Mondry Adrian, Wang Zhengyuan, Dhar Pawan K
Bioinformatics Institute, Singapore.
Curr Mol Med. 2005 Aug;5(5):489-96. doi: 10.2174/1566524054553531.
Despite its apparent static condition, the skeleton undergoes a permanent process of remodeling mediated by osteoblasts and osteoclasts. The activity of these cells is regulated by a plethora of factors, ranging from mechanical stress to the effects of hormones to the immune system. One well-studied regulatory system involves the maintenance of calcium homeostasis through a network whose main regulatory components include ionized calcium, phosphate, parathyroid hormone and active vitamin D. This system establishes the link between bone and kidney, as one of the kidney's endocrine functions is the activation of vitamin D, while electrolyte homeostasis is one of its excretory functions. Impaired renal function leads to disturbances in this regulatory system, resulting in the complex syndrome of renal osteodystrophy that affects the majority of patients with chronic renal failure. This review summarizes the current understanding of bone physiology on a molecular level, examines some of the pathological pathways related to renal disease, and concludes with an outlook on how the emerging field of systems biology may contribute to a more dynamic and quantitative understanding of the physiology and pathophysiology of renal bone disease.
尽管骨骼表面看似处于静止状态，但它却经历着由成骨细胞和破骨细胞介导的持续重塑过程。这些细胞的活性受众多因素调节，从机械应力到激素作用再到免疫系统。一个经过充分研究的调节系统涉及通过一个网络维持钙稳态，该网络的主要调节成分包括离子钙、磷酸盐、甲状旁腺激素和活性维生素D。这个系统建立了骨骼与肾脏之间的联系，因为肾脏的内分泌功能之一是激活维生素D，而电解质稳态是其排泄功能之一。肾功能受损会导致这个调节系统紊乱，从而引发影响大多数慢性肾衰竭患者的复杂肾性骨营养不良综合征。本综述总结了目前在分子水平上对骨生理学的理解，探讨了一些与肾脏疾病相关的病理途径，并展望了新兴的系统生物学领域如何有助于更动态、定量地理解肾性骨病的生理学和病理生理学。
