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Building capacity

Faculty of Medicine assistant professor funded almost $455,000 for musculoskeletal research

By Terri Coles

Memorial University’s musculoskeletal research expertise is growing, thanks in part to a $445,000, four-year project grant funded by the Canadian Institutes of Health Research.

Dr. Janna Andronowski and her research team will use high-resolution imaging and laboratory studies to investigate the long-term effects of opioid use on skeletal structure and health.

The interdisciplinary research aims to identify how and why opioid use impacts bone quality and fragility over time.

The funded research contributes to the growing scientific knowledge about the serious health effects of the ongoing opioid public health crisis, says Dr. Andronowski, principal investigator and assistant professor of clinical anatomy in the Faculty of Medicine’s Division of BioMedical Sciences.

The research will focus on preventative measures and therapeutic interventions for opioid users and improvements to human identification efforts.

It will also help with graduate student and research staff recruitment and provide student funding.

‘Living record’

Dr. Andronowski is a skeletal biologist, anatomist and forensic anthropologist by training.

Her research interests are in human anatomy and forensic anthropology and how techniques in those fields can be applied to questions related to human health.

“[The human skeleton] is a living record.” — Dr. Janna Andronowski

She previously conducted research with the Forensic Anthropology Unit at the Office of Chief Medical Examiner in New York City.

Part of that job involved examining the skeletons of unknown individuals to determine indicators useful for human identification, including age, biological sex and bone trauma or injuries.

“It’s a living record,” Dr. Andronowski said of the human skeleton. “It’s always changing and adapting in response to your biomechanical activities, diet and lifestyle factors.”

Those changes can help match unidentified skeletal remains with an identity — but they can also complicate the process.

Dr. Janna Andronowski, who is out of focus in the background, holds a small glass jar containing bone fragments. She is wearing blue medical gloves.
Dr. Janna Andronowski received CIHR funding to study the effects of long-term opioid use on bone health.
Photo: Submitted

Sometimes, someone can appear to be in earlier adulthood based on the condition of their large-scale bony structures. However, that same person can appear decades older based on the condition of their internal skeletal structure, Dr. Andronowski says.

“That sparked my interest. Our aging methods are not always accurate when applied to non-healthy individuals, and it can lead to issues with identification.”

Skeletal changes

The project focuses on microstructural changes to bone in response to long-term or prolonged opioid exposure.

One of the potential side-effects of opioid use is osteoporotic-like bone loss, even in younger people. People as young as their 20s and 30s show bone resorption and increased fracture risk. The problems often go clinically undiagnosed.

Dr. Andronowski will examine bone specimens from individuals known to use opioids, obtained via organ donation or autopsy.

“That, I think, is a good message: that your bone can recover.” — Dr. Janna Andronowski

The samples will be examined for overall porosity and any structural changes to bone, like resorptive areas, at a synchrotron facility for high-resolution 3D imaging.

Then the team will compare the results to changes in overall bone fragility. In addition, a lab study will control for other factors that could affect bone health, such as diet, hormonal changes or the use of other medications.

So far, literature on the long-term effects of opioid use on bone is limited, Dr. Andronowski says. But there are a few different hypotheses about why or how opioids might impact bone health. She hopes this research provides more information about what’s happening at the cellular level.

‘A good message’

The project will raise awareness of the often silent comorbidities seen in long-term opioid users, Dr. Andronowski said.

“There’s still stigma around people who use drugs, and they can be marginalized — not just in our community, but in the process of human identification. This will bring increased awareness to this group and help us develop novel methods that will be more accurate and precise when identifying unknown individuals.”

Some of the research focuses on what we learn from someone’s bones after they die. But other pieces can help people become healthier while they’re alive. Because the skeleton is always changing, that means it can also become healthier.

If someone knows they have a higher risk of osteoporosis or serious injuries due to past or current use of opioids, they can make choices to improve their health and protect their bones.

“That, I think, is a good message: that your bone can recover,” Dr. Andronowski said. “And we are trying to identify ways to encourage that.”

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