Bisphosphonates-much more than only drugs for bone diseases

Area of Science:

• Bone Biology and Pharmacology
• Oncology
• Radiology and Nuclear Medicine

Background:

• Bisphosphonates (BPs) are established treatments for bone diseases like osteoporosis due to their hydroxyapatite affinity.
• Their interaction with bone cells underpins classical therapeutic applications.
• Recent research reveals expanded pleiotropic functions beyond traditional bone disease management.

Purpose of the Study:

• To review the mechanisms of bisphosphonate interaction with bone cells for established treatments.
• To explore novel applications of bisphosphonates in bone cancer, metastases, and pain palliation.
• To describe the development and function of bisphosphonate-based theranostics for bone imaging and therapy.

Main Methods:

• Review of literature on bisphosphonate mechanisms and applications.
• Analysis of bisphosphonate interactions with bone cells.
• Description of theranostic systems combining bisphosphonates with imaging agents.

Main Results:

• Bisphosphonates effectively target bone tissue due to high hydroxyapatite affinity.
• Understanding BP-cell interactions enables applications in bone cancer and palliative pain relief.
• Theranostic agents, coupling BPs with imaging moieties (MRI contrast agents, PET radionuclides), are developed for targeted bone diagnosis and therapy.

Conclusions:

• Bisphosphonates possess versatile therapeutic and diagnostic capabilities beyond osteoporosis.
• Novel applications leverage BP bone-homing properties for targeted cancer therapy and pain management.
• Bisphosphonate-based theranostics represent a significant advancement in personalized bone disease management.