Orthopedics Research Laboratory, Research Center, Hôpital du Sacré-Cœur de Montréal, Université de Montréal, 5400 boul. Gouin ouest, Montréal, Québec, H4J 1C5, Canada.
Inflamm Res. 2021 Aug;70(8):859-875. doi: 10.1007/s00011-021-01484-9. Epub 2021 Jul 16.
The physiological balance between bone resorption and bone formation is now known to be mediated by a cascade of events parallel to the classic osteoblast-osteoclast interaction. Thus, osteoimmunology now encompasses the role played by other cell types, such as cytokines, lymphocytes and chemokines, in immunological responses and how they help modulate bone metabolism. All these factors have an impact on the RANK/RANKL/OPG pathway, which is the major pathway for the maturation and resorption activity of osteoclast precursor cells, responsible for osteoporosis development. Recently, immunoporosis has emerged as a new research area in osteoimmunology dedicated to the immune system's role in osteoporosis.
The first part of this review presents theoretical concepts on the factors involved in the skeletal system and osteoimmunology. Secondly, existing treatments and novel therapeutic approaches to treat osteoporosis are summarized. These were selected from to the most recent studies published on PubMed containing the term osteoporosis. All data relate to the results of in vitro and in vivo studies on the osteoimmunological system of humans, mice and rats.
Treatments for osteoporosis can be classified into two categories. They either target osteoclastogenesis inhibition (denosumab, bisphosphonates), or they aim to restore the number and function of osteoblasts (romozumab, abaloparatide). Even novel therapies, such as resolvins, gene therapy, and mesenchymal stem cell transplantation, fall within this classification system.
This review presents alternative pathways in the pathophysiology of osteoporosis, along with some recent therapeutic breakthroughs to restore bone homeostasis.
现在已知，骨吸收和骨形成之间的生理平衡是由一系列与经典成骨细胞-破骨细胞相互作用平行的事件级联介导的。因此，骨免疫学现在包括其他细胞类型（如细胞因子、淋巴细胞和趋化因子）在免疫反应中的作用，以及它们如何帮助调节骨代谢。所有这些因素都对 RANK/RANKL/OPG 途径有影响，该途径是破骨细胞前体细胞成熟和吸收活性的主要途径，负责骨质疏松症的发展。最近，免疫骨质疏松症作为骨免疫学中的一个新的研究领域出现，致力于研究免疫系统在骨质疏松症中的作用。
本综述的第一部分介绍了骨骼系统和骨免疫学中涉及的因素的理论概念。其次，总结了现有的骨质疏松症治疗方法和新的治疗方法。这些方法是从 Pubmed 上发表的关于骨质疏松症的最新研究中选择的，所有数据均涉及人类、小鼠和大鼠骨免疫学系统的体外和体内研究结果。
骨质疏松症的治疗方法可分为两类。一类是抑制破骨细胞生成（地舒单抗、双磷酸盐），另一类是恢复成骨细胞的数量和功能（罗莫珠单抗、abaloparatide）。即使是新型疗法，如 resolvins、基因治疗和间充质干细胞移植，也属于这一分类系统。
本综述介绍了骨质疏松症病理生理学中的替代途径，以及一些恢复骨稳态的最新治疗突破。
