Title:Bone-Muscle Crosstalk: Unraveling New Therapeutic Targets for Osteoporosis
Volume: 23
Issue: 41
Author(s): Anna Picca, Riccardo Calvani*, Ester Manes-Gravina, Leonardo Spaziani, Francesco Landi, Roberto Bernabei and Emanuele Marzetti
Affiliation:
- Center for Geriatrics, Neurosciences, Ear Nose and Throat, and Orthopedics, Catholic University of the Sacred Heart, Teaching Hospital "Agostino Gemelli", Rome 00168,Italy
Keywords:
Bone loss, DXA, inflammation, muscle wasting, sarcopenia, aging, biomarkers, fractures.
Abstract: Osteoporosis is a condition featured by bone mass loss and bone tissue microarchitectural alterations
due to impaired tissue homeostasis favoring excessive bone resorption versus deposition. The trigger of such an
impairment and the downstream molecular pathways involved are yet to be clarified. The natural course of osteoporosis
is particularly worrisome because, through a “silent” progression, it enhances bone fragility, increases the
risk of fractures and is associated with increased risk of disability and mortality. To date, the assessment of bone
mineral density by dual-energy X-ray absorptiometry, represents the non-invasive gold standard for the evaluation
of bone mineralization and the diagnosis of osteoporosis. Although long known as a condition merely related
to the hormonal-driven loss of bone homeostasis, emerging evidence supports the need of reframing osteoporosis
in the context of structural and functional changes of the musculoskeletal system as a whole. Several age-related
alterations of bone microenvironment and an altered bone-muscle crosstalk have been suggested to be relevant
contributors to loss of bone strength and mass characterizing osteoporosis. The present work provides an overview
of the current knowledge of the pathophysiology of osteoporosis obtained through advances in epigenetics,
cell biology and osteoimmunology. In light of the increasingly recognized importance of bone-muscle interconnection,
this review also discusses relevant pathways that may be dissected for identifying new therapeutic targets
for age-related musculoskeletal degeneration.