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New horizons in skeletal physiology and pathophysiology
Mone Zaidi1, Jameel Iqbal, Li Sun
1Mount Sinai Bone Program, Mount Sinai School of Medicine, New York, New York 10029 , USA. mone.zaidi@mssm.edu
Summary
New research reveals that anterior pituitary hormones directly impact bone health, challenging previous understandings of osteoporosis. This suggests a novel pituitary-bone axis with potential for new osteoporosis therapies.
Area of Science:
- Endocrinology
- Bone Biology
- Genetics
Background:
- Osteoporosis is a significant health concern, traditionally linked to master endocrine hormones.
- Current understanding of bone loss mechanisms, particularly in hypogonadal and thyrotoxic states, is being re-evaluated.
Purpose of the Study:
- To review recent scientific discoveries concerning the origins of osteoporosis.
- To examine the direct roles of anterior pituitary hormones in bone metabolism, using hypogonadal and thyrotoxic bone loss as models.
Main Methods:
- Analysis of cell biology, mouse genetics, and human studies.
- Investigation into the direct actions of follicle-stimulating hormone (FSH) and thyrotropin (TSH) on skeletal tissue.
- Review of emerging clinical data supporting a novel pituitary-bone axis.
Main Results:
- Human genetic studies and genetically modified mouse models have advanced the understanding of bone pathophysiology.
- Evidence suggests anterior pituitary hormones, FSH and TSH, act directly on the skeleton.
- Hypogonadal and thyrotoxic bone loss may result from direct pituitary hormone action, not solely master hormone level changes.
Conclusions:
- A direct pituitary-bone axis is proposed, where pituitary hormones influence the skeleton bypassing traditional endocrine glands.
- This axis demonstrates remarkable sensitivity, indicating previously unrecognized physiological and pathophysiological pathways.
- The identification of this axis opens avenues for novel therapeutic targets for osteoporosis.
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