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Modeling and remodeling : The cellular machinery responsible for bone's material and structural strength during growth, aging, and drug therapy
Seeman, Ego
Seeman, Ego
Author
Abstract
Bone modeling and remodeling assemble bone's structure during growth. Abnormalities in this cellular machinery appear around midlife and cause microstructural deterioration and bone fragility. For over 60 years, the gain and loss of bone strength have been inferred by measuring bone mineral density (BMD). This is an insensitive surrogate of bone fragility caused by microstructural deterioration, because microstructural deterioration compromises strength disproportionate to the bone loss producing it and the modest deficits in BMD found in most patients with fragility fractures. Quantification of microstructure is now available, but whether these measurements improve the detection of individuals at risk for fracture and improve treatment efficacy is unknown. Antiresorptive agents slow remodeling and microstructural deterioration. Anabolic agents may reconstruct bone, but available therapy produces mainly remodeling-based bone formation, which is limited for a range of reasons. Whether modeling-based bone formation or combined therapy offers better anti-fracture efficacy is unknown.
Keywords
aging, anabolics, antiresorptives, bone, fragility, growth, modeling, remodeling, strength
Date
2019
Type
Book chapter
Journal
Book
Principles of bone biology ; volume 1
Volume
Issue
Page Range
245-274
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled