Hormonal regulation of growth plate cartilage.

Longitudinal bone growth occurs in the growth plate through a process called endochondral bone formation, a process where resting zone chondrocytes are recruited to start active proliferation and then undergo differentiation, followed by apoptosis and later mineralization. The balance between proliferation and differentiation is a crucial regulatory step controlled by various growth factors/hormones acting in both endocrine and paracrine/autocrine ways. From studies of individuals with aromatase deficiency and a boy with defective oestrogen receptor (ER)-alpha it has become clear that oestrogen action is indispensable for normal pubertal growth and growth plate fusion. Both oestrogen receptors, ER-alpha and ER-beta, are expressed in the growth plate in boys and girls throughout pubertal development. Any functional role of ER-beta has not yet been defined in the human growth plate. Increased understanding about the effects of oestrogen and the interactions between oestrogens and other endocrine factors within the growth plate is important for the development of new treatment strategies in different disorders affecting longitudinal bone growth. As new specific modulators of oestrogen receptors are developed, these could offer more specific ways to modulate longitudinal growth and growth plate fusion.