Multi-omics analyses of drug repurposing reveal Acebutolol and Amiloride for osteoporosis treatment

Osteoporosis is a metabolic bone disease that occurs during aging, characterized by low bone mineral density (BMD) and a high risk of trauma fracture. While current pharmacological interventions provide symptomatic benefits, they are unsatisfactory and have major side effects. In this study, we used multi-omics data and drug similarity to construct osteoporosis driver signaling networks (ODSN) and drug functional networks (DFN), respectively. By integrating ODSN and DFN with treatment transcriptional responses, we observed 8 drugs that demonstrated strong targeting effects on ODSN. Mendelian Randomization analysis determines the causal effect on BMD using cis-eQTLs of the drug targets and BMD GWAS data. The findings suggested Acebutolol and Amiloride may increase BMD, while Acenocoumarol, Aminocaproic acid and Armodafinil may enhance bone loss. Zebrafish experiments experimentally showed Acebutolol hydrochloride and Amiloride hydrochloride had significant protective effects on osteoporosis in zebrafish embryos induced by Dexamethasone. Also, Acenocoumarol reduced bone mineralization compared with the control group. The findings suggest that the hypertension drugs Acebutolol and Amiloride warrant further investigation in functional mechanistic experiments to evaluate their effectiveness for osteoporosis treatments.