Precision biomaterial therapeutic strategies for osteolytic diseases

Osteolytic diseases are a group of conditions characterised primarily by progressive bone destruction and an imbalance in bone homeostasis; they are commonly observed in pathological conditions such as osteomyelitis, periodontitis, bone metastases and osteoporosis. Due to complex pathological mechanisms and abnormalities in the local microenvironment, traditional treatment strategies still face significant limitations in terms of precise intervention at the site of the lesion and the maintenance of long-term efficacy. In recent years, rapid advances in biomaterials have opened new avenues of research for the treatment of osteolytic diseases; by modulating the processes of bone resorption and formation, it is hoped that effective intervention in disease progression can be achieved. This review systematically summarises advanced therapeutic strategies, represented by stimulus-responsive drug delivery materials and bone mass-regulating materials, focusing on five typical categories of osteolytic diseases. Among these, stimulus-responsive materials can respond to the characteristics of the local microenvironment, enabling the spatiotemporally controlled release of therapeutic drugs within the lesion area; bone mass-regulating materials, meanwhile, restore bone homeostasis by inhibiting abnormal osteoclastic activity and promoting the osteogenic process. Furthermore, addressing various pathological aetiologies such as infection, tumours and metabolic abnormalities, this paper summarises the design strategies and research progress of representative biomaterials, whilst comparing and analysing the differences among various therapeutic systems in terms of their mechanisms of action, advantages and limitations. Overall, biomaterial-based therapeutic strategies offer significant opportunities for the precision treatment of osteolytic diseases and demonstrate broad prospects for driving a shift in treatment paradigms from symptomatic management towards aetiological intervention.