Research in the bone group focuses on osteoporotic fragility fractures and osteoarthritis by examining bone structure, shape and biology in health and disease. As part of a team lead by imaging experts Graham Treece and Andrew Gee from the University Engineering department, we developed a way of assessing the 3D structure and shape of cortical bone in life called Cortical Bone Mapping (CBM). We have used CBM, histology and microCT to discover that there are defined patches of focal osteoporosis in older people’s femurs that predispose them to hip fracture. CBM measurements from clinical CT predict hip fracture well. Analysing separate clinical trials, we found that teriparatide PTH1-34 and denosumab anti-RANK ligand antibody treatment of osteoporotic women improved bone in patches of the femur at risk of fracture. Older men undertaking high-impact short-duration exercise (the HIPHOP study) also responded well, with focal patches of cortical bone improving on CT.
Within the Department of Medicine, we represent the Division of Rheumatology and within Cambridge NIHR Biomedical Research Centre we represent the 'Metabolism, Endocrinology and Bone' theme. Evelyn Trust funding allowed us to purchase the UK’s first high resolution Xtreme CT scanner, and have supported clinical radiology researcher Dr Tom Turmezei to carry forward the shape and image analysis techniques into the field of osteoarthritis. He has published key papers on the assessment of hip osteoarthritis with novel CT techniques. We make use of the Wellcome Trust Clinical Research Facility (WTCRF) for our clinical studies. Our clinical trials research includes an investigator-led proof of concept study demonstrating that a single dose of intravenous zoledronate prevents bone loss after stroke.
The National Institute for Health Research (Research for Patient Benefit), Versus Arthritis, the Medical Research Council, the Evelyn Trust, the National Osteoporosis Society, Addenbrooke's Charitable Trust and the Cambridge NIHR Biomedical Research Centre support our current research program.
Bone Mapping work in Osteoporosis
- Poole KE, Skingle L, Gee AH, Turmezei TD, Johannesdottir F, Blesic K, Rose C, Vindlacheruvu M, Donell S, Vaculik J, Dungl P, Horak M, Stepan JJ, Reeve J, Treece GM. Focal osteoporosis defects play a key role in hip fracture. Bone. 2017;94:124-34. https://www.ncbi.nlm.nih.gov/pubmed/27777119
- Allison S, Poole KE et al. The Influence of High Impact Exercise on Cortical and Trabecular Bone Mineral Content and 3D Distribution across the Proximal Femur in Older Men: a Randomised Controlled Unilateral Intervention. J Bone Miner Res 2015. 30(9): 1709-16. http://www.ncbi.nlm.nih.gov/pubmed/25753495
- Poole KE, Treece GM, Gee AH, Brown JP, McClung MR, Wang A, et al. Denosumab rapidly increases cortical bone in key locations of the femur: a 3D bone mapping study in women with osteoporosis. J Bone Miner Res. 2015; 30(1): 46-54.http://www.ncbi.nlm.nih.gov/pubmed/25088963
- Gregson CL, Poole KE, McCloskey EV, Duncan EL, Rittweger J, Fraser WD, et al. Elevated circulating sclerostin concentrations in individuals with High Bone Mass, with and without LRP5 mutations. J Clin Endocrinol Metab. 2014: jc20133958. http://www.ncbi.nlm.nih.gov/pubmed/24606091
- Power J, Poole KE, van Bezooijen R, Doube M, Caballero-Alias AM, Lowik C, Papapoulos S, Reeve J, Loveridge N. Sclerostin and the regulation of bone formation: Effects in hip osteoarthritis and femoral neck fracture. J Bone Miner Res 2010; 25:1867-1876. http://www.ncbi.nlm.nih.gov/pubmed/20200987
- Poole KE, van Bezooijen RL, Loveridge N, Hamersma H, Papapoulos SE, Lowik CW, Reeve J. Sclerostin is a delayed secreted product of osteocytes that inhibits bone formation. Faseb J 2005; 19:1842-1844. http://www.ncbi.nlm.nih.gov/pubmed/16123173
Osteoarthritis imaging work
- Turmezei TD, Treece GM, Gee AH, Fotiadou AF, Poole KE. Quantitative 3D analysis of bone in hip osteoarthritis using clinical computed tomography. Eur Radiology. 2016 http://www.ncbi.nlm.nih.gov/pubmed/26443603
- Turmezei TD, Lomas DJ, Hopper MA, Poole KE. Severity mapping of the proximal femur: a new method for assessing hip osteoarthritis with computed tomography. Osteoarthritis and cartilage. 2014; 22(10): 1488-98.http://www.ncbi.nlm.nih.gov/pubmed/24631578
- Turmezei TD, Fotiadou A, Lomas DJ, Hopper MA, Poole KE. A new CT grading system for hip osteoarthritis. Osteoarthritis and cartilage 2014; 22(10): 1360-6. http://www.ncbi.nlm.nih.gov/pubmed/24642349