Potassium citrate prevents increased osteoclastogenesis resulting from acidic conditions: Implication for the treatment of postmenopausal bone loss

PLoS One. 2017 Jul 17;12(7):e0181230. doi: 10.1371/journal.pone.0181230. eCollection 2017.

Abstract

The extracellular acidic milieu in bones results in activation of osteoclasts (OC) and inhibition of osteoblasts (OB) causing a net loss of calcium from the skeleton and the deterioration of bone microarchitecture. Alkalinization through supplementation with potassium citrate (K citrate) has been proposed to limit the osteopenia progression, even though its pharmacological activity in bone microenvironment is not well defined. We evaluated if K citrate was able to prevent the adverse effects that acidic milieu induces on bone cells. OC and OB were maintained in neutral (pH 7.4) versus acidic (pH 6.9) culture medium, and treated with different K citrate concentrations. We evaluated the OC differentiation at seven days, by counting of multinucleated cells expressing tartrate-resistant acid phosphatase, and the activity of mature OC at 14 days, by quantifying of collagen degradation. To evaluate the effects on OB, we analyzed proliferation, mineralization, and expression of bone-related genes. We found that the low pH increased OC differentiation and activity and decreased OB function. The osteoclastogenesis was also promoted by RANKL concentrations ineffective at pH 7.4. Non-cytotoxic K citrate concentrations were not sufficient to steadily neutralize the acidic medium, but a) inhibited the osteoclastogenesis, the collagen degradation, and the expression of genes involved in RANKL-mediated OC differentiation, b) enhanced OB proliferation and alkaline phosphatase expression, whereas it did not affect the in vitro mineralization, and c) were effective also in OC cultures resistant to alendronate, i.e. the positive control of osteoclastogenesis inhibition. In conclusion, K citrate prevents the increase in OC activity induced by the acidic microenvironment, and the effect does not depend exclusively on its alkalizing capacity. These data provide the biological basis for the use of K citrate in preventing the osteopenia progression resulting from low-grade acidosis.

MeSH terms

  • Alendronate / pharmacology
  • Alkaline Phosphatase / metabolism
  • Animals
  • Bone Density Conservation Agents / pharmacology*
  • Bone Density Conservation Agents / toxicity
  • Cell Proliferation / drug effects
  • Cell Proliferation / physiology
  • Culture Media / chemistry
  • Drug Evaluation, Preclinical
  • Humans
  • Hydrogen-Ion Concentration*
  • Mice
  • Osteoblasts / drug effects*
  • Osteoblasts / metabolism
  • Osteoclasts / drug effects*
  • Osteoclasts / metabolism
  • Osteogenesis / drug effects*
  • Osteogenesis / physiology
  • Osteoporosis, Postmenopausal / drug therapy
  • Osteoporosis, Postmenopausal / metabolism
  • Potassium Citrate / pharmacology*
  • Potassium Citrate / toxicity
  • RANK Ligand / metabolism
  • RAW 264.7 Cells

Substances

  • Bone Density Conservation Agents
  • Culture Media
  • RANK Ligand
  • TNFSF11 protein, human
  • Tnfsf11 protein, mouse
  • Alkaline Phosphatase
  • Potassium Citrate
  • Alendronate

Grants and funding

This work was supported by the “Fondazione del Monte di Bologna e Ravenna (IT)” and grant funded by the Italian Government (5 per mille 2014). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.