Rheumatologist Nancy Lane discusses the latest research into osteoarthritis and osteoporosis

In less than two decades, adults aged 65 and over are projected to outnumber children for the first time in US history. Musculoskeletal disorders such as osteoporosis and osteoarthritis are common in older people.

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Nancy Lane

Internationally recognized medical scientist Nancy E. Lane has devoted her entire life to addressing the rheumatological problems of an aging population.

Lane, distinguished professor of medicine, rheumatology and aging research at UC Davis School of Medicine, discovered a compound, Llp2a-alendronate, that can improve common types of bone degeneration by directing stem cells to the surface of diseased bones to grow new tissue. She was recently named a 2022 Fellow of the National College of Inventors and one of the top 1000 female scientists in the world by Research.com.

We spoke with Lane about her pioneering research into osteoporosis and osteoarthritis.

What do you study in your latest research?

Recently, my team took a deep dive into the study of blood vessels and how they form in bones. Blood vessels bring energy and oxygen to build bones, so we’re trying to understand if they become abnormal with aging, inflammation, and when we’re given anti-inflammatory steroids like glucocorticoids.

We are also studying muscle composition in people with osteoarthritis of the knee. We have learned that the muscles of older people with this disease contain a lot of fat. This intramuscular fat may explain why people become weak when they have arthritis.

In addition, we looked at muscle energy. We have learned that mitochondrial energy and function are normal in older people with osteoarthritis of the knee. This is important because we prescribe exercises to patients with osteoarthritis of the knee thinking that they will stay in good physical shape and possibly strengthen the muscles around the arthritic joint. Our current results show that patients can exercise.

How would you like to develop these findings?

We do not yet have therapies to improve muscle and prevent strength deterioration or any muscle-targeted drugs. I believe it is a combination of bones, joints and muscles that wear out.

So, we’re currently working on a study that analyzes why older people have trouble walking as they get older. The Muscle, Mobility and Aging Study (SOMMA), funded by the National Institute on Aging, aims to use biopsies, novel biomarkers, advanced imaging, and intensive physical and cognitive assessments to identify the biological processes that contribute to changes in mobility and fitness. aging.

The study is very detailed, down to muscle biopsy and gene expression, and we are working to find the cause of the muscle deterioration.

How can aging Americans prevent osteoporosis?

One of the problems with osteoporosis is that it is silent until it is no longer quiet. Patients are rarely diagnosed with osteoporosis at an early stage. Every woman during menopause should be evaluated for risk factors for osteoporosis. All men must be screened at age 70.

If a person has had fractures as an adult, or if a parent has a history of hip fracture, the patient should have a bone density scan to see if there is an underlying problem that needs to be treated. Unfortunately, bone density assessment has become less popular in the United States.

One of the ways we’ve been successful in prevention at UC Davis is through our brittle fracture program. After a fracture, we provide complex treatment of patients to prevent fractures in the future. This is a good first step, but we still have a lot of work to do to identify these patients early.

What do you think should be the focus of research on osteoarthritis and osteoporosis?

For osteoporosis, we have quite effective drugs that can build bones. Our group has done a lot of work with parathyroid hormone, which is a bone-promoting peptide, and anti-sclerostin antibodies, which promote bone growth.

Once your bone grows, you can hang from it. You just need to diagnose people, treat them and not lose them for follow-up. I think this is the biggest area that needs to be addressed.

For osteoarthritis, it’s more difficult because we don’t have other treatments other than joint replacement.

But we do know that simple things like weight loss and exercise can really help a patient’s overall health and joints. So it’s also about getting people to work with a rheumatologist and giving them helpful treatment regimens.

I truly believe that within the next decade we will have drugs and treatments that can reverse osteoarthritis and possibly regenerate joints. But we don’t have them yet.

How can we make research on osteoporosis and osteoarthritis more objective?

We do not focus on the prevention of osteoporosis and osteoarthritis among ethnic minorities and men. This becomes even more of a problem when we start doing clinical trials. People who have more physical work cannot take a break during the day to devote themselves to studying. This way we get highly educated people who have more time and resources to participate.

This does not reflect the general population. So we really need to somehow find a way for these more disadvantaged, ethnically and socio-economically diverse people to take part in our research.

What did it mean to you to become a member of the National Academy of Inventors?

It was a great honor for me to become a member of the National Academy of Inventors. What makes it special is that I was nominated by my peers who recognize my creativity and contributions to science through my patents.

There is a community of musculoskeletal disease researchers who have inspired me throughout my career. I am indebted to my mentors and to all the people who believed in me. In return, I hope to have inspired and helped them too.

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