Osteoporosis: now and the future.
Osteoporosis: now and the future.
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DOI：
10.1016/s0140-6736(10)62349-5
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发表时间：
2011-04-09
期刊：
影响因子：
168.9
通讯作者：
Hofbauer, Lorenz C.
中科院分区：
文献类型：
--
作者：
Rachner, Tilman D.;Khosla, Sundeep;Hofbauer, Lorenz C.
骨质疏松症是一种常见的疾病，其特征是骨量和微结构的全身性损害，导致脆性骨折。随着人口老龄化，骨质疏松症的医学和社会经济影响，特别是绝经后骨质疏松症，将进一步增加。对骨生物学的详细了解以及对骨形成成骨细胞和骨吸收破骨细胞之间的通信以及协调信号网络的分子见解导致了新的治疗靶点的鉴定。基于此，已经开发了旨在（I）抑制过度骨吸收和（II）增加骨形成的治疗策略。最有前景的新型治疗包括denosumab（一种抗NF-κB配体受体激活剂的单克隆抗体，一种关键的破骨细胞细胞因子）、odanacatib（一种破骨细胞蛋白酶组织蛋白酶K的特异性抑制剂）和抗蛋白质sclerostin和dickkopf-1（两种内源性骨形成抑制剂）的抗体。本文综述了这些新的治疗方法，并解释了它们的基本生理学。
Osteoporosis is a common disease characterised by a systemic impairment of bone mass and microarchitecture that results in fragility fractures. With an ageing population, the medical and socioeconomic impact of osteoporosis in general and postmenopausal osteoporosis in particular, will increase further. A detailed knowledge of bone biology with molecular insights into the communication between bone-forming osteoblasts and bone-resorbing osteoclasts and the orchestrating signalling network has led to the identification of novel therapeutic targets. Based on this, therapeutic strategies have been developed aimed at (I) inhibiting excessive bone resorption and by (II) increasing bone formation. The most promising novel treatments include denosumab, a monoclonal antibody against receptor activator of NF-κB ligand, a key osteoclast cytokine, odanacatib, a specific inhibitor of the osteoclast protease cathepsin K, and antibodies against the proteins sclerostin and dickkopf-1, two endogenous inhibitors of bone formation. This review provides an overview on these novel therapies and explains their underlying physiology.