Osteoporosis: Pathophysiology and therapeutic options

Area of Science:

• Bone biology and metabolic diseases.

Background:

• Osteoporosis is a metabolic bone disease characterized by reduced bone mass and microarchitectural deterioration.
• It results from an imbalance between osteoclastic bone resorption and osteoblastic bone formation, leading to fragility fractures.

Purpose of the Study:

• To review novel pathophysiological mechanisms of osteoporosis beyond traditional endocrine factors.
• To provide an overview of current osteoporosis medications and future treatment perspectives.

Main Methods:

• Literature review of recent research on osteoporosis mechanisms.
• Synthesis of information on immune system interactions, gut microbiome, and cellular senescence in bone health.
• Summary of existing and emerging osteoporosis therapies.

Main Results:

• Emerging research highlights the roles of the immune system, gut microbiome, and cellular senescence in osteoporosis.
• Current treatments include antiresorptive and bone-forming drugs.
• Future treatments may target these newly identified mechanisms.

Conclusions:

• Osteoporosis pathogenesis is more complex than previously understood, involving systemic factors.
• A comprehensive understanding of these mechanisms is crucial for developing more effective osteoporosis treatments.