Department of Internal Medicine, Division of Bone and Mineral Diseases, Washington University, St. Louis, MO, USA.
Department of Biomedical Engineering, Washington University, St. Louis, MO, USA.
J Bone Miner Res. 2019 Aug;34(8):1393-1406. doi: 10.1002/jbmr.3822. Epub 2019 Jul 26.
The innervation of bone has been described for centuries, and our understanding of its function has rapidly evolved over the past several decades to encompass roles of subtype-specific neurons in skeletal homeostasis. Current research has been largely focused on the distribution and function of specific neuronal populations within bone, as well as their cellular and molecular relationships with target cells in the bone microenvironment. This review provides a historical perspective of the field of skeletal neurobiology that highlights the diverse yet interconnected nature of nerves and skeletal health, particularly in the context of bone anabolism and pain. We explore what is known regarding the neuronal subtypes found in the skeleton, their distribution within bone compartments, and their central projection pathways. This neuroskeletal map then serves as a foundation for a comprehensive discussion of the neural control of skeletal development, homeostasis, repair, and bone pain. Active synthesis of this research recently led to the first biotherapeutic success story in the field. Specifically, the ongoing clinical trials of anti-nerve growth factor therapeutics have been optimized to titrated doses that effectively alleviate pain while maintaining bone and joint health. Continued collaborations between neuroscientists and bone biologists are needed to build on this progress, leading to a more complete understanding of neural regulation of the skeleton and development of novel therapeutics. © 2019 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc.
骨骼的神经支配已经被描述了几个世纪,而我们对其功能的理解在过去几十年中迅速发展,涵盖了亚型特异性神经元在骨骼稳态中的作用。目前的研究主要集中在骨骼内特定神经元群体的分布和功能,以及它们与骨骼微环境中靶细胞的细胞和分子关系。
这篇综述提供了骨骼神经生物学领域的历史视角,强调了神经和骨骼健康的多样性和相互关联性,特别是在骨骼合成代谢和疼痛的背景下。我们探讨了已知的骨骼中存在的神经元亚型、它们在骨骼中的分布以及它们的中枢投射途径。然后,这个神经骨骼图作为骨骼发育、稳态、修复和骨骼疼痛的神经控制的全面讨论的基础。
最近,对该研究的积极综合导致了该领域的第一个生物治疗成功案例。具体来说,抗神经生长因子治疗的临床试验正在优化,以滴定剂量有效缓解疼痛,同时保持骨骼和关节健康。需要神经科学家和骨骼生物学家之间继续合作,以建立在这一进展的基础上,更全面地了解神经对骨骼的调节作用,并开发新的治疗方法。
© 2019 作者。《骨与矿物质研究杂志》由 Wiley 期刊出版公司出版。