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Springerplus. 2015 Feb 3;4:59. doi: 10.1186/s40064-015-0848-3. eCollection 2015.

Induction of creatine kinase release from cultured osteoclasts via the pharmacological action of aminobisphosphonates.

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Research Promotion, Ono Pharmaceutical Co., Ltd, 3-1-1, Sakurai, Shimamoto-cho, Mishima-gun Osaka, 618-8585 Japan.
Discovery Research Laboratories, Ono Pharmaceutical Co., Ltd, Shimamoto-cho, Mishima-gun Osaka, 618-8585 Japan.


An increase of serum creatine kinase (CK) has been observed in clinical studies of nitrogen-containing aminobisphosphonates (N-BPs). Osteoclasts are thought to be the source of the CK, but there is no clear evidence for the hypothesis. In this study, CK release from rabbit osteoclasts induced by N-BPs was examined in an in vitro culture system. Rabbit bone-derived cells were cultured for 3 days on the N-BPs pretreated cortical bone slices. CK activity in the culture medium was measured at 3 days of culture. The CK activity was increased with all N-BPs at concentrations at which showed antiresorptive activity over 60% inhibition of C-terminal cross-linking telopeptide of type I collagen (CTX-1) release. The maximum induction of CK activity was 2.6 times the control level. The lowest N-BP concentration inducing CK release was 3 times lower than that required to decrease the osteoclast number. Bafilomycin A1, an inhibitor of vacuolar H(+)-ATPase, abrogated all N-BP actions, including CK release. Bone-derived cells except osteoclasts were insensitive to bafilomycin A1, suggesting that osteoclasts were the source of CK. Regarding the time course, CK release occurred after a 1 day lag time and increased steadily until day 3 of culture. These results show that CK release is induced by N-BPs from osteoclasts at concentrations at which N-BPs show antiresorptive activity over 60% inhibition of CTX-1 release in vitro. These findings explain the mechanism of the CK increase induced by clinical use of N-BPs.


Alendronate; Bisphosphonate; Creatine kinase; Minodronic acid; Osteoclast; Risedronate

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