Description and History

The Rolanette and Berdon Lawrence Bone Disease Program of Texas is a collaborative program between the Baylor College of Medicine

Baylor College of Medicine

Baylor College of Medicine, located in the Texas Medical Center in Houston, Texas, USA, is a highly regarded medical school and leading center for biomedical research and clinical care...

 and the University of Texas M.D. Anderson Cancer Center.http://www.mdanderson.org/departments/boneprogram It was established by an initial endowment to the two institutions by Rolanette and Charles Berdon Lawrence, Houston philanthropists. The program was established in 2002 by the two academic institutions to focus on osteoporosis

Osteoporosis

Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...

 and other Metabolic Bone Disease

Metabolic bone disease

Metabolic bone disease is an umbrella term referring to abnormalities of bones caused by a broad spectrum of disorders.Most commonly these disorders are caused by abnormalities of minerals such as calcium, phosphorus, magnesium or vitamin D leading to dramatic clinical disorders that are commonly...

 and spread of cancer

Cancer

Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 to the skeleton

Skeleton

The skeleton is the body part that forms the supporting structure of an organism. There are two different skeletal types: the exoskeleton, which is the stable outer shell of an organism, and the endoskeleton, which forms the support structure inside the body.In a figurative sense, skeleton can...

 in patients with cancer. Baylor College of Medicine's mission in this program is to develop strategies for stimulating new bone formation while The University of Texas M.D. Anderson Cancer Center is focused on bone loss in patients with cancer and the development of strategies to prevent spread of cancer (bone metastasis) into bone.

Leadership

Robert F Gagel, M.D. was the founding director of the Bone Disease Program of Texas. The current director (2007) of the Bone Disease Program of Texas is Brendan H Lee, M.D., Ph.D. A Program Advisory Committee that includes representation from both Institutions and an external advisor provides overall direction and supervision. A Development Committee has worked to encourage philanthropic support from the community.

Significance

Osteoporosis

Osteoporosis

Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...

 is a major health problem. Fractures of the spine

Vertebral column

In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...

 or vertebral fractures occur commonly in men and women over the age of 60 and hip fracture remains a leading cause of death in elderly individuals. Repair and rehabilitation of hip fracture

Hip fracture

A hip fracture is a femoral fracture that occurs in the proximal end of the femur , near the hip.The term "hip fracture" is commonly used to refer to four different fracture patterns and is often due to osteoporosis; in the vast majority of cases, a hip fracture is a fragility fracture due to a...

s currently cost 15 billion dollars per year; as the "baby boomer

Baby boomer

A baby boomer is a person who was born during the demographic Post-World War II baby boom and who grew up during the period between 1946 and 1964. The term "baby boomer" is sometimes used in a cultural context. Therefore, it is impossible to achieve broad consensus of a precise definition, even...

s" enter their 70s (2020) this figure is expected to reach 40-60 billion dollars per year unless effective therapies are developed. Although the introduction of several new therapies have reduced the incidence of fracture by as much as 5-10%, low bone mass leading to fractures remains a major health issue. The Surgeon General

Surgeon General of the United States

The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...

's report on osteoporosishttp://www.surgeongeneral.gov/library/bonehealth/content.html, issued in 2004, estimates "One out of every two women over 50 will have an osteoporosis-related fracture

Fracture

A fracture is the separation of an object or material into two, or more, pieces under the action of stress.The word fracture is often applied to bones of living creatures , or to crystals or crystalline materials, such as gemstones or metal...

 in their lifetime, with risk of fracture increasing with age. Due primarily to the aging of the population and the previous lack of focus on bone health, the number of hip fractures in the United States could double or even triple by the year 2020."

It is this challenge that the Bone Disease Program of Texas is committed to address. Recent discoveries indicate that it is possible to build new high quality bone in older citizens. This program is committed to the development of strategies to increase bone mass and strength with the goal of preventing the epidemic of fractures expected over the next two decades.

Organization

The Bone Disease Program of Texas is defined by a contractual relationship between Baylor College of Medicine and University of Texas M.D. Anderson Cancer Center. The components include basic laboratory programs at the two institutions that include core facilities (bone density, small animal CT facilities, microCT, and bone histomorphometric facilities) that are available to members of the program from either institution. In addition, translational and clinical research programs are being developed at each institution. The program has a seminar series and monthly interdisciplinary meetings of researchers within the program.

Participants

Program Advisory Board

Brendan Lee, M.D., Ph.D., Director
Robert F Gagel, M.D., Co-director
Larry Chan, M.D., Member of Board
Michael H. Heggeness, M.D., Member of Board
Steven I. Sherman, M.D., Member of Board
Raphael Pollock, M.D., Member of Board
Henry Kronenberg

Henry Kronenberg

Henry Kronenberg is an American physician and academic. he is Division Head of Endocrinology at the Massachusetts General Hospital in Boston, MA and a Professor of Medicine at the Harvard Medical School...

, M.D., External Advisor

Accomplishments

Participants in this program have made a number of important scientific discoveries. Among them are:

1. Identification of the major regulator of osteoblast differentiation and bone formation, RUNX2 (Gerard Karsenty)
2. Identification of the role of fat cells and the hormone leptin in the regulation of bone formation (Patricia Ducy and Gerard Karsenty)
3. Identification of Osterix, an osteoblast transcription factor that is necessary for normal bone formation and mineralization (Benoit de Crombrugghe)
4. Definition of the physiologic role of the hormone calcitonin (Ana Hoff, Gilbert Cote, Robert F Gagel)
5. Identification of the relationship between intravenous bisphosphonate use and osteonecrosis of the jaw (Ana Hoff and Robert F Gagel)
6. Characterization of the role of TRAF6 in RANK receptor signaling and the development of inhibitors targeting this molecule to inhibit osteoclast-mediated bone resorption (Bryant Darnay)
7. Characterization of the role of CTAP, a gene responsible for bone collagen modification, and definition of its role in the osteogenesis imperfecta (Roy Morello and Brendan Lee)