The role of metabolic reprogramming in inflammatory bone diseases

Inflammatory bone diseases are characterized by bone destruction, resulting from an imbalance between bone resorption and formation due to chronic inflammation. The dynamic equilibrium among osteoblasts, osteoclasts, and various immune cells is crucial for disease progression. Metabolic reprogramming is a key factor involved in regulating the differentiation and function of these cells, and recent research has increasingly revealed its role in inflammatory bone diseases. This review focuses on the complex roles of glucose, lipid, and amino acid metabolic reprogramming in cellular processes, contributing to a deep understanding of the pathogenesis of inflammatory bone diseases. More importantly, targeting metabolic pathways to regulate the balance among osteoblasts, osteoclasts, and immune cells represents a promising therapeutic strategy for inflammatory bone diseases. Many preclinical studies have explored small-molecule compounds and nanoparticle-based drug-delivery systems targeting metabolism to restore bone homeostasis, suppress inflammation and bone destruction, and even promote tissue regeneration. However, the potential for clinical translation requires further validation in large animal models and human trials. This review highlights the critical role of metabolic reprogramming in inflammatory bone diseases and underscores the therapeutic potential of metabolism-based interventions.