Department of Geriatrics, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.
Department of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.
Exp Gerontol. 2022 Aug;165:111836. doi: 10.1016/j.exger.2022.111836. Epub 2022 May 19.
Osteoporosis is a bone metabolic disease characterized by reduced bone mass and deterioration of bone tissue microarchitecture, leading to enhanced skeletal fragility and susceptibility to fracture. Unbalanced bone remodeling is the primary pathogenetic factor of osteoporosis, in which osteoclast-mediated bone resorption exceeds osteoblast-mediated bone formation. Bisphosphonates and calcitonin are among the drugs commonly used to treat osteoporosis, in addition to the bone nutrients vitamin D and calcium supplements. The current treatments effectively prevent further bone loss by inhibiting the excessive activation of osteoclasts, accompanied by various degrees of side effects. Iron, one of the trace elements essential for life activities, has recently been recognized as an independent risk factor for osteoporosis. Abnormal iron metabolism increases the incidence of many bone diseases, especially osteoporosis. Iron metabolism does play a key role in bone homeostasis. Ferroptosis is a novel form of cell death that has been discovered in recent years. Its main features include iron overload and the accumulation of ROS. And lipid peroxidation is the key. There are increasing shreds of evidence that ferroptosis is involved in the occurrence and development of osteoporosis, and its regulation can effectively prevent osteoporosis. Therefore, this review further elucidates the role of ferroptosis in osteoporosis based on the mechanism and its relationship with osteoporosis and provides a new idea for treating osteoporosis.
骨质疏松症是一种以骨量减少和骨组织微结构恶化为特征的骨骼代谢疾病,导致骨骼脆性增加和骨折易感性增加。骨重建失衡是骨质疏松症的主要发病机制,其中破骨细胞介导的骨吸收超过成骨细胞介导的骨形成。除了骨营养素维生素 D 和钙补充剂外,双磷酸盐和降钙素也是治疗骨质疏松症的常用药物之一。目前的治疗方法通过抑制破骨细胞的过度激活来有效防止进一步的骨质流失,同时伴有各种程度的副作用。铁是生命活动所必需的微量元素之一,最近被认为是骨质疏松症的一个独立危险因素。异常的铁代谢会增加许多骨骼疾病的发病率,尤其是骨质疏松症。铁代谢确实在骨稳态中起着关键作用。铁死亡是近年来发现的一种新的细胞死亡形式。其主要特征包括铁过载和 ROS 的积累。而脂质过氧化是关键。越来越多的证据表明,铁死亡参与了骨质疏松症的发生和发展,其调节可以有效预防骨质疏松症。因此,本综述基于机制及其与骨质疏松症的关系进一步阐明了铁死亡在骨质疏松症中的作用,为治疗骨质疏松症提供了新的思路。