL and M-CSF. CLP promoted OC formation and bone resorption and expression of OC-associated genes. CLP-induced bone loss was prevented by Zoledronic acid. At the molecular level, CLP inhibited the activity of the ubiquitin E3 ligase Itch. CLP did not promote OC formation from bone marrow cells of Itch-/- mice in vitro nor induce bone loss in Itch-/- mice. Our findings indicate that CLP causes bone loss by enhancing Itch-mediated osteoclastogenesis, which was prevented by Zoledronic acid. Thus, anti-resorptive therapy could be used to prevent bone loss in patients taking antidepressants, such as CLP.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Marrow Cells / drug effects
  • Bone Marrow Cells / metabolism
  • Bone Marrow Cells / pathology
  • Bone Resorption / pathology
  • Bone Resorption / prevention & control
  • Cell Count
  • Clomipramine / adverse effects*
  • Diphosphonates / pharmacology
  • Diphosphonates / therapeutic use*
  • Imidazoles / pharmacology
  • Imidazoles / therapeutic use*
  • Mice, Inbred C57BL
  • Organ Size / drug effects
  • Osteoclasts / pathology*
  • Osteogenesis* / drug effects
  • Osteoporosis / chemically induced*
  • Osteoporosis / drug therapy*
  • Osteoporosis / pathology
  • Ubiquitin-Protein Ligases / deficiency
  • Ubiquitin-Protein Ligases / metabolism*
  • Zoledronic Acid

Substances

  • Diphosphonates
  • Imidazoles
  • Zoledronic Acid
  • Itch protein, mouse
  • Ubiquitin-Protein Ligases
  • Clomipramine