Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy
Abstract The effects of gender-affirming hormone therapy on the skeletal integrity and fracture risk in transitioning adolescent trans girls are unknown. To address this knowledge gap, we developed a mouse model to simulate male-to-female transition in human adolescents in whom puberty is first arre...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2024-01-01
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| Series: | Bone Research |
| Online Access: | https://doi.org/10.1038/s41413-023-00308-2 |
| _version_ | 1797355913660596224 |
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| author | Tian Nie Varun S. Venkatesh Suzanne Golub Kathryn S. Stok Haniyeh Hemmatian Reena Desai David J. Handelsman Jeffrey D. Zajac Mathis Grossmann Rachel A. Davey |
| author_facet | Tian Nie Varun S. Venkatesh Suzanne Golub Kathryn S. Stok Haniyeh Hemmatian Reena Desai David J. Handelsman Jeffrey D. Zajac Mathis Grossmann Rachel A. Davey |
| author_sort | Tian Nie |
| collection | DOAJ |
| description | Abstract The effects of gender-affirming hormone therapy on the skeletal integrity and fracture risk in transitioning adolescent trans girls are unknown. To address this knowledge gap, we developed a mouse model to simulate male-to-female transition in human adolescents in whom puberty is first arrested by using gonadotrophin-releasing hormone analogs with subsequent estradiol treatment. Puberty was suppressed by orchidectomy in male mice at 5 weeks of age. At 3 weeks post-surgery, male-to-female mice were treated with a high dose of estradiol (~0.85 mg) by intraperitoneal silastic implantation for 12 weeks. Controls included intact and orchidectomized males at 3 weeks post-surgery, vehicle-treated intact males, intact females and orchidectomized males at 12 weeks post-treatment. Compared to male controls, orchidectomized males exhibited decreased peak bone mass accrual and a decreased maximal force the bone could withstand prior to fracture. Estradiol treatment in orchidectomized male-to-female mice compared to mice in all control groups was associated with an increased cortical thickness in the mid-diaphysis, while the periosteal circumference increased to a level that was intermediate between intact male and female controls, resulting in increased maximal force and stiffness. In trabecular bone, estradiol treatment increased newly formed trabeculae arising from the growth plate as well as mineralizing surface/bone surface and bone formation rate, consistent with the anabolic action of estradiol on osteoblast proliferation. These data support the concept that skeletal integrity can be preserved and that long-term fractures may be prevented in trans girls treated with GnRHa and a sufficiently high dose of GAHT. Further study is needed to identify an optimal dose of estradiol that protects the bone without adverse side effects. |
| first_indexed | 2024-03-08T14:18:03Z |
| format | Article |
| id | doaj.art-482ef76d5bb24dadaf20fa057ce7576a |
| institution | Directory Open Access Journal |
| issn | 2095-6231 |
| language | English |
| last_indexed | 2024-03-08T14:18:03Z |
| publishDate | 2024-01-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Bone Research |
| spelling | doaj.art-482ef76d5bb24dadaf20fa057ce7576a2024-01-14T12:15:17ZengNature Publishing GroupBone Research2095-62312024-01-0112111210.1038/s41413-023-00308-2Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapyTian Nie0Varun S. Venkatesh1Suzanne Golub2Kathryn S. Stok3Haniyeh Hemmatian4Reena Desai5David J. Handelsman6Jeffrey D. Zajac7Mathis Grossmann8Rachel A. Davey9Department of Medicine, Austin Health, University of MelbourneDepartment of Medicine, Austin Health, University of MelbourneDepartment of Medicine, Austin Health, University of MelbourneDepartment of Biomedical Engineering, University of MelbourneDepartment of Medicine, Austin Health, University of MelbourneANZAC Research Institute, University of Sydney and Andrology, Concord Repatriation General HospitalANZAC Research Institute, University of Sydney and Andrology, Concord Repatriation General HospitalDepartment of Medicine, Austin Health, University of MelbourneDepartment of Medicine, Austin Health, University of MelbourneDepartment of Medicine, Austin Health, University of MelbourneAbstract The effects of gender-affirming hormone therapy on the skeletal integrity and fracture risk in transitioning adolescent trans girls are unknown. To address this knowledge gap, we developed a mouse model to simulate male-to-female transition in human adolescents in whom puberty is first arrested by using gonadotrophin-releasing hormone analogs with subsequent estradiol treatment. Puberty was suppressed by orchidectomy in male mice at 5 weeks of age. At 3 weeks post-surgery, male-to-female mice were treated with a high dose of estradiol (~0.85 mg) by intraperitoneal silastic implantation for 12 weeks. Controls included intact and orchidectomized males at 3 weeks post-surgery, vehicle-treated intact males, intact females and orchidectomized males at 12 weeks post-treatment. Compared to male controls, orchidectomized males exhibited decreased peak bone mass accrual and a decreased maximal force the bone could withstand prior to fracture. Estradiol treatment in orchidectomized male-to-female mice compared to mice in all control groups was associated with an increased cortical thickness in the mid-diaphysis, while the periosteal circumference increased to a level that was intermediate between intact male and female controls, resulting in increased maximal force and stiffness. In trabecular bone, estradiol treatment increased newly formed trabeculae arising from the growth plate as well as mineralizing surface/bone surface and bone formation rate, consistent with the anabolic action of estradiol on osteoblast proliferation. These data support the concept that skeletal integrity can be preserved and that long-term fractures may be prevented in trans girls treated with GnRHa and a sufficiently high dose of GAHT. Further study is needed to identify an optimal dose of estradiol that protects the bone without adverse side effects.https://doi.org/10.1038/s41413-023-00308-2 |
| spellingShingle | Tian Nie Varun S. Venkatesh Suzanne Golub Kathryn S. Stok Haniyeh Hemmatian Reena Desai David J. Handelsman Jeffrey D. Zajac Mathis Grossmann Rachel A. Davey Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy Bone Research |
| title | Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy |
| title_full | Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy |
| title_fullStr | Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy |
| title_full_unstemmed | Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy |
| title_short | Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy |
| title_sort | estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male to female mouse model of gender affirming hormone therapy |
| url | https://doi.org/10.1038/s41413-023-00308-2 |
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