Division of Endocrinology, Diabetes, and Bone Diseases, Dresden Technical University Medical Centre, Dresden, Germany.
Lancet. 2011 Apr 9;377(9773):1276-87. doi: 10.1016/S0140-6736(10)62349-5. Epub 2011 Mar 28.
Osteoporosis is a common disease characterised by a systemic impairment of bone mass and microarchitecture that results in fragility fractures. With an ageing population, the medical and socioeconomic effect of osteoporosis, particularly postmenopausal osteoporosis, will increase further. A detailed knowledge of bone biology with molecular insights into the communication between bone-forming osteoblasts and bone-resorbing osteoclasts and the orchestrating signalling network has led to the identification of novel therapeutic targets. Novel treatment strategies have been developed that aim to inhibit excessive bone resorption and increase bone formation. The most promising novel treatments include: denosumab, a monoclonal antibody for receptor activator of NF-κB ligand, a key osteoclast cytokine; odanacatib, a specific inhibitor of the osteoclast protease cathepsin K; and antibodies against the proteins sclerostin and dickkopf-1, two endogenous inhibitors of bone formation. This overview discusses these novel therapies and explains their underlying physiology.
骨质疏松症是一种常见的疾病，其特征是全身骨量和微结构受损，导致脆性骨折。随着人口老龄化，骨质疏松症（尤其是绝经后骨质疏松症）的医疗和社会经济学影响将进一步增加。对骨生物学的深入了解，以及对骨形成成骨细胞和骨吸收破骨细胞之间的通讯的分子见解，以及协调信号网络，已经导致了新的治疗靶点的确定。已经开发出了新的治疗策略，旨在抑制过度的骨吸收和增加骨形成。最有前途的新型治疗方法包括：针对核因子 κB 配体受体激活剂的单克隆抗体地舒单抗，这是一种关键的破骨细胞细胞因子；特异性抑制破骨细胞蛋白酶组织蛋白酶 K 的odanacatib；以及针对骨形成内源性抑制剂 sclerostin 和 dickkopf-1 的抗体。这篇综述讨论了这些新型治疗方法，并解释了它们的基础生理学。
