Rebalancing bone turnover in favour of formation with strontium ranelate: implications for bone strength.
This review updates our current knowledge on the mechanism of action of strontium ranelate and analyses the way it rebalances bone turnover and how it influences bone biomechanics. Strontium ranelate is able to increase pre-osteoblast replication, osteoblast differentiation, collagen type I synthesis and bone matrix mineralization probably through a calcium-sensing receptor (CaR)-dependent mechanism. Paralleling this anabolic effect there is inhibition of osteoclast differentiation and activity mediated by an increase in osteoprotegerin (OPG) and a decrease in RANK ligand (RANKL). The overall effect is a rebalanced bone turnover in favour of improved bone geometry, cortical thickness, trabecular bone morphology and intrinsic bone tissue quality, which translates into enhanced bone strength.
Rheumatology Research Unit, Instituto de Medicina Molecular, Edifício Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028 Lisboa, Portugal. jefonseca@netcabo.pt
J E
JE
Fonseca
D001696:Biomechanical Phenomena; D015519:Bone Density; D001862:Bone Resorption / Q000188:drug therapy*; D001842:Bone and Bones / Q000378:metabolism; D006801:Humans; D009942:Organometallic Compounds / Q000378:metabolism / Q000627:therapeutic use*; D010012:Osteogenesis / Q000187:drug effects*; D010024:Osteoporosis / Q000188:drug therapy* / Q000378:metabolism; D013876:Thiophenes / Q000378:metabolism / Q000627:therapeutic use*; D014475:Uncoupling Agents / Q000378:metabolism / Q000627:therapeutic use*
D009942:Organometallic Compounds; D013876:Thiophenes; D014475:Uncoupling Agents; C081587:strontium ranelate