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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.
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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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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 marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Myeloma Bone Disease: A Comprehensive Review.

Shiva Kumar Reddy Mukkamalla1, Dhatri Malipeddi2

  • 1Hematology/Medical Oncology, Presbyterian Healthcare Services, Rio Rancho, NM 87124, USA.

International Journal of Molecular Sciences
|July 2, 2021
PubMed
Summary

Multiple myeloma (MM) causes bone disease by disrupting bone remodeling, leading to osteolytic lesions and skeletal-related events. Understanding these mechanisms aids in developing targeted treatments for myeloma bone disease.

Keywords:
bone diseasemultiple myelomatherapies

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Area of Science:

  • Hematology
  • Oncology
  • Bone Biology

Background:

  • Multiple myeloma (MM) is a plasma cell cancer causing M-protein overproduction and immunoparesis.
  • MM frequently affects bone marrow, leading to myeloma bone disease with osteolytic lesions in 80% of patients.
  • Skeletal-related events (SREs) like fractures and hypercalcemia significantly impair quality of life and survival in MM patients.

Purpose of the Study:

  • To review the pathophysiology of abnormal bone remodeling in multiple myeloma.
  • To summarize recent developments in understanding myeloma bone disease.
  • To discuss approved and potential treatments for myeloma bone disease.

Main Methods:

  • Literature review of pathophysiology and treatment of myeloma bone disease.
  • Analysis of biochemical markers involved in bone remodeling.
  • Synthesis of information on approved and emerging therapies.

Main Results:

  • MM pathogenesis involves uncoupling of bone remodeling via myeloma cell interaction with the bone marrow microenvironment.
  • Elevated osteoclast-activating factors (e.g., RANK/RANKL, IL-6) increase bone resorption.
  • Inhibited osteoblast formation (e.g., Wnt/DKK1 pathway) decreases bone formation.

Conclusions:

  • Abnormal bone remodeling is central to myeloma bone disease, driven by specific biochemical factors.
  • Targeting these factors offers therapeutic strategies for MM patients.
  • Further research into these pathways is crucial for developing effective treatments.