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A Novel in vivo Gene Transfer Technique and in vitro Cell Based Assays for the Study of Bone Loss in Musculoskeletal Disorders
Published on: June 8, 2014
[What the clinician needs to know about the relationship between inflammation and bone formation. Is blocking
1Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España.
Abstract:
In spondyloarthropathies, the distinctive evidence of skeletal damage is de novo bone formation in the form of an ossifying enthesopathy, be it axial or peripheral, and bony ankylosis. Biologic therapy that neutralize the tumor necrosis factor have shown to be effective controlling the inflammatory activity of these diseases. However, data from animal models, clinical imaging studies and ecographic data seem to indicate that inflammation and bone formation could be independent processes and that control of inflammation might not be enough to impede the development of ankylosis in these patients. In the osteoblasts' differentiation and activation that leads to bone formation, the Wnt (wingless) pathway and the bone morphogenic proteins acquire a special role and might be determinant in the onset and progression of enthesopathic ossification, as well as become therapeutic targets. On the other hand, clinical and imaging findings as well as the determination of bone markers support the hypothesis that that ossification is initially related to inflammation as a repair process. These facts are reviewed and the latest theories are exposed, in an attempt to establish a link between inflammation and bone formation.
Insights
In spondyloarthropathies, controlling inflammation may not stop bone formation. New research explores the link between inflammation and bone growth, identifying potential therapeutic targets for ankylosis.
Area of Science:
- Rheumatology and Immunology
- Bone Biology and Pathophysiology
Context:
- Spondyloarthropathies are characterized by new bone formation, leading to ossifying enthesopathy and bony ankylosis.
- Current biologic therapies targeting tumor necrosis factor effectively control inflammation but may not prevent bone formation.
Purpose:
- To review current evidence on the relationship between inflammation and bone formation in spondyloarthropathies.
- To explore the roles of Wnt signaling and bone morphogenic proteins in enthesopathic ossification.
- To establish a potential link between inflammatory processes and bone formation as a repair mechanism.
Summary:
- While inflammation is implicated in spondyloarthropathies, evidence suggests inflammation and bone formation may be independent processes.
- The Wnt pathway and bone morphogenic proteins are crucial in osteoblast differentiation and may be key therapeutic targets.
- Ossification might initially be a repair response to inflammation, but its progression may be independent.
Impact:
- Highlights the need for therapeutic strategies addressing both inflammation and bone formation pathways.
- Identifies Wnt signaling and bone morphogenic proteins as potential targets for treating ankylosis.
- Provides a framework for understanding the complex interplay between inflammation and bone remodeling in spondyloarthropathies.
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