Datta Nabanita S
Nabanita S Datta, Department of Internal Medicine, Division Endocrinology, Wayne State University School of Medicine, Detroit, MI 48201, United States.
World J Orthop. 2011 Aug 18;2(8):67-74. doi: 10.5312/wjo.v2.i8.67.
Osteoporosis and age-related bone loss is associated with changes in bone remodeling characterized by decreased bone formation relative to bone resorption, resulting in bone fragility and increased risk of fractures. Stimulating the function of bone-forming osteoblasts, is the preferred pharmacological intervention for osteoporosis. Recombinant parathyroid hormone (PTH), PTH(1-34), is an anabolic agent with proven benefits to bone strength and has been characterized as a potential therapy for skeletal repair. In spite of PTH's clinical use, safety is a major consideration for long-term treatment. Studies have demonstrated that intermittent PTH treatment enhances and accelerates the skeletal repair process via a number of mechanisms. Recent research into the molecular mechanism of PTH action on bone tissue has led to the development of PTH analogs to control osteoporotic fractures. This review summarizes a number of advances made in the field of PTH and bone fracture to combat these injuries in humans and in animal models. The ultimate goal of providing an alternative to PTH, currently the sole anabolic therapy in clinical use, to promote bone formation and improve bone strength in the aging population is yet to be achieved.
骨质疏松症和与年龄相关的骨质流失与骨重塑的变化有关,其特征是相对于骨吸收,骨形成减少,导致骨脆性增加和骨折风险升高。刺激成骨细胞的功能是治疗骨质疏松症的首选药物干预措施。重组甲状旁腺激素(PTH),即PTH(1 - 34),是一种对骨强度有已证实益处的促合成代谢药物,已被视为骨骼修复的一种潜在疗法。尽管PTH已用于临床,但安全性是长期治疗的主要考虑因素。研究表明,间歇性PTH治疗通过多种机制增强并加速骨骼修复过程。最近对PTH作用于骨组织的分子机制的研究促使了PTH类似物的开发,以控制骨质疏松性骨折。本综述总结了在PTH和骨折领域为在人类和动物模型中对抗这些损伤所取得的一些进展。目前临床使用的唯一促合成代谢疗法是PTH,提供一种替代PTH以促进老年人群骨形成和改善骨强度的最终目标尚未实现。