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Osteoporosis, Fractures and Falls Current Research Projects

Vascular Mechanisms Underlying Skeletal Fragility in Older Adults
R01 AG065299

The vascular supply is critically important to the skeleton, yet the clinical implications of vascular dysfunction for skeletal fragility are poorly understood. Studies demonstrate associations between vascular disease and osteoporosis in older adults. However, it is unknown whether vascular dysfunction itself underlies these associations. We will use subclinical vascular tonometry and hemodynamic measures to investigate the impact of aging-related vascular impairments on the skeleton, in the unique setting of the Framingham Study. We hypothesize that individuals with more severe aortic stiffness and blunted peripheral hyperemic flow response will have more severe deterioration in bone microarchitecture, loss of bone strength, and higher incidence of fracture. To test this hypothesis, we will address the following specific aims: (1) Determine the contribution of vascular function to incidence of fracture, and (2) Determine the contribution of vascular function to longitudinal changes in bone density, microarchitecture, and strength. By identifying the vascular mechanisms underlying skeletal fragility, this project has the potential to be paradigm shifting, providing new targets for interventions to reduce the tremendous public health burden of fractures in our older population.


The Gut Microbiome and Bone Microarchitecture
NIAMS/NIH R01A R061445

The goal of this project is to understand the effects of the microbiome on skeletal health in humans. We will determine if the microbiome plays a modulatory role on BMD, microarchitecture and strength in men and women from two population-based cohorts, the Framingham Study Third Generation (Gen3) and the Osteoporotic Fractures in Men (MrOS) cohorts.


A Clinical Prediction Tool to Guide Treatment of Osteoporosis in the Nursing Home
1R01AG045441

The purpose of this project is to create a valid and practical prediction tool that will discriminate long-stay nursing home residents likely to reduce their fracture risk by taking an effective medication, and to identify which osteoporosis medications prevent fractures in long-stay residents.


Integrative Resource to Develop Translational Strategies to Promote Longevity
U24AG051129

This project is rooted in the evaluation and identification of likely causal chains of molecular and physiological activity connecting genetic variants to key aspects of human longevity for which pharmacological intervention at points in these chains could impact longevity. Our approach begins with longevity associated variants (LAVs) which we will identify and prioritize from published genome wide association study meta-analyses of longevity and from multivariate analysis of results from GWAS of longevity-related phenotypes to identify variants with pleiotropic effects. Potential LAVs will also be identified from genetic associations with human phenotypes that are likely to be influenced by genetic networks known to modulate aging in model organisms. Computational tools and curated resources of genomic functional characterization will be used to perform functional annotation of LAVs to identify the likely immediate functional impact of associated variants, such as the disruption of protein structure or a transcription factor binding site. We will employ methods that leverage tissue-specific genomic functional annotation to aid in the identification of tissues that might be relevant for genetic associations with longevity. We will assemble data and provide tools to determine if a variant may impact gene products/molecular phenotypes such as RNA expression that could be pharmacologically manipulated. Recognizing that genes do not work in isolation, but rather as part of networks or pathways with likely feedback and redundancy mechanisms, we will provide resources for assessing the role of a gene impacted by a LAV in the context of the functioning of gene networks or pathways. For this, we will use methods for assessing the ‘importance’ of a gene in network functioning and network information flow based on the topology of the network. Such analyses can lead to insights into how the manipulation of a gene may impact more downstream processes relevant to the development of a druggable target for longevity.


 

Predicting Hip Fracture using Biomechanical Approach
NIAMS R01 AR060816

The specific goal of this study is to investigate the contribution of trochanteric soft tissue thickness to hip fracture risk, and to include this in the biomechanical Factor-of-Risk model. 


Risk Factors for Age Related Bone Loss
NIAMS R01 AR41398

This is the fifth 5-year continuation of this project examining both genetic and lifestyle factors influencing age-related bone loss and fractures. The project involves the performance of a high resolution peripheral quantitative computed tomography scans on 3,500 Framingham Study Third Generation participants and the analysis of computed tomography scans of the paraspinal musculature to study the contribution of visceral adipose tissue to bone and muscle status


Combining Testosterone Therapy and Exercise to Improve Function Post Hip Fracture
NIA R01 AG051647

This is a multicenter randomized placebo controlled trial of exercise with and without testosterone in women who have recently sustained a hip fracture and have completed their traditional rehabilitation.  HSL is one of six clinical sites nationwide who will recruit women to participate in this study to improve mobility during recovery from hip fracture


Identifying Osteoporosis Genes by Whole Genome Sequencing and Functional Validation in Zebra Fish
NIAMS R01 AR072199

The goal of this study is to utilize whole genome sequencing in large well-phenotyped populations as well as the CRISPR/Cas9 gene-editing zebrafish model to identify potential causal variants and targeted genes influencing skeletal integrity. Findings from this work may eventually lead to new diagnostics and therapeutics of osteoporosis.