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October 8, 2025Journal of Orthopaedic Surgery and Research1 citationsOpen Access

Exenatide, a glucagon-like peptide-1 receptor agonist, may negatively impact bone healing in rats: histopathological, biochemical, and in silico findings

FUFatih UğurİYİbrahim YılmazEGErsin Güner

Key Result

Exenatide administered for 7 consecutive days before a bone defect was created resulted in slower bone healing compared to saline, whereas post-injury administration showed no significant negative effect.

Structured PICO

Does exenatide impact bone healing in rats with a single radius cortical defect?

P
Population
42 young adult male Sprague-Dawley rats aged 10-12 months underwent a single radius cortical defect model to evaluate the effects of exenatide on bone healing over 7 days.
I
Intervention
Exenatide (subcutaneous, administered either after bone defect creation or for 7 consecutive days before)
C
Comparator
Saline
O
Outcome
Bone healing assessed via histopathological (H&E, Masson's trichrome), biochemical (P, ALP, OC, TNF-α, IL-6), and in silico methodssurrogate

Pre-treatment with exenatide may negatively impact bone healing in a rat model, warranting further clinical investigation given the widespread use of GLP-1 receptor agonists.

Limitations

  • Animal model data may not fully translate to human bone healing.
  • The single radius cortical defect model is a non-load-bearing bone, lowering its translational relevance compared to femoral or tibial models.
  • Lack of histomorphometric, micro-computed tomography, or biomechanical analyses limits quantitative assessment of bone regeneration.
  • Evaluations were performed only on Day 7, capturing early inflammatory phases rather than complete bone healing.
  • Biochemical parameters used were not sufficiently bone-specific (e.g., lacking BSALP or TRAP5b).
  • In silico docking analyses were performed on static crystal structures without molecular dynamics simulations.
  • Preclinical design (experimental animal model)

Abstract

BACKGROUND: This study evaluates the effects of exenatide (EXE), a glucagon-like peptide-1 (GLP-1) receptor agonist, on bone healing in rats using a single radius cortical defect model and histopathological, biochemical, and in silico methods. METHODS: ), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (OC), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each specimen were measured. Radius samples were examined histopathologically using hematoxylin and eosin (H however, these changes may not have been due to EXE administration. No significant negative effect on bone healing was observed in the groups that received subcutaneous EXE after the bone defect was created. By contrast, it was observed that for the treatment group that received EXE for 7 consecutive days before the bone defect was created on Day 7, bone healing progressed more slowly than in the groups treated with saline. Regarding the binding of EXE to the other target receptors, root mean square deviation (RMSD) values were low, bruised surface area (BSA) was high, and electrostatic interactions were strong, indicating that the ligand (i.e., EXE) binds to the selected receptor surfaces. CONCLUSION: Although the data obtained from the in vitro analyses in this study were verified using molecular docking, it should be noted that its design is preclinical. Given the widespread clinical use of GLP-1 receptor agonists in the management of type 2 diabetes mellitus (T2DM), our research findings may have translational relevance. Although derived from an experimental animal model, these results suggest that GLP-1 agonists such as EXE can exert additional effects on bone healing and inflammatory processes, thus warranting further studies, including controlled clinical investigations, to elucidate the potential implications for patient care.

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Cite This Study

Uğur et al. (2025) studied Bone defect (n=42). Exenatide vs. 0.9% isotonic sodium chloride or no treatment was evaluated on Bone healing evaluated histopathologically (Huo score) and biochemically. Exenatide administered for 7 consecutive days before a bone defect was created resulted in slower bone healing compared to saline, whereas post-injury administration showed no significant negative effect.

synapsesocial.com/papers/6a9a8fb85778f37769016aeehttps://doi.org/10.1186/s13018-025-06300-2
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