Patients administered the OSTPO Capsule in clinical trials showed improved bone marrow density and serum oestradiol compared with those administered calcium. However, because of the small sample size of these trials, the conclusions need to be interpreted cautiously, and more well-designed, high-quality random-controlled trials are required.1 Controversy still exists regarding the healing effect and associated mechanism underlying OSTPO capsules in osteoporotic early process fracture healing and ovariectomized patients. In a study involving fifty female 12-week old Sprague-Dawley rats, OSTPO treatment enhanced the bone mineral density, X-ray radiography score and quantity of callus tissues in rats in the ovariectomy and fracture groups. No significant difference was observed in bone morphogenetic protein-2 expression. OSTPO also promoted the early vascular formation of osteoporotic fracture healing in ovariectomized rats.2

In a controlled study in 40 female SD rats, OSTPO was found to increase bone density and E2 levels of ovariectomised rats, and is effective in the treatment of osteoporosis.3

OSTPO-medicated serum promoted osteoblast mineralization in a mouse osteoblast MC3T3-E1 and an osteoclast induced by a mouse single nucleus macrophage RAW 264 co-culture system. Additionally, it reduced the count of absorption lacuna on bone chips. OSTPO-medicated serum could increase the ratio of OPG/RANKL in a dose dependent manner.4

The treatment for osteoporosis is presently targeted on the inhibition of bone-resorption, and OSTPO has been reported to be effective for pro- moting bone formation. In a randomised study involving 24 rats suffering osteoporosis induced by ovariectomy, OSTPO was found to partly prevent bone loss by inhibiting bone resorption and promoting bone formation, thereby reducing the bone turnover level.5

Icariin

The effects of icariin treatment combined with exercise therapy on bone parameters and body weight of ovariectomized rats were investigated. Exercise combined with icariin was found to have a synergistic effect in the early prevention of osteoporosis in ovariectomized rats. The effects of icariin and exercise on osteoporosis require further exploration.6

Pyrola decorata and Dipsacus asper

The effects of herbal medicines, such as Dipsacus asperi (RDD), Pyrola decorata (PHD), and Cynomorium songaricum decoction (CSD), on osteoporotic rats induced by ovariectomy (OVX) have been investigated. Compared to the normal control and non-overiectomized rats, trabecular bone formation was significantly reduced in OVX rats, but restored in DES-treated rats. Treatment with either RDD or PHD enhanced trabecular bone formation remarkably. No significant change in bone formation was observed in CSD-treated rats. OPG expression of protein and mRNA was reduced significantly in OB and bMSC of OVX control rats. RANKL expression of protein and mRNA was increased significantly in OB and bMSC of OVX control rats. These effects were substantially reversed by treatment with DES, RDD, or PHD in OB and bMSC of OVX rats. No significant changes in either OPG or RANKL expression were observed in OB and bMSC of OVX rats treated with CSD.

RDD and PHD were hence found to increase bone formation by stim- ulating overexpression of OPG and downregulation of RANKL in OB and bMSC. This suggests that RDD and PHD may be used as alternative therapeutic agents for postmenopausal osteoporosis.7

Dipsacus asper

The effects of Radix Dipsaci extract (RDE) on postmenopausal osteo- porosis have been evaluated. 16 weeks treatment of RDE slowed weight gain and prevented the loss of bone mass induced by ovariectomy. The prevention effect on bone loss was due to the alteration of the rate of bone remodeling, which could be inferred from the decreased level of bone turnover markers, such as serum ALP, OC and urinary DPD. The changes in urinary calcium and phosphorus excretion levels provided the same evidence. The treatment could also enhance the bone strength and prevent the deterioration of trabecular microarchitecture. Radix Dipsaci extract hence has the potential to be used in the treatment of postmenopausal osteoporosis.8

References


Zhao, Y-j., Hu, J., Chen, J. A systematic evaluation on Xianlinggubao capsule for postmenopausal osteopo- rosis. Tian Jin Zhong Yi Yao. 2010; 27(4): 279-282.


Tian, F-m., Zhang, L., Luo, Y., Song, Y-q., Jiao, A., Cheng, T. Xianlinggubao promotes vascular formation in osteoporotic fracture callus. Zhong Guo Zu Zhi Gong Cheng Yan Jiu Yu Lin Chuang Kang Fu. 2011; 15(28): 5161-5164.


Wang, J., Hu, X., Zhuo, J., Li, Y., Wang, L. Effect of Xianlinggubao on bone density and metabolism of ovariectomized rats. Shaan Xi Zhong Yi Xue Yuan Yuan Bao. 2010; (3): 64-65.


Zhang, Y., Yang, G., Sun, G-z. The experiment study of the effect of Xianlinggubao medicated serum on the co-culture system of mouse osteoblast and osteoclast. Tianjin. Zhong Guo Lao Nian Xue Za Zhi. 2011; 31(14): 2670-2673.


Xing, L., Jiao, Y-h., Geng, L-h., Sun, Y.. Xianlinggubao for treatment of osteoporotic rats: Serological and bone histomorphometric evaluation. Zhong Guo Zu Zhi Gong Cheng Yan Jiu Yu Lin Chuang Kang Fu. 2011; 15(15): 2786-2789.

Liu, M., Zhong, C., He, RX., Chen, LF. Icariin associated with exercise therapy is an effective treatment for postmenopausal osteoporosis. Chin Med J (Engl). 2012 May;125(10):1784-9.


Liu, M., Xiao, GG., Rong, P., et al. Therapeutic effects of Radix Dipsaci, Pyrola Herb, and Cynomorium Son- garicum on bone metabolism of ovariectomized rats. BMC Complement Altern Med. 2012 May 28;12(1):67.

Liu, ZG., Zhang, R., Li, C., et al. The osteoprotective effect of Radix Dipsaci extract in ovariectomized rats. J Ethnopharmacol. 2009 May 4;123(1):74-81. Epub 2009 Mar 4