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Related Concept Videos

Bone Disorders01:29

Bone Disorders

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
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Osteoclasts in Bone Remodeling01:31

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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Bone Remodeling01:40

Bone Remodeling

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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Role of Vitamins in Maintaining Bone Health01:25

Role of Vitamins in Maintaining Bone Health

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The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
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What is the Skeletal System?01:02

What is the Skeletal System?

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Overview
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Hormones and Bone Tissue01:17

Hormones and Bone Tissue

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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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
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Osteoporosis treatment: recent developments and ongoing challenges.

Sundeep Khosla1, Lorenz C Hofbauer2

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The Lancet. Diabetes & Endocrinology
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Osteoporosis is a growing public health issue, but effective treatments exist. Despite advances, a treatment gap persists, highlighting the need for better patient compliance and novel therapies.

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Area of Science:

  • Bone biology and pharmacology
  • Geriatric medicine
  • Public health

Background:

  • Osteoporosis is a significant and increasing public health concern, previously viewed as an inevitable part of aging.
  • While preventable and treatable, a notable treatment gap exists for high-risk individuals.
  • The evolution of osteoporosis drug therapy spans from early hormonal treatments to modern biologics.

Purpose of the Study:

  • To trace the historical development of drug therapies for osteoporosis.
  • To analyze the shift in drug discovery approaches around the year 2000.
  • To identify current challenges and future directions in osteoporosis pharmacotherapy.

Main Methods:

  • Historical review of osteoporosis drug development.
  • Analysis of therapeutic advances and drug discovery paradigms.
  • Examination of patient-reported outcomes and side-effect concerns.

Main Results:

  • Osteoporosis treatment evolved from oestrogen therapy to bisphosphonates, calcitonin, teriparatide, denosumab, romosozumab, and odanacatib.
  • Drug discovery shifted towards a deeper understanding of bone biology and rare bone diseases.
  • Concerns regarding rare side-effects of anti-resorptive drugs impact patient adherence.

Conclusions:

  • Despite therapeutic progress, a gap remains in treating patients at high fracture risk.
  • Enhancing patient acceptance and compliance with existing therapies is crucial.
  • Continued development of novel drugs with prolonged anabolic effects and improved safety profiles is needed.