Osteoporosis: molecular pathogenesis and therapeutic interventions

Osteoporosis is a systemic skeletal disease. Genetic and environmental factors work together to cause increased bone resorption, decreased bone formation, bone remodeling imbalance, reduced bone mass, and increased bone fragility. The global incidence of osteoporosis is relatively high, and osteoporosis negatively affects health and quality of life. Prevention and treatment research has continuously attracted the attention of scholars worldwide, and there is an extremely urgent need to find effective and safe treatment plans. This review elaborates on the physiological structure of bones and the principal relationship between bones and osteoporosis. The molecular mechanisms of osteoporosis development, including genes, inflammation, oxidative stress, signaling pathways, intestinal microbiota, autophagy, and iron metabolism, are systematically reviewed. This review comprehensively summarizes the latest advancements in the diagnosis and therapeutic interventions for osteoporosis. The therapeutic interventions include Western medicine treatment, Chinese herbal medicine treatment, nonpharmacological management and emerging therapeutic strategies. This review explores in depth the advantages and disadvantages of Western medicine and Chinese herbal medicine treatments, highlights the challenges that Chinese herbal medicine treatment for osteoporosis must overcome, and reveals the gap between emerging treatment methods and clinical applications, as well as potential directions for osteoporosis research, aiming to provide valuable references for the treatment of osteoporosis in the future.