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Background: Development of cost-effective platforms for identification of biomarkers is of paramount importance in low-income settings. The present work focuses on the development of a microfluidic paper-based analytical device (μPADs) for the diagnosis of osteoporosis by measuring three important bone biomarkers – calcium, alkaline phosphatase and vitamin D. Methods: Antibody-based detection is realized in μPAD reservoirs based on principle of colorimetric sensing, where μPAD images are captured using a smartphone. The results are compared with the calibration curves to give proper quantification of analytes. Conclusion: This device can be potentially developed into a point-of-care diagnostic device for low-income settings. To the best of our understanding, a μPAD platform for simultaneous diagnosis of multiple osteoporosis markers is not reported yet.

Introduction Osteoporosis results in significant morbidity and mortality for a large number of patients within Northern Ireland. Recombinant PTH (Teriparatide) is one of a growing number of treatment options for the disease. Methods A retrospective analysis was carried out for all patients who had been commenced on Teriparatide since it was first used in the Belfast Health and Social Care Trust (BHSCT) in 2007. Patient demographics, clinical history and prior treatment were recorded prior to an eighteen month treatment protocol. Outcome measures including bone densitometry, bone turnover markers and health status were assessed on commencement and completion. Results 138 patients have commenced teriparatide therapy since 2007 (9 male, 129 female). At the time of analysis 60 patients had completed treatment, 53 patients were receiving ongoing treatment and 25 patients did not complete the 18 month course. On completion vertebral bone mineral density (BMD) had increased by 8.3% while femoral neck BMD had increased by 3.5%. Bone turnover markers demonstrated a significant increase of bone formation and resorption at 4 months, with a smaller increase at 18 months. Health outcome measures (EuroQoL-5 and patient visual analogue scale) indicated improvement in the quality of life of patients of those who completed the treatment course. Conclusions Experience in the BHSCT with teriparatide since 2007 demonstrates improvement in BMD comparable to published data, changes in bone turnover markers consistent with increased bone remodeling and better health outcomes for patients.

Fourier transform infrared imaging spectroscopy (FTIRI)-assessed bone composition parameters (mineral content, collagen maturity, crystal size and perfection, and carbonate content) describe bone quality and correlate to bone fracture risk. The challenge with studying bone quality in patients treated with antiresorptive drugs such as bisphosphonates (e.g., alendronate) and selective estrogen receptor modulators (SERMs) (e.g. raloxifene) is being able to test bone mechanical performance and material properties pre- and posttreatment. The purpose of this study was to evaluate the FTIRI changes in a large animal model of osteoporosis (female sheep with dietary induced metabolic acidosis; MA). Previous studies have investigated the relationship between bone material properties and bone strength in humans and smaller animals and have shown that changes in compositional properties influence fracture risk. Here we characterize the MA model at 6 and 12 months, demonstrate the loss of bone and changes in compositional properties, and show that 6 months of treatment with both antiresorptives ameliorate the bone loss as assessed by bone mineral density and FTIRI. This preliminary data suggest that the MA sheep model allows investigation of whether drug treatments preserve bone properties that exist at the time of treatment or if they induce further beneficial changes.

Screening for osteoporotic vertebral fractures traditionally involves X-ray of the thoracic and lumbar spine. We evaluated use of dual energy X-ray technology in patients with osteoporosis. We found this technology useful in the clinic setting and it has advantages in that less radiation is delivered to the patient.