7, 2002, Gazette)
by HSIMSDr. Christopher Kovacs
Osteoporosis is a well-known bone disease that is usually associated with
older women. As women age, the ability to gain bone mass through calcium
absorption is totally lost, and after menopause, the skeleton actually
starts to lose calcium and bone mass. This decrease in bone mass leaves
women vulnerable to breaks and fractures. There is only limited effectiveness
to current available treatments, and the skeleton can never be restored
to normal levels of bone mass.
Dr. Christopher Kovacs, an endocrinologist in Memorials Faculty
of Medicine, is conducting research that might one day affect how osteoporosis
and other such conditions are treated. Endocrinology is the medical speciality
that deals with diseases of the glands and hormones.
Recently Dr. Kovacs was awarded more than three-quarters of a million
dollars from the Canadian Institute of Health Research for his research
on the bone metabolism in genetically-altered mice during pregnancy, lactation
and fetal development. Studying how bone mineralisation occurs in mice,
Dr. Kovacs hopes to identify the factors that regulate the process and
to ultimately determine what can be done to prevent or remedy the loss
of bone mass that occurs in the common condition of osteoporosis in humans.
The current treatments are based on our understanding of how the adult
skeleton is regulated. This is where Dr. Kovacs is breaking new ground.
The treatments that we have are based largely on what we know about
adult skeletons, and the hormones that regulate calcium metabolism in
the adult, he said.
His research is based on the fetal development of the skeleton. The fetal
skeleton goes from zero to full mineralization in a very short time and
it is clear that there are hormones and factors regulating the process
that may not be active later in adult life. By studying what happens during
development of the fetal skeleton, Dr. Kovacs hopes to identify the factors
that affect the rate of calcium transfer and absorption, which may lead
to changes in treatments of conditions such as osteoporosis.
Studying pregnant and lactating women could also provide some clues to
the factors affecting calcium levels in the skeleton. The human skeletons
ability to gain calcium is actually lost once the adult reaches mid-twenties,
with one very interesting exception pregnant and breastfeeding
women. Evidence from animal studies suggests that pregnant animals actually
absorb more calcium than usual during pregnancy in order to provide for
the offspring. Women that are breastfeeding actually lose calcium from
their skeleton as it is transferred to their babies through their breast
milk, a fact that is not well-known and continues to surprise people,
according to Dr. Kovacs.
In six months of breastfeeding, the woman will temporarily lose
five to 10 per cent of all the calcium in her skeleton, so her bone density
will actually drop by five to 10 per cent.
After a period of months, though, the womans skeleton naturally
rebuilds the bone mass. The process by which this occurs is not yet understood,
and learning more about this process will also help isolate the factors
affecting the bodys ability to regain bone mass in the reproductive
Similar processes in mice make them good subjects of inquiry. In
mice, mothers can lose a full one-third, 33-35 per cent, of their skeleton
in three weeks of lactation, Dr. Kovacs said.
His research employs mice that are genetically altered, so that normal
and genetically-altered siblings serve as controls for each other. In
isolating particular genes, he hopes to discover which genes are important
to the process. If, for example, one set of mice lose bone mass but cannot
regain, this will indicate that the gene that they are missing is an important
piece of the puzzle. Studying what happens to the mice during pregnancy
and lactation will give some clues as to what happens in humans. He hopes
that by understanding how a fetus builds a skeleton and how lactating
women regain skeletal calcium, there might be some application to treating
osteoporosis in adults. Studying fetal mice is no easy task and some of
the research money Dr. Kovacs has been awarded will be used to purchase
a bone densitometer that will yield accurate measurements of bone density
in small animals.
So, will Dr. Kovacs research unlock the door to curing osteoporosis? He
is cautious about making such claims.
My goals are more modest, explained Dr. Kovacs. In the
history of science, advances are made by stepping on others shoulders.
Im hoping to lay the groundwork in the area and in the end, maybe
Ill show the things that are not important factors in the process.
But the hope is that I will help identify what is important. It may be
someone else who comes along and investigates it further that will have