Department of Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, USA.
Nat Med. 2013 Feb;19(2):179-92. doi: 10.1038/nm.3074. Epub 2013 Feb 6.
Low bone mass and strength lead to fragility fractures, for example, in elderly individuals affected by osteoporosis or children with osteogenesis imperfecta. A decade ago, rare human mutations affecting bone negatively (osteoporosis-pseudoglioma syndrome) or positively (high-bone mass phenotype, sclerosteosis and Van Buchem disease) have been identified and found to all reside in components of the canonical WNT signaling machinery. Mouse genetics confirmed the importance of canonical Wnt signaling in the regulation of bone homeostasis, with activation of the pathway leading to increased, and inhibition leading to decreased, bone mass and strength. The importance of WNT signaling for bone has also been highlighted since then in the general population in numerous genome-wide association studies. The pathway is now the target for therapeutic intervention to restore bone strength in millions of patients at risk for fracture. This paper reviews our current understanding of the mechanisms by which WNT signalng regulates bone homeostasis.
低骨量和骨强度会导致脆性骨折,例如,老年骨质疏松症患者或成骨不全症患儿。十年前,人们发现了一些罕见的人类基因突变,这些突变会对骨骼产生负面影响(骨质疏松-假瘤综合征)或正面影响(高骨量表型、骨硬化症和范可尼贫血),并且这些突变都存在于经典 WNT 信号通路的组成部分中。小鼠遗传学证实了经典 Wnt 信号通路在骨稳态调节中的重要性,该通路的激活会导致骨量和骨强度增加,而抑制则会导致骨量和骨强度减少。自那时以来,大量全基因组关联研究也强调了 WNT 信号对骨骼的重要性。该通路现已成为治疗干预的靶点,以恢复数以百万计骨折高危患者的骨骼强度。本文综述了我们目前对 WNT 信号通路调节骨稳态的机制的理解。
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