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Related Concept Videos

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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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

Osteoclasts in 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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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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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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Dosage Regimen: Fixed Dose01:01

Dosage Regimen: Fixed Dose

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Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
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Author Spotlight: Integrating Traditional Chinese Medicine with Modern Pharmacology and Genomics for Assessing Postmenopausal Osteoporosis in Mice
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Long-term and sequential treatment for osteoporosis.

Ines Foessl1, Hans P Dimai1, Barbara Obermayer-Pietsch2

  • 1Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University Graz, Graz, Austria.

Nature Reviews. Endocrinology
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Osteoporosis impairs bone strength, increasing fracture risk, especially in aging populations. New approaches are needed for long-term osteoporosis management, considering diverse patient needs and potential treatment side effects.

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Area of Science:

  • Orthopedics and Bone Metabolism
  • Geriatric Medicine
  • Pharmacology

Background:

  • Osteoporosis is a growing global health concern, characterized by impaired bone structure and increased fracture risk.
  • The chronic nature of osteoporosis necessitates long-term management strategies, often involving pharmacological treatments.
  • Current long-term treatments raise concerns regarding adverse effects and potential rebound phenomena post-discontinuation.

Purpose of the Study:

  • To review current challenges in osteoporosis management.
  • To highlight the need for novel therapeutic and monitoring strategies.
  • To explore the potential of new pathophysiological insights in revolutionizing osteoporosis care.

Main Methods:

  • Review of current literature on osteoporosis diagnosis and treatment.
  • Analysis of long-term pharmacological approaches and their associated risks.
  • Discussion of emerging concepts in bone metabolism and their clinical implications.

Main Results:

  • Existing long-term osteoporosis therapies face challenges with adverse effects and treatment cessation.
  • Individualized treatment strategies incorporating imaging and bone turnover assessment are crucial.
  • Combination therapies are underutilized compared to sequential treatments.

Conclusions:

  • There is a critical need for innovative approaches to long-term osteoporosis therapy and monitoring.
  • Addressing secondary causes, rare forms, and specific populations (men, young adults, pregnant women) is essential.
  • Advancements in understanding bone metabolism promise to transform osteoporosis diagnosis and treatment.